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047-430-013
O r v 47-43-13 _ ANDY & MARGO WOOD) -r3-49 «� = 47-43=13TH M 42 Quail Covey Ct, Chico Permit#123-88A(gr`iculturaI Bldg Exeml: ontR- - Norah"+ Valley"Readymix:'"' "" st'g of hay &;,s ', stalls j PErmit#3920-88B,,P;E;M(new singel fam- ily) am-ity) 047-430-013'�` t` '` r � 04-1229 > Nt- 42 QUAIL COVEY+GT,4CH R COUNE� CONT: FOUR RE -ROOF_ 51 SQ t'� B06-2352 � �u,ga�;047.430-013 - MISCELLANEOUS Room Addn.First Stry '," ADDITION OF GRE O 42 QUAIL COVEY, C3`� WOOD; LIVING TRUST 4; .w'., • .�. • � chi'--® .� _ �3 f - , c ' � ♦J� v is }i j �:_c. ,.:.i,. s,• � . u.. t:. ._ .. -- .. _.. �p , �.�� a BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR RVSPECTION#.:. OROVILLE: (530) 538-7636 • CHICO: (530).891-2834 OFFICE #: (530).538-7541 A FEE WILL BE REOUIRED AT TIME OFAPPLICATION Website: www.buttecounty.net/dd''s **PLEASE PRINT CLEARLY** OWNER Last Name �A�� First Name Address City C�o� State Zip��.� Phone Lt 5--,1 L -CL Fax E-mail CONTRACTOR Name Addresses F„tS g L.:.. City C�o Co State C� Zip; Phone ._ .� Fax 3415 Sa�l(o E-mail Lic. #� C ass _g ARCHITECT/ENGINEER Name Address lb 2�- Address uz Ck CityCha C.A State- Zi Phone gq� _ Oq I Fax E-mail S L' is; berg Map Book . Page .11 APPLICANIC NAME Name 0 Address uz Ck City City Cho StateCa— Zi Phone Fax E-mail APPLICANT S NATURE X For office use only: Zoning j �' - ood Zone City j SRA Yes No Occ. Type Const. Subdivision Name Map Book . Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc LOCATION l Property Address City Cross Street IA(ARKAR'S. COMP NS ON Number Ty YJ ,z,q.3 ro Ca i r If hirinWgAe other than license tors, a certificate o worker's comp sa n must be shown ftetrof permit issuance. LEW,1411PAGENCY Nam dress /A\j cription or S of Work: Q± M 1. Foota ❑ Structu a uilt without Permits ❑ ropos d, Change of Occupancy ote, evious use): Page 1 of 2 E IRATION OF APPLICATION pp ' ations for which a permit has not been issued will expire one ear a r the date of application. In order to renew action on an applicati ` after expiration, anew application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work` plan checked and other department costs are not refundable. Received by: 61 _ Amounti 5k"'• q I Bldg t .1� 190 0 SRA Receipt #: 83 607 Sheriff IQb�S Date: 10 -mo 8 SMIP REV 2-24-05 BUTTE COUNTY FEE SUMMARY, 7 County Center Drive Oroville, CA 75965 Department of Development Services Phone (530) 538-7541 Fax (530) 538-2140 Permit Number: B06-2352 Job Address: 42 QUAIL COVEY CT Contractor: NORTH VALLEY BUILDING SYSTEMS 9E THREE SEVENS LANE STE 5 CHICO, CA 95973 Printed: 10/03/2006 2:13 pm Fee Description Account Number Fee Amount Paid Date Pmt Amt Fire Inspection (SRA) -Fire -Res Fire Plan Review (SRA) -Fire -Re 0100-450001-4617237-1010 $95.00 10/03/2006 $95.00 Fire Ping Appl Fee (SRA) -Bldg 0100-450001-4617240-1010 $95.00 10/03/2006 $95.00 Room Addition - First Story 0010-440001-4210500-1010 $109.98 Room Addition - First Story PC 0010-440001-4210500-1010 $775.36 SMIP - Residential 0010-440001-4210500-1010 $516.91 10/03/2006 $516.91 1001-0-280-1011298 — /0, (a q Printed By: Kourtni Graham 19601.49 $706.91 8ct6.03 Balance Due: 589448 At the time of permit application, I was advised the above fees are required prior ro issuance of the permit. These fees may be changed during the plan checking process. Date: 10/03/2006 Pursuant to Government code Section 66020, you are herby notified those items listed above may been imposed on your project. You have 90 days from the date of approval of the project or from the impostion of the above referenced items during which you may request a protest. The requirments for a protest are specified in Government Code Section 66020(a). T TF.c�` r G O p O. O Q O calJN1 , A�e1!10 WOR�y Department of Public Works County of. Butte J. Michael Crump, Director LAND DEVELOPMENT DIVISION Storm Water Management Program 7 County Center Drive Oroville. CA 95965 (530)538-7266 (FAX) 538-7171 National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement LLESS THAN 1 ACREI Project Description: \ k_-3Z� A Project Location and/or Parcel Number: L4 Z a 0 By signing below, I, the project owner/owner's agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that 1, therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site build -outs of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for a project that disturbs one acre or more of land may result in revocation of grading and/or other permits or other sanctions provided by law. Signed: Title: ,,,,,�°.` Date: Less than I Acre NPDES & SWPPP Compliance Certification Butte County Storm;,Water,Management Program Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 Fax www.buttecounty.net/dds NOTICE TO BUILDERS Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental Health, and the California Department of Forestry for their clearances and approvals. There are some things you can do to expedite your permit: • Make sure your application is complete. • Be responsive to requests from County departments for any additional materials or requirements. The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes without a complete application adds to processing time. Every permit issued by the Building Official shall expire and become null and void if the work authorized by such permit is not started or completed within one year from the date of issuance of such permit. A permit may be renewed (for a fee) prior to expiration an indefinite number of times, provided construction progress has been documented by the Building Division during each year during scheduled inspections. No changes may be made in the original plans and specifications for such work. In order to reinstate action on a permit after expiration, the permittee shall pay a new full permit fee and additional plan checking and documentation may be required. Upon completion of work covered by this permit, please contact this office for final inspection. As a reminder to you, it is illegal to occupy this building or any portion of the building for which this permit is issued without a final inspection. EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY Application for which a permit has not been issued will expire one year after date of application. Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications (not yet issued) must be requested within two years from the date of fee payment. Fees paid at the time of application are for Plan Check and administration. The Plan Check portion of fees is refundable only if the permit is cancelled or withdrawn before any plan checking is done. Building Division costs will be deducted prior to authorizing a refund and a charge of $54.99 to process the refund application will be assessed. Refunds on permits (issued) may be requested prior to the expiration of the permit, provided no work has been done pursuant to the permit. An Inspection may be required (and deducted from any refund amount) to determine no work was done. Fee/refund information can be read on-line at hqp://municipalcodes.lexisnexis.com/codesibutteco/ Reference Number: B06-2352 Location: 42 QUAIL COVEY CT Parcel Number: 047-430-013 Owner Name: WOOD, LIVING TRUST Description: ADDITION OF GREAT ROOM Date: 10/03/2006 Phone: (530) 345-7296 Signature of Property Owner<:� Date: 10/03/2006 FILE Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 75965 (530) 538-7601 Telephone (530) 538-7785 Fax www.buttecounty.net/dds PERMIT APPLICATION DATA SHEET Reference Number: B06-2352 Date: 10/03/2006 Location: 42 OUAIL COVEY CT By: KCG Parcel Number: 047-430-013 Sub Type: Room Addn-First Str Owner Name: WOOD, LIVING TRUST Phone: (530) 345-7296 Description: ADDITION OF GREAT ROOM Oroville Elementary School District, 2795 Yard Street, Oroville CA 95966 - (530) 532-3000 The above permit application has the following Clearances required prior to permit issuance. Please contact each department indicated below regarding specific requirements pertaining to your permit application. Yes No DRAINAGE DISTRICTS ❑ F] Thermalito Irrigation District, 410 Grand Avenue, Oroville CA 95965 - (530) 533-0740 Chico Unified School District, 1163 East 7th Street, Chico CA 95926 - (530) 891-3006 LOAPUD, 1960 Elgin Street, Oroville CA 95966 - (530) 533-2000 ❑ Durham Unified School District, 4920 Putney Drive, Durham CA 95938 - (530) 895-4675 City of Chico, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711 Gridley School District, 429 Magnolia, Gridley CA 95948 - (530) 846-4723 PARKS & RECREATION DISTRICTS ❑ ❑ Chico Area Recreation District, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711 Oroville Elementary School District, 2795 Yard Street, Oroville CA 95966 - (530) 532-3000 Durham Park & Recreation District, 9447 Midway, Durham CA 95938 - (530) 345-1921 Oroville Union High, 2211 Washington Ave, Oroville CA 95966 - (530) 538-2300 Ext:105 Feather River Recreaction & Park District, 1200 Myers Street, Oroville CA 95966 - (530) 533-2011 Paradise Unified School District, 6696 Clark Road, Paradise CA 95969 - (530) 872-6400 Paradise Parks & Recreation, 6626 Skyway, Paradise CA 95969 - (530) 872-6393 Signature of Property Owner: Date: 10/03/2006 FILE SCHOOL DISTRICTS Biggs Unified School District, 300 B Street, Biggs CA 95917 - (530) 868-1281 Chico Unified School District, 1163 East 7th Street, Chico CA 95926 - (530) 891-3006 ❑ ❑ Durham Unified School District, 4920 Putney Drive, Durham CA 95938 - (530) 895-4675 Gridley School District, 429 Magnolia, Gridley CA 95948 - (530) 846-4723 Marysville School District, 1919 B Street, Marysville CA 95901 - (530) 741-6000 Oroville Elementary School District, 2795 Yard Street, Oroville CA 95966 - (530) 532-3000 Oroville Union High, 2211 Washington Ave, Oroville CA 95966 - (530) 538-2300 Ext:105 Paradise Unified School District, 6696 Clark Road, Paradise CA 95969 - (530) 872-6400 OTHER Recorded copy of Agricultural Acknowledgment Statement- See Attached Instructions ❑ City of Biggs Planning Department, 3016 Sixth Street Biggs CA 95917 - (530) 868-5447 ❑ ❑ Other: ❑ ❑ Other: ❑ ❑ Other: Signature of Property Owner: Date: 10/03/2006 FILE Butte County Department of Public Works J. MICHAEL CRUMP, DIRECTOR LAND DEVELOPMENT DIVISION Storm Water Managment Program 7 County Center Drive Oroville, CA 75965 (530) 538-7266 Telephone (530) 538-7171 Fax www.buttecounty.net/dds National pollutant Disharche Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgment [LESS THAN 1 ACRE 1 Reference Number: B06-2352 Location: 42 QUAIL COVEY CT Parcel Number: 047-430-013 Owner Name: WOOD, LIVING TRUST Description: ADDITION OF GREAT ROOM Date: 10/03/2006 By: KCG Sub Type: Room Addn-First Str Phone: (530)345-7296 By signing below, I the project owner/owners' agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site buildouts of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the state of California Regional Water Quality Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for this project that disturbes one acre or more of land may result in revocation of grading and/or other permits or other santions provided by law. Title: FILE Date: 10/03/2006 BUTTE COUNTY FEE SUMMARY 7 County Center Drive Oroville, CA 75965 Department of Development Services Phone (530) 538-7541 Fax (530) 538-2140 Permit Number: B06-2352 Job Address: 42 QUAIL COVEY CT Contractor: NORTH VALLEY BUILDING SYSTEMS 9E THREE SEVENS LANE STE 5 CHICO, CA 95973 Printed: 12/11/2006 8:17 am Fee Description Account Number Fee Amount Paid Date Pmt Amt Fire Inspection (SRA) -Fire -Res 0100-450001-4617237-1010 $95.00 10/03/2006 $95.00 Fire Plan Review (SRA) -Fire -Re 0100-450001-4617240-1010 $95.00 10/03/2006 $95.00 Fire Ping Appl Fee (SRA) -Bldg 0010-440001-4210500-1010 $109.98 Room Addition - First Story 0010-440001-4210500-1010 $775.36 Room Addition - First Story PC 0010-440001-4210500-1010 $516.91 10/03/2006 $516.91 SN4IP - Residential Printed By: Alice Mefford 1001-0-280-1011298 $10.69 1,602.94 $706.91 Balance Due: $896.03 At the time of permit application, I was advised the above fees are required prior ro issuance of the permit. These fees maybe changed during the plan checking process. Signature: Date: 12/11/2006 Pursuant to Government code Section 66020, you are herby notified those items listed above may been imposed on your project. You have 90 days from the date of approval of the project or from the impostion of the above referenced items during which you may request a protest. The requirments for a protest are specified in Government Code Section 66020(a). BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION M (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.netWds 1 JPERMIT NO. BP041229 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date' 04/30/2004 APN• 047-430-013-000 the Business and Professions Code, and my license is in full force and effect. License class :8 - C3 S License Number: y�1 Site Address: 42 QUAIL COVEY CT CHI Date:11/ ' C Contractor-A)4/e COk�i�///i Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: RE -ROOF (51 SQ) Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: WOOD ANDREW J & MARGO CP to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 42 QUAIL COVEY CT 7000) of Division 3 of the Business and Professions Code) or that he or CHICO, CA she is exempt therefrom and the basis for the alleged exemption. Any 95973 violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who -builds or improves thereon, and who does Applicant: FOUR COUNTIES ROOFING such work himself or herself or through his or her own employees, i provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one 3 CRUSADER COURT year of completion, the owner -builder will have the burden of CHICO, CA 95973 proving that he or she did not build or improve for the purpose of sale.). (530) 343-1416 ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does I not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed Contractor'' FOUR COUNTIES ROOFING pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 of the Business and Professions Code 3 CRUSADER COURT CHICO, CA 95973 Date: owner: (530) 343-1416 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: License #: 774554 ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as Architect: required by Section 3700 the Labor Code, for the performance of Engineer: the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 0 S. F. Valuation: $0.00 Policy#: 05_73_6 ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to Census Code: ) become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. 41, % Date: Applicant. WARNING: Failure t(secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code and/o I hereby affirm that there is a construction lending agency for the ns to o Resolutiowork indicated above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) 4-3o-64 Name: By: Date: PERMIT E IRES ON: Address: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substa an official form or document of�Butte County. I hereby authorize representatives of Butte CountyNto enter upon the above mentioned property for inspection p oses. v Z Z�/ Print Name:Signatur (A Date: -r ❑ Owner Contractor ❑ Agent for Owner ❑ Agent for Contractor // BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE All: (530) 538-7541 FAX#: (530)536-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BP041229 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 04/30/2004 APN• 047-430-013-000 the Business and Professions Code, and my license is in full force and effect. License Class :,5 -- C3 S License Number: SS� Site Address: 42 QUAIL COVEY CT CHI Date:1// ContraclorFD!/Lo CDu /%f i ///rn Map Index: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Description: RE -ROOF (51 SQ) Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a permit to construct, alter, improve, demolish, or repair any structure, prior Owner: WOOD ANDREW J & MARGO CP to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's State License Law (Chapter 9 commencing with Section 42 QUAIL COVEY CT 7000) of Division 3 of the Business and Professions Code) or that he or CHICO, CA she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the 95973 applicant to a civil penalty of not more than five hundred dollars ($500).): ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does Applicant: FOUR COUNTIES ROOFING such work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If however, the building or improvements are sold within one 3 CRUSADER COURT year of completion, the owner -builder will have the burden of CHICO, CA 95973 proving that he or she did not build or improve for the purpose of sale.). (530) 343-1416 ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed Contractor: FOUR COUNTIES ROOFING. pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 of the Business and Professions Code 3 CRUSADER COURT CHICO, CA 95973 Date: owner: (530) 343-1416 WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: License #: 774554 ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation insurance, as Architect: required by Section 3700 the Labor Code, for the performance of Engineer: the work for which this permit is issued. My workers' compensation insurance and policy number are: �carder F/� Carrier: /T����/!Y Total Square Ft: 0 S. F. Policy#: /�—D00573 --6 ❑ I certify that in the performance of the work for which this permit is Valuation: $0.00 issued, 1 shall not employ any person in any manner so as to Census Code: become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date: , Applican . c11 WARNING: Failure o secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. 405104�� x/30% 3 CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Bette County Code anrvor I hereby affirm that there is a construction lending agency for the Resolutions to Qo work indicated above for which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) 4-.3o.64 Name: By: Date: PERMIT E IRES ON: 4-30-06 Date Address: ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substa an official form or document ol�Butte County. 1 hereby authorize representatives of Butte County.to enter upon theabove mentioned property for inspection p oses. /I v Z/4; Print Name: / C_ Signatur (��l Date: ❑ Owner Contractor ❑ Agent for Owner ❑ Agent for Contractor T . L ' ' BUTTE COUNTY o�VTTF0 DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION. . ° ° 24 HOUR INSPECTION M (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO). c _ ' o OFFICE M (530) 538-7541 PERMIT NO. BP o4l s.� DATE: 41-5-5/04- APN: 414-7 .43 O • C 13 ZONING: OWNER'S LAST NAME: OWNER'S FIRST NAME: PHONE: STREET ADD ESS' L ;Z C Or/ C FAX CITY, IP: C ( C V EMAIL: SITE ADDRESS: CITY, ZIP: NEAREST CROSS STREET: TRACTILOT 0: APPLICANT NAME: PHONE STREET ADD SS: n C ��/ C FAX ,� - � CITY, ZIP /, G 2=L2 �Il J E DMIL � CONTRACTOR NAME: v� C ^ S l PHONE: ,3 V4 STREET ADDR �— FAX CITY. ZIP: � � � � EMAIL• LICENSE NUMBER... U B R LICE SE 7Y C5 ARCHITECT/E INEER AME: PHONE STREET ADDRESS: FAX CITY, ZIP: LICENSE NUMBER E -NIHIL' DESCRIPTION OR SCOPE OF WORK: lea & IAe, ❑ Structure Built without permits ❑ Proposed Change of Occupancy (note previous use) EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order.to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee:: The request must be made prior to the expiration of the permit and,no construction work has been done. Filing fees, plan check fees.for work plan checked and other department costs are not refundable. For office use only: Notes: Y Application Received by: 4eDate: 4 3o c4 Receipt number: 4,054.4•5 Amount Received: September 13, 2001 Mr. Lloyd Hedenland 7-H Technical Services Group, Inc. 431 Crown Point Circle, Ste. C Grass Valley, CA 95945 DEPARTMENT OF PUBLIC HEALTH DIVISION OF ENVIRONMENTAL HEALTH FJ18-B County Center Drive Oroville, CA 95965 TEL: (530) 538-7282 FAX: (530).538-2165 FV411 Main Street P.O. Box 5364 Chico, CA 95927 TEL: (530) 891-2727 FAX: (530) 895-6512 B E A U T Y ❑ 7 County Center Drive Oroville, CA 95965 TEL: (530) 538-7281 FAX: (530) 538-7785 RE: Wastewater Treatment and Disposal Project; Pheasant Landing III; Garner Lane; APN X047-350-013, -014, and -6015 Dear Mr. Hedenland, Thank you, for the opportunity to review your waste treatment plant. As you may now know Butte County Environmental Health Division (BCEHD) has acquired the responsibility for permitting the wastewater treatment and disposal system for the subdivision known as Pheasant Landing III. This office received the first set of plans and project report for the wastewater treatment/disposal system on September 6, 2001. We have completed our initial review and have the following comments:' 1) It is our understanding that the design engineer employed by 7-H Technical Services Group, Inc. shall be completely responsible for the construction and inspection of the entire system starting from the connection at the collection system through to the disposal field. Staff from the BCEHD will complete visual secondary inspections throughout the construction of the system to verify component installation, adherence to the approved plan and to acquire some familiarity with the treatment plant. With that in mind, please submit a construction inspection schedule for review and approval. A signed construction inspection schedule and statement by the project engineer that the system was installed in substantial compliance with the approved plans shall be submitted to BCEHD at the end of construction. 2) This office requires that plans submitted for review for any permit be drawn to a commonly used scale and not reduced. Therefore please amend the components of your design: A) Provide a scaled site plan showing the following: a) A "continuous flow" plan depicting the major components of the treatment plant from the collection system connection to the disposal field. b) The site plan shall show all of the required property setbacks. This includes side yard and setbacks from right-of-way for Lindbergh Circle and Garner Lane. w Lloyd Hedenland Page 2 September 13, 2001 c) Show all setbacks from existing and' proposed wells. Any well setback that infringes onto Lot A shall be field marked before the construction of the disposal fields. B) Show all cross-sections of major system components and pipe installations to scale. This is often called a hydraulic profile cross-section. This shall show installation elevations of all components. If bedding material is required for any of the treatment components specify type and thickness of the material. Q In addition to the items mentioned above, the plan must specify construction details where appropriate. As an example, pipe sizes and their material specifications should be noted on the plan where they are identified to connect various components of the system. In other words the plan shall be detailed with construction specifics that would allow a contractor to work from it. 3) Both the active and replacement disposal zones shall be installed. The plans shall specify that all zones will be installed. 4) The following construction items shall be shown on the plans: a) Tracing wire shall be placed in the influent sewer line and pressure line trenches. b) All piezometers and monitor wells shall be a minimum of four inches in diameter. c) It appears that fill material has been placed on the site. Any fill material shall be roto - tilled into the top six inches of native soil. Please submit a written statement that this has already occurred or include it in the construction plans. d) Provide a grading plan for Lot A. The grading plan should detail any proposed fill or cuts. If any fill is to be used for the construction of the disposal fields, it must first be approved by the project engineer and its use detailed in the grading plan. A finished grade should be provided that will insure that surface runoff water will not sit on the disposal fields or gather around manhole risers. e) If a water service line is to be installed within Lot A for the purpose of cleaning pump chamber screens or treatment plant components then show its location on the plans. Minimum separation between sewer lines and water service lines is five feet. f) Give details on the fence that shall surround Lot A. The fence shall be constructed of durable material with gates large enough for service vehicles. g) The system shall have audio/visual alarms for the pumps and treatment system in case of failure. This should be reflected in the plans. 5) Submit information on the noise level of the treatment and pump systems. Noise shall not be a nuisance to surrounding properties. Lloyd Hedenland Page 3 - September 13, 2001 6) Provide a detailed engineers cost estimate for: installing the system. This cost estimate will be used for reviewing any bonding required 'if the map records prior to system installation. We must inform you that no further review of the system will occur until an application package consisting of a permit application, a fee of $968.00 and two copies of the construction plans with supporting data is submitted to the BCEHD. After twelve hours of work on the project, additional hours will be charged at a rate of $66.00 per hour. A comprehensive, construction grade plan of the wastewater treatment/disposal system, married to the rest of the improvement plans is a requirement of the subdivision map. Therefore, it is imperative that the revisions and additional information requested by this office be submitted in a timely manner if the developer wishes to commence with the project., Y Please note that the following requested items donot necessarily mean that additional information, changes, or requirements will be needed. Any additions or deletions, or modifications to the system required by the Regional Water Quality Control Board after the . installation permit has been issued shall be reviewed and approved by the BCEHD. If you have any questions please feel free to call me at 891-2727 between 8:OOam and 9:OOam Monday through Friday. Sincerely, Clifford Bottenfield, Jr., REHS Division of Environmental Health CCB/septic/Pheasant L III planr cc: Steve Schuster Stu Edell, Butte Co. Land Development Ron Dykstra, RWQCB #Butte County Building Division COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT P RMITQN� O A SF-SSOR PARCEL NUMBER �.� 4? ZONING BUILDING PERMIT -o NE ""_ -- — TELEPHONE SQ. FT. OCC. BUILDING VALUATION OR MAI ING DDR 5 ONTRA A ELEPHONE ) CO RA TORS M ILI A DRES 3 CONS UCTION L DER UNKNOWN Fireplace C Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee 5 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ " ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 ' Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP Water piping 1 5.00 Each pas water heater or vent 5.00 USE OF STRUCTURE SF Duplex[] Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home I S I G JW 1 10.00e TYPE OF WORK New ❑ Addition ❑ . Remodel ❑ Utilities ❑ Installation ❑ Other � Describe work: / Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service j00 AMP OR00V 01 LESS10.00 Main service EA. ADD'L 100 AMP 2.50 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 El 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST.( DWELLING OCCUR.& CC. BLDGS. New DCONSTR.A , , q t ULT'OUTLET NON-RESID BRANCH CIRC ITS .50es 2.50 ea POWER APPARATUS tr (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 800300 8AL030FIXED APLNS.0 EX. Occup. OUTLETS IPRESID 1REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ ! Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation. Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree 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 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 $ ; Energy Inspection Fee $ 1 occ CONST TYPE TOTAL FEE $ HAz I CUA PARK I SCHI I FIE) I PAR PD HD ISSUE This permit is nereby issued under sions of the Butte County. Code and/or work indicated above for which fees DIRECTOR OF PUBLIC BY the applicable provi- resolutions to do have been paid. WORKS Date Receiot No. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 t, 1 AGRICULTURAL BUILDING EXEMPTION PERMIT PERMIT7/ Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticulutral products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place used by the public. ASSESSOR PARCEL NO. 42 —5 r� ZONING OW R PHONE NO. 4 - -OWNER'S JJ OWNER'S ADDR SS Lir, t LOCATION OF BUILDING USE OF BUILDING O'er SIZE OF STRUCTURE r X 460 SO. FT. TYPE OF CONSTRUCTION: TI WOOD FRAME (� STEEL CONCRETE OTHER (Specify) TYPE OF SIDING ROOF COVERING FLOOR TYPE rn ESTIMATED COST OF CONSTRUCTION $ AG Buildings shall comply with the building front, side, and rear yard requirements of the applicable County Ordinances as follows:/ . FRONT SD '`.i-..� 4 SIDES �� � REAR 15 - AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a mobilehome, and 23 feet from a commercial building. AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a mobilehome, and 40 feet from a commercial building. I declare under penalty of perjury that the building will be used as stated above and the proposed use conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Department of Public Works and will obtain any necessary permits, inspections, and approvals to comply with the requirements in effect at that time and before occupancy. Date ���/��/t Signature of Owner -� Permit Fee - $25.00 The above described AG Building is exempt from a building permit. Receipt No. ��` / Director of Public Works By-- Date White - DPW, Yellow - Assessor, Pink - B.I., Goldenrod - Applicant AL COUNTY OF BUTTE - DEPARTMENT -OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE: 916/538-7541 M. PERMIT APPLICATION' -DATA SHEET ` -z'- OWNER Proposed Building Use Building Inspector P.11 ermit No. A. F. At time of p rmit application, I Was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . .................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer of plans .. 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Energy Design Compliance and supporting documentation ......... 6. Statement of Intent for Non -Heated and AC Buildings .............. 7. Engineered truss details and layout in duplicate (required prior to plan check) 8. Mobilehome installation data including manufacturer's installation instructions....................................................... 9. Fees of $ .......................... 10. Chico Urban Area fees paid ........................................ 11. Park fees paid ..................................................... 12. School District fees paid ................ . 13. Sanitation approval from Health Department ... 14. City of Chico plumbing. permit ..................................... . 15. Plot plan and business license approval from City of (see City for other requirements) 16. Planning approval for (A) Use: (B) Parking: 17. Improvements may be'required. 18. Driveway permit (construction approval required prior to occupancy) ... 19. Pre -Inspection for required ...... Pre-Inspec. request to Building inspector (Dal 20. Contractor's license information (No., Name Style, Classification) ....... 21. Certificate of Workmans Compensation Insurance .................... 22. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ......... 23. Recorded copy of Agricultural Acknowledgment Statement ............ 24. Letter of signature-autho.ni,kation .............. ; . Ir 25. .................. ..� 26. When you issue the permit, process as follows: Telephone and hold for Other t—Mai l to owner. Mail to contractor. ck p at office. Deliver w/inspector. Applicant Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitted prior to permit issuance 1. Index permit for above items No. 2. Additional items required: (Circle new item not checked above). Contractor, designer, owner, was advised of above required data by_phone---nail—counter by date Contractor, designer, owner, was advised of above required data by —phone _maII—counter by date Plans checked by Date Plans approved by Sets of plans on hold in File cabinet AP folder Copy—DPW Date 39 ` PERMIT NO. PERMIT EXPIRES OWNER ANDY 9 MAR(-,Q—WOOD CONTR.. North Vallee Rea;dymix r ASSESSOR PARCEL 47-4313 LOCATION 42 Quai 1 .wey1 �� OjtED ? 1 z_ OFFICE COPY j ' Address i GAS Meter By Date ELECTRIC ? Meter By Date c Temp. Power Pole n Called PG&E Temp. Elec. Service Called PG&E Z Temp. Gas Service 7`�%/. 'ffi►C� �(A A Called PG&E Af (,If�. JOB FINALED (Da / 2- Signature Signature =OK = 14ot pp - = Not Applicable RESIDENTIAL (Single and Duplex) Applicable/= Not Ready Date U ERFLOOR (Plans) OK except #'s Date F MNG (Continued) ning-Setbacks;-Easements-Flood-Slope ngers-Post Caps -Anchors -Connectors g., Main; Soils -Steel -E. d.-/1211/" Ftg. Depth g. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. g., Garage; Soils -Steel -7-/" Ftg. Depth ireplace`Ties or Type A Flue -Fireplace Throat Clearance g., Porches &Decks; Soils -Steel-/ /"Ftg. Depth gdic Access; Size & Romex Protection -Draft Stop -Ins. Baffles temwalls, Main; Steel- Bloc kouts-Wrapped �cirm. Windows or Exiting Doors -Sill Hgt. &Dimensions SKEr St mwalls, Garage; Steel-Blockouts-Wrapped A?� arage Fire Protection Framing 7. ab; Steel -Wrapped ,,� roperty Line Firewall & Openings iers "re lace -Steel Ext. Doors -One 3' -Check Garage -3rd story, 2 exits . D.W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test ,£stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 10. as Pipe; Size -Anchors Plywood on Roof Overhang -Attic Vents -Rafter Outriggers Water Pipe; Test -Anchors -Regulator -Service Test V. Siding -Nailing Veneer 12. Electric; Underground o esh-Drip Screed -Fd. Vents-Underflr. Access 13. Plenums & Ducts; Clearance-Material-Supprt-Ins. azing Area-Glas rotection-Sk lights -Plastic 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples hear Walls; N ing-Bolts 15. Insulation M. Ip4lation-Walls-Clg. . Infiltration-Walls-Wndws Card -61 $ Date Card -B1 Date Card -131 Date/Z Card -81 Date Card -131 Date Card -B1 Date Card-B1Date and -61 Date Date PLUMBING (Permit) OK exc 6'6YVater Ht. Vent-Acces ombustion A�affle Date FIN lads) OK except #'s V.Aater Pipe; Test & Anchors -Nail Protection 6 : E Steps -Door & Sidelight Protection -Landings W.V.; Test-Fttngs & Anchors -Nail Protection 62COmoke Detector ,ZG 5hower Pan; Test, First Floor -Tub Access . Furnace; Vents -Clearance -Comb. Air -Connector - In�Garage; Above Floor -Ducts -Meeh. Protection est T & Shower, 2nd Floor -Tub Access Size & Anchors 6 . Bpdroom Exiting 6 . G .. & Bath Fixtures & Tub Access -Spa I Trim & Subpanel; Breaker Sizes -Labels Card -B1 Date �� Card -81 Date fairs & Rails Card -81 Date Card -81 Date 6eFireplace or Stove; Clearances -Hearth 69-E!pc. Outlets at Wood Panel; Int. & Ext. W. F xture & Transformer Clearance -Ins. Protection 7�(it. Fixt. &Appliance; Grnd. -Air Gap -Cooking Clearance lec. Receptacles Spacing -Lights & Switches at Doors 7 . I . Outlets & Receptacles at Kit. -Counter 24. �%ze Boxes & No. of Conductors -Stapled 7 . Garage Fire Door; Swing -Landing -Closer Romex Installed Close to Edge of Studs & C.J. '?� ".Duct in Garage -Damper Ground made up w/Meeh. Fasteners -Bond & ter 74 Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor -Meeh. Protection ?/Appliance Circuts in Kitchen &Conductor Size/G.F.I. 7 Ib.. Elec. & Mech. Equip. Listed for Location W. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga.96 or Al lee. Receptacles in Garage; (G.F.I.)-Romex Protec. - Range Circ. / / ga. C orI-Oven Circ. / / ga. Gor Al. Xsulated Neutral hfo 7 sulation-Foam-Looked in Attic es 7 uard Rails & Deck Construction -Post Caps 3 . vice -Riser Conductors & Ground -Main Disconnect7 n. Vents & Crawl Hole Door -Drainage & Wood -Earth Cle ranee Looked under Flo r ❑ Yes p. Clearances Panels-Motors-Mech. Equip. lothes Closet Light -Shower Light -Spa Light 8 ollowing instld.; Driv ' es ❑ No; Walks es ❑ No; P niters ❑ Yes t�2`114c,Smoke Detector Card -131 Card -B1 301 Datez Card -81 DateC S& Date Card -B1 Date Eco; Brown -Finish "nit; Disconnect, Electrical, Plumbing 8 ents Above Roof; PIbg.-Appliance-Firep I. -Clearance to Openings. Date ME,.EHANICAL (Permit) OK except #'s er Well; Disconnect, Electrical, Plumbing ,A.C. Ducts Insulation & Support 8 terior Elec. Trim; G.F.I. Receptacle -Underground 3.y6nt Fan; Exhaust above insulation 8 . V ntilation throughout House . Condensa a Drain & Overflow; Size & Grade 8 . G}4ss Protection 3 urnace Ven Access -Comb. Air -Return Air Vent -115 outlet Attic Access & Platform if Furnace in Attic 8 orrectio s from Previous Inpections 8 . Ga t -Meters Tagged; Gas -Electric 3- 7- W. ater & Sewer Connected -C/O to Grade -HD Approval Energy Compliance Certificate -Other Certificates Card -81 Card -B1 >& Date Z4Card-81 Date Date Card -81 Date 92 Roofing Certificate Card -B1 1Y I Date 2-8- 1 Card -B1 Date Date F MING (Plans) OK except #'s Card -B1 Date Card -131 Date V. II , Proper Material & Anchors Card -81 Date Card -81 Date 4VYfalls Studs -Nailing, Spacing & Bracing—Plat #s -Sound Comments at Final: 4 • earing Walls over Girders & Floor Nailing 4 Draft Stop in Walls (rat proof) CgV,Are Stops; Furred Ceilings-Stairs-CaL&VTub • Header & Beam -Size & Bearing (NOTE: An entry must be made each time you visit job site) = OK 0=Not OK - = Not Applicable ' = Not Ready MOBILE HOMES - MISCELLANEOUS Date MOBILE HOME UTILITIES (Plans) OK except #'s Date DECKS,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Sewer; Location -Test -Fall -C/O -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts- Bea ms-Rftrs.-Connec.- Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 6. Gas; Location -Test -Wrap: / PV ft. " / /"Nat. or/ /"L"ft./ /"LPG 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. 8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh Card -B1 Date Card -B1 Date 10. Roof; Shthg-Roofing Card -B1 Date Card -B1 Date 11. Ext.; Steps -Doors -Landings Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Card -B1 Date Card -B1 Date 2. Footings; Size -Spacing -Marriage Line Card -B1 Date Card -B1 Date 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances Date POOLS (Plans) OK except #'s 5. Drain; MH Test -Fall -Flex Connector 1. Setbacks -Easements 6. Water; MH Test -Regulator -Connector 2. Soils; Compaction -Structure Stability 7. Water and Sewer Connected -C/O to Grade -HD Approval 3. Pool Structure; Steel -Connections -Thickness - Dead Men -Lining 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 4. Elec.; Receptacles and Lighting, Distances-GFI 10. Cert. of Occupancy 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 Card -B1 Date Card -B1 Date Card -B1 Date Card -B1 Date 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Card -B1 Date Card -B1 Date Card -B1 Date Card -B1 Date COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS / 196•MemoriEfl Way, Chico — Phone: 891-2751 7 County Center Drive, 0,?oviIle — Phon6: 538-7541 747 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE nn OWNER PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this m?tier, or need additional explanation, please contact this office immediately. x Ac. !;;:7 " <" So A Inspector /I% -'�" Date g A routine inspection indicates that the following violations of County Ordinance SL exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to•this matter, or need additional explanation, please contact this office immediately. LL c,4 --e— ilirr �n 0 W L.f- n t>, tis f e S C v. Inspector \,k Date_�1- U l t�; COUNTY OF~BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial e.Way:1C.hico _ Rhone: 891-2751 7 County Center Drive, Orovi Ile — Pliomz: 538-7541 -' 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE �. 39 d v -:<F OWNE I PERMIT NC A routine inspection indicates that the following violations of County Ordinance SL exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to•this matter, or need additional explanation, please contact this office immediately. LL c,4 --e— ilirr �n 0 W L.f- n t>, tis f e S C v. Inspector \,k Date_�1- U l t�; C1S �� •'V..'S`.'Oalv'�'Y�Y+1 ��`� •''�' A..4I" • t . ,� .Y 4iV" i'at r.+ .• JJ COUNTY OF BUTTE --�—' DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico— Phone: 891-2751 �= ` 7 County Center Drive, Oroville — Phohe:-538-7541 ° 747 Elliott* Road, Paradise — Phone: 872-6307 CORRECTION NOTICE 41� OWNER PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this ' matter, or need additional explanation, please contact this office immediately. Inspector 1*44r'� / Date o2 Owner; Permit NoA3'220_8 1E E'i�? (DUPLICATE) E N E R G Y C E R T I F I C A T I O N Woods Res on Quail Covey Court, Chico, CA. LOCATION A.P. No. DESCRIPTION OF INSULATION ROOF Material Thickness(inches) EXTERIOR WALL Material Fiberglass batts Thickness(inches) 3 5%8" CEILING Batt or Blanket Type .Thicknese(inches) Loose Fill Type FihPrglagg Minimum Thicknesj(Inches) 154" Area covered(ft. ) 1956 FLOOR, ELEVATED Material Thickness(inches) FLOOR, SLAB Material Thickness(inches) Width(inches) FOUNDATION WALL Material Thickngse(inches) Brand Name Thermal Resistance (R Value) Brand Name Owens-Corning Thermal Reeistance(R Value) R13 Brand Name Thermal Resistance(R Value) Brand Name nwPnc-rnrniog Number of Bags 39 Wt. per bag 31.5 lb. Thermal Resistance(R Value) R38 Brand Name Thermal Resistance(R Value) Brand Name Thermal Resistance(R Value) Brand Name Thermal Resistance(R Value) I hereby certify that the above insulation was installed in the above building in conformance With the State of California InerSY Requirements, Loerke'Insulation Co. 499150 FIRM NAME/OWNS STATE CONTRACTOR'S LICENSE NO. December 8. 1989 SI TURF OF INSTALLATION APPLICATOR DATE I hereby certify the above insulation and all required items as shown on the Building Department approved plans and attachments have been installed as, required by the State of California Energy Requirements. A11 equipment, devices and materials are of the quality prescribed or are specifically approved by the State of California. 7-WYZ�Ll' . - , FIRM NAME/ R-/(0 ee print) STATE CONTRACTORS LICENSE NO. SIGNATURE OF ENE L CON1tA TOR OWNER DATE THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION APPROVAL. AND A COPY SHALL BE POSTED WITHIN THE BUILDING, January 1984 :."eat" North Valley Ready Mix 3672 Esplanade Chico, CA 95926 Dear Sirs: L A N D O F N A T U R A L W E A L T H A N D BEAUTY DEPARTMENT OF PUBLIC WORKS WILLIAM (Bill) CHEFF, Director 7 COUNTY CENTER DRIVE ; OROVILLE, CALIFORNIA 95965 Telephone: (916) 536-7541 October 31, 1989 RONALD D. McELROY Deputy Director RE: Building Permit No. 3920-88 Expiration Date: 12-16-89 (A.P. No. 47-43-13 ) With reference to the above subject, our records indicate that your Building Permit expires on the above.date. Building permits are valid for one year and should construction be started but not completed by the expiration date of the permit, the permit shall be renewed for 1/2 the original Building Permit fee..(.plus a $10.00 "Filing Fee"). The renewal permit will extend the Building Permit fo_r:an additional year from the original expiration date. Should you not renew your permit in a timely manner, it cannot be renewed and all work must cease until a new building permit is issued. If your construction is .completed or should you have any questions concerning this matter, please contact the Chico office. For your convenience we are enclosing a renewal application form and an owner -builder form to be completed and signed by you where indicated and returned to this office together with the fee.shown. Please return all copies of the application form. Thank you for your prompt attention concerning this matter. Yours very truly, William Cheff Director of Public Work J.F. Glander Chief Building Inspector .JFC:ahb . Attachments: Permit Application Owner -Builder Information Owner -Builder Verification cc: Building Inspector - Chico Chico - 196 Memorial Way/891-2751 Paradise - 747 Elliott Road/872-6307 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orov ille, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT wml A SSE�$O P -A ��Ur.� /�• / ZONI G BUILDING PERMIT Id owN TEL HH E� SQ. FT. OCC. BUILDING VALUATION OWN R' IN A CO CTO SNA � or TE P - 6 CO Y C OR'S ILLt[ OD ES G° \ 9s Fireplace ria{. CON UCTION LEN ER UNKNOWN Total Valuation $ fly Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARC ECT OR ENG ER L C E Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS- Penalty $ BUILDING ADDRESS, r Lle i,Leg Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 t Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP /0-7-7 Water piping 5.00 Each qas water heater or vent 5.00 61-0 USE OF STRUCTURE SFX Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00ea TYPE OF WORK New 9 Addition ❑ Remodel ti lities ❑ Installation❑ Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 1 OR LE 100 AMP ORSLESS 10.00 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): /Yam 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. w Classification %- EJ1, 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 EA. AOD'L 100 AMP 2.50 OR ADDNST DWEACCLLIN GSCC '/z¢sgft NEW CONSTR U TI -OUTLET NON.RESID BRANCH CIRCUITS 2.50 ea POWER APPARATUS e SINGLE OUTLET CIR. Ex. OCcU OUTLETS OR FIXTURES p 20050t e AL030 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ T e permit is for $100.00 (valuation) or less. have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with Such provisions or this permit shall be deemed revoked. Contractor 1. MECHANICAL PERMIT Filing Fee 10.00 Heat' g Cooling 9 Hood 3.00 Ventilation Tmff-0 permit Fee $ Contractor I certify that I have read this application and state that the above information 1s 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 liabili 'es, judgments, co , and expenses which may in any way accrue agains d Co ty in cos ue ce o ranting of this permit. X �/ D to Signature of Applicant Owner Contractor gent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ occuP. CON ST.T�PE S�No FI - This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which C OR PUBLIC By PERMIT EXPIRES Date ARCEL PD ND ISSUE the applicable provi- resolutions to do fees have been paid. WORKS Date /z 41P —0, Receipt No. L WHITE-D.P.W., YELLOW-ASeE330K. PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT��XJLIFORNI495965- F_PUBLIC WORKS -BUILDING DIVISION c -e. 7 COUNTY CENTER DRIVE - OROVILLE, TELEPHONE: 916/538-7541 / PERMIT APPLICATION J C TION DATA SHEET OWNER Proposed Building Use Building Inspector Permit No. A. P. -No. � — Date gt At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted. .. 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer of plans .. 4. Complete engineered plans and calcs, with wet signature on plans . . 5. Energy Design Compliance and supporting documentation ......... 6. Statement of Intent for Non -Heated and AC Buildings .............. 7 -Engineered truss detailsond layout in duplicate (required prior to plan check) 8. Mobilehome installation data including manufacturer's installation instructions....................................................... 9. Fees of $ .......................... 10. -'Chico Urban Area fees paid........................................ 11. Park s paid ..................................... I �chool District fees paid ................. 13. Sanitation approval from Health Department .. . 14. City of Chico plumbing. permit ............... ..................... 15. Plot plan and business license approval from City of (see City for other requirements) 16. Planning approval for (A) Use: (B) Parking: 17.1ImQ ovements may be required. $. . rVeway permit (construction approval required prior to occupancy) ... 19. Pre -Inspection for required ...... Pre-Inspec. request to Building Inspector (Date) 20. Contractor's license information (No., Name Style, Classification) ....... 21. Certificate of Workmans Compensation Insurance .................... 22. Owner Builder Verification (Given to owner ❑, Mail to owner ❑) ........ 3. Recorded copy of Agricultural Acknowledgment Statement ............ 24. Letter of signature authorization ..................................... 25. 26. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at� 2office. Deliver w/inspector. Other Applicant ��G Date Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone_-mall—counter by date Contractor, designer, owner, was advised of above required data by_phone_mall_c mt by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW TO: Building Department FROM: Environmental Health, Chico SUBJECT: Sanitation Clearance Owner Location AP# 'Plan approved for: sewage disposal water supply• Hold final for: water supply Final clearance O.K. for: water supply Clearance for_ bedroom mem home. Other Note*** Sanitarian a! u ff ate F . W ,� ' . >,-� ir. ,. ,. yi ,;rd• ' ' �'4•-.-ry -i%, �.�..�. _-�+�.v7`,: �� •1 fir, 'a'.�w�, jrr :ltin,+".^ i�""''ti"^ .._ > , . . ,r. Y r y+ BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM (One Form per- Building) A.P. Number ��' � Building Department No. School District (_�� r City Q County Jurisdiction Property Owner Jil A % W60 _J i A X n Project Location/Address Subdivision Lot Number Residential Development: Sq. Footage of Liven # g MHI Addition (Groin M) P Units Commercial/Industrial: New -ITiiiAN Build.kng'bepartmen't Re -presentative Sq. Footage Addition (Including Exterior Roofed Areas) Date ******************************************************************* District Id No. f9l ,A n I )rV1I _ A D � � School District certifies that Applicant Name eet address :'IF 7 -1) A:> �- (Phone Numb r (City) (,State) (Zip Code) has complied with the requirements of Resolution No. 360�- ? g by the payment of $�.,(>0 representing , square feet. /--z /3 S hoof D str'ct Representative Da e PAID BY CHECK NO.( BANK NO.11- 11- S 2 PAID :BY CASH REMARKS:' white -applicant, yellow -building department, pink -school district SCHOOL . FEE (5/88) 9 SUM COUNTY RDER SERIAL NO. �?`f a a I S RECOROED /IR Tib: REQUEST OF MID VALLEY TITLE COMMM' DATE RECOROM DEC 14 n TIME; g o oA M Esc. #102924 Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT FOR RESIDENTIAL DEVELOPMENT Scction 26-8.1 of the Butte County Code r requires this acknowledgement be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property 'may be subject to incon- veniences or discomfort arising from the use of agricultural chemicals, including, but not .limi.ted to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally .generate dust, smoke, noise, and 'odor. Butte County has establ .i shed- tural-,zones which have as a priority use for productive agricultural purposes, :and rctiidcnl:: within sa i.d zones and on adjacent property should be prepared to accept such int anavt aI i c me or disconform from normal, necessary farm operations. All that. real property situate in the County of Butte, State of California, desuribc•(l :IK follows: In book 71 of Haps, at page 84. Beginning at the most notherly corner of said parcel 1: Thence south 37 Deg. 421 0011 East, 150.99 feet; thence south 72 DLG. 391 0511 West, 53.33 feet; thence north 37 DEG. 391 0511 Last, 3.88 feet; Thence North 71 -DEG -:131 261, East, 49.10 feet to the point of beginning.. �j[mnountunrnutt1N[rnnunfill [ontr►ualitlltlliifit fill OFFICIAL, SEAL TA MI BAAL©W NOTARY PUBLIC — CALIFni?NIA' ' PRINCIPAL OFFICE IN BUTTE COUNTY c My Commission Expires October 24, 1392 !!nnonuttnuunuuuu................................. ... PROPERTY OWNERS: State of. CA r ) On this the 13th day of December , 19 88 before mei, ) SS. the undersigned Notary Public, personally appeared County of Butte ) ANDREW WOOD & MARGO WOOD***************************** �t!wrr::r,:!ee:rtnrs!:rssssr:::ar.:ana.^s.:::ar.::anro:rtt OFFICIAL SEAL .• ' i ARLO YY1AI 77iM! CARLOW •..::'.RY'UBLIC—CALIFORNIA ' PR;% IPAL Q=FIC - IN ._... BU1TECCUNTY , ,., My Expires October 24, 1992 , r~:::a::: cer�::::::::ea::::::rrsrr t ur[t!mst rluutuns::atat!rurrn i Present A.P Personally known to me. E] Proved to me on the basis of satisfactory evidence. be the person(s) whose name(s) a r e bscribed to the within instrument.and acknowledged Lhat. they ecuted the same for the purposes therein contained. IN W I'1'NI?SS EREOF, I hereunto set my hand and off.ici.al. seal.. No. Notary Public TAMI BARLOW RESIDENTIAL PLAN CHECKING GUIDE 7/85 (S.F., DUPLEX°.& MISE. ONLY) Bldg. Permit # OWNER p 0V 1>!/ W000 A.P. # V7 -43 - /3 GENERAL Q.._oning requirements: (sideyards Valuation. Aw-.�Pans signed by designer. Energy Design and Compliance. 50Existing violations on property. and number of permitted living units). PLOTT PLAN 7&oO omplete parcel size and dimensions. backs, sideyards, easements, etc. 3!_Other buildings or structures. Ao,r rading, fills, drainage. glMood hazard. 4/ Special conditions on creation map or compliance document. FLOOR PLAN omplete to scale plan with dimensions. quired windows for light and ventilation (Sec. 1205). Required windows for second exit (Sec. 1204). .Skylights (Chapter 34 & Sec. 5207). 0;'-1.1uman impact glass (Sec. 5406). equired room sizes, ceiling heights (Sec. 1207). G.F.C.I.'s in baths, garage and exterior outlets (Article 210-8). &4000'L*ight fixtures, switches, receptacles, and exterior receptacles for maintenance of -°echanical equipment. 6/ "Locations of water heater, heating and cooling equipment, other electrical or gas equipment, and plumbing fixtures. W*-' age firewall, door size, and closer (Sec. 503(d)(3)). 1 1 3'0" exterior exit door (Sec. 3304(e)). fireplace and wood stove location. 1&,"`§`moke detectors (Sec. 1210). STRUCTURAL DETAILS I00undation plan complete enough :to construct building. &.0- Zloor construction details complete enough:to construct building. A E vations and wall construction details complete enough to construct building. ,R�of construction details complete enough to construct building. F replace construction details and calcs if necessary. oo Sufficient data and details to satisfy energy requirements (State Law) (Form 1). MISCELLANEOUS ITEMS TO LOOK OUT FOR �xPosure I plywood on exposed locations and overhangs. 71lStairway details: landings, rise and run, head clearance, handrails (Sec. 3306). lo-005uardrail details (Sec. 1711 & 3306(j)). —Brick or stone veneer (Chapter 30). .--E terior plaster - weep screeds (Sec. 4706). (:/ Proper roof pitch for roof covering (Chapter 32). Rafter ties or bearing ridge beam. RESIDENTIAL PLAN CHECKING GUIDE (CONT'D) 7/05 MISCELLANEOUS ITEMS TO LOOK OUT FOR (CONT'D) arage door or porch header sizes. ; Adequate bracing. 1.O.Y--Living area over garage - complete 1 -hour separation required on garage side including supporting walls and posts, etc. 4-1: Two exits on three-story dwellings (Sec. 3303 & see Mezannines 1716). 140007A ttic access and ventilation (Sec. 3205). B �b derfloor access and ventilation (Sec. 2516). �jood stoves, clearances, alcoves & 1 -hour shafts. Combustion air for fuel burning appliances. =Noise requirements on duplexes. -14-.--Adobe soils - special foundation design. 4-8--- taining walls requiring design. 1 . Unusual shape, size or split level house requiring lateral design. Certificate of Compliance: Residential Climate Zone 11 GcJooO r2�S t 0481dIL G ,JectTIde U U Ille 0l Galt/ C.JD Bu t ermit 0 Project Address Cbedced By / Date nnrumentation Author Telephone Fnfomernent Agency Use Only ---- - Glass Area % Glass BUILDING DATA North /'i/. S y 6 Co 'oned Floor Area �c Number of Stories Z- East '�_ >L Number of -Units �_ South s Q�sed Floor West A-- I [ ] Single Family Detached (SFD) [ ] Addition Alone Skylight -A— -8— [ ] Single Family Attached (SFA) [ ] Existing Building Total [ ] Multi -Family (MF) [ ] Existing -Plus -Addition • y BUILDING SHELL INSULATION Component Insulation Location/Comments Type R -Value (attic. to fiamp, typical, etc.) Wau ............... �•/� Roof ............. Roof ............. Floor ............. Floor......... Slab Edge ..... GLAZING Shading Devices Glazing Area Glass Type Interior Exterior Overhang Framing Type Orientation (sf) (single, double) (tolls blind. etc.) (Shoescreett, etc.) (yes/no) (Metaliwood) North North East (.) 'East ( ) « South Sou Lh West ( ) •• West ( ) Skylight......: THERMAL MASS Type/Covering Area Thickness . _ _ � _._ . lcf% (inrhesl Loeation/Descliotion (kitchen. bath, etc.) f174, ACs 3 ,. XF4r�I� DAt 41 ft A#rl/ HVAC SYSTEMS Minimum Duct Type (furnace, air Efficiency Location Duct Output Manufacturer / Model # conditioner, heat pump) (SE, SEER,HSPF) (attic, etc.) R -Value (Btuh) (or approved equal) IGuR�•� bFy S.. ��� Maximum Furnace Heating Output: Btuh HOT WATER SYSTEMS Tank Manufacturer/Model # SPECIAL FEATURES/REMARKS (Add extra sheets if necessary) db al Mandatory Measures Checklist: Residential MF -1R NOTE: t.owrise residential buildings subject to the Standards must contain these m&esw-es MgwdL= of the compliance approach used. items marked with an asterisk (•) may be superseded by more stringenf compliance mquuements fisted on Ute Certificate of Compliance. When this checklist is incorporated into the permit documents, the features noted shall be considered by all parties as binding minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. DESCRJFTION DESIGNER ENFORCEMENT Building Envelope Measures • §2.5352(a): Minimum ceiling insulation R-19 weighted average. §2.5352(b): Loose fill insulation manufacturer's labeled R -Value. • §2-5352(c): Minimum wall insulation in framed waits R -I 1 weighted average (does not apply to exterior mass walls). §2.3352(k): Slab edge insulation - water absorption rate no greater than 0396, water vapor transmission ram no greater than 2.0 perm/inch. §2-5311: Insulation specified or installed mats California Energy Commission (CE.L7 quality standards. Indicate type and form. §2-5352(f): Vapor barriers mandatory in Climate Zones 14 and 16 only. 62.5317: Infiltration/Eicfiltration Controls a Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. b. Doors and windows certified. c. Doors and windows weatherstripped: all joints and penetrations caulked and scaled §2-5352(c): Special infiltration barrier installed to comply with 12.5351 mats CEC quality standards. . §2-5352(d): Installation of Fireplaces 1. Masonry and factory -built fireplaces have: L Tight fitting, closable metal of glass door b. Outside air intake with damper and contra e. Flue damper and contra 2. No continuous burning gas pilots allowed. MVAC and Plumbing System Measures 52-5352(g) and 2-5303: Space conditioning equipment siring: attach calculations. §2-5352(h) and 2-5315: Setback thermostat on all applicable heating systems. • §2-5316(a): Ducts constructed, installed and insulated per Chapter 10, 1976 UMC. §2-5316(b): Exhaust systems have damper controls. §2.5314(c): Gas -rued space hating equipment has intermittent ignition devices. §2-5314: HVAC equipment, water haters. showerheads and fauces certified by the CEC. §2.5352(i): Water heater insulation blanket (R-12 or greater) or combined interior/exterior insulation (R-16 or greater): fust 5 feet of pipes closest to tank insulated (R-3 or grater). §2.5312(Exception 1): Pipe insulation on smarm and steam condensate return At recirculating piping. , §2.5318(d): Swimming Pool Hating I. System has: a Oru/off switch on hater. b. Weatherproof instruction plate on hater: : c. Plumbed to allow for solar. 2. 75 percent thermal efficiency. 3. Pool cover. 4. Time clock. 5. Directional water inlet. Lighting and Appliance Measures 12.53520): Lighting - 25 lumcns/watt or greater for general lighting in kitchens and bathrooms. 62.5314(c): Gas fired appliances equipped with intermittent ignition devices. §2.5314(a): Refrigerators, refrigerator-fraurs, freezers and fluorescent lamp ballasts certified by the CEC. Indicate make and model number. COMPLIANCE STATEMENT This certificate of compliance lists the building features and performance specifications needed to comply with Title 24. Chapter 2-53 and Title 20, Chapter 2, Subchapter4. Article I of the California Administrative code. This cemfitate has been signed by the individual with overall design responsibility and the building owner, who shall retain a copy of it and transmit the certificate to any subsequent purchaser of the building. Designer Name: TitkJFum: Address: Telephone (sigtatum) (date) Documentation Author Name: Ttk/Fum: Address: Building Owner Nance: Tideffium- Address: Tetephon: /dart (signal=) (date) Enforcement Agency Name: Agency: Tekpho= 1. Ceiling Insulation Detached Attached Family Number of stories -51 R -value One Two Three R-0 -103 49 32 R-19 -8 4 -2 R-30 -2 -1 0 -1 0 R38 0 U -value -29 U -value 37 0.80 0.50 -176 -84 -54 0.30 -102 43 -68 0.10 -26 0.30 -82 a 0.08 -18 -9 4. 0.06 -11 -51 0 0.04 -4 2 1 0.02 4 5 3 0.00 11 5 0.04 14 11 2. Wall Insulation 0.02 19 Single- Single - 0.00 Family Family Multi - R -value Detached Attached Family R-0 -68 -51 34 R-11 0 0 0 R-13 2 2 1 R-19 8 6 4 U -value -29 -40 37 0.80 -153 -114 -76 0.50 -91 -68 -46 0.30 -47 -36 -24 0.10 0 0 0 0.08 4 3 2 0.06 9 7 5 0.04 14 11 7 0.02 19 -14 10 0.00 24 18 12 3. Raised Floor Insulation -13 -4 Insulation in Floor 29 -58 -20 Number of stories -3 R -value One Two Three R-0 t -17 -8 -5 R-11 -3 -2 -1 R-19 0 0 0 R-30 3 1 1 U -value 7 14 25 - 0.60. 144 r -70 46 0.50 -120 -58 38 0.40 -95 -46 -30 0.30 -69 -34 -22 0.20 -43 ' -21 -14 0.10 -17 -8 -5 0.08 -11 3 -4 0.06 -6 . -3 -2 0.04 -1 0 0 0.02 4 2 1 0.00 10 5 3 Controlled Ventilation Crawlspace 6 11 Number of stories 18 R -value One Two Three R-0 -11 -7 -5 R-5 -4 -4 3 R-11 -2 -2 .2 R-19 -1 .2 -2 4. Slab Edge Insulation -17 - 6 Number of Stories 14 R -value One Two Three ' R-0 0 0 0 R-5 8 5 2 R-7 8 6 3 F2 factor 6 9 12 0.90 -4 3 -1 0.80 -1 -1 0 0.70 2 2 1 0.60 6 4 2 0.50 9 6 3 0.40 12 8 4 5. Inriltration (Air Leakage) -14 -48 Specification -64 na Points -12 -42 Standard -55 na 0 -10 6. Glass Heat Loss -50 -46 na Total -8 -29 -40 37 U -value 11 Percent -26 -36 .51 to .41 to .31 to 0.30 or Glass Single Double .60 .50 .40 less 50 -121 -53 -39 -24 -10 4 40 -90 37 -26 -14 3 8 35 -75 -29 -19 -9 1 10 30 -61 -21 -13 -4 4 12 29 -58 -20 -12 -3 5 12 28 -55 -18 -10 -2 5 13 27 -52 -17 -9 -2 6 13 26 -49 -15 -8 -1 7 14 25 -46 -14 -7 0 7 14 24 -43 -12 -5 1 8 '14 23 -40 -11 -4 2 8 15 22 -37 -9 3 3 9 15 21 34 -7 -2 4 10 15 20 31 -6 0 5 10 16 19 -29 -4 1 6 11 16 18 -26 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 9 -1 10 13 15 17 20 8 2 12 14 16 18 20 -23 -12 -8 -6 -5 2.4 WSB 7. Shading (Shade Open) -8 -6 -5 Effective Percent Giza _ p U _23 -12 (percent glass x SC) -_ -6 -5 Effective None -8 -4 -3 .2 - - %Glass North East South West Skylight 18 5 1 27 4 1 na 16 4 2 IE 5 1 na 14 4 2 5.6 5 1 na _ 12 3 3 1.5 5 2 na 11 3 3 3 5 2 na 10 2 3 4.4 5 2 1 9 2 3 5.9 5 2 2 8 2 3 1.8 5 2 2 7 1 3 3.3 4 2 2 6 1 3 4.1 4 2 3 5 1 2 6.2 4 2 3 4 0 2 2.1 3 1 3 3 0 1 3.5 2 1 3 2 0 0 5 1 0 3 1 -1 -1 65 -1 .1 2 0 -1 -2 24 -a -2 0 na = not allowed 3.4 3.6 3.8 4.1 4.3 �B. Shading (Shade Closed) 4.7 4.9 5.1 Effective Prremt Glass 5.5 5.7 5.9 (percent &lase x SC) 6.4 Effecda Gins North East South West Skylight 18 -14 -48 -69 -64 na 16 -12 -42 -59 -55 na 14 -10 -35 -50 -46 na 12 -8 -29 -40 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 -30 4 -1 -6 -8 -7 -23 3 0 -4 -5 -4 -16 2 1 -1 -2 -1 -9 1 1 1 1 1 -4 0 2 3 4 3 0 9. Interior Thermal Mass Interior Single - Slab Floor Raised Floor Mass Family Stories Multi (assumes ducts In attic) - Stories Detached /CFA One Two Three One Two Three 0.0 -8 -5 -4 -2 -1 -1 0.1 -8 -5 3 -1 0 0 0.3 -7 -4 -2 0 1 1 0.5 -6 -3 -1 1 1 2 0.7 -5 -2 -1 1 2 2 0.9 -5 -1 0 2 3 3 1.1 -4 -1 1 3 4 4 1.3 -3 0 2 3 4 5 1.5 -3 1 2 4 5 5 2.0 -1 2 4 5 6 7 2.5 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 11 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 Wall Thermal Mass Exterior Single- . Single - 0.2 Unit Size (so Wall Family Family Multi (assumes ducts In attic) - Mass Detached Attached Family 0.00 0 0 0 16 or 0.20 3 2 1 8.0 0.40 5 4 3 -9 -7 -6 -5 0.60 8 6 4 -2 0.80 10 8 5 -1 1.00 13 10 7 10.0 1.20 13 12 8 i 1.40 12 13 9 4 1.60 10 13 1 1. 5 1.80 10 12 122 None 2.00 10 11 - 13 (SEER xduct efficiency) 11. Heating System Solar Sum of 7-10 -1 -1 SE or RSPF +610 16 or SEER (assumes ducts in attic) +15 more 5.0 Sum of 1-6 .13 -9 6.0 25 or -24 to .14 to 4 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 6.88 3 3 3 2 2 1 0.80 0.85 7.33 8 7 7.79 13 11 6 5 10 8 4 7 3 5 0.90 8.25 17 15 13 11 9 7 0.95 8.71 20 18 15 13 11 8 15 Effective SE or HSPF -19 Zonal Control Adjustment (SE or HSPF x duct efficiency) j Effective -25 or -24 to -14 a -4 to +610 16 or SE HSPF less -15 -5 +5 +15 more 0.30 2.75 -73 -64 -56 -47 -38 -30 na 3.41 -45 -39 -34 -29 -24 -18 0.40 3.67 -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 1 2 0.70 6.42 17 15 13 11 9 7 0.80 7.33 25 22 19 16 13 10 0.90 8.25 32 28 24 20 17 13 1.00 9.17 37 32 28 24 19 15 7 Zonal Control Adjustment :„ 4 System Type HP HWR 9 Resistance 10 9 7 6 4 3 Other . 6 5 4 3 2 2 12. Cooling System 0 0.2 Unit Size (so SEER Water 1.1 1199 (assumes ducts In attic) - - 2200 Sum of 7-10 Heater Gedit or -25 or -24 to -14 to .410 +6 to 16 or SEER less .15 •6 +5 +15 more 8.0 --14 -12 -10 -8 -6 -4 8.5 -9 -7 -6 -5 -4 -3 8.9 -5 -4 4 3 -2 -2 9.0 -4 -3 -3 -2 .2 -1 9.5 0 0 0 0- 0 0 10.0 4 3 3 2 2 1 10.5 7 6 5 4 3 2 11.0 10 9 7 6 4 3 120 15 13 11 9 7 5 13.0 20 • 17 14 12 9_ 6 None Effective SEER -24 -18 -15 (SEER xduct efficiency) 3.1 Solar Sum of 7-10 -1 -1 Effective -25 or -24110 -1410 410 +610 16 or SEER less -15 -5 +5 +15 more 5.0 -30 -25 -21 -17 .13 -9 6.0 -12 -11. -9 -7 -6 -4 6.6 -5 -4 -4 3 -2 2 7.0 0 0 0 0 0 0 8.0 9 8 6 5 4 3 9.0 16 14 12 9 7 5 10.0 22 19 16 13 10 7 11.0 26 23 19 15 12 8 12.0 30 26 22 18 14 9 13.0 33 29 24 20 15 10 -19 Zonal Control Adjustment -11 j 10 8 7 6 4 3 5 No Cooling System Installed 3 Stories One -5 -4 -4 -3 -2 -2 Two + 3 ' 3 2 2 2 1 Single -Family Detached and Attached Interior Mass/CFA . rT•e : e,,ss 1t•"�t�'••=� . 4 TYPO. I MASS tUIMC 4.2, is: exposed sl_ ab) - Ic.'p.c.e .r.el „ 0% 5% 101/. 15% 20Y. 25% 301/. 35% 40% 45% 50% 55% 60% 6914 70% 75% 809 85Y. 90% 95% 100%105% 110Y. 115: 120'/.125-1 OY. 0 0.2 Unit Size (so 0.6 Water 1.1 1199 1200 1700 2200 2700 Heater Gedit or to to to or Type Type loss 1699 2199 2699 more SG None 0 0 0. 0 0 or Solar 12 8 6 5 4 HP HWR 8 5 4 3 3 4.2 WSB 5 3 3 2 2 20% POU 8 5 4 3 3 SE None -37 -24 -18 -15 .12 3.1 Solar -1 -1 -1 0 0 4.5 HWR -18 -12 -9 -7 -6 0.5 WSB . .25 -16 -12 -10 -8 2 POU -18 _-12 -9 -7 -6 n None -5 -3 -2 -2 -2 4.9 Solar 7 5 4 3 2 0.9 POU 3_ 2 1 1 1 IE None -28 -19 -14 -11 -9 1. 3.8 Solar 8 5 4 3 3 `' 5.3 POU -10 -6 -5 -4 ,. -3 1.3 Multi -Family (individual unit's) w 21 23 25 Unit Size (sf) w 3 Water 3.4 699 700 1200 1700 2200' Heater Credit or b to to; or-. Type Typr loss 1199 1699 2199 more SG None 0 0 0 -0 Z"0 or Solar 14 7 5 :„ 4 "3 HP HWR 9 5 3 ".2 2 60% WSB 9 4 3°" 2 2 2.3 POU 9 5 3 "' 2 2 SE None -45 -23 -154 - .11 - -9 5 Solar 2 1 1 0 0 65% HWR -23 -12 -8 -6 -5 2.4 WSB -25 -13 -8 -6 -5 3.8 _ p U _23 -12 -8 -_ -6 -5 IG None -8 -4 -3 .2 ) .2 1.2 Solar 6 3 2 1 1 27 POU 1_0 3.3 0_ 0 0 IE None -30 -15 -10 .8 -6 5.6 Solar 18 9 6 4 4 1.5 POU -8 -4 -3 -2 .2 Interior Mass/CFA . rT•e : e,,ss 1t•"�t�'••=� . 4 TYPO. I MASS tUIMC 4.2, is: exposed sl_ ab) - Ic.'p.c.e .r.el „ 0% 5% 101/. 15% 20Y. 25% 301/. 35% 40% 45% 50% 55% 60% 6914 70% 75% 809 85Y. 90% 95% 100%105% 110Y. 115: 120'/.125-1 OY. 0 0.2 0.4 0.6 0.8 1.1 1.3 1.5 1.7 1.9 21 23 2.5 2.7 2.9 3.2 3.4 3.6 3.8 4 4.2 4.4 4.6 4.8 5 5.3 tOY. 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.9 21 23 25 2.7 2.9 3.1 3.3 3.5 3.7 4 4.2 4.4 4.6 4.8 5 5.2 5.4 20% 0.3 0.6 0.8 1 1.2 1.4 1.6 1.8 2 2.2 24 27 29 3.1 3.3 3.5 3.7 3.9 4.1 4.3 4.5 4.8 5 5.2 5.4 56 30% 0.5 0.7 0.9 1.1 1.4' 1.6 1.6 2 2.2 24 26 2.8 3 3.2 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.3 5.6 58 40Y. 0.7 0.9 1.1 1.3 1.5 1.7 1.9 2.2 24 2.6 2.8 3 3.2 3.4 3.6 3.8 4 4.3 4.5 4.7 4.9 5.1 5.3 5.5 5.7 5.9 W. 0.9 1.1 1.3 15 1.7 1.9 21 23 25 27 3 32 3.4 3.8 3.8 4 42 4.4 4.6 4.8 5.1 5.3 5.5 5.7 5.9 6.1 55%0.9 1.1 1.4 1.6 1.8 2 2.2 24 2.6 28 3 3.2 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.3 5.6 5.8 6 6.2 60% 1 1.2 1.4 1.7 1.9 21 2.3 2.5 2.7 2.9 3.1 3.3 3.5 3.8 4 4.2 •4.4 4.6 4.8 5 5.2 5.4 5.6 5.9 6.1 63 65% 1.1 1.3 1.5 1.7 1.9 2.2 2.4 2.6 2.8 3 3.2 3.4 3.6 3.8 4 4.3 4.5 4.7 4.9 5.1 5.3 55 5.7 5.9 6.1 6.4 709'. 1.2 1.4 1.6 1.6 2 2.2 2.5 27 2.9 3.1 3.3 3.5 3.7 3.9 4.1 4.3 4.6 4.8 5 5.2 5.4 5.6 58 6 6.2 64 75% 1.3 1.5 1.7 1.9 21 23 25 2.7 3 3.2 3.4 3.6 3.8 4 4.2 4.4 4.6 4.8 5.1 5.3 5.5 5.7 5.9 6.1 6.3 6.5 801/. 1.4 1.6 1.8 2 2.2 2.4 26 2.8 3 3.3 3.5 3.7 3.9 4.1 4.3 4.5 4.1 4.9 5.1 5.4 5.6 5.8 6 6.2 64 66 85% 1.4 1.7 1.9 2.1 2.3 25 2.7 2.9 3.1 3.3 3.5 3.8 4 4.2 4.4 4.6 4.8 5 5.2 54 5.6 5.9 6.1 63 65 67 901/. 1.5 1.7 2 2.2 24 26 2.8 3 3.2 3.4 3.6 3.8 4.1 4.3 4.5 4.7 4.9 5.1 53 5.5 5.7 5.9 6.2 6.4 66 68 95% 1.6 1.8 2 2.2 2.5 27 2.9 3.1 33 3.5 3.7 3.2 4.1 4.3 4.6 4.8 S 5.2 5.4 5.6 5.0 6 6.2 6.4 6.7 6.9 100Y. 1.7 1.9 21 2.3 2.5 28 3 3.2 3.4 3.6 3.8 4 4.2 4.4 4.6 4.9 5.1 5.3 55 5.7 5.9 6.1 6.3 6.5 6.7 7 105% 1.8 2 2.2 2.4 2.6 28 3 3.3 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.4 5.6 5.8 6 6.2 6.4 6.6 68 7 110*/. 1.9 21 2.3 2.5 2.7 29 3.1 3.3 3.6 3.8 4 4.2 4.4 4.6 4.8 5 5.2 5.4 5.7 5.9 6.1 6.3 6.5 6.7 69 7.1 115% 2 2.2 2.4 2.6 2.8 3 3.2 3.4 3.6 3.8 4.1 4.3 4.5 4.7 4.9 5.1 5.3 5.5 5.7 5.9 6.2 6.4 6.6 6.8 7 7.2 120% 2 2.3 2.5 2.7 2.9 3.1 3.3 3.5 3.7 3.9 4.1 4.4 4.6 4.8 5 5.2 5.4 5.6 58 6 6.2 6.5 6.7 6.9 7.1 7.3 M% 21 2.3 25 2.8 3 3.2 3.4 3.6 3.8 4 4.2 4.4 4.6 4.9 5.1 5.3 5.5 5.7 5.9 6.1 6.3 6.5 6.7 7 7.2 7.4 Point System Summary: Climate Zone 11 SCORE CARD Measures 1. Ceiling Insulation A 36 or R -value 1381 U -value [0.030] 2. Wall Insulation // or R -value [ 111 U -value [0.098] 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 r: r �9. Interior Thermal Mass 10. Exterior Wall Mass 11. Heating System Zonal Control? ( Y / N ) 12. Cooling System Zonal Control? ( Y / N ) 13. Water Heating or R -value 1191 - U -value [0.037] J!,qP-- or R -value [01 F2 factor [0.771 Standard of i3Lr/� : Type [double] U -value [0.65] Point Scores 0 % Total Glass (161 Sum 1.6 % Glass SC Eff. % Glass p dez I. I X 17 = X .77 X b % Glass SC Eff. % Glass �,/• �' X .lot = .2 97 X X .2.17 X 40' X c3 TYPE 1 MASS AREA _�� $ AREA Interior Hiss/CFA ; COND. FLOOR (5 REA �D TYPE 2 MASS ACO Exterior Wall Mass ND. L OR AREA SE or SPF Duct Efficiency 10.781 Effective SE or [0.7216.61 HSPF [0.56/5.151 ,a•,.5 x SEER [9.5] Duct Efficiency (0.741 Effective SEER [7.03] 5G, Type (SG] Credit [none] Point Total: 10, ,- I _w wn .�,�,... ,T_.., ..,,....,♦. . .J,y.43.,wi.. -..,x.�-.,.•, mw.. .. .m1 r :M' .x:.� .»� ..,., �9a.r.. � h. I. ... � r ..,. d J.�....:.X. .�,'1t�.:wW.�. .'v ,. ya ,y1, ..,,.,n,1Mi,'.�.,.,. . �a .: .` .:i.".w1, , ,.-�. ,. ...u,;.,.,a. '. YFi.,.i I,.4J.,a.�. .. .i,...l. �.t� m„it. uu, u1.. ue,,i.s:lIur �.k,«, r �,,a ;s ,.. ... r vl p' �I .yf '� �F. - N i.�. . a 1.. '., � . re �,�n�,..�c "'C W "1�P n. . ,... 1'1�14"4r. ;.te�a. � %.' . ,. _ HT1 1 ..t "i,�. �AC,' ,� .. �_. G , ,N �� _..r :. .,. .L.. ,.