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1:58-33-652789-90E. f SIMMONS, Richard'& aren 3625 Charqui Ct, Conc (elec for.'2 wells) 58-33-65 q 1 Permit #96-91B,P ,M (� f (new sf) I ) QC7 y �f 'gRESIDENTIAL 58-33-65 96-91B,P,E,M SIMMONS, Richard 3625 Charqui Ct, Concow Contr: Advanced Energy (new sfO -0����� r y 1 _ L` a 1. OFFICE COPY 0 I Address j J GAS AI Meter BY-- g/f/ - E RIC Me ' Y Date Address �� `I BY Date ELECTRIC Meter By.�/f' Dat OFFICE COPY" Address r � Date ELECTRIC Meter By Dat / G L- – — -_I JOB FINALED (Date) Signature _ V=OK 0, Not OK = Not Readyable MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap: / P L" ft. / /"Nat. or/ P L" ft./ /"LPG 7. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Appro4al- 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 10. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 I ' MI.SC9LLANEOUS Date DECKS COVERS ZARPORTS, GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/6'r Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Coonectors 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-Stuccoo-Mesh 10. Roof; Shthg-Ro.Qfing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 V OK O = Not DK =No No- Readeadyt y ble RESIDENTIAL (Single & Duplex) ' = Date UND FLOOR (Plans) OK except #'s Zoning-Setbacks-Easements-Flood-Slope ._Main; Soils-Elec. G " Ftg. Depth ec Grnrl -/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 0--stemwalls, Main; Steel -Bloc kouts-Wrapped walls, Garage; Steel -Blockouts-Wrapped 6a_Hold Downs and Special Anchors 7. Slab; Steel -Wrapped Piers -Fireplace Ftg.-Steel W.V.; Fall in est -2 ay/O- ewer st 10. Gas Pipe; Size -Anchors eater Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 3 ucts; Clearance- aterial-Support- s.- 1 rde i Is -Anchor Bol 0 -V ripples 15. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING Per except #'s Water Htr.; Vent -Access -Combustion Air -Baffle ter Pipe; Test & Anchor -Nail Protection 01W.V.; Test -Fittings & Anchor -Nail Protection S ower Pan; Test, First Floor -Tub Access ao.IlTot Tub & Shower, Second Floor -Tub Access Gas Pipe; Size & Anchors Date di7 Cy 7 Card 13-1 Date Card B-1 Date / Card B-1 Date Card B-1 Date EL TRICAL Permit OK except #'s 2. Fixture & Transformer Clearance -Ins. Protection ec. Receptacles Spacing -Lights & Switches at Doors e Boxes & No. of Conductors -Stapled Romex Installed Close to Edge of Studs & C.J. Equip. Ground made up w/Mech. Fastners-Bond Gas & Water 2 Appliance Circuts in Kitchen & Conductor Size/GFI Sub ee ire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 29. Range Circ. /�e g . C r AI -Oven Circ. / / ga. Cu or Al. M Insulated Neutral &�-fes AD No ul0!S5ervice-Riser Conductors & Ground -Main Disconnect E uip. Clearances Panels-Motors-Mech. Equip. Clothes Closet Light -Shower Light -Spa Light t3 . moke Detector Date 7,//26 / Card B-1 Date Card B-1 Date H— Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s . uc s nsulation & Support ent Fan; Exhaust above insulation in & Overflow; Size & Grade -7--FdrnarrCa - ent; Access -Comb. Air -Return Air Vent -115 outlet atform if Furnance in Attic Date (, / Card B-1 W W, Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except #'s I_39o.�ai4s Proper Material & Anchors LOT Walls Studs -Nailing, Spacing & Bracing -Plates -Sound aring Walls over Girders & Floor Nailing raft Stop in Walls (rat proof) 3 i Stops; Furred Ceilings -Stairs -Chases -Tub i Headers & Beam -Size & Bearing Date FRAMING (Continued) angers -Post Caps -Anchors -Connectors Ing. Joist-Rftr. ties -Pu rlin -roof Brac-Truss-Shthng.-Rfng. Fireplace Ties or Type A Flue -Fireplace Throat clearance Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions SO- garage Fire t!Eotection Framing ewall & Openings Doors -One T -Check Garage -3rd Story, 2 Exits tair, ' th-Headroom-Rise-Run-Landing-Fire Protection plywood on Roof Overhang -Attic Vents -Rafter Outriggers mg -Nailing Veneer 4p4creed-Fd. Vents-Underflr. Access Glazing Area -Glass Protection -Skylights -Plastic 58. Shear Walls; Nailing -Bolts Insulation -Walls -Ceilings jiltration-Walls-Windows , fA . Date y! / Card B-1 Date Card B-1 Date % O Card B-1 Date Card B-1 Date FINAL (Plans)OK Wxcepi #'s steps -Door & Sidelight Protection -Landings S oke Detector Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection �6 edroom Exiting C(�5i P.I. & Bath Fixtures & Tub Access -Spa Elec. Trim & Subpanel; Breaker Sizes & Labels 16 airs & Rails `6 fireplace or Stove; Clearances -Hearth lec. Outlets at Wood Panel; Int. & Ext. Ki ixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Elec. Outlets & Receptacles at Kit. Counter 7k--$arage-Fw4.Door; Swing -Landing -Closer in Garage -Damper JXWtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. I arage; Above Floor-Mech. Protection Pib., Elec. & Mech. Equip. Listed for Location 76-Zaeo,Reeeplec1es in Garage; (G.F.I.)-Romex Protection b; -Foam -Looked in Attic ❑ Yes CA-lu-ard Rails & Deck Construction -Post Caps n. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 80. Following instld.; Drive ❑ ; Walks Yes o; Planters ❑ Yes o -� 5T'St17t t rown-Finish 1.8'7.X1`. Unit; Disconnect, Electrical, Plumbing Vents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to Openings L.&*--GVater Well; Disconnect, Electrical, Plumbing Exterior Elec. Trim; G.F.I. Receptacle -Underground . V tilation Throughout House GI Protection Corrections from Previous Inspections as Test -Meters Tagged; Gas -Electric 90. WqJw1& Sewer Connected -C/O to Grade -HD Approval Energy Compliance Certificate -Other Certificates Date , �� Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: (NOTE: An entry must be made each time you visit job site) Owner �-D��LJ�'- Permit No. ENERGY CERTIFICATION c-, cxro-j C-4. [�IZII:Y�ILI ROOF MATERIAL_ THICKNESS DESCRIPTION OF INSULATION BRAND NAME_ THERMAL RES. A. P. NO. EXTERIOR WALL MATERIAL FIBERGLASS BRAND NAME CERTAINTEED THICKNESS ea. . s, THERMAL RES. /19 CEILING BATT OR BLANKET TYPE BRAND NAME CERTAINTEED THICKNESS THERMAL RES. LOOSE FILLTYPE INSUL-SAFE IIIBRAND NAME CERTAINTEED THICKNESS 1 V 31 it THERMAL RES. -3 6 FLOOR,ELEVATED MATERIAL FIBERGLASS BRAND NAME CERTAINTEED THICKNESS THERMAL RES. 1 Q FLOOR, SLAB MATERIAL_ THICKNESS WIDTH FOUNDATION WALL MATERIAL THICKNESS BRAND NAME THERMAL RES. BRAND NAME THERMAL RES. I HEREBY CERTIFY THAT THE ABOVE INSULATION WAS INSTALLED IN THE ABOVE BUILDING IN CONFORMANCE WITH THE STATE OF CALIF. ENERGY REQUIREMENTS. SHASTA INSULATION INC. #530235 NAME STATE CONTR. LICENSE NO. I here°y certi �yt e above insulation and all required items as shown on the Building Depart. approved plans and attachments have been installed as required by the State of California Energy Requirements. All equipment, devices and materials are of the quality prescribed.or are specifically approved by the State of Calif. -----a -C" A4 t-3 F-----------.!5-Z-!�n-`_izl-�---------- FIRM NAME/OWNER (PLEASE PRINT) STATE CONTRACTOR'S LICENSE NO. �.� --7 - a - Cl t SIGNATURE OF GENERAL CONTRACTOR/OWNER DATE This certificate must be on file with the BUILDING DEPARTMENT prior to final inspection approval and a copy shall be posted within the building. JANUARY 1984 COUNTY OF BUTTE #DEPARTMENT OF PUBLIC -WORKS ` 196 Memorial Way, Chico — Phone: 891-2751 ` 7 County Center Drive, Oroville — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE OWNE J144,01-4 fERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter,, or need additional explanation, please contact this office immediately. — 'eja — 4 -(- l V 8 1,/ re E— Date Inspector��C/� I COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 538-7541 747 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE OWNER PERMIT A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. Well� Date '� Inspector,) I COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. 94`�--/ ASSESSOR PARCEL NUMBER 58-33-65 ZONING FR10 BUILDING PERMIT OWNER Richard Simmons TELEPHONE 533-7182 SQ. FT. OCC. BUILDING VALUATION '1976 R 79,040 OWNER'S MAILING ADDRESS 3625 Charqui Ct., Concow 799 CnIT CONTRACTOR'S NAME Advanced Energy TELEPH NE 572-052 36 Open isn CONTRACTOR'S MAILING ADDRESS Granite Ridge, Oroville 11,000 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ 15 On ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 3625 Charqui Ct., Concow Permit fee $ 625 00 PLUMBING PERMIT Filing Fee 10.00 Each Trap 12 2.00 24.00 Solar or heat pump water heater 20.00 LOT NO. �/ SUBDIVISION NAME PARCEL MAP 13irr f—b 1O Water piping 5.00 5.00 Each qas water heater or vent 5.00 5.00 USE OF STRUCTURE SF a Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 5.00 Building sewer 5.00 5.00 Mobile Home I S I G JW I 10,00e TYPE OF WORK New Ek Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: 3 BR Permit Fee $ 54.00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP OR00V OR LESS10.00 10.0 CONTRACTORS LICENSE LAW 1 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 lGr'sale. (Sec. 7044) I, as the owner, am exclusively contracting with licensed contract- ontract- ors.(Sec. 7044) ors. ❑ I am exempt under Sec. , Business and Professions Code for this reason Main service EA. ADD'L 100 AMP 2.50 2.5 NEW CONST.( DWELLING OCCUP.E) OR ADDNS. ACC, BLOGS. 2yz2sgft 49.4 NEW CONSTR. MULTI -OUTLET NON-RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS ek (SINGLE OUTLET CIR. ) Ex. Occup(OUTLETS OR FIXTURES 20050C e AL030 FIXED APPLNS, Ex. Occup. OUTLETS RESID IREA.) 2.00 'Temporary service 10.00 Mobile Home Facilities 15.00 Misc. tYirin g 15.00 Permit Fee $ 71.9 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 Consent to Self -Insure. hall 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 FiIingFee 10.00 Heating wood stove Cooling g Hood 3,00 11 Ventilation Permit Fee $ Contractor A30 I certify that I have read this application and state that the above information is correct. I agree to comply to all County dinances and State Laws relating to building construction, and hereby autho ze representatives of the Countyot Butte to enter upon the a ve-mentioned roperty for inspection purposes. 1 also ree to s e, i demnif n ke harmless the County of Butte against all abilities, ' g nts, c t and xpenses which may in any ay accrue ag Inst sai ount in co ace the granting of this permit. X -� �� , %��®�— _ Date Signature of Applicant — Owner Contractor 11Agentwork An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ 0( o CONST PE TOTAL FEE 79 6. HAz `- ICUA — PARK SCHL FLllPA PD H ISSUE This permit is nereby issued under sions of the Butte County Code and/or indicated above for which fees DIRE R OF PUBLIC By PE46T IT EXPIRES Date the applicable provi- resolutions to do have been paid. -WORKS Date1-3/,�i� — — Receipt No. 83924-$255// !Rl V 12 —f TV/. q0 WHITE-D.P.W., ew-0"JR, PINK -INSPECTOR, GOLDENROD -APPLICANT `i.-,�i,,.i,aY`r. "y�'-�,'^,c''='A.�:�iJ`y, 'acv" T.�"'3..,,, 4�H,�-.�._,rt.:�. :'�f, `"'� .u".w+,.-•.rt'�t,. "P_. ��..s .lrYav�:..�i:-, r.l�.H�. �.,;. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 ' PERMIT APPLICATION DATA SHEET Permit No. OWNER 2p A. P No. Proposed Building Use � Building Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . ........................ .......... 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. 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. ®® s . 0. $T fi.................. Fees of ........................ Chico Urban Area fees paid ....................................... Park f aid ................................. CJ School District fees paid .............. L -T 4. Sanitation approval from _ Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 4. ecorded copy of Agricultural Acknowledgment -Statement ......... Letter of signature authorization 26. X14 f Chi to f- n -Gtnc �t7vt Y l c 3 27. W en you issue the permit, process as follows: ' Mail to owner.Mail to contractor. Telephone3'and hold for pickup a office. Deliver w/inspector. Other Cam A ppl i calit Date ` 11 ht I Copy of Haz-Mat corm sent - Health Dept. Fire Dept. _Air Pollution Date Copy of plans sent • Health Dept. _Fire Dept. Other Date By. The following data must be submitted prior toULS&Syc XUw" iof ch }cid oy 1. Index permit for above items No. (� 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone_-nail counter by .date Contractor, designer, owner, was advised of above required data by—phone —mal l—count r by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW TO Buildina Department FROM: Environmental Health SUBJECT: Sanitation Clearance RUA a_j Yn M J�'Vs a6A Owner Loc tion AP# Plan Approved for: Sew aqe Disposal Water Supply totll Fold final for: Water Supply Final clearance O.R. for: . Water Supply Clearance for 7> bedroom mobil ome Other NOTE * * * ate Sanitarian TO: Building Department FROM: Encroachment Permit Section RE: 'Driveway Clearance owner location tl AP # Driveway permit ot�-,has been issued /l�v �o-�✓.� / 7��G e�c�P� O-ei g "Z si;ature for the above property. date TO Buildina Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Location AP# Plan Approved for: Sewage Disposal _ Water Supply �I Hold final for: Water Supply Final clearance O.R. for: Water Supply Clearance for bedroom mobile home Other NOTE *** tiatei Sanitarian COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER ZONFG� BUILDING PERMIT_- OWNER S TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 3jaAzepyr 43rCa e ?:Z O CON RACTOR' A E TELEPHONE S 67 D ` CONTRACTOR'S MAILING AL)DRESS %Z Fireplace /Ooo CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS ` Filing Fee $ 10.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS 3(� , Permit fee $ _r PLUMBING PERMIT FiiingFee 10.00 Each Trap 2.00 G0.1t 9 LA,1 Solar or heat pump water heater LOT NO.SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 r+ USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 �- Building sewer 5.00 Mobile Home Is G W 0.00e TYPE OF WORK New& Addition❑ Remodel[:] Utilities❑ Installation[] Other ❑ Describe work: 3�CZ Permit Fee $ �C Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 10.00 100 AMP OR LESS �. Main service EA. ADO'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Busines$ and Professions Code and my license is in full force and effect. License No. Classification El1, 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.✓f y OR ADONS. ( ACC. SLOGS. /z¢sgft t �/ NEW CONSTR. MULTI -OUTLET 2.50 ea NON-RESID BRANCH CIRC ITS -. POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20050t eALO 30 FIXED Ex. Occup. OU LETS PRESIO )APLNS.REA.) 2.00 Temporary service 10006 -717�p� Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ 77 1 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 WOOD STbl/C-- Cooling g Hood 3.00 Ventilation J Permit Fee $ 7-�- Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA i permit is required For Kcavations ove 5'0" deep and demolition or construct- ion of struct res over 3 stories ' height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST TYPE AL TOTAL FEE $ HAz CUA PARK FLo PAR PD o ISSUE It Th;s permit is nereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date Receipt NY . WHITE-D.P.W.. YELLOW-A38E 30R, PINK-INSPE R, GOLDENROD -APPLICANT i..•�vSlv�cs.rYp�{ri'.-..ZT'—w•�...-y--•-w`w =r-=i,f•-Y^..,r-" ..,-...^-y„r ••+,-a. ..- ..�.,-ter --v-v—rte,,�.-,...7'�.r".r7.s�+:(^-��"nrr.n...=+=t' �+r'�i�f>i%+4».'i^���.��'a•,�ti:.,,,w•e,....w:e..�t �.•(.- =i . , P . BUTTE COUNTY SC OOLS DEVELOPMENT FEE CERTIFICATION FORM �5�- ,330_00t) ( One Form per Building) A.P. Number ��--��� 1'�js , Building Department No. School- District = City County e Jurisdiction Property Owner a,2m QA SL444M OWS Project Location/Address • 36? -S d114&Q1A= <277 t_nvroZ4 Subdivision Lot Number Residential Development: r - a Sq. Footagd226 # of Living MHI Addition (Group R) -Units Commercial/Industrial: New Sq. Footage Addition (Including Exterior Roofed Areas) A _/k/19, /19, Date ******************************************************************* (Floor Plans reviewed by School District Personnel) District Id No.` 7 1O 1 5 + School District certifies that 33- 7/ 7 (Applicant Name) (Phone Number) (Street Address) has complied with the requirements of Resolution No.�(j by he payment of $ representing square feet. hool District Repre ntative Date PAID BY CHECK NO. BANK NO //—,5 a I 0 REMARKS: PAID�B-Y� CASH A gok(A& white -applicant, yellow -building department, pink -school district SCHOOL.FEE (8/88) All that real :property., 'situate in .the County of Butte, State of California, described as follows: ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE STATE OF CALIFORNIA, COUNTY OF BUTTE, DESCRIBED AS PARCEL II AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON OCTOBER 14:y 19:82., IN BOOK 89 OF MAPS, AT PAGE 66. COPY OF PARCEL MAP ATTACHED. Date: fX y/ , PROPERTY OWNERS: RICHARD A. SIMMONS State of CALIFORNIA) ) SS. County of BUTTE ) OFFICIAL SEAL JANIE STEVENS NOTARY PUBLIC - CALIFORNIA COUNTY OF BUTTE (Comm. Exp. SOPL 11, 1992 On this the 31st day of JANUARY , 19 91 , before me, the undersigned Notary Public, personally appeared Personally known to me. SE] Proved to me on the basis of satisfactory evidence. to be the person(s) whose name(s) are subscribed to the within instrument and acknowledged that _rhPy executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Present A.P. No. 058-33-0.=065-0 Notary Public Janie Stevens EN® OF DOCUMENT 9l -040a! 1 Return' to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8.1 of the Butte County Code `requires this acknowledgement be recorded prior to issuance of a building permit. ;• '` The property described herein is adjacent 91-004001 Ree Fee 5.00 to land or included within an area zoned . .,Cash,_ ... ti •5•'001, i for agricultural purposes, and residents Recor.d.ed. of this property may be subject to incon- Official Records-„�.,a. 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, 2 c 04pm 31 -Jan -91 XX 1 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 :property., 'situate in .the County of Butte, State of California, described as follows: ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE STATE OF CALIFORNIA, COUNTY OF BUTTE, DESCRIBED AS PARCEL II AS SHOWN ON THAT CERTAIN PARCEL MAP, RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON OCTOBER 14:y 19:82., IN BOOK 89 OF MAPS, AT PAGE 66. COPY OF PARCEL MAP ATTACHED. Date: fX y/ , PROPERTY OWNERS: RICHARD A. SIMMONS State of CALIFORNIA) ) SS. County of BUTTE ) OFFICIAL SEAL JANIE STEVENS NOTARY PUBLIC - CALIFORNIA COUNTY OF BUTTE (Comm. Exp. SOPL 11, 1992 On this the 31st day of JANUARY , 19 91 , before me, the undersigned Notary Public, personally appeared Personally known to me. SE] Proved to me on the basis of satisfactory evidence. to be the person(s) whose name(s) are subscribed to the within instrument and acknowledged that _rhPy executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Present A.P. No. 058-33-0.=065-0 Notary Public Janie Stevens EN® OF DOCUMENT COU DSpr °�o2p Won,(, s FEB 2 1991 d Y:•.ytd�.ca..+ I N 09'01'07' 709.07' I M17°O� O O O ^1°•,O � wL n Ari C Av• to Z • a � •C v2^ ^g • v � m I v NN is n O + 7p T>14 ^I A ►a n " Q� �lhl I N 09'01'07' 709.07' I • � �A � - r+dbi w .•T.. .• o c I �. 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I a •. tj �I a b *I �^ t a H ,a • O" \(\ � <RE.E �.� ` � Cpl I I CIA 1 O ` p w� ^ • . � NB/i•/D.oTp JYJ.7K • 1 A .aj � �. � � � m� °ate Z�ti� a<y�o y°aT:,m3 �mN •�. ...•z R " �, yg10 fin. 2ann ^°` �oA�•`n2on,2"' '�'.''• c o i i y _ oo MU20 c�xi�a qne°aA iM at <CTM?OMo � ,`\•'`. o� m 7Z y 000y m� v°2T2�Ca 2 �n 4 e�.y .l � •. �Oy my NA O of tnp �''2e"' o?°ayc�im°�? o� � � Anlma ^e• m� �� c.,�,oC� e•, rl p o n c3ti� A ias A T Z n y�Tot III I I Ac.fl, to, vi rs NI ��'(''(��•� <o � - �� Z x'10 �4y O � ham`^ a 2AMy O � K •• f .a m (D ° Vo , - __._..... 5/89' _. RESIDENTIAL PLAN CHECKING GUIDE (S.F., DUPLEX & MISC. ONLY) .... ... ._ RTO _ pormi t $ • �i• � fly-' �i ,ter • GENERAL ✓lam Zoning requirements: (sideyards and number of permitted living units). Valuation. �(5.j Plans signed by designer. Energy Design and Compliance. T Existing violations on property. Items on data sheet. . PLOT PLAN Complete parcel size and dimensions.' Setbacks, sideyards, easements, etc.. ' Other buildings or structures. Grading, fills, drainage. lood hazard. Sp ecial conditions on creation map or compliance document. FAU & FAS road setback. ' FLOOR PLAN Complete to scale plan with dimensions. Required windows for light and ventilation (Sec'.. .1205).'.'' Required windows for second exit (Sec. 1204). - Skylights (Chapter 34 & Sec. 5207). Human impact glass (Sec. 5406). Required room sizes, ceiling heights (Sec. 1207).. GFCIs in baths, garage, and exterior outlets'-(,Ar-ticle 210-8) Light fixtures, switches, receptacles, and exterior receptacles for maintenance- of aintenance of mechanical.. equipment. . Locations of mer -heat r, heating and cooling )equipment,' other electrical or gas equipment, and plumbing fixtures. . Garage firewall, door size, and closer (Sec. 5 3(d)(3)). - 3'0" exterior exit door (Sec. 3304(e)). -ireplace and wood stove location, alcoves, 'nd clearance. moke detectors (Sec. 1210). STRUCTURAL DETAILS Foundation plan complete enough to construct building. Floor construction details complete enough to construct building. Elevations and wall construction details complete enough to construct building. Roof construction details complete enough to construct building. �. .Fireplace construction details and calcs if necessary. MISCELLANEOUS ITEMS TO LOOK OUT FOR Stairway details: landings, rise and run, head clearance, handrails (Sec. 3306). Guardrail details (Sec. 1711 & 3306(j)). Brick or stone veneer (Chapter 30). 5/89 RESIDENTIAL PLAN CHECKING GUIDE MISCELLANEOUS ITEMS TO LOOK OUT FOR (CONY D) terior plaster'-- weep screeds (Sec. 4706). -roper roof pitch for roof covering (Chapter 32). Roof covering type - (fire hazard). Rafter ties or bearing ridge beam. 401 Garage door or porch header sizes. Adequate bracing. . iving area over garage - complete 1-hour separation required on garage side including supporting walls and posts, etc. . Two exits on three-story dwellings (Sec. 3303 & see Mezannines - 1716). is access and ventilation (Sec. 3205). . Underfloor access and ventilation (Sec. 2516)... . . Combustion air for fuel burning appliances.. . Noise requirements on duplexes. . Adobe soils --special foundation design. .q Retaining walls requiring design. . Unusual shape, size, or split level house' requiring lateral design. lashing at all exterior openings. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County,Center Drive - Oroville, California`95965 - Telephone: 916/538-7541 k APPLICATION AND PERMIT PERMIT NO. 7_2-40 A� .E.S,SO.R PARCEL NUMBER -33-65 ZONIN PR -10 - BUILDING PERMIT OWNER Richard A. & Karen C. Simmons TELEPHO E 533-7 $2 S0. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 4065 Windermere Ln. Oroville 95965 CONTRACTOR'S NAME owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER - none UNKNOWN Total Valuation is Filing Fee $ 10,00 LENDER'S MAILING ADDRESS -; Permit Fee $ ARCHITECT OR ENGINEER riOrie LICE tAIE NO. � Plan Checking Fee $ Ener Plan Checking Fee Energy g $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 3625 Charqui Ct. Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Concow Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Xf W -J Water piping /� 5.00 5000 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex ,Mobilehome❑ Other YJ@l�` p, _SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W O.00e TYPE OF WORK New,❑ Addition❑ Remodel❑ UtilitiestS f' `•Installation❑Other ❑ Describe work: elec for -,2 wells �, _ ' Permit Fee $ 15.00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the'' Business and Professions Code and my license is in full force and effect. License No. Classification J (, as the owner, Or my employees with wages as their S011e 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) j ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. OR ADONS. C ( DWELLING OCCUP.& ACC. BLDGS. 2h¢sgft NEW CONSTR. MULTI -OUTLET NON-RESID BRANCH CIRC ITS 2.50 ea /POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occu p OUTLETS OR FIXTURES 20®50t BALD 30 FIXED S. OR EX. Occup. OUTLETTSS (RESID.) EA.) 2 2 2.00 4. 00 Temporary service 10.00 Q.QQ Mobile Home Facilities 15.00 Misc. Wiring 9 15.00 pre insp. 15.00 Permit Fee $ 39.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. I ❑ 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 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 Cooling g •Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree' 'o save, int gn;ify/and keep harmless the County of Butte against all,liabilitie§, '�dgme4p, costs, and expenses which may in any wa accrue ;against aid%Oounty Ac. onsetuence of the granting of this per Ii . � � Date �U Signature of Applicant — Owner K Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 54.00, HAz CUA PARK scHL FLD PA Po Ho IssuE si ;n permit is Butte Co issued Baer sions of the Butte County Code and/or work indicated above for which fees DIRECTO OF PUBLIC BY / ' ` PEFJM T EXPIRES Date the applicable to do resolutions to do have been paid. WORKS Date Receipt No. 70615 WHITE-O.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT I/l''IlIx COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLIDATIQ=N AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 58-33-65 ZONING FR10 BUILDING PERMIT OWNER Richard A. & Karen C. Simmons TELEPHONE 533-7182 SO. FT. OCC, BUILDING VAILUATJON OWNER'S MAILING ADDRESS 4065 Windermere Ln. Oroville 95965 CONTRACTOR'S NAME owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER none UNKNOWN Total Valuation is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER none LICENSE No. Plan Checking Fee ,$' Ener Plan Checking Fee Energy g $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 3625 Charqui Ct. Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Concow Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARC/EL MAP Water piping 5.00 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other well SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00e TYPE OF WORK New❑ Addition❑ Remodel[] Utilities[] Installation❑ Other❑ Describe work: elec for 2 wells _ Permit Fee $ 15.00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 8001 OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD -L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the BuslnesS 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.& OR ADONS. \ ACC. SLOGS. , 2/2¢sgft NEW CONSTR. ULTI.OUTLET NON.RESID BRANCH CIRC ITS 2,50 ea /POWER APPARATUS &) (POWER OUTLET CIR. p OUTLETS OR FIXTURES Ex. Occup( zo. eAL030 FIXED APPLNS. OR Ex. Occup. OUTLETS IRESI D.) EA.) 2 2.00 4.00 Temporary service 10.00 LO.00 Mobile Home Facilities 15.00 Misc. 1Yirin 9 15.00 pre insp. 1 15.00 Permit Fee $ 39.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of -Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above -me Toned property for inspection purposes. I also s e, in ify and keep harmless the County of Butte against all abiliti gm , o s, and expenses which may in any way accrue ainst aid unty ' nse uence of the granting of this permi . X p9�'�� Date /U �v Signature of Applicant — Owner Contractor ❑ Agent ❑ MYl An OSHA permit is required for exc7avvations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE ALS TOTAL FEE $ 5 .00 . ,:�f HAz CUA PARK FED PA IssuE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTO OF PUBLIC BY PEP/dT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date �� .i Receipt No. 70615 WHITE-D.P.W., YELLOW-A88198OR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - ORGVL�,L'CALIFORNIA 95965 - TELEPHONE: 916/538-7541 / PERMIT AfPPLICATION DATA SHEET �^ + Permit No. _ OWNER Vl (� �I W) P71 0 ✓I S A P, o. 3 _ Proposed Building Use ty' , C_ 7 P ( Building Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED , 1. All items have been submitted . ........................ .......... 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer, of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $.... ................ 11. Chico Urban Area fees paid ................. ...................... 12. Park fees paid .................................................... 13. School District fees paid ... ........ . 14. Sanitation approval from Health Department 15. City of Chico plumbing permit .......................... ......... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. 0. Driveway permit (constructio appy va required prior to occupancy) Pre -Inspection for co�' cI Com- required Pre-Inspec. request to Building Inspector (Date) 2 . 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 ................................... 26. ` 27. When you issue the permit, -process as follows: Mail to owner. J it to contractor. Telephone and hold for pickup at o 'ice. Deliver w/inspector. Other Applicant Date Copy of Haz-Mat Torm sent Health Dept. Fire Dept. .---Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Otter Date By. The following data must be submitted prior to permit issuance: (Circ) new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by—phone---mall—coulter by ..date Contractor, designer, owner, was advised of above required data by—phone —ma ll—counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW COUNTY OF. BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUt�.tp Eg.._, (C//iOJ Vv`` 0`Y I r. `� K Qf^LdYI 0- m o ZONING TELEPH NE S33- /&9 _ BUILDING PERMIT SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADORE'S / 1 CO TRACTOR'S NAME TELEPHONE ( tl '✓- i CONTRACTOR'S MAILING ADDRESS Fireplace C OUCTION LENDER V$ UNKNOWN Total Valuation - LENDER'S MAILING ADDRESS ARCHITECT OR ENGINEER LICENSE No. Filing Fee $ 10.00 Permit Fee. Plan Checking Fee $ $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ . BUILDING ADDRESS y Permit fee $ , PLUMBING PERMIT Filing Fee 10.00 ® yL Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 0 v Each qas water heater or vent 5,00 USE OF STRUCTURE J SF❑ .Duplex❑ Mobilehome❑ Other_ l/ SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 0.00. TYPE OF WORK New ❑ Addition ❑ R model ❑ Utilitie Install tion ❑ Otlte �1' ` r Describe work: / _ 0-0-r 1 C 11 �( e / Permit Fee $ l5 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 8000 V OR LE AMP ORSLESS 10.00 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): El I am licensed under p provisions Of Cha t. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification ElFIXED I, as the owner, of 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) El I, as the owner, am exclusively contracting with licensed contract - ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and. Professions Code for this reason Main service EA. ADD'L 100 AMP 1 2.50 NEW CONST. DWELLING OCCUPM OR ADONS. ( ACC. BLOGS. , /2¢sgft NEW CONSTR. ULTI.OUT LET NON.RESID BRANCH CIRCUITS) 2.50 ea (POWER APPARATUS el SINGLE OUTLET cIR. / Ex. Occup(OUTLETS OR FIXTURES 200309 SALO 30 APPLNS. OR Ex. Occup. OUTLETS (RESIO.) EA. �/ 2.00 of Temporary service 10.00 l0 (� Mobile Home Facilities 15.00 M' c. Wiring 15.00 C& — h fs r Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ 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 FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature of Applicant — Owner ❑ . Contractor ❑ Agent ❑ I An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3/stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE AL TOTAL FEE $ HA2 cuA PARK FLD PAR Po Ho ISSUE Th;s permit is nereby issued under sions or the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date Receipt No. WHITE-O.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -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 permi.t 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 ma� 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 work. 3. I have contracted with the following person (firm) to provide the proposed construction: 0Name _ - Address _ City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supe vise, -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 Ad"i�•ess Phone Type of Work Signed: Property Owner Social Security Security Number Date NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. PRE -INSPECTION OWNER: G� Cc ►^C� J Y( DATE &-(/O /go LOCATION: ; S ho r JC 0 1 . fo Cox(WA.P. # S-8--3 C�� S CONTRACTOR: Ott me, ✓^ ZONING / k9 ----------------------------------- - - PRE -INSPECTION FOR : I�- e + f i C� �d r1 OL �,cJ c`� ! , S D rl y- re's" _DATE TO INSPECTOR ------------------ v PERMIT HISTORY: NONE AS FOLLOWS: yll TYPE OF OCCUPANCY ------------------------------------------------------------------------------------- ------------------------------------------------------------------------------------- FIELD - INFORMATION BUILDING USAGE: TENNANT: [� OCCUPIED HAS ELECTRIC Q HAS GAS Q HEATED -COOLED PERSON CONTACTED OTHER COMMENTS: ACTIONRECOMMENDED: ii�ISSUE Q HOLD FOR OTHER: HAS SANITATION -FACILITIES BY DATE / -• - - ---= ---- -70 -46 �, tntittrauon (Air.Leaka e g -120 R -value Number of stories Three R-0 -17 -8 .5 '. is 3 .2 R -value . One Two Three SAa�n 3 1 1 Prints A R-0 -103 -1.9 32 Starz trd o.C6 -6 0 .2 R-19 3 -t .2 0.02 A. 2 1 0.00 P30 .2 -1 •1 6 1 3 4. 2 3 5 1 2 d 2 3 d 0 2 3 1 3 3 0 1 Eieat:I.oss:_- 1 3 2 a 0 i 0 ---: 0.50 ...._..... _176 : _ - 6a :- :-.:-. •5¢.. ..roar._. _ :..._ _ _.. _..... U -value-........ 0.30 -102 -49 32 Percent .51 b ,41 to .31 to 0.30 or 0.10 -26 -13 -8 Glass Single Double .60 .50 .40 less 0.08 -18 •9 .5 3 . -4 50 -121 -S3 •39 -24 -10 4 US -11 2 '1 SO 30 37 26 -;4 J 8 0.02 0.02 4 4 2 1 35 -75 •29 •19 .9 1 10 i 0•� t1 5 3 30 31 -21 29 -58 -20 -13 -12 -4 -3 4 5 12 12 5.50 5 5 4 28 •55 -18 •10 •2 5 13 -1 .1 13 Stm of 7-10 27 -52 -17 -9 -2 6 13 2, Wall Itlsulation 1S% 20% 26 se i< 7 0 7to S0% SS% Single- Single- rM% 2 V% 100Y. I05Y. Itt7X 115"7.....120X.125: Family Family Multi- 24 -43 -12 s0 23 Z3 - -t1 1 •5 -t 1 2 8 8 14 15 R-slue Detached ch Attached Family - J 3 9 15 R-0 -68 -51 34 21 34 -7 .2 4 10 15 R-11 0 0 0 20 31 3 0 5 10 16 R-13 2 2 1 19 -29 -4 1 6 11 16 R-19 8 6 4 18 -26 3 62 2 7 12 16 U -value 3 -'0.5' '--•6 J "'-- =1 - -1� 17 23 3 8 12 1 ' y 10!: __a1 a2" 0.4-'-x6' 16 -20 0 4 9 13 17 0.80 -153 -114 -76 15 -17 1 6 10 14 17 0.50 -91 -68 -46 14 -14 3 7 10 14 18 0.30 •47 36 -24 13 -12 4 8 11 15 18 0.10 0 0 0 12 -9 6 9 12 15 19 0.08 4 3 2 11 3 7 10 13 16 19 0.06 9 7 5 10 3 9 11 14 17 19 0.04 14 11 7 9 •1 10. 13 15 17 20 0.02 19 14 10 8 2 12 14 16- 18 20 0.00 24 18 12 Z6 Z/ 3 3.2 1S 17 19 4.1 4.3 4.5 4-1 4.9 S.1 3. Raised Floor Insulation U -value 0.60. Insulation in Floor -70 -46 Number of stories -120 R -value One Two Three R-0 -17 -8 .5 '. R-11 3 .2 •1 R-19 0 0 0 R -a0 3 1 1 U -value 0.60. -144 -70 -46 0.50 -120 -58 38 0.40 -95 -A8 30 0.30 -69 .34 •22 0.20 -L3 -21 -14 0.10 -17 A -5 0.08 Al -6 -4 o.C6 -6 -3 .2 0.04 -1 0 0 0.02 A. 2 1 0.00 10 . 5 3 Controlled Ventilation Crawlspace •4. Slab Edge Insulation - 1 Number of stories -- Number of Stories R -value one Two Three R-0 -11 -7 -5 R-5 -4. -d 3 R-11 _2' -2 -2 R-19 -1 -2 .2 •4. Slab Edge Insulation - 1 4 -- Number of Stories na R -value One Two Three ' R-0 0 0 0 R-5 8 5 2 R-7 8 6 . 3 F2 facbr 2 na 0.90 -t -3 -1 0.80 .1 •1 0 0.70 2 2 1 0.60 6 4 2 0.50 9 6 3 0.40 12 8 4 7.•Shading (Shade Open) --Etrectfve Percent Clam - • .. (percent glr�sa x SC) Effective o Glass North East South :West Skylight 18 S. - - 1 4 1 na 16 - 4 2 5 1 na 14 4 2 5 1 na 12 3 3 5 2 na 11 3 3 5 2 na 10 2 3 5 2 1 9 2 3 5 2 2 -10 3 5: 2 2 7 1 3 4 2 2 6 1 3 4. 2 3 5 1 2 d 2 3 d 0 2 3 1 3 3 0 1 2 1 3 2 a 0 i 0 3 1 •i -i •1 .1 2 0 •1 .2 -t 2 0 na - not allowed -38 5 •2 9 & Shading (Shade Closed) Single- Single. 12. Cooling System Wall FYreelve Pes cant"Gtasa Family I. N Masa (percent glass x SC) Attached EI1'ectiv� 0.00 0 0. 0 0.20 %Gisu Nom East Sarth west Skylight 18 -14 -18 -69 _U rta 16 .12 -12 -59 -55 na 14 -10 •35 -50 -16 na " 12 d -29 -to •37 na 11 •7 •26 36 •33 na 10 3 -23 31 -29 -74 9 •5 -20 -27 .25 .65 8 -5 •17 -23 21 •56 7 -t •14 -19 -18 -47 6 .3 it -15 •I4 -38 5 •2 9 •11 -10 -30 4 •1 o J -7 .23 3 0 .4 -5 -1 -16 2 1 t 2 -1 -9 1 1 1 1 1 -1 0 2' 3 4 3 0 9. Interior Thermal Mass 8.0 5 Single- Single. 12. Cooling System Wall Family Family I. N Masa Detached Attached Family 0.00 0 0. 0 0.20 3 2 Interior MasslCFA 0.40 5 4 .3 0.60 8 6 4 interior 10 Stab Floor 5 Raised Fbor 13 10 7 1.20 13 12 8 1.40: 12 13 9 1.60 10 13 11 . . 1.80 10 12 12 2.00 10 11 13 t 17 15 13 11 9 7 0.95 8.71 Mass 18 Stories 13 it Stories 3 = SEER SE or HSPF u.��vnc•..n 2 2 (SE or HSPF x duct elnciene7) Effective -25 or -24 to -141a -4 to +6 b 16 or SE HSPF less -15 -5 +5 +15 more 0.30 2.75 -73 -64 -56 -t7 a -30 na 3.41 -45 -39 -34 1CFA One Two Three one Two Three -30 (-s ,tnetducts Inlittle)tom..-° -22 -18 •'�' 0.50 4.58 -10 -9 -8 -7 -5 -t t-rrrt t WS tutrC t 4.2. set e: sed ,t_bl 0 0 0 0.60 5.50 5 5 4 0.0 -8 -5 .4 •2 -1 .1 13 Stm of 7-10 9 7 0.80 0% 5% 10% 1S% 20% 25% 33% 1S% 40% 4S% S0% SS% W% 65x rM% 7S% V% as% 0Q% 9SX 100Y. I05Y. Itt7X 115"7.....120X.125: 24 19 15- Unit Size (SQ Water 699 700 1200 1700 2200 Heater Credit or b to b or Type Type 666 1199 1690 2199 more SG . .-0:3_7.._-..4 ._...,2_._.,0..,._.._1_-L._ 0 0 0 0 or Solar ' 14 7 5 0.6..0.6 3 1.1.._x1-•15;:-1.T:.]2_i!_.1d::1.b.:':t-.<.2=TI�1:6--1.8.-S-:St( HWR 9 5 3 2 2 WS8 9 4 3 -'0.5' '--•6 J "'-- =1 - -1� 1 ' 2 _....SEER-.{acv---.`•15:.135mara.: �- 5 3 .:..-•-7/._-0__.02-O.t. 10!: __a1 a2" 0.4-'-x6' -45 0.6__1 ' _ 1.2:_ 1.4 _ 1.6 ..•1.9 _. 21:._.21". 1 25....27.._ a 29.. 11..: 13... IS-.. 17 • 4_... 4.2 - 4,4:- t.b•- t 6 "--S-- •25 S 2-' S't J -5 --2 _ --:-.__ 8.0 ___ . - •�-•--__._.... td 12 •10 8 _8 -d --- IG 0.d 0.6 1' 1.2 1.! 1.6 1.6 2 Z2 Z4 Zy Z9 ].1 11 SS Il 19 t.l 4.7 t.S t.6 S 52 5.4 56 0.9 5 1 0 2 3 3 85 J 3 M% a5 al 0.9 1.1 1.4 1.6 1.6 2 22 26 Z6 Z/ 3 3.2 1S 17 19 4.1 4.3 4.5 4-1 4.9 S.1 5.3 56 5 6 1.1 -4 .i 1 3 4 4 _ •9 -7 .5• -d 40% aT a9 1.1 1.3 1.S 1.7 1.9 Z2 Zt Z6 L6 3 12 3.4 16 16 4 4.3 4.5 4.7 4.9 it 5.1 5.5 51 59 1.3 0 2 3 d 5 8.9 .5 1 .4 J -2 •2 S0% 09 1.1 1.3 15 1.7 1.9 L1 Z3 IS L7 3 12 14 16 16 4 42 4.4 4.6 4.8 5.1 S3 5.5 5.7 5.9 6.1 .3 9.0 t 3 J -2 .2 •1 1.5 -3 1 2 4 5 5 9.5 0 a 0 0 0 0 SS% 0.9 1.1 1,4 1.6 1.8 2 22 14 Z6 Z6 1 12 IS 3.7 19 4.1 U 4.3 4.T.4.9 S.I S.3 5.6 56 6 62 2.0 -1 2 d 5 6 7 10.0 d 3 3 2 2 1 60% 1 1.2 1.4 1.1 1.9 Lt Z3 15 LI Z9 11 13 1S 16 4 4.2 4.4 4.6 4.6 S 52 S.4 56 5.9 6.1 63 25 0 3 5 5 7 7 8 10.5 7 6 5 d 7 3 2 65% 1.1 1.3 1.S 1.7. 1.9 22 Z4 23 26 3 12 14 36 16 4 4.3 t.S 4.7 4.9 5.1 53 55 5.7 5.9 6.1 64 3.0 1 4 8 8 9 9 11.0 9 7 6 4 3 IM 1.2 1.6 1.6 1.8 2 22 25 21 29 11 13 15 11 19 4.1 4.3 4.5 4.8 5 52 5.4 S6 58 6 62 64 3.5 2 5 5 7 9 9 9 12.0 11 9 7 5 7S% 13 15 1.1 1.9 21 Z3 25 Zt 3 12 14 16 16 4 4.2 4.4 4.6 4.6 5.1 5.3 S3 i7 i96.1 6.3 6S 4.0 3 8 9 10 - 13.0 15 13 n 17 14 12 9 6 eat. 1.4 1.6 1.6 2 Z2 24 '23 26 3 11 15 17 19 4.1 4.3 4.5 4.7 4.9 5.1 54 56 5.8 6 62 64 66 4,5 3 7 8 10 11 11 - - - 651r. 1.4 1.7 1.9 2.1 23 25 V 29 11 3.3 3.3 16 4 42 4.4 4.6 4.6 5 52 54 5.6 59 6.1 61 6 5 6 7 5.0 4 7 9 11 12 12 ERealreSEER WY.' 1.5 1.7 2 Z2 24 26 26 3 3.2 14 15 St 11 4.3 4.5 4.7 4.9 5.1 53 55 5.7 S.9 62 64 66 66 5.5 5 8 9 it 12 12 (SEER xduet cfflelenc7) 95 Y. 1.6 1.6 2 Z2 25 2.7 29 11 33 1S 17 19 11 4.3 4.5 4.6 5 5.2 5.4 5.6 5.6 6 6.2 6.4 67 69 6.0 5 8 . 10 12 13 13 Way. 1.7 1S It Z3 2.5 Z8 3 12. 3.4 16 16 t Al t.4 4.6 4.9 it S.3 53 5.7 5.9 41 43 6.5 6.1 7 6.5 6 9 10 12 13 13 Smt of 7-10 105% 1.6 2 22 2.4 26 2.8 3 13 3S 17 19 4.1 4.3 4.5 4.7 4.9 S.t 5.4 Se S.6 6 62 6.4 66 7 7.0 6 9 11 13 13 14 Effective -25 or -24 to -14 b -4 b +6b 16 or 1107: 1.9 It Z3 IS 27 29 11- 13 3.6 3.6 4 4.2 4.4 4.5 4.8 S 5.2 5.4 5.7 5.9 61 6.3 6 S 6.7 6 6 69 7.1 7.5 6 10 11 13 1d 14 SEER gess 15 S +S +15 more 11S% 2 Z2 Z4 2.5 Z6 3 3.2 14 3.6 3.8 4.1 4.3 4.5 4.7 4.9 5.1 S.3 5.5 5.1 5.9 6.2 6.4 6.6 6.6 7• 72 8.0 7 10 11 13 14 14 12074 2 Z] ZS 2.7 29 1.1 ].1 15 17 3.9 4.1 t.t 4.6 4.6 5 5.2 5.4 5.6 so 6 6.2 &S 6.7 6.9 7.1 73 8.5 7 10 12 13 . 14 15 5.0 30 •25 -21 -17 -13 -9 125Y. 2.1 23 2-5 16 3 3.2 14 14 16 4 41 4.4 4.6 4.9 5.1 5.3 S3 5.7 5.9 6.1 6.3 6.5 6.7 7 7.2 7.4 6.0 -12 -11 -9 -7 3 -4 Point System Summary: Climate Zone 11 6.6 o 0 0 o a 0 0 I 10. Exterior Wall Thermal Mass Exterior Single- Single. Sum of 13 Wall Family Family I. N Masa Detached 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 1.20 13 12 8 1.40: 12 13 9 1.60 10 13 11 . . 1.80 10 12 12 2.00 10 11 13 t 11. Heating System SE or RSPF (assumes ducts In attic) Zonal Control Adjustment System Type Resismnce 10 9 7 6 4 3 Other 6 5 4 3 2 2 9.0 10.0 9 16 22 8 14 19 Sum of 13 9 13 3 7 5 10 7 SCORE CARD 11.0 26 _ -25 or -24 to •14 to .4 to +6 b 16 or SE HSPF less -15 -5 +5 +15 more 0.72 6.60 0 0 0 0 0 0 0.75 • lim 3 3 3 2 2 1 0.80 7.33 8, 7 6 5 4 3 0.85 7.79 13 11 10 8 7 5 0.90 8.25 17 15 13 11 9 7 0.95 8.71 20 18 15 13 it 8 3 = Efrective SE or HSPF 3 2 2 (SE or HSPF x duct elnciene7) Effective -25 or -24 to -141a -4 to +6 b 16 or SE HSPF less -15 -5 +5 +15 more 0.30 2.75 -73 -64 -56 -t7 a -30 na 3.41 -45 -39 -34 -29 -24 -18 0.40 3.67 -34 -30 -26 -22 -18 -14 0.50 4.58 -10 -9 -8 -7 -5 -t 0.56 5.13 0 0 0 0 0 0 0.60 5.50 5 5 4 3 3 2 0.70 6.42 17 t5 13 11 9 7 0.80 7.33 25 22 19 i6 13 10 0.90 8.25 32 28 24 20 17 13 1.00 9.17 37 32 28 24 19 15- Zonal Control Adjustment System Type Resismnce 10 9 7 6 4 3 Other 6 5 4 3 2 2 9.0 10.0 9 16 22 8 14 19 6 12 16 9 13 3 7 5 10 7 SCORE CARD 11.0 26 23 19 15 12 8 Measures - Point Scores 12.0 13.0 'M 33 26 29 22 24 18 20 14 9 15 10 1. Ceiling Insulation or O Zonal Control adjustment 10 8 7 6 4 3 No Coaling System Installed -Stories % G SC Eff. °'o Glass Type (double) U -value 10.651 One •5 -1 -t 3 .2 -2 Two + 3 3 2 2 2 1 • Single -Family i Detached and _ . Attached c. South. x =%(, Unit Size (so d. West Water = ;139 1200 1700 2200 2700 Heater t;redd . or b to to. or Type. Type less ,1699 2199 2699 more SG None 0 0 0 0 0 or Solar 12 8 6 5 4 HP HWR 8 5 4 3 3 = Wsa 5 3 3 2 2 13. Water Heating POU 8. 5 4 3 3 SE None 37 -24 -18 -15 -12 Solar -1 •1 •1 0 0 HWR •18 •12 -9 -7 -6 WS8 -25 -16 -12 •10' a P0U_ -18 - •12 -9 •7 -6 IG None -5 -3 .2 -2 •2 Solar 7 5 4 3 2 POU 3 2 1 1 1 IE None -28 -19 14 -11 -9 Solar 8 5 4 3 3 POU -t0 -6 -5 s .3 Multi-Famlly (individual units) Unit Size (SQ Water 699 700 1200 1700 2200 Heater Credit or b to b or Type Type 666 1199 1690 2199 more SG None 0 0 0 0 0 or Solar ' 14 7 5 d 3 HP HWR 9 5 3 2 2 WS8 9 4 3 2 2 POU 9 5 3 2 2 SE None -45 -23 -15 •11 •9 Solar . 2 1 1 a 0 HWR -23 -12 -8 -6 -5 Wsa •25 -13 -8 J -5 EQU 23 _12.. _8 b •5 IG None -6 .4 3 .2 -2 Sciar 6 3 2 1 1 POU 1 0 - 0 a 0 IE None 30 _ 15 t0 a -6 Solar 18 9 6 4 4 POU . -8 ..4 -3 •2 -2 . R -value 1381 U -value [0.0301 2. Wall Insulation _ or R -value [111 U•valuo (0.0981 3. Raised Floor Insulation or R -value (191 U -value (0.17371 4. `Slab Edge Insulation or R -value (01 F2 factor (0.771 5. Infiltration Standard 6. Glass Heat Loss % G SC Eff. °'o Glass Type (double) U -value 10.651 90 Total Glass (161 7. Shading (Shade Open) • 1F/ b. East ---�z A, It x % Glass SC. Eff. % Glass a. North x �.). _ �• a3 b. East x x p�5 c. South. x =%(, x d. West x = .9a e. Skylight x = Q 8. Shading (Shade Closed) COND. FLOOR AREA 0 Sum 13 a q. Sum 7-10 '1'0 . PnrntTnlrll' % G SC Eff. °'o Glass a. North x • 1F/ b. East ---�z A, It x = .$k c. South 5• y x - d. West x = ---/ e. Skylight x = --- d 9. Interior Thermal Mass TYPE 1. MASS AREA _ 9 InteriOrNlsa/CFA COND. FLOOR AREA 10. Exterior Wall Mass TYPE 2 MASS AREA 9 r Exterior WaLL Mass N0. : L OR AREA 11. Heating System x = Zonal Control? ( Y / N) , SE or HSPF Duct Fificienry (0.781 Effective SE or [0.7716.61. ; . HSPF (0.5615. 151 12. Cooling System x = _ Zonal Control? ( Y / N) SEER [9-511 Due Efficiency (0.741 Effective SEER (7.031 13. Water Heating Type [SGl .....''-`_7. Credit (aonel:. 0 Sum 13 a q. Sum 7-10 '1'0 . PnrntTnlrll' _..... Climate Zone II V --Certificate of Compliance: Residential � _ - � � . - / Mandatory Measures Checklist: Residential MF -IR - Prof eet Tlua _ _ �SP� . ( be � these moan �i� ra o°mplo .raed . NOTE: Lownse residential buildings subject to the Standards Building Permit ti �. awfia = c Com plmiar+o��W1+ut tJti: checklist u ey�red into Ne permK docurt+atu, the (Duna Dora! Y+aLL -...... - _. . mss., . _....... •---�— —pro teL Addrva .._....:j.�•- - -• - ...:-..._. .. _.. .:".:" ._.. ... ._ �j---—•�•-=' - _ -- - - .. - � _..--- ..... .. . - .. tne7• by �terr>1w.+�dx+Aba�eintlfeeo�a+amia ehe�lisrontlr .. _..... ... ....._. _.._..__ ._ ._ ... .. .. -. _ ... .. ._. - _... _ Pons+ spec ,cations or mevara Checked By I Date . Jt� Teltphon� DESCRJPRON Documentatloa Author Enforcement Agency Use Only - DFStGrFJt F?rFaRCt7aFX17- Building FnvOtape Measures ' BUILDING DATA Glass Area °b Glass • 42.5352(3}- Minimum ceslinginsulation R-19wesglntedaverage North - f� / 42.3352ft Losse fill inwratiat manufactwv's labeled R-Vahw- S Conditioned. Floor Area / Number of Stories East �• , l `1 • 42.5352(c): Minimum .gall insubtion in (nmcd rafts R-1 t weighted average (docs not apply two _ .. Sia s """°r""a n'oor Number of .Units �_ South U S- W / . a 12-5352(k): Stab edge insulation - waterwaterabsorption rate no gr�we tet U 03 %. crier vapor , it Detached (SFD) [ ] Addition. Alone 'nny'ss'°n rate no scoter than 2A perW=h_ " Y est " Skylight 42.5311: trssuotn lation spftcd or installed meets California Commission (CSCE qualnry [ ] Single Family Attached (SFA) [ ] Existing BuildingO [ ] Existing -Plus -Addition Total _ e/. 9 a'^�� I"dKatc type and tuna [ ] Multi -Family lT'¢7 g- 42.3352(rk Vapor barriers mandatory in Climate zona la and 16 only. 42.5317: InaltratiavEaGlc•ation Controls B LTII. D Ii`i G SELL INSULATION' a. Doors and windows between conditioned and unconditioned spaces desiped to limit air leakage. b. Doors and windows unified Loeaioalco .nts _ . -. c Doors arta windows wUxrsaipped: au joints and pawls forts caulked and soled Component InsuiadOn Type R -Value (artie, to g=g4 =i --CL etr-) 42.5352(.)•• Special infiltration barrier installed tocomplr with 42.5351 nw.UCEC quality standards _. . _.... .. __ ...._ _,,:...... - 12-5352(d):Irtstalbtionof Ftrtx eptas . Wall .............. 1. Masonry and factory -built ftreplaecs Lave .. Wall ......:....... ==1 ant ratting. loseable metal o glass door Roof ...:......... b. aide air intake with damper and coneol e Flue dumper and control ............. 2. No tontwos brining Bas pilots allowed. .. . . -� Floor. HVAC and PtumbintSystem Measures. Fi00 r.. - S2(g) and . Space coed, tons l 42-53 2-3303 boning rgtripmau sizing: ateaeh r . h.l. ' i _• :..•. : __r- .-, .._ 42-5352(h) and 2-5315: etback U+amouaGt afi apoiobte Mating sysems.SlabEdge....,.- --. _ 42-5316(a): Ducts constructed. insalkA and insulated per Chapter 10. 1976 UMC . GLAZIitG. ShadingI7eviees 42.3316ft Exhaust systems have dampa.controls. - .... -;• -._ �o_i=r ..__. -_ i 42.5314(c): Gasfvedspace hetingcqu;pmenthas intersnitteneignitsondcvieet Glaz;n Area Glass Interior Exterior Overhang Framtn - :: ^: $ $ g Type J2.5314, HVAC equipmem water heaters, showerheads and muerte certified by Use CFC- 06entadon (Sf) (sing double) ( OUez blind. etc.) (shadescreen, etc.) (ye3/110) (metal/wood) 42.5352(ir. Water hecto insulation blank. (R• I2 tx greater) «combined interiorkateriet .- --- -- - •- =". insulation (R-16 or gstaterr fust 5 feet or pipes closest to tank irmdated (R-3 or grocer). NO [th \ ).. 42.5312(F�teeption q: Pipe insulation onstrarn and steam condensate resura dt rtazcculating . ,.. piping. N40nh ( ) 2r5 1Bd 5 1H - -. .. l East ( ) / r �/ 4 1. System has: ins P eating East ( ) a. om/orf switch on heater.. {..., plate on Souch 2 73 p� Plumbed solar. ( ) _ _.. 3. Pool cove. heater. r. _ West ( ) /r ,� a. Timetlock - - 5. Directional water inlet. • Weft ( ) Uthtingand ApplianceMeasures- Skyli ght....... r/ .. - — 42•5332()x Lighting • 25 lumeu/wut a greeter (err general lighting in kitchens and bathrooms. , THERMAL MASS 42.5314(c): Gas fired appliances equipped with intermittent ignition devices.- Type/Coverirg Area Thickness 42.5314(ay Rcfrigcrators. refrigcrau r•frt=crs. freaers and ntwreaceat lamp ballasts certified (slab/exvosed, tile, etc.) (Sf) (inches) LOCadOn/DCSCnby the CEC Indicate make and model number. pCIOn(kitchen, bath, ere.) - -�----••-- - ' t, COMPLIANCE STATEMENT This certificate of compliance lists the building features and performance Specifications needed to comply with Title 24, Chapter 2-53 and Title 20, Chaptcr 2, Subchapter 4, Article I of the Califomia Administrative code. This certificate has been signed by stye individual with ovaall design respctuibiliry and the building owner. who shall HVAC SYSTEMS Minimum Duct rttain a copy of it and transmit the certificate to my subsequcm purdiaser of the building. Type (furnace, air Efficiency Locadon Duct Output Manufacturer / Model # conditioner, heat urn) (SE. SEER.HSPF) (attic, etc.) R -Value tuh Designer :-:.. Building Owner ' pump) (B ) Cor approved 4 .... _ .. ._ ...._. . roved equal) Name nie Nan Dlle, ! Tuk/Fusn Mdc/F•trm: Address: TckpSonc Tc Maximum Furnace Heating Output: Btuh- J= HOT WATER SYSTEMS Q�Q Tank Manufacturer/Model # (�\1v (�` �'� r f' 'System Type (story a as, etc.) Ca aeit or ao roved a ual - v�`� cial Fea �© e3i�,a�tre) (dere) �(Iicnat�> : _ (date) Documentation Author Enforcement Agency • Name - . Narsx: SPECIAL FEATURES/REMARKS (Add extra sheets if necessary) !::. Aeerxy: ' ,ter--..• -., � � _