HomeMy WebLinkAbout043-430-01443-43-14 14qlll'rg4C1
TONY GAi1LIS�,� 722 Creekha e, lace of co
Creek Estates, .Chico
Contr: Monty Betty Const, Chico
Permit#3480-82B,P,'E;M(new S/F).
043-300-012 05-1975
POTKIN, MARK & CONNIE
16 YALE WY, CHICO
Cont: GALLAGHER'S HEATING
HVAC(ROOFMNT)
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BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834
OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION
Website: www.buttecounty.net/dds
**PLEASE PRINT CLEARLY** .
APPLICANT NAME
OWNER
Last Name
'
irsl Nam
Address 1 .
K 11Qven Ce-,
City •cO
State
State CA
ZipGj
1
Phone G
-�J
I
&? a
Fax
E-mail
E-mail
APPLICANT NAME
CONTRACTOR
Name C ll61
'
Address PO
35
City OII
O
State
Zip
Phone
Planner
Fax
Fax 31K
9 c4 4
E-mail
Lic. # -P7,3341
,-773
t;,l ss C
APPLICANT NAME
ARCHITECT/ENGINEER
Name
City ] o
Address
Occ.
City
Fax
State
Zip
Phone
Planner
Fax
E-mail
State License Number
APPLICANT NAME
Nam `
Address
City ] o
State :ni
Occ.
Phone
Fax
E-mail
APP (CANT SIGNATURE
X
For office use ly:
Zoning
Flood Zone
SRA I Yes I No
Occ.
Type Const.
Subdivision Name Map
Book
Page
Lot #
Planner
Date Approved:
OVER FOR SUBMITTAL REQUIREMENTS
PERMIT
NO.
6:5tOil 1L
BIN #
LOCATION
AP#�� 2 0
P+ropgrt Addressco
Cross Street
WORKER'S COMPENSATION
Policy Numberz4ia-
Carrier
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
Description or Scope of Work:
Sq. Footage
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
I I Received by: Amount: 5!3-- Bldg I I
Receipt #: Sheriff
SMIP
I n Other
Date: ( Igu6 Total
K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 REV 2-24-05
SUBMITTAL & PERMIT REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply for a
permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK.
❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper!
❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR
Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes!
❑ 4. Energy compliance design and supporting documentation in duplicate.
❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 6. Manufactured homes:_(A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in
duplicate.
❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor
plans in triplicate. All of these must be stamped and wet -signed by the engineer.
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required).
❑ 9. Site plan and business license approval from the City of Biggs.
❑ 10. Letter of intent for non-residential buildings.
❑ 11. Detached Accessory Building Form filled out by the owner (if required).
❑ 12. Hazardous Material Form (for Commercial Buildings only).
Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning
review (May
require additional plan review upon receipt of the following items.)
❑
1.
Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required).
❑
2.
Impact Fees.
❑
3.
California Department of Forestry plan approval (if required).
❑
4.
NPDES Form.
❑
5.
Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy).
❑
6.
Contractor's license _information. (Number, Name Style, Classification).
❑
7.
Worker's Compensation Carrier and Policy Number.
❑
8.
Owner -Builder Verification (if required).
❑
9.
Letter of Signature authorization (if required).
❑
10.
Recorded copy of Agricultural Acknowledgment Statement.
❑
11.
❑ Grant Deed, ❑ M.H. Title/Statement of Facts.
❑
12.
Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, please contact a
Permit Assistant at (530)538-7541.
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one year after date of application. In order to renew action
on an application after expiration, a new application, plans and fees will be required.
REQUEST FOR FEE REFUNDS
Refunds can only be made upon written request by the person who paid the fee. The request must be made within two
years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits
issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not refundable.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES_
BUILDING PERMIT.
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAX#: (530)538-2140
WEBSITE:. www.buttecounty.netkdds
PERMIT NO.
BP051974
LICENSED CONTRACTORS DECLARATION
I hereby affirm under penalty of perjury that I licensed under
provisions of Chapter 9 (commencing with Section 700000 ) of Division 3 of
Issued Date: 07/26/2005 APN: 043-430-014-000
the Business and Professions Code, and my license is in full force and
effect. —7
License Class :CX C5D License Number
Site Address: 1435 CREEKHAVEN PL CHI
Date, Contractor:
Map Index:
Description: CHANGE OUT GROUND MOUNT HVAC
, - OWNER -BUILD DECLA TION
hereby -affirm under penalty,.bf perjury that. I .am exempt from the
_.. .....,...":,.,..,... .>_
Contractors' State License Law ,for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
Owner: WIENS HARVEY J & FRIEDA,J • • -•--•-_-- ,.-•r=•-•..,.{
permit to construct, alter, improve, demolish, or repair any structure, prior
• 1435 CREEKHAVEN PLACE '
to its issuance; also requires the applicant for such permit to file a
signed''st'atement that'he or she is licensed purs0ant to the. provisions of,
`CH IC:Q, CA'; ' '',, `
the Contractor's State L' icense Law (Chapter 9 commencing with Section
95926
7000),6f division 3 of the Business and Professions Code) or that he or
_„ r
she, is exempt therefrom and ,the basis for. the alleged, exemption. Any
1. - 1. •. j
viotation--6f'Secti6n•70311.5 by any app'kant`for a permit. subjects the.
' R
applicant to,a civil penal►y.of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
,
intended or,offe{ed,fpr sate (Sec.. 7044,,,Bus�ness and,P�oressions.
,
..,....,Applica.nt: GALLAGHER;S:,HEATING„&.AI,R_,,, ..
Code: The Contractors' State License Law does not apply to an
,,owner.of property who builds or,improves thereon, and who does
..,, such work himself or.,,herself or, through his or her own employees,
E. HWY 99
„ provided that. such improvements• are not intended or offered for
sale: If however; the building or improvements are sold within one
LOS MOLINAS, CA ”
year of completion, the owner -builder will have the burden of
800-892-3556
'proving that he or she did not build br'improve for -the purpose of
sale.).
❑ ,..,,,1,,. as., owner„ of. the,: property,,, am -exclusively, contracting:. with.
licensed contractors to construct the. project (Sec. 7044, Business
- - -
,a , nd Professions Code., The Contractors' State License Law does
G
-Contractor: GALLAGHER'S HEATING AIR
nt. apply. to an owner of property who builds or improves thereon,
and who contracts -for 'such projects with a contractor(s) licensed
pursuant to the Contractors' State License Law.).
E. HWY 99
LOS MOLINAS, CA
LIl am Exempt under Article 3 of the Business and :Professions Code •
'
- 800-892-3556•
bate: °' Owner:
Llce(tse #: 777334' - -
, i;,.4-. -- �.W.P! KERS',COMPENSATION DECLARATION, : _
I h y affirm under penalty of perjury one of the following declarations:
I fiave'and'will maintain a certificate of consent to self -insure for
`
..,,.... ,.,..,..... ,,.,. , ....,:.,'.
workers' compensatio,n,. as provided for, by Section 3700 of the
Labor Code, for,the performance of the work for which this permit
Architect:
issued.,: -
will
Engineer: 4i .__," �� «•
have"ad maintain,workers' compensation~insurance,-as
required, by Section .3700 the Labor Code, for the performance of
;he.work for which this permit is issued. My workers', compensation
insurance carrier and policynumber are:
Carrier"
Total Square Ft: 0 S. F.
Policy':00 3 5 —13
Valuation: $0.00
Census Code:
« µ .. i ..
❑ I certify thatin'the performance of the'work for which this permit is
issued;: I' shall not'employ any person in .any manner so as to
become subject to'the'workers` compensation laws'of California,
and agree • that if I should-, become subject to, the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
-
Applica :.c.«
WAR•;fir Failure ecure workers' compensation coverage is
unlawful, and- shall subject an employer to criminal penalties and one
^ •^� «- - • --
hundred 'thousand dollars ($100,000), in addition to' the cost of
compensation damages as provided for in Section 3706 of the Labor
code interest and ,attomey's fees.-,
L6�«.) /1v� ,.', , - „, ,,^ •._, _•, ,,• , • ,_w
y a CONSTRUCTION LENDING AGENCY
This permit is her by is ped under the applicable provisions of the Butte County Code anrVor
1 hereby affirn.that there is a construction lending agency for the
Resolutions t nidi ted above for which fees have been paid.
performance of the work for which this permit is issued (Sec 3097 Civ.)
y
Name:
By: Date:
PERMIT EXPIRES �i
Address:
0
Date
O L hereby certify ttiat.the use of this facility shall comply Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and;use of hazardous materials. ,..1.
❑ Notification in accordance with`Sectiod 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ 'Attached are copies of the regLired.E.P.A. notification forms.
sr
I hereby certify that I have read: this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. 1 agree fo comply with
all county and state Taws relating to building construction. ,I acknowledge it is unlawful to alter. the substance of any fftcial form or document of Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspect n tposes.
::u:, .._._...
Print Name: t Signatur .
,. "
V.
Date .,1
r ,. , •-,.• ,. ';...❑ Owner.. c ❑ Contractor ❑ Agent for Owner U Kgent for Contractor
d
PERMIT NO. 3480-82B,P,E,M
PERMIT EXPIRES /�/
OWNER TONY GAULIS
CONTR. Monty Betty Const, Chico
'u
ASSESSOR PARCEL- 43-43-14
a
LOCATION 722 Creekhaven Place, lot 44, Big _
Chico Creek Estat•s,- Chico .
' 1
j
.. is
/ .
ds
Temp. Power Pole 7
*� Called PG&E
Temp. Elec. Service. J
Called PG&E
Temp. Gas Service G'
N
Cal led PG&E
' JOB /ALEED (Date)
Signature
i
t
J = OK
0' _ Not OK
Not Applicable
= Not Ready
MOBILEHOMES
r
U,
MISCELLANEOUS
Date
MOBILEHOME UTILITIES (Plans) OK except N's
1. Zoning Requirements—Setbacks—Easements
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's
1. Zoning Requirements—Setbacks—Easements
2. Soils; Special MH Support—Sketch
2. Footings; Size—Depth—Spacing—Connectors
3. Sewer; Location—Test—Fall-C/0—Concrete
_
3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails
4. Water; Location—Test—Easement Needed (Sketch)
_
4. Wood Awn.; Posts—Beams—Rftrs.— Con nec.—Shthg.—Rfg.—Bracing__
5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete
5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures
6. Gas; Location—Test—Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG
6. Carports; Windows—Doors•
7. Utility Clearance
_
7. Elec.
Card -BI
Card -BI
Date
Date Card -BI Date
Date Card -BI Date
MOBILEHOME INSTALLATION (Plans) OK except N's
Card -BI
Card -BI
Date
Date Card -BI Date _
Date Card -BI Date
POOLS (Plans) OK except #'s
1. Zoning Requirements—Setbacks—Easements
1, Setbacks—Easements
2. Footings; Size—Spacing—Marriage Line
2. Soils; Compaction—Structure Stability
3. Gas; MH Test—Demand—Valve—Connector
3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining _
4.. Electricity; MH Test—Crossovers—Breakers—Clearances
4, Elec.; Receptacles and Lighting; Distances—GFI
5. Drain; MH Test—Fall—Flex Connector
5. Elec.; Pool Lighting; 15 volts—GFI
6. Water; MH Test—Regulator—Connector
6. Elec.; Enclosures; Conduit Entries—Termi6als—Listed
7. Water and Sewer Connected—C/0 to Grade—HD Approval
7• Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater
8. Gas and Electricity Tagged
8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg.
Boxes—Enclosures—Panel boards—Ins. to Main in Conduit
9. Exits; Insp.—Sketch
10. Cert. of Occupancy
9. Health Department Approval
10. Plumb; Cir. Test—Water Supply Test
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
F
V = OK
0 = Not C&
- = tVot Applicable
* #-Not Ready
RESIDENTIAL (Single and Duplex)
Date
UNDERFLOOR Plans OK exce tk's
Date FRAMING Cofttinued
o ing requirements -Setbacks -Easements
4 roperty Line Firewall & Openings
Fig., Main; Soils-Steel-EleoG-GmT.- / /" Ftg. Depth
40.-Ezt. Doors -One 3' -Check Garage -3rd story, 2 exits
Wig., Garage; Soils -Steel- / /" Ftg. Depth
50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth "
&i8temwalls, Main; Steel-Blockouts-Wrapped
emwalls, Garage; Steel-Blockouts-Wrapped- a
5 lywood on Root Overhang -Attic Vents -Rafter Outriggers
52. Siding -Nailing -Veneer
53 Stucco Mesh -Drip Screed-Fdn. Vents-Underfir. Access
_ iers-F' .-Steel
54. Glazing Area -Glass Protection -Skylights -Plastic
8. D. .: Fa0--Fitt' s -T 2 way C/0- er s
55. Shear Walls; Nailing -Bolts
$`Gas j1pe; Sq_-'- Anq0drs
10. Water Ripe; ice TestN
1. a tric; Underground
_ erwAts & Du learn e ' up -I
-
1 rrd ill -A ts-Joi
Card -BI Date Card -BI Date
Card-BIDate ' Card -BI �. Date
v
2!!2es
Card -BI Date Card-Bi'� Date
Card-BI/IL
Date' Card -BI Date
Date F OK except q's
to -Door & Sidelight Protection -Landings
Spoke Detector
Card -BI 7 Date Card -BI Date
Date PLM ING (Permit) OK except q's
_-iWate
t.; V -Access-Combustion Air
• Furnace; Vents -Clearance -Comb. Air-Connector-
In Garage; Above Floor -Ducts -Meth. Protection
ater Pipe; Test & Anchors -Nail Protection
([B> D.W.V.: Test-Fttngs & Anchors -N ction
• Bedroom Exiting
Sht�Pan; Test, First Floor ub Access
CyF.I. & B h Fixtures & Tub Access ,d
_____.17.
-1.5 Fest Tub & Shower, 2nd Floor -Tub Access
& Subpanel; Breaker Sizes- %
$2-atairs & Rails
—!
as Pipe; Size &Anchors
63. Fireplace o o earances-
d6r/Elec. Outlets at Wood Panel; Int. & Ext.
Card -BI
Date Card -BI Date
Kit. Fixt. & A liance; Grnd.-Air Ga-Cookin Clearance
Card -BI
Dafd. ( Card -BI Date
6�/E` Outlets & Receptacles at Kit. ter
Date
ELECTRICAL P pit OK except q's
Garage Fire Door; Swing -Landing
-9V" A.C. Duct in Garage -Damper
---
2 . Fixture & Transformer Clearance -Ins. Protection
tr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
R
. . Receptacles Spacing -Lights & Switches at Doors
Ib., Elec. & Mech. Equip. Listed for Location
_
Si Boxes & of Conductors -Stapled
7y lec. Receptacles in Garage; (G.F.I.)-Romex Protec.
mex Installedd Close to Edge of Studs & C.J.
Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water
t -O Insulation -Foam -Looked in Attic es
. 2 Appliance Circuits in Kitchen & Conductor Size
-r-3rIuard Rails & Deck Construction -Post Caps
_
--
26. Subfeed Wire Size / ga. Cu o A.C. Wire Size / % ga r At
. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance
Looked under Floor rJSles
'21 -'Range Circ. / ./ ga. Cu or AI -Oven Circ. / / ga. Cu or Al,
_ Insulated Neutral ❑Yes ONO
75. Following instld.: Drive' es ❑ No; Walks l�Ies ❑ No;
Planters ❑Yes C,No
_
a&i Service -Riser Conductors & Ground -Main Disconnect
eco; Brown -Finish
- --ip.
Clearances; Panels-Motors-Mech. Equip.
9.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
Clothes Closet Light -Shower Light —
. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
Card B-1_Date
Card B -I
------___-- _ _
v _ Card -BI _ Date64
_
DateCard-BI Date
mater Well; Disconnect, Electrical, Plumbing
Exterior Elec. Trim; G.F.I. Receptacle -Underground
Ventilation throughout House
lass Protection
Date
MEC ANICAL (Perrr,it) OK except Ws
_
8 Corrections from Previous Inspections
s Test -Meters Tagged; Gas -Electric
-__
TC. Ducts: Insulation & Support
ter & Sewer Connected -C/O to Grade -HD Approval
-
_
Vent -Fan; Exhaust above Insulation _
O'ondensate Drain _& Overilow; Size & Grade
Energy Compliance Certificate -Other Certificates
34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet
_
-
__.3&, -Attic Access & Platform if Furnace in Attic
Card -E-1
Card-Bi��
Date ��/l Card -BI Date
�/j
Date w Card -BI Date
Card -BI Date Card -BI Date
�7
Card -BI Date Card -BI Date
Card -BI Date Card -BI Date
Comments at Final:
/r��
Date FRA PI0n_) OK except q's
-
_
S' _s; Proper Material & Anchors _
- 4_ Wa 'lls: Studs -Nailing, Spacing & Bracing -Plates -Sound
3� B aring Walls_over Girders &Floor Nailing-- _ -
3 t Stop in Walls (rat proof)
�7
- -
_ Stops; Furred Ceilings -Stairs -Chases -Tub
eaderBeam-Size & Bearing
Hang -Post Caps-Anchors_Connectors -
ng. Joist-Rftr. Ties-Purlin-Roof Brac.-Trus S np.-Rfnq
44gFireplace Ties or Type A FluQgj�pl a Thrq � �`
��.-" 'ic Access; Size --Romex Protection -Draft St p -Ins. Battles
64 0(Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions __-
4]y/Garage Fire Protection Framing — -
(NOTE: An entry must be made each time youvisit jobsite)
to
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS• '
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 5344541
Skyway and Elliott Road, Paradise— Phone: 872-2961, Ext. 57
CORRECTION NOTICE
OWNER PERMIT NO.
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
Inspector— - Date
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534-4541
Skyway and Elliott Road, Paradise— Phone: 872-2961, Ext. 57
CORRECTION NOTICE
FR •� DCD�i t ni
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
Inspector_ Date
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
BUILDING OR PROPERTY ADDRESS
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
/,--\ 1 'I-
Inspector Date
3
"M
:+' ^ COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
J 196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
BUILDING OR PROPERTY ADDRESS
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
10
Inspector �--���` °~ �'� Date
NOR
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
t 196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, OroviIle — Phone: 534-4541
Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57
CORRECTION NOTICE
BUILDING OR PROPERTY ADDRESS
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
1
Inspector Date
1
3 �a 70 1 c�
\I
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RESIDENTIAL
ENERGY CONSERVATION STANDARDS
CONSTRUCTION "COMPLIANCE - CERTIFICATE
THIS IS TO CERTIFY'THAT ENERGY CONSERVATION REQUIREMENTS HAVE.BEEN
INSTALLED IN CONFORMANCE WITH CURRENT ENERGY CONSERVATION REGULATIONS: r
AT l i-! 3 S C RLt9,y > P
IYAZ L \
(location)
BU ILD ING PERMIT NO 3L) A ; P.. NO. t4 3
THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED,.PLANS:
(Check each item or write N/A if not applicable)
INSULATION:
GLAZING:
Slab Edge
Single Glazed
Fdn. Walls
Special (Insulated)
Floors i!
CERT.'& LABELED WDS.
Walls /q'
& SLIDING DRS.
Ceiling/Roof 9 ,3 0
WEATHERSTRIPPED DRS.
Ducts
BACK DAMPERED FANS
Circulating Pipes
INTERMITTENT IGNITION
DEVICES '
APPROVED HEATER c:.
CERT. APPLIANCES
6 /
APPROVED WTR.HTR. i
I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED
IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND.AGREE TO
THE COMPLETENESS OF THIS CERTIFICATE AS..SUBMITTED.
Insulation Applicator Name mr-M L4
Signature of I(P1�print)
Insulation Applicator
stdContractors
/y)License No. 5 D 13,13,2c?rqS
General Contractor/Owner Name / "/ Oh 7i/► P cif '
(pleas print)
Signature of '� Q,
General Contractor/Owner Date
StateUtontractors
License No. 3O Sl8 9 S
THIS CERT IF ICATE MUST BE ON FILE WITH THE BU ILD ING DEPARTMENT PRIOR TO
REQUESTING FINAL'1NSPECTION AND SHALL BE -POSTED IN A CONSPICUOUS LOCATION
WITHIN THE DWELLING. '
;of4
J
TABLE NO. III
FIREPLACE HEAT EXCHANGERSiINSERTS
Report No. 3410
Minimum dimensions must be maintained for the entire designated masonry firebox height.
Hearth extension of masonry fireplace must have been built per Uniform Building Code.
Hearth extension must consist of Winch -thick asbestos millboard.covered by 24 x 41/', x 9 common brick.
-See Figures Nos. --,rand 8. p
j I''
COMBUSTIBLE MANTEL
r--�� SHROUDS
A
C
_,eK t
COMBUST
UNIT WALL
-.{ D
FRONT VIEW
FIGURE NO.7
TOP VIEW
FIGURE NO.8
l
MINIMUM MASONRY
HEARTH
OVERALL SIZE FIREBOX SIZE'
EXTENSION SIZE2
CHIMNEY
MINIMUM CLEARANCES4
(Inches) (Inches)
(Inches)
AREA
(Inches)
(Inches)
Width
Depth
Height Width x Depth x Height
Width it Depth
A
B
C
D
NO.
MODEL
I
Glass door insert
24
36
23 28 x 20 x 24
4 02 x 28
60
451/2
d
36'/
18
14
See Footnote 3
;
Minimum dimensions must be maintained for the entire designated masonry firebox height.
Hearth extension of masonry fireplace must have been built per Uniform Building Code.
Hearth extension must consist of Winch -thick asbestos millboard.covered by 24 x 41/', x 9 common brick.
-See Figures Nos. --,rand 8. p
j I''
COMBUSTIBLE MANTEL
r--�� SHROUDS
A
C
_,eK t
COMBUST
UNIT WALL
-.{ D
FRONT VIEW
FIGURE NO.7
TOP VIEW
FIGURE NO.8
l
International Conference of Building Officials
RESEARCH REPORT
Filing Category: FIREPLACES
WOODSMAN MODELS 24, 30,36 AND 36-IN*CH FRET: AIR
FREESTANDING FIREPLACE STOVES AND MODEL GLASS
DOOR FIREPLACE LNSERT
WOODSMAN NEST, L\�,
13-;9 —Itr.U�vT001) ROAD
SALT LAKE CITY, UTAFI 84119
L Subject: Woodsman Models 24, 30, 36 and 36 -inch Free Air Free-
standing Fireplace Stoves and Model Glass Door Fireplace Insert.
H. Description: Models 2.3, 30 and 36: The stoves are top or rear
vented wood -burning freestanding fireplace stoves designed for use with a
chimney connector pipe and a listed low -heat appliance chimney. They are
available in three models identified as the 24, 30 and 36. Overall size of the
units and clearance to combustibles are shown in Tables Nos. i and H. Air
vents on the doors rc-::ulate the amount of combustion air entering the
firebox. The distance bet%veen the plate and air hole controls the rate of flow
of combustion air. A steel ball type handle is provided on each door. A cast-
iron damper is installed in tile collar of all units.
Model 36 -inch Free Air: The unit is a wood -burning freestanding
fireplace stove designed to be used with an 8 -inch -diameter single-wall
chimney connector and listed low -heat appliance chimncy system. Descrip-
tive details of the unit and clearance to combustibles are shown in "fables
Nos. 1 and 11.
The firebox is of double-wall construction on the back and bottom. The
double wall at the back of the firebox forms a plenum chamber which heats
the circulating air drawn from the living space. The circulating airenters the
chamber through a square opening in the lower portion of the back plate,
travels along thz- back and exits through two outlet openings, one located in
the upper rear portion of each of the side plates. The firebox is fabricated
from''/; -inch -thick steel plate.
An optional Fasco electric blower is available for boosting aircirculation.
The blower assembly is a UL -listed 115 -volt, 1.1 -ampere, 60 -hertz
appliance cord connected centrifugal blower, mounted on the lower left
comer of the back of the unit. A two -position rocker switch is located on [tic
housing of the blower motor.
A 3 -inch -diameter combustion air inlet pipe centered in the lower portion
of the back pLte extends out 3% inches from the back of the unit. Combus-
tion air enters through this opening. A damper plate located in the bottom
plenum chamber is connected to a rod which in tum is connected to a
wooden knob extending forward just below the ash fender. Pushing or
pulling on the rod slides a damper plate across the opening in order to
control combustion air flow.
As an option, reduced clearance to combustibles are allowed as noted in
Table No. 1, provided ,vall protection shields are installed and the unit is
equipped with a listed chimncy system starting from the flue collar. The
wall ;shield is fabricated from No. 20 gauge, low -carbon steel and must be
spaced a minimum of f inch from the walls using noncombustible spacers
16 inches on center both horizontally and vertically. The bottom of the wall
shield must rest directly on the floor. The wall shield must extend outward
from the chimney or chimney connector the minimum distances noted in
Figures A and B. The wall shield must also extend a minimum of 15 inches
above the top of the stove. Special care must be taken to ensure that the l -
inch air space behind the wall shields is not blucked. This air space is
required in order to ensure the proper air circulation behind the wall shield.
rl
I�3�fr
Report No. 341
December. /9(,
Model Glass Door Fireplace insert: The unit is deli -red to be inscri!
in a single -opening masonry fireplace constructed in accordance w
Chapter 37 of the Uniform Building Code. The existing masonry firepk
and chimney should be inspected and approved by t"e laical building of i.
prior n> installing the insert. The existing masonry fireplace d :mper shot
beeither removed or welded in a penrianently open RosLnLm. Oiler meths
may be usee to secureTfiL cBanapec provide they are appro\ed by '
building official and failure of the system would not allow the damper
close. Descriptive and installation details for the unit are noted in Tab
Nos. 11 and 111.
The firebox is of double-wall construction for the portion which extei
into the masonry fireplace. The firebox is fabricated from 1,-inch-th
steel plate. The double walls form a plenum chamber which heats circa'
ing air drawn from the living space. The circulating air enters the chain'
through a screened opening below the ash fender when the optional blot
assembly is not installed. When the blower assembly is installed.
circulating stir enters through the blower. The circulaiimt air pa:;e'; alt
the bottom of the sides and back and forward across the top and thou c•
through a screened opening extending across the top of the firebox.
optional Fasco electric blower with a cylindrical manifold asscnibls
available for boosting air circulation. The blower assembly is a UL. -Ii".
115 -volt, 1. l -ampere, 60 -hertz appliance cord connected centrifUL,.il hlk
er mounted to discharge into the end of a cylindrical -shaped manifold.
Products of combustion exit the firebox through an 8 -inch -diameter t
collar located on the sloped portion o` the wall connccting the back and
plates.
When the unit is installed, the firebox rotrv"'e I?i's inches out from
face of a shroud. A 3 -piece shroud extends above t --ill, ert and beyond
left and rit,.ht side of the insert. The shroud is bolted to the stove to cover
gap between the unit and the face of the masonry. The shroud overlaps
masonry and a seal is provided with fiberglass insuiation.
identification: Each unit is identified by a permanently affixed I,
containing the manufacturer's name and address, the model number. sc
number, the ICBO research report number• the name of the inspect
agency, :Icarance to combustibles, type of fuel, type of chimney requ+
and details of the hearth extension.
Ill. Evidence Submitted: Report of tests conducted in accordance
Underwriters Laboratories Inc. Standard No. 737 and a quality con
manual are submitted.
Findings
IV. Findings: That the Woodsman fireplace stoves and firept
insert described in this report comply with the 1979 Uniform Builc
Code, subject to the following conditions:
1. The units are fabricated, identified and installed in accords
with this report.
2. They are produced under a recognized quality control progi
with inspections by Gas and Mechanical Laboratories, Inc.,
Angeles, California (TL -106).
3. Combustion air shall be available as specified in Section 60
the 1979 Uniform Iblechanical Code.
This report is subject to re-examination in one year.
�ICBO re,warch reports are issued solely to provide information to Class inemberc oJ'1he organization ittilizing tire code upon which the report i
based. Research reports are not to be construed as representing aesthetics or any other attributes not spec•ific•ally addrevsed nor as an endorsentet.
or recom tit endatiwl fin• use of the subject report.
This report is based upon independent L sts or other technical data submitted by the applicant. The ICRO tec•hItic•al.stufJhns reviewed cd the to r n :, r
and/or other data, but doges riot possess test facilities to retake air independent verificatimi.
paq? t c c
1 ,
n
COUNTY OF BUTTE - DEP.ARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT NO.
to
M
ASSER PARCEL NUMBER
3_
ZO ING
BUILDING PERMIT
OW -
� ��
TELEPHONE
SQ. FT. OCC. BUILDING
VALUATION
L 7X37,00
OWNER'S MA ING ADDRESS
7
CON TORS E TELEPHONE
i0AI t
CONTRACTOR`S AILING ADDR S
�— t �Gf�
CONSTRUCTION LENDER UNKNOWN
AZZ)AIC
Fireplace l YG•d O
Total Valuation $ 0
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHII��T%%ECT OR ENGINEER
�HITECT
LICENSE NO.
Plan Checking Fee
,$
Penalty
$
OR ENGINEER'S MAILING ADDRESS
Permit fee
$ rj
BUILDING ADDRESSP f
`L
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00 661k,00
Solar Water Heater
20.00
G
Water piping
5.00 QU
LOT NO.SUSDI
VISION NAME
1)f.4 `66fFcle
PARCEL MAP
G -
Each qas water heater or vent
5.00 , -f v
Gas piping system 1 - 5 outlets
5.00 - p
USE OF STRUCTURE
SF Duplex ❑ Mobi lehome ❑ Other
SPECIFY
Building sewer
5.00 d
Mobile Home I S I G JW 1
10.00 e t
TYPE OF WORK
NewAddition ❑ Remodel ❑ Utilities ❑ Installation[] Other ❑
Describe work:
Permit Fee $ C�
c
Contractor
ELECTRIC L PE MIT Filing Fee 10.00
Main service 600V OR LESS 10.00 V
100 AMP OR LESS ,
-
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. DWELIN OR ADDNS. ( ACCLBL G S &/\
21/20sgft O
CONTRACTORS LICENSE LAW
I declar under penalty of perjury (check one):
I am licensed under provisions of Chapt..9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No.)6 [� Classification 6 i
El 1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONSTR ULTI-OU LET 2.50 ea
NON-RESID. BRANCH CIRCUITS
NEW CONSTR (POWER APPARATUS &'1 `
NON-RESID. SINGLE OUTLET CIR. /
Ex. Occup(OUTLETS OR FIXTURES BA ®g o`c
FIXED APPLNS. OR
EX. OCCUp. OUTLETS (RESID.) EA.) { 2.00
Temporary service I 10.00 Q,OQ
Mobile Home Facilities 15.00
Misc. Wiring
15.00
Permit Fee $ Q e)
XF
CorZ
MECHANICAL PERMIT
Filing Fee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
Fhave placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance. or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Heating Q G
,
ti
Cooling
00
Hood3.00
. 00
Ventilation TWA -
,0U
permit Fee
$ , 00to
Contractor VA71,-A106JA1
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
X ate /1 �L
Signature of Applicant — Owner ❑ Contractor Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee
$
TOTAL PERMIT FEE $ 4
OCCUP. GROUP
TYPE OF CONST.
PARC
PD
HD Issu
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF UBLIC
By �
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
—/
Receipt No. 75 .P
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
I
STATE OF CALIFORNIA Iss.
COUNTY OF Butte I
On November_ 24, 1982 before me, the undersigned, a Notary Public in and for
said State, personally appeared Monty Betty ,personally
known to me (or proved to me on the basis of the oath of Mon ty Be t t
a credible witness who is personally known to me) to be the person whose name is subscribed to the within instrument,as
a witness thereto, who being by me duly sworn, deposed and said:
That he/she resides in Butte County
w .that he/she +
was present and saw Anthony J. G au 1 i s
N �
and Ann M. Gau 1 i s personally
3 known to him/her to be the same person(s) described in and who
i executed the within instrument, as a party(ies) thereto, sign, seal
6 and deliver the same and that said party(ies) duly acknowledged
m in the presence of said affiant, that heoe4e/they executed the
o same, and that said affiant, thereupon at the party's(ies') request,
subscribed his/tie[ name as a witness thereto.
0
WITNESS Md and official se_
Signature [•���/
MARY R. CASEHER I
NOTARY PUBLIC
.� Butte County
State of California
My Commission Expires, Nov. 30, 1984
•+Y+¢+M.l..P4•�•1•�.t+$••i.q••r•¢ 1. �.f..p•c•:++h.t•.o.t•x+i+.:-
END OF DOCUMENT
(This area for official notarial seal)
. .. �13 �L8-1�
Return to DPW AGRICULTURAL' STATEMENT ,OEV ACKNOWLEDGEMENT DFFiC;A
FOR` RESIDENTIAL DEVELOPMENT BUTTE
Section 26-81permit.
the Butte County Code requires this acknowledgeme` rit
p�_ :,` 5�
be recorded rior to issuance of a building '� ° 2 ay'.a0
ELEAtdOR M. 8UKF+7 `` "a
The property described herein is adjacent to land or included CLERK - RECORDER
within an area zoned for agricultural purposes, and residents of 82-35216 EE
this property may be subject to inconveniences or discomfort arising
from the use of agricultural chemicals, including, but not limited to herbicides,
pesticides, and fertilizers; and from the pursuit of agricultural operations including,
but'not limited to cultivation, plowing, spraying, pruning, and harvesting which occa-
sionally generate dust, smoke, noise; and odor. Butte County has established.agricul-
tural zones which have as a priority use for productive agricultural purposes, and
residents within said zones and on adjacent property should be prepared to accept such
inconvenience or discomfort from normal, necessary farm operations.
All that real property' situate in the County of Butte, State of California,
described as follows:
Lot 44, as shown,on that certain Map entitled, "BIG CHICO CREEK ESTATES,,
UNIT NO. 3", which Map was recorded in",,the Office of the Recorder of the
County of Butte, State of California, on May 28, 1981, in Book 80 of Maps,
at pages 76 and 77.
Subject to Covenants, Conditions and Restrictions recorded June 23, 1981,
in Book 2633 of Official Records, at Page 454, Butte County Records.
Date: ,JZG�� j / ./ a PROPERTY OWNERS':
!Id�ayof
State of ) On this the , 19 ,
SS. before me, the undersigned Notary Public, personally
County of ) appeared
• w
known to me to be th son(s) whose name(s)
subscribed to th ithin in ent and acknowledged
that executed the same the purposes
therein c . ained.
IN WITE"�S WHEREOF, I hereunto set my hand and official
rn
• seal/ . ,,,, .
•
C�
Notary Public
Present A.P. NO.
t j 3111+ Y:7.IJAVUitA
r
fi Jack Burman & Aseo iaie8 1919 M`angrove Avenue 9 Chico, CA 95926 • (016),348.6 6-68 � „
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