HomeMy WebLinkAbout043-710-005:Q
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PERMIT. NO:
PERMIT EXPIRES
v
i
'O*NER a
ager.
CONTR.
'ASSESSOR PARCEL 42
46 95
I;
LOCATION':;
•
r
Temp. Power Pole
Called-PGBE
Temp Elec Service
CelledPGBE
f
Temp. Gas'Service
Y' Called'PGBE
lkhk
i
f JOB FINALED (Date)
Signature
/
R
= OK
0 =,Not OK _
='=Not Applicable �-. r N
Not Ready MOBILE HOMES L- MISCELLANEOUS .
Date'
'MOBILE -HOME UTILITIES (Plans) OK ekcept #'s •
.:Date
DECKS,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s
Zoning'Requirefnents-Setbacks-Easements,'•',.,
_
1.,Zonin9-Requirements-Setbacks-Easements
,2..Soils;-Special MH,Support-Sketcfi:_..,
2: Footings; Soils -Size -Depth -Spacing -Connectors -Steel
" •"
3. Sewer; Locatioh-Test-Fall-Q/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,-Rfg.-Bracing
5.. Electricity, Location_ -Clearances Grnd ,/" ,:,1 Amq-Concrete
= " 6: Gas; Location Test -Wrap• /;. / L" ft::. ;'•: -'
- / -P-Nat. or/ _ /"L"ft / /"LPG
5. Alum.'Awn:; Columns -Connections -S lice -Decal -Enclosures.
P
6.,Carports; Windows -Doors
7.: Utility Clearance_ " . -
7. Elec.
Ic
-
8: ,Pring; Sills-Anchors-Studs-Rftrs-Trusses-
9.'Siding;-Nailing-Veneer-Stucco=Mesh
Card -131
Date'' Card -131 'Date
10. -Roof; Shthg-Roofing -
Card -B1:;.,.;, . Date,.. .; ,;, m'Card-131 - ` Date .
11: Ext.; Steps -Doors -Landings -
Date' '
MOBILEHOME INSTALLATION -(Plans) .OK:except #'s .
1. Zoning Requirements-Setbacks-Easeinerits- ".:,
°Card -131
. Date • Card -B1 bate %,
2. Footings; Size -Spacing -Marriage Line -
:Card -B1
.
Date Card -B1 Date.
3: Gas; MH Test -Demand -Valve -Connector.
4. Electricity; MH Test-C'rdssovers-Breakers-Clearances
Date
POO (Plans) OK except #'s.
5. Drain; MH Test -Fall -Flex Connector ; -
. etbements
6. Water; MH Test -Regulator -Connector
o' ,Compaction-Structure.Stability -
_
,7.•Water.,and Sewer. Connected -C/O to Grade -HD Approval
ool Structure; Steel-Connections-Thickness-
Dead Men -Lining
.8.,Gas and Electricity Tagged: 1
9.. Exits; lnsp..-Sketch -
A. Elec.; Receptacles and•Lighting, Distances-GFI
10. Cert. of.Occupancy
5..Ele Lighting; 15 volts=GFI
eo:; Enclosures;. Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5'-Circul6ting Equip. -Heater
8• Elec.;Grounding; Equip. w/5' -circulating Equip. -Pool Lghtg.:
Boxes-Enclosures-Panelboards-Ins. to Main in Conduit
Card -61 '- Date' 'Card -B1 'Date. .' -
Card -131 '
Date Card -131 'Date
9. H$pkK Department Approval
y _.—
1 Jumb.;.Cir. Test -Water Supply Test. .
Card -131
DateCard-B1 Date
'Card -Bl'
x:. ° Date -•Card-131 Date =
r•�, _ - - .. .. '- .- Doc
�' pIC.
_
s•,.
Ic
=OK j
0 =Not OK
- =Not Applicable.. ..RESIDENTIAL (Single and Duplex) '
Applicable
' = Not Ready `
Date" UNDERFLOOR(Plans);,,.O.K except #'s ^
Date FRAMING (Continued),` ...
A. Zoning requiiemenfs-=Setbacks-Easements-
44. Hangers-Post.Caps-Anchors-Connectors'
Z Ftg.;'Main;,.Sgils-Steel-Elect`Grrid.-/ 7" Ftg. Depth _ ..
;. 45. Cing. Joist-Rftr: Ties-Purlin=Roof Brac.-Truss=Shthng.=Rfng..
3.- Ftg., Garage;•Soils-Steel-/ ' "/" Ftg. Depth
46. Fireplace Ties or Type AFlue-Fireplace Throat . j
4. Ftg.,- Porches & Decks; Soils -Steel-/ /" Ftg'.' Depth
47. Attic Access;:Size & Roniex Protection -Draft Stop=Ins. Baffles
5 Sterriwalls, Main; Steel-Blockouts-Wrapped .
48:"Bdrm. Windows or Eziting'Doors-Sill Hgt. &•,Dimensions:
6. Stemwalls, Garage; Steel=Blockouts-Wrapped
49. Garage Fire Protection Framing
'
7. Slab; Steel -Wrapped '• .1
50. Property Line Firewall & Openings
8. Piers -Fireplace Ftg:-Steel
51. Ext. Doors -One T -Check Garage' -3rd story, 2 exits
- 9. D.W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test
52. Stairs; Width-Headroom-Rise-RLiK.-Landing-Fire, Protection '
10. Gas Pipe; Siie-Anchors
53. Plywood on Roof Overhang-Attic.Vents-Rafter Outriggers
1.1. Water Pipe;.Test-Anchors-Regulator-Service Test
54. Siding -Nailing Veneer.
12: Electric; Underground'
55. Stucco Mesh -Drip Screed -Fd. Vents-Underflr.. Access -
13. Plenums &Ducts; Clearance-Material-Supprt-Ins.
56..Glazing`Area-Glass Protection-Skylights-Plitstic `" •.
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
57. Shear Walls; Nailing -Bolts
15. Insulation -
58. Insulation-Walls-Clg.
59. Infiltratio n-Walls-Wndws
Card -131 Date Card -B1 Date
Card -61 Date Card -81 Date
Card -B1 Date Card -B1 Date .
Card -B1 Date Card -81 ' Data
Date- PLUMBING (Permit)`OK except #'s
16. Water Ht. Vent -Access -Combustion Air
Date FINAL (Plans) OK except #'s.
17. Water Pipe; Test & Anchors -Nail Protection
60. Ext. Steps -Door & Sidelight Protection' -Landings
18. D.W.V.; Test-Fttngs & Anchors -Nail Protection
61. Smoke Detector
19. Shower:Pan; Test, First•Floor-Tub Access82:
Furnace; Vents -Clearance -Comb. Air -Connector-
In Garage; Above Floor -Ducts -Mach. Protection
20. Test, Tub &:Shower, 2nd Floor -Tub Access
21. Gas Pipe; Size.& Anchors.
63. Bedroom Exiting
64. G.F.I. & Bath Fixtures & Tub Access -Spa.
65. Elec. Trim & Subpanel;-Breaker Sizes -Labels.
Card -B1 Date Card -B1 Date
Stairs &Rails
Card -B;1 Date Card -B1 Date.66.
67. Fireplace or Stove; Clearances -Hearth
68. Elec. Outlets at Wood Panel; Int. & Ext.
Date ELECTRICAL Permit OI<.exce t #'s
22.*Fixture :& Transformer Clearance -Ins. Protection
69. Kit..Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance
- 23: Elec. Receptacles Spacing -Lights &Switches at Doors
70. Elec. Outlets & Receptacles at Kit. Counter
24. Size Boxes & No. of Conductors -Stapled
71. Garage Fire Door; Swing -Landing -Closer
25. Romex Installed Close to Edge of. Studs• & C.J.
72. A.C. Duct in Garage -Damper
26.Equip.:Ground made up w/Mach. Fasteners -Bond Gas & Water
73. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor -Mach. Protection
27. 2 Appliance Circuits in Kitchen & Conductor Size
74. Plb., Elec. & Mach. Equip. Listed for Location
28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga.
Cu or Al
75. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
..29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al.
Insulated Neutral Yes No
76• Insulation -Foam -Looked in Attic ❑ Yes
77. Guard Rails & Deck Construction -Post Caps
30. Service -Riser .Conductors & Ground -Main Disconnect
78. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth j
Clearance Looked under Floor ❑ Yes
31. Equip. Clearances -Panels -Motors -Meeh. Equip.
32. Clothes Closet, Light -Shower Light -Spa Light
79. Following instld.; Drive ❑ Yes O No; Walks ❑ Yes ❑ No;
Planters ❑ Yes ❑ No
80. Stucco; Brown -Finish
Card -131 Date Card -61 Date
81. A.C. Unit; Disconnect, Electrical, Plumbing
Card -131 Date Card -131 Date
82. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to
Openings.
Date MECHANICAL(Permit) OK except #'s
83. Water Well; Disconnect, Electrical, Plumbing j
- . 33. A.C. Ducts Insulation & SuReceptacle-Undergroundj
pport
84. Exterior Elec. Trim; G:F.I. -
34. Vent Fan; Exhaust above insulation
85. Ventilation throughout House i
35. Condensate Drain & Overflow; Size & Grade
86. Glass Protection
f 36. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet
87. Corrections from Previous Inpections {
37. `Attic Access & Platform if Furnace in Attic
88. Gas Test -Meters Tagged; Gas -Electric jl
89. Water & Sewer Connected -C/O to Grade -HD Approval .
`
90. Energy Compliance Certificate-Other.Certificates
• - Card -81 Date Card -81 Date
Card -81; Date Card -131. Date
Card -B1 Date Card -131 Date
Date FRAMING (Plans) OK except #'s
Card -B1 Date Card -91 Date
.
38. Sills, Proper. Material & Anchors
Card -131 Date Card -131 Date.
39. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound
Comments at Final:
40. Bearing Walls over Girders & Floor Nailing
41. Draft Stop in Walls (rat proof)
42. Fire Stops; Furred Ceilings -Stairs -Chases -Tub
43. Header & Beam-Siie & Bearing
..,, (NOTE: An entry must be made each time you visit Job site)
I
COUNTY OF, BUTTE.- DEPARTMENT OF. PUBLIC WORKS : .p
, .� ERMIT N0. "
7 County Center. Drive'- Oroville, California -95965 -'Telephone; 916/538-7541.
• - . L .
APPLICATrON'AND PERMIT
AS SSR PARCEL NUMBER
_ O"S,
ZO d
- -
BUILDING PERMIT.
owNeR
•SS •/ -'
?HON.E_
SQ., FT. OCC. BUILDIINNG.VALUA ION
O NFj�tM,AFL.I ADD. -. ../,_
IE '.vc .. _'r .�.
EE�LEPHO(NE
-
CONTRACTOR'S MAILING ADDRESS I
a -S- '
Fireplace'
CONSTRUC ON LENDER - `.
UNKNOWN
-Totdl Valuation $
Filing Fee ,` - - .'
$ .1 10,00
LENDER'S MAILING ADDRESS - . + -
'
-
'Permit Fee
$ -SO
ARCHITECT OR ENGINEER -
LICENSE NO. -
Plan Checking Fee
$
Energy -Plan Checking Fee -
$ _
ARCHI=TECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS ..
Permit f@@
$
PLUMB NG PERMIT
Filing Fee 10.06
S
Each' Trap
2.00
Solar' or heat pump water heater
20.00;
LOT NO. �'-
,SUBDIVISION NAMEPA
CEL MAP
Water piping.
5.00
Each qas water heater or vent
5.00
USE OF STRUCTURE
SF& Duplex❑ .Mobilehome❑ Other ^
SPECIFY
Gas -piping system 1 -'5 outlets
5.00
Building sewer.
5.00
Mobile Home S I G W
0.00 ea.
TYPE OF WORK'.
New ❑ Addition ❑ Remodel ❑ . Utilities ❑ Installation❑ 'Other❑"
Describe work: ' ,p
�/
-
Permit Fee
$ �-
Contractor
-
ELECTRICAL PERMIT
FiIing Fee 10.00
Main service e00V OR LESS 100 AMP OR LESS
10.00 ,
Main service EA,.ADD'L 100 AMP
2.50
CONTRACTORS. LICENSE LAW:
I declare under penalty p J y- (check. one):
of perjury,
I am Licensed under provisions of Chapt. 9, Diy. 3 of the Business
and Professions_ Code and my license Is• In full force and effect.
3 ��j1 - C --s -
License No. J 7 F JP Classification
F-1 1, as the owner, or my employees with wages as their sole compen-
satiori, will do the work,and the structure is not intended or offered
a for sale. (Sec. 7044)
❑ 'I, as the owner, am exclusively contracting with li'censed,contract-
ors.(Sec. 7044)
❑ I am exempt under Sec. Business and Professions. Code
for this reason
NEW CONST. DWELLING OCCUP.&
OR ACDNS. ACC. BLDGS.
/20Sgft
NEW CONSTR U T .OU LET
NO N•RESID BR A NCH CIRC ITS
2,SO ea '
- POWER APPARATUS 6
-SINGLE OUTLET CIR.''
Ex.,Occup(OUT LETS OR FIXTURES
eALO 30
FIXED APP LNS, OR \
Ex. Occup. OUTLETS IRESIO.) EA.)
2:00
Temporary service
10.00
Mobile Home.Facilities
15.00
Misc. Wiring
15.00 S —
Permit Fee
$
Contractor
WORKMEN'S COMPENSATION INSURANCE,
I declare under penalty of perjury (check one):
_ ❑ The permit is for $100.00 (valuation) or less.
❑ I 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 .
FiIingFee 10.00
Heating
Cooling
Hood
3.00
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 to enter upon the above-mentioned property for inspection purposes.
I also agree`t save, indemnify and keep harmless the County .of Butte against
all liabi.lit' s, judgments, cost ,and expenses -which may in any way accrue
agai st s Id ounty i co sequ ca of the anting of this permit.
X Date
Signature of Applicant —, Owner Contractor 11Agent'❑',,
An OSHA permit is req uiredfor excavations over'5'0" deep and.d'emolition or construct-
ion of structures over 3 stories in height..
Mobile -Home Installation Fee
$
Energy Inspection Fee $
TOTAL 'PERMIT FEE
occup.
CONST.TYPc
I Loo
RCE
, PD
t
ND
39
This permit'. is' Hereby' issued under
si6ns" of.the .Butte County. Code and/or
work' indicated above for which- fees
DIRECTO F PUBLIC
By
PER EXPIRES 'Dat@
the applicable prove=.
resolutions to-do
have been paid.
WORKS
;
to
Receipt No.
WHITE-D.P,W.. TELLOW-ASD(33OR;� PINK -INSPECTOR, GOLDENROD -APPLICANT _
f .;
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-t"" ste.t1� t ,�.•+C ; r> On.� �♦ r j, -Y ' - f1,,•r. Swt \' ��,
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now
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ai?..f..- .. t_,•�„rF:i,p..� .,.0 .....»�,,.„...} .>. ,_,. `���, a .i _a. .... _.. rS-. 1 i ,.. .... ,,. t �._r....., .a. '. kr,'.tic..: i .r i�!... d•%`, _......?'. �`.'''`r°A;{.».i .{ -Fk. ^./+>, > ,.t+ - =' rr ��"Irl-.._ -4a�r' _��. __.
--�..� '�,r Gi^,{ � a`L a.'^ -H\`:1 ""S'.�C ': �'+.. ` -� .. �. 1:� n M.. )Ln ,4Y:�fF' t[>L 1..jC1 4." 3� A, r .-•Sy.Cryly,
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1' COUNTY OF BUTTE - DEPARTMEN+T. OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, rMA F� R_c N* IA 95965 - TELEPHONE: 916/538-7541
PERMIT APPLIOAUON DATA SHEET
Permit No.
OWNER�� A. P. No.
Proposed Building Use GG :':Building Inspector Date -
At time of permit application, I was advised the following data must be submitted prior to permit processing
and/or Issuance:
DATE RECEIVED APPROVED
1.
All items have been submitted. . . . ... . . . . . —
2.
Plot plans in duplicate/triplicate, signed by preparer of plans, _
3.
Complete plans in duplicate/triplicate, signed by preparer of plans,
4.
Complete engineered plans and calcs, with wet signature on plans.
5.
Plans with Energy Design Compliance Statement. . . . . .
6.
School District "Fees Paid" Stamp on Floor Plan.
7
Statement of Intent for Non -Heated and AC Buildings.
8.
Fees of $ . . . . . .
-Letter
of signature authorization., . . . . . .
Sanitation approval from Health Dept,
11.
Planning approval for (A) Use: (B) Parking:
12,
Certificate of Workmen's Compensation Insurance.
13.
Contractor's License Information (no., name style, classif.)
_14.
Owner -Builder Verification (Given to owner0„ Mail to owner Q) —
_..._15.
Improvements may be required. . . . . . . .
16.
Mobilehome Installation Data. . . . . . . .
17.
Pre-Inspec. request
Pre -Inspection for--------- .. _ _Required, Building Inspector (D'art)
18.
Recorded copy of Agricultural Acknowledgment Statement.
19.
Driveway Permit. — A,';
_ 20.
Plot plan approval.from city of
21.
22.
—
When, you issue the permit
Telephone
Other
process as follows: Mail to owner, ai I to contractor.
and hold for pickup at office, Deliver w/inspector.
Copy of plans sent Health Dept.; Fire Dept., Other Date
The following data must be submitted prior to permit issuance: (Circle new item not checked above).
1. Index permit for above items No. —
2. Additional items required: —
Contractor, designer, owner, was advised of above required data by_phone_—naiI—counter by date
Contractor, designer, owner, was advised cl above required data by—phone —mai I—counter bye, date
Plans checked by
Copy–DPW
Date Plans approved by
Sets of plans on hold in File cabinet AP folder
,A _
�• 1. _ ..
.t � �/ :'!a �''4i. _ l .,-I U�' e
r
+^
J
a
`
.
.. - ..
.T � is-� ._.
.{'. }C' f +'iJ It'.
.. .�c . •'Ce 11; �1
= OK
0=Not OK
NotReaable= dy' MOBILE HOMES.. ` s.' MISCELLANEOUS
Date" ` `"MOB ILE`HOME'UTIL'ITIES"(Plans) OK except#'s '..
< Date
DECKS,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s:
• 1'.Zoning.Requirements=Setbacks-Easements:
1. Zoning Requirements -Setbacks -Easements
;,`•";` ` ,,,2.,Soils;:$peciAl MH Support -Sketch • -
:2: Footings; Soils -Size -Depth -Spacing -Connectors -Steel
_
"3. Sewer, Location-Test-Fall=C/Q;Concrete
..
3: Decks;.Girders and/or Joists -Decking -Bracing -Stars -Rails
...,$_4. Water „Location -Test -Easement Needed,.(Sketch)
4. Wood ' Awn.; ' Posts_Beams-Rftrs.-Connec.-•'
- Shthg _-Rfg.-Bracing'
5:. Electricity; Location=Clearances-Wnd:-/ /Amp -Concrete
- --
,6.'Gas; Location Test'Wrap / .,/ L"ft: �;
/. /" Nat.'or/ /L".ft / ; /'LPG_
—
- S. .Alum. -Awn.; Columns-Connections-Splice-Decal=Enclosures.
6.,C®rports; Windows -Doors - -
7-Utility:Clearance _=. . - :'
-
7. Elec:
- -
8. Frm Sills-Anchors-Studs-Rftrs-Trusses
.1
9:Siding; Nailing -Veneer -Stucco -Mesh
Card=91 Date' -Card-'131, .. ; .Date "" _
10: Roof; Shthg-Roofing
Card -B1 ' : , , Date-. : ' Card -B1. Date .'
11 ,Ext.; Steps -Doors -Landings -
Date " MOBILEHOME',INSTALLATION:`(Plans) OK except:#'s"
1: Zoning Requirements,Setbacks=Easements. •-
Card -61
Date. •-•Card-131 Date
2. Footings; Size -Spacing -Marriage Line
Card -131
Date Card -131 Date .
3. Gas;'MH-Test-Demand-Valve-Connector
Electricity; MHTest=Crossovers-Breakers-Clearances"
Date
POOLS (Plans) OK except#'s.
5. Drain; MH ,Test -Fall -Flex Connector
1. Setbacks -Easements
6. Water; MH.Test-Regulator-Connector
..2. Soils; Compaction -Structure Stability ,
_7..Water and Sewer Connected -C/O to_ Grade-HD,Approval•
.3. Pool Structure; Steel -Connections -Thickness- ,
Dead Men -Lining
B.,Gasand Electricity. Tagged ':
9. Exits'dnso.-Sketch'- :'
-4. Elec.' Receptacles and Lighting, Distances-GF1 .
10. Cert. of Occupancy
g
5. Elec.; Pool' Lid hting;.15'volts-GFI
,., .
6. Elec.; Enclosures;.Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8: Elec.;Ground ing; Equip. w/5'-circulating°Equip:-Pool Lghtg.
Boxes- End losures-Panel boards -Ins. to Main in Conduit
Card -B1 Date .. Card -131 Date,
Card -131 Date Card -B1. Date
9. Health Department Approval
-. - -
-
10: Plumb.; Cir. Test -Water Supply Test
:Card -B1
Date ;Card -131 Date:
Card -B1
` Date Card -131 Date -
= OK
0=Not OK
- = Not Applicable'
= Not Ready
RESIDENTIAL (Single and Duplex),.
Date:
UND LO,OR (Plans OK exce t #'s
Date
FjiA)IlffiCi (Continued)
mg'requirements=Setbacks-Easements41gers-Post
Caps -Anchors -.Connectors
than; Soils-Steel=Elea Grnd.-/ i /" Ftg..Depth
Jpg. Joist-Rftr. Ties-Purlin=Roof Brac.-Truss-Shthng.-Rfng..
. tg., Garage; Soils -Steel=/ Ftg. Depth
. i place Ties or Type7A Flue -Fireplace Throat., .
4. F ., Porches'& Decks; Soils -Steel-/ /"Ftg., Depth
KAtpt At'Access; Size &Romex Protection -Draft Stop -Ins. Baffles
feails, Main; Steel-Blockouts-Wrapped
m. Windows -or Exiting Doors -Sill Hgt. & Dimensions
e walls, Garage; Steel-Blockouts-Wrapped
AIr. Garage Fire Protection Framing
Atograb; Steel -Wrapped
.a`6'
arty Line Firewall &Openings
8. Pi - -Steel
xt. Doors -One 3' -Check Garage -3rd story, 2 exits
'W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test
r62r9tairs; Width- Headroom -Rise=Run-Landing- Fi re` Protection
10. Gas Pipe; Size -Anchors
ywood on Roof Overhang -Attic. Vents-Rafter.Outriggers
iy�ater Pipe; Test -Anchors -Regulator -Service Test
54. Siding -Nailing Veneer
12:Electric; Underground
55. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access'
13: Plenums & Ducts' Clearance-Material-Supprt-Ins.
56: Glazing Area -Glass Protection -Skylights -Plastic''' .
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
rWalls;Nailing-Bolts'
15. Insulation
. Insulation-Wells-Clg.
09. Tnfiltration-Walls-Wndws
Card -131
Datyw Card -131 Date
Card -131
Date Card -B1 Date
'Card -131
PdieCard-B1 Date
-Card-131
Date Card -131
Date
PL G Permit OK except #'s_
e
-
ter Ht. Vent -Access -Combustion Air
,Date
OK except #'s , - ;' `^Crr1
er. Pipe; Test & Anchors -Nail Protection
_
St s=Door & Sidelight Prof
. D.W.V.; Test-Fttngs & Anchors-Nail'Protection
a Detector
9. Shower Pan; Test, First,Floor-Tub Acces
.- Furnace; Vents -Clearance -Comb. Air -Connector -
In _ age; Above Floor-Ducts-Mech. Protection
Tub & Shower, 2nd Floor -Tub Access
Gas,Pipe; Size &-Anchors
ftEleSLworn Exiting
.F . & Bath Fixtures & Tub Access -Spa -
"16c. Trim & Subpanei; Breaker. Sizes
Card -131.
Date Card -B1 . , Date
-Labels
W. airs & Rails
Card=131
Date Card -131 Date
fireplace or Stove; Clearances -Hearth
Date
ELECTRICAL Permit OK except #'s
c. Outlets at Wood Panel; Int. & Ext.
xture & Transformer Clearance -Ins. Protection
it. Ffxt. & Appliance; Grnd. -Air Gap -Cooking Clearance
tkl'EJiqc.' Receptacles Spacing=Lights'& Switches at Doors
VI-Iffigp. Outlets & Receptacles at Kit. Counter
. Size Boxes & No. of Conductors -Stapled
76,10arage Fire Door; Swing -Landing -Closer
Romex Installed Close to Edge of Studs &
• Duct in Garage -Damper
quip. Ground made up°w/Mech. Fasteners- - Water
r. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
Inf3arage; Above Floor-Mech. Protection
Appliance Circuits in Kitchen &Conductor Size
7dt!�Jb� Elec. & Mech. Equip. Listed for Location
U Sd6feed Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga.
1. Cu or Al
, E!oe,.�Receptacles in Garage; (G.F.I.)-Romex Protec.
nge Circ. / ' / ga. Cu or AI-Oven.Circ. / / ga. Cu or Al.
Ins ted_ Neutral Yes No
�!�nsulation-Foam-Looked in Attic D Yes
. Guard Rails & Deck Construction -Post Caps
vice -Riser Conductors & Ground -.Main Disconnect
__48—nn.
Vents & Crawl Hole Door -Drainage & Wood -Earth
Clearance Looked Under Floor o Yes
440.�Eq_ulp. Clearances Panels-Motors-Mech. Equip.
lothes Closet Light -Shower Light -Spa Light
79. Following instld.; Drive es o No; Walks 0 Yes . 0 No
Planters O Yes Dlqo
�ee'Ssco; Brown -Finish
Card -B1
Date Card -B1 Date.
A. . nit; Disconnect,. Electrical, Plumbing
Card -81
Date Card -131 Date
WVents Above Roof; Plbg.-Appliance-Firepl.-Clearance to
Openings.
Date
M H ICAL Permit OK except #'s
mer Well; Disconnect, Electrical, Plumbing
C. Ducts Insulation & Support
$4.—Exterior Elec. Trim; G.F.I. Receptacle -Underground
44 nt Fan;.Exhaust above insulation `
entflation throughout House
Sidndensate Drain & Overflow; Size & Grade
rnade-Vent; Access -Comb. Air -Return Air Vent -115 outlet
AK -Glass Protection
87. Cqrrectlonfrom Previous Inpections
Attic Access & Platform if•Furnace in Attic
88. Ga st-M s Tagged; Gas-Electric_%/�S//,jrj,�g+7
ater & Sewer Connected -C/O to Grade -H6 Approval.
-
nergy Compliance Certificate -Other Certificates
Card -131
� Date Card -B1 Date
Card -131
Date Card -131 Date
Card -131
,. Date Card -131 Date
Date
F G (Plans OK exce t #'s
Card -B1
Date V) -/Card -1311 Date
,Siff"Proper Material & Anchors
Card -B1
Date Card -B1 Date
W. Wal Studs -Nailing, Spacing &Bracing—Plates-Sound
=Comments aYFlnal:
e ' g Wails over Girders & Floor Nailing
r top in Wails (rat proof).
4 re Stops; Furred Ceilings -Stairs -Chases -Tub
Header & Beam -Size & Bearing
(NOTE: An entry.must be made each time..you visit job site)
Owners Monty-Betty/Krause
Permit -No.
ENE R G Y CE.F1.T IF I C A T 1 0 N
Lot # 112, Big Chico Creek Estates
LOCATION
A.P. No,
DESCRIPTION
OF INSULATION
ROOF
Material
Brand Name
Thickness(inches)
Thermal Resis"tanceT(R Value)
EXTERIOR WALL
and all required items as shown on the
Material Fiberglass
Brand Name Certainteed
Thickness(inches) 61"
Thenal' Resistance(R Value). R-1 9
CEILING
."r
Batt or Blanket Type N/A
Brand Name . Certainteed
Thickness(inches)
ThermalResistance(R Value)
Loose Fill Type Insul-Safe III
Brand, Name Certainteed
Minimum.Thicknesi(Inches) 11"
Number of Bags Wt. per bag lb.
Area covered(ft. ) 2015
The.rmal•Resistance(R Value) R-30
FLOOR, ELEVATED
Material Fiberglass
Brand Name Certainteed
Thickness(inches) N/AThermal,Resistance(R
Value)
FLOOR, _SLAB.
J1?oivey �crr
Material
iirand Name
Thickness(inches) '
Thermal.,Resistance(R Value)
Width(inches)
rint
P )RACTOR'S
FOUNDATION WALL
Material
71rand Name
Thickness(i.ncl►cs)
Thermal Resis.tance(R Value)
I hereby certify that the above insulation
was installed in the above building
- in conformance with"the State of California
Energy Requirements.
Shasta Insulation
# 272941
FIRM M%�JE/OWWER
STATE CONTRACTOR'S LICENSE NO.
RAC1'OR '
DATE
SIGNATURE -OF INSTALLATION APPLICATOR
DATE
.OWNER
January 198,;
I hereby certify the above insulation
and all required items as shown on the
Building Department approved plans and
ate-:achments have been installed.as
."r
required by the, State of
California Energ_: Requirements.
All equipment, devices and materials are cif the quality prescribed or are
r
specifically approved by
the State of
California.
"<!
"
J1?oivey �crr
c �,� sT-
g 5
`
FIRM NAME/OWNER .(Please
rint
P )RACTOR'S
STATE CONT LICENSE NO-
`'"`
SIGNATURE 0 ENERAL, CO
RAC1'OR '
DATE
.OWNER
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 198,;
COUNTY OF BUTTE = DEPARTMENT'OF PUBLLC WORKSA,,,ZP�E MIT NO.,f
7. County Center Drive - Oroville,'Califprnla 95965:•-i.Telephone. 916Y538-7541 v
APPLICATION. AND PERMIT:
'ASSESSOR PARCEL NUMBER - -•
-�.
Z N'ING-
''BUILDING PERMIT. r
OWNER ,- ..
LA�
TELEPHONE'
�ff6- a61o
SO. FT. ,-OCG. BUILDING VALUATION •.
o
o4 oo
.OWNER -.5 MAILING ADDRESS -
Stiefd��P�l..
✓ope
0
-.CONTRACTOR'S NAME
N
-TELEPHONE
/.— O
•'" �'-
. CONTRAC OR'.S MAILING ADDRE49- - - -
S
FiYeplace �..
O b v. C, .
• CO NSTR TION LENDS - - ,
UNKNOWN..
Total Valuation .$
:Filing Fee: -�
$- 10,00
LE'NDER'S MAILING 'ADDRESS - _
4
Permit Fee'.*.` .
$ , r.
•ARCHITECT(ORR G�NEER-LICENSE No -- -
_ S.MAILINGAD,DRESS . .
ARCHITECT OV7 ENGINEER „
ti
Flan Ghecking.Fee -
;
:Ehergy..Plan Checking Fee
$ : iS...aL)
.,Penalty 7
$
' BUILDING ADDRESS. -
- - -
Permit fee-
$ `6
S ..7
PLUMBING PERMIT'
Filing Fee 10.00
ach:Trap,
1 2.00 ay, cyc,
-.Solar'or heat pump water. heater
20.00
I LOT NO.
�_
SUBDIVISION NAME- . -
I-��c.1 G � c�F� T
CEL �MyAP
IPT
.�zl -
-Water piping -
.5.004
Each pas water heater'or Vent
5.00 , CS.>
USE OF STRUCTURE
SF,� .Duplex'❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00 Is, CxO, . ,
Building sewer .
15.00 - !JD
Mobile Home S 1 G W
O.00ea
TYPE OF WORK
New Addition ❑ • Remodel ❑. Utilities ❑ Installation❑ .Other ❑
Describe work:
Permit Fee., .
$ , 04D ,
Contractor
ELECTRICAL PERMIT .
Filing Fee 10.00:
Main'service'e00V OR .LESS10.00
100 AMP OR LESS
/d, CJU -
Main rs Ce EA, ADD'L 100 AMP
2.50'•
- _
CONTRACTORS LICENSE LAW
I declare under Small of perjury, -,(check
penalty p y' (check one):.
[ell11am licensed under •_ provisions of Chapt: 9, Div. 3 .of the BusinessPOWER
-and Professions Code and my license is in full force .and effect...
"
License No3o Rl--cy5 Classification - r
❑ 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 Iicensed'.contract-'
ors. (Sec.: 7044)
❑ I am exempt under Sec. Business and professions Code
for this reason
ST: DWELLING OCCUP.8
ADDNS. 'ACC. BLDGS.
NEW CONSTR MULTI -OUT LET 2.50 Ba
NON-RESID BRANCH IRC ITS)
APPARATUS E l
SINGLE OUTLET'CIR,
EX, OCCUp�OUTLETS OR FIXTURES 20930t
°AL@30
FIXED APPLES„OR
Ex. OCCUp. OUTLETS (RESID:) EA.) 2.00"'
Temporary service . 10.00 0;uo '
Mobile Home Facilities 15.00
Misc.-Wiring 15.00
Permit Fee $ / . a0
Contractor
WORKMEN'S COMPENSATION INSURANCE .
I declare under penalty of perjury (check one): -
❑ The permit is for $100.00'(valuati6n) or less.
Qlhave 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 shal l be,deemed revoked.
MECHANICAL PERMIT
FiIingFee. 10.00.
Heating-. Q boo
'Cool i ng ;'3 y
; CUP
, Hood.
3.00 3. op
Ventilation,
Cw
Permit Fee
$ cx3
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,represent atives of the County 9t
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 ranting.of this.peirrit
X " ate
Si nature of cunt — .. Owner ContractorVA:gent
-,9 PP,'
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
$
Energy Inspection Fee $ d,'�j
TOTAL PERMIT FEE $ $q 70 .
o SOP.
x+3
`
CON ST. TYPE
`-SUN
FLOOD
CE
PD N I
This permit -is hereby issued under
§ions of the Butte County: Code and/or
work Indicated -.-above' for which
• DIRECTOR OF PUBLIC
By
.
PER . EXPIRES. Date'
the applicable'provi-
resolutions to do
fees have been 'paid.
WORKS
Date �— LZ - 1” 7
Receipt'No. - e :.
3� -�
WHITE-D.P:W., •ELLOiV438E33OR,'PINK-INSPECTOR, GOLDENROD -APPLICANT ,
i
04.Y
V t4!, '4 TIN 1"' --10 T VO-1 0
L
az�
.t`'f a Ork X
U'L p
. ic—
d I R -,IA 54 0e
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77
d,�V*i T A-'�
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F."o nVi"! ;00 00 P. r-1 F—,t
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"'�,00,rf
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61�r ')V" , ObOy --1 a1 I
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wi�vva
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e, fi'j
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TIV
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77
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fir.. •h:....-__, v:.-...v,.,,.....rw.-....„„^^:r^':-^-..y.��r..,...+.r_,�•r •rte: m"'vax't,ff"-,r,�ysta'.•''ac.�*,.^`yt:.....• J�."r.,:.r "•x.»1.;1<;, ... ,
^.: COUNTY OF BUTTE -DEPARTMENT OF`��UBLIC WORKS -BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CARN�FA 95965 - TELEPHONE: 916/534541 /
PERMIT APPLICATION DATA SHEET t l
Permit No.
OWNER A etv A P. No:
Proposed Building Use S/F Building Inspector Date (&/-3/S-7
'-At time of permit application, I was advised the following data must be submitted prior to permit processing
andJor issuance: DATE RECEIVED APPROVED
1. All items have been submitted. . . . . . . .
_* Clot plans in duplicate/triplicate, signed by preparer of plans: .
3. omplete plans in duplicate/triplicate, signed.by preparer of plan ,
4. Complete engineered plans and calc's, with wet signature on plans.
5 Plans with Energy Design Compliance Statement.
K_- , CUSD '-Fees-PaWs'-Stamp-on-�F,loor Plan . . . . . .
. Statement of. Int�ht6for N, 2prr-Heed iAd
8. Fees of. $ . . . . . . . .
/99. Letter of signature authorization. . . . . . . . . . ..
Sanitation approval from 4_kt« Health Dept.
1/Planning approval for (A) Use: (B) Parking: ,
1 Certificate of Workmen's Compensation Insurance. . . . .
13. Contractor's License Information (no., name style, classif.)
14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ ).
_15. Improvements may be required.
16 Mobilehome Installation Data
•
17. Pre -Inspection for Required. Pre-Inspec. request to (Date)Building Inspector 4
18.Recorded copy of Agricultural Acknowledgment Statement.
19. Driveway Permit.
220. Plot plan approval from city of
._,'9 1 - 1,w11— 5 sro.. 6_4-. 1,v,,11 se, q_ Se.w-er Z
When you issue the permit, process as follows: Mail to owner, _MaW to contractor.
Telephone and hold for pickup at—off ice, Deliver w/inspector.
Other -
22.
Copy of plans sent , Health Dept., Fire Dept., Other Date
The following data must be submitted prior to permit issuan e: (Circle new item not checked above).
1. Index permit,for above items No.
2. Additional itl ms required:
Contractor, designer, owner, was advised of above required data by_phone_mail_counI by date
Contractor, designer, owner, was advised of above required data by_phone_ma��our) r by date
Plans checked by
Date Plans approved by
Sets of plans on hold in File cabinet AP folder
— Flours: 10:00 a.m. - 3:00 p.m.
5.
Copy—DPW.:
,d-. ,.
TO:' -.Building Department
FROM: Encroachment Permit Section
'RE: `.,D*Iuew;yI.ICIearqnce
eP7 A 9z LIP .5,
4
owner,
location
4P #
Driveway permit
has be n is6u"ed.for-the above—oroperty."
number
a ature
date'
ORM
RESIDENTIAL ENERGY PLAN CHECK/INSPECTION SUMMARY I
Owner pV Climate Zone _ Permit No.! 2,6
Floor Area
Compliance path: Package ❑ A ❑ B ❑ C Point System'Cl Budget C,Other A 6 j1_
MIN. R -VALUE DESCRIPTION
REQ'D
(D) Moveable
INSTALLED. ITEMS (1)
INSULATION:
Rte.
Roof/Ceiling.
®�
Walllie
❑
Slab Floor Perimeter
❑
Raised Floor
(2)
INFILTRATION•
❑
(A) A vapor,barrier is required in climate zones, 1, 14 & 16.
I�
(B) All manufactured windows and sliding. glass doors shall meet the
1972 ANSI Air Infiltration Standards and shall be certified and -
Type
labeled.
(1�
(C) All swinging doors and windows leading to unconditioned areas
MC=,3_
shall be fully weatherstripped. ;
�= y, ,�j�;/,f,
BUTTE COUNTY
❑
Tight - the above standard features plus:
(�
(D) Continuous infiltration barrier BUILDING DEPARTMENT
❑
(E) Electrical outlet plate gasket
❑
(F) Air-to-air heat exchanger P O V E D ".
(3)
GLAZING:
❑
(A) Location
Area Glazing %Floor Area Single Double Triple
R=
Total Bldg 407
MC=.
North / �3. -
s
,�I;1 —X .
East7.
❑
South o3~ X,
West`..3'
❑
Skylights
MC=
(B) Shading
Shading
Q�
Coefficient D scrtion
East
74
South 4e y/
R=
West J1.�
❑
Skylights
Q�
(C) South Overhang
7/83
Length of projection .. ft. Description
❑
(D) Moveable
insulation:
Area _ft2 Description
(E) Thermal mass
Type
- Areaa7s3' Ft. 2 HC=I_YXL
R=
MC=&
Location
[H
Type
A
Area Ft . 2 HC= /2R= ,/3
MC=,3_
Location
�= y, ,�j�;/,f,
❑
Type
- Area Ft. HC ---'R=
MC=
Location
❑
Type
- Area Ft. HC=
R=
MC=.
Location
❑
Type
- Area. Ft.2 HC=
R=
MC=
Location
❑
Type
= Area Ft.Z1 HC=
R=
MC=
Location
7/83
Ir
❑ (4) MASONRY AND FACTORY -BUILT FIREPLACES shall bei equipped with -tight
fitting closeable metal or glass doors covering the entire opening
of the firebox; a combusion 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.
o -
1 ,..
(5) HEATING, VENTILATING, AIR:CONDITIONING SYSTEM
(A) 'Heating
0 Central GasFurnace
brand and -model number SE
Btu/hr
(heating capacity)
❑ Heat Pump
(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 1
(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 & INSULATION. 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 provisioris of Section 1005 of the UMC, 1976 Edition.
j
7/83 2
r
(6) DOMESTIC WATER SYSTEM "
(A) Gas Only Gallons:
(brand and model number)- (tank size)
❑
Heat Pump w/Electric Backup.
..(brand and model number)
Gallons .
(tank size)
*21Active
..'.l _ ❑
Solar . -
.(collector brand and model number)
(rated y -intercept) (rated slope)(solar fraction).
-
ft2'
(backup heater type, brand and model number) (collector area)
(collector. orientation) (collector tilt)
13
Location f Solar Panels
❑ .
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 feet of pipe closest to the
.water
heater and outside conditioned space shall be insulated with -a
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 -documentation 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
following:
Heating: Winter
design temperature°, ;elevations " Sa,0 ' , heating load ,?� JC BTU
-elevation
factor f61 -d x heating load = maximum'outlet capacity gas furnace
06 D BTU
Cooling: Summer.'design.temperature
/OJA), °, cooling load BTU
(USE ONLY AS A SIZING GUIDE, COOLING MAY BE INADEQUATE)
*2 Submit T.I.P.S.E.
chart or other approved system (form #5) to document sizing of
solar panels.
® DESIGN COMPLIANCE
STATEMENT: The above building design meets the requirements af..
Title 24, .Part 2,
Chapter 2-53 of the California Administration Code.
7/83
SIGNATURE F.BUILDING ESIGNER OR APPLICANT
r
ZONE. 11''.Table.3-3a. Ceiling Insul.tiorc .--Table 3-77. South -Fact n Clazin Pte. -Table 3-10. Shadlnk Coefficient Points
POINTS
OWNER ��• d2 iCI�'t,
points
( titlon .-I
1 K ,
East
PERMIT N0. a •' % - % ASSIGNED.
ACTUAL
1 R-valtia of Iaeulacfon l Zi6ta I
I I Glazing Type
I,. Total' i'
'i SLAB - INSULATION "
Y)
1 0.-1 +1 I +2
2 of. f Sngl, ,Dbl,. .Trill„
I,(U -. I (U - (U
2. PAISED FLOOR - . R=19 • '�-
-'
19 -' I -d, 1
0
_I
.1 • Area • ;.il' 1.10) 1',0.65) 10.41)
- 30 . ,�..
-�
:i 22._
1 1_3 0 I�,
`-South :I 0 1•.3 2 1 6..4 1 a O -j. 9.6
1 ants I points 1points
•
O . +! ♦! a 3,"1
3-. ..CEILING .R
1
WALL pR
..
I: 38 ;I' +2 I
49,. I ° +8 I
•,I
al
::
up,,to 1:5 I, +2 1. +2 1 +2.: 1
1'. 6-.3.6 { -1. F 0,. I o;•I
.19
L I
0 12 ' 1 0 1 +1 1' +3
.13 36 .1 10 1. 0 1 0-1. •.0,1-•.0
.a
377.'57, > 1 0.1 1 1 • =3-1 6:;1 ..-7.
c'
5. NORTH:GLAZIAG 2,4�'3.6� ''•7t�p
''- _-
Skyllght''I 1 "1. -.a.l 1:6 13..2 1. 4.0
I , 5.3- �6s 6.. 6: Li��l -3 `I .
-1.5 4 3:1
_0-10 htl'1 7 I . +641:: *7,
13. 36 0 .0
58 82---1 I 3
6..£AST'GLAZING 2:5-3.67. c�i
I ' T e .8.9 I' .:-11 I "-B I 7•"
7 .. SOUTH; GLAZING -1:6-3:6%.. -
`'
9.0-10:0 1 -13 I -10 - . I . -9 i
Table 3-4a. 'Wall Insulation Points ( '10.1-11.5, I. -17. : I -13 1 11 ..I
8: GLAZING 2 9 3.67.1.E
Fj
I, R -value of Insulation I. Yoiritb : I
.1.6=13.0;1 =21 (.-16 1 if?:I
1 '13.1-14.5 1: -25 1 =19'. I:
,WEST
1 I' J-
1 14:6-16.0 1. -29 1 -22 .-I -19
9. SKYLIGHT .'.. 0-1.3i
t
10. SHADING°(Exclude',:Overhang)
1 -19" -') 4 0 I
^Table
3-8. -{leaf-Faeln Glatln Pts
r
I -24_
EAST bby i,G G
-- I I
I
Glazing
•' Total L' -Type
SOUTH 19-.42
i
1.
x of ' I Sngl, Dbl, • Trpl,
.'. WEST 5 13-::36 C _
`�
table ]-5. Horth-Facin Glazln Pts
Floor ' I (U(U
Area. I 1.10) 1 0.65)•.1 0.41)1
SKYLIGHT 37, ' 57 '�'��
��
U. 1 Glazing, Type.. I
.1
I
,
: I oints I oints 161n'ts l
11. HORIZONTAL' SOUTH `OVERHANG 2'
r
I Total ( 1.
I'' hof .'I Sngl,IDb-, ` Trill,
1
. l
o• •6 1 •6 +6
up to' 1.3 1- +5 I +6 I :. +6 .I
1.4 y2:3 h.+s+3 1' •'Ii
MOVABLE INSULATION NONE
Floor
Area 1 0.66
1 0.42
U
10.41 {
"
>3
- 3.6 -3 0 tl '
y
13. ,INFILTRATION (Standard= 0)
1.10
0.65
down
.I
4 3_
o
o a ,
a �...
♦�.
THERMAL MASS.VI3.a'AtSF
-. �-9 "
1 0 1--1'.2 1 +4'
I 1 3- 2.3 1 +1
! +4
I +2
1= +6 1
I. I-
1
:'S
S 1-•5.6 I'- -10'
3.6 1 ,:-2
,
I 0
_+2
11'
- 1
S•7= 6.2 1 -13 F -B. I -6 .I
6:3- 6.9. 1._ -15 1' -10 1_„-7
15. GAS FURNACE- -(SE) '. _ 71-767
I 3.1=; '4.8 1 -6. '
1 . -2
7.0- 7.6 I`.:'-18
_
.
7.5-7.'9%
HEAT PUtfP, (EER) ,•I'
I' 4 9- 6' 1 1 " -7
6.2- 7.3 I -9
I '4
I 6 I
�' -3.:1
-3' 1,'
1
I
7: 7- 8.2 I -20 1 -14 1 -11 )
8.3- 8.8 I -22 f: -16 ' I'
17: DUAL PACK (SE, SEER)", -8 3/71=767
An
_
1 7.4- 8:2 I -12
`I' 8.;3,`9:71' -14
I -8 I
Imo,-T0�1
..-7 I'
'-8 L_
. I.
1
-13 .J
8.9- 7:5 1:: -25.:1 .:-18 I -15
9.6>i0:i: { '-27 1 '-20 . I _-16.*;:I
WOAD 'STOVE --
-,I: 1.8-10.8 1..._17 I•
1 10'9-12.0 I -19 I
-.=12 1-,-10 I;
_-14 I -12. I
1
:' I
..
10.2-11-•0.1 r29' I -23 I 17-- 1
11:1-11.8 I -35 I -26 1 21 :.I '
,.
YEA
1 12.1-13.,2 1. -22 .I
33
1.14.6-15.3 1 -27 1
-16 1 -13 I.:'j
-1s
ITER
-20 1 -17
I
,
11.9=12.7 I -38 'I -29,1-'424'.`-,.I1I
`12.9-3.s :-z -32'1 z�WATER.
13.614.3 -46
TIL'' �O TI Ufa
f 3
1 1 I I (
1
..735 -29'.
.14.4-15.2 I '' -50 1 =39 I -32'.T
SC by
1, Orten-. d 2:Floor -Ares
( titlon .-I
1 K ,
East
I. 1 3.2 1
.:
1 ;
.
10-3.1,1 to 16 4 up '...
6.
1 0.-1 +1 I +2
I A .491
20 36 ,1
0 'A 0 1 . m -
:07 66
0
1. ; .8] up
`-South :I 0 1•.3 2 1 6..4 1 a O -j. 9.6
Ito :I to I to I to ` I up
I a '- 13.l lr6 3 l X7:9. 19.3`-•I.
I ,.19 42 •I 0 I.; 0 1 0 I 0_I:: 0
I.43 66 10 A-1 I1'2 I -2,:'I .-3
`0.
I :67 up =1' -4' 1. -6
West "I' 1 I 1 6 k 3.4 I 64'.;1 -a.0
to I;'to I to' I to ';I',up
tl 1 5-1-3.1-0.3 1 7 9: 1". ,
L I
0 12 ' 1 0 1 +1 1' +3
.13 36 .1 10 1. 0 1 0-1. •.0,1-•.0
.a
377.'57, > 1 0.1 1 1 • =3-1 6:;1 ..-7.
.58 82 'I. 1 '1C::93 1t�-6 I 12 1 � l5
.8� up 1 -2 I 4 1 -a I-16•.1 -20
I° I 1.. I I .
Skyllght''I 1 "1. -.a.l 1:6 13..2 1. 4.0
1 -to I to. I to- 1.w_l-to
-1.5 4 3:1
_0-10 htl'1 7 I . +641:: *7,
13. 36 0 .0
58 82---1 I 3
:a3 up I 2 t. =4 .1 8 . I 16 i• -20
Table, 311 - rRorizontal South
OTHER
Overh'ana.Points
Table 3-9•-: Sk light Points South-Glazlag
% TOTAL '�OINrS - _ ��G� 7able'3-b: East-Facin Claxin .Pts. IiLength Out I Area Z,of Floor -14
1. 1 Glazing Type I,f .hfrom Wall
I claxing Type 1 L ., Total I I I ft
-,I Total 1'
-of, Sngl, Dbl, . Trp1,-
0-6.3' 1 ' 6:4 up I -
. I I of - .1 Sngl, ' Dbl, Trill, 1-Ylooi; 1 U 1 U'.. .I U'
?able 3-1. Slab Floor Points Table ] 2 Rafsed Floor Points 1 Floor ' 1 (U I (U - I (U - I 'I Area 1.0.66-•1 0.42- .1'0:41 I 0.5 -2 -
I Area. 1 1:10) 1 0.65).1 0.401 •1 `I 1.10 1 0:65 1/down 1 1 0.6 .1.0 1 --2 '1 3 I'
I ' 7n ••jla- [ 4 -Value of. Insvletlori I 1
I - '_ ,I-Va1-e �1L'o+'nts I .oints-. 1 olnsT
1.1 1.99 11 -1 „ 11 ; .2 .zIl1
up to l.] 0 1Inpuu�� r�o rlue lYo2.2Derch;; „pco 1:3 I +] +4::. 1.4 z
-4 -3 ] 12.Movable'Insulatfon6I
I trichesI0213-4-1 5- I �+ Yy`
_,.
be r 3 3.6 1
I 1 2.5 ' -2 0 29 _3i6 I. O I. I I I -9 I -6. 1 -s 1 Points
3.7- :6.6 C -5 I . -2 I, . -1 " I `I ' .3.7- A.2 1 -11 I y'=8' ') =6 1 y rt
1 r0 _11 1 .-5 I- -S I ( -S 1 =3�I> .1. ' S -7 I 1 I 4.7-_S.6 1 -8 I -4 • I -3 1 I 4.3- 5.0 1141 -10. I 4a ' I !lo abla•.Insulatioa I i I-`
i iT- 1S I -3 A _3 . 1, -2 ; I 1' • I I .. a'= I -4 '- .I 1 5.7=,6.7 1' -10 1 -6 I -S I I : 5.1- 5.6 1 -16 1' -i2 ) to l ': F Area ' Z,oi'Flooc /I' :Points I '
6. '- _• � j ' :L6.8- 7.7 l:.-131. I (: - -7 . 2191?I-1'4',,
ib _ _12-5 -2 0 8 -//
0} 6 I=1]20 1 -5'A -1 ' 0 I +1 7.8-,8.7 1S -10 .3,69,1 i { : `✓ �
8.8- 9.7 1 -47 I ._ -12.1 -10
' . .-_7 0,- 76, 1-44 I -a \-15 1 1 ,.'0 x;S s
20\ `-17 6 11.5 . .�.:�+2-11.x.1 -2l I -15 I -13 7 7 e2- i -z6 I -
Al: 3-12.7 -18 1-1s 8.
3- a.61 -28 1 ; -i 119 I I 11.6 u.,5
2.8- 76:7 7 �.�3 ' 1 3.5 4,6,-3 9.6-10.1 33 26 I-114 1 15.3 o
;
`23.6+' 1 +a
Table 3-13. Infiltration Control
Feetures 'Polab
,-�-
1 Coctrol Features I Pointe I
I I
Standard I 0
0.9 air changes per hr I
Tight I +12
0.6 air changes per hr I
I
Table 3-I3. Cas Furnace Without
- Refriaeratlon Cool!ne Points
I Seasonal Efficiency I
Points I
' (SE), i I
I
I 71 - 76 I
0 1
I 77 - 82 I
+2 I
I 83 - 38 I
+4 I
I ' 89 - 94 I
+6 I
I 95 up I
I I
+8 I
I
I +13 I
I 9.7 -
Table 3-16. Heat Pumo Points
Energy Etfic!ency I Points I
,I Eatlo (EER) 1 I
I 7.5
- 7.9
I +3 1
I S.0 -
8.3
I +6 I
I 3.4 -
8.7
I +9 I
l 8.8
- 9.1
I +12 I
I 9.2 -
9.6
I +13 I
I 9.7 -
10.2
1 +L8 I
I 10.3 -
10.8
1 +21 1
I 10.9 -
11.5
I +24 I
I 11.6 -
12.3
I +27 I
I 12.4 -
I
13.2
I +30 I
I I
Table 3-17. Cas Furnace With '
Refrieeration Coollne Points
'Refrigeracionl Gas Furnace I
I Cooling I SE ; 1
I171 -177-i 8 - 89--T9-5-7
1 1,761 821 881 941 uo 1
1 e . o. - 8.3 1 "OF +21 +•41 +61 +8 1
1 8.4 - 8.7 1 +21 +41- +61 +91+10 1-
1 8.3 - 9.2 1 +41 +61 4-61+101+12 1
1 9.3 - 9.7 1 +61 +81+101-121+14 1
1 9.8 - 10.3 1 +81+101+121+141+16 1
1 10.4 - 10.9 1+IG1+L2i+1.1+161+18 I
1 11.0 - 11.6'1+121+1.1+161+181+20 I
7/7/83
TABLE 3-14 (ADAPTED)
MASS OWEL1
AREA 1,000 1,500
SQ. FT. , A 5 C D A 8 C
Z X70i 103.
200
253
7 y, 300
l 400
50
600
703
230
L03
l,e.o
1,;00
1,200
1.100
7,400
1.SOo
2,300
2.507
J.000
3,500
4.030
4,500
_ 5_o _
ZONE it
INTERIOR THERMAL MASS POINTS
TARE FOOT
,00 2,500 I 3,000 3,500 4,000 I 4,SG0 S,000 i
C D A 8 C D A 6 C D I A B C 0 A 6 C 17 I A B C D I B C D
2 2
2
2 2
2
2
0
1 2
2
2
0
1 0
0
0
0
0
O
0
0
o
0
0
0
0
0
0
0
0
0
0
O
1 0
0
0
1
4 4
4
2 2
2
2
2
2
2
2
..2
2
2
2
0
2
2
2
0
2
2
0
0
2
2
0.
0
2
2
0
OI
0
o
0
0
0
6 6
6
4 4
4
4
2
2
'2
2
2
2
2
2
2
2
7
2
2
2
2
2
2
2
2
2
0
2
f
2
0
2
2
2
0
8 8
6
4 6
6
4
2
4
4
4
2
4
4
2.2
2
2
.2
2
2.2
2
2
2
2
2
2
2
T
2
I
2
x
7
ti
10 10
8
6 k
6
6
4
6
6
4
2
4
4
4
2
4
4
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
2
12 12
10
6 8
B
6
4
6
6
6
4
6
6
4
2
4
4
4
2
4
4
2
2
2
2
7
2
2
2
2
7
2.
7
2
2
;!
14 14
l2
8 10
iG
8
6
6
6
6
4
6
6
6
2
6
4
4
2
4
4
4
2
4
4
2
I
4
4
2
7
2
2
2
It 14
12
8 10
108
6
8
8
6
4
6
6
4
4
6-6
4
2
4
4
4
2
4
4
4
2I
4
4
2
2
4
4
7
2
2
2
18 18
16.
10 12
12
10
6
1
10
8
6
A
8
6
4
6
6
6
4
6
6
6
2
6
6
4Z
4
4
4
2
4
4
4
j
22 20
18
12 14
14
12
8
12
12
10
6
10
10
8
6
8
8
6
4
8
C
6
4
6
6
6
4
I 6
6.
4
2I
6
6
4
2'
24 24
20
14 18
16
It
10
14
14
12
8
10
10
10
6
10
10
8
6
8
8
6
4
B
6.
6
4
6
6
6
41
6
6
F
2 1
26 24
12
16 70
16
16
10
1 4
14
12
8
12
10
10
6
10
10
8
6
10
R
6
4
e
6
6
4
8
6
6
t
6
6
6
1
28 28
74
16 22
20
18
12
16
16
14
10
14
14
12
8
12
12
10
6
10
10
3
6-I
3
8
'8
4
B
8
6
4
6
i
30 JO
26
18 ?2
20
20
14
18
18
16
10'A4
14
12
8
12
12
10
6
12
10
10
6
10
10
8
6
8
B
0
4
"
8
6
6
6
c
4 i
.1? 32
28
20 14
24
22
14
20
20
18
10
16
16
14
8
114
14
12
8
12
12
10
6
10
to
10
6
11
10
8
(!I
10
e
B
I
34 32
30
22 26
26
22
16
22
20
18
12
18
18
14'
10
14
14
12
8
14
12
12
8
'17 012
10
6
10
10
8
6i{
10
in
8
6
34 34
32
22 28
26
24
16
22
22
20
12
18
18
le
10
lu
14
14
8
14
12
12
8
12
12
10
6
12
10
10
CI
10
`0
E
o
34 34
32,
24 28
28
26
18
24
24
2014
20
20
18
12
18
16
14
10
14
14
12
8
14
14
12
8
12
1?
'.G
t1
10
13
l0
5
36 34
34
24 30
30
26
18
24
24
22
14 122
20
18
12
18
18
16
10 116
16
14
8
14
14
12
8
17
1?
to
(.1
1?
1I
1:
!
0 1
34
34
32
22
30
30
26
18
26
26
22
16
22
22
20
14 120
20
18
12
18
18
16
10
16
16
i4
6
14
14
12
3 I
34
34
30
22 130
30
26
18
26
26
24
16
24
24
22.
14
22
22
19
:2
20
20
18
1
is
13
�
It
34
32
]0
T2
10
30
26
18
28
:6
24
16
124
24
22
14
22
22
20
14,
::
:3
'•
12
12
32
30
.20
30
30
26
td
26
ii
16
26
N
27
T< ±
±a
,a
20
i
14
12
32
30
2ld
0
30
2 6
18'
78
28
�3d
24
lE
Z6
24
Ii
if
-
1]0
32
32
26
20
i 30
2F
lE' j
ie
...
?=
;f
_-
-
32N1,-
2e
231
la
6
1;
A) 1. 311• ConcreteSlab:. HC -8.97; R•.29; Factor -7.3 -
2. 3 3/4• Thick Common Brtck: IIC=7.125; R-. 13; factor -7.3
8) 1. 54' Concrete Slab: HC -14.106; P.-.458; Factor -7.1 WOOd StOV2
e t. 8- so ltd Filled Block: HC -20.63; R-1.93; Factor -6.1 #33 points'(no back up)
2. 8-,Selld Filled Block With Both Sides ExposedToConditioned Air. casablanca fan + !.point
NOTE: Use all square footage directly exposed to conditioned air
for Thermal'Mass Area: HC -10.164; R-.965; Factor -6.1
D) 1' Thick Concrete/Tiler HC-2.SS; R-.083; Factor.3.7
Table 3-19. Zonally Controlled
Eleetrtc-Resistance
_
Space Heatlnq Points
I Points for this erasurev!11 I Table 3-20. Solar Water Heatin With Cas Backe Points
I be completed after, theCEC i
I has approved an Alteinative I
1 Component Package for ReSLstance 'I
I Befit. \
Table 3-13.\ Active Solar Space
\Heatin virn vas Points
Net Solar'fractton I Points I
I
(NSF) \%, .. ,
I o-6,-
I 0 I
Net Solar Fraction (NSF), Z
I +2 i
15 ='23
'V' , I +4
I 24'- 30
) +6 I
39
)` +8 I
I 40 - 47
I : +LO I
I 48 - 55
I 4-12 I
( 56' - 63
I +14 I
64 - 71
I +l8 I
72 up. { +20\�
Multifamily ( er unit ants)
Floor Area
Net Solar Fraction (NSF), Z
per unit,
ft2.
jseat P.mp i
0
I Solar -with Electric i
I Re+!stance Backup I
I
I Meeting the Require- I
I
I cents to Part 2 I
I
0 1
0.9
iv -i9
2ir29
30-39
40-49
50-59
60-69
70-79
600-.799
800-999
1,000-1,499
1,500-1,999
2 0V) and uo
0
0
0
0
0'
+3
+3
+2
+1
+l
+7-
+5.
+4r
+3
+2
+10
+8
+6
+4
+•4
+14
+11
+8
+6
+5,
+17
+14
+10
+7
+5'
+21
+16
+12
+8
+7
+24
+19
+14
.+10
+9
All others.(per build nn oints)
8u0-899
0
+5
+10
x14
+19
+24
+29
r +34
900-999,
0
+4
+9
+13
+17+il
+26
+30
1,000.1,199
0
+4
•1.7
+11
+15+-19
+22
+26
1.20(x1,499
1,500-1,999
2,000-'_,999
0
0
0
+3
+2
+2
+6
+5
+3
+9
+7
+5
+12
+9
+7
+15
+12
+8
+18
+14
+10
+21
+16
+11
3,000 ar.d uo
0
+1
+3
+4
+5
+7
+S
+I0
I
r
Table 3-21. Other Water I!eatlnq Pts.
I System Type I Points I
I Gas Only 1
0 i
jseat P.mp i
0
I Solar -with Electric i
I Re+!stance Backup I
I
I Meeting the Require- I
I
I cents to Part 2 I
I
0 1
I
I EIEtErtt Rt'si/tanee
I
I Only
-40
COMPLIANCE CHECKLIST FORM -2
For.Low-Rise Residential Buildings
(except hotels and motels)
Step l: Enter on the form the values for each measure from .your building plan
and specifications sheet.
Step 2: Eater points on this page while working through the point system in
Part 3.
Building Shell
*Total .Floor Area . . . . . .
1. Slab-on-Ground.Perimeter ft; Depth in
2. Raised Floor R -Value. . . . . . . . . .
3. Ceiling Insulation orConstruction
Assembly, R -Value . ... . . . . . . . . . . . .
4. Wall Insulation or Construction Assembly, R -Value
Glazing.Total % Floor, Area
Measure
ZD•i 5 ft2
R
R-
R-�R -
Single Double Triple
'5 .
North -Facing . . . 47, %
f t2
1 `j b f t2
f t2
6..
East -Facing. .
ft27�5'ft2
ft2
7.
South -Facing
ft
-2-2
t2
ft
8.
9.
West -Facing . . .
Skylight . . . . .
ft2
ft2
ft
ft
—f t2
. . .
10.
_
Shading Coefficient
(exclude overhang)
a. East . . .
(v3 SC . . .
. .
b. South . . . . . . .
—, Z—SC .
.
c. West . . . . . . . . . . .
. . .0
. .
. . . .
d. Skylight . . . .... . . .
-.South
. . .
SC . . .
. .
11.
Horizontal Overhang Length .
. . .
ft.
. . . .
12.
Movable Insulation, % Floor Area .
... ..
—Z . . .
. ,
13.
Infiltration (indicate Standard or
Tight)
Sfa i4��.r�
.
14.1
Thermal Mass
Exterior Wall Thermal Mass
Area, Heat Capacity, R -Value .
.. --ft2, HC,
R=
Interior Thermal Mass
Area, Heat Capacity, R -Value .
�2&f t2, HC,
R-___2
HVAC System**
15. Gas Furnace Without Refrigeration Cooling .
(Seasonal Efficiency)
16. Heat Pump (Energy Efficiency Ratio) .
11. Gas Furnace with Refrigeration Cooling � J ��,SE
(Seasonal Efficiency -(SE), Seasonal Energy
Efficiency Ratio -(SEER)]
18. Active Solar (Net Solar Fracti Z)
Points
SE � •
EERY
f3. d SEER �- Z , V000
on, x NSF � I /�
19. Zonally Controlled Electric ^
Resistance Space Heating . . . . . . . . (Yes No
Domestic Water Heating**
20. Solar With Gas Backup (Net Solar Fraction, %) . . % NSF
21.. Other .Water Heating (Describe type) 14-5.
Point System Compliance Total (must be greater than or equal to 0) --
*Checklistitems; not a point system measure.
"Attach documentation for efficiencies and NSF.
75
RECOR ED BUTT fr COUNTY Y�
- r OFFICIAL RECORDS BY
K
F.
SHOW14.
�.. ,. ,yf
r 1981 lf�@J � 3 P� 12� 03 -
CANDACE J. GRUBBS
, CL tkk RECORDER EEE' �
20121
Return to DPW; AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT+
FOR RESIDENTIAL DEVELOPMENT
Section 26-8.1 of the Butte'`County Code requires this acknowledgement
be recorded prior toissuance of a building permit. -.
The property described h°erein is adjacent to eland or included
within an area zoned for agricultural purposes, and,residents'of this
' property may be subj,ect.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 purposes, and residents within said zones:.and on
adjacent property should,beprepared,-'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
Lot:112,,as'Shown on,that certain map entitled, "BIG CHICO CREEK ESTATES
UNIT.`4"; which Map,was filed in the Office of the Recorder of the County
of Butte, State of.:California, on May 13,.'i983, in Book 91 of Maps, at
Pages• .28 thru 33. t NOT-COMPARED WITH
- -ORIGINAL DOCUMEN3�
i .
• ytrl: -
Date.: C; PROPER Y. OWNERS:
'
Kenneth D. Krause
State of California ) On this.the 3rd day of- June 19 87, before
)'SS,.; .me'; =the undersignedNotary:;Public,.;personally appeared .
z:
County of Butte )
Kenneth D. Krause_
LlPersonally known to me. Proved to me on the basis
/
of satisfactory evidence.
to be the person(s,) whose�-name(s) subscribed vibe to
p............. .............................. q
c�-.cIAL s u the within instrument and; acknowledged that
executed the same for the .purposes therein contained.
c. -•-e-- C�tl�� f 3i-1
NGTO,'Y ::CL:C - C� Li=�:�;aA IN WITNESS WHEREOF, I hereunto set , my hand and . official seal
x.x
CO. OF CL rIE
q�r My Commission Erp;res April 2, 19S7
............................ ...............
[s }
Notary Public,-
n�Y{ Denise • Smith
{a Y6 --os
k Present A P. No. s