HomeMy WebLinkAbout047-100-11547--1011 3> & 117
ARTHUR HOWARD
APPLICAT O/N� FOR DETERMINATION
(Not; oc�YN /-�.y-�0� 5/12/82
047-10-0-115 91-3947
" GORECKI, PETER
CONTR: OWNER
MERIDIAN MEADOWS LN, CHeon NEW SINGLE FAMILY �
047-107.0-115 92-03.32
GORECKI,-PETER
CONTR: OWNER
14884 MERIDIAN MEADOWS LN I 0
WOODSTOVE/SF
047-100-115 PERMT.I#94-3320
GORECKL, PETER J.
14884 MERIDIAN MEADOWS LN., CHICO
ADD SF .
,1
rG.ORECKI
B08-0116 047-100-115
MISCELLANEOUS Re -Roo REROOF 14 SQ WITH COMP
4884 MERIDIAN MEADOWS LN'
PETER J,
n
0
34
� s+ h < � ;
y � t ' ` 0
�- � w .rr T'� i11•'.
,re"d* i3utte
OROVILLE, CALIFORNIA
GENERAL CLAIM
CLAIMANT: PETER .T- ' rORF( KT
ADDRESS: -- 14884 MERIDIAN RD
CITY�B STATE: CHT('.(1� CA 25996 IMPORTANT:
2/6/95 SEE INSTRUCTIONS
DATE OF CLAIM: ON REVERSE SIDE
4.;
SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES
DATE
DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY)
i AMOUNT
OWNER HAS CANCELLED PROJECT. (BLDG PERMIT #94-3320,
`
A.P.#47-100-115,�RECEIPT #170935 DATED 12/14/94, OWNER:
�.
-PETER J. GORECKI)
ITOTAL
FEES PAID..............................$349.95
I
RETAIN REFUND PROCESSING FEE ....... $25.00
1
IRETAIN
BLDG FILING FEES ............. $20.00
RETAIN PLUMB.PERMIT FILING FEE ..... $20.00
RETAIN SRA PLAN CHECK FEES ......... $89.00
I
IAMOUNT RETAINED ......................$154.00
I
I .
ITOTAL
AMOUNT TO BE REFUNDED ........... $195.95
TOTAL $195
95
I, the undersigned, leclere under penalty of perjury that the services or articles claimed �havRep.erforrned or delivereda that thiclaim is true and correct as stated.
Dated thin 2- t> ............... day of �,19 et Calif.t...... .
Signa a o[ Claimant
I, the undersigned. hereby certify that, to the best of my knowledge, the services or erti a ecified abov ve b en performed or de-
livered and that thrre��++ree is a Budget AppropriationE] or SpecificBoard ApprovalE](Checko e) r e a a. /f
Dated this .......... 6hA1................. day of ....l+A�.LI�IA\t.. 19 ..... TSt ........Q+�QV.i.}54 Cellf. k�. .... ... ... ..11...Y.. .................
apartment Head or Authorized Deputy
Dept. Exp.
................... coati ........ 4.21.OSQQ.................... PAYABLE FROM ........QQ.N.$1R.0 TION PERMITS......................... FUND
DO NOT WRITE BELOW THIS LINE — AUDITOR'S USE ONLY
DEPT. & SUB.
PROJ.
SUB. OBJ.
CLP IM NO.
INV. NO.
INV. DATE
ENCUMB.
GROSS AMT.
% - �;r -1 -,
Cad
'?4*' .w .... --.'?T.•Y
REFUND CLAIM APPLICATION
CLAIMANT'S NAME
MAILING ADDRESS
ASSESSOR PARCEL .# q7- -100- PERMIT # 9`�- 3 3 L
RECEIPT NUMBER (S) 1 -% 04'3' -
Request a refund of fees paid on the 'above receipt number(s) for
the following ;!!Sons:
11
�,� z ^ V4 .
Lkgi77� .-rr
(Check those categories which
g you wish to have refunded.)
[
Building Permit Fees [ ] Sheriff Fees
[ 4q"� SRA.Fee (CDF Fire Planning) [ J Urban Area Fees
D14292ition of nlang;
[ Plans returned to me at Counter. �v�4 i ZS" $S o/,4,f c4e
oN c-�is
[ ] Please mail plans to me at above address.
[.] Please dispose of plans.
0
SIGNATURE
.�\�=�
RATE
KO'd e00'ON VO:ST S6`SZ uer 'oN X31
k1j
o o
6t"
�r
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
_ 7 County Center Drive - Oroville,Califonnia 95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATION AND PERMIT -3�--3 a D
ASSESSOR PARCEL NUMBER 047_100_115
ZONING AZO
BUILDING PERMIT
OWNER
TELEPHONE
SQ. FT, OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
429 R 23.1,66.00
CONTRACTOR'S NAME
OWNEIR
TELEPHONE
CONTRACT'OR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
LENDER'S MAILING ADDRESS
Filing Fee $
20.00
Permit Fee $
943.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
157-95
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee $
n
Penalty $
BUILDING ADDRESS
14884 MERIDIAN MEADOWS LN
GHIGO, 95926
PERMIT FEE S
443-95
PLUMBING PERMIT
Filing Fee 20.00
Each Trap 4
7.00
Solar or heat pump water heater
23.00
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
Water piping
15.00 1 5
Each gas water heater or vent
-nn
15.00
USE OF STRUCTURE
SF R Duplex ❑ Mobilehome O Other
SPECIFY
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G I W
@20.00
TYPE OF WORK
New ❑ AdditionPERMIT
CK Remodel ❑ Utilities ❑ Installation ❑ Other Cl
Describe Work:
FEE $
78.00
Contractor
ELECTRICAL PERMIT
Filing Fee 20.00,
Main Service ( 1OV OR LESS )
200A OR LESS
23.00
Main Service( 200A TO 1000A )
46.00
NEW
OR ADDNS CONSTD BEACC BLDS. )
so
3.5. FT. 15.00
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one)
O 1 am a licensed under provisions of Chapter 9, Division 3 of the Business and
Professions Code and my license is in full force and effect.
License No. Classification
I, as the owner, or my employees with wages as their sole compensation, 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 contractors. (Sec 7044)
I am exempt under Sec. Business and Professions Code
for this reason
NEW CONST. MULTI.OUTLET
•NON,RESID. ( BRANCH CIRCUITS )
@7.50
( W ER APPARATUS 1
&TNGLE OUTLET CIR. I
Ex. Occup. ( OUTLET OR FIXTURES )
BAL. @ 1.00
Ex. Occu FIXED APPLNS. OR
p (OUTLETS IRESID.1 EA. )
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
WORKER'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ This permit is for $100.00 (valuation) or less.
10 I have placed on file with the County of Butte Dept. of Development Services,
Building Division 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 Worker's
Compensation laws of California.
otica to Applicant: If after making this statement, should you become subject to the
Worker's Compensation provisions of the Labor Code, you must forthwith comply with
such provisions or this permit will be revoked.
PERMIT FEE $
35.00
Contractor
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEE $
Contractor
I certifythat I have read this application and state that the above information is correct.
I agree to comply to all Butte County Ordinances and California 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 ' c nsequence of he granting of this permit.
X LA&AoDate ^' 9+-
na ure 6f Appll ant - ❑ Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 5"0" deep and demolition or
construction of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $ 46.00
occ
CONST. TYPE
TOTAL FEE S602. 95
HAZ.
I D. FEES
I IMP
FLOOD
I CDF
PARCEL I PD
HD
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
BY Date
PERMIT EXPIRES ON
(Date)
Receipt No. 170935 / 260.95
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
""114 IVXil��11WKfAlov
!.
YI
COUNTYOF BUTTE -DEPARTMENT OFD,EVELOPMENT SERVICES -BUILDING DIVISION
7 COUNTYCENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541
OWNER I6 2
Proposed Building Use
PERMIT APPLICATION DATA SHEET
r
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED BY
1. All items have been submitted . ........................................
2. Plot plans, 3/4 sets, signed by preparer of plans. .. t
'L,*"'- 3. Complete plans, its; signed-brpfepemwef s. t '................
4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . .............
5. Hazardous Material Form . ........................................... .
• �_ 6. Energy Design Compliance and supporting documentation. ..................
7. Statement of'lntent for Non -Heated and A/C Buildings . ......................
8. Engineered truss details and layout in duplicate (required prior to plan check). ....
9. Mobilehome data an manufacturer's installation instructions, 2 sets. ...........
10. Fees of $ ZA40, taQ . ............. ... .... .................
b� 11. Impact fees as shown on attached schedule.5 . .
• ✓ 12. California Department of Forestry plan approval/ ees./.S .......
T_ 13. Flood elevation letter (100 year flood) by California gineer. ................. .
�� • (� 14. Sanitation and plot plan approval �X) Health Department . ............
15. City of Chico plumbing permit . .........................................
16. Plot plan and business license approval from City of Biggs/Gridley.
17. Planning approval for (A) Use: (B) Parking:
18. Contact Land Development about (A) Improvements (B) Drainage. .......... .
19. Driveway permit (construction approval required prior to occupancy). .. . .
�Freanspection requ�
20. Pre -inspection for required. .. to Building Inspector (Date)
21. Contractor's license information. (No., Name Style, Classification) . ..............
22. Certificate of Workmans Compensation Insurance . ..........................
23. Owner -Builder Verification (Given to owner , Mail to owner . .......... .
24. Recorded copy of Agricultural Acknowledgement Statement . ..................
25. Letter of signature authorization . ........................................
26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... .
27. Letter of intent on building use . ........ ............................... .
28. Mobilehome utility clearance . ..........................................
29. Documentation of legal access . ..................... :..................
30. Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning area and frontage requirements . ...............
31. Existing violations/expired permits . ......................................
32. Plan check list . .....................................................
33.
34.
When you issue the permit, rocess as follows: - Mail to owner. Mail to contractor.
✓ Telephone - and hold for pickup at 10 g2)Ui I (_n-. office. Deliver with inspector.
Other
Parcel Creation 0
Acreage Applicant mDate
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submitted prior to per it issuance: (Circle :new item not checked above . r
>
1. Index permit for above items No. �'��� ��' .0 eG2 c � �i �� �vT 40
,2. Additional items required:
Contractor, designer, owner, was advised of above required data by _ phone,_ mail Counter by _ Date
Contractor, designer, owner, was advised of above required data by _ phone _mail Counter by _ Date
Plans checked by Date Plans approved by Date
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Works
COUNTY :OF BUTTE ,
Department of Development Services
Building Division
Oroville: 7 County Center Dr., Oroville CA 95965 Ph: 916-538-7541
Chico: 1469 Humboldt Rd., Chico CA 95928 Ph: 916-891-2751
OWNER -BUILDER VERIFICATION
Property Owner:
An j owner -builder" building permit has been applied for in your name and bearing your signature.
S
ease complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and
wing your building permit. No building permit will be issued until this verification is received.
1. I personally IDIan to provide the major labor and materials for construction of the proposed property improvement
(yes or no) ` L,—
12.' I (have/have not) signed an application for a building permit for the proposed work.
I have contracted with the following person (firm) to provide the proposed construction:
Name
Address City
Phone Contractor's License No.
14. I plan, to provide portions of this work, but I have hired the following person to coordinate, supervise, and
provide the major work:
Name
Address City
Phone Contractor's License No.
5., I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated:
Name Address Phone Type of Work
❑e
Property" Owner /
Social Security Number
Date /'L"— /4-- ':) -4—
This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California
Health and Safety Code.
This verification must be completed and returned to our office before we are permitted to issue the
permit.
I
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
1469 Humboldt Road, Chico, CA - (916) 891-2751
7 County Center Drive, Oroville, CA - (916) 538-7541
747 Mott Road, Paradise, CA - (916) 872-6307
f
CORRECTION NOTICE
oY111i8i PERMIT NO.
ti
AramOm ispecGun ideates that the following violatigns of Butte County Ordinances exist at
lm arwa addka and should be corrected. Please notify this offic d when correction of work
"scompbomLEV=1 many questions pertaining to thiiAatter, or need additional explanation,
pbomm eat tis n M a immediately.
J'1 -
LLi�� `/ a
J Q
0 +
Date Inspector
e'
FaEV
1QW
.1'+k'M:.*�`���'�"ly�sK•a"k:+r�"'.. ril: �ls�•'Y'��'6�7re`�ff•�'i1:.�rdPG ql`. . tYii T tJ� ,�.jer tr' .:r r . '1 .° �..a
~" + 047-1 ='0-1 15 92- -332
GORECX I , PETER
CONTR: OWNER
14884 MERIDIAN MEADOWS LN, CHICO
WOODSTOV_E./SF
' . ���/Q3 � �'a accuoo vl� •
• .�'har�� .�.0-�,.dl. cam, c,.►�2-5�•.�. �
S'• �= a— �2c�� w rw
v _ • P.�; `"!�^�`7'.�����'f�J�.e3" . �-:� .rc7-i: ' _ ,..� �`'�'. '+ �G`lfxYr � .
f I COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
` 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
A, a APPLICATION AND PERMIT
PERMIT N0.
ASSESSOR PA C .i. NUMBER
"047-100-11
ZONING
A-10
,.,,.. �
BUILDING PERMIT
OWNER
Petr Gari
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
37 Glenshire Dr., Chico 95926
CONTRACTOR'S NAME
Owner
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace i "All 1 500 OO
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $105 M
LENDER'S MAILING ADDRESS
Filing Fee $ 15,00
Permit Fee $30.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
Permit fee $45.00
PLUMBING PERMIT Filing Fee 15.00
14884 Meridian t;� QWA Ln., Chico
Each Trap 5.00
Solar or heat pump water heater 20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping 7.00
Each qas water heater or vent 7.00
USE OF STRUCTURE
SF EN Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets 5.00
Building sewer 15.00
Mobile Home S I G I W @ 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other]
Describe work: Listed Woodstove _
f 3q y
Permit Fee $
Contractor
ELECTRICAL PERMIT Filing Fee 15.00
00V OR SS
Main service 200A OR LESS 18.50
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 Code and my license is in full force a* effect.
License No. 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)
❑ 1 am exempt under Sec. , Business and Professions Code
for this reason
Main service 200A TO 1000A, 37.50
NEW CONST. ( DWELLING OCCUP. �\ 3.64 sq.ft.
OR ADDNS. 1 ACC. BLDGS. /
NON.RESIO R BRANCH C. RCTITS) @ 5.00
POWER APPARATUS &)
SINGLE OUTLET CIR.
Ex.,Occup( OUTLETS OR FIXTURES 20 76
FIXED APPLNS. OR
Ex. Occup. OUTLETS (RESID.) EA.) 3.00
Temporary service 15.00
Mobile Home Facilities 15.00
Misc. byirin g 15.00
Permit Fee $
—
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
xt�f Consent to Self -Insure.
shall not employ any person in any manner so as to become subject
othe 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.
Contractor
MECHANICAL PERMIT FiIingFee 1 15.00
Heating
Coolin g
Hood 6.50
Ventilation
permit Fee $
LContractor
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 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 our ty in c equenc of the granting of this permit.
X j Date Z. ` 7— 2 Z
Signature of Applic Owner Contractor EJ Agent I]sions
—
An OSHA permit is required for extava'tions over 5'0" deep and demolition or construct -
ion of structures over 3 stories in height.r
Mobile Home Installation Fee S
Energy Inspection Fee $
OCC
CONST TY PE
$
TOTAL FEE 45.00
HAz
1 0FEES I
IMP
I FLOOD
I CDF
PARCEL
I PD
HD
ISSUE I
This permit is hereby issued under the applicable provi-
of the Butte County Code and/or resolutions to do
or which fees have been .
work indica'tef abov poi
R F PUBLIC WORKS//� S"Z
BY �T""` Date r
PERMIt`EXPIRES Date `
Receipt No. 103822
WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
/ 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
✓ APPLICATION AND PERMIT
PERMIT NOb,,
ASSESSOR PARCEL NUMBER
047-100-115
ZONING
A-10
BUILDING PERMIT
OWNER
Peter Gorecki
TELEPHONE
SQ. FT. OCC. BUILDING VALI.YATibN
OWNER'S MAILING ADDRESS
37 Glenshire Dr., Chico 95926
CONTRACTOR'S NAME
Owner
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace "All 1.5 0.00
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $ 1 5oo -no
LENDER'S MAILING ADDRESS
Filing Fee $ 15,00
Permit Fee $ 30.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee $
Penalty $
BUILDING ADDRESS
Permit fee $
PLUMBING PERMIT Filing Fee 15.00
14984 Mpridian Meadows Ln.. Chico
Each Trap 5.00
Solar or heat pump water heater 20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping 7.00
Each qas water heater or vent 7.00
USE OF STRUCTURE
SF ❑X Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets i 1 5.00
Building sewer 15.00
Mobile Home S I G I IN 1 615.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Installation ❑ OtherK]
Describe work: Listed Woodstove _
39y 7
Permit Fee $
Contractor
ELECTRICAL PERMIT Filing Fee 15.00
1
Main service 200AORLESS 1. 18.50
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 Code and my license is in full force and effect.
License No. 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
Main service 200A TO IOOOA) 1 1 37.50
NEW CONST. DWELLING OCCUP.E\ 3.64 sq.ft.
OR ADDNS. ACC. BLDGS. /
NEW CONSTR. ULTI.OUTLET
NO ESID BRANCH CIRC ITS @ 5.00
(POWER APPARATUS 61
(SINGLE OUTLET CIR. /
Ex. OCcU 20 7i
Occup(OUTLETS
OUTLETS OR FIXTURES
APPLNS. OR \
Ex, Occup. OUTLETS (RESID.) EA./ I 3.00
Temporary service 15.00
Mobile Home Facilities 15.00
Misc. Wiring '15.00
Permit Fee $
—
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
f 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.
Contractor
MECHANICAL PERMIT Filing Fee 15.00
Heating
Cooling
g
Hood 6.50
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 to save, indemnify and keep harmless the County of Butte against
all liabilities judgments, costs, and expenses which may in any way accrue
against sa ou ty in con.equenc of the granting of this permit.
X� Date 2 ' ,
Signature of Applic — Owner Contractor ❑ Agent ❑
OSHA permit is required fore ovations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee S
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $
HAz
I DFEES I
IMP
I FLOOD
COF
PARCEL
I PD
110
ISSUE
This permit is hereby issued under the applicable provi- i
Bions of the Butte County Code and/or resolutions to do j
work Indic a�abovorl which fees have been paAn
IPUBLIC WORKS zl� 27*103822 By-- Date
P MI XPIRES Date S Z
Receipt No.
WNITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
� '•� � 'h y� w,�i` .,tlj,yr ? .;�,� Yrs. r•.. � � .ri. .. 4 � u � .
.�� -- . r
•� �
,-
t .
�_� � . � �
... , 1
- . �,`� �-
�,
;,
.Y
♦ � ,.
.ti
�,
,
��
,�
�!,
�;
�r�T
�'-
•�
�.
.ti
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE,"CALIFORNIA 95965 - TELEPHONE: 916/538-7541
` Zr iO m ct a
""PERMIT APPJ+ �EATION ,Q;ATA SHEET `% 1
` Permit No.
OWNER l �/ �� �C yC�� A. P. No. 7.7
Proposed Building Use _-7�%�� Building Inspector Date
At time of permit -application, I was advised the following data must be submitted prior to permit processing and/or issuance:
�lAll items have been submitted . .................................... DATE RECEIVED APPROVED
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. Hazardous Material Form ..........................................
6. Energy Design Compliance and supporting documentation ..........
7. Statement of Intent for Non -Heated and AC Buildings ..............
8. Engineered truss details and layout in duplicate (required prior to plan check)
9. Mobilehome installation data including manufacturer's installation
instructions ................................ ................... .
10. Fees of $
11. Chico Urban Area fees paid .......................................
12. Park fees paid ....................................................
13. School District fees paid ..............
14. Sanitation approval from Health Department
15. City of Chico plumbing permit .....................................
16. Plot plan and business license approval from City of
. • (see City for other requirements)
17. Planning approval for (A) Use: (B) Parking:
18. -Improvements may be required. Contact Land Development Section DPW
19. Driveway permit (construction approval required prior to occupancy)
20. Pre -Inspection for required Pre-Inspec.request to
21. Contractor's license information (No., Name SBuilding Inspector (Date)
tyle, Classifications ...
`- 22. *Certificate of Workrnans Compensation Insurance ............ ,.... .
23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) .....
24.` Recorded copy of Agricultural Acknowledgment Statement .........
25. Letter of signature authorization .... ...............:............. .
26. �.
27.
When you issue the permit, process as follows: ail to owner.Mail to contractor.
Telephone and hold for pickup at office. Deliver w/inspector.
•. lla L.._
C
I
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date
Copy of plans sent _Health Dept. Fire Dept. = Other , Date By
The following dat d prior to permit issuance: (Circleinex itAm not d above).
1. Index permit for above items No.
2. Additional items required:
Contractor, designer, owner, was advised of above required data by_phone_maiI—counter by .date
Contractor, designer, owner, was advised of above required data by—phone —ma II—counter by date
Plans checked by
Copy—DPW
Sets of plans on hold in
Date Plans approved by
File cabinet AP folder
Date
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone: 916.538-7541
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBERZJ
85-
IN
BUILDING PERMIT
OWNER �tJv�•-�— ll
LI-PPH0NE
SO. FT. I OCC. BUILDING VALUATION
OWNEM _I_LING
��((''77� e:_ �� l..//1
CON TR�KC TOR• VA
TELEP�H OMIJrNE[l
CONTRACTOR'S MAILING ADDRESS
Fireplace /
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
Filing Fee
S 15.00
LENDER'SMAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING1A DDR s
Permit fee
$
PLUMBING PERMIT
Filirx3Fee 15.00
Each Trap
1 5.001
Solar or heat pump water heater
1 20.00
LOT NO.
SUBDIVISION NAME PARCEL MAP
Water piping
7.00
Each qas water heater or vent
7.00
USE OF STRUCTURE
SFDuplex❑ Mobilehome❑ Other
/V SPECI FY
Gas piping system 1 - 5 outlets E�,
5.00
Building sewer
j 15.00
Mobile Home IS I G W
615.001
TYPE OF WORK
New ❑ 1 Addition ❑ Remodel ❑ U t i I%'ti�e� I Installation I OtherA
work: �b CV
Describe I1t �
t
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 600V oR LEss
200A OR LESS
18.50
Main service 200A TO 1000AI
37.50
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 Code and my license is in full force and effect.
License No. Classification
jl, 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
rfor sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I I am exempt under Sec. Business and Professions Code
for this reason
NEW CONST. ( DWELLING OCCUP.al)
OR ADDNS. ACC, BLOGS.
rIEw CON5TFL ULTI.OUT LET
NON.RESIO. BRANCH CJ RC 'ITS
I� 5.00
POWER APPARATUS a
(SINGLE OUTLET CIR. )
I
Ex. Occup( OUTLETS OR FIXTURES
120 (. 76d
RAL 4r 114
FIXE❑
Ex. OCCUp. OUTLETS P
TS (RES10 LNS )REA.)
I 3.00
Temporary service
j 15.00
Mobile Home Facilities
15.00 �
Misc. Wiring
15.00
Permit Fee
$ f
—
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 becomesubject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
j
MECHANICAL PERMIT
Filing Fee 15.00 I
Heating
j
Cooling
Hood
6.50
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 County or
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
againstisaid County in consequence of the granting of this permit.
X I Date
Signature of Applicant — Owner ❑ Contractor I i � Agent Flsions
An OSHAwork
permit .s required for excavations over 5'0" deep and demolition or construct.
ion of structures over 3 stories .n height.
Mobile Home Installation Fee $
Energy Inspection Fee $
OccCONST TYPE
I TOTAL FEE $
HAZ
1 0FEES I IMP I FLOoo I COF I PARCEL PO HD SSUE
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees
DIRECTOR OF PUBLIC
By
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
have been paid.
WORKS
Date
Receipt No.
,ttention
An "c
your signN
Pleals
=ecessaz
rill be is
: I
I.
M
4.
5.
S
M:
COUNTY OF BUTTS - Deoarcment of Pub L is too r'.cs
7 Councy Cancer Drive, Orolrille, CA 95965 Phone: 916-538_7J41
T. �
OWZiER-BUILDER VERIFICATION
Property Owner:
ner-builder" building permit has been applied for in your name and bearing
ure.
e complete and return this information at your earliest opportunity to avoid
y delay in processing and issuing your building permit. No building permit
sued until this verification is received.
I personally plan to provide the major labor and pacerials for construction of
the proposed property improvement (yes; or no)
I (have/heve=zot) 96 «� signed an application for a building permit
for the proposed work.
I have contracted with the following person (firm) to provide the proposed
construction:
Name
Address City
Phone Contractors License No.
I plan to provide portions of this work, but I have hired the following person
to coordinate, supervise, and provide the major work:
Name
Address City
Phone Contractors License No.
I will provide some of the work but I have contracted (hired) tie following
.persons to provide the work indicated:
Name Address Phone Type of work
a ed :
Property Owner &
Social Security Number
Data
(This Owner -Builder Verification is sent to you as required by Sections 19831 and
19832 of the California Health and Safety -Code.
This verification must be completed and returned to our office before we are per-
micted to issue the permit.
{
Y
g N E R a T C R R T I T I C A.T I U n
A �
14884 Merridian Meadows L.
LOCATION
DEBCitIPTION OF IMIATION
ROOF '
Materiel -- -
Tit ickness(inclted)
gXTERIOR NAIL
Materiel FIOER i5
Thickness(Inches)
Brand Name
Thermal Resistance (R Value)
Brand Name
Thermal Resistance(R Value). R13 _
CRILINO n aSs OpYI brand Nam_ OWNS -CORNING
Batt oe Blanket. Type FI fl s_ �_ Thermal Resistance R Value) Ran
Thickneea(incher)� 9�__ _ - — brand Name
Loo@e.Fill Type wt, per 'ba lb.
Minf.munt Thicknesf(Inches) -Nmber df sets d --
Area covered(ft. ) Thermal Resistonce(R Value)___
FLOOR, ELEVATED
Material
Tit ickness (incite a) - -
FLOOR, ALAN
Material
Thickness Inthe•
Width(inches) - ��----
FOUNDATION NAL@.
Material
Thick-- ndhe•
brand Name
Thermal Resistance(R Value)
Strand Nanus
Thermal ResistanceCK Value)
stand Nowa
ihan ai R•ei@tono• R VA ue ,
I hereby eartitp thst-ths AWS WOW *j inlitalled in the abnta building
in oonformanee with the state of dalitild ftarp Requirmenta.
LOERKE INSII`ATION C0.' INC. STATS CONTI CTOR $ L
FIRM NAME ONMER -,
February 271 1
481gTeulAgor IN TA TION APPLICATOR DATE
N9 E NO.
I hereby certify tits above Insulation and all required lteenms � i tatteown on tl�e
Building Department approved plans and attach%snts Revs been installed as
required by the State of Celifotnla gnarly Requirements. '
All equipment. devices and material@ are Of the quality prescribed or are
specifically approved by the State of California.
F1RN NAME MOR (Please print) STAT g CONTRACf'OR 8 LICENSE N0.
81011ATURK OF Qr11ERAL OONTRACTOROi1NER DATE
Tntg CERTIFICATE MIST BE ON FILE WITH THE BUILDIDEPAR'C HT PRIOR TO FINAL,
1N9PEG"fION APPROVAL. AND A COPY e11Al.L std " OSTED NlMOTill" �TI�T IB�UILDINo .
Janu. 1964
1?T':r Y •�I'.-''Y'i.. Ate....: i\. r wV �• �.«�Yi!� '
COUNTY OF BUTTE
�N.
DEPARTMENT OF PUBLIC WORKS:
1469 Humboldt Rpad, Chico, CA - (916) 891-2751
1" 7 County Center Dflve;"Ordvllle, CA -t916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
V11
? OWNER PERIiIQI" NO_
A routine inspection indicates that the following violations of Butte County Ordinances elostat '
}- the above address and should be°corrected. Please notify this office when correction of work
'is completed. If you have any questions"] ertaining to this matter, or need additional explanation.
please contact t office immediately. \
CA k cL 4-'5 4,e ed n
1 1 i /— L> i
�u
Date Inspector EA G62 1-- ?2
't REV 11/81
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
1469 Humboldt -.Road, Chico, CA - (91 6) 891-2951
7 County Center Drive, Oroville, CA - (916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE-
l;nreC kl J q? — q1
OWNER PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please notify this office when correction of work
is completed. If you have any questions pertaining to this matter, or need additional explanation,
please contact this office immediately.
I I P'/' J J : d 2 ; < n I. .1 /Dom/ 'f"" J- -% i N / .0,-/
5Auk a� a 1 V e_ �AaMoro11C
I) Re4-e
Date r 14— Inspector �X4 5 5 e 1\ C
REV 11/91
COUNTY OF BUTTE 1
DEPARTMENT -OF PUBLIC WORKS..
J
1469 Humboldt Road, Chico, CA - (916) 891-2751
7 County Center Drive, Oroville, CA - (916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
Cf - ,e C_ Ic i 35 If/ 7 - r/
OWNER PERW NO_
A routine inspec 'on indicates that the following violations of Butte County Ord-ummmaseaistat
the above ad ess and should be corrected. Please notify this office when correction mf ter=
is complet . If you have any questions pertaining to this matter, or need additionalexpfanatiorc
Please c cY this Mice immediately.
401 a 1 u �O f
r //
f CJ S �L tea/ C G 5 n� /C i ,L G 6 L
3 �0 U e- y0o
//�e,S
J - of 'µ ! 5 P r U f C -C f
� y
f� " YV1>° �. D ppN o� -1 c c/C .14 -
Date 3� Inspector
REV 11/91' I
r
107-11-91 A43. No t rc.t,q f r- 40(A -All' i v
s�•
0-13-9/ R4 Not- re -40;! 564
0. \ V •e�� ll U`�(� 1 �`�i G
Dk
As
2wsi�: i� 3cl 4,7 -11 �\
R SIDENTIAL
047-10-0-115 91-3947
GORECKI, PETER
CONTR: OWNER
MERIDIAN MEADOWS LN, CHICO
NEW SINGLE FAMILY
/ 2 -
OFFICE
OFFICE COPY
i
Address11ne f;zk(l
GAS
Meter By Date
ELECTRIC Q
Meter By %2�i Date 3/
OFFICE COPY
Addressffny/ &"A -v /, eoe-10t•+S
GAS
Meter By
Date
ELECTRIC \
Meter By
Date =�
JOB FINALED ) ��
Signature
r
2wsi�: i� 3cl 4,7 -11 �\
R SIDENTIAL
047-10-0-115 91-3947
GORECKI, PETER
CONTR: OWNER
MERIDIAN MEADOWS LN, CHICO
NEW SINGLE FAMILY
/ 2 -
OFFICE
OFFICE COPY
i
Address11ne f;zk(l
GAS
Meter By Date
ELECTRIC Q
Meter By %2�i Date 3/
OFFICE COPY
Addressffny/ &"A -v /, eoe-10t•+S
GAS
Meter By
Date
ELECTRIC \
Meter By
Date =�
JOB FINALED ) ��
Signature
P
J=OK
O = Not OK
Not Readyable MOBILE HOMES
Date MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements-Setbacks-Easements
2. Soils; Special MH Support Sketch
t 3. Sewer; Location-Test-Fall-C/O Concrete
4. Water; Location-Test-Easement Needed (Sketch)
5. Electricity; Location-Clearences-Grnd-/ /Amp-Concrete
6. Gas; Location-Test-Wrap: / /"L"ft.
/ /-Nat. or/ /"L"ft./ /"LPG
7. Well Clearance & Disconnect
8. Utility Clearance
Date Card B-1 Date Card-B-1
Date Card B-1 Date Card B-1
Date MOBILE HOME INSTALLATION (Plans) OK except #'s i
1. Zoning Requirements-Setbacks Easements
2. Footings; Size-Spacing-Marriage Line
3. Gas; MH Test-Demand-Valve-Connector
4. Electricity; MH Test-Crossovers-Breakers-Clearances
5. Drain; MH Test-Fall-Flex Connector ,
6. Water; MH Test-Regulator-Connector
7. Water and Sewer Connected-C/O to Grade-HD Approval
8. Gas and Electricity Tagged
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
.•
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rftrs.-Connectors
Shthg.-Rfg.-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distances-GFI
5. Elec.; Pool Lighting; 15 volts-GFI
6. Elec.;Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes -Enclosures -Panel boards -Ins. to Main in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
A
J=OK,
O = Not OK
Not Applicable
Not Ready RESIDENTIAL (Single & Duplex)
=
Date UNDE OOR (Plans) OK except h's jitJ�/ O& Date AMING
f. -Setbacks -E ements- food -Slope 46 . Han -Posl
2 Ft M o - les nd - " Ft a th /------- ----
tinued)
s -Anchors -Connectors
g" p 4 Joist-Rftr. ties-Purli
3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth g�/% reolace Ties nr Tvoeld
4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped
6. Stemwalls, Garage; Steel- Bloc kouts-Wrapped
6a. tWd Downs and Special Anchors
SlaWSteel-Wrapped
JZ• j� �Fireplace Ftg.-Steel Portri.
W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10. OF Gas Pipe; Size -Anchors - yard gas piping: size -test
jooOIW'aJer Pipe; Test -Anchor -Regulator -Service Test
1 lectric; Underground
13. Pienums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
15. Access & Ventilation
16. Insulation
Date -ll Card B-1 Date Card B-1
Date/1-/6-91 Card B-1 /2/Z Date Card B-1
Date PLUMMINGAPermit) 911K ezvl€ot h's / i
tr.: V66t-A^ressFCgmbuffi`on Ai
---- 1 - - ----- -----------------
�- W.V : T Fit ' & Ar�F a' a D.
19. Shower Pan; Test. First Floor -Tub Access ------------
20. j—Tub & Shower, Second Floor -Tub Access
----/-- --- -------PPPPPP------ -----------------
Gas Pipe: Size & Anchors
Date 3/-92- Card B-1 Date Z - *1 Card B-1
Date I'll -Card B -t ,62 /_ j Date Card B-1
Date ELECJJ:trCAL (Permit) OK except h's
Fixture & Transformer Clearance -Ins. Protection
-------- ------------
23�Tec. eceptacles Spacing -Lights & Switches at Doors ----
----------------------------------------- ---
2 ize s & No. of Conductors -Stapled
------------- ----- ------------------------------------------------------
2 o nstalled Close to Edge of Studs & C.J.
aEubfeed
Ground made up w/Meth. Fastners Bond Gas & Water
------------ --- ------ ------ -- --------------------------
2
--------------- ------
iance Circuts in Kitchen & Conductor Size/GFI
Wire Size ga. Cu or AI-A.C. Wire Size / / ga.
Cu or Al
29_. 2aagg Circ r qa Cu or AI -Oven Circ. / / ga. Cu or Al.
I/nsylated Neutra- ❑_ Yes- 0 No -
- ------ 3B�Service_Riser Conductors & Ground -Main Disconnect ---------------------
-
-- - -
31.E Clearances Panels Motors -Meth Equip
--------------- -- ------------------ -------------------------------
C es Closet Light -Shower Light -Spa Light
--------PPPPPP ---- -
--------------------------------
----- --- -- -
-------------------
Smoke Detector
-Date 1/% 41Z- Card B_� ----------------------------------------------------
-Date
- - --Date------------Card-B_�-------------
Date
-- --
- 3 -- - ---------- ---------------------
Date C B -t Date Card B-1
Date MJ,g44ANICAL (Permit) OK except h's
ucts Insulation & Support
-----------------------------------------------------
-
3 en Exhaust above insulation
ii 16o/neer-fs'ate Drain & Overflow_Size-&-Grade-- -
3u7/F r ce Vent. Access Comb Air -Return -Air Vent -115 outlet
--- -- --- -------------------- - -- ---------------------
3" itis Access-&_ Platform if Furnance in Attic
---------------------------- ---------------------------------------
Card
- -- --- -- ---- --- -----------
Date Card B-1 Date Card B-1
bat -1. _3l _9 ---------- ---- -----------------------
Datq� 2/' Car 1 Date Card B-1
Date FRA G (Plans) OK except h's
3 S Proper Material & Anchors
- - - 4 - ----------------------------------------------
- PPPPPP -------
Walls s -Nailing, Spacing & Bracing- Plates-Sound
---------------------------Nailing.S-----------------Plat----------------- - ---
Girders & Floor Nailing
- - - - -- - -- -- -- - - - - ----
4 Dr top in Walls (rat proof)
-- - - ---- --- --
-/---- --- --------------------------------------------------------------
4 fire Stops: Furred Ceilings -Stairs -Chases -Tub
-- ---- --- -�/- ---- --PPPPPP------- - ---------
i
-
4 . Headers &Beam -Size &Bearing
-royrac-Truss-Shthng.-Ring.
Throat clearance
access; Size & Romex Protection -Draft Stop -Ins. Baffles
46,-ffdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
rotes ion Framing
1?1- P r y Line_ firewall & Openings
_ Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits
53. Siailb, WT6i�d fit -Rise -Run -Landing -Fire Protect
on Wa6t Uverhan4=Attic vents3Hatter &Mriaaers
,5A!Stuc esh-Drip Screed -Fd. Vents-Underflr. Access
_
5 lazing Area -Glass Protection -Skylights -Plastic
-------------��-�� ��--��----
S8;7' ,3 Valls: Nai ' q -Bolts
69' Infiltration -Walls -Windows
------- - - ----
Date / S/ Z -Card B 1 Date R- f/ 92_ Card B-1
Date �l Z Ca;d B Date Card B-1
Date • f FIN (Plans) OK except ft's
�E . to =Door & Sidelight Protection -Landings
93!Sm e Detector
urn : Vents -Clearance -Comb. Air -Connector -
I arage: Above Floor -Ducts -Meth. Protection
jl�Be oom Exiting
& Bath Fixtures & Tub Access -Spa
---------------- ---- - -
6a4
les_ Trim & Subpanel: Breaker Sizes & Labels
;668.Fire7per Stove: Clearances -Hearth
--------------. Outlets at Wood Panel; Int. & Ext.
& Appliance; Grnd -Air Gap -Cooking Clearance
�- -
Z4-'Elec. Outlets & Receptacles at Kit. Counter - -- -_
wing -Landing -Closer
gelDamper
7 . tr Vents -Clearance -Comb. Air-Connecto V
---
In arage: Above Floor -Meth. Protection
----------------- -- PPPPPP- Floor
7 Plb.. Elec & Mech._Equip. Listed for Location
- - ---- - ep ac es in Garage; (G.F.I.)-Rome- rotection
7 Ins on -Foam -Looked in Attic ITYes
uard Rails & Deck Construction -Post Caps
-------- ---------- -- - - ---
7 dn. Vents & Crawl Hole Door -Drainage & Wood -Earth
Clearance Looked under Floor Yes
...... .. -- -----------
80. Following
---------------------- —
instld.: Drive 0 Yes O No; Walks C1 Yes 0 No;
Prs 0 Yes ❑ No
------------- -------------'l --� ---- ----
-- - it: Disconnect. Electrical, Plumbing
d s Above Roof: Plbo.-Appliance-Fireplace.- rance to
V.te
l:is n�n t, Ele ric u in
--- Elec. T6#11 G.F. Ree lacl Und ound----
6 nt on Throughout House -
... ....... . -- - - ------- -PPPPPP------- ----
Gla r coon
7_ d 'recti o from Previous Inspect'
pi01g2
5*.' est -Meters Tagged: lectric --
/ 9 -at Sewer Connected -C/O to Grade -HD Approval
-------------------
9L,15nirgy Compliance Certificate -Other Certificates t
Date �a���'L Card B-1 Date Card B-1
- -
- -- ----2 -
--- - - M -- —
Date�- Card B-1 IL� -Date -- Card B-1
Date Card B -t y Date Card B-1
Comments at Final_
COUNTY OF BUTTE - DEPARTMENT OF PUPLIC
-WORKS PERMIT
NO.
7 County Center Drive - Oroville. California 95965 - Telephone: 916/538-7541 % l-. 2
` APPLICATION AND PERMIT i
ASSESSOR PARCEL NUMBER
47-100-115
ZONING
A 10
BUILDING PERMIT
OWNER
TELEPHONE
893-1377
SO. FT. OCC.1 BUILDING VALUATION
OWNER'S MAILING ADDRESS
DRIVE37 GLENSHIRE CHICO 95926
R 44.880
C 234
CONTRACTOR'S NAME
QWNFR
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
45 11A
LENDER'S MAILING ADDRESS
Filing Fee
$ 15,00
Permit Fee
$ 346.50
ARCHITECT OR ENGINEER
NONR
LICENSE NO.
Plan Checking Fee
$ 173.29
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee
$
Penalty
$
BUILDING ADDRESS
MERIDIAN MFADOWS, LANE RICO 95926
Permit fee
$ 534.75
PLUMBING PERMIT
Filing Fee 15.00
Each Trap
51 5.00 25.00
Solar or heat pump water heater
1 20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
1 7.00 7.00
Each qas water heater or vent
7.00 7.00
USE OF STRUCTURE
SF D( Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00 5.00
Building sewer
15.00 15.
Mobile Home S I G I W
@ 15.00
TYPE OF WORK
Newo] Addition❑ Remodel❑ Utilities[:]Installation❑ Other❑
Describe work:P f ��fy� _
Permit Fee
$ 74.00
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 200AORLESS
18.50
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 Code and my license is in full force and effect.
License .JO. 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
Main service 200ATO1000A)
37.50
NEW CONST. OR ADDNS. 1 ( DWELLING OCCUP.&ACC. BLDGS. /
)
3.6Q sq.ft.
NEW CONSTR U TI.OUTLET
NO ESBRANCH CIRC ITS
@ 5.00
POWER APPARATUS e
SINGLE OUTLET CIR.
E X. Occu20
pOUTLETS OR FIXTURES
76
FIXED APLNS,
EX. Occup. OUTLETS PRESID .)OR EA.)
3.00
Temporary service
15.00
Mobile Home Facilities
15.00
Misc. Wiring
'15.00
Permit Fee
$
-
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.
FICA 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.
Contractor
MECHANICAL PERMIT
Filing Fee 15.00
Heating SPLIT SYSTEM
9.00
Cooling 22 TOT)
9._00
Hood
6.50 6.50
Ventilation il
Vent
4.50
pencil 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 to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
again s d County in��ence o the granting of this permit.
y
m, `� �"�`Q -�,Date it - �� -91
Signature of Applicant - Owner Contractor ❑ Agent Elsions
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 S
Energy Inspection Fee $ 40.00
occ
i CO s T PE
TOTAL FEE $ 772.05
HA
0 FEES I
IMP
I FLOOD CDF
PARCEL
PD
1 H9001
Iss-ve
This permit is hereby issued under the
of the Butte County Code and/or
work indicated a ve for which fees
/ R OR F PUBLIC
By /
PER IT XPIRES Date
applicable provi
resolutions to do
have been paid.
WORKS
t�
Receipt No. 0 v Q /7 $772.05
WHITE-D.P.W., TELLOW-ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
174-
m
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - OrovIIIa, California 95965 - TeIe0hone: 9161538-7541
APPLICATION AND PERMIT
PERMIT NO.
gi-,3
ASSESSOR PARCEL NUMBER
-(/
ZONING
BUILDING PERMIT
i OWNER
ecki
TEL Ho E
191)3 _62 2
SO, FT. OCC.1 BUILDING VALUATION
(3
O
' OWNER'S MAILING ADDRESS
. 3 �l��t Sh"cl pr Cti:�uCA �59Z6
B C
<
I CONTRACT``O..R',,StN/AME
TELEPHONE
"
i CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
Filing Fee
$ 15.00
! LENDER'S MAILING ADDRESS
!
Permit Fee
$_39t, _ 5'O
. RCHITE'T OR ENGINEER
�l/dn%
LICENSE No.
Plan Checking Fee
$
Energy Plan Checking Fee
$
• ARCHITECT OR ENGINEER'S MAILING ADDRESS
' I
Penalty
$
i BUILDING ADDRESS'
J _
Al A�a....s l N�
Permit fee
$
11/1-U C�
PLUMBING PERMIT
Filing Fee 15.00
Each Trap
51 5.00 .Z S.CSb
!
Solar or heat pump water heater
1 20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping
7.00 7, t9J
Each qas water heater or vent
7.00 (}�
USE OF STRUCTURE
SFeQ Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00 mp
Building sewer -
15.00 ,.pp
Mobile Home S G W
@ 15.00
+ TYPE OF WORK
I NewU Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑
1
Describe work: 7—
1
Permit Fee
Contractor
--
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 200AORLESS
18.50 O
Main service 200ATO1000AI
37.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
I
[711 am licensed under provisions of Chapt. 9, Div. 3 Of the Buslnes$
_ and Professions Code and my license is in full force and effect.
License No. Classification
( ❑ 1, as the owner, or my employees with wages as their sole compen-
i 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❑ I am exempt under Sec. , Business and Professions Code
i for this reason
NEW CONST./ DWELLING OCCUP.&
OR ADONS. ( ACC. BLDGS.
3.6a sq.ft. 30.6>0t
NEW CO NSTR "ULT' -OUTLET
NON•R ESID BRANCH CIRC ITS
@ 5.00
POWER APPARATUS &)
(SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES
20 76d
FIXED APPLNS. OR
Ex. Occup. OUTLETS (RESID.) EA.)
I 3.00
Temporary service
15.00 j,pp
Mobile Home Facilities
15.00Misc.
Wiring
9
15.00
Permit Fee
$ 19-30
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
I 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.
Contractor
MECHANICAL PERMIT
Filing Fee 15.00
Heating _1T S
p�
Cooling
9 -T O►J
I Hood
6.50 —o
Ventilation
fi, 5"0
Permit Fee
$ , 0�
L Contractor
j I certify that I have read this application and state that the above information
I is correct. I agree to comply to all County Ordinances and State Laws relatingO
I to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
i 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 Date
f 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 S
Energy Inspection Fee $ Ll o
CONS TYPE
TOTAL E $
r1A2
DFEES I IM
I FL oo
1 COF
I PARCE
Zf
HD
ISSUE
This permit is hereby issued under the
sions of the Butte County Code and/or
work indicated above for which fees
DIRECTOR OF PUBLIC
By
PERMIT EXPIRES Date
applicable provi-
resolutions to do
have been paid.
WORKS
Date
I
Receipt No. 1030 _?7 � % Z ' 5
WHITE-D.P.W.. YELLOW -ASSESSOR, PINI+ -INSPECTOR, GOLDENROD -APPLICANT
TO - Buildina Department
FROM: Environmental Health '
SUBJECT: Sanitation Clearance
14
- Oyu Location AP#
Pian Approved for:
Sewage Disposal Water Supply
Hold final for: Water Supply
Final clearance O.R. for: Water Supply
Clearance for-LA.Q bedroom mobile home. Other
NOTE
-t
Dat
Sanitarian �
!�'P,�`��'r pe'i6,11/v'cl�v� i�...�.1r�{sa,'74a�}�,:Rr-4Ft��~�r7Y J�""_'lt,irr'''r/��•.r'w"j"�.I�FrW'!`�'�7�"`..��"Y1�..�i�•.,��iti�Yti.l;
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541
PERMIT APPLICATION DATA SHEET
Permit No. -7
OWNER --A A. . No. L/ / IUCS' ps
Proposed Building Use `"�� z �2 Building Inspector— Date C71
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 ........
y 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . .
4. Complete engineered plans an`d talcs, with wet signature on plans ..
5. Hazardous Material Form .
6. Energy Design Compliance and supporting documentation ......... ti
7. Statement of Intent for Non -Heated and AC Buildings ...............
8. Engineered truss details and layout in duplicate (required prior to plan check)
9. Mobilehome installation data including manufacturer's installation
r-. instructions....................................................... .
10. Fees of $
11. Chico Urban Area fees paid .......................................
12. Park fees paid ..................................................
�
13. !' k �c r School District fees paid .............. i
14. Sanitation approval from CNA, a o Health Department _
15. City of Chico plumbing permit .....................................
16. Plot plan and business license approval from City of
(see City for other requirements)
17. Planning approval for (A) Use: (B) Parking: ......
18. Improvements may be required. Contact Land Development Section DPW
�lEZ 19. Drive&ay i"ermit (construction approval required prior to occupancy) _tl—
20. Pre -Inspection for required Pre-Inspec. request to
Building Inspector (Date)
21. Contractor's license information (No., Name Style, Classifications ...
22. Certificate of Workmans Compensation Insurance ..................
3. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) .....
Recorded copy of Agricultural Acknowledgment Statement ......... �
25. Letter of signature authori ation
f k 1526. In er-� F -Fs fife- 1030
27. i
When you issue the pe it, r ess as follows: _Mai o owner. Mail to contractor.
�elephone and hold for pickup at r office. Deliver w/inspector.
Other
Applicant_AA X11 LLL A4� Date
Copy of ! laz-Mat form sent Health Dept. Fire Dept. Air Pollution Date
Copy of plans sent Health Dept. _Fire Dept. Other Date By
The following data must be submitted prior to permit issuance: (C' a to 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_—inaiI—counter by .date
Contractor, designer, owner, was advised of above required data by—phone —ma ll—counter by date
Plans checked by )-,% Date �a Plans approved by e Date a.
Sets of plans on hold in File cabinet AP folder
Copy—DPW
U
4
COUNTY OF BUTTE - Department of Public Works
7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541
OWNER -BUILDER VERIFICATION
Attention Property Owner:
IAn 'owner -builder" building permit has been applied for in your name and bearing
your signature.
Please complete and return this information at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit
will be issued until this verification is received.
1. I personally plan to provide the major labor and materials for construction of
the proposed property improvement (yes or no) Y C ,S
2. I (have/haver not) 9A Y45' signed an application for a building permit
for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed
construction:
Name
Address City
Phone Contractors License No.
4. ,I plan to provide portions of this work, but I have hired the following person
to coordinate, supervise, and provide the major work:
Name
Address City
Phone Contractors License No.
5. I will provide some of the work but I have contracted (hired) the following
persons to provide the work indicated:
Name Address Phone Type of Work
Signed: �J,.A � a
Property Owner
Social Security Number ,
Date
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and
19832 of the California Health and Safety Code.
This verification must be completed and returned to our office before we are per-
mitted to issue the permit.
T COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE = OROVILLE, CALIFORNIA 95965 - TELEPHONE (916)5387541
A. P. NO. Z
'IOSED BUILDING USE �� DATE 7— 91
IREC. # DATE REC
1. School Distric Fees C v11 C �'
I (paid at District Office)
P 2. Sheriff .Fees b
(paid at Building Department) 2
Residential X J co $dpl
unit amt.
Commercial(per sq.f.t.) X =$
sq.ft. amt.
3. Urban Area Fees
(paid at Building Department
Residential (per unit_) X =$
# units amt.
Commerical(per sq.ft.) X =$
sq.ft. amt.
4. Recreation District Fees
(paid at District Office)
5. Drainage District Fees
(Contact Land Development) „ .......................
6. Other
7. Other
163677 i�—I —ate
At time of permit application, I was advised the above fees are required to be paid prior
to issuance of the permit.
APPLICANT. ' DATE /— f
3
9.00
2.00
11.00
XX 3
occasionally 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 Ithat real :property:-.sit'uate in .the County of Butte, State of California, described as
follows:
Da
L
State of
County of Lea,)
PROPERTY OWNERS:
AL" .
On this the f day of 19�, before me, the
SS. undersigned Notary Public, personally appeared
OFFICIAL SEAL
NINA M LORACK
Notary PublIC-Callromla
BUTTE COUNTY
My Commission Expires
November 22, 1993
Pre sent A.P. No .
LJ Personally known to me. ® Proved to me on the basis
of satisfactory evidence.
to be the person(s) whose name(s)
subscribed to the within instrument and acknowledged that
executed the same for the purposes therein contained. IN WITNESS
WHEREOF, I hereunto set my hand and official seal.
00- M� � // i � 0
i
9!--48373
Return to DPW AGRICULTURAL STATEMENT OF
ACKNOWL�DGaIENT
I FOR RESIDENTIALDEVELOPMENT
Section 25-8.1 of the Butte* County Code
requires this acknowledgement be recorded
prior to issuance of a building permit.
1
The property described herein is adjacent
91-048373
I Rec Fee
to land or included within an area zoned
I STF
for agricultural purposes, and residents
Recorded
1 Cash
of this property may be subject to incon-
Official Records
veniences or discomfort arising from the
County of
use of agricultural chemicals, including, ;
Butte
but not limited to herbicides, pesticides, Candace J. Grubbs
and fertilizers; and from the pursuit
Recorder
of agricultural operations including,
1:42pm 20 -Nov -91
1
but not limited to cultivation, plowing,
spraying, pruning, and harvesting which
3
9.00
2.00
11.00
XX 3
occasionally 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 Ithat real :property:-.sit'uate in .the County of Butte, State of California, described as
follows:
Da
L
State of
County of Lea,)
PROPERTY OWNERS:
AL" .
On this the f day of 19�, before me, the
SS. undersigned Notary Public, personally appeared
OFFICIAL SEAL
NINA M LORACK
Notary PublIC-Callromla
BUTTE COUNTY
My Commission Expires
November 22, 1993
Pre sent A.P. No .
LJ Personally known to me. ® Proved to me on the basis
of satisfactory evidence.
to be the person(s) whose name(s)
subscribed to the within instrument and acknowledged that
executed the same for the purposes therein contained. IN WITNESS
WHEREOF, I hereunto set my hand and official seal.
00- M� � // i � 0
... 48373
Order No. 2-147011
SCHEDULE C
The land referred to herein is described as follows:
All that certain real property situate in the County of Butte, State of
California, described as follows:
The North one half of the South one half of the East one half of the East
one half of the Southwest quarter of Section 13, in Township 23 North,
Range 1 West, M.D.B. & M.
RESERVING THEREFROM an easement for road and utilities purposes 30 feet in
width lying Easterly of and adjacent to the Westerly boundary of the land
described herein.
ALSO RESERVING THEREFROM an easement for road and utilities purposes 30
feet'in width lying Westerly of and adjacent to the easterly boundary of
the land described herein.
Saidleasement is for the benefit of and appurtenant to•the South half of
the South half of the East half of the East half of the Southwest quarter
of Section 13, Township 23 North, Range 1 West, M.D. B. & M. and shall
inure to the benefit of and may be used by all persons who may hereafter
become the owners of said appurtenant property or any parts or portions
thereof.
PARCEL I:
A right of way for road and utility purposes over and along the South 30
feetlof the North one half of Section 13 and the North 30 feet of the South
one half of Section 13, Township 23 North, Range 1 West, M.D.B. & M.
PARCEL II:
An easement for road and utilities purposes over and along the following
described property:
The East 30 feet of the West one half of the East one half of the Southwest
one quarter of Section 13, Township 23 North, Range 1 West, M.D.B. & M.
PARCEL III:
An easement for road and utilities purposes over and along the following
described property:
The West 30 feet of the North one half of the North one half of the East
one half of the East one half of the Southwest one quarter of Section 13,
Township 23 North, Range 1 West, M.D.B. & M.
PARCEL IV:
An easement for ingress and egress over the following described property:
i
(Continued)
9 1_ 4`8 3 7 3
11
Order No. 2-147011
t
The South 60 feet of the East feet
the
ofsoutheast
l3quarter
Township t23
Northeast quarter of the Southwestquarter
North, Range 1 West, M.D.B.&M.
PARCEL V:
An easement for ingress and egress over the following described
property:
he North
ast
er
The west 30 feet of the Southeast qua
rter of t23 NortheBRangealtWestf
the Southwest quarter of Section 13, Township
M.D.B.&M.
AP No. 047-100-115
END OF DOCUMENT
t.er11IICULtr UI I..UL 1JJ"aLA%-%-• nc�lu�la�lal L11111dLC L.UIIe ii
project Tlua
Project Address
d4a4
Documentation Author
BUILDING DATA
I_ _
C�onditioned Floor Area
0"ja'�/�Ftaised floor
(6]' Single Family Detached (SFD)
[ ] . Single Family Attached (SFA)
[ ] multi -Family (MF)
Number of Stories
Number of Units �-
[ ] Addition Alone
[ ] Existing Building
[ ] Existing -Plus -Addition
cl/• WW7
_ Building Permit I' - '
meted B'""Y
Enforcement Agency Use 0*
Glass Area °b Glass
North 7. 5 ,R, 0 .' .
Fast •_
South
west s. o
Skylight IV
ad • /
Tota!
BOI.DLNG SHELL INSULATION
Component Insulation LocaiiotX/G„mrae.-us
Tvne R•Value (antic, :c garage, mixt, etc)
Wali ..............
//
Wall ..............
Roof .............
Roof ....»...
Floor .............
Foor.............
Slab Edge .....
I
GLAZING
GIa
Shading Devices
ng
Area
Glass Type
Inte for Exterior
Odintation
(SI)
(sins k, double)
(Jolla blind, etc.) (shadc=ecm etc.)
Nor-Uh (
) 1 % S
rw /®
No i—,h (
)
East C
East-'' (
)
)
•�
�in�
South
.s
Sou L', (
)
Overhang Framing Type
Aw
J/
West
West .( )
Skylight.......
THERMAL MASS .
Ty*Covetirg • , Area Thickness
(slab/eicxsed, tile, etc) (sf) - (Inches) Locadoft/Etscriotion (kitchen, bath, etc.)
HVAC SYSTEMS NX=gfinimum Duct
TYPe (ft=ac&, air ' -Efficiency Location Duct Output Manufacturer / Model #
conditioner, heat vutitoj (SE, SEER,HSPF (atdc, etc.) R -Value (Btuh) (or aoproved equal)
Maximum Furnace Heating Output: Btuh
HOT WATER SYSTEMS Tank ManufacturerNodel #
System Type (storage gu, etc.) Capacity (or aooroved equal) Soecial Features)
I
SPECIAL FEATURES/REMARKS (Add extra sheets if necessary)
Syst•:m
SEER
(ammel ducts in attic)
Stm of 7--10
or .24 to 04 to -4 to +6 ti3 16 or
x AS I S +5 +15 mors
.6 1
.d -3
.2 -2
.2 .1
0 0
2 1
3 2
4 3
7 5
9 6
•12
-10
-8
.7
-6
-5
1
QU -15 S
.3
J
a
-2
0
0
0
3
3
2
6
5
4
9
7
6
15 13
11
4
17
S 14
12
EtSadve SEER
(SEER
Y48ct eRlcient7)
Ota of 7-10
.t
-3
3 or -2410 -1410
-4 to .
+6 lo
16 or
QU -15 S
+5
415
mors
-21
-17
.13
-9
•11 -9
-7
S
.4
_t .4
-3
-2
-2 .
to
to
0
0
1699
2199
2699
more
14 12
9
7
5
19 16
13
10
7
23 19
15
12
8
Ilia•25
26 22
18
14
9
29 24
20
15
10Zonal
Control Adjustment
3
8 7
6
4
3
Cooila; System Installed
-12
.t
.t
-3
-2
-2
2
2
2
2
1
mily
Detached and Attached
/�
X . y /
urrt Size
(sq
Duct Effiemary (0.741
.199
1204
1700
2200
2700
or •
n
to
to
or
WSS
1699
2199
2699
more
0 •S 0
0.
0
0
12 -' a
6
5
4
8
5
4
3
3
5
3
3
2
2
8
5
4
3
$
47
-24
-18
-15
-12
�
-18
.12
-9
.7
-6
•25
-16
-12
-110'
a
•t8
_-12
•9
-7
-6
5
-3
.2
-2
-2
7
: 5
-4
3
2
3
2
1
1
1
-28
-19
•t4
-11
-9
8
5
4
3
3
-10
-6
-5
.4
-3
fazwd y (iadivldual units)
It Unit Size
(s4
tts-.
699
700
1200
1700
2200
or
teas
to
1199
10
1699
a
2199
or
mars
0
0
0
0
0
14
7
5
4
3
9
5
3
2
2
9
4
3
2
2
9
5
3
2
2
1s
-23
-t5
•11
.9
2
1
1
0
0
-23
.12
-8
•6
-5
.25
.13
•8
-6
•5
?3
_12
a
-6
.5
19
1.1
2
22
2
6
3
11
?
13
1
0
0
0
0
v"0
15
-:a
d
-6
18
9
5
a
a
1.6
-4
•3
_
•2
Point System Summary: CIimate Zane 11
SCORE CARD
Measures
1. Ceiling Insulation A30 or
R,•�(0.03017-
(381 U -value (001
2. Wall Insulation (( I I or
R -value (111 U•value (0.0981
3. Raised Floor Insulation
4. Slab Edge Insulation
S. Infiltration
6. Glass Heat Loss
7. Shading (Shade Open)
a. North
b. East
c. South
d. West
e. Skylight
8. Shading (Shade Closed)
a. North
b. East
c. South
d. • West
e. Skylight
9. Interior Thermal Mass
10. Exterior Wall Blass
11. Heating System
Zonal Control? ( Y / N )
12. Cooling System
Zonal Control? ( Y / N )
13. Water Heating
or
R -value (191 U -value (0.0371
or
R -value (01 F2 facsar (0.711
Standard
Type jdambial
wo Glass
.0 X
X
X
-a- x
C°o Glass
c2.0 X
x
X
•� X
n x
i
IruenarNuZCFA
U -value [w
SC
Point Scores
SC Eff. To Glass
TYPE 1 MASS AREA
CONO. FLOOR AREA
TYPE 2 MASS AREA 3
Ex=w Wad
-COND.
FLOUR R
AREA
2
X
SE or HsPF
Net Efficiency (0.781
Effative SE ar
[0.77/66[�j
Q. "I
/�
X . y /
Interior MaWCFA
SEra 19.51
Duct Effiemary (0.741
-_
EffaeuvaSEER 17.031
s,
-�-
TrPeiscl
TV" r PASS
TTfe t
KU3
MAC b 4.2. t•, ..oa..d •l_OI
�
ox
sx
las
tsx
lox
2S7G
Sox
35x
40%,
4$
Sox
SSx
lox
'M
7o1c
7S1G
to%
t5x
Sox
05%
tour.
rosr.1t11x
tts-.
120L i
0%
0
02
0.4
0.6
0.6
1.1
1.3
iS
1.7
1.9
21
23
25
23
29
12
14
16
1t
4
42
44
107.
a2
tt4
O6
0.1
1
1.2
1.4
1.6
1.9
it
23
IS
27
29
11
13
15
17
4
4.2
44
46
4.6
'4.6.
.4.6
S
lox
til
06
at
1
1.2
1.4
19
1.1
2
22
24
27
19
11
13
13
17
19
4.1
43
4.5
4.8
S
S
S2
3071.
OS
QJ
0.9
1.1
1.4
1.6
1.6
2
22
24
26
21
1
32
15
17
39
4.1
4.3
4S
4.1
4 9
5.1
52
S.4
40%
0.7
0!
1.1
1.3
1.5
1.7
19
22
24
26
it
3
12
14
15
18
4
43
4.S
4.7
49
5.1
S.3
5.3
So
Sox
0.9
U
1.2
iS
V
19
21
U
25
27
3
32
14
U
It
4
42
4.4
4.6
41
S1
S3
S.7
13
15
S]
19
S5%
U
1.1
1.4
1.6
1.8
2
22
24
26
2t
3
12
15
17
19
It
42
4.5
4.7
4.9
11
s3
56
5.8
60%
1
12
1.4
1.7
1.9
it
V
15
21
29
1113
13
1t
4
42
44
4.6
4.1 '
S
12
S.4
56
5.9
6 !
65%
1.1
U
1.5
1.7
1.9
22
24
26
21
3
3.2
14
36
31
4
4.3
lS
4.7
4.9
11
53
S S
5.7
5.9
$1 1
1
70%
12
1.4
1.6
1.1
2
2.2
2S
2.7
29
11
13
15
17
3a
4.1
V
is
4t
S
5.2
5.4
5.6
so
6
61
75%
1.3
13
V
1.2
2.1
2.3
2S
17
3
32
14
to
it
4
42
u
u
It
5.1
sa
ss
5.7
62 1
19
6.1
5.3 1
MY.
1.4
t.t
1.1
2
22
14
16
it
3
13
1S
17
19
4.1
43
45
4.7
4L9
S.1
S 4
y5 t
S.6
6
45%
1.4
1.7
t.9
It
23
25
27
29
it
13
3 S
2t
4
4.2
l4
46
4.1
S
S2
54
59
52
9.1
6 2
6 4 !
901:'
1.5
1.7
2
22
24
26
1t
3
32
14
16
SI
4.1
43
4.S
4.7
V
11
53
S7
S9
12
43
65 !
951:
1.6
• U
2
22
25
27
29
It
33
13
17
39
41
43
4.6
4/
552
5.4
.55
5.6
1t
6
62
64
66 I
1001:
1.7
1.9
21
b
2S
26
3
12
14
16
it
4
4.2
l4
46
49
11
53
SS
17
S9
6.4
6.7 t
61
6.3
6s
6.7
105%
1.6
2
1.2
2.4
26
2.1
3
13
15
3.7
19
4.1
4.3
43
47
4.9
11
5.4
So
Et
t
6.2
64
11QT.
1.9
21
23
2S
27
29
3.1
13
16
31
4
42
44
46
4.1
S
12
14
5.7
19
6.1
i3
4S
Go
go i
115%
2
U
24
i6
26
3
12
14
15
18
4.1
43
4.S
4.7
4.9
it
13
SS
5.7
19
6.2
6.4
6.6
6.7
69 i
120%
2
1I
IS
27
29
1t
13
15
17
19
4.1
44
4.6
4.0
5
12
SA
16
54
6
[2
6.S
6.7
6.1
6.9
7 i
7.1
125%
2.1
13
15
2.2
3
32
14
16
18
4
42
u
46
49
it
13
U
S.7
5.9
U
U
63
6.7
7
7.2
Point System Summary: CIimate Zane 11
SCORE CARD
Measures
1. Ceiling Insulation A30 or
R,•�(0.03017-
(381 U -value (001
2. Wall Insulation (( I I or
R -value (111 U•value (0.0981
3. Raised Floor Insulation
4. Slab Edge Insulation
S. Infiltration
6. Glass Heat Loss
7. Shading (Shade Open)
a. North
b. East
c. South
d. West
e. Skylight
8. Shading (Shade Closed)
a. North
b. East
c. South
d. • West
e. Skylight
9. Interior Thermal Mass
10. Exterior Wall Blass
11. Heating System
Zonal Control? ( Y / N )
12. Cooling System
Zonal Control? ( Y / N )
13. Water Heating
or
R -value (191 U -value (0.0371
or
R -value (01 F2 facsar (0.711
Standard
Type jdambial
wo Glass
.0 X
X
X
-a- x
C°o Glass
c2.0 X
x
X
•� X
n x
i
IruenarNuZCFA
U -value [w
SC
Point Scores
SC Eff. To Glass
TYPE 1 MASS AREA
CONO. FLOOR AREA
TYPE 2 MASS AREA 3
Ex=w Wad
-COND.
FLOUR R
AREA
2
X
SE or HsPF
Net Efficiency (0.781
Effative SE ar
[0.77/66[�j
Q. "I
/�
X . y /
HSPF [10-V5.151
_
.-X
SEra 19.51
Duct Effiemary (0.741
-_
EffaeuvaSEER 17.031
s,
TrPeiscl
Credit(nmej
0
. 0 -A
Sum i.
11 v
-t3
-fl
Pninr'rntal: a
1. Ceiling Imsu;au,:;c
r
Controlled Ventilation Crawispace
2. Wall Insulation
Numoer of scenes
Number of stories
R -value
One
Two
Three
R-0
-103
-9
32
R-19
-8
-t
.2
R-30
.2
-1
.1
iR38
0
0
0
U-raiue
2 2
1
•_i
10.50
-176
-84
.54
10.20
-102
-49
32
10.10
-26
-13
-8
Us
0.C6
.18
-11
.9
•5
-6.
.4
0.04
_t
.2
-i
10.02
4
2
1
O.CO
it
5
3
.4
-3
0.04
14
r
Controlled Ventilation Crawispace
2. Wall Insulation
Stab Floor
Number of stories
r
Single- Single.
One
Two
Three
Famtly Family
Multi•
-7
1 R -value
Detaaled Atta=ed
Family
.4
R-0
-68 -51
34
.2
R-11
0 0
0
.2
R-13
2 2
1
•_i
R-19.._ _.....8
.__._.� 6......---.t
50
- .. U -value ..
.. '.. .:..
Number of Stones
-_.
- - -_0.80 • _-_---153 ..... -•-ltd --
-76
�-46
-
. 0.50
91 38
0
0
{ 0.20
-t7 36
.24
5
0.10
0 3
0
-
0.08
4 3
2
r
1
0.90
.4
-3
0.04
14
7
j
0.02
3 _
10
2
j . O.CA
•
:4 3
12
4
i
J O• -`O
Y
:-3. Raised Floor Insulation
6
3
i
Insulation In Floor
8
4
25
Number of sauies
-15
: -8
(R -value
One Two
Three
25
R-0
-17
.7
0
R-11
3 .2
.1
-4
R -19R-30
0 0
0
8
14
3
-4
-11
U -value
2
8
'
_-0.60
-144 _70
46
-1
0.50
-120 -5e?
38
21
0.40
-95 _46
vb
4
0.20
-69 3a
-22
31
{ 0.20
-3 -21
.14
10
0.10
-17 -8
.5
.4
0.08
-11 -6
-4
16
0.06
-6 .3
-2
2
j 0.C4
0
.10.02
0
17
-23
A '
3
8
U0
10 5
3
r
Controlled Ventilation Crawispace
Specfintion
Standwd
Stab Floor
Number of stories
Points
0
R -vacua
One
Two
Three
. i 4 R-0
-i l
-7
•5
R-5
-4
.4
3
R-11
.2
.2
.2
.41 to
.31 b 0.30 or
.2
.2
4: Slab FACe Insulation
.EO
•_i
.40
less
50
-121
-53
Number of Stones
.24
R -value
One
Two
Three
' R-0
0
0
0
R-5
8
5
2
R-7
8
6
-
3
F2'acmr
•
31
r
1
0.90
.4
-3
-t
0.80
.1
.1
0
0.70
2
2
1
0.60
6
4
2
J O• -`O
9
6
3
p 0.40
f
12
8
4
S.Inffitratioa (Air Leaka;e)
7.•Shading (Shade Open)
Specfintion
Standwd
Stab Floor
0
Points
0
&ective Pereatt Claw
I
6. Glass Heat Loss .
Slone:
0.40
5
Total
Alan x SC)
rCFA
E9e=w
Two Three
U -value
Two
Percent
0.0
:Glass
.5113
.41 to
.31 b 0.30 or
Glass
Single
Oouble
.EO
.50
.40
less
50
-121
-53
-M
.24
.10
4
40
-90
-37
-26
.14
3
8
35
-75
-29
.19
.9
1
10
30
31
-21
-13
•4
4
12
29
-58
•ZO
•t2
3
5
12
28
-55
-18
-10
.2
5
13
27
-52
-17
-9
.2
6
13
25
-t9
-15
: -8
.1
7
14
25
�6
-14
.7
0
7
14
24
-4
-12
.5
1
8
14
23
-4
-11
.4
2
8
15
22
37
-9
.3
3
9
15
21
34
-7
.2
4
10
15
20
31
5.0
0
5
10
16
19
-29
.4
1
6
11
16
gts x SC)
12
-3
2
7
12
16
17
-23
-1
3
8
12
17
16
.20
0
4
9
13
17
:.•15
-17
1
6
10
14
17
14
.14
3
7
10
14
18
13
-12
4
8
11
15
18
12
-9
6
9
12
15
19
11
-6
7
10
13
16
19
10
3
9
11
14
17
19
1-1
6
10
13
15
17
20
8
2
12
14
16
_ 18
4
7.•Shading (Shade Open)
0
Stab Floor
0
Raised Floor
&ective Pereatt Claw
2
Slone:
0.40
5
(percent
Alan x SC)
rCFA
E9e=w
Two Three
One
Two
Three
0.0
:Glass
Nona
East
South ':West
Srtyright
18
5
1
4
1
na
16
.. ' .4 : _. 2.
5 _._
1 ., ..
na
14
4
2
5
1
na
12
3
3
5
2
na -"
11
3
3
5
2
. na
10
2
3
5
2
1
9
2
3
5
2
2
8
2
3
5
2
2
7
1
3
4
2
2
6
1
3
4
2
3
5
_ t
2
4
2
3
4
0
2
3
1
3
3
0
1
2
1
3
2
0
0
1
0
3
1
.1
-1
-1
.1
2
0
.1
.2
.l
.2
0
na = not allowed
10
11
11
5.0
& Shading (Shade Closed)
7
9
it
12
Effective Peremt Claw
5.5
5
8
9
• (percent
gts x SC)
12
Effectin
5
8
10
12
Giets Norlt Eget
Soudt
West Sltyfi*
18
.ice
-t8
39
b4
ra
16
.12
-12
-59
-55
na
14
.10
-35
-50
-t6
na
12
-a
-29
_to
.37
na
11'
.7
-26
-36
33
na
10
-6
-23
31
-29
-74
9
•5
' -20
-27
-25
-65
8 '
•5
-17
23
.21.
-56
7
.4
-14
.19
•18
.47
6
3
-11
.15
-14
38
5
..2
-9
-11
-10
M
4
.1
-6
-8
•7
.23
3
0
.5
-4
.16
2
1
1
.2
.1
-9
1
1
1
1
1
1
0
2
s
3
0
no . not nk' ed
9. Interior Thermal Mass
Intortor
0
Stab Floor
0
Raised Floor
Mast
2
Slone:
0.40
5
Slodes
3
rCFA
One
Two Three
One
Two
Three
0.0
-8
-5
1
.2
-1
.1
0.1
-8
-5
3
-1
0
0
0.3
-7
.4
.2
0
1
1
03
-6
3
-1
1
1
2
0.7
-5
.2
-1
1
2
2
0.9
-5
-1
0
2
3
3
1.1
-!
.1
1
3
4
4
1.3
3
0
2
3
4
5
1.5
3
1
2
4
5
5
Z.0
-1
2
4
5
6
7
25
0
3
5
7
7
8
3.0
1
4
6
8
8
9
3.5
2
5
7
9
9
10
4.0
3
6
8
9
10
10
4.5
3
7
8
10
11
11
5.0
4
7
9
it
12
12
5.5
5
8
9
11
12
12
6.0
5
8
10
12
13
13
6.5
6
9
10
12
13
13
7.0
.6
9
11
13
13
14
7.5
6
10
11
13
14
14
8.0
7
10
11
13
14
14
8.5
7
10
12
13
14
15
10. Exterior Wail Thermal Mass
Erarior S•ingis- . $mg1e.
Wad Family Family MUN
!lass Demdod Attached . Famtiy
0.00
0
0
0
O ZO
3
2
1
0.40
5
4
3
0.60
8
6
4
U0
10
8
5
1.00
13
10
7
1.20
13
12
8'
1.40
12
13
9
1.60
10
13
il.. .
1.M
10
12
12
zCO
10
11
13
11. Heating System
SE or HSPF '
(assumes duets la atsira .
Zonal Control Adjustment
System Type
Resisance 10 9 7 6 4 3
Other 6 5 -4 3 2 2
Sum of l-6
-25 or -24 to
-14 to -t to
+6 to
16 or
SE
HSPF
less
-15
-5
+5
+15
more
0.72
6.60
0
0
0
0
0
0
0.75
fi 88
3
3
3
2
2
1
0.80
7.33-
8
7
6
5
4
3
0.85
7.79
13
11
10
8
7
5
0.90
8.25
17
15
13
11
9
7
095
8.71
20
18
15
13
11
8
Effective SE or HSPF
(SE or HSPF x duct eiMciene7)
Elfeme -25 or -24 to -14 Io
.4to
+6 b 16 or
SE
HSPF lass
-15
_S
+5
.15 more
0.30
2.75
-73
34
-56
.47
38
vM
na
3.41
-t5
-39
-34
-29
-24
.18
0.40
3.57
-34
30
-26
.22
-18
-14
0.50
4.58
-10
-9
-8
-7
.5
.4
0.56
5.13
0
0
0
0
0
0
0.60
5.50
5
5
4
3
3
2
0.70
6.12
17
15
13
11
9
7
0.80
7.33
ZS
22
19
X16
13
10
0.90
8.25
32
28
24
Z0
17
13
1.00
9.17
37
32
28
24
19
15
Zonal Control Adjustment
System Type
Resisance 10 9 7 6 4 3
Other 6 5 -4 3 2 2
IY12ndator7 Measures Checklist: Residential MF -IR
HOTS: to-nze rt odatdal bwl&np wbi¢t u Nc Sandards mug couaa Nae ttsastarea regadleaa of the mmplian¢
approach tacd IMM marcor .mu an uumk (-) may be ntpasded by tradearnt eompturtae AOureAea 4st1
on me Crstifcae o(Compuance When tius cho 1st u tncorpWAled into the pamtt donuntrna- the (cuuoaodaLW
be conadacd br idl p w um as hnding mounds component ptorfomw= somfcatsats for the mandatory sm3swes
.nraner utcr we shown CL=Wttae tat the docuoatu or on Nis ChWA M Gay.
DESCIUMOM I DESIGNFI I ENPORCEMFNr
Building Envelope Memurts
•
12.5352(a): Mimmurncetling atsulauon R•19-altuad avenge.
12.5352(br Loose fill i tmiumn manufamuv's kbded R -Valu-
• i2.5352(c): Minuets wall inwlaoon in tamed walls R• 1 I weighted swage (does not apply a
euenor mass walk).
12- 5352(k): Slab edge insudatwn - water absorguan roe no grater than 0.3%. rawer vapm
uangmsswo rate no pcauer than 2.0 pamfmceb.
12.5311: Isaulauoo spccirwd or itsadled meta Cali(amia Energy Commimon (CFC)gtWity
%w%dardc lndcare type and form.
0.53=1( Vapor barters mantatery in CLmate Iota la and 16 only.
J2.5317: Infilowxx rFiftltraaonCono*is
a. Doors and wwdows Bowe ca eoncuuomed and unconditioned spaces des VmW to Lima air
lokagc
b. Doors and-intao-s cwfued.
e Doors and -thanes wuwj%mppcd: all join& and W=worts caulked and sakd
12-5352(e): 5P=W ailtsauon barites uwalled ioedmpdy wills 12-5351 ateeu CEC auaUry
standards.
32.5352 a Installation of Rcotw=
I. Masonry and factory -bull rut plaees have
L Tugs sung. Closable mead or glass door
0. Oatsde au tome +nth damper and Gonad
L Flue oamo r and band
2. No coonotuous otomng gas ptloc& alkwad.
HVAC sad Plumbing System Measure
r
12-5352W and 2-M- Spree conditioning cgrapnrtmt wing: atracb calculations
42.5352(b) and 2.5315: Scuwk tttcmmaat en all appliab(e hating sysemL
•-42-5316(a)-. Duets co mtructea- installed and insulated per Chapter 10. 1976 UMC
12.5316(b): Exhaust systems have damper cooaolt
i2.5314(e): Gas.raeo space heating egWp m= ha inim miu m ignition deviea
12-531&: HVAC equipment. water he^•—• shov shads and fauea& acrtiGed by the CM
12.53520 W acv hater iroulation bLsni= (R• 12 orplater) orcombined inteeiodealrsior
insulation (R-16 or V==r fust 5 lets of pipes arses to ink insulated (R-3 or pater).
t ;2.5312(EAccption rr Pipe insulation on steam and scam condensate rc um A reveeuluing I
pn nnr-
i 12.5318(dr S -smarms Pool Heating
I 1. System has
a. Onmff Perch on hcater-
b. Wcutwo oof insotctton plate on nota.
r Plurnom to afow for solar.
2. 75 percent Unn al c(rtarney.
3. Pont cower.
a. Time clots.
5. Dueeuosd watt inks.
t t-(ghting and Appliance Measures
ir 12.53520 4ghung - 25 bsncns/wm or grate for gtsrral lighting in kitchens and trashaooss.
i 12.5314(c): Gas fired appliances agwpprd -ith intermittent ignition devi=
P-5314(at Rdrigenaors. mfrigamor-(metras- fneaers and fluosaeon lamp ballasts eadf od I
by the CEC Indu=ce make and snood number.
COWLIANCE STATEN NT
This Cc the. to of compliance lists t2r_ building feamtres and performance specifications needed to comply with
Title 24. Chapter 2-53 and Title 20. C7>am., 2. Subchap= 4. Article 1 of the California Administrative code. ibis
Ctruf tate has bear signed by the individual with overall design tespcnsibUity and the building owner. who stall
retain a copy of it and transmit the Cettif Bate to say stibsequar t purchaser of the building,
Designer
Nam= 6
TulrlFim=
Telephone:
Ur— a:
(signaaue) (date)
Documentation Author
Name
Tit)vFum:
Addrea:
Building Owner
Name:
rwerru=
Addn=
Telephone:
(signature) - - (date)
Enforcttment Agency
Name
Agc r.
RESIDENTIAL PLAN CHECKING GUIDE 8/91
(S.F., DUPLEX -.& MISC. ONLY)
A
Bldg. Permit # 7%' -3q"7'1-7OWNER A.P. #
Plan Checker S
GENAL
moi. onin
g requirements: (sideyards and number of permitted living units).
Valuation.,
lans signed by designer.
Proper description of work on application.
Existing violations on property.
6. tems on data sheet. (W.C., fees, Health, Developer Fees, License law, etc).
. Recorded notice of violation.
PLOT PLAN
t
mplete parcel size and dimensions.
tbacks, sideyards, easements, etc.
her buildings or structures.
ading, fills, drainage.
ood hazard.
ecial conditions on creation map,
tible, and foundations).
& FAS road setback.
(noise, CDF, fire sprinklers, non-cdmb-
Building or utilities across lot lines (Record form).
OOR PLAN
/Complete to scale plan with dimensions.
Required windows for light and ventilation (Sec. 1205).
Required windows for second exit (Sec. 1204).
jSkylights.(Chapter 34 & Sec. 5207).
iuman impact glass (Sec. 5406).
�equired room sizes, ceiling heights (Sec. 1207).
�FCIs in baths, garage, kitchen, and exterior outlets (Article 210-8).
Light fixtures, switches, receptacles, and exterior receptacles for main-
,tenance of mechanical equipment.
Locations of water heater, heating and cooling equipment, other electrical
r gas equipment.
age firewall, door size, and closer (Sec. 503(d)(3)).
1 3'0" exterior exit door (sec. 3304 M.
eplace and wood stove location, alcoves, and clearance.
F-ilumbing
ke detectors (Sec. 1210).
fixtures, water closet clearances and shower size.
STRUCTURAL DETAILS
Standard, bracing or engineered design (Table 25V)
usual shape, size, or split level house requiring lateral design.
DEQ restory requiring balloon framing and/or engineering.
��Three story building requiring engineered calculations and plans.
�Fooundation plan complete enough to construct building.
Floor construction details complete enough to construct building.
Elevations and wall construction details complete enough to construct building
�oof construction details complete encugh to construct building.
;__-,F,ireplace construction details and calcs if necessary.
f. Rafter ties or bearing ridge beam.
?!'Ga -age door or porch header sizes.
tud heights.
3. Adobe soils - special foundation design.
4 Retaining walls requiring design.
t -r -Special Inspection required.
RESIDENTIAL PLAW CHECKING GUIDE
MISCELLANEOUS ITEMS TO LOOK OUT FOR
-t--�tairway details: landings, rise and run, head clearance, handrails
(Sec. 3306).
--2-. Guardrail details (Sec. 1711 & 3306(j).
-3----Brick or stone veneer (Chapter 30).
-4!'Exterior plaster - weep screeds (Sec. 4706).
roper roof pitch for roof convering (Chapter 32).
t{� goof covering type - (fire hazard).
Foam insulation - protection.
"8J36" halls and stairways.
�fLiving area over garage - complete 1 -hour separation
including supporting walls and posts, etc.
AO� o exits on three-story dwellings (sec. 3303 & see
L-YI. Attic access and ventilation (Sec. 3205).
- nderf loor access and ventilation (Sec. 2516).
Isombustion air for fuel burning appliances - L.P.G.
..;oise requirements on duplexes.
ad-S�!Energy design.
,_14rrFlashing at all exterior openings.
responsible area requirements.
1
LO
'fie ��� �f.
8/91
required on garage side
Mezannines - 1716).
requirements.
h'
r
BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM
(One Form per Building)
A.P. Number 040 Building Department 'No. ~
School District•ChiG a City = County Jurisdiction
Property Owner ��" �0re 'tc, -
e-- A 10da/ --- �/+/V L- a1a)
Project Locatibn/Address .
Subdivision Lot Number
Residential Development:
a Sq. Footage
# of , Living. • MHI Addition ( Group R)
Units
Commercial/Industrial:
aSq. Footage
New Addition (Including Exterior
Roofed Areas)
r Oa" -L,, / / _ 7-5/
B lding Department Representative Date
(Floor Plans reviewed by School District Personnel)
District Id No. 9203 70
C` / School District certifies that
�ic � r��/ i , -
- / e- r G o G
(Applicant Name) (Phone Number)
3� (.9lEr�shSrP: _ r
(Street Address)
C;AICo.
(City), (State) (Zip Code)
has' -complied with the requirements of Resolution No. knl-%l
by t e payment of $ yo representing ?61�110 square feet.
ar a,r% e r Ir
School District Representative ate
PAID BY CHECK N0. � REMARKS:
BANK NO
o=aWASH
NOV 2 0.1991
white -applicant, yellow -building department, pink -school district
SCHOOL.FEE (8/88)
-.
LAh•.:C) OF NA1'URA1.. _A_ T H Af•f._
DEPARTMENT OF PUBLIC WORKS
CLAY CASTLEBERRY, Director.
7 COUNTY CENTER DRIVE, OROVILLE, CALIFORNIA 95965
Telephone: (916) 534.4681 William(Bill) Chef
Deputy Director
May 12, 1982
Arthur Howard RE: AP 47-10-115 and lly
2+58 Third St. Applications for
La Verne, CA 91750 Determination
Dear Mr. Howard:
At the regular meeting of the Butte County.Subdivision Violation.
Committee held on May 12, 1982, the committee issued conditional
Certificates of Compliance for the above -referenced parcels. The
conditions are:
Health Dept.:
1. Provide satisfactory evidence that suitable sites for the
installation and replacement of a sewage disposal system for a
single family dwelling exists on each parcel.
Public Works:
2.. Verify legal access from both parcels to a maintained public road.
3. Provide traversable access -to both.parcels from a maintained
public road.
There is a fifteen (15) day appeal period before a Certificate of
Compliance can be recorded unless you sign and return the enclosed
waiver waiving your right to appeal the Committee's decision.
Should you have any questions regarding this matter, please contact this
office.
Very.truly yours;
Clay Castleberry
Director of Public Works
J #.m Men onsa
Assistant Director
JM/ds
attachment
cc Planning
Health
wilding
Arthur Howard
2458" Third St.
La Verne, CA 91750
Dear Ms. Howard:
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
7 County Center Drive
Oroville, CA 95965
534-4266
June 7,. 1982
Re: AP 47-10-115
Application for Determination
Enclosed please find a copy of the Certificate of Compliance issued
by the Butte County Dept. of Public Works , which was
recorded on May 27, 1982 , in Book 2723 ,
Page 1 , in the Office of the Butte,County
Recorder..
Should you have any questions regarding this matter, please contact
this office.
Very truly yours,
Clay Castleberry
Director of Public Works
J Mendonsa
Assistant Director
JM/ns
Enc.
cc: Planning Dept.
Health Dept:
B�t ilding' Dept.
RETURN TO:
Public Works
Land Development Section
CERTIFICATE OF COKPLIANCE
PUBLIC WORKS
Mei � 2 �3
ELEAsOR Ei_S2
Issued to: Arthur Howard CLERK-RECORUER
.FEE
2458 Third St.
La Verne., CA 91750
This Certificate of Compliance is.hereby issued by the County
of Butte to certify that the land division which created the parcel of
property identified below complies with the applicable provisions of the
Subdivision Map Act and of Chapter 20 of the Butte County Code.
1. Property location: 2600 ft. west of Meridian Rd. and approx.
4000 ft. south of Munjar Rd. North
Chico area...
2. Assessor's Parcel Number: 47-10-115
Description: All that certain property located in the County
of Rutte, State of California, more particularly
described as follows:
ae South one-half of the North one-half of the East one-half of the East one-half
f the Southwest one-quarter of. Section 13 in Township 23 North, Range 1 West,
.D..B. & M.
?gether with rights-of-way of record recorded in Book 1911 of Butte County
(ficial Records at Pages 31 and 32.
Issuance of this Certificate is conditional upon the following
conditions which have been imposed pursuant to the Butte County Code
Chapter 20-167 and Government Code, Section 66499.35 (b), to protect
the public health and.public safety.
Provide satisfactory evidence that .a'�suitab le site for the installation and
. replacement of a sewage disposal system for a single family dwelling exists on the
parcel. .
Verify legal access from the: parcel to a maintained public road.
Provide traversable access to the',parcel from a maintained public road.
County of Butte
Subdivision Violation Committee
LD 1400 SND OFA.`
END OF DOCUMENT
0
M
�V
-11
w
cn
rn
1�
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
7 County Center Drive
Oroville, CA 95965
534-4266
June 7, 1982
Arthur Howard Re: AP 47-10-117
2458 Third'St. Application for Determination
La Verne, CA 91750
Dear Mr. Howard:
Enclosed please' -find a copy of the Certificate of Compliance issued
by the Butte County' Dept. of Public Works , which was
recorded on May 27, 1982 , in Book 2723 ,
Page 61F2 , in the Office of the Butte County .
Recorder.
Should you have any questions regarding this matter, please contact
this office.
Very truly yours,
Clay Castleberry
Director of Public Works
iqynn Mendonsa
Assistant Director
JM/ns
Enc.
cc: Planning -Dept. '
Health Dept.
Building Dept.
LD 1330.
RETURN TO:
Public.Works OFFiG:cL 9". t; i
Land.Development_ Section3!i'TTE ;OUN"'{
pUBL16 WORD' '
� 272l 2 5t4 PH 1997
CERTIFICATE OF COMPLIANCE ELEANOR H. BtCKE
issued. -to: CLERK -
o: Arthur Howard RECORDER FEE.
2458 Third St.
La Verne, CA 91750.
This Certificate of Compliance is hereby issued by the County
of Butte to certify that the land division which created the parcel of
property identified below complies with the applicable provisions of the
Subdivision Map Act and of Chapter 20 of the Butte County Code..
1. Property location: 2600 ft. west of Meridian Rd. and approx.
4000 ft. south- of Munjar -Rd. North
Chico area.
2. Assessor's parcel Number: 47-10-117
Description: All that certain property located in the County
of 'Butte, State of California, more particularly
described as follows:
The South one-half of the South one-half of the East one-half of the East one-half
if the Southwest one-quarter of Section 13, Township 23 North, Range 1 West, M.D.B. & M.
Together with rights-of-way.of record recorded in Book 1911 of Butte County Official
Records at Pages 31 and 32.
Issuance of this Certificate is conditional upon the following
conditions which have been imposed pursuant to the Butte County Code
Chapter 20-1.67 and Government Code, Section 66499.35 (b), to erotect
the public health and public safety.
1. 'Provide satisfactory evidence that a suitable site for the ixm tallation and--
replaceue nt of a sewage disposal'system for a. single family dwelling exists on the
parcel.
2. Verify legal access from the parcel to a maintained public road.
3.. Provide traversable access to the parcel from a maintained publi6 road.
County of Butte
Subdivision Violation Committee CIZ
ti
rn
LD 1400 Ei�D C6. CGU
tqjWA
w
t�7
'C.Y.d...�.. "
a fill
Y -Eutte County
t — - - LAND OF NATURAL VV E A L T H AND BEAUTY
DEPARTMENT OF PUBLIC WORKS
WILLIAM (Bill) CHEFF, Director
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965
Telephone: (916) 538-7681
RONALD D. McELROY
1 Deputy Director
i January 24, 1990
1
Arthur Howard RE: CAP 47-1.0=-1y15m
2458 Third Street Notice of Compliance
La Verne, CA 91750
Dear Mr. Howard:
Enclosed please find the Notice of Compliance which was recorded by
the Butte County Department of Public Works in the office of the Butte
! County Recorder on December 29, 1989. The Recorder's Serial Number
is: 89-050367.
i
If you have any questions regarding this matter, please contact this
= office.
1
}
Very truly yours,
t
r.
William Cheff
Director of Public Works
J04 Mendonsa
Assistant Director
JM/ds
attachment
cc: 3u ding Department
Environmental Health Department
RETURN TO:
Public Works
Land Development Section
89-050367
Recorded
Official Records
County of
Butte
Candace J. Grubbs
Recorder
8:02am 20 -Dec -89
NOTICE OF COMPLIANCE
., 89-50351
Rec Fee .00
Total .00
AGENCY SHOWN
Issued to: Arthur Howard
! 2458 Third Street
La Verne, CA 91750
This Notice of Compliance is hereby issued by the County of Butte to certify
that the conditions imposed on the Certificate of Compliance; recorded on
May 27, 1982, under Recorder's Document Serial Number: 82-15884 have been
fulfilled to the satisfaction of the Subdivision Violation Committee on
Property identified as:
a. Assessor's Parcel Number: 47-10-115
b. Property Location: 2600 feet west of Meridian Road
and approximately 4000 feet south
of Munjar Road. North Chico area.
DESCRIPTION:
All that certain property located in the County of Butte, State
of California, more particularly described as follows:
The South one-half of the North one-half of the East one-half of the East
one-half of the Southwest one-quarter of Section 13 in Township 23 North,
Range 1 West, M.D.B. and M.
pTOGETHER WITH and reserving therefrom an easement for road and utility
urposes 30 feet in width lying easterly of and adjacent to the westerly
boundary of the land described herein..
TOGETHER WITH rights-of-way of record recorded in Book 1911 of Butte County
Official Records at Pages 31 and 32.
f
TOGETHER WITH rights-of-way of record recorded under Recorder's Document
Serial Number 85-12340.
Issuance of this Notice of Compliance is pursuant to Butte County Code,
Chapter 20-167.
9
County of Butte
Subdivision Violation Committee
VS 1
i .
END OF,'. OCUMENT
END OF DOCUMENT
k
, .' � t1CliWT MRiN MidC't1
UM MAI INSI IN, "n �,t(ATITIIML MIUM MCI►ICATICH ►t
span ite eitr
"t+►tt"`rt
ltti IITMKIMIt
0n �
+q on RRuCRt+lnt
1
for >Iis�R TWI#
►iRD Ltwtr
..
U LL ' I O.0 PSP
7�r�gi. 1b ..0 PSF
( ,
TOT .,t,0: 31.0 Pte,
GATE`
t� .
r...,1, i�
avRArxal ►.na
OiIR PAO.:; -1.25,,
PITCH
SPACING . 30 0
tivp
ar•y�.
ALPY
,
ot,ltsr~a
iloo
Q
r coaTt[c
�,
ewatr+; rer►hih
acca stc
.,�"Fi115S
, .' � t1CliWT MRiN MidC't1
UM MAI INSI IN, "n �,t(ATITIIML MIUM MCI►ICATICH ►t
span ite eitr
"t+►tt"`rt
ltti IITMKIMIt
0n �
+q on RRuCRt+lnt
1
for >Iis�R TWI#
►iRD Ltwtr
..
U LL ' I O.0 PSP
7�r�gi. 1b ..0 PSF
( ,
TOT .,t,0: 31.0 Pte,
GATE`
GRKG c�
r c
dA -EW,
O/A LEI
OiIR PAO.:; -1.25,,
PITCH
SPACING . 30 0
tivp
ar•y�.
„17/30.
M100!7017
2-0_p