HomeMy WebLinkAbout043-550-016SHASTAN �1�
!i 0 ✓/�I:YOs/rr� /�� Hol lybrook, Ch ico - -
ermit X43'-3-8�,P,E,M(new single family) J
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PERMIT NO. 633--85B,P,E,M
PERMIT EXPIRES
4 OWNER SHASTM
� CONTR.
owner
d
ASSESSOR PARC1�10 X861*Qa9M 43-29 125
Hatupshire ,
M��� ,lot 36 Chico
'„�. LOCATION '�
V _
OF COPY i
r Address
GAS
Meter By Date
y ELECTRIC.
F Meter By Date
OFFICE COPY
Address 3�
GAS
Meter By S Date
ELECTRIC
Meter By Date
y
ot
,a Temp. Power Pole
Called PG&E _
+ Temp. Elec. Service
Called PG&E
Temp. Gas Service _
r
Called PG&E _
i
s
fi JOB FINALED (Date)
Signature
Owner • S11AS7-*i1 C- , Permit No. X33' J
ENERGY CE°RTI"FICATION
Lot #36
LOCATION A.P. No.
DESCRIPTION OF INSULATION
ROOF
Material
Thickness(inches)
EXTERIOR WALL
Material Fiberglass Batts
Thickness(inches) 3 5/8"
CEILING
Batt or Blanket Type FihPrQ1ass Ratts
Thickness(inches)1�___�
Loose Fill Type_ Fiberalass
Minimum Thickness (Inches) 14"
Area covered(ft.2) 913
FLOOR, ELEVATED
Material
Thickne'ss(inches)
FLOOR, SLAB
Material
Thickness(inches)
Width(inches)
FOUNDATION WALL
Material
Thickness(inches)
Brand Name
Thermal Resistance (R Value)_
Brand. Name Owens-Corning
Thermal Resistance(R Value) R13
Brand Name nwPns-Cnrning
Thermal Resistance(R Value) Ran
Brand Name Owens- nrninQ
Number of Bags 18 wt. per bag _5 _lb.
Thermal Resistance(R Value) R3_ 0
Brand Name
Thermal Resistance(R Value)
Brand Name
Thermal Resistance(R Value)
Brand Name
Thermal Resistance(R Value)
I hereby certify that the above insulation was installed in the above building
in conformance with the State of Californla Energy. Requirements,
LOERKE INSULATION CO. #432518
FIRM NAME/OWNER STATE'CONTRACTOR'S LICENSE NO.
November 21, 1985
RGNATUkE OF INSTALLATION APPLICATOR DATE
I hereby certify the above insulation and all required items as shown on the
Building Department approved plans and attactmnents have been installed as
required by the State of California Energy Requirements.
All equipment, devices and materials are of the quality prescribed or are
specifically approved by the State of California.
s sats
7,4AI co
FIRM NAME/ 7(Plea e print) STATE CONTRACTOR'S LICENSE NO.
y./ -, ., t
OF CONTRACTORIOWINER. DATE
THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL
INSPECTION APPROVAL AND A COPY SHALL BE'POSTED WITHIN THE BUILDING. '
January 1984
U1!
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 TI E
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 �J Date )6,�,d--5-
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
"I.f3-8.S
IT
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 A4� Date /U// &
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
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.
I
Inspector__ I Date % t
• 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
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
Inspector
Date
t
V =+OK
�0 = Not OK
- = Not Applicable RESIDENTIAL' (Single and Duplex)
Not Ready
Date _ UN RFLOOR Plans OK except #'s
Date FRAMING Continued
ning requirements -Seta asements
. Property Line Firewall & Openings
j2. Ftg., Main; Soils -Steel -EI . Grnd.- / /" Ftg. Depth
Ext. Doors -One 3' -Check Garage -3rd story, 2 exits
3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth
69. -Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
K. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab
52.Siding-Nailing-Veneer >
6. emwalls, Garage; Steel-Blockouts-Wrapped-SlabW.
Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access
VPiers-Firepiace Ftg.-Steel
X94 -Glazing Area -Glass Protection -Skylights -Plastic
D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test
-56., --Shear Walls; Nailing -Bolts
9. Gas Pipe i nchors
( 1 -
FjjqU 10. Water Wpej T -Anchors-Regulator-Seryice Test
11. Electric; Underground
12. Plenums & Ducts; Clearance -Material -Support -Ins.
13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
Card -BI j Dat 7 Card -BI Date
Card -BI Date Card -BI Date -- -
Card -BI Date Card -BI Date
Card -BI Date Y I M Card -BI Date
Date FI AL (Plans) OK except N's
Card -BI Date Card -BI Date
Date PLU BING (Permit) OK except q's
Ext. Steps -Door & Sidelight Protection -Landings
5 . Smoke Detector
1 ter Ht.; Vent- ccess-Comb stion A!k
56. Furnace; Vents -Clearance -Comb. Air -Connector -
/ In Garage; Above Floor-Ducts-Mech. Protection
ter Pipe; T&Anchor ail ecti
f D.W.V.; T t-Fttngs ai otect-o
5� Bedroom Exiting
-+?,.^Shower Pan; Test, First Floor -Tub Access
46V G.F.I. & Bath Fixtures & Tub Access
18. Zest Tub & Shower, 2nd Floor -Tub Access
., Elec. Trim & Subpanel; Breaker Sizes -Labels
Gas Pipe; Size & Anchors
62: Stairs & Rails
face or Stove; Clearances -Hearth
V./Elec. Outlets at Wood Panel; Int. & Ext.
Card -BI 1, Date Q b- Card -BI Date
6T. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI Date Card -BI Date
Date' EL TRICAL Permit OK except q's
W. Elec. Outlets & Receptacles at Kit. Counter
e-F•ire Door; Swing -Landing -Closer
A.C. Duct in Garage -Damper
fixture & Transformer Clearance -Ins. Protection
. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garagg; Above Floor-Mech. Protection
te let. Receptacles Spacing -Lights &Switches at Doors
ize Boxes & No. of Conductors -Stapled
P lec. & Mech. Equip. Listed for Locatio
omex Installed Close to Edge of Studs & C.J.
JSW Elec. Receptacles in Garage; (G. F.I.) o e"
Equip. Ground made up w:/Mech. Fasteners -Bond Gas &Water
InsulationLooked in Attic
Foames
Appliance Circuits in Kitchen &Conductor Size
�a & Deck Construction -Post Caps
ySubfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At
7� Fdn. Vents Cr wl Hole Door -Drainage & Wood -Earth Cle rance
Looked u El Yes
W. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al,
Insulated Neutral ❑Yes ❑No
Following instld.: Driv Yes ❑ No; Walks Yes ❑ No;
Planters ❑Yes No
,Service -Riser Conductors & Ground -Main DisconnectStu
Brown -Finish
2VJrquip. Clearances; Panels-Motors-Mech. Equip.f0f
, A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
3b -Clothes Closet Light -Shower Light
Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opn s.
Water Well; D'sconnect ectrical, Plumbing
xt io r .F.I. Receptacle -Underground
Card B -I n Date % Card -BI Date
Ven elation throughout House
Card B -I Date Card -BI Date
Glass Protection
Date MEC . ANICAL (Permit) OK except k's
ge Corrections from Previous Inspections
4. G st-Meters Tagged; Gas -Electric
. A.C. Ducts; Insulation & Support
&6 -.,-Water & Sewer Connected -C/O to Grade -HD Approval
Vent Fan; Exhaust above Insulation
Energy Compliancj gertificate-Other Certificates
Condensate Drain & Overflow; Size & Grade
Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet
Attic Access & Platform if Furnace in Attic
Card -BI Date 2 Card -BI Date
Card -BI (MAL, Date/4Zjf �W!5_ Card -B I Date
Card -BI ` k_ Date�,� Card -BI Date
Card -BI Date Card -BI Date
Card -BI Date Card -BI Date
Date FR MING Plans OK except q's
Comments at Final:
W. Sills; Proper Material & Anchors -
IIs; Studs -Nailing, Spacing & Bracing -Plates -Sound
Bearing Walls over Girders & Floor Nailing
J�raft Stop in Walls (rat proof)
!K. Fire Stops; Furred Ceilings -Stairs -Chases -Tub
Header & Beam -Size & Bearing
Hangers -Post Caps -Anchors -Connectors
4 Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfn_g_._
-t3'" Fireplace Ties or Type A Flue -Fireplace Throat
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
�drm. Windows or Exiting Doors -Sill Hgt. & Dimensions
Garage Fire Protection Framing
r
(NOTE: An entry must be made each time youvisit jobsite)
OK `•
0 _ Not OK
- = Not Applicable
= Not Ready
MOBILEHOMES
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.-Connec.-Shthg.-Rig.-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 #'s
1. Zoning Requirements -Setbacks -Easements
Card -BI
Card -BI
Date
Date Card -BI Date
Date Card -BI Date
POOLS (Plans) OK except a's
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 -Terminals -Listed
7. Water and Sewer Connected -C/0 to Grade -HD Approval
7. Elec.; Bonding; Metal w/5'-Circ6lating Equipment -Heater
8. Gas and Electricity Tagged
8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghig.
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
r
/I
COUNTY OF BUTTE.- DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - OroviIIe, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUM ER
ZONING
0M 13
BUILDING PERMIT
Oil ER
TELEPi oa E�
SQ. FT. OCC. BUILDING VALUATION
3
N R' MAILING A DRESS
CO TR TO 'S NA E
TELEPHONE
0.
CO TRAC O 5 MAIL NAD RESS n %
1q,
Fireplace
CONSTRUCTION LENDER
UNK. OY]I�L
L!
Total Valuation $
I
Filing Fee •
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ p'1 2.j0
CHITECT OR E NEER ,
qqh
LICENSE NO.
Plan Checking Fee
$ ,,d
Lpenalty.
$ /5.,"D
ARCHITECT O ENGINEER'S ALADDRESS
Permit fee V
$ `7,
BUILDING ADDRESS
PLUMBING PERMIT .
Filing Fee 10.00
110
Each Trap
2.00
Solar Water Heater
20.00
1?C9
Water piping
5.00 ,
LOT NO.
3
SUBDIVISION NA E
`iVJLJ�/�
PARCEL MAP
Each qas water heater or vent
5.00 J.
Gas piping system 1 - 5 outlets
5.00 , 61�)
/ USE OF STRUCTURE
SF 1� Duplex ❑ Mobi lehome ❑ Other
SPECIFY
Building sewer
5.00
Mobile Home S I G I W I
110-00e4
TYPE OF WORK
NewLj/addition❑ Remodel E] Utilities [:1 Installation[] Other ❑
Describe work: /`GS / %��—��
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V OR LESS
100 AMP OR LESS
10.00
3 \, 11
Main service EA. ADD'L 100 AMP
2.50 SD
NEW CONST. DWELLING O
OR ADDNS. ( ACC. BLDGS
21/20sgft 'S13.30
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
�m 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. � � O Z7T % Classification ,�
❑ I, 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 ULT'-OUTLE 2.50 ea
NON-RESID BRANCH CIRCUITS)
NEW CONSTR POWER APPARATUS &
NON-RESID. (SINGLE OUTLET CIR.
20@60C
Ex. Occup(o Ts OR FIXTURES SAL®30
FIXED
EX. Occup.FUTL APPLES. OR \
OUTLETS (RE..I D.) EA.1 2.00
Temporary service Vtt-LX__, 10.00
Mobile Home Facilities 15.00
Misc. Wiring
15.00
Permit Fee
$
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
L� have 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
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
Filing Fee 10.00
Heating
.67j)
Cooling
Hood
3.00 '3
Ventilation
Permit Fee
$
Contractor
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 Countyot
Butte toe r upon the above- entioned property for inspection purposes.
to sav i emn' y and kee harmless the County of Butte against
I also a2a"
all liabs, ju a s, s, a xpenses which may in any way accrue
againstCo t i co uen the granting of this permit.
X Date
Signature pplica — 0 er❑ Contractor ❑ Agent
An OSHA permit is equired f excavations over 5'0" deep of or construct-
ion of structures ov 3 stories in height.
Mobile Home Installation Fee $
p�
`
TOTAL PERMIT FEE s
OCCUP. ROUP
k3
TYPE of CONST.
Lr
PARCEL PD D
ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF PUBLIC
By
PERM EXPIRES Date_
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Receipt No. - ? ,� /S\ -OU
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDE O -
coGINAL DOCUM&NT -,� lyg�l�t4L R'EC tD`
Return to DPW AGRICULTURAL STATEMENT .OF ACKNOWLEDGEMENT z3jr-TE C.MJ%n" -'''
FOR RESIDENTIAL DEVELOPMENT. F' e. .7
Section 26-8.1 of the Butte County Code requires this.acknowledgement M0 7 55
be recorded prior to issuance of a building permit. :.i,L:�
CLE►1K' h�CU:;DfR
'The property described herein is adjacent to'land or included 84.. s425 EE
within an area zoned for agricultural.purposes, and residents of this
property I ay 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 occasionally generate dust,
smoke, noise, and odor. Butte County has established agricultural zones which have as a
priority use for productive agricultural'pur'poses, and residents within said zones and on
adjacent property should be prepared to accept such inconvenience or.disconform from normal,
necessary farm operations.
All that real property situate in the County of Butte, State of California, described
as follows:
Being a.portion of Lot, 13, of the Second Subdivision of the John Bidwell
Rancho, according to the'Official Map therecf filed in the Office of the
Recorder of the.County of Butte, State of California,. September 17, 1.900
in Map Book 5, at page 27; and being a portion of lots 3, 4 and 5 of the
MaCulley Block. formerly Lot 12 of the Section Subdivision of the John
Bidwell Rancho, filed £or record May 5, 1903 in the Office of the Recorder
of said Oounty of Butte, State of California in Book 4 of Maps, at page 23,
more particularly described as follows:
Parcel 3, as shown on -that certain Parcel Map recorded in the Office of the
Recorder of the 0ounty of Butte, State of California on May 18, 1983,.in
Book 92 of Parcel Maps, at page 70..
Date: February 15, 1984
State of
County of
Present E
.1
On this the
PROPERTY OWNERS:
SHASTAN COMPANY, INC., A CALIFORNIA CORPORATI%
Jdy a rt, rest n
15th day of February 19 84—, before
j
I
STATE OF CALIFORNIA Butte Iss.
COUNTY OF -
0, February 15, 1984 before me, the undersigned, a Notary Public inand for.
said State, personally appeared Jay S. Halbert
__and
_—, personally known to me basis
.
to be the persorJ who executed the within instrument as enceonceibed t0
the President and --------- Secretary, on behalf of
Shastan Cou>pany, Inc. _
the corporation therein named, and acknowledged to me If
suchcorporalion executed thewithin Instrument pursuant to
by-laws or a resolution of its board of directors.
WITNESS my hand and official seal.
SignaturaAaAOL4�
Sharon R. Howell
-----.................
OFFICIAL SEAL
SHARON R. HOWELL
-� NOTARY PUBUC — CAUFORNIA
CourRY OF /trRe
Comm. Exp. April 12, 1995
n�NHutnnittt�t�������rj��f'd�hL+lY>!ffdl�i'I�i'S�r
al seal.
-(F
TWIS go 63 plants CM -6 goeewleciflo"s lz
kept on the job at all times -'and it is unlawful to -
make anv c+,clnq-Ps or alterations on some without N
Pubic bl14
P144 -An permission from the Department of Pu10
\A! ._C_OMnty_of Butte.
loo,co
S
I
rLAN H
V17
FLM -P $ FLM e -D
61Ar, W7
AIL -
.21, N:t.
W
llo
PUIL C, DEPAwrW 41
'APPROVER".
WML4W46&� i 00 Z, X-2
7.00'
Iq X oV# 1404
A -setback of 40k f r,8m*%
property lines and a setback
of 50ft. from the road
centerline shall be clear of
structures or equipment except
FQr 2 ft. save overhang:.
OWN
See'Klasfer Plan on Pile for buildling
plans.
<
t-, 00., /7(0 1:;
rLAN4 DG
S�F -E V,
V17
FLM -P $ FLM e -D
61Ar, W7
AIL -
.21, N:t.
W
llo
PUIL C, DEPAwrW 41
'APPROVER".
WML4W46&� i 00 Z, X-2
7.00'
Iq X oV# 1404
A -setback of 40k f r,8m*%
property lines and a setback
of 50ft. from the road
centerline shall be clear of
structures or equipment except
FQr 2 ft. save overhang:.
OWN
See'Klasfer Plan on Pile for buildling
plans.
<
FORM
;
RESIDENTIAL ENERGY PLAN CHECK/INSPECTION SUMMARY.
.owner
5H,�s-rhN 6o• Climate Zone Permit No.
'oor Area
133
Area
aplianc`e
path:
Package OA DB ❑ C IRPoint System []Budget ❑ Other
MIN
R -VALUE DESCRIPTION.
SET Fc,zvli I
REQ'D
INSTALLED
ITEMS
(1) INSULATION:
- Area.
Roof/Ceiling-
RC=
®
Wall
MC=
❑
Slab Floor Perimeter --""
❑
Raised Floor
0
Type
(2) INFILTRATION:
- Area
❑
(A) A vapor barrier is required in climate zones, 1, 14 & 16.
R=
(B) All manufactured windows and sliding glass doors shall meet the
Location
1972 ANSI -Air Infiltration Standards and shall be certified and
labeled.
Type
(C) All swinging doors and windows leading to unconditioned areas
Ft.Z
HC=
shall be fully weatherstripped. �U
--
MC=
�EJ0�D191/G TY
Tight - the above standard features plus :
infiltration barrier ®�'�ARNEW
❑
(D). Continuous
®
(E) Electrical outlet plate gasket APPROVED
HC=
❑
(F) Air-to-air heat exchanger
MC='
Location
(3) GLAZING:
(A) Location
❑
Type
Area Glazing Uloor Area Single Double- Triple
- Area
[�
Total'Bldg / , 0_//f S /'3� /
N,
®
North 1 9, D 3, (6'7 _
Location
East73n /,X
®
South
West 0 2.�5
❑.
Skylights '--
(B) Shading
Shading
Coefficient Description
East DvALC-)L-AZ/NC) cFA1)it 0g�sfi_-5
®
South , (061
®
West Flo
❑
Skylights
®
(C) South Overhang
Length of projection _ ft.- Description
_. ❑
(D) Moveable insulation: Area ft.2 Description
(E) Thermal mass
;
®
TYPe A
-
Area
/83, / Ft. 2
HC= n, 162
R= , Z9
MC= i, 3
Location
SET Fc,zvli I
❑
Type
- Area.
Ft.
RC=
R=
MC=
Location
0
Type
- Area
Ft.2
HC=
R=
MC=
Location
❑
Type
- Area
Ft.Z
HC=
R=
--
MC=
Location
❑
Type
- Area
Ft. .
HC=
R=
MC='
Location
❑
Type
- Area
Ft.
HC=
R=
MC=
Location
7/83
FDR M
❑ . (4) MASONRY AND FACTORY -BUILT FIREPLACES shall be equipped with tight
feting closeable metal or glass doors covering the entire opening
of the firebox; a com usion air intake equipped with a readily
accessible, openable, and tight fitting damper to draw air.from the
outside of the building; and a tight fitting flue damper with'a .
readily accessible control. ?.F Ti`,Ttfl" '^'l° t1QT 2� •_
*1(5) HEATING, VENTILATING.. AIR CONDITIONING SYSTEM
(A) Heating
Central Gas Furnace M W 7/ %
® 506m)7 specs (brand and model number) SE
P2iv2 -(O Btu/hr
INSTALL41i(n) (heating capacity)
❑ Heat Pump
7/83
(brand and model number) ACOP'
Btu/hr
(heating capacity at 47°F)
Active Solar
type (liquid or air) Collector brand and
ft2
model number solar fraction collector area. collector
orientation collector tilt rated y -intercept
.rated slope
Other
(describe)
(B) Cooling
Electric Air Conditioner
(brand and model number) (seasonal EER)
Btu/hr
(cooling capacity at 95°F)
Electric Heat Pump
EER
. Btu/hr
(cooling capacity at 95°F)
Other
(describe)
(C).A TWO-STAGE THERMOSTAT, which controls the supplementary heat on
its second stage, shall be required for heat pumps.
(D) AN AUTOMATIC SETBACK shall be provided for all thermostats, except
those controlling heat pumps. `
® (E) AN INTERMITTENT IGNITION DEVICE shall be provided for all gas-fired
fan type central furnaces, gas=fired fan type wall furnaces and
gas cooking appliances..
(F) BACKDRAFT DAMPERS shall be .provided for all fan systems exhausting
air to the outside.
(G) DUCT CONSTRUCTION.& INSUTATION. All transverse duct, plenum, and
fitting joints shall be sealed with pressure sensitive tape or
mastic to prevent air loss and shall be insulated .to conform to
the provisions of Section 1005 of the UMC, 1976 Edition.
2.
f- V K M
(6) DOMESTIC WATER SYSTEM
® (A) Gas Only UP Iwowd. 40 Gallons
(brand and. model. number) (tank size)
Q Heat Pump w/Electric Backup
(brand and model number)
Gallons
(tank size)
Q *2 Active Solar
is
(collector brand and model number)
(rated y -intercept) (rated slope) (solai fraction)
ft
2
(backup heater type, brand and model number) (collector area)'
(collector orientation) (collector tilt)
Q Location of Solar Panels
Q Other
(Describe)
(B) TANK INSULATION: Storage type water heaters and storage and
backup tanks for solar systems shall be externally wrapped with
R-12 insulation or greater.
® (C).PIPE INSULATION. The.five 1.:et of pipe closest to the water
heater and outside conditioned spaceshall be insulated with a t
minimum of R-3. Steam and steam conditioned space shall be
insulated with a minimum of R-3. Steam and. steam condensation
return piping and recirculating hot water piping outside the
building envelope shall be insulated in accordance with
T20 -1408(d).
(D) FLOW RESTRICTORS shall be provided for showerheads and faucets
as outlined in the new appliance efficiency standards and shall
be certified to the Energy Commission.
(7) LIGHTING
(A) Lamps used in luminaries for general lighting in kitchens and
bathrooms shall have an efficacy of not less than 25 lumens per ;.
watt (usually florescent).'
*1. Submit do ion of sizing heating and cooling equipment by Manual J, sizing
charts.form #4 or other approved methods, section 2-5352(g), and fill out the
followin
heating load BTU
Heating: Winter design temperature °, elevation , $
elevation factor 1,0 x heating load — maximum outlet capacity gas furnace
BTU
/p L .
Cooling: Summer design temperature °, cooling load &0 .
*2 Submit T.I.P.S.E. chart or other approved system (form #5) to document sizing of
solar panels... USE.ONLY AS SIZING Gll!n- F.
04
COOLING MAY BE INADEQUA s E
DESIGN COMPLIANCE STATEMENT: The above building design meets the. requirements of
Title 24, Part_2, Chapter 2-53 of the Californ Admi istration Code.
OA
7/83 SIGNATURE OF ILDIN DESI R'OR APPLI
3
ZONE ii - T2AN G, � LoTS `3 Z� 3l�
OWNER .HAS i/W do. POINTS
PERMIT NO. '-"' ASSIGNED ACTUAL
1. SU.B - INSULATION NONE
2. RAISED FLOOR - R-19.
3. CEILING - R-30..
. � r
4. WALL - R-19
5. NORTH GLAZING - 2.4-3.6-1.
6. EAST GLAZING - 2.5-3.6%
7. SOUTH GLAZING - 1.6-3.6%
S. WEST•GLAZING 2.9-3.67 2 .5� ✓
9. SKYLIGIIT - 0-1.3%
10. .SHADING (£xclude.Overhang)
EAST - .67-.82 ,6 Ci
SOUTH . 19-.42 i G (p
WEST - .13-.36 , GCo - 3
SKYLIGHT - .37-.57 - -
11. HORIZONTAL SOUTH OVERHAIIG 2'12.- NOVAIILE 'INSULATION --maoNONE
f v N
13. INFILTRATION +Stonderd *KT49ht 12i C-(Il�i'•E7Ti
14. . TNERHAL_MASS A - SF
15. CAS FUMACE (SE) (f�76%
16. HEAT PUIIP (EER) 7.5-7.9% -7-3
17. DUAL PACK ($E. SEER) 8.0-8.3/71-76Z N/A
19. ACTIVE. SOLAR 607. IIIN (PONE) / 1
19. ZONALLY CONTROLLED ELECTRIC 01A
20. SOLAR WITH CAS BACKUP (HW) /J
21. OTHER - NO ELECTRIC (11W) N/2
7-7-, /00 %c . ATT1 C_ I
SHOT IRO POINTS�� - --
Cable )-1. flab Floor P lnt���t,, t.Ll ]-2. A.t..d Floor Points I
I 1 IF I
I In+via- I R -Value of nSul at141 &-Value of
clue I I Insulation
I Inches- 1 0-2 1 3-i I -4 1 7+11
I I
I I!
I I
I below 3
1 0= 11 I -5
1 -5 I -S
1_-;;_5_1
I 3-4
I S- 7
I 12 - 15 I -S
1 -3 I -2
1 -1 I
I 8- 12
( 16.- 19 I -5
i -2 I -1
1 0 I
I 13 - 18
I 20 + I -5
I -1 I 0.
I +1 I
I -19+
7MO
I +•4
I +44 I +4 I
19.5 t
Tabic :-rt. Ccii:ng in-:.:at.9z
Points
e
I Claaing Type
I" I
I R -Value of Insulation I
I I
Points I
I
Trpl,
I Floor
I 22 I
-2 I
I 30 I
0 I
( 38tz
10.42-
10.41 I
I
11.10
10.65
-4a. Wall Insulation Po
R -Value of Insulation I Points I
Y9 I o I
24 1 +2•
30. I +3 I
'r.A1. I -a_ N. h_r..._. r....__ o._
I
II Total
I of
e
I Claaing Type
I" I
Sngl.
Dbl,
Trpl,
I Floor
i v-
l U-
I U.- I
I Aa04
10.66
10.42-
10.41 I
I
11.10
10.65
I dove 1
(U -I I
,
+
1 0.1- + 1.2
I +•4
I +44 I +4 I
19.5 t
1 +1
.
olnts 1 otntis I
-2...
I ,I +1 I
1 '3.1-•"4:0
I -4
I -2
1 4.9- 6.1
i -F
I -4• ( .3. I
I 6.2- 7.3 I
-9
I -6 I -5 'I
I 7.4- 8.2 I
-12
I 68 I -7 I
I 8.3-.9.7 1
-14
( -10 I -8
( 9.8-10.8 I
-17 (
-I2 I -10 I
110.9-12.0 I
-19 I
-14 1 -12 I
112.1-13.2 I
-22 I
-16 1 -13 I
113.3-14.3 I
-24 I
X18 I -15 I
14.6-1S.3 i
-27 ;
-20 i =17
I Glazing Typ•
Total I
Z of I Sngl. Obl, Trpl,
Floor I (u - I (v - I (v -
Area 11.10) I o.bs).1 0.4t)
able i -i. Soca-r'actn Ciartn Pts Yab'le 3-10. Shadin6 Coefficient Pointm.
T -------T-
. T_�-T__ --
I I
Glazing Type
I I
SC by
I
I• Total I
1 0 I 0 1 -1
I I
Orion-
I Z F10.0r Area
I I of I
Sngl, I Dbl, r_T__rp_1_,7
16.4
tatlon
I
I Floor i
(u - I (U - I
(U -I I
..•
I
'I Area 11.10)
10.63) 1
0.41)1
19.5 t
1 +1
I I
olnts 1 otntis I
olntsl• I
Last
1 I 3.2 1
O
+3 +3
• 3 I
1 0 I
1 0-3.1 I to 16.4 up
I up to 1.5 1
+2 1 +2 1
+2 I I
1 -6
I I 6.3 I
1 1.6- 3.6 I
-1 1 0 1
0 1 1
1 -6 1 .4
I I I
I 3.7•• J.2~(�
-4 1- 1
-2 I' I
6.4 1 S.A
-b 1
I cs"i= 6-� -;6• _1jj:1 -3 1
7.7 1 -9 1 -6 1 -5 1
I 7.8- 8.9 1 -ll I -8* I -7 .I
I 9.0-10.0 I. -13 I -10 .1 -9 i
110.1-11.5 I -1.7 I -13 I -11 I
111.6-13.0 I -21 I =1'6 I -14 I
117.1-14.5 I -25 I -19 I -16 I
'14.6-16.0 i -28 i -22 i -19
Table 3-8. Vert-Facine Clarine Pts.
Iotal
I of
Floor
Area
up to 1.3
1.4-_2.y2
2•]- 2.8
2.9='3:6
).7- 4.2
4.3- 5.0
5.1- 5.6
5.7- 6.2
6.)-.6.9
7.0- 7.6
7.7- 8.2
8.3- 8.8
8.9- 9.5
9.6-10.1 I
10.'t-11'.0 I
11.1-11.8 I
11.9-12.7 I
12.8-13.5 I
13.6-14.3 I
14.4-15.2 I
Glazing Type
angl, 1 MI. 1 Trpl.
(U -- I (U - I (v -
1.10)'1 0.65) 1 0.41)
oints loolnts loolnts
e6 1 +6 1
+6 1 +6 1
+v} I +3 I
-2 I +o I
-4 .I -2 I
-6 I -4
-to I .-i I
-12 I -9 1
-li I -ll I
-16 1 -13 I
-18 I -ls I
-20 I -16 I
=26 ( -21 1
-2q I -24' '1
-32 I -27 1
-)S I -29 I
-33 I -32 I -
Table 3-11. Horizontal South
Overhane Points*
south. Claaing
1 Length Out I Area. I of Floor 1
fro`tVAIL I 1
0-6.3 1 6.4 up I
-2
10.6 - 1.0 I -2 I -] I
11.1 - 1.9 I -1 I. -2 I
1 2.0 up I 0 I 0 I
1 I 1 I
Table 37-12. Movable Insulation
Points
Moveable Insulatloa•l I
I Area, I of Floor I Points I
I 0- s.s I 0 I
I 5.6 - it.$ +2 I
I 11.6 - 17.3 +4 1
I 17.6 - 23.1 +6' I
I >23.6+ ' ✓ +8 I ..
I 0 -.19
1 0 1 +1 I +.2
.20-.36
1 0+1
I t1
,
I .37c66�1 0 l Co, I o
1 .67-.82
1 0 I 0 1 -1
I .83 up
.i 0
I South
I. o
1 3.2
16.4
1.3.0 1 '7.1
I
I to
I so
I' to
I to I vp
1
13.l
1 6.)
1.7.9
19.5 t
1 +1
1 +2
i +T�-
I 0--18
1 0
I .19-.42
1 0
1 0
1 0
1 0 I
( .43-.66
1 0
3.6
f -9
1 -6
I .67 up
i
1 0
1 -2
1 -6
1 -6 1 .4
Vest
1 .1
1 1.6
13.2 1
6.4 1 S.A
-b 1
1 to
I to
I to
I to 1 up
-3 1
1.5 i
3.1 i
6.3 11.9
1 ' -10 ..
0-.12
i 0 1 +1 I
+3 1 4.6 I +7
.13-.36
1 0..1 0 1
0 1 0 1 0
5.1-
.0 1 -1 I
-3 I -6 1 -7
.38-.82
I -1 1 -3 1
-6 I -12 1 Is
.83 up
I -2 1 -4 I
1 I I
-8 1 -16 1 •21
i 1
Skylight
1 .1 1 .9 1.1.6 1 .3.2 1 4.9
6.2 I
1 to i to I to I to i is
1 -14
1.7 1_s l7 3_1 l 3�9 ,li, s. r
0-.13
1 0 1 +1 1 +) I +6 ( +7
.13-.36
1 0 1 0 1 0 1 0 1 0
.37-.57
1 0 1 -1 1 -3 I -6 I
.S8-.8.2
1 -1 I -3 'i -6 1 -12 I •,
-83 up
I -2 I -6 1 -8 1 -16 1 -20
I I I I 1
Table 3-9. Sk ileht Points
1 1 Glazing Typa I
I Total i l
I Z of I Sngl. I Dbl, I Trpl,
I Floor I U- l u- l U- 1
I Area 10.66- 10.42- 1 0.41 1
I 11.10 10.65 I down 1
Pointe
. o 1
+ -f
1 4,41 I
+4 I
I up to
1.)
1 .1
1 0
I. 0 1
1
I up to 1.) I
+3
1 I
t4 1
1 1.4-
2.2
I -3
1 -2
I -1 1
--'-'-T
I 1.6=o •I' z
-41-
1 c 4 I
+2 1
1 2.3-
2.8
I -6.
1 -4
I, -3 I
-12 I
( 2.5-`1.6 1.
-2
I 0 1
0 1' •1
2.9-
3.6
f -9
1 -6
1 -5 1
-8 1
1 1.7- 4.'6 I
-S
1 -2 1
-1 I
I 3.7-
4.2
I -11
I -8I
-b 1
-6' ( '
I 4. i- •3..6 I
-8
I -4 1
-3 1
I 4.3-
5.0
1 -14
1 ' -10 ..
I -8 I .
-i• I'
I S.7-'6.7 I
-10
1 -6. I
-S I I
5.1-
5.6.1
-16
1 -12
1 -10 1
72 I
I 6.8- 7.7 1
-13
I =8. I
-1 I I
5.1-
6.2 I
-19
1 -14
1 -12 I
C l•
1 7.8- 8.7 I
-15
I -10 1
-6 I I
6.3-
6.9 I
-21
1 -16
1 -13 I
I 6.8- 9.7 1
-1.7 I
-12 (
-10 I I
7.0-
7.6 (
-24
1 -13
1 -15 I
1 9.8-11.2 I
1 -15 I
-13 I I
7.7-
8.2 I
-26
1 -20
1 -17 I
i 11.3-12.7 1
I -18 1
-15 I I
8.3-
8.8 1
-28
1 -22'
1 -19 I
112.8-14.0
-21 1
-18 I I
8.9-
9.5 1
-31
1 -24
1 -21 1
•::
14.1-13.3 ,
`i
-24 I
-20 I
9.6-10.1
-33
-26
1 -22 I
TAL
GLAZING PLAN TAKEOFF
SHEET t -U N rl. 0
3'5 North Glazin.&
ZING
FLOOR AREA
3-6 East Glazing
QUANTITY S IZE
AREA (SQ. FT .)
SQ.FT.
QUANTITY SIZE AREA (SQ . FT .)
.... 2 x ¢tiff
�U•o
(a)
/ x 4050 t 2°•p
x 100 = %
SQ. FT.
SQ.FT.
X c
(C)
X c
x _
(d)
x
x _ _-
Total North Glazing =
..
^'9.0 (SQ.FT.)
(e)
x
Total East Glazing Zo,o (SQ,.FT.)
(a+bic+d+e)
(a+b+c+d+e)
TAL
TOTAL
RTH
TOTAL BLDG
ZING
FLOOR AREA
0
x
.FT.
SQ.FT.
3-7 South Glazing
QUANTITY SIZE AREA (SQ.FT.)
I x �0�0s s.c,.�:'. = Zo,o
_
x
x =
x _
Total South Glazing 73.3 (SQ.FT.)
(a+b+c+d+e )
1i7
TOTAL
^)
TOTAL BLDG
CONVERSION TOTAL %
EAST
TOTAL BLDG
CONVERSION TOTAL %
FACTOR NORTH GLAZING
GLAZING
FLOOR AREA
FACTOR. EAST GLAZING
100 _ . �, ic7.Z'/.
• O -_
/ w33, d
x 100 = %
SQ. FT.
SQ.FT.
3-7 South Glazing
QUANTITY SIZE AREA (SQ.FT.)
I x �0�0s s.c,.�:'. = Zo,o
_
x
x =
x _
Total South Glazing 73.3 (SQ.FT.)
(a+b+c+d+e )
1i7
TOTAL
^)
TOTAL BLDG
6[.1..J
FLOOR AREA
FACTOR. SOUTH GLAZING
x
t. FT.
SQ.FT.
3-8 West Glazing }
QUANTITY SIZE AREA (SQ.FT.)
(a) x '.-0,.50 - = /S, 0 . .
(b) --� x 2 g Fe, 1-r-, _ / d �
(c) x
(d) x =
(e) x _
Total West Glazing (SQ.FT.
;+
(a+b+c+d+e)
3-9 SkyliLhts
QUANTITY SIZE
)) x
:) x
Total Skyli
(a+b+c)
MAL
L'LIGHT TOTAL BLDG CO�
kZI,NG FLOOR AREA
- x
�.FT. SQ.FT.
AREA (SQ.FT.)
c
c
s = (SQ.FT.)
VERSION TOTAL %
ACTOR SKYLIGHT. GLAZING
100 = %
\�R SMASTA/V
RrIIT NO.
83
CONVERS1014 TOTAL %
FACTOR UTEST GLAZINr
100
`'I-A/J - Lo7"S
My
0
TOTAL
CONVERSION TOTAL %
WEST
TOTAL BLDG
FACTOR. SOUTH GLAZING
GLAZING
FLOOR AREA
100 = S .S o q,
'�. o :-
/ 333, 0 x
SQ.FT.
SQ.FT.
3-9 SkyliLhts
QUANTITY SIZE
)) x
:) x
Total Skyli
(a+b+c)
MAL
L'LIGHT TOTAL BLDG CO�
kZI,NG FLOOR AREA
- x
�.FT. SQ.FT.
AREA (SQ.FT.)
c
c
s = (SQ.FT.)
VERSION TOTAL %
ACTOR SKYLIGHT. GLAZING
100 = %
\�R SMASTA/V
RrIIT NO.
83
CONVERS1014 TOTAL %
FACTOR UTEST GLAZINr
100
`'I-A/J - Lo7"S
My
0
OWNER THERMAL MASS TAKEOFF SHEET '
PERMIT NQ.
'The-tmal mass: Materials Which have the ability to- store heat (typical types are masonry,
brick and, ceramic tile).
Tnarmal mass cannot be insulated from the interior of the building. (If covered by car-
et,- cabinets, or enclosed in closets the mass is considered insulated)...
Thermal mass floors must have
an exposed and textured
surface
or design
s.o
that carpeting t711:
' not occur. (Covering of vinyl or asphalt tile and linoleum
is permitted).
TYPE THICKNESS
IACATION
DIMENSIONS
AREA
I�
A _ 5U16
Entry Floor
' x
'
. 5 S") a n.,
Bath #1' Floor
' x
'
13310 SQ . FT ,
( l
Bath #2 Floor
' x
. '
Q
7 7, a SQ . FT .
\
Bath #3 Floor
' X'
'
n
SQ . FT
1
Kitchen Floor
' x
'
a
/ 9, SQ . F'T .
'
LAWJ-04 r Floor
' x
SQ.FI,
Floor
' x
'
a
SQ. F! ,
Fireplace
' x
'
SQ.F. '
Fireplace
' x
'
a
SQ. 17
Bath #1 Counters
' x
'
a
SQ.F11
Bath #2 Counters
' x
'
a
SQ. FT
Bath 0 Counters
' x
'
SQ.F-' ,
Kitchen Counters
' x
'
SQ. r .►' ,
Wall Shield
' x
'
SQ.n'
-----�—'SQ.
Walls
x
Fi ,
Walls
'• x'
..
so., 1 ,
Walls
' x
\\
x
'
o
SQ.�T'
' x
SQ.�•r.
x
'
a
SQ. r.....
If compliance method proposed
is other than the point
system
(Where thermal
mass point
charts are available), use calculation methods on reverse of
this form
to
show thermal
mass compliance.
G. rZ �vv A scA
�.--•.,7/83
a? t
1 �
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT NO.
Z3 33-e,!z
ASSESSOR PARCEL NU BER
3 —2 `03 �3 —� Q — y2
ZONING
BUILDING PERMIT
OWNER
"41
TELEPHONE
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILI . G ADDRESS
-l0, ox
108
CONTRACTOR'S AME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
�QD
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
3
Filing Fee
$ 10,00
LENDER'S MAILING ADDRESS
Permit Fee
$ OL 110, 00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ S, ft
Penalty
$ 1.5 , 016
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$ 6 6, cz
BUILDING ADDRESS
PLUMBING PERMIT
FiIingFee 10.00
o Liam QS h
Each Trap
2.00 �
Solar Water Heater
20.00
Water piping
5.00
Loa SUBDIVISION NAME
fo
PARCEL MAP
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
5.00
USE OF STRUCTURE
SF Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer
5.00 �!
Mobile Home ISI G W
10.00 e
TYPE OF WORK
New [� . Addition ❑ Remodel F1 Uti 'tie ❑Insta la_z_io'n E] Other ElContractor
Describe work: P� 1
Permit Fee
$ q6, 00
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 100 OR LESS
100 OROR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
NEW CONST. (DWEL H0�'f P.&)
OR ADDNS. 1 ACC. M
2��ZQ3q ft 36 &5
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check One):
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions ode and my license is in fullforce and effect.
License No. Classification
❑ I, as the owner, or my. em loyees 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 C__._. U TI.OUTLET 2,50 ea
NON.RESID BRANCH CIRCUITS)
NEW CONSTR POWER APPARATUS &'\\
NON-RESID. SINGLE OUTLET CIR. 1
zoea0C
OR FIXTURES BAL®30
Ex. OccUP.
FIXED A
FIXED APP LNS. OR \
Ex. Occup. OUTLETS (RESID.) EA./ 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $ 0.
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
gyl have placed on file with the County of Butte Building Department
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
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
Filing Fee 10.00
Heating
Cooling `r
,076
Hood
3.00 3 _6b
Ventilation
3 �,OD ,60
permit Fee
$
Contractor
1 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 t save, indemnify and keep harmless the County of utte against
all liabilities, 'udgments, cost , and expenses which may in a 4waaccrue
against said C unty in c equ n e of the granting of this permit
X Date
Signature of Applicant — Owner Contractor ❑ Agent
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures ov r 3 sto ' height.
Mobile Home Installation Fee $
`� , 0Q
TOTAL PERMIT F $
OCCUP. GROUP
TYPE OF CONST.
PARCEL
PD
No
ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF PUBLIC
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Receipt No.��a1 6-0By
WHITE-D.P.W., YELLO ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT