HomeMy WebLinkAbout058-330-0521 �
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58-33-52 2831-91B,P,.E,M
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GRAHAM, David '
3597 -Hoffman Rd, Oroville
(new sf) ��,L_q�
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058-330-052 `�� PERMIT#953030
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3597• Hoffman RdI..,,,orovil, e
r4'.Woodst6ve/SF
MISCELLANEOUS Demo -Fire
DEMO PERMIT - JUNE LIGHTNING F:
3597 HOFFMAN RD
GRAHAM DEBRA FAY & DAVID -
- 038=330=052 ##
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ISCELLANEOUS Electric Panel
LECTRICAL PERMIT - JUNE LIGHTI
z
597 HOFFMAN RD _ w:
RAHAM DEBRA FAY &DAVID --
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION (IVR): (530) 538-4365
OFFICE: (530) 538-7541 FAX#: (530) 538-2140
ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds
PROJECT INFORMATION
Site Address: 3597 HOFFMAN RD
Owner:
Permit NO: B08-1486
APN: 058-330-052
GRAHAM DEBRA FAY & DAVII
Issued Date: 7/31/2008 By GLB
Permit type: MISCELLANEOUS
3597 HOFFMAN RD
Subtype: Electric Panel
OROVILLE, CA 95965
Expiration Date: 7/31/2009
Description: ELECTRICAL PERMIT - JUNE LIG
(530) 532-0566
Occupancy: Zoning: FR10 I
Contractor
Applicant:
Square Footage:
TRI - R TRACTOR SERVICE
GRAHAM DEBRA FAY & DA`
Building Garage Remdl/Addn
P O BOX 270
3597 HOFFMAN RD
MAGALIA, CA 95954
OROVILLE, CA 95965
Other Porch/Patio Total
(530)873-2058
(530)532-0566
FEE INFORMATION
DBE Single Phase Service-Resid $59.00
Total Charged: $59.00 Fees Paid: $59.00
Balance Due: $0.00 Receipt No: B8138
LICENSED CONTRACTOR'S DECLARATION
OWNER / BUILDER DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
TRI - R TRACTOR SERVICE 617318 / A / 4/30/2009
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance,
also requires the applicant for such permit to file a signed statement that he or she is licensed
1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license
pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000)
is in full force and effect.
of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
X 7/31/2008
the applicant to a civil penalty of not more than five hundred dollars [$500];
Please check one of the following:
Contractor's Signature Date
-11, 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
WORKERS' COMPENSATION DECLARATION
OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractors License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
the work himself or herself or through his or her own employees, provided that such improvements
❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR
are not intended or offered for sale. If, however, the building or improvement is sold within one
WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the
year of completion, the owner -builder will have the burden of proof that he or she did not build or
performance of the work for which this permit is issued.
improve for the purpose of sale.).
I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, by
❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
as required
❑ Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code:
The Contractor's License Law dows not apply to an owner of the property who builds or improves
My Workers' Compensation insurance carrier and policy number are;
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Cartier: Policy Stated Exem t
Number. P E Date:
Contractor's License Law.).
(This section nee not a completed if the permit is or on7 a hum dollars ($100) or less.)
❑ I AM E PT under Section B. 8 P.C. for this reason:
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 become subject to the Workers' (,
Compe sation Laws of California, and a that if I should become subject to the workers' t
Xs _ 7/31/2008
comp tion provision Section of the La or Code, I shall forthwith comply with those l
w is Signature ate
prow io s.
-X 7/31/2008
I hereby certify that I have read this application and slate that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
,.Signature Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
construction, and with any and all conditions of permit. I agree to defend, indemnity, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE
injury, including death, and property damage caused by, arising out of, or in any way connected with
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
his
the issuance of this mit. I hereby ackn ledge the ' suance of this permit does not authorize the
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
use or occupancy f a y sidewalk, stye r bsi Ik. I hereby representatives of Butte
ATTORNEY'S FEES.
County to enter e a ove ma tione p f i pection pyobses. I hereby certify that I am the
property, own r a auI oriza to o e arty own ehalf.
��
CONSTRUCTION LENDING AGENCY
�17/� 1/2008
1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency fork
Name -6f PtIrmittee [SIGN]Print Date
the performance of the work for which this permit is issued. (3097 civ. code)
❑ Owner ❑ Contractor OR: DAgent for Owner Agent for Contractor
FILE COPY
Lender's Address City State Zip
C
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION*
OFFICE #: (530) 538-7541 FAX #: (530) 538-2140
A FEE WILL BE REQUIRED AT TIME OF APPLICA TION
Website: www.buttecounty.net/dds
PLEASE PRINT CLEARLY
PERMIT
NO.
BIN #
*"When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information
related to this application is'subject to public inspection and will be posted on the County's website for electronic access.
OWNER INFORMATION -
e Flrst Nam
Vr
M ® W119A-1 to
City (// 1–e-
State �p
Phon r _ . 6 we
E-mail
E-mail
CONTRACTOR
Name ; �r— N
Address L4'A S8
City V"/\O, C, Ste
Zip
Phone C6 Fax
E-mail
Lic. # I _
Class
APPLICANT INFORMATION
ARCHITECT/ENGINEER
Name
City
Address
Zip
city
Fax
State
Zip
Phone
Fax
E-mail
State License Number
APPLICANT INFORMATION
Name
Address
City
State
Zip
Phone
Fax
E-mail
PROJECT LOCATION
API 0,;�85
Property Address Z–!;7 7 o�
City
I WORKER'S COMPENSATION
Policy Number
IIf hiring anyone other than licensed contractors, a certificate of
worker's compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
DESCRIPTION OR SCOPE OF WORK.
Sq FT- Living Garage Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
For office use 41yi
Zoning
Flood Zone
SRA
Yes
I No
Occ•
Type Const
ke wacvcA-
Butte .County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 95965
(530) 538-7601 Telephone
(530) 538-2140 Fax
www.buttecounty.net/dds
OWNER -BUILDER INFORMATION
An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified.
For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed
by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from
possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by
law to put their license number on all permits for which they apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and
protection:
° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire
project and such persons are not licensed as contractors or subcontractors, then you may be an employer.
° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal
° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions.
There may be financial risks to you if you do not cavy out these obligations, and these risks are especially serious with respect to workers' compensation insurance.
° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business
Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial
Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees,
without a license contractor or subcontractor, only under limited conditions.
A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is
providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at
1-800-321-CLSB (2752) or by accessing thier website at www.CSLB.ca.gov.
PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE
AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED.
OWNER BUILDER VERIFICATION
PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING
PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED.
1. 1 PERSONALLY PLAN TOE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY
IMPROVEMENT. (YES O NO)
2./ I(HAV /HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK.
3. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION:
NAME
ADDRESS Cl
PHONE CONTRACTORS LICENSE NO
4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE
THE MAJOR WORK:
NAME
ADDRESS Cl
PHONE CONTRACTORS LICENSE NO.
S. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED:
NAME ADDRESS PHONE TYPE OF WORK
Description: ELECTRICAL PERMIT - JUNE LIGHTNING FIRE 062208
Reference Number: B08-1486
Applicant Name: GRAHAM DEBRA FAY & DAVID
Owner's Name: GRAHAM BRA F & AP # : 058-330-052
Signature -of Property Owner- Cu/ Date: c�
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION (IVR): (530) 538-4365
OFFICE: (530) 538-7541 FAX#: (530) 538-2140
ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds
PROJECT INFORMATION
Site Address: 3597 HOFFMAN RD
APN: 058-330-052
Owner:
GRAHAM DEBRA FAY & DAVII
Permit No: B08-1485
Issued Date: 7/31/2008 By GLB
Permit type: MISCELLANEOUS
3597 HOFFMAN RD
Subtype: Demo -Fire
OROVILLE, CA 95965
Expiration Date: 7/31/2009
Description: DEMO PERMIT - JUNE LIGHTNIN
(530) 532-0566
Occupancy: Zoning: FRIO I
Contractor
Applicant:
Square Footage:
GRAHAM DEBRA FAY & DA`
Building Garage Remdl/Addn
3597 HOFFMAN RD
OROVILLE, CA 95965
Other Porch/Patio Total
(530)532-0566
FEE INFORMATION
Total Charged: $0.00 Fees Paid: $0.00
Balance Due: $0.00 Receipt No:
LICENSED CONTRACTOR'S DECLARATION
OWNER / BUILDER DECLARATION
Contractor (Name) State Contractors License No. / Class / Expires
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License
Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that
requires a permit to construct, alter, improve, demolish, or repair any structure prior 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 License Law [Chapter 9 (commencing with Section 7000)
of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the
basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9
(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license
is in full force and effect.
X 7/31/2008
the applicant to a civil penalty of not more than five hundred dollars [$500];
Please check one of the following:
Contractors Signature Date
❑ 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
WORKERS' COMPENSATION DECLARATION
OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License
Law does not apply to an owner of the property, who builds or improves thereon, and who does
the work himself or herself or through his or her own employees, provided that such improvements
I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:
❑1 HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR
are not intended or offered for sale. If, however, the building or improvement is sold within one
WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the
year of completion, the owner -builder will have the burden of proof that he or she did not build or
performance of the work for which this permit is issued.
improve for the purpose of sale.).
11I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required byCONTRACTORS
Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED
TO CONSTRUCTTHE PROJECT (See. 7044, Business and Professions Code:
The Contractor's License Law dows not apply to an owner of the property who builds or improves
My Workers' Compensation insurance carrier and policy number are;
thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the
Contractor's License Law.).
Carrier: Policy Number: Exp. Date:
(This section nee not a completed if the permit is or one' hundred dollars ($100) or ess.
❑ 1 AM EXEMPT under Section B. & P.C. for this reason:
�--t,
MA 1 CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS
- ---y -
X d 7/31/2008
ISSUED, I shall not employ any person in any manner so as to become subject to the Workers'
nsatio Laws of California, and agree t t if I should become subject to the workers'
4Lc-ompensa
' provisions of Secti 700 of Labor C e, 1 shall forthwith comply with those
Owners ignatureOate
7/31/2008
I hereby certify that I have read this application and state that the above information is correct. I agree
to comply with all City and County ordinances, rules, regulations, and State laws relating to building
construction, and with any and all conditions of permit. I agree to defend, indemnity, and hold harmless
Butte County, its officers, agents and employees from any and all claims and liability for personal
injury, including death, and property damage caused by, arising out of, or in any way connected with
the issuance of this permit. I hereby a wledge that issuance of this permit does not authorize the
use oro ancy of any sidewalk, str , or subs' ewalk. I hereby authorize representatives of Butte
County o ter the above me tion roperty inspection purposes. I hereby certify that I am the
.. prope , r 2 er or am auth act on th roperty owner's behalf.
7/31/2008
Sig'nat Date
WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL,
AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE
HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION,
DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND
ATTORNEY'S FEES.
CONSTRUCTION LENDING AGENCY f
I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for
Perms ee 3 G ] Print Date
the performance of the work for which this permit is issued. (3097 civ. code)
E] Owner Contractor OR; DAgent for Owner DAgent for Contractor
FILE COPY
Lenders Address City State Zip
Butte County Department of Development Services
TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR
7 County Center Drive
Oroville, CA 95965
(530) 538-7601 Telephone
(530) 538-2140 Fax
www.buffecounty.net/dds
OWNER -BUILDER INFORMATION
An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified.
For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed
by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from
possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by
law to put their license number on all permits for which they apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and
protection:
° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire
project and such persons are not licensed as contractors or subcontractors, then you may be an employer.
° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal
° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions.
There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance.
° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business
Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial
Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees,
without a license contractor or subcontractor, only under limited conditions.
A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is
providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work
personally.
Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321
-CLSB (2752) or by accessing thier website at www.CSLB.ca.gov.
PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE
AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED.
OWNER BUILDER VERIFICATION
PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING
PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED.
=I PERSONALLY PLAN TO PWVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY
IMPROVEMENT. (YES OIQ29
1 . IV311AVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK.
3. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION:
NAME
ADDRESS CITY
PHONE CONTRACTORS LICENSE NO_
4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE
THE MAJOR WORK:
ADDRESS CITY
PHONE CONTRACTORS LICENSE NO
S. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED:
NAME ADDRESS PHONE TYPE OF WORK
Description: DEMO PERMIT - JUNE LIGHTNING FIRE 062208
Reference Number: B08-1485
Applicant Name: GRAHAM DEBRA FAY & DAVID
Owner's Name: GRAHAM DF/$p2A FA(
Owner:
AP # : 058-330-052
Date:
_t
IN
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT APPLICATION"
OFFICE #: (530) 538-7541 FAX #: (530) 538-2140
A FEE WILL BE REQUIRED AT TIME OFAPPLICATION
Website: www.buttecounty.net/dds
PLEASE PRINT CLEARLY
y%<'
PERMIT
NO.
BIN #
"When filed, this application and all supporting material becomes subject to the California Public Records Act All public information
related to this application is'subject to public inspection and will be posted on the County's website for electronic access.
OWNER. INFORMATION
` Fhst Na
VI
M O Wi9iU
City f////•.c
State zip ��1G
Phon=_ OS 6 6
E-mail
Email
CONTRACTOR
Name o I
I I? - -h-� n JO
Address 1 LA 4,6M W
City Y ` \A Ste C'kZip
Address
Phone
E-mail
Lic. # 1 _ !�
Class
APPLICANT INFORMATION
ARCH/TECTIENG/NEER
Name
City
Address
Tip
City
StateTip
Phone
Fax
E-mail
State License Number
APPLICANT INFORMATION
Name 0
Address
City
te
PFax
Tip
Phone
E-mail
PROJECT LOCATION
Property Address
jg
City
LENDING AGENCY
Name
Address
DESCRIPTION OR SCOPE OF WORK.
W', c L'2
Sq FT- tiring Garage Open Cov
❑ Structure Built without Permits
❑ Proposed Change of Occupancy
(Note previous use):
For office use 2414
Zoning FloodZone
SRA
Yes
No
Occ•
Type Const
�0.� }-<C wa ( vch-
058-330-052 PERMIT#95-3030'�Y-
-GRAHM, David
3597 Hoffman Rd., oroville
Woo'ds`tove/SF
i
i�
7 +.
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t.
7
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t
COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISIO �
7 County Center Drive,-Oroville, California 95965 - Tzlephone (916) 538-7541 PERMIT NO.
APPLICATION AND PERMIT 16�
ASSESSOR PARCEL NUMBER 5833-52 -
ZONING FR10
BUILDINdPERMIT
OWNER DAVID GRAFI
TE=7834
SO. FT. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS 3597 HOFFMAN RD OROVILLE, 95965
CONTRACTOR'S NAMEOWER
TELEPH`ONE
1
CONTRACTOR'S MAILING ADDRESS
Fireplace A 1.500.()0
CONSTRUCTION LENDER
UNI(N N
`
Total Valuation is
Filing Fee
$ 20,00
LENDER'S MAILING ADDRESS
Permit Fee
$ 35.00
ARCHITECT OR ENGINEER
LICENSE NO.
- Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS 3597 F40FFMILN RD
PERMITFEE $00
OROVILLE
PLUMBING PERMIT
Filing Fee• 20.00
Each Trap r►
7.00
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
Solar or heat pump water heater
23,00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Water piping
15.00
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
TYPE OF WORK
New ❑ Addition O Remodel ❑ U61ities ❑ Installation ❑ Other ❑
Describe Work: �� (�l. '# 'f ,/ i'
Mobile Home .'.. S G I W
@20.00
''(?
PERMITFEE
$
Contractor
ELECTRICAL PERMIT
Filinq Fee 20:00
Main Service OOOV OR LESS
( zooA OR LESS )
23.00
t
Main Service ( 200A TO I000A )
46.00
LICENSED CONTRACTOR'S 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 the Business and Professions Code,
and my license is in full force and effect.
License Class LIC. No.
OWNER -BUILDER DECLARATION i
1 herebyaffirm under penalty of perjury that I am exempt from the Contractors License
p ty p I ry p
Law fir the following reason:
f9' 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'.
❑ 1, as owner of the property, am exclusively contracting with licensed jcontractors
to construct the project. • I
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
NEW CONST. DWELLING OCCUR
OR ( a ACC. )BUDS.
SO -
FT.
NEW CCONST. MULTI-OUTLENS.
UTLET
NON-RESID. ( BRANCH CIRCUITS )
-
@7.50
( POWER APPARATUS )
a SINGLE OUTLET CIR.
Ex. Occup. (OUTLET OR FD(TURES)
20 0 I.
BAL .S50
O
FIXED APPWS. OR
Ex. Occup. (OUTLETS,(RESID.) EA)
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMITFEE
$
Contractor
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 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.
❑ 1 have and will maintain workers' compensation insurance, as required' by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
MECHANICAL PERMIT
Filing Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMITFEE
$
Contractor
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 1 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 become subject to workers'
compensation laws of California, and agree that if I should become subject to the
w6rkers' compsatioril provisions of section 3700 of the Labor Code, I shall
forthwith comp y wit those provisions.
X. . _ Dete/ A.5
Signa ure of Applicanti - Owner ❑ Contractor ❑ Agent��
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee
$
Energy Inspection Fee Is
OCC
CONST. TYPE
TOTAL FEE $ 55.00
HAZ.
D. FEES
I IMP
I FLOOD
CDF PARCEL
PD I HD
ISSUE
This permit is hereby issued under the
of the Butte County Code and/or
indicated above for which fees have
B 1 ►ems-b'Gti�
Y
PERMITEXPIRESON1
applicable provisions
Resolutions to do work
been paid.
Date
— (� '- u
(Date)
Receipt No. "! "/ 0 A 9
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
COUNTY OF BUTTE- DEPAR EKTOFD.€VELOPMENTSERVICES -BUILDING DIVISI
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO.
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER 58-33-52
ZONING FR IO
BUILD!PERMIT
OWNER DAVID GRAMM
TEME7834
SO. Fr. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS 3597 HOFFMAN RD OROVILLE, 95965
CONTRACTOR'S NAME OVJ14ER
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace 1,500.00
CONSTRUCTION LENDER
UNKNOWN
Total Valuation is 1.500.00
Filing Fee
$ 20,00
LENDERS MAIUNG ADDRESS
Permit Fee
$ 35.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Penalty
$
BUILDING ADDRESS 3597 HOFFMAN RD
PERMITFEE $ UU
OROVILLE
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
Solar Or heat pump water heater
23.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Water piping
15.00
Each gas water heater or vent
15.00
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: U� �X dS, -� (/-e--
Mobile Home ISI GI W1
920.00
PERMITFEE
$
Contractor
ELECTRICAL PERMIT
Filina Fee 20:00
Main Service OOOV OR LESS
( zooA OR LESS )
23.00
Main Service ( 200A TO 1000A )
46.00
LICENSED CONTRACTOR'S 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 the Business and Professions Code,
and my license is in full force and effect.
License Class Lic. No.
OWNER -BUILDER DECLARATION
1 hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law ff the following reason:
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.
❑ 1, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
NEW CONST. DWELLING OCCUP.
OR ADONS. ( & ACC. BIDS. )
SO.
3.50 FT.
NEW CONST. MULTI.OUTLET
NON-RESID. ( BRANCH CIRCUITS )
97.50
( POWER APPARATUS )
8 SINGLE OUTLET US
Ex. Occup. (OUTLET OR FIXTURES )
20 Q 1.00
BAL Q .50
Ex. Occup. (oFIXED PLNS..j OR)
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wiring
23.00
PERMITFEE
$
Contractor
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 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.
❑ 1 have and will maintain workers' compensation insurance, as required by Section
3700 of the Labor Code, for the performance of work for which this permit is issued.
My workers' compensation insurance carrier and policy number are:
Carrier
MECHANICAL PERMIT
Filing Fee 20.00
9
Heating
Cooling
Hood
6.50
Ventilation
PERMITFEE
$
Contractor
Policy Number
(The above sections need not be completed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
1 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 become subject to workers'
compensation laws of California, and agree that if I should become subject to the
vArkers' comp ation provisions of section 3700 of the Labor Code, I shall
hwith com y wi se provisions.
X �+ Date �/ _S
Si a ure of Applican - Owner ❑Contractor ❑ Agent
An OSHA permit is required for excavations over 60" deep and demolition or construction
of structures over 3 stories. in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
coNsr. TYPE❑
TOTAL FEE $ 55.00
HAZ.
I D. FEES
IMP
I FLOOD
I COF
PARCEL I PD I HD
ISSUE
This permit is hereby issued under the
of the Butte County Code and/or
indicated above for which fees have
%�
By l G
PERMITEXPIRESO (!
applicable provisions
Resolutions to do work
been paid.
I ( _
Date ( 9s
�-- I ( '-'
(Date)
Receipt No. I L30 -/ g 2
I
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
•.G
O.B.- I
w:::::• .vrr. •0.4CQ:iii?.: ..t}y;,'.:}�?.^^\x t'•Y• .4v 4!SSr�•::.. .........v.t........: •\•.v:: �::;...
:.4, Yk v. ••:::::: •. •.•:: nv t ......::nw::. �.:u+: .: •n tt •.:kv:nx..vnjT}:: �tk:;}}:::; ;ii.: `?:�i:G`.: ..,
t r t...:...,.n................t}:...::. ..j .?.... t`4'.�. 4}....``n.T.v .,::r....n •...}i.}.,. \ 4:n�xn..?•{'
�kti�:k%k�:k�` ,�.: ;}. •': '"}• } .. :...'.\�.�'`:.����.. :. .:. ..�ik•. .::.�`•:?ka\\�d.���:.:?::4}+4,5:��.�:rtt::.::•�': ;{r'?:'Y".i,,�`\�`�>'`: •:
a k
t•
i >}
v
w.:....... �:::..:.::::::v:�:.:?.}:?:::wn........:: T::•}}:4.. J..: n..:::..:: �. �:.......... ........... .,..... ..,.... ., .... r.4 :v: v::.......:...:.;:::TT:;:;:??;i:}.:;.;.,...,..,.....v..t.......................:. �: T:: :••\.
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing your
signature.
Please complete and return this information at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit will
be issued until this verification is received.
1. I personally plan to provide the major labor and materials for construction of the
proposed property improvement: YES[,NO[ J.
2. I HAVE[ 'V HAVE NOT[ ] signed an application for a building permit for the
proposed work
3. I have contracted with the following person .(firm) to provide the proposed
construction:
NAME:
ADDRESS: CITY:
PHONE: CONTRACTOR'S LICENSE NO.
4. I plan to provide portions of this work, but I have hired the following personto
coordinate, supervise, and provide the major work:
NAME:
ADDRESS: CITY:
PHONE: CONTRACTOR'S LICENSE NO.
5. I will provide some of the work but I have contracted (hired) the following persons to
provide'the work indicated:
NA_T E ADDRESS PHONE TYPE OF WORK
SIGNED:
PROPERTY OWNER: jlA v i d
SOCIAL SECURITY NUMBER:
DATE: /%Z///
NOTE: This owner -Builder Verification is required by Section 19831 and
19832 of the California Health and Safety Code.
This verification must be completed and returned to our office before
we are permitted to issue the permit.
OVER
�L
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of
property improvements specified
For your protection, you should be aware that as "owner -builder" you are the responsible party of record
on such a permit. Building permits are not required to be signed by property owners unless they are personally
performing their own work. If your work is being performed by someone other than yourself, you may protect
yourself from possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a
business license from the city or county. They are also required by law to put their license number on all permits
for which they apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you
should be aware of the following information for your benefit and protection:
0 If you employ or otherwise engage any persons other than your immediate family, and the work (including
materials and other costs) is $300 or more for the entire project, and such persons are not licensed as
contractors or subcontractors, then you may be an employer.
0 If you are an employer, you must register with the State and Federal Governments as an employer and you are
subject to several obligations including state and federal income tax withholding, federal social security taxes,
workers compensation insurance, disability insurance costs, and unemployment compensation contributions.
0 There may be financial risks for you if you do not carry out these obligations, and these risks are especially
serious with respect to worker's compensation insurance.
0 For more specific information about your obligations under Federal Law, contract the Internal Revenue
Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your
obligations ',:..^der State Law, contact the Department of Benefit Payments and the Division of Industrial
Acs dents.
if the struc-Lure is intended for sale, property owners who are not licensed contractors are allowed to
perform their work personally or through their own employees, without a Licensed contractor or subcontractor, only
under limited conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "ownerbuildee'
building permit, erroneously implying that the property owner is providing his or her own labor and material
personally. Building permits are not required to be signed by property owners unless they are performing their own
work personally.
Information about licensed contractors may be obtained by contracting the Contractors State License
Board in your community or at 1020 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm
that you are aware of these matters. The building permit will not be issued until the verification is returned.
i
Sinc/l rel
Michail C. Vieira, C.B.O.
Manager, Building Inspection
NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
OVER
RESIDENTIAL
�58-33-52 2831-91B,P,E,M
tf�Gvl Dq c, t cL
3597 Hoffman'Rd, Oroville
(new sf )
l
h ,h,
1
7
OFFICE COPY
Address
GAS
Meter
+By Date
E Lei @S C
M er
Address
o i
M r By Date
ELECTRIC .
Meter By ; „r� Date Z4�Z.
JOB FINALE
Signature
,I OK
O Not OK "" 1
=NotReadyawC MOBILE HOMES
• e
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails
1. Zoning Requirements -Setbacks -Easements '
4. Wood Awn.; Posts- Bea ms- Rftrs.-Cony ectors
Shthg.-Rfg.-Bracing
2. Soils; Special MH Support Sketch
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
3. Sewer; Location -Test -Fall -C/O Concrete
6. Carports; Windows -Doors
4. Water; Location -Test -Easement Needed (Sketch)
7. Electric
5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete
8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses -
6. Gas; Location -Test -Wrap: / P L" ft.
/ /"Nat. or/ /"L"ft./ /"LPG
9. Siding; Nailing -Veneer -Stucco -Mesh ►
7. Well Clearance & Disconnect
10. Roof; Shthg-Roofing
8. Utility Clearance
11. Ext.; Steps -Doors -Landings
Date
Card B-1 Date Card B-1
_
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
POOLS (Plans) OK except #'s
1. Zoning Requirements -Setbacks Easements
1. Setbacks- Ease pients
2. Footings; Size -Spacing -Marriage Line
2. Soils; Compaction -Structure Stability
3. Gas; MH Test -Demand -Valve -Connector
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Electricity; MH Test -Crossovers -Breakers -Clearances
4. Elec.; Receptacles and Lighting, Distances-GFI
5. Drain; MH Test -Fall -Flex Connector
5. Elec.; Pool Lighting; 15 volts-GFI
6. Water; MH Test -Regulator -Connector
6. Elec.;Enclosures; Conduit Entries -Terminals -Listed
7. Water and Sewer Connected -C/O to Grade -HD Approval
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Gas and Electricity Tagged
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
9. Exits; Insp.-Sketch
Boxes-Enclosures-Panelboards-Ins. to Main in Conduit
10. Cert. of Occupancy
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
MISCELLANEOUS
I Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts- Bea ms- Rftrs.-Cony ectors
Shthg.-Rfg.-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses -
9. Siding; Nailing -Veneer -Stucco -Mesh ►
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
Date
Card B-1 Date Card B-1
Dater .
Card B-1 Date Card B-1
Dated .L
POOLS (Plans) OK except #'s
1. Setbacks- Ease pients
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distances-GFI
5. Elec.; Pool Lighting; 15 volts-GFI
6. Elec.;Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Panelboards-Ins. to Main in Conduit
_
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
J=OK
O = Not OK
- = Not Applicable
Not Ready RESIDENTIAL
=
Date UNDERFLOOR (Plans) OK except ti's
kf�mg-Setbacks-Easements-Flood-Slope
Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
3. Z1j.,-.6arege�-Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
4. Ftg. orches &-Decks; Soils -Steel-/ /Ftg. Depth
temw a IIs, Main; Steel-Blockouts-Wrapped
I alls, Garage; Steel-Blockouts-Wrapped
Hol owns and Special Anchors
ab; Steel -Wrapped
--8_2i.,,Fireplace FW. -Steel
W.V.: F_ ittin - est -2 -Sewer Test
10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test
�11. Water Pipe; Test -Anchor -Regulator -Service Test
1 ectric; Underground
_13--Pienu ucts; Clearance -Material -Support -Ins.
V,AKrders-Sills-Anchor Bolts -Joists -Vents -Cripples
15. Access & Ventilation ^
16. Insulation
Data / z Card B-1 Ve Date and B-1
Date 111/2
L(Card B-1 , Date Card B-1
Date i OLUMBING (Permil),OK except h's
--- - Water Htr : Vent- ccess-Combustion Air -Baffle
------ ------------------------------
ater Pip An or -N rotection
ttin s & Ancho�ccess
_- - 19. Shower Pan; Test. First Floor -Tub- —
20. Test Tub & Shower. Second Floor -Tub Access
-- ----------------------------------------------------
1. as Pipe: Size & Anchors
--------- --- - - - -
----------------------------------- ------- - --- -
Card B-1 Date Card -
B -1
---------- rd B---` ------------------ -- - ----- --- ------
Date Card B-1 Date Card B-1
Date ELECTRICAL (Permit) OK except h's
- 22. Fi re_& Transformer Clearance -Ins. Protection
EI2 Receptacles Spacing -Lights & Switches at Doors --------
------ - -----------------------------------
ze
Boxes -& No. of Conductors -Stapled
----- ----- 5. Romex Installed Close to Edge of Studs & C.J. ------------------------ - -
20
Equip. Ground made up wrMech. Fastners-Bond Gas & Water
--------- -- --------------------------------- - --- -- --- ------
2 Appliance Circuts in Kitchen & Conductor SizerGFI
----- ------------------------------------------------------- - ------------
fii-.teed
- -------------------------------------------------------
teed Wire Size ! r ga. Cu or AI-A.C. Wire Sizer ! ga.
Cu or Al
----------- -------------------------------------------------------
nge Circ. ga. Cu or AI -Oven Circ. r ! ga. Cu or Al.
Insulated Neutral ❑ Yes ❑ No
---------------------------------------------------------- --------
- 13Q5ervice-Riser Conductors & Ground -Main Disconnect
dip Clearances Pane Is- Motors- Mech. Equip_
o es Closet Light -Shower Light -Spa Light
------ ------
--- - - --o-k- e --
------------------------------------------------ - --
SmDetector--- ---
-- --------------------------------------------------
Date �) Cj y Card B:1 M , Date Card B-1
Date Card B-1 Date Card B-1
Date 4e_MECHANICAL (Permit) OK except h's
34. A.C. Ducts Insulation & Support
----------------------------------------------------------------------------------
35.-Vent Fan Exhaust above insulation - ----------
36.
-----
36 Condensate Drain & Overflow Size & Grade
37 Furnance Vent: Access -_Comb. Air -Return Air Vent -115 -outlet
38 Attic Access & Platform if Furnance in Attic
--
---------------------- -----------
Date Card B-1 Date Card B-1
----------- --------------------------------------------------
Date Card B-1 Date Card B-1
Date FR ING (Plans) OK except ft's
JPJ'9. Sils. Proper Material & Anchors
- .. ------------- - - - - - -- - - -
L40"Walls Studs -Nailing. Spacing & Bracing -Plates -Sound
Bearing Walls over Girders -&, Floor Nailing
�
- -- - in Walls (rat - proo- f) -- --- - ----
------- --
�.aft--Stop
------ --- 9])-----------.---
IJr-------------- -- - ------
4 re Stops: Furred Ceilings -Stairs -Chases Tub
------- - - - ------------------- -- -- ---- --
44. Headers & Beam -Size '& Bearing
(Single & Duplex)
Date FRAMING (Continued)
-- Hangers -Post Caps -Anchors -Connectors
t46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Rfng.
---.47_ ireplace Ties or Type A Flue -Fireplace Throat clearance
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
- -- 9.. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
Fn-�aFire Protection Framing
F; TCine Firewall & Openings
xt. Doors -One 3' -Check Garage -3rd Story, 2 Exits
------fFt-Head room -Rise -Run -Landing -Fire Protection
4. plywood on Roof Overhang -Attic Vents -Rafter Outriggers
------------------------
L-5f-aiding-Nailing Veneer
ee9 Mesh -Drip Screed -Fd. Vents-Underflr. Access
--------------- - --
Glazing Area -Glass Protection -Skylights -Plastic
alts: Nailing -Bolts
-----------
- Insulation -Walls -Ceilings e
60. Infiltration -Walls -Windows
Date `2- Card B-1 Date _ Card B-1
Date 92Card Date Card B-1
Date FINAL (Plans) OK except ti's
61 Ext. Steps -Door & Sidelight Protection -Landings
--- --------- ---
moke Detector
urnace: Vents -Clearance -Comb. Air -Connector -
In Garage: Above Floor -Ducts -Meth. Protection
-- -Bedroom Exiting
F.I. &Bath Fixtures & Tub Access -Spa
-- -- EI - Trim -& Subpanel: Breaker Sizes & Labels
7 Stags & Rails
�6F' eplace or Stove: Clearances -Hearth
4�J. ec. Outlets at Wood Panel: Int. & Ext.
' .Fixt & Appliance: Grnd.-Air Gap -Cooking Clearance
.11 -1. -Pec. -Outlets& Receptacles at Kit. Counter
- -- - --- - - _
arage ire wing -Landing -Closer
uct in GarageDam
-per
Wtr. Htr Vents -Clearance -Comb. Air-Connector-P.R.V.
In Garage: Above Floor -Meth. Protection
-
------------ ------ --------
- -
------ -
Ib.. Elec. & Mech. Equip. Listed for Location
------------------------------------
7t5. njec. Te—ceptacles in Garage: (G.F.1.)-Romex Protection
-----------------------------------
on-Foam-Looked in Attic ❑ Yes
- - -- ua Rails & Deck Construction -Post Caps
n. Vents & Crawl Hole Door -Drainage & Wood -Earth
Clearance Looked under Floor ❑ Yes
-------------------------------- —-
80. Following instld.: Drive ❑ es o; Walks ❑ Yes G-mrr,
Planters ❑ Yes 1"i-<0
gown -Finish
- n isconnect. Electrical, Plumbing
Vents Above Roof: Plbg.-Appliance-Fireplace.-Clearance to
- --no
O__penings _
W er Well; Disconnect, Electrical, Plumbing
ter Elec. Trim. G.F.I. Receptacle -Underground
- --- - --- —
�X66 �V ntilalion Throughout House --
' 667. Glass P otection--------- ------------------
- - - ---- -----------------------------
Corrections from Previous Inspections
-
-`6
-
--- -------- - -)-------------------------------
Gas Test -Meters Tagged; Gas -Electric _
90. WaIeL& Sewer Connected -C/O to Grade -HD Approval
Energy Compliance Certificate -Other Certificates
Da _
LCard B_1 Date Card B-1
9----___--- _-=------=--
Date Card B-1 Date Card B-1
------------------------------------- -----
Date Card B-1 Date Card B-1
Comments at Final_ �K - ��� ��� � akn=
��` , . '''"` � �`=�''�*•, mss:-- _ ;h�-_ _ . �, �,
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Orovi Ile — Phone: 538-7541 s
747 Elliott Road, Paradise — Phone: 872-6307 s
CORRECTION NOTICE
OWN
2133/- T l
HEHMIT 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
;mater, or need additional explanation, please contact this office immediately.
:i
Date Inspector, e
i
A
i
-J
y
Date Inspector, e
W.
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
1469 Humboldt Road, Chico, CA - (916) 891-2751
7 County Center Drive, Oroville, CA - (916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
8 3 /.-.
NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please notify this office when correction of work
is completed. If you have any questions pertaining to this matter, or need additional explanation,
please contact this office immediately.
Date Inspector
REV 11/91
4
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
1469 Humboldt Road, Chico, CA - (916) 891-2751
7 County Center Drive, Oroville, CA - (916) 538-7541
747;Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
OWNER PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances a Cwt at
the above address and should be corrected. Please notify this office when correction of work
is completed. If you have any questions pertaining to this matter, or need additionalexpLum8on,
please tact this office immediately.
Q .��s�. 1 I �'�,, s CC - t5-
74-
-dip -dip
4r
Datej2 Inspector
REV 11/91 - '
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
1469 Humboldt Road, Chico, CA - (916) 891-2751
7 County Center Drive, Oroville, CA - (916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
C 1i
OWNER PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please notify this office when correction of wort[
is completed. If you have any questions pertaining to this matter, or need additional explanation,
pie 7d contact this office immediately.
%
[.J nc'-r S 1-4, ✓L dls i ti.3 fG1 �/O�
a X,
Date -2 Inspector
REV 11/91 ---
ENERGY INSTALLATION CERTIFICATE
Building Owner DA V 1
Q
Building
Permit # P
Building Location
'*7
EXTERIOR WALL
tj, �� ke elA 2c'; (�
DESCRIPTION OF INSULATION
ROOF
Material �S y� Azedu�,wJs��Brand
_T
Name
�t�JPAJ �� �.•g
S
Thickness(inches) U,�cd
Thermal
Resistance (R Value)�
EXTERIOR WALL
Material /C, / )fWBrand
Name
C JQ� e&4 Aji^,�
Thickness(inches)
Thermal
Resistance(R Value)
G
Bat Blanket
or Type
—Brand Name
0W Pm S en t7 /v/rr
Thickness(inches) Thermal
Resistance(R Value) .
Loose Fill Type
Brand Name-,
Minimum Thickness (Inches)
Number of
Bags Wt. per bag lb.
Area covered(ft.2)_ /,CiD
Thermal
Resistance(R Value)
FLOOR, ELEVATED
Material `X'010. /�Sd ��i I, Brand Name
6 C.t) C�iU� Cr0 eAj)~S
Thickness(inches)
Thermal
Resistance(R Value) A /9
FLOOR, SLAB
Materialeyti A/_ e I P � e—
Thickness(inches) z �r
Width(inches)
FOUNDATION WALL
Material /en ,(j e4
Thickness(inches)
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,
is consistent with approved building department plans and attachments and con
forms with requirements of Chapter 2-53 of State of California Energy Requirement
FIRM NAME/ 0 R
4.j j
SIGNATURE OF INSTALLATION APPLICATOR
STATE CONTRACTOR'S LICENSE NO.
DATE
I hereby certify the required features, devices, and equipment, a5 shown on the approved
Building Department plans and attachments have been installed and conform to the appli-
ance standards and Chapter 2-53 of the State of California Energy .equirements.
D'4'V ►'d Ca w o -A is �
BUILDING CONTRACTOR/OWNER (Please Print)
FIRM NAME)
SIGNATURE OF BUILDING CONTRACTOR/OWNER
HVAC FIRM NAME/OWNER (Please Print)
SIGNATURE OF HVAC CONTRACTOR/OWNER
STATE CONTRACTOR'S LICENSE NO.
DATE
STATE CONTRACTOR'S LICENSE NO.
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.
SEPTEMBER 1988
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COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLIGATIONr AND PERMIT
r
ASSESSOR PARCEL NUMBER
58-330-052
ZONING
FR 10
BUILDING PERMIT
OWNER
DAVID
TELEPHONE
533-9401
S0. FT. OCC. BUILDING VALUATION
1000 R 51,000
OWNER'S MAILING ADDRESS
4968 DURHAM PENTZ RD OROVILLE
CONTRACTOR'S NAME
OWNER
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace "A" 1500
CONSTRUCTION LENDER
BUTTE COMMUNITY
UNKNOWN
Total Valuation $ 52500
Filing Fee
$ 10,00
LENDER'S MAILING ADDRESS
Permit Fee
292.00
ARCHITECT OR ENGINEER
NONE
LICENSE NO.
Plan Checking Fee
l$
$ 146.00
Energy Plan Checking Fee
$ 15.•00
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS RD OROVILLE
3597 HOFFMAN
Permit fee
$ 463.00
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
7 2.00 14.00
_
Solar or heat pump water heater
20.00
LOTq. .
SUBDIVISION NAME
PARCEL MAP
Water piping
5.00 5,00
Each qas water heater or vent
5.00 5.00
USE OF STRUCTURE
SF g Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00 5.00
Building sewer
5.00 5.00
Mobile Home Is
10.00 ea
TYPE OF WORK
New 5 Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work: j RnRM
Permit Fee
$ 44.00
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 6001 OR LESS
100 AMP OR LESS
10.00 10.00
Main service EA. ADD'L 100 AMP
2.50 ' 550
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business/POWER
and Professions Code and my license is in full force and effect.
License No. Classification.
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. DWELLING OCCUP.ad
New CONSTR.( ACC.1
•TB
, , 00
h¢sgft
U OUTLET
NON-RESID BRANCH CIRCUITS)
2.50 ea
APPARATUS &)
ISINGLE OUTLET CIR.
/
Ex. Occup(OUTLETS OR FIXTURES
2ALO 30
eLo
FIXED \\
Ex. Occup. OUTLETS P(RESID )REA.1
2.00
Temporary service
10.00 10.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ 1 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.
[P,--l-shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
Heating WALL HTR
Cooling WAttlg%j EVAPOR
16.00'
Hood
3.00 3.
Ventilation Wrro
10;00
penult Fee
$ UU
'
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 Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also a ee to save, indemnify and keep harmless the County of Butte againstPHAL
all Iia I ties, jud men s, osts, and expenses which may in any way accrue
again id Cou i sequen of the granting of this perm't.
X a�• s �" /�
Date
Signature of Applicant - Owner El Contractor ❑ Agent
An OSHA permit is required for excavations over 5'0" deep ar de lition�}r construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
, Energy Inspection Fee 30.00 $
c rrtPq
P/ TO)AL F $
623. 0
CUA PARK sc
F
CD
PAR
PD
l Hq,
v
Issu
This permit is hereby issued under the applicabie provi-
sions of the Butte County. Code and/or resolutions to do
work indicated abov for which fees have been paid.
D 11 R OF PUBLIC WORKS
By Dateq^6
PE MIT EXPIRE ate �+^
A •� /:PA
Receipt No. 97169 2m -no l/ / t0 _
WHITE-O.P.W., YELLOW-ASSEa•.10R, PINK -INSPECTOR. GOLDENROD -APPLICANT
�. . ......7•�i�se,i; �11s.--w�- "jr�'.ir�wy�{a��77!"^'wFrr /7F :'t�,.'. _ ,� ..r;ri . , \�
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION /
7 COQ I�NTY DETER SRI VE - OROVILL {CALIFORNIA 95965 -TELEPHONE: 916/538-7541
PERMIT APPLICATION DATA SHEET
Permit No.
OWNER l�l A. P. No. S�'-.3- > -
Proposed Building UseBuilding Inspector Daie
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. Hazardous Material Form ..........................................
6. Energy Design Compliance and supporting documentation .........
7. Statement of Intent for Non -Heated and AC Buildings ..............
8. Engineered truss details and layout in duplicate (required prior to plan check) �.
9. Mobilehome installation data including manufacturer's installation
instructions ...........................................
10. Fees of $ �2 ........................
�Tz 11. Chico Urban Area fees paid .......................................
12. Park fees p iid
13. 0'0 UNrar► rG SchoolDis rict fees paid ............. .Wit
14. Sanitation approv from (�Yb Vi I �e Health Department
15. City of Chico plumbing permit .....................................
16. Plot plan and business license approval from City of
(see City for other requirements)
17. Planning approval for (A) Use: (B) Parking: ......
18. Improvements may be required. Contact Land Development Section DPW
b1,-19. Driveway permit (construction approval required prior to occupancy)
20. Pre -Inspection for requiredPre-Inspec. request to
' Building Inspector (Date)
21. Contractor's license information (No., Name Style, Classifications ...
22. Certificate of Workmans Compensation Insurance ..................
23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) .....
24. Recorded copy of Agricultural Acknowledgment Statement .........
25. Letter of signature authorization ................................... 0%7��t/
26.
27.
When you issue the permit, process as follows: Mail to owner. Mail to contractor.
Telephone_5.33C1yOand hold for pickup at office. Deliver w/inspector.
Other
t
Applicant .Date 8
Copy of ! Idz-Mat form sent Health Dept. Fire Dept. Air Pollution Date
Copy of plans sent Health Dept. Fir ept. Other Date By
The following data must be submitted pri perm't 'ssuance: (Ci cle ew 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---- inail_counter by .date
Contractor, designer, owner, was advised of above required data by -phone -mal l -counter hal date
Plans checked
Sets of plans on hold in
Copy -DPW
Date Plans aooroved by
File cabinet AP folder
nate
3
c {,
4.
t'
'I
7
• J
TO z Buildina Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
r
Owner
-,,S-
Location AP#
Plan Approved for: Sewage Disposal Water Supply ,Pl/
Hold final for:
7inal clearance O.R. for:
Clearance for bedroom mobil ome. Cher
NOTE * * *
Sanitarian
Water Supply
Water Supply
ate
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COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telepnone: 916.538-7541
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER2ON
59-3 Q - 0 • .
NG
- / Q
BUILDING PERMIT
OWNER, U[V
V r�/tp /
TELEPHONE ON
SJ /
SO. FT. OCC. BUILDING VALUATION
O
O
OWNER'S MAILING A ORES
LW, P w vl e
I
CONT R AAyC'�T�O�,R^•S NAME
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace I '� 1' D-0
CON RU T10LENDER
ui�uvt 1�L
UNKNOWN
Total Valuation $h
I✓
Filing Fee
S 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ 29T 3c,
ARCHITECT OR ENGINEER
VL 6y\-
LICENSE NO.00
Plan Checking Fee
S 6.
Energy Plan Checking Fee
S /5 O
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
g
BUILDING ADDRESSPermit
S o kd
fee
S 00
PLUMBING PERMIT
FilingFee 10.00
/�
®lo v'(l (-C- , Gl si 6 S�
Eacn Trap
7 2.00 11/100
Solar or heat pump water heater
20.00•
LOT NO. SUBDIVISION NAME PARCEL MAP
Water piping
5.00 v"0
Each qas water heater or vent
5.00 57 CiO
USE OF STRUCTURE
/�,(
SF 111 Duplex❑ Mobilehome❑ Other
/� SPECIFY
Gas pipings stem 1 - 5 outlets
y
5.00 S �'
Building sewer
1 5.00
Mobile Home S I G W
0.00 ea
TYPE OF WORK
NewlX Addition El Remodel❑ Utilities❑ Installation ❑ Other[]
Describe work: / he�vz�yn�l
Permit Fee
$ L1L1,C)
Contractor
I
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 6001 OR LESS
100 AMP OR LESS
10.00 00
Main service EA. ADO'L 100 AMP
2.50 I s0
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification.
I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUP.y)
OR AODNS. ACC. SLOGS.
yx2Sgft 25-oo
NEWCONSTR ULTI.OUTLET
NO N.R ESID BRANCH CIRC ITS
12.SOeal
POWER APPARATUS &)
SINGLE OUTLET CIR.
EX. OCCUP�OUTLETS OR FIXTURES
1.20911001
IeAI. 30:
FIXED APPNS
EX. OCCUD. OUTLETS IIRESID .)OR EA.)
1 2.00 1
Temporary service
10.00 Ooo
Mobile Home Facilities
15.OQ
Misc. Wiring
g
15.00
Permit Fee
$ 70 SIJ
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.
Contractor
MECHANICAL PERMIT
Filing Fee 10.00
Heating W011 0fCLf_1%—
Coolin 9 4 ei
oe
Hood
3.00
Ventilation
permit Fee
$ nd
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 againstTOTAL
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
XThis
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 33/ sttor,es in height.
Mobile Home Installation Fee $
Energy Inspection Fee $ Oo
OCC CONST TYPE
FEE S 60�
~A` I OF 1 PARK I scrL i Flo i coF i PAH Po i, D.•ISS'vc
permit is hereby issued unser
sions or the Butte County Code and/or
work indicated above for which fees
DIRECTOR OF PUBLIC
By
PERMIT EXPIRES Date
the appiicaole provi-
resolutions to do
have been paid.
WORKS
Date
y
Receipt No. 9 10 14920/.CT6
"WITC-D.P.W.. TtLL0W-A5eE330A, PINR.INSPCCTOR, GOLOCNROD-APPLICANT
COUNTY OF BUTTE - Department.of Public Works
7 County Center Drive, Oroville, CA. 95965 Phone: 916-538-7541
OWNER -BUILDER VERIFICATION
Attention Property Owner: _
An 'owner -builder" building permit has been applied for in your name and bearing
your signature.
1
Please complete and return this information at your earliest opportunity to avoid
unnecessary delay in processing and issuing your building permit. No building permit
will be issued until this verification is received.
1. I personally plan to provide the major labor and materials for construction of
the proposed property improvement (yes or no)�.
2. I (have/have not) signed an application for a building permit
for the proposed wvfk.
3. I have contracted with the following person (firm) to provide the proposed
construction:
Name
Address City
Phone Contractors License No.
4. ,I plan to provide portions of this work, but I have hired the following person
to coordinate, supervise, and provide the major work:
Name
Address City
Phone Contractors License No.
5. I will provide some of the work but I have contracted (hired) the following
persons to provide the work indicated:
Name Address . Phone Type of Work
Signed: "
Property Owner
Social Security umber
Date
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and
19832 of the California Health and Safety Code.
This verification must be completed and returned to our office before we are per-
mitted to issue the permit.
BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM
(y $b 3.3 D- 05 Z. 2, ,(One Form per . Building ) 'TA X} 110-003
A:.P;, Number S'�30 '0..7 2, Building Department No.
School District OM I)J17 /031 ! I/ A City Q County Jurisdiction
— . A /I 1
Property Owner
Project Location/Address 3.591 7
Subdivision Lot Number
Residential Development: �%
k�J a O Sq. Footage /000
# of Living MHI Addition (Group R)
Units
Commercial/Industrial: a a Sq. Footage
New Addition (Including Exterior
Roofed Areas)
Buildin epar t Representative Date
(Floor Plans reviewed by School District Personnel)
District Id No.
3
Applicant Name
StraE,t Address
_School District certifies that
J33- 7 yo /
(Phone Number)
MQVIA % 9596 )'
(City) (State) (Zip Code)
has complied with the requirements of Resolution No.
by he payment of $ 58(o representing lood square feet.
tCG,_(Fhoo1 District Represen tive Date
PAID BY CHECK NO.
BANK NO
PAID BY CASH ��—
REMARKS:
white -applicant, yellow -building department, pink -school district
SCHOOL.FEE (8/88)
I_'
�1
Return to DN AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT
w FOR RESIDENTIAL DEVELOPMENT
' Section 26-8.1 of the Butte County Geode
requires this acknowledgement beirrecorded
prior to issuance of a building permit.
AUG 2 7 1981
The property described herein is adjacent
purposes over n strip of land 60.00 feet in width, the South lino of sold casement
to land or included within an area zoned
being described as follows;
for agricultural purposes, and residents
91-035501
of this property may be subject to incon-
along the South line of that certain property conveyed to L. A. Scharer, et ux, by
veniences or discomfort arising from the
i)eed dnlsd Jttly 8, 1955 nand recorded July 12, 1955, a distance of 720.00 feet; thence
use of agricultural chemicals, including,
North 11 32' east, along the South line of said L. A. Sehagcrj)roperty, a distance of
but not limited to herbicides, pesticides, .
NM COMPARED WITH
and fertilizers; and frot the pursuit
ORI(aiNAl DOCUMEM
of agricultural operations including,
conveyed to F. S. Mnr:aall dated October 30, 1942 and recorded December 3, 1942 in
but not limited to cultivation, plowing,
nark 305 of Official Records, at pore 473, records of Butte County, California; thence
spraying, pruning, and harvesting which
nlonr the Northerly line of snid F. S. Marshall property, Easterly to the East line of
occasionally generate dust, •smoke, noise, and odor.
Butte County has established agricul-
tural zones which have as a priority use for productive
agricultural purposes, and residents
within said zones and on adjacent property should Abe
prepared to accept such inconvenience
or discomfort from normal, necessary farm operation6'.
In the Decd frc-n Donald L. Maxon and Elizatmth E. Maxon, ct nl, to Slarin
All that real property situate in the County of Butte, State of California, described as
follows: 1
I nr',SCRIPTION I
Date:
State of (I
County of
UNSO N"601B1
m �
a -Rs
® Ms t'
ir
"O v ao sr N O IJi
Present A.
All tint certain real property sltuntc In the County of Butte, State of California,
described as follows:
Parcel 4, as slxiwn on that certain Parcel Map of a portion of Sections 3 and 10,
Township 22 North, Range 4 East, M.D.O. h M., filed In the office of the Recorder
of the County of Butte, State of California, on September 17, 1981 In hook 86 of
Parcel Maps, at page 10.
TOGETHER WITH n right of way for road and public utility purposes ns shown on lie
Map referred to hereon.
ALSO TOGE•TIIER WITH n non-exclusive casement for road purposes and public utilities
purposes over n strip of land 60.00 feet In width, lying 30.00 feet on•'cithcr side of
(lie East line of sold Parcel Map.
4,
ALSO TOGETIIEB IVITll n non-exclusive easement for road purposes and public utilities
purposes over a strip of land 60.00 feet In width, lying 30.00 feel on either side of
n line beginning at n point In the East line of said Southwest quarter of Section 3,
which point bears North 000 12' East, 30.00 feet from the Southeast corner thereof;
thence from sold point of beginning, parallel witP the South line of said saglion 3,
North 890 54' West, 512.00 feet; thence North 76 A5' 30" West, 137.00 feet; thence
North 3G° 31' 30" West, 292.68 feet; thence North 65 53' 45" West, 63.25 feet; thence
North 890 44' 45" West, 164.53 feet; thence South 580 53' 15" West, 170.15 feet;
thence North 736 24' 30" West, 107.94 feet; thence N%th 300 00' West, 300.00 feet;
thence N8rth 200 00' West, 300.00 feet; thence Ngrlh 25 .00' West, 2G9.40 feet; thence
Nojlh 35 00' West, 100.00 feet; thence North 10 00' West, 200.00 feet; thence i:orth
25 00' West, 192.00 feet; thence North 80 00' Hest, 61.74 feet to the East line of
said parcel.
ALSO TOGrTHER WiTII n non-exclusive casement for rond purposes find public utilities
purposes over n strip of land 60.00 feet In width, lying :1.00 feet on either side of
n line txginnlng at o point In the East line of snid Par:cl Map, which point bears
North 01 56' 47" West, 754.14 cel from the Southeast corner there$(; thence from
said point of beginning, North 64 02' 40" East, 204.84 fest, North 16 36' 25" West,
227..93 fest, North 29 59' 15" East, 122.77 feq, North 72 22' 05" East, 195.94 fcetd
North 0.1 24' 40" East, 161.87 feet, North 24 47' 40" East, 417.70 feet,. North 34
3G' 40" East, 100.19 feel, North 010 49' 23" East, 148.41 feet and North 000 12' East,
312.75 feet to the centerline of the above described ensemcnt.
AISO TOGETHER Wrrll n non-exclusive easement for road purposes and public utilities
purposes over n strip of land 60.00 feet in width, the South lino of sold casement
being described as follows;
BEGINNING at the quarter corner common to Sections 3 and 10; thence running Easterly
along the South line of that certain property conveyed to L. A. Scharer, et ux, by
i)eed dnlsd Jttly 8, 1955 nand recorded July 12, 1955, a distance of 720.00 feet; thence
K��}YyALL.
North 11 32' east, along the South line of said L. A. Sehagcrj)roperty, a distance of
147.00 fest; thence continuing along said South line, North 56 18' East, 774.00 feet,
South 69 28' East 445.54 feel to the Northwest corner of that certain property
conveyed to F. S. Mnr:aall dated October 30, 1942 and recorded December 3, 1942 in
nark 305 of Official Records, at pore 473, records of Butte County, California; thence
`CRR
nlonr the Northerly line of snid F. S. Marshall property, Easterly to the East line of
`
N
Section 3, snid point being 381.50 feet Northerly of the Southeast corner tilercof.
ALSO TocE*rhIER with an casement for road purposes and public utility purposes
6,0.0 feet In width, over the North 1000.0fbet of the parcel of land described
In the Decd frc-n Donald L. Maxon and Elizatmth E. Maxon, ct nl, to Slarin
m
Vny Capps, et nl, recorded August 9, 1965 In Rook 1385 of Official Recordn,
,it Iwige 150, lie exact loenllon of snid casement to tv determined nt n future
date by snid parties or their assigns. 04DC1Toncunnta+1
J
K��}YyALL.
:
h
K��}YyALL.
Return
v
Section
require
prior t
The pr(
to lanc
for ag:
of this
venienc(
use of
but not
and fe;
of agi
but not
spraying
occasion
tural zo
within
or disco.
All that
follows:
Date: —
State of
SS.
County of
e .M0=8RODOWN °
® NOTARY KBUCCAMANI I
■ -d gufta
® �, a:
Oct. Is, 1991
®meat7sa���°esee�af9glead®�®;
ed agricul—
residents
convenience
i
scribed as
PROPEFfY OWNERS:
On this the -�ay of , 19 1 before me, the
undersigned iov tary Public, person y appeared
v i d F, C7 r
Personally known to.me. [�-roved to me on the basis
of satisfactory evidence.
to. :be the person(s) whose name(s)
subscribed to the within instrument and acknowledged that
executed the same for the purposes therein contained. IN WI 1 TS.
WHEREOF, I hereunto set my hand and official seal.
Present A.P. No.
Notary Pub is
RESIDENTIAL PLAN CHECKING GUIDE .12/90
(,S.F., DUPLEX & MISC. ONLY)
�� Bldg. Permit #
OWNER 4Z ►CA 9 A NA A.P. # SS -3]. SZ_
Plan Checker ,� (G
GENE 8-z 6 - 9 1
TAL
1. oning requirements: (sideyards and number of permitted living units).
2/Valuation.
lans signed by designer.
Proper description of work on application.
Existing violations on .property.
6 Items on data sheet. (W.C., fees, Health, Developer Fees, License law, etc).
corded notice of violation.
PLOT
t/
lomplete parcel size and dimensions.
2. Set�b cks, sideyards, easements, etc.
FFlooer buildings or structures.
d
ding, fills, drainage.
hazard.
Special conditions on creation map,
ustible, and foundations).
7. U'& FAS road setback.
(noise, CDF, fire sprinklers, non -comb -
8. Bui ng or utilities across lot lines (Record form).
FLOOR PLAN
l�.�C mplete to scale plan with dimensions.
!!//2. squired windows for light and ventilation (Sec. 1205).
3�. Required windows for second exit (Sec. 1204).
ghts (Chapter 34 & Sec-. 5207).
man impact glass (Sec. 5406).
fE✓ Required room sizes, ceiling heights (Sec. 1207).
GFCIs in baths, garage, kitchen, and exterior outlets (Article 210-8).
8k ---fight fixtures, switches, receptacles, and exterior receptacles for main-
enance of mechanical equipment.
Locations of water heater, heating and cooling equipment, other electrical
or gas equipment.
LOv.-G&r-ager firewall, door size, and closer (Sec. 503(d)(3)).
19—I - 3'0" exterior exit door (sec. 3304 (f).
fireplace and wood stove location, alcoves, and clearance.
1 -*'—Smoke detectors (Sec. 1210).
19-1-flumbing fixtures, water closet clearances and shower size.
STRUCTURAL DETAILS
11_UCStandard bracing or engineered design (Table 25V)
usual shape, size, or split level house requiring lateral design.
undation plan complete enough to construct building.
41" zYloor construction details complete enough to construct building.
54/,,.,,Elevations and wall construction details complete enough to construct
6V Roof construction details complete enough to construct building.
lreplace construction details and talcs if necessary.
�zfter ties or bearing ridge beam.
9. Gauge door or porch header sizes.
1pA/S�` heights.
l Adobe soils - special foundation design.
INRetaining walls requiring design.
13.SKcial Inspection required.
building.
12/90
RESIDENTIAL PLAN CHECKING GUIDE
MISCELLANEOUS ITEMS TO LOOK OUT FOR
Iv S-taiyw&y-details: landings, rise and run, head clearance, handrails
(Sec. 3306).
details (Sec. 1711 & 3306(j).
3--Erie�or stone veneer (Chapter 30) .
4, erior plaster - weep screeds (Sec. 4706).
5.�� � roof pitch for roof convering (Chapter 32).
6.�Roofecovering type - (fire hazard).
oam insulation - protection.
8---3-64--halls and stairways.
area over garage - complete 1 -hour separation required on garage side
including supporting walls and posts, etc.
o exits on three-story dwellings (sec. 3303 & see Mezannines - 1716).
1 V..Attic access and ventilation (Sec. 3205).
124-->Aerfloor access and ventilation (Sec. 2516).
1h'Combustion air for fuel burning appliances - L.P.G. requirements.
MMdserequirements on duplexes.
design.
1;,,nergy
Flashing at all exterior openings.
1?. C:,�s ponsible area requirements.
Dr•,SCRIPTION
All that certain real property situate In the County of Butte, State of California,
described as follows:
Parcel 4, as shown on that certain Parcel Map of a portion of Sections 3 and 10,
Township 22 North, Range 4 East, M.D.B. & M., filed In the office of the Recorder
of the County of Butte, State of California, on September 17, 1981 In (look 86 of
Parcel Maps, at page 10.
TOGETHER WITH a right of way for road and public utility purposes as shown on the
Map referred to herein.
AI SO TOGETHER WITH a non-exclusive ensement for road purposes and public utilities
purposes over n strip of land 60.00 feet In width, lying 30.00 feet on either side of
the East line of said Parcel Map.
ALSO TOGETHrR h1TH a non-exclusive easement for road purposes and public utilities
purposes over a strip of land 60.00 feet In width, lying 30.00 feet on either side of
n line beginning at a point in the Esst line of said Southwest quarter of Section 3,
which point bears North 000 12' East, 30.00 feet from the Southeast corner thereof;
thence from said point of beginning, parallel wit �i
° the South line of said segtion 3,
North 89° 54' West, 512.00 feet; thence North 76 $5' 30" West 137.00 feet thence
North 36 31' 30" West, 292.68 feet; thence North 65 53'
° 45" West, 63.25 feet; thence
North 89 44' 45" West, 164.53 feet; thence South 58° 53' 15" West. 170.15 feet;
thence NOrth 73d 24'30" West, 107.94 feet; thence North 30° 00' West, 300.00 feet;
thence N8rth 200 00' (Vest, 300.00 feet; thence N8rth 25 00' West, 269.40 feet; thence
North 35 00' West, 100.00 feet; thence Nor�h 10 00' Wcst, 200.(I0 feet; thence North
25 00' West, 392.00 feet; thence North 80 00' West, 61.74 feet to the East line of
said parcel.
AfSO TOGETHER WIT11 a non-exclusive easement for road purposes and public utilities
purposes over n strip of land 60.00 feet In width, lying :•100 feet on either side of
n line beinning at a point in the East line of said Per cel Map, which point bears
North 01 56' 47" West, 754.14V, et from the Southeast corner there$(; thence from
said point of bc6,inning, North 64 02' 40" East, 204.84 fest, North 16 36' 25" West,
222.93 fc&t, North 29 59' 15" East, 122.77 fc% North 72 22' 05" East, 195.94 feeb
North 04 24' 40" East, 161.87 feet, North 24 47' 40" East, 417.70 feet,. North 34
3G' 40" East, 100.19 foul, North Olo 49' 23" East, 148.41 feet and North 000 12' East,
312.75 feet to the centerline of the above described easement.
AISO TOGETHER WiTH n non-exclusive easement for road purposes and public utilities
purposes over n strip of Innd 610.00 feet In width, the South line of said casement
being described as follows;
BEGINNING nt the quarter corner common to Sections 3 and 10; thence running Easterly
Nong the Soaith line of that certain property conveyed to L. A. Scharer, et ox, by
Deed dalsd Jelly 8, 1955 and recorded July 12, 1955, a distance of 720.00 feet; thence
North 11 32' cast, along the South line of said L. A. Schegcropro pert y, a distance of
147.00 fe&t; thence continuing along said South line, North 56 18' East, 774.00 feet,
South 69 28' Enst 445.54 feet to the Northwest corner of that certain property
conveyed to F. S. t.lnrshgll dated October 30, 1942 and recorded December 3, 1942 in
nook 305 of Official Records, at page 473, records of Butte County, California; thence
c
nlong the Northerly line of sold F. S. Marshall property, Easterly to the East line of
Section 3, said point being 381.50 feet Northerly of the Southeast corner thereof.
iU
ALSO TOGE'rilF ll with an easement for road purposes and public ut;llty purposes
CT)
60.0 feet In width, over the North 1000.Ofbet of the parcel of land described
in the Decd frc:m Donald L. Maxon and Elizabeth E. Maxon, ct nl, to Sharin
T
xny Copps, et at, recorded August 9, 1965 In Book 1385 of Official Records,
nt Ixil,e 150, the exact location of said easement to iK• determined nt n future
l7�
date by said parties or their assigns.
-,CC I
Return to DPW AGRICULTURAL STATEMANT OF AC1GIOWLEDGEMENT
FOR RESIDENTIAL DEVELOPMENT
' Section 26-8.1 of the Butte, County Code
®
requires this acknowledgement 'be recorded
®
prior to issuance of a building permit.
The property described herein is adjacent
91-035501
to land or included within an area zoned
for agricultural purposes, and residents
Recorded
of this property may 'be subject. to incon-
Official Records
veniences or discomfort arising from the
County of
use of agricultural chemicals, including,
Butte
but not limited to herbicides, pesticides,
Candace J. Grubbs
and fertilizers; and from the pursuit
Recorder
of agricultural operations including,
12:56pm 27 -Aug -91
91 355o'l
I Rec Fee
I STF
I Cash
I
I
I
1
I
I
7.00
1.00
8.00
XX 2
but not limited to cultivation, plowing,
spraying, pruning, and harvesting which
occasionally generate dust, smoke, noise, and .odor. Butte County has established agricul-
tural zones which have as a priority use for productive agricultural purposes, and residents
within said zones and on adjacent property should be prepared to accept such inconvenience
or.discomfort from normal, necessary farm operations.
All that real :pro.perty- situate in the County of Butte, State of -California, described as
follows:
-
State of
County of
i
PROPE Y OWNERS:
On this the lay of , 19' before me, the
SS. undersigned rotary Public, personaJAy appeared
0 Began s l�wfig �I EI t951�f91 t�f�f��®
rte)
Personally known to me. EA-1-1roved to me on the basis
of satisfactory evidence.
to be the person(s) whose name(s)
subscribed to the within instrument and acknowledged that
executed the same for the purposes therein contained. IN 6JIT S
WHEREOF, I hereunto set my hand and official seal.
Present A.P. No. .111 `;
Notary Pub is
E�® OF DOCUMENT
®
R9gUA M
®
NOTARY RBIC(;ALlFM A
®
Butte Cuungy
Mly Cammisst0, Exp►ras
®
MI. Is, 1991
0 Began s l�wfig �I EI t951�f91 t�f�f��®
rte)
Personally known to me. EA-1-1roved to me on the basis
of satisfactory evidence.
to be the person(s) whose name(s)
subscribed to the within instrument and acknowledged that
executed the same for the purposes therein contained. IN 6JIT S
WHEREOF, I hereunto set my hand and official seal.
Present A.P. No. .111 `;
Notary Pub is
E�® OF DOCUMENT
.S
J
1
.�
Z/^
7
w_
k4
equ C 20M
wofecfion and a Type-A-Ffd'"_
Wao �115ova:.
I V/)'j Roo 'n
Ode :1 Provide 1 bedroom window with minimum
$0
ow dimensions of 24" high, 20* wide.
&I sq. fL area, and 44" ma)dffn*n
we
hetght
Ap�
If
,_: 36
6 At )�nc
PROVIDE APPROVED VENT
A LIP%
a-,
lam
ts par
doSct USU
la
Se t
I
i; ADEQUATE QUMBUSTION
AAIR FOR HEATER &/OR W. K pp
Li/7 7VIV
11 X 17 PRINTED ON NO. 1000" CLEAAPRINT *
Access 4 comm. An- F*,m eyrseia,
;Q0 4 . Ar
� 0 Z 1 (0
0
101) A2 to
MMM- All Materials & Workmanship Shell Be In
A=rdmce with Recognized Good Piactices and
of a Quality Prascribed for the 81jecifted uEe
1A MA'Uniform Building, Plumbing & Meebantual
-Codss aW the NsUcard Electrica Coft
SCALE:-,- APPROVED BY. DRAWN BY1041D 4
3UILDING DRARTMW�
DATE: aLs/ SEO
o A P P �oq Ig Ql!aj 95&
A. 57
DRAWING NUMBER
I
LJ 14c�c,�s
7A
47"
E
G
X
;Q0 4 . Ar
� 0 Z 1 (0
0
101) A2 to
MMM- All Materials & Workmanship Shell Be In
A=rdmce with Recognized Good Piactices and
of a Quality Prascribed for the 81jecifted uEe
1A MA'Uniform Building, Plumbing & Meebantual
-Codss aW the NsUcard Electrica Coft
SCALE:-,- APPROVED BY. DRAWN BY1041D 4
3UILDING DRARTMW�
DATE: aLs/ SEO
o A P P �oq Ig Ql!aj 95&
A. 57
DRAWING NUMBER
11 'X 17 9RPffED ON NO. 10OOH CLEARVRINT •
4
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13.4 ofle
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11 X 17 PRINTED ON NO. 100011 CLEARPRtNT •
Fo-o
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100
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IT
11 X 17 PRMrW,ON no. to00N. CLEARPRft(i.
�— -- - - _ - r - - h --� - -�r- - Tl
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IWEC1AL FAOOF COVERNG REOUtFt£O.
• GL S %C.,•Mt�-
,�rt S7vD Jd1DaR-
TVp,
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IWEC1AL FAOOF COVERNG REOUtFt£O.
• GL S %C.,•Mt�-
,�rt S7vD Jd1DaR-
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i. LCiNu� aa. -a...........
Floor Insulation
4
Single-
Number of stories
R -value
R-vaius
One
Two
Three
R-0
-103
-49
J2
R -t 9
-8
-1
.2
Rao
.2
.1
.1
Rab
0
a
o
U -Value
_ -_.0.so -._ . -153 ...-^tt4
-. ---i6
0.50 --1
0.50
.176
-84
-S4
0.20
-102
.49
J2
0.10
-26
-13
J
O.C8
-18
-9
-6.
Us
-11
-5
-4
0.134
13
12
.
O
d
2
1OM
O.CO
11
5
3
0
0.70
2
2
1
0.60
6
2. Wall Insulation
Floor Insulation
4
Single-
Single.
R -value
Family
Family
Multi•
R -value Oetacned
A= -,ed
Family
R-0 -68
-51
J4
R-11 0
0
0
R-13 2
2
1
R-19
-121
-53
• U -value
4. Slab Edge Insulation
.10
_ -_.0.so -._ . -153 ...-^tt4
-. ---i6
0.50 --1
S8
-A6
• a 30 --i7
.36
-24
0.10 0
0
0
0.08 4
3
2
Us 9
7
5
0.04 14
1
7
• 0.02 ',3
=
10
O.Co 4
13
12
0
0.02
-.3. Raised
Floor Insulation
4
-
Insulation In Moor
R -value
One
Number of swries
Three
R -value
One Two
Three
R-0
. -17 S
-S
R-11
J -2
-1
R-19
t
.2
R-19
-121
-53
Uwaius
4. Slab Edge Insulation
.10
- ---0.60
-144 -70
46
• '=:! 0.50
-120 -59
J8
0.40
.95 -t6
_w
0.30
-69 _t
.22
0.20
_4 .21
-14
0.10
.17 ._8
-5
0.08
-11' -6
-4
0.06
-6 -0
.2
O.C4
.1 i 0
0
0.02
4 , 2
1
O.CO
10 - S
3 '
Controlled Ventilation Crswispace-
5 1
4
Number of stories
na
R -value
One
Two
Three
i R-0
-11
-7
-S
R-5
.4
.d
3
R-11
.2
•2
.2
R-19
-121
-53
J9
4. Slab Edge Insulation
.10
4
40
-90
J7
-'
.14
Number of Stories
8-
R -value
One
TWO
Three
' R-0
0
a '
• 0
R-5
8
5 •
2
R-7
8
6
3
F2 iasis
-12
J
5
0.90
-1
J
•1
0.60
-1
.1
0
0.70
2
2
1
0.60
6
4
2
0.50
9
6
3
0.40
12
8 4,
1 n
iltradou (Air Leakage)
Spedfrsoon Points
Sland" 0
6. Glass Heat Loss
5 1
4
- Total
na
16
' .4 ,_•.....r. 2.
5 _.
U -value
na
Ptamnt
4 2
5
.51 b
.41 to
.31 t, 0.30 or
Glass Single
Double
.60
-50
.40-klesss���
50
-121
-53
J9
.24
.10
4
40
-90
J7
-26
.14
J
8-
35 '
-75
-29
.19
-9
1
10 r)
30
Si
-21
-13
-4
4
12
29
-58
-20
-12
J
5
12
28
.55
.18
.10
.2
5
13
27
-52
-17
-9
-2
6
13
26
-49
-15
-8
.1
7
14
25
-i6
-14
.7
0
7
14
24
-43
-12
•5
1
8
14
23
40
-11
d
2
8
15
22
J7
-9
J
3
9
15
11
J4
-7
•2
4
10
15
20
J1
-6
a
5
10
16
19
-29
-4
1
6
11
16
_18-:-26
-9
J
-2
-.7
12
16
17
4_3
.1
3
8
12
17
16
-20
0
4
9
13
17 ' t
--•15
-17
1
6
10
.14
17
14
-14
3
7 •
10
.141.
18'
13
-12
4
8
11
15
18
12
A
6
9
12
15 .
19
11
S
7
10
'13
is
19
10
-3
9
11
14
17
19
9
..1
10
13
15
17
10
8
2
12
14
16
18
20
5
4
3
26
2.6
3
s
r
7. -Shading (Shade Open)
ESective Pet c t Glass
(Percent glass x SC)
EReemm
%Goss North East South ':West Sigrtght
18
5 1
4
1
na
16
' .4 ,_•.....r. 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
2
3
''1
3'
3
0 1
2
1' '•
` 3
5.0 4 7 9
11
12
a
3
11
12
12
.1
2
13
13
65 6 9 10
.2
0
'na not allowed -
7.0 6 9 11
13
13
�!. Shading (Shade Closed)
Etfedive Percent Glace
(percent Siam x SC)
GIs" Norte Est South Went Sky6g111
16
16
-14
.12
-i8
-12
-69
-59
4;4
-55
na
na
14
12
-10
-a
-35
-29
-50
"a
-46
37
na
na
11
10
-7
-6
-26
-23
.36
Jt
J3
-29
na
.74
9
8
-5
-5
4.0
-17
-27
.23
-25
-21
-65
-56
7
6
-t
J
•14
-11
-19
.15
-18
AA
d7
J8
5
4
2
t
•4
-6
-11
-8
-10
.7
M
_213
3
2.
a'i•
C
y-
_2
f
_g
Q, 2 3 4 3 0
rta . not ab-_ ed
7. interior. 1 nermat mass
Sika.
Single.
Interior Slab Floor
Raised Floor
Mass Sbries
SEER
Sbries
Um
iCFA One Two Three
One
Two
Three
0
-2
.1
-1
0.1r-1-8 �s� iy .3
-1
0 .
0
5
4
3
0.60
8
6
4
0.80
0.7 .2 .1
0.9 �. -5 1 -,1 `0; , :
1
2
2
3
2
3
13
10
7
120
0 2
3
4
S
1.5 -3 111 2
120 �"-i �tli2. 4
4
5
5
6
S
7
25 0 3 5
7
7
8
3.0 1 4 6
8
8
9
35 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
SS 5 8 9
11
12
12
6.0 5 8 10
12
13
13
65 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 it
13
14
14
8.5 7 10 12
13
14
15
10. Exterior Wall Thermal Mass
Emrior
Sika.
Single.
- _Stories
Wad
FDeWct ed
SEER
West
Um
•5 /
Attached
Family
0.00
0
0
0
0.20
3
2
1
0.40
5
4
3
0.60
8
6
4
0.80
10
8
5
1.00
13
10
7
120
13
12
8
1.40
12
13
9
1.60
10
13
11•.., .
1.80
10
... 12
12
zoo
10
11
13
11. Heating System % .
SE or HSPF -
(assumes ducts In attic)
Sum of 1.6
-25 or -24 to •14 to -4t* +6 to 16 or
SE HSPF less -15 -5 +5 +15 more
0.72 6.60 0 0 0 0 0 0
0.75 6.28 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 US 17 15 13 11 9 7
095 8.71 20 18 15 13 11 8
Effective SE or HSPF
(SE or HSPF x duct eincieney)
Effective -25 or -24 to •14 b .4 to +6 b 16 or
SFE HSPF less -15 S +5 +15 more
0.30 Z75 -73 -U -56 -17 J8 JO
na 3.41 -45 -39 -34 -29 -24 -18
0.40 3.67 -34 -M -26 -22 -18 -14
0.50 4.58 -10 -9 -8 -7 A -5 -4
0.56 5.13 0 0 0 0'0
0
0.60 5.50 5 5 d 3 3 2
0.70 6.42 17 15 11 9 7
0.80 7.33 25 22 19,. 13 10
0.90 8.25 32 28 24 �0 17 13
1.00 9.17 37 32 28 24-.19 15
Zonal Control Adjustment
System Type
Resisance 10 9 7 6 4 3
Other 6 5 4 3 2 2
tz. L;ooting by%.:m
No Cooling System Installed
b.
- _Stories
c.
South
SEER
West
One
•5 /
D4
J-4
(assumi I ducts
to attic)
-2
Two +
a
3
Stm o(7-10
.,2
, 7-7
2
1
-25 or -24 b 04 b
-4 b
+6 t0
16 or
SEER
.)us
-1S 1 S
+5
+15
mom
8.0
-14
-12 -10
J
S
-4
8.5
•9
-7 S
-5
.
J
8.9
.5
l -4
J
.2
•2
9.0
-4
J J
-2
.2
•1
9.5
0
0 0
0
0
0
10.0
4
3 3
2
2
1
103
7
6 5
4
3
2
11.0
10
9 7
6
4
3
120
15
13 11
9
7
5
13.0
23
17114
12
9
6
-
Solar
•1
-1
.1
a
0
1.3
Etf4dre SEER
-18
-12
-9
-7
(SEER xitad cf cfeae7)
21
WS8
-ZS
S%v of 7-10
-12
-10'
Effecive-25 cr -24b -1411*
-4b.
+6b
16or
SEER
was
-15 S
+5
+15
mon
5.0
JO
-25 -21
-17
-13
-9
6.0
-12
-11 ,
1t. •9
-7
-6
-4
6.6
-5
-4 -4
J
. 4
•2 .
7.0
0
0 0
a
a
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
:6
23 19
15
12
8
12.0
20
26 22
18
14
9
13.0
33
29 24
20
15
10
Zonal Control Adjustmcnt
10 8 7 6 4 3
rr.. r PASS
No Cooling System Installed
b.
- _Stories
c.
South
d.
West
One
•5 /
D4
J-4
J
-2
-2
Two +
a
3
3
.,2
, 7-7
2
1
Singie•Famiiy Deuched and
Attached
r& X
=
Il.7
! Unit Size (so
Water
O X--
.199
1203
1700
2200
2700
Heater
Credit
or -
b
to
to
: or
Type
Type
toss
1699
2199
2699
mora
SG
None
0'
s 0
0.
0
0
or
Solar
12 '
8
6
5
4
HP
HVIR
8
5
4
3
3
0%
WS8
5
3
3
2
2
3S%
POU
8
5
4
3
3
SE
None
J7
-24
-18
-15
-12
-
Solar
•1
-1
.1
a
0
1.3
HWR
-18
-12
-9
-7
J
21
WS8
-ZS
-16
-12
-10'
-a
4.2
POU
-18
_-12
-9
-7.
-6
C
None
-5
J
-2
-2
-2
1.9
Solar
7
5
.4
3
2
POU
3_
2
1
1
1
IE
None
-28
-19
14
-it
•9
1
Solar
8
5
4
3
3
24
POU
-10
•6
-5
-4
J
19
Multi-Faut4 (individual
units)
4.5
4.8
5
52
Unit Size (sf)
M%
Water
0]
699
700
1200
1700
2200
Heater
*04
or
b
to
In
or
Type
Type
rasa
1199
1699
2194
more
SG
None
0
0
0
0
0
or
Solar
14
7
5
4
3
26
2.6
3
s
3.4
i6
36
4
WS8
9
4.1
3
2
2
SS
POU
9
5
3
2
2
SE
None
-45
-23
-i5
-11
-9
32
Solar
2
1
1
0
a
4.6
HVIR
.23
-12
a
•6
'-5
55%
WS8
-25
•13
•8
0
-5
22
_ EQU
23
--:!Z-
3
-6
-5
37
None
.8
1
-3
.2
•2
11
Solar
6
3
2
1
1
12
POU
1
0
0
0
0
IF
None
.30
71s
-t0
-a
-o
42
Solar
18
9
5
4
4
5.6
POU
a
-i
.3
-
-2
rr.. r PASS
North
b.
East
c.
South
d.
West
e.
Skylight
Type" (domblej
U-vaiue (0.651
% Total GLtt (161
`wo lass
SC
Eff. `)l1 Glass
r X
, 7-7
ZI►7 X
r& X
=
Il.7
(P -0 X
= 4 r(.,
O X--
_ 0
S Tr►e 1 Mss
(utme 6 4-2. 1*S *:Dosed Stab1
......
0%
S%
10%
t5%
20%
2S%
70%
3S%
40%.4S7•.
50%
55%
60%
SK
70%
75%
W%
Os%
110%
0%
100?: 105% 1101..115 . 120% 12
0%
0
02
04
0.6
0.8
1.1
1.3
13
1.7
1.9
2.1
U
2S
21
21
32
-13
14
16
16
' 4
4.2
4.4
-4.8
4.8
5 S1
107.
0.2
0.4
0.6
0.6
1
1.2
1.4
1.5
1.9
21
23
23
it
21
11
SS
17
4
4.2
4.4
4.5
Z.6-
5
52 S.4
20%
0.3
46
0.1
1
1.2
1.4
1.3
1.8
2
22
24
27
21
It
13
23
17
19
4.1
4.3
4.5
4.8
5
52
5.4 56
M%
0
0]
as
1.1
1.4
1.6
1.6
2
22
24
26
21
3
32
13
17
19
4.1
43
4.5
4.7
4.9
S1,
S.3
56 S a
407.0.7
U
1.1
1]
1.S
1.7
13
22
24
26
2.6
3
12
3.4
i6
36
4
4.3
4.5
4.1
4.9
S.1
5.3
SS
5.7 59
50%
0.9
1.1
U
13
1.7
13
2.1
2.3
2S
27
3
32
14
IS
16
4
42
4.4
4.6
4.8
&1
13
IS
3.7
5.9 6.1
55%
0.9
1.1
1.4
1.5
1.6
2
22
24
26
26
3
32
SS
37
3A
41
43
4.5
4.7
4.9
11
53
SS
5.6
6 6 2
60%
1
12
1.4
iJ
1.9
21
23
25
27
29
11
13
13
18
4
42
44
4.6
4.8 '
S
12
5.4
5.6
5.9
$1 6 3
65%
1.1
U
1.3
7.7
1.9
22
24
26
21
3
12
14
36
31
4
4.3
AS
47
4.9
11
53
55
5-7
5.9
6 1 6 A-
M
1.2
1.4
1.6
1.6
2
22
2S
27
21
11
13
23
3.7
3.1
41
43
46
41
S
5.2
5.4
3.6
58
6
626 4
75%
1.3
13
1-7
13
2,1
23
23
27
3
32
14
16
ib
4
42
11
46
4,6
5.1
13
_ iS
5.7
19
&1
6.3 63
607:
1.4
1.11.1
2
22
24
26
26
3
13
15
37
19
4.1
43
4S
4.7
49
5.1
SA
56
5.6
6
62
64 66
157.
1.4
1.7
21
23
25
27
Z9
it
23
3.5
11
4
4.2
44
AS
4.1
S
52
54
$6
59
6.1
63
65 67
9".'
1.5
1]
2
22
24
26
26
3
22
14
16
14
41
43
4.3
47
49
S1
33
. 55
17
3.9
62
64
66 6e
95%
1.5
t1
2
22
25
27
23
21
33
1S
17
19
41
43
4.5
41
S
12
5.4
5.6
18
6
6.2
6.4
6.1 69
1001.
1.7
U
U
23
2S
26
3
32
2A
16
16
4
4.2
La
"
43
U
5,3
SS
5.7
11
it
13
6.S
6.1 7
105%
1.1
2
22
24
216
28
3
13
15
17
19
4.1
4.3
43
47
4.9
It
14
56
5.8
6
8.2
64
so
so 7
"Orr.
1.1
21
23
25
27
29
11
13
16
3.1
4
42
l4
46
4.8
S
S2
14
5.7
S.9
Q1
6.3
6.5
6.7
69 7.1
,IS%
2
U
24
26
26
3
12
14
31
16
4.1
4.3
4.S
4.7
4-9
Si
13
SS
5.7
5.9
6.2
6.4
6.6
6.e
7 72
120%
2
13
25
27
29
3.123
IS
77
3.9
4.1
4,4
4.6
4.1
S
S2
S4
5.6
SO
6
62
6.S
6.1
6.9
7.1 7::
125%
21
23
2S
26
3
12
14
16
31
4
4.2
4.4
4.6
49
11
13
U
S7
5.9
6.1
13
63
E7
7
7.2 •7a
Point System Summary: Climate Zone 11
SCORE CARD 4;ct o Me
1. Ceiling Insulation r -n ---r) 7 � or
2. Wall Insulation
3. Raised Floor Insulation
4. �SIab Edge Insulation
S. Infiltration
6. Glass Heat Lass
7. Shading (Shade Open)
a.
North
b.
East
c.
South
d.
West
e.
Skylight
R -value (381 U -value (0.0301
.� or
/ R -value (1I U-vaiue (0.0981
(� 19 Or
R-value(191 U -value (0.0371
S. 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 CDnaol? (Y/ N )
12. Cooling System
Zonal Control? ( Y / N )
13. Water Heating
or
R -value (01
F2 factor (0.771
Standard
L99
Type" (domblej
U-vaiue (0.651
% Total GLtt (161
`wo lass
SC
Eff. `)l1 Glass
r X
, 7-7
ZI►7 X
r& X
=
Z'
(P -0 X
= 4 r(.,
O X--
_ 0
% Gl=s SC Eff. % Glass
X GG Z/1
X - ! d
X = 7ir 8 _ ..
X
TYPE 1 KASS AREA 0
COND. FLOOR AREA
Interior It/uarCFA ��--J/
Y>r!f 2 !U1S5 AREA
ND. rL OR AREA 9
EA
Point Scores
Z, -
p Z. -
Sum
Sum l0
vx AMR
SE at HSPF Net Efficilincy (0.181 Effective SE or
(0.77!661 41
HSPF 10-%5. is]
SEER (9S i?uctEfricicwy (0.141 Eficaive SEER (7.031
Type tSGI f Cred4fw( mcj
d
Pnrnr Tnta
t;eruncam or t-.ompltduue: i%xtacientun comate 'Lone 11
Address
: sDocurnentaLion Author Telephone
:_gU1DING DATA
" :Conditioned Floor Area V O O
Slab/Raised Floor &G a- tSEb
Single Family Detached (SFD)
C3 Single Family Attached (SFA)
(J Multi -Family (MF)
Number of Stories
Number of Units
(] Addition Alone
[ l Existing Building
(] Existing -Plus -Addition
79S/ i
Buildir► iti��
Checited By / Date ..
Enforcement Agency Use only
Glass Area 9b Glass
North 4,4--•
East
South 3.0
West
Skylight 9
Total /&
BLM.DLNG SHELL INSULATION
Component Insulation L=oon/[.-'Mrner2t$
Tyce R -Value (attic, to garages, =i:- 3, eke.)
Wall .............. Z_ ALL EXTER.Io TL
Wall ..............
Roof ......:...... FT Affflc
Roof ............. R -19n SITED ROOF - Kr?ctfEu 1-40ht-1Floor.............
Floor .............
Slab Edge.....
GLAZING
Glazing
Orientation
^�L GOO SQ FT IZt41SCDFLaotZ
Shading Devices
Area Glass Type Interior Exterior Overhang Framing Type
(sr) (single, double) (Jolla blind, etc.) (shade=een, etc.) (yeshto) (metaUWnewn
Noah ( ) 44- D gL
/�7-
Norti
_
East C )
East ( )
South ( )
South ( )
West ( )
_ NTi Ili 1►�DS
West ( )
Skylight.......
THERMAL MASS
Type; Covering Area
Thickness
(slab/exuaserd, tile, etc.) (sf)
(inches) L,ocadon/Descsiption (kitchen. bath, etc.)
GN L s4--
BiQTlf Q M a
HVAC SYSTEMS bii:.imum
Duct
Type (furnace, air Efficiency
Location Duct Output Manufacturer / Model #
conditioner, heat Dump) (SE. SEER.HSPF)
(alder, etc.) R -Value (Btuh) (or approved equal)
-N&U, 72 - -
'..Maximum Fumace Heating Output: 'Tf��• BNh SUN I 1
-'.,HOT WATER SYSTEMS Tank Manufacturer/Model # JU1
'System T (story a g3s. etc.) Capacity or approved equal) SbeREPAM
SPECIAL FEATURES/REMARKS (Add extra sheets if necessary)
•
Mandatory Measures Checklist: Residential MF -IR
14CM- Lowrisc nsdautal buildings aabiea iia the Sanduds mag cassia these m=sur,.a rcPrdk= of U* compliance
-VV- ft used. Menu maraed wrtn an attrut (•) may be wpowded try mac smngat compliance rmquara�fiord
onLnc C"ufsote tat Compliant When bus ch .Um u incorpmavA inw ow puma awunsans Use feutom mond sMa
be cangdaed by iU Wnaes as binding maamam eompoenent perfermann spearJ-n• for" mandatory masaea
wnetMt they ate shorn elsewhere m the documenta a on this checUi st only.
DFSOUrno" DETIGM D ORCEMENT
Building Envelope Measures
•
12.5352(3): Minimum coling "twLataon R-19 waghted sucrate.
42.5352fbt Loose fill inwlawn marwfarttnr"'s Labeled R -value
• §2.5352(cr Manama .all insulation in (loaned walls R. 11 weighted average (does act apply to
cstanor man walls).
12.5752fkt Slab edge insulation - ower absorption rate na pryer than 0.3%. rata vapor
tra s mason n¢ no palet than 2.0 panJtneL
r , §2.5311: Lmu{ation sp=rtcd or insW icd meas Caaifamia ErcrV Commission ((= gtolity
sunwards. Indicate type and tarso.
12.5352(r): vapor banners mandatory in Clinsate Zones Ie- and 16 only.
42.5317: Infill auon/EsfrltraconControls
a. Doors and wudows between conditioned and uncordiuoned spaces designed to limit air
leakage -
b. Doors and wi wo- c"tifsed.
C. Doors and rmdows wauWx=pped: all joins and pczwA=ons auLked and sealed.
12-5352(et Special infilaatson barrier installed wtamply with §2.5351 marts CEC Quality
na dards.
12.53=4): Installation of Fireplaces
1. Masonry and factory -bisalt rueplacrs have;
X Tegm sung. Uosable meal or glass door
b. Outsade ar coke wnth damper• and conav(
C_ Flue oameer and control
2. No conanuous bw=g Sas pilm allowed.
HVAC sad Plumbing System Measures
52-5352(s) and 2-5303. Space candi6onint equipment sizing: sumeb c kvandont.
§2.5352(b) and 2.5313: Setback Warnosm cn aL apoiabk heating rfortns-
§2-5316(a): Ducts constructed. Lasnlled and insulated per Chaplet IQ 1976 UMC.
§2.5316(bk Eahaua systcas have damper conaoLs
§2.5314(c): Gas -Reed space heating equipment has intermittent ignition devices
§2-5314: HVAC equipmem wars haters, owoerhradz and faucets certiried by the CEC
§2.5352(09 wart hater insulation blanket (R• 12 or ga=rs) or combined interior/eaterior
insulation (R-16or part rust 5 feet of pipes closest to tank insulated (R-3 or pout).
§2.5312(PseeptionIt Pipe insulation oa mcmn and su=m condensate return & recirculating
(„ptng-
§2.5318(d)- Swimming Pool Heating
1. System has:
a. Orloff switch an hater.
b. Wcatnapeoof instruction plate on haus.
C. Plumbed to altaw for sour.
2. 75 percent thenal clrnic cy.
3. Pont cover.
a. Time clock.
5. Direeuonnl water inlet.
Lighting and Appliance Measures
12.53520 Lighung - 25 bmnnslwatt or pryer for general fighting in kitchens and bathrooms
§2.5314(c): Gas rued aWfiatees equipped wiU inunnia=t ignitioo devices
§2.5314(a)- Retrigensom refrigerator -f reruns, freezers and fluorescent lamp ballots certified
by the CEC India - make and model numb".
CobeLIANCE STATEMENT
'Phis O=ficare of compliance lists the building featutts and performance specifications needed to comply with
Title 24. Chapter 2-53 and Title 20. (2mmc; 2. Subchapter 4e Article 1 of the California Administrative code. This
certificate has been signed by the individual Frith overan design tupcnsibiiity and the building owner. who shall
retain a copy of it and transmit the certificate to lay subsequent: purchaser of the building.
Designer
N=n= .
TitlerFunc
Adm
Tekphorse
L ic. I:
(sign M) (date)
Documentation Author
Narrn�
TitlerFtmt
Ad&=:
Building Owner
i
Name
7 idg F"urre
Address:
Tc1cpho
(signscum) ( ate)
Enforcement Agency
None:
ACercy:
I