HomeMy WebLinkAbout055-450-007'J77
,r} 55-45-07
,�.
.Theodore Kalivas r M
N, 2 Red Sky Ln-, Paradi§e
Perms 1103=82 P,E,�(MH utiUties)-
r; Electr'ic�3 --'O/� --•--?cel- -- - :,Y
.' Gas /Z-83 `�/y" GTS
Support structure re
iLW 4
�, + .,Compaction test req.
Contr: Gene Scbm!X-- -H Ser, Vina - ' >
! Permit#1260s83NHHI
$ 55-45-07,
KALIVAS
�1.,Neal Rd, Paradise
itR:' •Steve"Lane" .
_3
rmit#1533-89B,P,E,M(new single family)
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1.533-89B,P,E,m
PERMIT NO.
PERMIT EXPIRES 17 IY,-�
TED �KALIVAS
OWNER
Steve Lane
CONTR.
ASSESSOR PARCEL 55-45-07
'3251 Neal Rd, Paradise
LOCATION
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1.533-89B,P,E,m
PERMIT NO.
PERMIT EXPIRES 17 IY,-�
TED �KALIVAS
OWNER
Steve Lane
CONTR.
ASSESSOR PARCEL 55-45-07
'3251 Neal Rd, Paradise
LOCATION
6••C d � , 9cl
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Temp. Power Pole
Called PG&E
,A
Temp. Elec. Service
Called PG&E
�emg/Gas Service
��Called / .4 C' 0,
PG&E
3 ��
JOB FINALED (Date)
,• F
Signature
0 Not OK
- = Not Applicable
' MOBILE HOMES
MISCELLANEOUS
= Not Ready
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
Date
DECKS,COVERS,CARPORTS,GARAGES, (Puns)
1. Zoning Requirements -Setbacks -Easements
1. Zoning Requirements-Setbacks-Eassmerits
2. Soils; Special MH Support -Sketch
2. Footings;"Soils-Size-Depth-Spacing -Con nectors- tee
3. Sewer; Location -Test -Fall -C/O -Concrete
3. Decks; Girders and/or Joists-Decking-Bracing`Stairs-Ra,; .
4. Water; Location -Test -Easement Needed (Sketch)
4. Wood Awn.; Posts- Beam s-Rftrs.-Connec.-
5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete
Shthg.-Rfg.-Bracing
6. Gas; Location -Test -Wrap: / /"L"ft.
5. Alum. Awn.;
Columns -Connections
-Splice -Decal -Enclosures -/'Nat: or/ /"L"ft./ /"LPG
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 i
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 -
8. Gas and Electricity Tagged
Dead Men -Lining
9. Exits; Insp.-Sketch '� r
4. Elec.; Receptacles and Lighting, Distances=GFI
10. Cert. of Occupancy IN,
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.
Date Card Date IN
Card -B1
-B1
Boxes-Enclosures-Panelboards-Ins. to Main in Conduit
Card -B1
Date Card -B1 ...Date
9. Health Department Approval
r
10'. Plumb.; Cir. Test -Water Supply Test
ti
Card -B1 '
Date Card -B1 Date
Card -B1
Date Card -B1 Date
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piicable
ady
RESIDENTIAL (Single and Duplex)
(NOTE: An entry must be made each time you visit iob site)
;1JND RF400W(Plans) OK except #'s
Date
FRAMING (Continued)
.Zoning=Setback NEasement -Flood-Slop
45. Hangers -Post Caps -Anchors -Connectors
'8f, Ftg., Main; Soils-I-Elec. G d.-/ /"FV. Depth
Ing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng.
Garage; Soils -Steel-/ P' Ftg. Depth
Fireplace Ties or Type A Flue -Fireplace Throat Clearance
Porches & Decks; Soils -Steel-/ /"Ftg. Depth
. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
. Stemwalls, Main; Steel- Bloc kouts-Wrap ped
Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
Stemwalls, Garage; Steel- Blockouts-Wrapped
Garage Fire Protection Framing
7. Slab; Steel -Wrapped
roperty Line Firewall & Openings
Pie -Fireplace Ftg.-Steel
xt. Doors -One 3' -Check Garage -3rd story, 2 exits
-9. W.V., II-Fi gs-Test-2 way C/O -Sewer Test
39-3t3tm-, Width -Headroom -Rise -Run -Landing -Fire Protection
\1 . was Pipe; Size -Anchors
54,,Kywood on Roof Overhang -Attic Vents -Rafter Outriggers
N. WaN4 Pipe; Test -Anchors -Regulator -Service Test
55. Siding -Nailing Veneer
ectric; Undergroun
t6 16? tfft
Stucco -Dr creed -Fd. Vents-Underflr. Access
Ple s & D Clea c - prt-
Glazing Arreea lass Protection- Protection -Plastic
58. Shear Walls; Nailing -Bolts
-6ifders- 'IIs-Ancho I -J 's - ipples
Insulation
. Insulation-Walls-Clg.
60. Infiltration-Walls-Wndws
Card-BDates
-,Aand-B1 Date
Card-
Dat -B1 Date
Card -131
re,, Dat2 ff-7,$9 Card-BlA , Date -
Card -B1
c^Datey=tq�q Card -131M_ 6 Date
Date
PLUMBING (Permi OK except #'s
�_
/ o lQ, ICA 15
ater Ht. Vent -Access -Combustion Air -Baffle
Date
FINAL (Plans) OK except #'s
ater Pipe; Test & Anchors -Nail Protection
Of. Ext. Steps -Door & Sidelight Protection -Landings
V.; Test-Fttngs & Anchors -Nail Protection
. Smoke Detector
how an; First Floor- b AAZa§ss
. Furnace; Vents -Clearance -Comb. Air -Connector- `
In Garage; Above Floor -Ducts -Mach. Protection
20. Test Tub & Shower, 2nd Floor -Tub Access
Gas Pipe; Size & Anchors
$4: Bedroom Exiting
. G.F.I. & Bath Fixtures & Tub Access -Spa
66. Elec. & Subpanel; Breaker Sizes -Labels
r'Stairs
Card -B1
t,� Dateq �.��' Card -B1 Date
s
Card -131
Date Card 131 Date
Fireplace or Stove; Clearances -Hear
E-1
69. Elec. Outlets at Wood P�'nel; Int. &
Date
LECTRICAL (Permit) OK except #'s
. Kit. Fixt. & Appliance; nd. -Air Gap -Cooking Clearance
22. Fixture & Transformer Clearance -Ins. Protection
. Outlets & les at Kit. Counter
23. Elec. Receptacles Spacing -Lights & Switches at Doors
GaraElec.ge r; Swia
. Garage Fire Door; Swing -Landing -Closer
24. Size Boxes & No. of Conductors -Stapled
i'3-A.C. Duct in Garage -Damper
Romex Installed Close to Edge of Studs & C
• Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
26. Equip. Ground made up w/Mech. Fastener and Gas & Water7
2 Appliance Circuts in Kitchen & Co ctor Size/G.F.I.
Plb., Elec. & Mech. Equip. Listed for Location
WSubfeej Wire Size /9 9 ga. Cu or ABA.C. Wire Size /6/ga.
Cu o
70 Elec. Receptacles in Garage; -Romex Protec.
Insulation -Foam -Looked in Attic ,d Yes
Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al.
Insulated Neutral Yes No
4X. Guard Rails & Deck Construction -Post Caps
39-SepAce-Riser Conductors & Ground -Main Disconnect
7X Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth
Clearance Looked under Floor ,ZI Yes
Equip. Clearances Panels-Motors-Mech. Equip.
80. Followin insticl rive 0 Yes o; Walks ❑Yes oIfo;
Plantersg ❑ Y ;Vo11
3P!lothes Closet Light -Shower Light -Spa Light
moke Detector
81. Stucco; B n -Finish
Card -131
GQ Date 497.85 Card -B1 Date
§t A.C. Unit; Disconnect, Electrical, Plumbing
Card -131
r,_ DateU15 /1fCard-B1 Date
$3 Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to
Openings.
Date
M HANICAL (Permit) OK except #'s
-44-Water Well; Dis conngcLElectrical, Plumbing
. Ducts Insulation & Support
. ent Fan; Exhaust above insulation
85. Exterior Elec. Trim, . . Receptacle -Underground
Ventilation throughout House
odensate Drain &Overflow; Size &Grade
. Glass Protection
urnace-Vent; Access -Comb. Air -Return Air Vent -115 outlet
. Corrections from Previous Inpections
Attic Access & Platform if Furnace in Attic
. Gas T --Meters Tagged; Gas -Electric
Water & Sewer Connected -C/O to Grade -HD Approval
Energy Compliance Certificate -Other Certificates t2s8Y
Card -131M
Date- Card -131 Date
ryQ- Roofing Certificate G,
Card -131
Date Card -B1 Date
Card -81
rA Date 11-Z: 0ard-B1 Date
Card -131
jyt,d Date3-13-f Card -B1 Date
Date FRAMING (Plans) OK except #'s
30 -Sills, Proper Material & Anchors
Card -131
Date Card -131 Date
Comments at Final:
40-'W-aUs Studs -Nailing, Spacing & Bracing—Plates-Sound
B aring Walls over Girders & Floor Nailing
raft Stop in Walls (rat proof)
al Fire Stops; Furred Ceilings -Stairs -Chases -Tub
Header & Beam -Size & Bearing
(NOTE: An entry must be made each time you visit iob site)
COUNTY OF BUTTE
„_. DEPARTMENT OF PUBLIC WORKS
y� 196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 538-7541
747 Elliott Road, Paradise — Phone: 872-6307
CORRECTION NOTICE
V, A C 15 -3 a�
OWNER PERMIT O.
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.
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Inspector Date
COUNTY OF BUTTE'
DEPARTMENT OF PUBLIC WORKS
�� 1 • 196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, OroviIle — Phone: 538-7541
747 Elliott Road, Paradise — Phone: 872-6307 ---
CORRECTION NOTICE
OWKIE 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, r need additional explanation, please contact this office immediately.
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Inspector ��/_�/r��/J� Date .1o,2
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COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
a 7 County Center Drive, Orovi Ile — Phone: 538-7541 ;s
747 Elliott Road, Paradise— Phone: 872-6307
CORRECTION NOTICE-----
PERMIT
OTICE-
PERMIT NO.
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately. .i
'S -74
J
Inspector. r / Date
—
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COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS ;
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, OroviIle — Phone: 538-7541 ;r
747iE1liott Road, Paradise — Phone: 872-6307 `
CORRECTION NOTICE
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.
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�tor Date
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
198 Memorial Way. Chico — Phone: 891-2751
7 County Center Drive. OroviIIs — Phone: 538-7541
47 Elliott Road. Paradise — Phone: 872.8307
CORRECTION NOTICE
�3-
UNFfi ocou
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.
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Inspector, Date Date
pCOUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 -Memorial Way, Chico — Phone: 891-2751 y
7 Cohty Center Drive, Orovi Ile —'Phone: 538-7541
' ..747,EIIiott Road, Paradise — Phone: 872-6307
CORRECTION NOTICE
I/�/ tL/ is3�
UWNtH PERMIT NO.
A routine inspection indicates that thefo oWing violations of County Ordinance
exist at the above address and shoull-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.
4 . Yom, S�x r; v
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Inspector Date—
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
! 7 County Center Drive, Orovi Ile — Phone: 538-7541
747 Elliott Road, Paradise— Phone: 872-6307
CORRECTION NOTICE
�s
E
S —'� _-
PERMIT N
i' 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 wed" additional explanation, please contact this office immediately.
Inspector Date
751
:;anter Drive, Orovi Ile — Phone: 538-7541_..—
-14?"Elliott Road, Paradise — Phone: 872.-6307
CORRECTION NOTICE
OWNER a 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.
r: W�VTW
Inspector_�Uf l � Y ' Date—
a
-NTY OF BUTTE
F-
iMENT OF PUBLIC WORKS
zmorial Way, Chico -Phone: 891-2751
^`:ounty Center Drive, Oroville -Phone: 538-7541
747 Elliott Road, Paradise - Phone: 872-6307
CORRECTION NOTICE
LA (HAS 1'5 2
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.
t - eo22IEC rio.j5 Na r M-A�/& Ff?-a-M IVor(C(7
--7-Qr- - 't"
Inspector l.J ,bl.d.-,.o Date �4_��
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico —Phone: 891-2751
7 County Center Drive, Oroville —Phone: 538-7541
747 Elliott Road, Paradise —Phone: 872-6307
. CORRECTION NOTICE
OWNER PERMIT NO.
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this ,
matter, or need additional explanation, please contact this office immediately.
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Inspector /-Jal" Date 9 -2 -RC)
,
COUNTY OF BUTTE
r EP rial Wa T OF PUBLIC WORKS 2
196 Memorial Way, Chico - Phone: 891-2751
W
rr 7 County Center Drive, <Orovi lie _ Phone: 538-7541
747 Elliott Road, Paradise— Phone: 872-6307
�ej. - , CORRECTION NOTICE
VLN 533-35
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 A'c Q----4 Date —�� &
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Orovi Ile — Phone: 538-7541
747 Elliott Road, Paradise— Phone: 872-6307
-� - CORRECTION NOTICE
OWNER PERMIT NO.
A routine inspection indicates that the following violations of County, Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
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Inspector ���� 'Date 7/ 7
t4lo
13100 -,'-e PlJ-
co',P'e, Q261ghfOr 70 Q
6579 MILTON CT, MRGRLIR
16 MISSION CT, OROVILLE
20 GREENBRIRR, OROVILLE
101 PERKVIEW OR, OROVILLE
1514 LONE TREE RD, OROVILLE
2914 6TH ST, BIGGS
1484 PERCH ST, GRIDLEY
905 KENTUCKY, GRIDLEY
1495 PERCH, GRIDLEY
601 INDIANA ST, GRIDLEY
1755 SYCAMORE ST, GRIDLEY
381 OHIO ST, GRIDLEY
151 OREGON ST, GRIDLEY
170 PARK, GRIDLEY
172 PARK OR, GRIDLEY
227 OHIO ST, GRIDLEY
380 HASKELL, GRIDLEY
335 SAGE ST, GRIDLEY
282 LITTLE AVE, GRIDLEY
20 HASTINGS AVE, BIGGS
287 E. EVANS REIMER RD, GRIDLEY
7 WRIGHT RIE, GRIDLEY
TU LUMPLtit
RDDITION/SF
ELEC/GRRRGE
TRANSFER
NEW GARAGE
REPLACE FURNACE
REPLACE FURNACE
REPLACE FURNACE
REPLACE FURNRCE
REPLACE FURNACE
REPLACE FURNACE
REPLACE FURANCE
REPLACE FURNACE
REPLACE FURNACE
REPLACE FURNACE
REPLACE FURNACE
REPLACE FURNACE
REPLACE FURNACE
FURNACE '
FURNACE
FURNACE'
FURNACE
I, VVV. iu 1-j
4,080. 12/18
------ 12/13
----- 12/13
7,392. 12110
-------
'12/15
------ 12/15
--------
12/15
-------- 12/15
-- ---
12/15
-------
12/15
-- -- 12/15
-------
12/15
-------
12/15
------
12/15
----- 12/15
12/15
-------
12/15
--- -- --
12/15
----- 12/15
------ 12/15
------
12/15
Owner:
EINERGY 11 77, 1, ' I C* A T 1 0 N
A.P. No.
DESCRIPTION OF INSULATION
ROOF
Ma t c r in L.— Brand Name
'lit ickile 9 s-(,illclle s) Thermal Rentstntice (11 Value)
ExTu"Mi-oR WALL
Hateri;1.1 Fiberg-lasss
1'hickno-9.9(inche'
8
CEILING
Batt or Blanket Type Fiberglass
I'Mckness(Inches) - 0
Loose Fill Type Fiberglass
ickil e (I nches)
Area covered(f.t.,
FLOOR, E(-EIVATED
flaterin I 1'it)erqlass
FLOOR, S'!,Aj.1
Material.
Width(Lilciles)
FOUNDATIoN WALL
Ma t �� r ]n I
Till.cky.less(inches -)
Brnnd Name CertainTeed
Thermal Re9istnncT(R Value)
Brnnd Name CertainTeed
Thermal Resisuince(It Value) 3e)
Brand Name CertainTeed
Number of lIngs-Z-9 Wt. per bag 25 -1b.
Thermal Renistance(il Vnlue)- (0
J•'ralld 11,11ne- Certain'.Peed
Therinal. Resistance(II Value)
Brand Nnmc
'Oletililli 1(csistnilce(II vallle.)--
Brawl Vanii:.
Thermal Re.sistrince(R Vnl.i.ie)_
I herch), cort:11y that the above inruIntion was illqt,111-ed in the above bijUdIng
in c01lf(--)r,n--Al,cc with the State of California rt iergy Requirements.
Hawkins Insulation
319407
STATE C011TRACTOR'S LicEnsi-,, 11().
-ILLZ-n,6. z
SIGNATURI,
Wr HISTALLATIO)N APPLICATOR DATE .
1 hereby r-cet.tfy the above J.lj0j1jntt01!,nj!,j,
at requir,"d nr the
Buildilig Ocillirt'lle"t approved plans and attachments have been installed as
by tile State Of California Energy Requirements.
All dj:!vjce-Q'!j!,,
arl, Of "Ne qijaliLy pre-nerl.bed or are
specificall-'? 1pprovebd.y
lease print)
OF (11
THIS CE1ZTIFICN.l'r MUST BE ON FILE WITH I ' -11E BUILDING DEPARTMEtTr PFUOR TO FINAL
insri,1*cT1,-0N APPROVAL A14D A COPY SHALL BE POSTED WITHIN' THE BUILDING .
.1;.11M.ary 1984
COUNTY OF BUTTE - dEPARTMENT OF PUBLIC WORKS PERMIT NO-
7 County Center Drive - Obville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT c� U
ASSE�OR P(� C L NUMBER
ZONING
BUILDING PER
OW�JJJJJJR 1
1 •
TELEPHONE
SQ. FT. OCC. BUILDING VALUAT N
OWNER'S MA A
-
C �NTR CTOR• NAME
TELEPHONE
CO TRACTOR'S MAILING ADDR S J
S
Fireplace
CONSiR CTIO ENDER
1
UNKNOWN
Total Valuation $
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
•
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE No.
Plan Checking Fee
$
Energy Plan Checking Fee
$ S -'U V
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESSP^\J T 024 U,Permit
fee
$
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
1a 2.00 a4
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
7 g 7
Water piping
5.00 S•
Each qas water heater or vent
5.00
USE OF STRUCTURE
SFt�_Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
5.00
Mobile Home S I G I W
110.00 ea
TYPE OF WORK
NeWA Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work:
Penult Fee
$ P
Contractor
1,
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 6101 OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
I declare er penalty of perjury (check one
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Profess'o s f• an my license is in full rce 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)
❑ 1, 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. / DWELLIN \
OR ACDNS, `ACC. BL / , /:2sgft
NEW CONSTR I.OUTL T 2.50 ea
NON.RESID .BRA C CIRC ITS
POWER APPARATUS e
SINGLE OUTLET CIR. I
Ex. OCCUp(OUTLETS OR FIXTURES 200500
eAL030
Ex. Occup. OUTLETS FIXED P(RESID )REA.I 2.00
Temporary service 10.00 ---'—
Mobile Home Facilities 15.00
Misc. �Yirin 15.00
9
Penult Fee $
Contractor
WORKMEN'S COMPENSATION INSURANCE _
I declare under nalty of perjury (check one):
❑ T 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
❑1,910
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement,should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
FiIingFee 10.00
Heating
,
Cooling
Hood
3.00
Ventilation
penult Fee
$
Contractor
I certify that I have read this application and state that the above information
iscorre I agree to comply to all County Ordinances and State Laws relating
to buil n construction, and hereby authorize representatives of the Countyot
Butte t me upon the above-mentioned property for inspection purposes.
I also ree o save, indemnify and keep harmless the County of Butte against
all Iia 'I s, j ments, costs, and expenses which may in any way accrue
agains Co y in consequence of the granting of t permit.
X ate
Sig tur o App icant - 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 $
TOTAL PERMIT FEE $ ,
oeeuP,
coNST.TTPE
�
ecH L
PL000
PARC
PD D
ssu
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECT OF PUBLIC
BY
PER EXPIRES Date `
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date ��7 -�%
7-7- ��
Receipt No.
WHITE-D.P.W.. YELLOW -ASB E550K. PINK -INSPECTOR. GOLDENROD-AP►LI CANT
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TO; Building Department
FROM: Environmental Health
SUBJECT: SANITATION CLEARANCE
r OWNER
Plans approved for:
Hold final for:
LOCATION AP #
Sewage Disposal Wat�rupl
Water Supply
Final Clearance O.K. for: Water Supply
Clearance for bedroom mebtome Other
Clearance for addition of
No te-'
DATE
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541
PERMIT APPLICATION DATA SHEET
t� Permit No. �.
OWNER [11f l/ A. . No.
Proposed Building Use r1111�� Building Inspector Date
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED APPROVED
KQ 7.
8.
9.
10.
11.
13.
14.
15.
16.
17.
18.
19.
20.
21.
22.
23.
All items have heen suhmitteci
Plot plans in duplicate/triplicate, signed by preparer of plans........
Complete plans in duplicate/triplicate, signed by preparer of plans ..
Complete engineered plans and calcs, with wet signature on plans ..
Energy Design Compliance and supporting documentation .........
Statement of Intent for Non -Heated and AC Buildings .............. _
Engineered truss details and layout in duplicate (required prior to plan check)
Mobilehome installation data including manufacturer's installation
instructions.......................................................
Fees of $ ..........................
Chico Urban Area fees paid ........................................
Park fees paid .. ............................... .......
�f School District fees aid . ?•. r• � - <
Sanitation approval from Health Department ...
City of Chico plumbing permit ......................................
Plot plan and business license approval from City of
(see City for other requirements)
Planning approval for (A) Use: (B) Parking: .........
Improvements may be required. 4
Driveway permit (construction approval required prior to occupancy) ...
Pre -Inspection for required ...... Bu Building Inspector tort to (Date)
Contractor's license information (No., Name Style, Classification) .......
Certificate of Workmans Compensation Insurance ....................
Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ........
Recorced copy of Agricultural Acknowledgment Statement ............
Letter of signature author' tion ......... _ -
44:
K64.
I
you issue the permit, process as follows: Mail to owner. Mail to contractor.
Telephone!RQ moi //0 and hold for pickup at a office. Deliver w/inspector.
Other
Applicant
Copy of plans sent Health Dept., Fire Dept., Other Date
The following data must be submittedp i r to permit i
1. Index permit for above items No.
2. Additional items required:
Date
idle new item not checked above).
ontract designer, owner, was advised of above required data b L''"— 5 26--g�
g_ q y �one�nail_counter byQ�—� da�te
Con ractor, esigner, owner, was advised of above required data by_phone_mall_counter by R`-&- ate b -' I Z ��
Plans checked bDae �Q Plans approved by -� Date — '�9`
Sets of plans on hold in
Copy—DPW
File cabinet AP folder
OWNER'S NAME: Lm C --
PERMIT
PERMIT # : i' -t?' V U L e A. P. #: RECEIVED
When approved, process as follows:. DATE ---7/-7
Mail to owner TIME
(Address)
Mail to contractor
(Name.and Address)
Call and hold for pickup at office.
Deliver with next inspection.
REVISED PLAN CHECK FEES PAID:
$15.00 $30.00 •Additional Fees Not Required
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BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM
4 (One,Form per Building)
A.P. Number SS -4 --0 / Building Department No.
School District ,��s City County ® Jurisdiction
Property Owner"°�d �ao t V6U,.0
4L
Project Location/Address K),Q LL.,Q pal.
Subdivision Lot Number
Residential Development:
Sq. ,Footage c�oZOt�/
# of Living MHI Addition (Group R)
Units
i
Commercial/Industrial-.:` Sq. Footage
New Addition (Including Exterior
i
1 Roofed Areas)
nth//'�ia D
'Building`Depa,r�tment Representative I bate'
(Floor•Plans•re`viewed by:Schooh District Personnel)
r
~ n
g9.=Dirstrlct fId No.
l �,4 . ..,�
School District
certifies that
- '(Appl`ica/nt(Name)
(Phone Number) -
{/
(Street Address)
1 ,A Aztu 0;
"(City)
(State)
(Zipf Code)
has complied with,the.requirements
of Resolution No. L'
t
by the• payment of $ J�(y :��0
representing.
, 7756 square feet.
14
Nq
School District Representative
Date.
t'AlU bX l:HLUA REMARKS:
BANK NOL ,P_ gb--�fi4j_ ..
PAID BY CASH
:y white -applicant, yellow -building department, pink -school district
SCHOOL.FEE— (8/88)
H76r
1
RESIDENTIAL PLAN CHECKING GUIDE
(S.F.., DUPLEX & MISC. ONLY)
7/85
l Bldg. Permit # X5 33' 8 /
OWNER - \ AL -1 VAS A.P.#
GENERAL
Zoning requirements: .(sideyards and number of permitted living units).
Valuation.
3. Plans signed by designer.
Energy Design and Compliance..
"Existing violations on property: i RAlLeRAiOIST PC QEw-o-,cry UAo--4 PiNaL-
PLOT PLAN
-1 / Complete parcel size and dimensions.
Y Setbacks, sideyards, easements, etc.
Oth'er buildings or structures.
jGrading, fills,.drainage.
Flood hazard.
Special conditions on creation map or compliance document..
FLOOR PLAN
X'). Complete to scale plan with dimensions.
Required windows for light and ventilation (Sec. 1205)'.
/ Required windows for second exit (Sec. 1204,).
f: Skylights (Chapter 34 & Sec. 5207).
k Human impact glass.(Sec. 5406).
6! Required room sizes., ceiling heights.(Sec. 1207).
XG.F.C.I.'s in baths, garage and exterior outlets (Article 210-8).
-Light fixtures, switches, receptacles, and exterior receptacles for maintenance of
mechanical equipment.
Locations of water heater, heating and cooling.equipment, other electrical or gas
..�equipment, and.plumbing fixtures.
Garage firewall, door size, and closer (Sec. 503(d)(3)).
11 - 310" exterior exit door (Sec. 3304(e)).
1A.,/ Fireplace and wood stove location. -
Smoke detectors (Sec. 1210).
STRUCTURAL DETAILS
Foundation plan complete enough.to construct building.
X,/Foundation
Floor construction details complete enough:to construct building.
Elevations and wall construction details complete enough to construct building.
Roof construction details complete enough to construct building.
Fireplace construction details and calcs if necessary.
Sufficient data and details to satisfy energy requirements (State Law) (Form l).
MISCELLANEOUS ITEMS TO LOOK OUT FOR
V. Exposure I plywood on exposed locations and overhangs.
2; ----
Stairway details: landings, rise and run, head clearance, handrails (Sec. 3306).
51�Brick
Guardrail details (Sec. 1711.& 3306(j)).
or stone veneer (Chapter 30).
Exterior plaster - weep screeds (Sec. 4706).
Proper roof pitch for roof covering (Chapter 32).
7/ Rafter ties or bearing ridge beam.
RESIDENTIAL PLAN CHECKING GUIDE (CONT'D) 7/85
MISCELLANEOUS ITEMS•TO' LOOK OUT FOR (CONT'D)
Garage door or porch header sizes.
Adequate bracing.
Living area over garage- complet 1 -h -our separation required on garage side
including supporting walls—a:n'd posts, etc.
1sY,/ Two exits on three-story' dwellings (Sec. 3303 & see Mezannines 1716).
1!� Attic access and—veentiiation (5ec�.3205).
Underfloor access and—vent ation (Sec. 2516):_
1 ood staves, c �a ar nces, alcoves & 1 -hour shafts_.__
Com stio � it for fuel but-ing`appliances.
se equirements'on duplexes.
1 . Ad e soi special foundation design.
eta" ng walls requiring design.. _
4fi
HERMIT NO. E
PERMIT EXPIRES
' OWNER Theodore.Kalivas
CONTR. Owner
ASSESSOR PARCEL 55-45-07'
LOCATION —3-211-2 Red—S•ky-4.n�.p, . Paradise
r•
r
Temp. Power Pole
Y
Called PG&E / ^�
k T Elec. Service
� Called PG&E4 7/?',9� A5:!r4�44111;07
A!/ Gas
Called PG&E
JOB FINALED (Date)
i
Signature
V = .OK
0 = Not OK '
— = Not Applicable
= Not Ready
r.
MOBILEHOMES
MISCELLANEOUS
Date MOBIL ME UTILITIES (Plans) OK except #'s
Date. DECKS, COVERS, CARPORTS,'ETC. (Plans) OK except #'s
1 oning Requirements—Setbacks—Easements
1, Zoning Requirements—Setbacks—Easements
2. Soils;• pecial MH Support—Sketch M
2. Footings; Size—Depth—Spacing—Connectors
3 e , Location—Test—Fall-C/0—Concrete
3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails
4 a Location—Test—Easement Needed (Sketch)
4, Wood Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.—Rfg.—Bracing
5 I ctricity; Location—Clearances—Grnd.—/ / Amp—Concrete 1
5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures
_ ; Location—Test—Wrap:/ /"L"ft./ /"Nat. "L"it./� "LPG
6. Carports; Windows—Doors
tility Clearance J
_
7. Elec.
Card-BIate -BI Date
Card -BI Date Card -BI Date
Card -BI Date BI Date •
Card -BI Date Card -BI Date
Date MOBILE OME I STALL TON (Plans) OK except #'s M
Date POOLS (Plans) OK except #'s
1.oni g Requirements—Setbacks—Easements
1. Setbacks—Easements
2. ootings; Size—Spacing—Marriage Line
2. Soils; Compaction—Structure Stability
3, asJ,MH Test—Demand—Valve—Connector
3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining
4. ectricity; MH Test—Crossovers—Breakers—Clearances
4. Elec.; Receptacles and Lighting; Distances—GFI '
5, rai ; MH Test—Fall—Flex Connector I
5. Elec.; Pool Lighting; 15 volts—GFI
6. ater; MH Test-Regulator—Connector
--
6. Elec.; Enclosures; Conduit Entries—Terminals—Listed
7. atec and Sewer Connected—C/O to Grade—HD Approval
7• Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater
8. a d Electricity Tagged i
8. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg.
Boxes—Enc losures— Pane Iboards— Ins. .to Main in Conduit
9, x' Insp.—Sketch
10. Cert. of Occupancy
9. Health Department Approval
10. Plumb; Cir. Test—Water Supply Test
Card B -I Date and -BI Date
Card -BI Date Card -BI Date
Card B -I Date Card -BI Date
Card -BI Date Card -BI Date
= OK
= Not OK
= Not Applicable RESIDENTIAL (Single and Duplex)
= Not Ready
Date
UNDERFLOOR Plans OK except #'s
Date
FRAMING (Continued)
1. Zoning requirements -Setbacks -Easements
48.
Property Line Firewall & Openings `
2.
Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth
49.
Ext. Doors -One 3' -Check Garage -3rd story, 2 exits
3.
Ftg., Garage; Soils -Steel- / /" Ftg. Depth
50.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
_
4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab
51.
52.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
Siding -Nailing -Veneer
6.
Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab
53.
Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access
7.
Piers -Fireplace Ftg.-Steel
54.
Glazing Area -Glass Protection -Skylights -Plastic
8.
D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test
55.
Shear Walls; Nailing -Bolts
9. Gas Pipe; Size -Anchors
10.
Water Pipe; Test -Anchors -Regulator -Service Test
11.
Electric; Underground
12.
Plenums & Ducts; Clearance -Material -Support -Ins.
13.
Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date
Date Card -BI Date
FINAL (Plans) OK except k's
Card -BI Date Card -BI Date
Date
_
PLUMBING (Permit) OK except q's
14. Water Ht.; Vent -Access -Combustion Air
56.
Ext. Steps -Door & Sidelight Protection -Landings
57.
Smoke Detector
58.
59.
Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
Bedroom Exiting
15. Water Pipe; Test & Anchors -Nail Protection
16. D.W.V.; Test-Fttngs & Anchors -Nail Protection
17.
Shower Pan; Test, First Floor -Tub Access
60.
G.F.I. & Bath Fixtures & Tub Access
18.
Test Tub & Shower, 2nd Floor -Tub Access
61.
Elec. Trim & Subpanel; Breaker Sizes -Labels
19.
Gas Pipe; Size & Anchors
62.
Stairs & Rails
63.
Fireplace or Stove; Clearances -Hearth
64.
Elec. Outlets at Wood Panel; Int. & Ext.
Card -BI
Date Card -BI Date
65.
Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI
Date Card -BI Date
66.
Elec. Outlets & Receptacles at Kit. Counter
Date
ELECTRICAL Permit OK except p's
67.
Garage Fire Door; Swing -Landing -Closer
68.
A.C. Duct in Garage -Damper
20.
Fixture & Transformer Clearance -Ins. Protection
69.
Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.-
In Garage; Above Floor-Mech. Protection
21.
Elec. Receptacles Spacing -Lights &Switches at Doors
70.
Plb., Elec. & Mech. Equip. Listed for Location
22.
Size Boxes & No. of Conductors -Stapled
71.
Elec. Receptacles in Garage; (G.F.I.)-Romex Protec.
23. Romex Installed Close to Edge of Studs & C.J.
24.
Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water
72.
73.
Insulation -Foam -Looked in Attic E] Yes
Guard Rails &Deck Construction -Post Caps
25.
2 Appliance Circuits in Kitchen &Conductor Size
74.
Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance
Looked under Floor ❑ Yes
- 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al
27.
Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al,
Insulated Neutral []Yes El No
75.
Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No;
Planters ❑Yes F-1 No
28.
Service -Riser Conductors & Ground -Main Disconnect
76.
Stucco; Brown -Finish
29.
Equip. Clearances; Panels-Motors-Mech. Equip.
77.
A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
30.
Clothes Closet Light -Shower Light
78.
Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
79.
Water Well; Disconnect, Electrical, Plumbing
80.
Exterior Elec. Trim; G.F.I. Receptacle -Underground
Card B -I
Date Card -BI Date
81.
Ventilation throughout House
Card B -I
Date Card -BI Date
82.
83.
Glass Protection
Corrections from Previous Inspections
Date
MECHANICAL (Permit) OK except p's
31. A.C. Ducts; Insulation & Support
84.
Gas Test -Meters Tagged; Gas -Electric
85.
Water & Sewer Connected -C/O to Grade -HD Approval
-
32.
Vent Fan; Exhaust above Insulation
86.
Energy Compliance Certificate -Other Certificates
_
_33.
Condensate Drain & Overflow; Size & Grade
34.
Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet
35.
Attic Access & Platform if Furnace in Attic
Card -BI
Date Card -BI Date
Card -BI_
r
Cad -BI
-
---. - - -- --
Date _- _ _ Card -BI Date
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Comments at Final:
Date FRAMING(Plans) OK except N's
36.
_ Sills; Proper Material & Anchors
37.
38.
39.
_
Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound
Bearing Walls over Girders & Floor Nailing
Draft Stop in Walls (rat proof)
40.
Fire Stops; Furred Ceilings -Stairs -Chases -Tub
41.
42.
43.
44.
Header & Beam -Size & Bearing
Hangers -Post Caps -Anchors -Connectors
Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfnq.
Fireplace Ties or Type A Flue -Fireplace Throat
_
45.
Attic Access; Size & Rom_ex Protection -Draft Stop -Ins. Baffles
_
46.
Bdrm. Windows or Exiting Doors -Sill Hgt. &_Dimensions
47.
Garage Fire Protection Framing
(NOTE: Anentrymust be made each time youvisit jobsite)
COUNTY OF BUTTE1
DEPARTMENT OF PUBLIC WORKS
695 Oleander Avenue, Chico — Phone 343-4211 Ext. 70
7 County Center Drive, Oroville — Phone 534-4541
Skyway and Elliott Road, Paradise — Phorte-877-3435
� 7,2--A9ir i - XS -7-
..; CRRECT111 NOTICE
-All
BUILDING OR PROPERTY ADDRESS
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
/moi '1 • '. i
i
L
x ce) t2 Nl. ! /V G 002 C �,�¢ c� A o r2
Q iii mud
Inspector
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE
OROVILLE, CALIF. - 534-4541
CERTIFICATE OF OCCUPANCY
This mobilehome has been installed in accordance with the requirements
of the Califocn a{Administrative Code, Title 25, Chapter 5, under permit
number for the -following location:
Owner L f s
z
Owner's Address
Mobilehome Mfg 21 l Model Year
Insignia No. Serial No.
It is hereby certified for occupancy at the above described location and
may be occupied.
Date
Director of Public Works
By
THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED
White - 0wner, Yellow - Installer, Pink - D.P.W.
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
Y ~ •T 7 County Center Drive - Orovlller Cali orn'a 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT 0.
�7
ASSESSOR PAR EL NUMBER.
^_ c —07
ZONING
'
BUILDING PERMIT
OW
%�0 D O,l� 1 4� V�-s
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
Q
CT — I�TO 5 N�'GI���TT V �
yI
ZH O()V/ T7T//
7
CONTRACTOR'(o/JS�j.AAILING ADDR�SS V/� ^ /
ZS /-t
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
Flling Fee
$ 10.00
LENDER'S MAILING ADDRESS -
Permit Fee
$
ARCHITECT OR ENGINEER/7
LICENSE NO.
Plan Checking Fee W7.$QU
Penalty
$
ARCHITECT OR ENGINE R'S MAILING ADDRESS
Permit fee
$
BUILDLp.If ESS ^ �T 4 -Al / .
`i/{/`J (`J`_//v/
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Solar Water Heater
20.00
/1
Water piping
5.00
LOT NO.
SUBDIVISION NAMEPARCEL
MAP
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
5.00
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome Other
SPECIFY
Building sewer
5.00
Mobile Home S I G I W
10.00e
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Uti •ties ❑ nstallation Other ❑
Describe work: /� �nL- ��'% �r gZ —
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V OR LESS
100 AMP OR LESS
10.00
I X6�
Main service EA, ADD'L 100 AMP
2.50
NEW CONST,(DWELLING OCCUP.&
OR ADDNS. ACC. BLDGS.
1
2/20sgft
-
CONTRACTORS LICENSE LAW
I declare nder penalty of perjury (check One):
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. 131: 3 -,? i Classification ' C G iEX.
❑ I. as the owner, or my employees with wages as their sole compen-
sation, will do the work, and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST'3 ULT' -OUTLET 2,50 ea
NON-RESID BRANCH CIRCUITS
NEW CONSTR (POWER APPARATUS &)
NON-RESID, SINGLE OUTLET CIR,
Ex. Occup(OUTLETS OR FIXTURES SA ®30C
FIXED APPLN5. OR
Occup. OUTLETS (RESID.) EAJ 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee
$
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ 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.
VI 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.
Heating
Cooling
Hood
3.00
Ventilation
permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I• also agree to save, indemnify and keep harmless the County of Butte against
all Liabilities, judg ants, osts, and expenses which may in any way accrue
against s id County con aqua " of the granting of this permit.
X Date S ��^ �;
Signature of Applicant — Owner ❑ Contractor 0�/ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 storiesin height.
Mobile Home Installation Fee
$ Op
TOTAL PERMIT FEE $ (�rOd
OCCUP, GROUP
I TYPE OF CONST.
JPARCFLJ
PD
MD'
SSU
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DI CTOR OF PUBLIC
MIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Dates" -13— ?D
— - O
Receipt No.
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDEN ROD-APPLICANTP
1
'BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS
.7 County Center Drive, Oroville, CA.
PHONE:'534-4541
9
MOBILEHOME. INSTALLATION
SHEET
1.
Owner's name: f D A -A .( ! U,4
2.
Installer's name: C�U_r- lcl-Z /7�
-
3.
Is the site currently under permit? Yes
No
(If yes, furnish permit number
) OR
Is the -site an existing site? Yes / /
No
(If yes, furnish two (2) plot plans.)
4.
Will the mobilehome be located at least 5 ft. away
from septic tank
and leach fields and
clear of all setbacks and easements? Yes
No / /
(If no, clarify
5.
What is the mobilehome electrical rating? -------------------=---
/DD
Amps
6.
What is the mobilehome site service rat1n g? ---------------------
`,- .�Q'
Amps
7..
What is the mobilehome site circuit breaker rating?
-------------
Amps
8.
Is there any other electric load to be served by the mobilehome.
siteservice? ---------------------------------------------------
Yes Pio
/l//
(If yes, identify the load and size:
(Load)
(Amps)
9.
What is the mobilehome site gas pipe size? -------------=--------/
(in.)
10.
What'is the type of gas service? ------=----------------------
Natural/%
LPG
/L,--/
11.
What is the gas pipe length from meter'or tank to the mobilehome?
12'0
What is the mobilehome gas demand? --- ------------------------
(BTU)
(This information not required if pipe length
less than 6 ft.
on natural gas .
or less than 50 ft. on LPG.)
9
MOBILEHOME SUPPORT DATA
If.other than single wide,
Mobilehome'Mfr. S'I.t UEfi'r/�tt<i� furnish Setup Model No. S 2 Year g
Width /i (ft.) Box Length40 (ft.) Tagalong or Expando Size ft. x ft.
(SHOW SUPPORT DETAILS BELOW)
On all mobilehomes manufactured after October 7, 1973; furnish manufacturer's installation
manual and structural setup sheets (if not on file with the County of Butte).
All center supports measured from front of
mobilehome-unless otherwise specified.
Single
x
(ft.)(in.) --(in.) (in.)
Center support Center.support
locations* footing sizes
.(in.)
L_J I x
(in.) (in.)
(in.) (in.)
L L-- x --�
(in.) (in.)
Footings (check one)
lh 1. Wood either
pressure treated or
foundation grade.
E] 2. Other (specify)
Supports (check one)
51-1l: Concrete block."
2: Other (specify)
Tagalong or Expando"
show support -details.
t/a'x,3e"j Typical Support
(in.) (in.) Footing Size
Max. Pier Spacing
x., -- Max. Overhang
(ft.) (in.) (in.) (in.)
BUTTE COUNTY
BUILDING DEPARTMENT
APPROVED
*If center piers are other than drawn above,
draw in -.•locations, spacing, and dimensions.
COUNTY OF BUTTE'- DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATIDN AND PERMIT
PERMIT NO.
AA
ASSESSOR PARICEL NU 7_0 1-7 a
ZONING I
C `-.G
BUILDING PERMIT
'
L,r �—Sar
ELEPHONE
73s
SO. FT. OCC. BUILDING VALUATION
O NER'S MAILINGADDRESS
CONTRACTOR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
C STRUCTION LENDER
UNKNOWN
C
Total Valuation $
Filing Fee
$
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$
BUILDING ADDRESS
3292
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Repair drainage or vent piping
5.00
Water piping
LOT NO.
l
SUBDIVISION NAME
1
PARCEL MAP
7 - -7
Each qas water heater or vent
55,00
Gas piping systerp 1 - 5 outlets
,®
USE OF STRUCTURE
SF ❑ Duplex[] Mobilehomey Other
SPECIFY
Building sewer
0
Lawn sprinkler system
5.00
TYPE OF WORK }�
New ❑ Addition ❑ / Remodel ❑ Utilities,�l InstallationInstallation[]Other ❑
Describe work:
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 60OV OR LESS
100 AMP OR LESS
—&Go-
Main service EA. ADD'L 100 AMP
2.50 2
NEW CONST. ( DWELLING OCCUP.N)
OR ADDNS. \ ACC. BLDGS.
20 sq ft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business50
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
O II -
NNEW CONST(MUIOUT
BRANCH CIRCT TS 2.50 ea
NEW CONSTR./ POWER APPARATUS e'
NON-RESID. SINGLE OUTLET CIR,
(
@ 25C
Ex. Occup o OR FIXTURES BAL@100
FIXED PPLNS. OR
XED A
Ex. Occup.(OUTLETS (RESID.) EA. 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 7.50
Permit Fee $ .�
Contractor
MECHANICAL PERMIT
FiIirig Fee 10.00
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.
Heating
Cooling
Hood
3.00
Ventilation
permit Fee
$
Contractor
1 certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree 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 Z
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 $
-O
TOTAL PERMIT FEE $
OCCUP. GROUP
I TYPE OF CONST.
PA CE
Pb HD
1550
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DiREP.T44111 OF P
By.
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
IC WORKS
q
Date `
-"!
Receipt No. (n 1 7 4.
WHITE-D.P.W., YELLOW-ASSESSO:.R. PINK -INSPECTOR, GOLDENROD -APPLICANT
Return to ,DPWYA
AGRICtTLTURA'L Sl[�T",.:i1BNT_.OF ACKNOWLEDGEMENT
FOR RESIDENTIAL DEVELOPMENT
Section 26-8.1 of the Butte County Code requires this acknowledgement .;.,``=
be recorded prior to issuance of a building permit. �n
The property described herein is adjacent to land or included' y.
wRrr
within an area zoned for agricultural purposes, and residents of ELEA�ti?'.. g kh
this property may be subject to inconveniences or'discomfort arising :��fl��� u
°s
from the use of agricultural chemicals, including, but not limited to herbicides; rc
pesticides, and fertilizers; and from the pursuit -of agricultural operations including; -
but not limited to cultivation, plowing, spraying, pruning, and harvesting which occa-
sionally generate dust, smoke, noise, and odor. Butte County has established'agricul-
tural zones which have -as a priority use for productive agricultural purposes; and
residents within said zones and on adjacent property should be prepared to accept such
inconvenience or discomfort from normal, necessary farm operations.
All that real property situate in the County of. Butte, State of California,
described as follows:
c� Zoe
Date: P2�( Z�-_ 1 $'I,� PROPERTY OWNERS:.
0
o CksgJ� _
State of On this the- qday of
SS. before me, the,undersigned Notary PA011
Upersonally
County of &a ) appeared G
� .
VIWAN H. CLEVELAND
NOTARY PUBLIC
}^'
Butte County
1 '
State of California
Poly Commission Expires Mar. 22, 1985
Present A.P. NO.
J
t
known to me to be the person(s) whose name ,(s)"'.. _ P�
subscribeto the within instrument and acknowledged
that YhZe__1 executed.the'same for the purposes
therein cont ined.
IN WITNESS WHEREOF,. I hereunto set my hand and official
sear.
Notary Public
��The land referred to he>,ein -,is c ;, �;,ri_bed as follows:
All of tl_at certain real property situate in the County of Butte,
of California, described as follows: -
PARCEL A:
State
Parcel 1, as shown orr that certain Parcel slap being a portion of the
Southeast quarter. of Section 29, Township 22 North, Range 3 East, M. D.
B. & M., filed in the.office'of the Recorder, County of Butte, State of
California, on November 7, 1.980, in Book 79 of Parcel Maps,...at.page�s 73
and 74.
RESERVING THEREFROM an easement for waterline purposes. Said easement
to be for the benefit of and app.urtenant to' he r a"ming land of the:
`r:l ..� icr hez L_eY, -an Zha 1 4 n...r,2' t0 t1ie 7 F ar r• used
b
-- - - - _4 . :..�_�� _ .. .cne. i t of u:.d :ay b:. ..saU yr
all persons who may hereafter become the owners of any parts or portions
of said appurtenant land.
PARCEL B: �.
An casement for waterline purposes as shown on that certain Parcel Map
being a portion of the Southeast quarter of Section -29', Township 22
North, Range 3 East, M. D. B. & M., filed -in the office.of the Recorder
County of Butte, State of California,'on November 7, 1980,' in Book 79
of Parcel Maps, at pages.73 and 74.
PARCEL C: x:
An casement for a common well located on Parcel 2 as shown on that certain
Parcel Map being a portion of she Southeast quarter of Section 29.; Town-
ship 22 North, Range 3 East, M.D. B. & M., filed in the office of the
Recorder, County of Butte, State of California'; on November 7, 1980,:in'
Hook 79 of Parcel Maps, at pages 73 and 74.
MAIL TAX STATEMENTS AS DIRECTED ABOVE
COUNTY OF RUT.T.E... DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
PERMIT NO.
L NUMBER
ASSES PARCE\— l:
'
Y37
ZONING
BUILDING PERMIT
�v++�
e Q o�� ,+L. f vis
TELE
7-33- �' PHONE
S0. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
S -Lz0 Rd-�I•
CONTRACTOORR'�S SNA E
W P NGJ�J
TE EPHONE
CON RACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
Filing Fee
$ 10,00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
'
LICENSE NO.
Plan Checking Fee
$ to
Penalty
$
ARCHI-TELT OR ENGINEER'S MAILING ADDRESS
Permit fee
$ 0 —
BUILDING ADDRESS
•
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00
Repair drainage or vent piping,
5.00
Water piping
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Each qas water heater or vent
5,00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome� Other
SPECIFY
Building sewer
Lawn sprinkler system
5.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities[], nstallation Ltd Other ❑
Describe work: ✓1--
D U _
Permit Fee I
$
Contractor
ELECTRICAL PERMIT,
Filing Fee 10.00
Main service 6101 OR LESS
100 AMP OR LESS
5.00
Main service EA. ADD'L 100 AMP•.
2;5'50
NEW CONST. /DWELLING OCCUP.�)
OR ADDNS. \ ACC. BLDGS.
20sgft
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
ElI 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
NEW CONSTROUTLET 2,50 ea
NON-RESID BRA CH CIRC S
NEW CONSTR. /POWER APPARATUS &)
NON-RESID. %SINGLE OUTLET CIR,
Ex. Occup OUTLETS OR FIXTURES BAL@1
FIXED APPLNS, OR
Ex. Occup.(OUTLETS (RESID,) EA.) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 7.50
Permit Fee $
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
t 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.
Heating
Cooling
Hood
3.00
Ventilation
[Permit
Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
g/�,
X QW5 Date J
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 $ J
TOTAL PERMIT FEE $ S�
OCCUP. GROUP
I TYPE OF CONST.
PARCEL
PO
ND
IseuE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OF PUBLIC
By
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Receipt NO. Ca Z 7 0
WHITE-D.P.W., YELLOW -ASSESSOR, INK- INSPECTOR, GOLDENROD -APPLICANT
' � +1; h .�
1
a �
i.
' J •
`
� r'
i. �
•
`
•
�
�
�
.i
i
Certificate of Compliance: Residential
Documentation Author Telephone
Climate Zone 11
1533-
Building Permit #
Qtecked By/ Date l
Enforcement Agency Use Only
BUILDING DATA Glass Area % Glass
North 35.5 wa
ConditiQLled Floor Area 2.204 _ Number. of Stories � East 7(0 3.3
Sl s oor ' Number of "Units _— South
Do Single Family Detached (SFD) [ ] Addition Alone West 10160 4.(0
[ ] Single Family Attached (SFA) [ ] Existing Building Skylight (2 as
[ ] Multi -Family (MFS [ ] Existing -Plus -Addition Total I ('05i 5 I .
BUILDING SHELL INSULATION
Component
Insulation
Location/Comments
Type
R-VaIue
(attic, to garage, typical, etc.)
Wall ..............
-13
tXT. WALLS
Wall ..............
�-
' rttldFtrm -
Addm a:
Roof .............
Tekpho
GE e S
Roof .............
--
t (si a
6r )
Floor .............
t SF5 FLPS .
Floor .............
--
Name:
Slab Edge.....
--�
Agency:
GLAZING
Telephone:
Shading Devices
Glazing
Area
Glass Type Interior Exterior Overhang Framing Type
Orientation
On
(single. double) (roller blind. etc.) (shadeseretan, etc.) (yes/no) (metWwood)
North
35.5
17, t- A- el -
AJ -North ( )
East
East ( )
South
Sou til ( )
West (✓f
!Q�
West
Skylight.......
THERMAL MASS
Type/Covering
-
Area Thickness •�
HVAC SYSTEMS Minimum
Type (furnace, air Efficiency
conditioner, heat pump) (SE, SEER,HSPF)
Av I �1ac.E 22
on
Duct
This certificate of compliance lists
Location
Duct
Output
(attic, etc.)
R -Value
tuh .
r I tc.
AlnEk_
,i
657
' rttldFtrm -
Addm a:
TRWFum:
Address:
Tekpho
Maximum Furnace Heating Output: _
HOT WATER SYSTEMS ,rte
ut"
Manufacturer/Model #
Manufacturer / Model #
system's (storage gas, etc) Capacity or approved equal) Special Feature(s)
SPECIAL FEATURESIREMARKS (Add extra sheets if necessary)
Mandatory Measures Checklist: Residential I MF -1R
NOTE: Lowrise residential buildings subject to the Standards must contain these measures regardless of the compliance
approach used Items marked with an asterisk (•) may be superseded by more stringent compliance requirements listed
on the Certificate of Compliance. Wben 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.
DESCRIPTION DESIGNFR 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 walls R-1 I weighted average (does not apply to
exterior mass walls).
§2.5352(k): Slab edge insulation - waw absorption rate no greater than 03%, water vapor
transmission rate no grcaw than 2.0 pemrlmch.
§2-5311: Insulation specified or installed meets California Energy Commission(CEC) quality
standards. Indicate type and form.
§2.5352((): Vapor barriers mandatory in Climate Zones 14 and 16 only.
§2-5317: Infiltration/Eaftltration Controls
a. Doors and windows between conditioned and unconditioned spaces designed to Emit au
leakage.
b. Doors and windows certified.
c. Doors and windows weatherstripped: all joints and penetrations caulked and sealed.
§2.5352(e): Special infdautioa barrier installed to comply with §2.5351 meets CEC quality
standards.
§2-5352(d): Installation ofFireplaces
1. Masonry and factory -built fireplaces have: _
a. Tight fitting, closable metal or glass door
b. Outside air intake with damper and control
c. Flue damper and control
2. No continuous burning gas pilots allowed.
HVAC and Plumbing System Measures
§2-5352(8) and 2.5303: Space conditioning equipment sizing: attach calculations.
§2-5352(h) and 2-5315: Setback thermostaton all applicable heating systems.
• §2-5316(a): Ducts constructed, installed and insulated per Chapt& 10, 1976 UMC.
§2.5316(b): Exhaust systems have damper controls.
§2-5314(c): Gas-fued space heating equipment has intermittent ignition devices.
§2-5314: HVAC equipment, water heaters, showerheads and faucets certified by the CEC.
§2.5352(1): Waw heater insulation blanket (R-12 orgreatex) or combined interior/exterior
insulation (R-16 or greater): fust 5 feu of pipes closest to tank insulated (R-3 or greater).
§2.5312(Exception 1): Pipe insulationon steam and steam condensate return & recirculating
piping.
§2-5318(d): Swimming Pool Heating
1. System has:
a On/off switch on heater.
i b. Weatherproof instruction plate on heater.
c. Plumbed to allow for solar-
? 2. 75 percent thermal efficiency.
I 3. Pool cover.
4. Time clock.
5. Directional water inlet.
Lighting and Appliance Measures
§2-5352(1): Lighting - 25 lumens/watt or greater for general lighting in kitchens and bathrooms.
§2.5314(c): Gas feed appliances equipped with intermittent ignition devices,
§2-5314(a): Refrigerators, refrigerator -freezers, freezers and nuorescent lamp ballasts certified
by the CEC. Indicate make and model number.
COMPLIANCE STATFIAENr
This certificate of compliance lists
the building features and performance specifications needed to comply with
Title 24, Chapter 2-53 and Title 20. Chapter2, Subchapter4. Article 1 of the California Administrative code. This
certificate 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.
1 Designer
Building Owner
Name:
Name:
' rttldFtrm -
Addm a:
TRWFum:
Address:
Tekpho
Telephone:
Lic. 4:
t (si a
6r )
(date) (signature) (dart)
Documentation Author
Enforcement Agency
Name:
Name:
Titk/Firm:
Agency:
Address:
Telephone:
1. Ceiling Insulation
-4
-3 -1
Number of stories
-1
R -value One
Two
Three
R-0 -103
-49
-02
R-19 -8
-4
-2
R-30 -2
-1
-1
R-38 0
0
0
U -value
R-19
0
0.50 -176
-84
-54
0.30 -102-
-49
-32
0.10 -26
-13
-8
0.08 -18
-9,
-6
0.06 -11
-5
-4
0.04 -4
-2
-1
0.02 4
2
1
0.00 11
5
3
2. Wall Insulation
-22
0.20
Single-
Single -
.-14
Family
Family
Multi -
R -value Detached
Attached
Family
R-0 -68
-51
-34
R-11 0
0
0
1 R-13 2
2
1
R-19 8
6
4
4:
U -value
1
0.00
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
-4
-3 -1
Insulation in Floor
-1
-1 0
0.70
Number of stories
2 1
R -value
One
Two
Three
R-0
-17
-8
-5
R-11
-3
-2
-1
R-19
0
0
0
R-30
3
1
1
U -value
-26
-14
-3
0.60
-144
-70
-46
0.50
-120
-58
-38
0.40
-95
-46
-00
0.30
-69
-34
-22
0.20
43
-21
.-14
0.10
-17
-8
-5
0.08
-11
-6
4
0.06
-6
-3
-2
0.04
-1
0
0
0.02
4
2
1
0.00
10
5
3
Controlled Ventilation Crawlspace
-14
-7
Number of stories
7
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
15
21
--
Number of Stories
-2
R -value
One
Two
Three
R-0
0
0
0
R-5
8.
5
2
R-7
8
6
3
F2 factor
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. Infiltration (Air Leakage)
Specifica6w,, Points
SWr4wd 0
6. Glass Heat Loss
Total
-14
-48
-69
-64
U -value
East
Percent
West
Skylight
.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
7..Shading (Shade Open)
Efrective Percent Glass
(percent glass x SC)
Effective
-14
-48
-69
-64
%Glass North
East
South
West
Skylight
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 1
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
-4
.2
0
na = not allowed
2
3
4
3
a3. Shading (Shade Closed)
Effective Pei cc it Class
(percent &Iris x SC)
Effective
%Glatt North Eats 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
na . not afbwed
9. Interior Thermal Mass
SCORE CARD
/ I .
Interior
Slab Floor
Raised Floor
Mass
Stories
1200
Stories
2200
/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 WaU Thermal Mass
-4 -4
Exterior
Single-
Single -
7.0
0
Wall
Family
Family
Multi
Mass
Detached
Attached
Family
0.00
0
0
0
14 12
0.20
3
2
1
22
0.40
5
4
3
11.0
0.60
8
6
4
8
0.80
10
8
5
14
1.00
13
10
7
20
1.20
13
12
8
or
1.40
12
13
9
4
1.60
10
13
it
5
1.80
10
12
12
WSB
2.00
10
11
13
i
11. Heating System
POU
9
5
3
SE or
HSPF
SE
None
(assumes ducts In attie)
-23
-15
Sum
of 1.6
3.4
Solar
2
-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 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
0.95 8.71
20 18
15 13
11
8
1.1
Effective SE or HSPF
1
(SE or HSPF x duct efficiency)
0
Effective -25 or -24 to -14
to .4 to
+61o, 16 or
SE HSPF less -15
-5 +5
+15 more
-10
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
3
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
Zonal
Control Adjustment
3.4
System Type
.3.8
4
4.3
4.5•
Resistance
10 9
7 6
4
3
Other
6 5
4 3
2
2
12. Cooling Syst.:m
SCORE CARD
/ I .
Unit Size (sQ
Measures
Water
SEER
1139
1200
1700
2200
2700
(assume; ducts
In attic)
or
10
' to
Som of 7.10
or
Type
Type
less
-250t -24 to -14 to
-410
+6 to
16 or
SEER
less
-IS -5
+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
12.0
15
13 11
9
7
5 .
13.0
20
17 14
12
9
6
-12
-9
Effective SEER
-6
IG
None
(SEER xduct eMclency)
1
-2
-2
Sum of 7-10
2.3
Solar
7
Effective -25 or -24 to -14 to
-410
+6 b
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
0
Zonal Control Adjustment
or
1
10
8 7
*6
4
3
HP
No Cooling System Installed
9
5
Stories
One -5 4 4 -3 -2 -2
Two + 3 3 2 2 2 1
Single -Family Detached and Attached
Point System Summary: Climate Zone 11
SCORE CARD
/ I .
Unit Size (sQ
Measures
Water
K -3g or
1139
1200
1700
2200
2700
Heater
t.rodit
or
10
' to
to
or
Type
Type
less
1699
2199
2699
more
SG
None
0
0
0.
0
0
or
Solar
12
8
6
5
4
HP
HWR
8
5
4
3
3ts
AREA
WSB
5
3.
3
2
2 '
POU
8
_ 5
_4
3
3
SE
None
-37
-24
_
18
-15
-12
Effective SEER,[7.031
Solar
-1
-1
-1
0
0
20%
HWR
-18
-12
-9
-7
-6
55%
WSB
-25
-16
-12
-10
-8
95%
POU
-13
-12
-9
-7
-6
IG
None
-5
-3
-2
-2
-2
2.3
Solar
7
5
4
3
2
3.8
POU
3
2
1
1
1
IE
None
-28
-19
-14
-11
-9
1.2
Solar
8
5
4
3
3
2.7
POU
-10
-6
-5
4
-3
4.2
Multi
-Family (individual
4.8
units)
5.2
5.4
20%
0.3
Unit
Size (sQ
1
Water
1.4
699
700
1200
1700
2200
Heater
Credit
or
b
to
to
or
Type
Type
less
1199
1699
2199
more
SG
None
0
0
0
0
0
or
Solar
14
7
5
4
3
HP
HWR
9
5
3
2
2
4.5
WSB
9
4
3
2
2
40Y.
POU
9
5
3
2
2
SE
None
-45
-23
-15
-11
-9
3.4
Solar
2
1
1
0
0
4.9
HWR
-23
-12
-8
-6
-5
0.9
WSB
-25
-13
-8
-6
-5
23
e0U
-23
12
8...
-6
-5
IG
None
8
-4
-3
-2
f -2
5.3
Solar
6
3
2
1
1
1.1
POU
1
_0
0
0
0
IE
None
-30
-15
-10
-8
-6
4.1..4.3
Solar
18.
9
6
4
4
5.6
POU
-8
4
-3
-2
-2
Point System Summary: Climate Zone 11
SCORE CARD
/ I .
Type [double]
Measures
1. Ceiling Insulation
K -3g or
SC
R -value [38] U -value [0.030]
2. Wall Insulation
K- 13 or
R -value [11] U -value [0.098]
Interior MasslCFA
or
JIG X
R -value [ 191 U -value [0.037]
X
1
s4
-• X
Type7 PSS
% Glass
Eff. % Glass
to(* X
rSIC
ctOto
= ).05-
,t7Sx
X
1
= 2-113
v
f
=. 1.65-
4.(* x
-
.33
TYPE 1 MASS AREA = Q
Interior Mass/CFA
COND. FLOOR
AREA
(arpeten[•..7
(wyyxted a.n)
TYPE 2 MASS AREA
ND. FLOOR AREA
Exterior Wall Mass
,72 X
b3
a TYPE 1
MASS
(UIMC-• 4.2,
le: exposed slab)
HSPF [0.56/5.15]
X
1132
_ • ,29.
•
Effective SEER,[7.031
SGr
+
0%
5%
10%
15%
20%
25%
30%
35%
40%
45Y.
50Y.
55%
60%
6SY-
70%'r 75%
80%
85%
90%
95%
100% 1051/6 110% 1159: 12011. 125•
OY.
0
0.2
0.4
0.6
0.8
1.1
1.3
1.5
1.7
1.9
2.1
2.3
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
10%
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
1.9
-2.1
2.3
2.5
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
2.9
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
1.8
2
2.2
2.4
2.6
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
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
5.5
5.7
5.9
50y.
0.9
1.1
1.3
1.5
1.7
1.9
21
23
25
27
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
55%
0.9
1.1
1.4
1.6
1.8
2
2.2
24
2.6
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
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
2
4.'4.4
4.6
4.8 '
5
5.2
5.4
5.6
5.9
6.1
6.3
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
70%
1.2
1.4
1.6
1.8
2
2.2
2.5
2.7
2.9
3.1
3.3
3.5
3.7
3.9
4.1
4.3
4.6
4.8
5
52
5.4
5.6
58
6
6.2
64
75%
1.3
1.5
1.7
1.9
21
2.3
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
809:
1.4
1.6
1.8
2
2.2
2.4
26
2.8
3
3.3
3.S
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
64
66
85%1.4
1.7
1.9
2.1
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
52
54
5.6
5.9
6.1
63
65
67
909.
1.5
1.7
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
53
5,5
5.7
5.9
6.2
64
66
68
95%
1.6
1.8
2
2.2
2.5
2.7
2.9
3.1
33
3.5
3.7
3.9
4.1
4.3
4.6
4.8
5
5.2
5.4
5.6
5.8
6
6.2
6.4
6.7
69
100% .1.7
1.9
21
2.3
2.5
2.8
3
3.2
3.4
3.6
3.8
4
4.2
4.4
4.6
4.9
5.1
5.3
53
5.7
5.9
6.1
6.3
6.5
6.7
7
105%
1.8
2
2.2
2.4
2.6
2.8
3
3.3
3.5
3.7
3.9
4.1
4.3
4.5
4.7
4.9
5.1
5.4
56
5.8
6
6.2
6.4
6.6
68
7
110%
1.9
2.1
2.3
2.5
2.7
2.9
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
72
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
125.%
2.1
2.3
2.5
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
/ I .
Type [double]
Measures
1. Ceiling Insulation
K -3g or
SC
R -value [38] U -value [0.030]
2. Wall Insulation
K- 13 or
R -value [11] U -value [0.098]
3. Raised Floor Insulation
or
JIG X
R -value [ 191 U -value [0.037]
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 Mass
11. Heating System
Zonal Control? ( Y / N )
12. Cooling System
Zonal Control? ( Y / N )
13. Water Heating
or
R -value [01 F2 factor [0.77]
Di..
/ I .
Type [double]
U -value [0.65]
% Total Glass (16]
% Glass
SC
Eff. % Glass
,G X1
,%%
3.3 x,
N
JIG X
X
1
s4
-• X
% Glass
Eff. % Glass
to(* X
rSIC
ctOto
= ).05-
,t7Sx
X
1
= 2-113
X
f
=. 1.65-
4.(* x
.33
TYPE 1 MASS AREA = Q
Interior Mass/CFA
COND. FLOOR
AREA
O
TYPE 2 MASS AREA
ND. FLOOR AREA
Exterior Wall Mass
,72 X
b3
SE or HSPF Duct Efficiency [0.78]
Effective SE or
[2/6.61
HSPF [0.56/5.15]
X
1132
_ • ,29.
SEER [9.5] Duct Efficiency [0.74]
Effective SEER,[7.031
SGr
O
Type [SG]
Credit [none]
Point Scores
a
0
Sum 11>
.0
Pnimt rntlyl. +G
`l
_4-
- 2
r
Sum 7.10 _
+3
.0
Pnimt rntlyl. +G