HomeMy WebLinkAbout059-085-010�
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(COUNTER 7
1 �160 manzanita, Stirling City
COUNTER, H. D. 5317B* 489Permit# 4250-74B(carport)
473, 5
,vow ocz"'Vet 1
4ND 608 Manzanita St., Stirling,City
(repairs) �*New siding & change windows)
45.59-085-10
BICKMORE,.Gregory 41 0 91
17160 Manzanita, Stirling C t'-
-��traiiel trailer utilities--- ,replace & add
GAS
COMPACTION TEST RE S-77 j
SUPPORT STRUCT REQ _
BICKMORE, Gregory
'17160 Manzanita Ave, Stirling City
Misc wiring/travel trailer p
1 7160
= 9_0 _
059-08- -010 92-3/65 BFF
ICKMORE, Gregory
17160 Manzanita, Stirling :Lty
contr: John Wing
new sf
BICKMORE, Gregory
'17160 Manzanita, Stirling City
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- V COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 9,2 _ /)
APPLICATION AND 4DERMItT �✓
ASSESSOR PARCEL NUMBER
059-085-010
ZONING
U
BUILDING PERMIT
OWNER
Gre or Lee Bickmore
TELEPHONE
873-1696
S'Q T. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
P.O. Box 98 StirlingCit 95978
240 5.00 1 200.00
CONTRACTOR'S NAME
John Win Construction
TELEPHONE
873-0375
CONTRACTOR'S M (LING ADDRESS
P.O. Box 673 Paradise 95969
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $ 1,200.00
LENDER'S MAILING ADDRESS
ARCHITECT OR ENGINEER LICENSE NO.
Filing Fee $ 15.00
Permit Fee $ 25.50
an Checking Fee $ 20.00
`energy
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Plan Checking Fee $
Penalty $
BUILDING ADDRESS '
Permit fee $ 60.50
PLUMBING PERMIT Filing Fee 15.00
Each Trap 5.00
UV Ir I Adr
Solar or heat pump water heater 20.00
LOT NO.
SUBDIVISION NAME
PARCEL
Water piping 7.00
Each qas water heater or vent 7.00
USE OF STRUCTURE
SF [I Duplex❑ Mobilehome❑ Other Ga aBuilding
SP cl Fr
Gas piping system 1-- 5 outlets 5.00
sewer 15.00
Mobile Home S G W @ 15.00
TYPE OF WORK
New ❑ Addition ElRemodel E]Utilities ❑ Installation[ -Other
Describe work: - Convert Carport to Garage
RE: B.P. #4250-74
Permit Fee $
Contractor
ELECTRICAL PERMIT Filing Fee 15.00
Main service 200AORLESS 18.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. 5^J i 7(t.
� 7 Classification
I, as the owner, or my employees with wages as their SOIe COmpen-
sation, will do the work,and the structure Is not intended or offered
for sale. (Sec. 7044)
El 1,
I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ 1 am exempt under Sec. , Business and Professions Code
for this reason
Main service 200A TO 1000A) 37.50
NEW CONST. /DWELLING OCCUP.S\ 3.64 sq.f[.
OR ADDNS. 1 ACC. BLOGS. II
NEW CONSTR.U TI -OUTLET
NON-RESID BRANCH CIRCUITS @ 5.00
(POWER APPARATUS eI
(SINGLE OUTLET CIR.
Ex. Occu / 20 76
p\OUTLETS OR FIXTURES
EX. OCCUp. FIXED APPLNS. OR OUTLETS (RESID.) EA.F 3.00
Temporary service 15.00
Home Facilities 15.00
Misc. Wiring -15.00
Permit Fee $
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
dof Consent to Self -Insure.
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 15.00
Heating
Cooling
Hood 6.50
Ventilation
Permit Fee $
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against sa'd ounty in con se ence of the granting of this permit.
X ate IW—-!q�--
$ignatu a of Applicant owner ❑ Contractor Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee S
Energy Inspection Fee $
OCC
CONST TYPE
TOTAL FEE $ 60.50
HAZOFEES
IMP
I FLOOD
I CDF
PARCEL
I PD
HD
ISSUE
This permit is hereby 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 No. 129844
WNITC-D.P.W., rELLOW-A38[350R, PINK -INSPECTOR. GOLDENROD -APPLICANT
v Y ,t • r Y .r:.lt.. • � �� , .'� ..���;_ K, ,',,-.tit.�,ti� ,,,7'1-.!�`'I�-.-���v� �''.'r, �� .. � �,� Y*�r-�-"�. of^•..�........,r:-a: r._•
COUNTYOF BUTTE - DEPARTMENTOF DEVELOjP_yI kKTSERVICES -BUILDING DIVISION
7 COUNTYCENTER DRIVE - OROVILLE, CALIFORNIA95965 -TELEPHONE (916) 538-7541
PERMIT APPLICATION DATA SHEET
OWNER 6Rcc-oRv 8A. P. No.-S;q -01�s - Z5 /Q
Proposed Building Use a Building Inspector Date /� Z _11e -S Z
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED BY
1. All items have been submitted . ........................................
2. Plot plans, 3/4 se signed by preparer of plans . ..........................
3_ Complete plans�� sets, signed by preparer of plans. .
.4. Engineered pla and calcs, 3/4 sets, with wet signature on plans . .............
5. Hazardous Material Form. ......................................... .
6. Energy Design Compliance and supporting documentation . ..................
7. Statement of Intent for Non -Heated and A/C Buildings . ..................
8. Engineered truss details and layout in duplicate (required prior to plan check). ....
9. Mobilehome data and manufacturer's installation instructions, 2 sets. ...........
10. Fees of $.........................................
11. Impact fees as shown on attached schedule. ............................. .
12. California Department of Forestry plan approval/fees. ....................... .
13. Flood elevation letter (100 year flood) by California Engineer . ................. .
14. Sanitation and plot plan approval Health Department . ............
15. City of Chico plumbing permit . .........................................
16. Plot plan and business license approval from City of Biggs/Gridley. .............
17. Planning approval for (A) Use: (B) Parking: . ........
18. Contact Land Developmental (A) Improvements (B) Drainage. .......... .
19. Driveway permit (construction approval required prior to occupancy). .. . .
20. Pre -inspection for I..,Insp.cfi. `�q° t
required. . . to Building Inspector (Date)
21. Contractor's license information. (No., Name Style, Classification) . ..............
22. Certificate of Workmans Compensation Insurance . ..........................
23. Owner -Builder Verification (Given to owner , Mail to owner _ ) ............
24. Recorded copy of Agricultural Acknowledgement Statement . ..................
25. Letter of signature authorization . ....................................... .
26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... .
27. Letter of intent on building use . ........................................ .
28. Mobilehome utility clearance . ......................................... .
29. Documentation of legal access . ..................... :.............
.... .
30. Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning area and frontage requirements . ...............
31. Existing violations/expired permits . ......................................
32. Plan check list . .....................................................
33.
.34.
When you issue the permit, process as follows: Mail to owner. Mail to contractor.
L_,�/Telephone8736 37< and hold for pickup at office. Deliver with inspector.
Other
Parcel Creation
Acreage Applicant Date�-
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submitted prior to permit issuance: (Circle new item not checked above).
1. Index permit for above items No.
2. Additional items required:
Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date
Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date
Plans checked by Date Plans approved by Date
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Works 'Y Z,4 0 �7�-
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - OroviIIe, California 95,965 -, T$lephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
— /0
G J
ZONIN'V
BUILDING PERMIT
OWNER6.6,,,
LEPHONE
7316
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
Am CIA S77 GING Ci �'i5
CON
�
ELEPlnnJHON—/E
7 S_
CONTRACTOR'S MAILING ADDRESS
to
b &n_
6 23 m
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
ARCHITECT OR ENGINEER LICENSE No.
Filing Fee
$ 15,00
Permit Fee`
Plan Checking Fee
$ ZS7Sfl
$ ZOOC)
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee
$
Penalty
$
BUILDING ADDRESS 11-/ V C^ ^Aj�
Permit fee
���� Crff�i. S� �J
l�
PLUMBING PERMIT
Filing Fee 15.00
Each Trap
5.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME PARCEL MAP
Water piping
7.00
Each gas water heater or vent
7.00
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome❑ Other G,,y1-1i-(r
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home S G W I
@ 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other
Describe work: C0A)1/EZF, CA PU r��P�9�lC
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service R LESS
200A OR LESS
18.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ i am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License No. Classification
1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ 1 am exempt under Sec. , Business and Professions Code
for this reason
Main service 200A TO 1000A1
37.50
NEW CONST. / DWELLING OCCUP.81
OR ADDNS. l ACC. BLDGS. //
3.64 sq.ft.
NEWCONSTR. ULT' -OUTLET
NON .RESID BRANCH CIRC ITS
@ 5.00
POWER APPARATUS e
(SINGLE OUTLET CIR.
Ex. Occup(.UTLETS OR FIXTURES
20 76d
A
FIXED APPLNS. OR
Ex. Occup. OUTLETS (RESI0.) EA.)
I 3.00
Temporary service
1 15.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 15.00
Heating
Cooling
Hood
6.50
Ventilation
Permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrueNAz
against said County in consequence of the granting of this permit.
Mobile Home Installation Fee S
Energy Inspection Fee $
occ
CONST TYPE
TOTAL FEE $ ,S
DFEES I
IMP
I FLOOD
I CDF
PARCEL
PD HD
sSUE
1 A
Signature of Applicant — Owner ❑ Contractor
An OSHA permit is required for excavations over 5'0"
ion of structures over 3 stories in height.
Date
❑ Agent ❑
deep and demolition or construct -
Receipt No.
Il
WHITE -O. .W.. YELLOW-ASD(390R, PINK -INSPECTOR, GOLDENROD -APPLICANT
I his permit is hereby 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
RESIDENTIAL 013, 1 c"i
92-3765 BPF -14
059-08-5-010
BICKMORE, Stirling.CitY
17160 Manzanita,
contr : John Wing,,
new Sf- �- 2, �
9z - �� Gs—
i
OFFICE COPY
Address 1 % 16 6 ani G""
1
GAS
Meter By Date
ELECTRIC
Meter By Date �-2-
p C' .441 -clecl
JOB FINALED (Date)
Signature
d=OK
O = Not OK
= Not Applicable
Not Ready RESIDENTIAL (Single
=
Date UNDERFLOOR (Plans) OK except h's Date
1. Zoning -Setbacks -Easements -Flood -Slope
2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth t ---'
3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth
5. Stemwalls, Main; Steel-Blockouts-Wrapped
6. Stemwalls, Garage; Steel-Blockouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab; Steel -Wrapped
6. Piers -Fireplace Ftg.-Steel
9. O.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test
11. Water Pipe; Test -Anchor -Regulator -Service Test
12. Electric; Underground
13. Pienums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
15. Access & Ventilation
16. Insulation
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date PLUMBING (Permit) OK except ft's
Vent -Access -Combustion Air -Baffle
-------- - - -- --------------------------
Water Pipe; Test & Anchor -Nail Protection
lfi. bG.V.: Test -Fittings & Anchor -Nail Protection
--------��------------- — --------------------
hoover Pan; Test. First Floor -Tub Access
.29 -Test Tub & Shower. Second Floor -Tub Access
2A-Gesf3ipe'-•Size & Anc s
------- --- - �Date
----------DateZ- �-Qard 6-1 Card B -1 ----------------------------------------
Date CB-1Date Card B-1
Date ELECTRICAL (Permit) O 'except h's
ix ur_e_&Transformer Clearance -Ins. Protection
-------------- - -----------------------------
Elec. Receptacles Spacing -Lights & Switches at Doors
------------------ -----------------------------------------------------
_ ze Boxes &
No. of Conductors_Stapled -
----------
ippliance
mex Installed Close to Edge of Studs & C.J.
-------- -- -----------------------
26 u' -Ground made 'up wlMech. Fastners-Bond Gas &Water
--;,rGrandmdeuw/Meh.Fa------------------------
Circuts in Kitchen & Conductor Size!GFI
------------------------------------'-------------------------
---Qt"5ubfeed Wire Sizer r ga. Cu or AI-A.C. Wire Size ! ! ga.
Cu or -Al
------------- ----------------------------------- ------
�L _29> Range Circ. ! r ga. Cu or AI -Oven Circ. / / ga. Cu or Al.
Insulated Neutral ❑ Yes ❑ No
0. ervice-Riser Conductors & Ground -Main Disconnect .
-- --- ----- - ------ ---- ---------------------------------------------- -
;-3r. Equip. Clearances Panels-Motors-Mech. Equip.
'-32. Clothes Closet Light -Shower Light -Spa Light
3 e Detector
------------- - - - - -- ---- ---
---------- - -------1 ----- -- - Date
------- ------- ---
Date 2 - ! Card B-1 Date Card -B-1
Date Card B-1 Date Card B-1
Date MECHANICAL (Permit) Ok except h's
C. Ducts Insulation & Support
-------------- --------------- - ----------------------------------- ---- ----------
-----------`--9SVent Fan: -- -above- above -- insulation
----------------------------------------------- -- -----------
ontlensate Drain & Overflow: Size & Grade
------- ---------------------------------- -- -- -
3 Furnance:Vent: omb. Air -Return Air Vent -115 outlet
--- ------------------------------------ -
38 Attic Access & latforrr' Furnance in Attic
Dated Card B-1 Date Card B-1
t -------------- ---------------------- --------------
- - -- - -- - - -- - -- ---- --- ---- -
- - - - -- - ------
--- ------ ------------ -- ------ - - -- --------------------------
Date Card B-1 Date Card B-1
Date FRAMING (Plans) OK except fr's
Sits roper Material & Anchors
------- -- ------------------
-------------- --------------
---------
alls Studs -Nailing. Spacing & Bracing -Plates -Sound
4 Bearing Walls over Girders & Floor Nailing
- - -- Draft Stop in Walls (rat proof)---------------- - ----- ------
- 43 Fire Stops: Furred Ceilings -Stairs -Chases -Tub
------------------ --------------------------------------
44. Headers & Beam -Size & Bearing
& Duplex)
NG
-'4S HapQers-Post Caps -Anchors -Connectors
Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-R
Ties or Type A Flue -Fireplace Throat clearance
ass; Size & Romex Protection -Draft Stop -Ins. Baffles
ndows or Exiting Doors -Sill Hot. & Dimensions
araqe Fire Protection
.-F+--Prope Line Firewall & Openings
------------- - ----
5 xt. Doors -One 3' -Check Garage -3rd Story, 2 Exits
aidilgNailing
Width -Headroom -Rise -Run -Landing -Fire Protection
don Roof Overhang -Attic Vents -Raster Outriggers
---- Veneer —
_-ti.'•Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
Glazing Area -Glass Protection -Skylights -Plastic
-5S-755ear Walls; Nailing -Bolts
59. Insulation -Walls -Ceilings
• - - 60. Infiltration -Walls -Windows
N
Date Card B-1Date Card B-1
--2-��--------14?t�
Date ? AS Card B-1 Date Card B-1
Date FINAL Plans) OK except h's
t. Steps -Door & Sidelight Protection -Landings
Smoke Detector
----------------------------------
63. Furnace: Vents -Clearance -Comb. Air -Connector -
In Garage: Above Floor -Ducts -Meth. Protection
--------------
------droomExiting -----
Bedroom Exiting
.I & Bath Fixtures & Tub Access -Spa
-- ---
Elec. Trim & Subpanel Breaker Sizes a s
J; --Stairs & Rails
- - Fireplace or v nces earth
c. Outlets at Wood Panel; Int. & Ext.
.. ----- - .... ----------------------------------
�it.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
-
Elec. Outlets & Receptacles.at Kit. Counter
-
--------- - �---------------
---- ----
7�Garage Fire Door; Swing -Landing -Closer
--- -----------------------------
---------- —
7t.C. Duct in
------------------------------Garage-Damper---------- -----
�Ntr. Htr.: Vents -Clearance -Comb. Air-Connector-P.R.V. .
In Garage: Above Floor-Mech. Protection
------------------------------------- -
! . Plb.. Elec. & Mech. Equip. Listed for Location
------------------------------
76. Elec. Receptacles in Garage: (G.F.I.)-Romex Protection
------------
- - -- insulation -Foam -Looked in Attic ❑ Yes -
--------------------------------
Guard Rails & Deck -Construction -Post Caps
7,9-Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth
Clearance Looked under Floor ❑ Yes
-__-------------------------------------------------- —
811r -Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No;
Planters ID Yes ❑ No ----- —
84-6tucco Brown -Finish --
8?A.C. Unit: Disconnect, Electrical, Plumbing
---------------
- -- ------ - -y -------------------- ----
83. Vents Above Roof: Plbg.-Appliance-Fireplace.-Clearance to
Openings
84 -water Well: Disconnect, Electrical, Plumbing
------------------------------
&6Cf-xterior Elec. Trim: G.F.I. Receptacle -Underground -
f6. entilation Throughout House -- - --- - -- ----
Glass Protec n
---- ------ d orrecti s from Previous Inspections -_
-- --- - -- -- ---- --------------- -------------
--- --- -----------------------------------------
--------------
s est- eters Tagged; Gas -Electric__
- - 90,"Water & Sewer Connected -C/O to Grade -HD Approval- -
_- Energy -Compliance -Certificate -Other Certificates ---
Date- Card B-1 Date Card B-1
----$ -- - -----------G� ----------------
Date �30Card B_1 G.,f;r --Date -- Card B-1
Date rC1 !�4ard B-1 G<S Date Card B-1
Comments at Final:rr
v=Qc
O = Not OK
Not =
Not Ready MOBILE
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/0 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/ /" L"ft./ /"LPG
7. Well Clearance & Disconnect
8. Utility Clearance
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
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/0 to Grade -HD Approval
8. Gas and Electricity Tagged
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts- Beam s-Rftrs.-Connectors
Shthg.-Rfg.-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distances-GFI
5. Elec.; Pool Lighting; 15 volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
_
Boxes- Enclosures -Pane lboards-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
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES,
1469 Humboldt Road, Chico, CA - (916) 891-2751
7 County Center Drive, Oroville, CA - (916) 538-7541e
747 Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
%Nc\4-moV_�i_ �� �7�5.
OWNER PERMIT NO. 4
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, =,
pl�eassee ontact this office immediately. ?
.Y- SAFQ C� A S WITN�ni Z4��WT �160Y2 ,
u
lb�l W o o b S 16\j ff- D o ILS K A T- 01 t2ir'J'- (" c oM R MiOff
K
2 Gtr l� i ►i �n-•u,•� s . - .
(I//- T- Nr -r- RIz-Qe,iRif A. /,/
=a
Date Inspector
REV 10/92 '�
COUNTY OF BUTTE . n
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
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� U�� �7 3�'63
OWNER PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above and should be corrected. Please notify this office when correction of work
is coir If you have any questions pertaining to this matter, or need additional explanation,
please this office immediately.
( �v¢Cott- t -6o S 6/IvcC�.
,1
UV.
- COUNTY OF BUTTE
BUILDING DIVISION s
DEPARTMENT OF DEVELOPMENT SERVICES
1469 Humboldt Road, Chico, CA - (916) 891-2751 y
7 County Center Drive, Oroville, CA - (916) 538-7541
747 Elliott Road, Paradise, CA - (916) 872-6307 N
CORRECTION NOTICE
13tCoar,
OWNER PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at 4
the above address and should be corrected. Please notify this office when correction of work ,,
is con.pleted. H you have any questions pertaining to this matter, or need additional explanation,
please contact this office immediately.
c. .
U/-) X
s
REV 10f92
X10 RENEWAL
SEKIT - AAk4,blSE
OFT=i CZ cprrl IJ OT
PIQD 2ECoCDS
1N S�EcmO�d a�
T
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC 'ERIC PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone: 16/538-7 41 V n
APPLICATION AND PERMIT -I
ASSESSOR PARCEL NUMBER
.059-085-010
ZONING
U
BUILDING PERMIT
OWNER
ERe GeAD
TELEPHONE
873-1696
SQ. FT. OCC. BUILDING VALUATION
OW MAIILINoy
ADDRESS
P.O. Box 98 Stirling City 95978
1310 R 55,020.00
140 C 1,820.00
CONTRACTOR'S NAME
John R. Wing Construction
TELEPHONE
873-0375
CONTRACTOR'S MAILING ADDRESS
P.O. Box 673 Paradise 95969
Fireplace A 1,500.00
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee $ 15.00
Permit Fee S 413.00
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $ 206.50
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee $ '20,00
Penalty g
BUILDING ADDRESS
.,
Permit tee $654.50
17160 Manzanita. Stirling Cit
PLUMBING PERMIT Filing Fee 15.00
Each Trap 5 5.00 25.00
Solar or heat pump water heater 20.00
LOT NO.
SUBDIVISION NAME
Township Stirling City
PARCEL MAP
Water piping 1 7.00 7.00
Each qas water heater or vent 1 7.00 7.00
USE OF STRUCTURE
SF R Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets 11 5.00 5.00
Building sewer 15.00 15,00
Mobile Home S FG W @ 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ OtherEN
Describe work: Replace Burned Structure _
3 Bedroom Home
Permit Fee $ 74.00
Contractor
ELECTRICAL PERMIT Filing Fee 15.90
Main service 200A OR LESS 1 18.50 18.5.0
Main service 200ATO1000A) 37.50 '
CONTRACTORS LICENSE LAW
I declare under of
penalty
p y perjury lur y (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._ 5377121 Classification Q�
❑ 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 offe ed
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.&) X
OR ADDNS. ACC. BLDGS. 3.60 sq.ft. OTF
NEW CONSTR. ULTI-OUTLET
NO N.RESID BRANCH CIRC ITS @ 5.00
POWER APPARATUS &
(SINGLE OUTLET CIR. )
Ex. Occup(OUTLETS OR FIXTURES 20 76
FIXED APPLNS.
EX. OCCUp. OUTLETS (RESID )KEA.) I 3.00
Temporary service 15.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $ 74.50
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 15.00
Heating 1 111.001 11.00
Dual Pack Htr.
Cooling 1 16.50
Hood 1 6.50 6,50
ventilation 1 4.50 4.50
Permit Fee $ 53.50
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
unty ' co uence of the granting of this permit.
X Date _l�% ' 1 ��
againrpermit
signaricant - owner ❑ Contractor ❑ Agent ❑
An 0Sis required for excavations over 5'0" dee and demolition or construct-
ion of structures over 3 stories in heigh .
Mobile Home Installation Fee S
Energy Inspection Fee $40.00
occ
CONST TYPE
TOTAL FEE $ 01.50
HAZ
11 FEES I
1M'J
FLOOD
I CDF
PARCEL D HD
ISSU
i
This permit is hereby issued under the applicable provi-
sions of the Butte County Code and/or resolutions to do j
work indicated above for which fees have been paid.
ECTOR OF PUBLIC WORKS
cry Datel1-a-�
PER,PMEXPIRES Date
t No. 2�'= 129843 $615.00 Bala
Receip�` '-7- 193%
WHITE-D.P.W., YELLOW -ASSESSOR. PI K-INSPECTOR,Z�DEHROD-APPLICANT
'�- �sir +'- MENT OF PUBLIC WOHK5 PERMIT NO.
:\\ ;iia 95965 -Telephone: 916.538-7541
059-08-5-010 �92-3765rgpE IIND PERMS ' n
BICKMORE, Gregory I I M too
17160 Manzanita, Stirling. )NE
City_ SO. FT. OCC. BUILDING VALUATION
contra John Wing !qb
1 new sf 13t /� _ 2 SS L O _
RA TOR'S NAME--,"-/-. _ -7_ AONE
W rt Ld:15�• - ! u
CO TRACTOR'S MAILING AO ESS I O
6)-G C Fireplace /.x
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $ S
Filing Fee $ 15.00
LENDER'S MAILING ADDRESS ___.
Iv ;.,,,Z
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $O(,,- v
4
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS. . p•
-7/
60nL
Permit fee $ 6S y
PLUMBING PERMIT Filing Fee 15.00
Each Trap 5.00 Z
So eater 20.00
Water piping
LOT NO.
SU DIVISIOCCN//NAME PARCEL MAP
�J✓►�
Each qas water heater or vent 7.00
USE OF STRUCTURLY
SF Duplex ❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets 5.00 .5—
Building sewer 15.00
Mob le Home S I G I W @ 15.00
TYPE OF WORK
New F1 Addition Remodel[] Utilitie ❑ Installation❑ Other (
Describe work:/t lU t, e ���c ^n z �%�r� L..� 7^2 _
3 B Al e heti. �: 2� �_ C/L
Permit Fee $
Contractor
ELECTRICAL PERMIT Filin Fee 15.00
Main service 600V OR LESS -18.50 >
200A OR LESS
_
Main service 20CATOI000A,
CONTRACTORS LICENSE LAW
Olare under penalty of perjury (check one):
F1 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 -3171, ( Classification
❑ I, as the owner, or my employeeg 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
_37.50
NEW CONST. ( DWELLING OCCUP.k\ 3.60sq.ft. _
OR AODNS. ACC. SLOGS. /
ru
NEW CONSTR. ULTI.OUTLET
NON.RESID BRANCH CIRC ITS @ 5.00
POWER APPARATUS tt
( SINGLE OUTLET CIR.
76d
Ex. Occup(OuTLETS OR FIXTURES 20 494
Ex. Occup. OUTLETS IFIXED PRESID ILNS.REA.) I 3.00
Temporary service 15.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $
Contractor
WORKMEN'S COMPENSATION INSURANCE
1 declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
f Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California. ,
Notice to Applicant: If after making this stahement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT Filing Fee 15.00
Heating / -
��� �ayL;Z �yT
Cooling 'o
Hood 6.50
Ventilation y 5-
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 i County in consequence of the granting of this permit.
'C _
• ate 1110 •' / •�--
arur of A licanr - owner
PP ❑ Contractor Agent ❑
An OSHA permit is required for xcavations over 5' "deep and demolition or construct-
ion of structures over 3 stories 'n height.
Mobile Home Installation Fee S
Ener Inspection Fee $ a
9Y p -
OCC
CONST TYPE
TOTAL FEE $ CJS; • SC
HAz
1 0FEES
IMP o0o
coF
PARCE
O
H0
ISSUE
This permit is hereby 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.
/ 5•a ., /��
Receipt No. •G- l� � f IZL y l �iY7 6�J
WHITE-D.P:W.. TELLOW-ASD 30R, PINK -INSPECT R, GOLDENROD -APP (CANT
COUNTY OF BUTTEPARTMENT OF PUBLIC WO'. BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -'TELEPHONE (916) 538-7541
PERMIT APPLICATION DATA SHEET
OWNER G,tp�, 9 t G k(/h04e-No. 5- 5 O 3 O► -0
A„ P.
Proposed Building Use Building Inspector Date 3 Z
r
At time of permit application, I was advised the.following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED BY
1. All items have been,submitted........................................ .
2. Plot plans, 3/4 sets, signed by preparer of plans.
3. Complete plans, 3/4 sets, signed by preparer of plans.
4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............ .
5. Hazardous Material Form . ............................................
6. Energy Design Compliance and supporting documentation . ................. .
!Statement of Intent for Non -Heated and A/C Buildings . ......................
gineered truss details and layout in duplicate (required prior to plan check). .... 3 �l
obilehome dp6td manufacturer's installation instructions, 2 sets. ... .
Fees of $ .........................
11. Impact fees as shown on attached schedule. '
12. California Department of Forestry plan approval/fees. ....................... .
13. Flood elevation letter (100 year flood) by California Engineer . ................. .
14. Sanitation and plot plan approval Health Department . .............
15. City of Chico plumbing permit . ......................................... .
16. Plot plan and business license approval from City of Biggs/Gridley. ..............
17. Planning approval for..(A) Use: (B) Parking: . ........
18. Contact Land Development about (A) Improvements (B) Drainage. .......... .
19. Driveway permit (construction approval required prior to occupancy). .. .. ....
20. Pre -inspection for Fre-Inspection request
regUlred. . . to Building Inspector (Date)
21. Contractor's license information. (No., Name Style, Classification) . ............. .
22. Certificate of Workmans Compensation Insurance . ......................... .
23. Owner -Builder Verification (Given to owner , Mail to owner ). .......... .
24. Recorded copy of Agricultural Acknowledgement Statement . ..................
25. Letter of signature authorization . ........................................
26. Copy of recorded deed of parcel cre 60 right of way to a public road. .... .
27. Letter of intent on building use. ..... nn ................................ .
28. Mobilehome utility clearance.
29. Documentation of legal access.
30. Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning area and frontage requirements . .............. .
31. Existing violations/expired permits . .................................:... .
41) Plary rhprk lief
Whe ou issue theermit, process as follows: Mail to owner. Mail to contractor.
Telephone �-73 - 037�nd hold for pickup at Af^ �e- office. Deliver with inspector.
Other
Parcel Creation
Acreage Applicant Date
Copy of Haz-Mat form sent Health Dept. Fire Dept. ' Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be,submitted prior to permit is:
1. Index permit for above items No.
2. Additional items required:
I/
ked above).
(trasterrifesigner, owner, was advised of above required data by (hone _ mail Counter by'--'�a Date
Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date
Plans checked by Date Plans approved by�Date `l—
Sets of plans on hold in Filecpbint AP folder �s
Copy - Department of Public Works �c
' I;Illlf) l'Y 111' (III I -I I'. - I11'.1'All if II;11I' 111' 1'11111.1 l: N1111R!� - - IIII I I,III fll; 111 V I.'3111tr
(;(IIINI'Y I;f11'I'I:II MOVEIIIl11Vl1.l.l:, I:AI.I11111111A 95961II:I.I.I'III)III: ('ll(i) i lllvi /I
I
4)MIER -
I'It(►I'(►5EI►'1I1111.UINC II5L' ____�� I►A'I'I's _---
I(EC. 1 I►A I E It LC
-------- "-- - ----- I---__ _
(I►nl�l nl: 111n1:1Ict: office) ...................... �7!�
• 1. Sher l f f Cees
(110141 at D,il.ldiiig I)epartmenl:) '
ilea141el:)ol _--- x
n-�---
unll: +amt.
ger
Cununerclol(1 I•.- - - -
sq.ft, amt.
3:
Ile Ipme Aren Cees--
-(I)old of 131111411118 heportment
�� nnits omL•.
Commerical( per=�--
all. f t. amt.
4. Recleatlull Illatrlcl: C'eea -
(paid at l)lstrlct Office) ..........................
5,' hrn)nnge hl.st:rlct Cees
(Contact I.aa41 hevelupment:) ...... :..................
G. Other
). Other
At time of permlt appllcatlun, 1 woo advised the above fees are reyolre,l to Ile pnld 11rlor
to 18s11011ce of the permlt.
1
AITLICAIIT I
�i'y�F i«�'4"'�y"�i+�'OM1:p�4+,�+e*;'�',,.-..-at-+�'r'd�hl•ifi3�..c�'wr'a.rY`�'ry,�-i.�.�ryr^�f�Y•+y,i�'�t1S�''�+rJ,R+'�i�+r`�r�9�41'41;ri+a•�`t'*'�v�.+sjr+w�-�'+"�1;1'`::,rw:..r"'„'�+t"'11,,{ �S"�'`�..,�w.�.; ,,:,'. ...1�-..
jqf o
0
BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One Form Per Building)
School District ^— '^"'� ' +`i'1 Building Department No
®10.
A.P. Number ®�S' Jurisdiction 0 City ® County
Property Owner /1 eS QR -r__
Property Location/Address
Subdivison X02 1i."+( C �.�t a Lot No.
Residential Development
No. of Living - MHI Addition
OOUNTY OF BUTTIE
BUILDING DEPT
Commercial/Industrial
NOV 2 3 1992, New Addition
Sq. Footage
(Group R)
Sq. Footage
(Including Exterior
Roofed Areas)
Builth artment Representative Date
(Floor Plans reviewed by School District Personnel)
I
tDistriLtLcation No.
School District certifies that
(Applicant)
(Street Addre s) (Phone Number)
(City) (State) (Zip Code)
has complied with the requirements of Resolution No. by payment of $
representing I S 10 square feet.
School District Representative Date
Paid by Check Number Remarks:��� p
Bank Number
Paid by Cash o _^
If, subsequent to the School District Representative signing this Butte County Schools Impact Fee
Certification Form, the School District is notified by the applicable Local Planning Agency that this project
is being reviewed under the California Environmental Quality Act (CEQA), this.project may be subject to
additional school fees to fully mitigate its impact on the school district's schools.
White (applicant), Yellow (building department), Pink (school district) feeformmkl (4/92)
Certificate of Compliance: Residential
. ,.p �=�
----—.---�_..'. .. .------'.--- - ..--------•---- .. ;--- _._....._..- --:
Mandatory Measures Checklist: Residential MF-1R
f
Project TlUe /^t �/�j �.y�1.
/L/
`
7r
NOTE. L.owrise residential buildings wbj= u the Standard: must contain these mcaana re gardka or clic aotapliance
+90-11turd Items mated nN (•)
J
ProjccYAddreta
BUtldYlj Pemtt tar
an t wzuLt may be arpeseded -'
on the Cuufscate of Com M mac stria it d eomplitnoe reeatures w listed
di•++t'e. when this cnecklia is incorporated into the D�+tt the features wed >rs>d
be considered by all binding
/I
caked
panus as minimum component paroornw ce speorcationa for the mandatory mcie, virca
whether Uscy arc shown clsewhnae in the documatu or on this chactlisa only.
By/>i
'
Documentation Author
Telephorm
FnforoQneru Agency Use Only
DESC7UFnON DESIGNER ENFORCEMENT _
•
- Building Envelope Memories
BUILDING DATA
Glass Area % G
• §2.5352(a): Minimum ceiling insulation R-19 weighted average
�. .
Conditioned Floor Area 1310 Number of S tortes
North 7t
12.5352fbk Loose fill inastuion manufacuuvs taDetod R-value
-
Sia Floor Number of Units$Otlth
Eg$t p
--s•�'-LLQ -
12.535uc), Minimum .yl insulation io framed walls R-1 t weighted average (doe not apply to
essenor mass waits).
[-]'�Smg]e Family Detached (SFD) [ ] Addition Alone
west
§2.5352(kk Slab edgeimsdation-wacr.
uwsmsssion rase greater than 2.0 perm/ rase nm greater thin 0.3%. nater Rv«
[ ] Single Family Attached(SFA) [ ] Existing Building
Skylight
§2-All:Ins�u�specifiedainsWkdmesaCalforniaEswtyCommiss (CEC)gtaliry
[ ] Multi-Family (NM [ ] Existing-Plus-Addition
Total
surdzrdL type and form
IndicVapor
§ (fk arrirts 111213,41311017 in Climate Zones 14 mid 16 only.
B UILDING SHELL INSULATION
'
12.5317: InfilauiorvEsfdtration Conools
L Doors and windows between eondusoKd and unconditioned spaces dc=Vled to limit air
Component _ Insulation Location/Comments
leakage
b. Doors and windows ccrurwAC-
Type R-Value (attic. to gmgG, calx etc,)
C Doors and windows wotheRmlpped all pints and petxaaticru caulked and scaled
52.5352(c)- Special inrdtrasion barriuinstalkdtocomply with §2-3351 meeuCECquality
wall..... ..... r
.
ssandardL
«..
wall..............
62.5352(dr- InssallationofFveptaces
L Masonry and factory-built fireplaces have:
Roof 3 t7
L Tight fitting. durable mesal or a gim door
.............
Roof .............
b. auside air intake with damper and control
e Flue damper and eased
:
Floor
-
2. No continuous burning gas pilau alkrted. - . ..
f
.............
Floor
HVAC and Plumbing SystemMeasmre,
'. :
.............
Slab Edge..... " '
§2-5352W wA 2-5303: Space conditioning equipen.At sizing: attarJsoleulations-
52-5352(h) and 2.5315: Setback stseros0asat on all applinbk heating systrtns
LAZING Sh
Shading
ading Devices
I
_ • 52-5316(2): Duca eortanscted, installed andula
insted per pupae lo• 1976 UMC-
MC- -
-
§2.5316ft Eahaust systems have damper conaol:
Glazing Area Glass Type Interior - EzietjOr !
Orientation QYerhari$ Framing
§2-5314(ck Gas-fucd space hating cquiprment has intermittent ignition devicm
§2-5314: HVAC
(
r S sin double) oUa blind. etc. (SltadescTCert, etc.) e:sino) (metaliw
North
equipmentwaterhrstess.shOwQ}Ka& and faucets certified bythe CEC.
§2-5352(i} water heats iraulation Dtanket (R-12 a greats) or tronrtbirsud interior/cYterior :
\ ) vinsulation
(R-16or greater): first nst 5 reof pipes closest to tank insulated (R-3 or greater). 1-
Noith )
�'�"� ��
- 12-5312(Eaception f): Pipe insulation on stcam and scamcondensate coensate return & recirculating
EastCC(
fI
piping.
§2.531g(dk Swimming PoolHcasing
t East l
1
1. System hat
=
SOUEh ( )
L On/off switch on heater.
b. Weatherproof iesuuction platoon beater.
""•SOU
ill ( )
c. Plumbed to r
2. 75 percent thunsalflow effseiency,lar.
-
West ( )
3. Pool tours.
West ( )
4. Time clock.
5. Dvoctional water inlet :
Skylight.......—" LY
-
Lighting and Appliance Measures
THERMAL MASS - - _
I
§2.53520 greater :'Lighting - 25lumenywau or ter for general lighting in kitchens and bathrooms.
"l�pelCOYenng Area — nes$ --
Thick
§2.53§2-5314(c)-Gas need appfiancct equipped with interminent ignition device.
-
(slab/exposed, We. etc.) (sf) (inches) Location/Description
(kitchen• bath. etc.)
§2.5314(a): Rcfrigemutm refrigerator-freezers. (recces and fluorescent lamp baltaas certified
by the CEC. Indirauc make and model number.
--
,
COMPLIANCE STATEMENT
--"
--
'This certifiC=C of compliance lists the building features end performance specifications neededto with
Mile
HVAC SYSTEMSMinimum Duct
tracomply
24. Chapter 2-53 and lisle 20. Chapter 2. SLbchaptcr 4. Article 1 of the California Administive code. This
mrdficate has baa signed by the individual with ovaall design responsibility and the building owner. who shall
_ _
Type (. air Efficiency Location Duct Output
Manufacturer / Model #
retain a copy of it and am=2it the certificate to nasubsequent purchaser subsequpurchaser of the building.
_
conditioner, hest pump) (SE, SEER HSP17 (attic, etc.) R-Value (Btuh)
(or approved equ al)
Designer Building Owner
S-7
N•rr+c
T'tkJi=ma
---
Milk/
Addre=- T cleft-vert. l
Address:
Maximum Furnace Heating Output; Btuh
Teleplwrsc
t.x Telephone-,:
HOT WATER SYSTEMS -
_
Tank Manufacturer/Model #
System Type (storage gas, etc.) Capacity (or aooroved equal)
Special Feature(s)
(sitn•turc)
_ (date) (signature) (dart)
.
Documentation Author Enforcement Agency
SPECIAL FEAT URESIREMARKS (Add extra sheets if necessary)
Nvrsc: Name:
3. Raised Floor Insulation
s
Number of stories
West
R -value
One
Two
Three
R-0
-120
-59
-40
R-19
-10
-5
3
R30
.2
.1
.1
R-38
0
0
p
U -value
0
0
0
t 0.50
.200
-99
-66
- i 0.30
-118
-59
39
0.10
32
-16
-11
0.08
•23
-11
-8
0.06
-14
-7
.55
-44
0.04
-5
-2
-2
0.02
5
2
2
- 0.00
14
7
4
2. Wall Insulation
-8
0
0
Single-
Single -
-4
3
Family
Family
Multi -
R -value
Detached
Attached
Family
R-0
-102
-77
-51
R-11
-11
-8
-5
R-13
-8
-6
-4
R-19
0
0
0
U -value
One
Two
Three
0.80
-212
-160
-107
0.50
-132
-100
-67
0.30
-74
-56
37
0.10
-11
-8
-6
'0.08
-5
-3
-2
_. 0.06
2
1
1
0.04
9
6 -
4
0.02
15
11
8
0.00
22
16
11
3. Raised Floor Insulation
S. Infiltration (Air Leakage)
s
Insulation in Floor
West
Skylight
18
16
106
9
Number of stories
12
11
R -value
One
Two
Three
6
6
R-0
-24
-12
-8
s
R-11
-5
.2
-1
a7terior
Mass
R-19
0
0
0
_
R-30
4
2
1
/CFA
U -value
Stories
Two
-
Stories
Two
Three
0.60
-218
-103
{7
'!
0.50
0.40
-180
-142
-85
-67
.55
-44
-4
0.30
0.20
103
-64
49
31
32
Heat Loss
0.10
-24
12
-20
8
4
0.08
-17
-8
0
0
0.06
.9
-4
3
U -value
0.04
.1
.1
0
.2
-1
0.02
6
3
2
Single Double
0.00
14
7
5
0.7
0.9
Controlled Ventilation Crawlspace
.2
-1
-1
0
2
Number of stories
West
SO
R -value
One
Two
Three
1
R-0
-15
-10
-7
2
3
R-5
-4
-5
4
-42
.31
R-11
-1
3
-2
-3
R-19
0
.2
-2
5
6
4. Slab Edge
Insulation
-
`
R -value
One
Number of Stories
Two
Three
3
4
R-0
R-5
-13
-8
-4
29
28
R-7
-1
0
-1
0
0
16
17
F2 factor
1
5
7
8
9
0.90-19
0.80
4
-13
9
-6
.15
0.70
.19
5
-5
3
2
0.60
0.50
-4
0
3
.1
12
0.40
5
0
3
0
2
S. Infiltration (Air Leakage)
s
South
West
Skylight
18
16
106
9
6
12
11
4
4
SpecificationPoints
14
12
7
6
6
6
Interior Thermal Mass
4
na
na
11
Standard
5
9
8
p
na
a7terior
Mass
4
Slab Floor
Raised Floor
4
w
9
8
4
3
4
4
7
6
/CFA
One
Stories
Two
Three One
Stories
Two
Three
3
5
5
4
1
1
2
3
0.0
-10
-6
-4
.2
-1
-1
6. Glass
Heat Loss
.1
-2
3
0'1-9
4
-5
3
-1
0
0
Total
na = not allowed
0
13.0
U -value
20
0.3
0.5
-8
.7
-4
3.
.2
-1
0
1
1
2
1
2
Percent
Glass
Single Double
.51 to
.41 to
.31 to
0.30 0
less
0.7
0.9
-6
.5
.2
-1
-1
0
2
South
West
SO
190 85
.60
63
.50
41
.40
20
1
1.1
1'3
-5
.3
-1
0
1
2
2
3
3
4
4
4
40
35
-141 -59
-117 -46
-42
.31
.25
-17
.8
.2
8
12
1.5
-3
1
3
4
5
5
6
5
6
30
-93 34
-21
.9
3
15
20
25
1
0
3
4
4
6
6
7
8
29
28
-88 31
-84 29
19
-17
7
5
5
6
16
17
1 3.0
1
5
7
8
9
9
10
9
10
27
-79 -26
.15
-4
7
17
` 3.5
2
6
8
10
11
12
26
25
-75 -24
-70 -22
-13
-11
3
-1
8
9
18
19
4.5
4
8
0
12
13
14
24
23
-65 -19
51 17
9
-7
1
2
10
11
19
20
5.0
. 5.5
5
6
9
10
11
12
13
14
14
15
14
15
22
21
-56 -14
-52 -12
-5
3
4
5
12
13
21
6.0
6.5
7
7
11
11
12
13
15
15
16
16
16
16
20
41 9
-1
7
15
22
22
7.0
7.5
8
8
12
12
13
14
16
17
17
19
18
-43 -7
-39 -5
1
3
8
10
16
17
23
24
8.0
8
12
14
16
16
17
17
17
18
i 17
34 -2
4
11
18
24
8.5
9
13
14
17
18
18
16
-30 0
6
13
19
25
S.1
52
5.4
Unit Size (sQ
W%
SO%
Water
1.1
I 15
-25 2
8
14
20
26
Credit
or
tot
12
to
or
Type
14
•13
-21 5
-17 7
10
12-
16
17
21
22
26
27
10. Exterior Wall
Thermal Mass
0
12
11
12 9
-8 12
14
16
19
20
23
24
28
28
I Exterior
7
Single-
3
Single -
HP
HWR
10
9
-4 14
0 16
18
19
21
23 -
25
26
29
Wall
Mass
Fami
Detached
Attachryed
Multi
amu illy
8
4 18
21
24
27
30 .
30
0.00
3
0
SE
0
0
-23
-15
•12
-9
29
Solar
-
0.20
1
2
0
2
1
-23
-11
-8
3
-5
WS8
0.40
11
5
5
4
2
POU
-23
-11
-8
_6
-5
IG
0.60
-2
7
-1
6
0
4.6
4.7
7. Shading
(Shade Open)
P )
6
4
3
OM
6.1
10
8
8
5
2
2
IE
None
-28
-14
.9
1.00
5
13
Solar
10
6
7
6
Etrective Percent Glass
S
POU
1.20
1.40
-2
16
19
_,
12
14
8
.
(percent glass
x SC)
1.60
22
i6
9
11
16
Effective
4
u
4.4
l6
4.0
2.00
53
1
22
-
19
12
6 2
°/.Glass
North Eat
1.4
1.1
2.1
21
25
27
29
21
4
Heating System
SE or HSPF
(assumes ducts in attic)
' Sum of 1.6
SE HSPF leSssr -15 .5 � 5to +5 5 more
0.72 6.60 0 0 0 0 0 0
0.75. 6.88 4" 4 3 3 3 2
0.80 7.33 11 10 9 8 7 6
10-85-7.79 16 15 13 12 10 9
0.90 8.25 21 19 17 15 13 11
0.95 8.71 26 24 21 19 16 14
- .__ Effective SE or HSPF
(SE or HSPF x duct efficiency)
Effective -25 or 16
SE HSPF less .150 -14to
+5 15 mo e
0.30 275 -94 -85 .76 -68 .59 SO
na 3.41 -57 -52 -46 -41 -36 -
0.40 3.67 43 39-31
.35 31 -27 -23
0.50 4.58 -13 -12 -11 -10 -8 .7
0.56 5.13 0 0 0 0 0 p
0.60 5.50 7 6 6 5 4 4
0.70 6.42 21 19 17 15 13 11
0.80 7.33 32 29 26 23 20 17
0.90 8.25 40 37 33 29 25 22
1.00 9.17 47 43 38 34 30 25
Zonal Control Adjustment
System Type
Resistance 10 S- 4 6 5
6 3
Other 4 3 2
12. Cooling$ystem
s
South
West
Skylight
18
16
106
9
6
12
11
4
4
na
14
12
7
6
6
6
10
4
na
na
11
5
5
9
8
4
4
na
10
4
5
8
4
na
4
9
8
4
3
4
4
7
6
4
4
5
5
6
2
3
.4
3
5
5
4
1
1
2
3
2
6
3
0
1
0
2
0
1
0
6
5
2
1
.1
-2
3
-2
4
0
-1
•2
-4
-6
-6
-11
3
-6
3
0
na = not allowed
0
13.0
25
20
S. Shading (Shade Closed)
10
5
0
Efrective Percent Glass
Zonal Control Adjustment
7
(percent glass x SC)
10
Effective
6
4
2
0
'
%Glass
North
East
South
West
Skylight
18
16
-9
-8
32
-27
46
39
.45
38
na
12
5
0
0
0
na
11na
-5
8
-16
25
.22
24
-21
na
10
9
4
-14
-19
-18
-63
8
•4
3
-13
-10
-16
-14
-15
-13
-54
-46
7
6
-3
-2
-8
5
-11
-11
-38
5
-1
-4
-8
-5
-8
-6
30
-23
4
3
-1
0
.2
-3
3
-17
2
0
-1
1
-1
1
.1
2
-11
1
0
1
1
23
9
4
.7
3
POU
4
4
6
0
na = not allowed
SE
None
39
.26
Heating System
SE or HSPF
(assumes ducts in attic)
' Sum of 1.6
SE HSPF leSssr -15 .5 � 5to +5 5 more
0.72 6.60 0 0 0 0 0 0
0.75. 6.88 4" 4 3 3 3 2
0.80 7.33 11 10 9 8 7 6
10-85-7.79 16 15 13 12 10 9
0.90 8.25 21 19 17 15 13 11
0.95 8.71 26 24 21 19 16 14
- .__ Effective SE or HSPF
(SE or HSPF x duct efficiency)
Effective -25 or 16
SE HSPF less .150 -14to
+5 15 mo e
0.30 275 -94 -85 .76 -68 .59 SO
na 3.41 -57 -52 -46 -41 -36 -
0.40 3.67 43 39-31
.35 31 -27 -23
0.50 4.58 -13 -12 -11 -10 -8 .7
0.56 5.13 0 0 0 0 0 p
0.60 5.50 7 6 6 5 4 4
0.70 6.42 21 19 17 15 13 11
0.80 7.33 32 29 26 23 20 17
0.90 8.25 40 37 33 29 25 22
1.00 9.17 47 43 38 34 30 25
Zonal Control Adjustment
System Type
Resistance 10 S- 4 6 5
6 3
Other 4 3 2
12. Cooling$ystem
Elrective SEER
SCORE CARD
-_ I
SEER
-
(SEER x duct efrrciency)
(0-5615.15]
Effective -25 or -24to o- of 1
14 to -4 to
(assumes ducts
in attic)
SEER less
.15
Sum of 7-10
+5
+15
more
SEER
-25 or -24 to -14 to
less
-4 to
+610
16 or
3
-15 -5
+5
+15
more
8.0
8.5
-6 -5 3
-2 .2
.2
-1
0
8.9
-1
0 0 0
.1
0
0
0
0
0
9.0
1 0 0
0
0
0
00
6 4 3
2
1
0
10.5
8 6 5
3
2
0
11.0
120
10 8 6
13 10 8
4
2
0
13.0
16 13 9
5
6
3
3
p
0
Point System Summary: Climate Zone 16
Elrective SEER
SCORE CARD
-_ I
SE or-HSPF
(0.7216.61
Duct
Due Efficienry (p 7gJ Effective S or
(SEER x duct efrrciency)
(0-5615.15]
Effective -25 or -24to o- of 1
14 to -4 to
+6 to
16 or
SEER less
.15
.5
+5
+15
more
5.0
6.0
-16
-5
-13
-10
.6
3
0
6.6
0
-4
0
.3
0
-2
0
-1
0
0
0
8.0
9
7
5
4
2
p
9.0
13
11
8
S.
3
0
10.0
17
14
10
7
3
0
11.0
20
16
12
8
4
0
120
23
18
14
9
5
0
13.0
25
20
15
10
5
0
oT •
a
Zonal Control Adjustment
7
10
8_
6
4
2
0
'
No
Cooling System Installed
1.2. tit •rpo.M TDI
=
�
8. Shading (Shade Closed)
One
0
0
0
0
0
0
Two +
5
4
3
2
1
0
13. Water
Heating :-
-
Single -Family Detached and Attached
- -
i-
Wate�--
1199
Unit
1200
Size (sQ
1700 2200
..
2700
Heater
Type
Credit
Type
or
less
to
1699
to
2199
to
2699
or
SG
None
0
0
0
0
more
0
or
HP
Solar
HWR
12
9
8
6
6
4
5
4
1.7
WS8
17
12
9
3
7
3
6
POU
9
6
4
3
3 ..
SE
None
39
.26
-19
-15
-13
0.6
Solar
-2
.1
-1
-1
-1
21
HWR
-18
-12
-9
.7
_6
14
WS8
2
2
1
1
1
4.6
POU
-18
-12
.9
-7
-6
IG
None
-2
-1
-1
-1
-1
149
Solar
10
7
5
4
3
17
POU
7
5
3
3
2
IE
None
-28
-19
-14
-11
-9
1.5
Solar
10
7
5
4
3
_
POU
-7
-5
3
3
-2
4 3
Multi -Family (individual
units)
1.9
S.1
52
5.4
Unit Size (sQ
W%
SO%
Water
1.1
699
700
1200
1700
2200
Heater
Credit
or
tot
12
to
or
Type
Type
less
1199
1699
2199
more
SG
None
0
0
0
0
0
or
Solar
14
7
5
3
3
HP
HWR
10
5
3
3
2
WS8
29
14
10
7
6
S.S
POU
10
5
3
3
2
SE
None
46
-23
-15
•12
-9
29
Solar
2
1
1
0
0
HWR
-23
-11
-8
3
-5
WS8
22
11
7
5
4
1.T
1.8
POU
-23
-11
-8
_6
-5
IG
None
-2
-1
-1
0
0
4.6
4.7
Solar
11
6
4
3
2
6.1
POU
8
4
3
2
2
IE
None
-28
-14
.9
-7
5
15
Solar
22
11
7
6
4
S
POU
-4
-2
.1
_,
.1
Point System Summary: Climate Zone 16
SCORE CARD
-_ I
SE or-HSPF
(0.7216.61
Duct
Due Efficienry (p 7gJ Effective S or
(0-5615.15]
I. Ceiling Insulation
Measures
- -
--.- .
_.
point Scores
Interior MxyICFA
Type [SGj
or
'
R-value(381
'[Q
or
. r.w r •wss
- _...
__.._� .
3. Raised Floor Insulation
R -vela - 19�
U -value (0.066]
-
- y
:
4. Slab Edge Insulation
�
or
U -value (0.037]
-
- - - - --- --
S. :Infiltration
R -value (7]
or-
F2 factor [0.51 ]
_
-
-
:.
I1.7"IF4.1l
6. ;Glass Heat Loss-
Z�7Pe
7. Shading (Shade Open)
( 1
U-value (065]
- =
To Total Glass (16]
- - Sum 13
_
North
b. East
% Glass
--
_ .
x
SC _ .
Eff. %a. GI
_
- -
L ,
x
- 3
- C. South
. West
oT •
a
x
le•ew<.Lsl
..:..
-_
e
. e. Skylight
,
lD
x
x
It TF" 1
PASS
IVt'C t
1.2. tit •rpo.M TDI
=
�
8. Shading (Shade Closed)
0%
S%
10%
1S%
20%
2S%
30%
35%
40%
!S%
5076
C. South
oto-
x
d. West
x
= a, u
. e. Skylight
�-
x
= -----
9. Interior Thermal Mass
TYPE 1 MASS AREA
51%
•1.9
60% 654: 70% 75% 60% 6S% 90% tots% IU1% i057G
10. Exterior Wall Mass
Interi'7- CFA
0
0.2
0.4
06
_
Exterior Wall Masi
1.1
1.3
1.6
1.7
110%
ltsx
120%
t25
10%
10
0.2
0.4
0.6
1t
1
1.2
1.4
1.6
21
21
23
23
25
25
27
27
29
29
11
32
14
1.6
3.6
4
42
4!
4.6
4.6
S
]0%
0.5
0.7
09
1
1.1
1.4
1.6
t
2
Zz
149
33
15
17
4
4.2
4.4
46
4.6
S
52
S3
5 A
0.7
0.9
1.1
11
1.5
1.7
1.8
19
t
22
22
2!
24
26
26
26
26
3
3
3.2
1S
17
39
4.1
4 3
4.S
1.7
1.9
S.1
52
5.4
6
W%
SO%
0.9
1.1
13
13
1.7
1.9
21
2.3
25
27
3
12
3 2
14
3.4
3.6
16
IS
17
4
4
4.7
4.5
1.7
4.
1.9
5.1
S 3
5.3
SS
S 6
5.7
5
5
0.9
42
4.4
4.5
l6
5.3
S.S
531.
S.9
9
6.1
6Q�%
1.1
12
13
1.4
1.7
1.9
21
21
25
-7
29
11
1]
35
3 S
3.7
3.t
19
4.2
4.7
70%�%
1.2
1.4
1.5
1.6
1.T
1.8
1.9
2
22
22
21
25
26
it
3
12
it
] 6
].t
4
4.3
1A
4.3
4.6
4.7
4.9
5.9
3.1
52
5.!
S.6
5.9
6.1
63
75%
7S%
11
13
f.7
13
2t
2.3
23
27
27
2.9
3
11
12
13
15
17
3.9
4.1
4.3
4.5
4.8
S
S 2
S ]
S.4
S S
S.6
S.7
5.9
'6
6.1
61
14
16
1t
4
u
4.4
l6
4.0
S.1
53
54
5.7
S 6
59
6 2
6 4
1.4
1.1
2.1
21
25
27
29
6.1
63
65
900%!G
90%
957:
1.5
1.7
2
2
22
24
26
IS
3
11
32
33
14
3.3
3.5
It
3.6
1�
4.1
42
4.4
4.6
4.6
50.
32
S/
S6
59
6.I
62
94
86
10076
1.6
1.7
1.1
19
2
21
22
25
2T
29
11
3 3
15
17
19
4.1
4.3
4.3
4.5
1.6
4.7
4.1
4.9
S
5.1
s3
ss
17
1
5
5.9
6z
63
64
6S
66
ie
v
2S
26
3
32
3A
l6
16
4
42
4.4
4.6
4.9
11
S.2
5.3
5.4
SS
5.5
3.7
19
6 I
6./
6.7
6 9
toy%
115%
1.9
1.9
2
21
22
23
2S
IS
26
27
26
29
3
11
13
1.S
17
3.9
4.1
4.3
4S
4.7
4.9
5.1
5.4
S.6
5.6
41
43
6S
6.7
7
its%
2
22
24
26
26
3
3.2
13
14
3.6
16
388
1
4
4.1
4.2
4.3
4.4
4.5
4.6
S
5.2
S.4
5.7
S.9
t
61
62
6.3
6.4
6.5
6 6
6 t
7
120%
1257.
2
21
23
23
25
27
3.1
1]
15
].7
19
1.1
4.4
1.5
4.6
4.7
4.8
4.9
S
5.1
5.2
5.3
S.S
5.7
5.9
62
6A
6.6
6.7
6.6
6 9
7
7.1
7.2
7.3
23
26
3
]
32
34
16
1t
4
4.2
4A
4.6
4.9
St
S]
5.4
SS
5.6
5.7
58
6
QS
6 S
6.7
6.9
7.1
5.9
61
6.3
65
6.7
7
7.2
7.4
Point System Summary: Climate Zone 16
SCORE CARD
-_ I
SE or-HSPF
(0.7216.61
Duct
Due Efficienry (p 7gJ Effective S or
(0-5615.15]
I. Ceiling Insulation
Measures
- -
--.- .
_.
point Scores
Type [SGj
or
---.._..
2. Wall Insulation
R-value(381
'[Q
or
U -value (0.030]
- _...
__.._� .
3. Raised Floor Insulation
R -vela - 19�
U -value (0.066]
-
- y
:
4. Slab Edge Insulation
R-value119
or
U -value (0.037]
-
- - - - --- --
S. :Infiltration
R -value (7]
or-
F2 factor [0.51 ]
_
-
-
:.
Q
6. ;Glass Heat Loss-
Z�7Pe
7. Shading (Shade Open)
( 1
U-value (065]
- =
To Total Glass (16]
- - Sum 13
_
North
b. East
% Glass
--
_ .
x
SC _ .
Eff. %a. GI
_
- -
L ,
x
- 3
- C. South
. West
oT •
a
x
..:..
-_
e
. e. Skylight
,
lD
x
x
=
�
8. Shading (Shade Closed)
. a. North
t
x
SC
Eff %aGlassss
-
b. East
3-7-x-ly�
°
C. South
oto-
x
d. West
x
= a, u
. e. Skylight
�-
x
= -----
9. Interior Thermal Mass
TYPE 1 MASS AREA
10. Exterior Wall Mass
Interi'7- CFA
COND. FLOOR AREA e
TYPE 2 MASS
1
_
Exterior Wall Masi
AREA
ND. e L R AREA !
11. Heating System
Zonal Control? ( Y / N )
12. Cooling System
Zonal Control? ( Y / N )
13. Water Heating
•7�
x
-_ I
SE or-HSPF
(0.7216.61
Duct
Due Efficienry (p 7gJ Effective S or
(0-5615.15]
x
, ��` = T,
SEER (811
Duct EIF- tcieniy (0.741 Effective SE R (6.59]
5
Type [SGj
Credit (Hanel
Ser -um_ �7-1-10
GENERAL
.0 4
RESIDENTIAL'PLAN'CHECKING'GUIDE
(S.F., DUPLEX-& MISC. ONLY)
Fi 7 k /
;r + Bldg. Permit # V�/�
' 3
A.P. # ,,5 _ OF -
Plan Checker G �5
8/91
Vioning requirementl: (sideyards and number of permitted living units).
•r/Valuation.
/Plans signed by des gner.
'.Proper description bf work on application.
xisting violationslon property.
ems on data sheet. (W.C., fees, Health, Developer Fees, License law, etc).
Recorded notice ofviolation.
PLOT PLAN j
4Y Complete parcel size -and -dimensions.
`Setbacks, side rd' easements, etc.
Other buildings or�structures.
Grading, fills, dr�irage.
Flood hazard.
Special conditions'on.creation map,
ustible, and foundations).
FAU & FAS road setback.
(noise, CDF, fire sprinklers, non -comb -
Building or utilities across lot lines (Record form).
FTnnp PT.AN
%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).
quired room sizes, ceiling heights (Sec. 1207).
�FCIs in baths, garage, kitchen, and exterior outlets (Article 210-8).
Light fixtures, switches, receptacles, and exterior receptacles for main-
tenance of mechanical equipment.
Locations of water heater, heating and cooling equipment, other electrical
or gas equipment..
Garage firewall, door size, and closer (Sec. 503(d)(3)).
i� 3'0" exterior exit door (sec. 3304 (f).
''�eplace:and wood stove location, alcoves, and clearance.
Smoke detectors (Sec. 1210).
C� °Plumbing fixtures, water closet clearances and shower size.
STRUCTURAL DETAILS
�^t.andard bracing or engineered design (Table 25V)
Unusual shape, size, or split level house requiring lateral design.
lerestory requiring balloon framing and/or engineering.
hree story building requiring engineered calculations and plans.
�roundation 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.
�. Rafter ties or bearing ridge beam.
arage door or porch header sizes.
Stud heights.
5— --Adobe soils - special foundation design.
�Ketaining walls requiring design.
3-.—S-pecial Inspection required.
RESIDENTIAL PLAN•CHECKING GUIDE
..
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).
----I-terior plaster - weep screeds (Sec. 4706).
. ,Proper roof pitch for roof convering (Chapter 32).
/Roof covering type - (fire hazard).
oam insulation - protection.
,36" halls and stairways.
Living area over garage - complete 1 -hour separation required
including supporting walls and posts, etc.
D�Ttwo exits on three-story dwellings (sec. 3303 & see Mezannines
_g 1. tic access and ventilation (Sec. 3205).
derfloor access and ventilation (Sec. 2516).
�C
8/91
on garage side
- 1716).
ombustion air for fuel burning appliances - L.P.G. requirements.
4 -.--Noise requirements on duplexes.
5ergy design.
lashing at all exterior openings.
7. OF responsible area requirements.
20,E F -'-1 11 -d -e)
r � f
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville,"California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.
7��O
ASSEStfJ JAbCft N�Jty dR
�f Ul
ZOttN5
�J
BUILDING PERMIT
OWNER TELEPHONE
GREGORY BICKMORE 872,-1696
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
PO BOX 98 STIRLING CITY 95978
CONTRACTOR'S NAME TELEPHONE
CONST 873-037
CONTRACTOR'S MAILING ADDRESS
PO BOX 673 PARADISE 95967
Fireplace
CONSTRUCTION LENDER UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filling Fee $ 155.00
Permit Fee $
ARCHITECT OR ENGINEER LICENSE NO.
Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee $
Penalty $
BUILDING ADDRESS
Permit fee $
17160 MANZANITA STIRLING CITY
PLUMBING PERMIT Filing Fee 15.00
Each Trap 3 5.00 15.00
Solar or heat pump water heater 20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping 7,00
Each qas water heater or vent 7.00
USE OF STRUCTURE
Gas piping system 1 - 5 outlets 5.00
SF ®X Duplex[] Mobilehome❑ Other
Building sewer 15.00
SPECIFY
Mobile Home S I G I W @ 15.00
TYPE OF WORK
New ❑ Addition [3X Remodel ❑ Utilities ❑ Installation❑ Other ❑
Permit Fee $ 30.00
Describe work: ADD BATH IN EXISTING CLOSET
Contractor
RE: #92-3765
ELECTRICAL PERMIT Filing Fee 15.00
Main service 200AORLESS 18.50
Main service 200ATOI000A, 37.50
CONTRACTORS LICENSE LAW
I declar under penalty of
p y perjury lur y (check one):
NEW CONST. DWELLING OCCUP.&) 3.6asq.ft.
OR ADDNS. ACC. BLDGS.
I am licensed under provisions of Chapt. 9, Div. 3 of the Business
NEW CONSTR. ULTI-OUTLET
NON-RESID BRANCH CIRC ITS @ 5.00
and Professions Cod and my license is in full force and effect.
POWER APPARATUS &)
SINGLE OUTLET CIR.
License No. 7 Classification
20 76
EX. OCcup�OUTLETS OR FIXTURES qAL- 46
I, as the owner, or my employees with wages as their sole compen-
FIXED APLNS.
Ex. OCCUp. OUTLETS (RESID,)REAT I 3.00 3.00
sation, will do the work,and the structure is not intended or offered
Temporary service 15.00
for sale. (Sec. 7044)
Elas the owner, am exclusively contracting with licensed contract
Mobile Home Facilities 15.00
ors. (Sec. 7044)
o
Misc. Wiring
9 15.00
❑ I am exempt under Sec. , Business and Professions Code
for this reason
Permit Fee $
WORKMEN'S COMPENSATION INSURANCE
Contractor
I declare under penalty of perjury (check one):
MECHANICAL PERMIT Filing Fee 15.00
❑ The permit is for $100.00 (valuation) or less.
Heating
❑ I have placed on file with the County of Butte Building Department
of Workmen's Compensation Insurance or a Certificate
ZICertificate
f Consent to Self -Insure.
Cooling
shall not employ any person in any manner so as to become subject
Hood 6.50
to the W. C. laws of California.
Ventilation
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
Permit Fee $
provisions or this permit shall be deemed revoked.
Contractor
I certify that I have read this application and state that the above information
Mobile Home Installation Fee $
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Energy Inspection Fee $
Butte to enter upon the above-mentioned property for inspection purposes.
OCC CONST TYPE
I also agree to save, indemnify and keep harmless the County of Butte against
TOTAL FEE $ 48.00
all liabilities, judgments, costs, and expenses which may in any way accrue
HAz DFEES IMP FLOOD CDT PARCEL PD HD IssuE
against s i County in copse .ence of the granting of this permit.
I I I I I
XDate �� Ci
This permit is hereb issued under the applicable provi-
�—
Sign re of Applico t — Owner ❑ Contractor Agent ❑
sions of the Butte o ty Code and/or resolutions to do j
An A permit is required for excavations over 5'0" deep and demolition or construct-
Work indi a for which fees have been paid.
ion o structures over 3 stories in height.
OR OF PUBLIC WORKS
Receipt No. 129731
By Dat —? 93
WNIT6'D.P•W.,YELLO W-ASSE$SOR, PINK -INSPECTOR,
PE T EXPIRES Date `23
GOLDENROD -APPLICANT �
. r.. r ...-.f',,I;;�i-.r•,:}�.F:✓t.}tlrrl�,�i„i'1Wf'i{-t'�"�i�f'f�,.l��"nMPW-�y t!}t1:r+.�.:.�'-rr. •,,.r �j� If.,7v�-�+}�firfi
COUNTY OF BUTTE -. DEPARTMENT•OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE,,:CALIFORNIA 95965 - TELEPHONE (916) 538-7541
PERMIT APPLICATION DATA SHEET
OWNER (Oa c -,(O cm T �6`C [-
--l��0 � A. P. No. ��r�/0
Proposed Building Use AV/j /'j{f / IT -:M -319' 7 < ''5>i#g Inspector Date
At time of p rmit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED BY
1. All items have been submitted.........................................
2. Plot plans, 3/4 sets, signed by preparer of plans . ..........................
3. Complete plans, 3/4 sets, signed by preparer of plans . ..............:.... .
4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . .............
5. Hazardous Material Form . ............................................
6. Energy Design Compliance and supporting documentation . ..................
7. Statement of Intent for Non -Heated and A/C Buildings . ......................
8. Engineered truss details and layout in duplicate (required prior to plan check). ....
9. Mobilehome data and manufacturer's installation instructions, 2 sets. ...........
10. Fees of$ ..........................................
11. Impact fees as shown on attached schedule . ..............................
12. California Department of Forestry plan approval/fees. ....................... .
13. Flood elevation letter (100 year flood) by California Engineer . ................. .
14. Sanitation and plot plan approval Health Department . ..............
15. City of Chico plumbing permit . ........................................ .
16. Plot plan and business license approval from City of Biggs/Gridley. .............
17. Planning approval for (A) Use: (B) Parking: . ........
18. Contact Land'Development about (A) Improvements (B) Drainage. .......... .
19. Driveway permit (construction approval required prior to occupancy). . .
20. Pre -inspection for to Building
Inspector
required. . to Building Inspector (Date)
21. Contractor's license information. (No., Name Style, Classification) . ..............
22. Certificate of Workmans Compensation Insurance . ...........................
23. Owner -Builder Verification (Given to owner , Mail to owner _) ............
24. Recorded copy of Agricultural Acknowledgement Statement . ..................
25. Letter of signature authorization . ........................................ .
26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... .
27..: Letter of intent on building use . ..........................................
28. •.Mobilehome utility clearance . ..........................................
29. Documentation of legal access . ........................................
30. Documentation of 50% subdivision developed or (A) Road improvements completed
and (B) Parcel meets zoning area and frontage requirements . ...............
31. Existing violations/expired permits . ......................................
32. Plan check list . .....................................................
33.
34.
When you issue the permit, process as follows: Mail to owner.
Telephone and hold for pickup at
Other
Parcel Creation
Acreage • Applicant
Mail to
_ contract
office. ggr
eliveinspector.
Date / , � " 3
Copy of Haz-Mat form sent Health Dept. . Fire Dept. V Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submitted prior to permit issuance: (Circle new item not checked above).
1. Index permit for above items No.
2. Additional items required:
Contractor, designer, owner, was advised of above required data by _ phone -mail Counter by _ Date
Contractor, designer, owner, was advised of above required data by - phone _ mail Counter by _ Date
Plans checked by Date Plans approved by Date
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Works
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone: 916,538-7541
APPLICATION AND PERMIT
ASSESSOR P=RCEiNUDQB R`� ��
UU —
ZONING
BUILDING PERMIT
O WNE � o
� � lL Aill�`r�
TE -7 O1N�E�
�S7 �lt/i0J_ fQ
SQ. FT. OCC. BUILDING VALUATION
OWNER'S MAILI
1/N/��i
V/�DD 1q STI 2t,Jl�l�
CON�7R�1/Ah1TOR' NAME �` �
tflo
T LEPHONE�
3
c0 CTOR' MAILING ADDRESS'n
L p�IC( ��^ (�
Fireplace
CONSTRUCTION LENDER
VNKNOWN
Total Valuation $
Filing Fee
$ 15.00
LENDER'S MAILING ADDRESS
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penally _
$
BUILDING Ao RESS NZ e--
mlI fee
$
PLUMBING PERMIT
FllingFee
15.00
h Trap
iSol
5.00
arr or heat pump water heater
20.00
LOT NO.
'SUBDIVISION NAME
PARCEL MAP
Water piping
7.00
Each qas water heater or vent
7.00
USE OF STRUCTURE
SF Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home S I G I :W=
@ 15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities(] Installation[] Other ❑
Describe work: _
i-GC�S-%�
Permit Fee $
Contractor
ELECTRICAL PERMIT Filing Fee 15.00
`
Main service 600V OR LESS 18.50
200A OR LESS _
Main service 200A To IOOOA1 37.50
CONTRACTORS LICENSE LAW
declare under penalty of perjury (check one):
r_1 I am licensed under provisions of Chapt. 9, Div. 3 Of the Business
and Professions Code and my license Is In full force and effect.
License No. Classification
El 1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
[] I, as the owner, am exclusively contracting with licensed contract
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW corlSr. ( DWELLING OCCUP.11e\ 3.66Sq.1t.
OR ADONS. ACC. SLOGS. //
NEw CONSTR NON-RESID BRANC CIRCUITS)
POWER APPARATUS &)
(SINGLE OUTLET CIR.
Ex. Occup(OVTLETS OR FIXTURES L.20XFIXED 76
Ex. Occup. OUTLETS IPRESID 1REA.) 3.00 rO V
Temporary service 15.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $
LK
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
Filing Fee 15.00
Heating
Cooling
Hood
_ 6.50
Ventilation
Permit Fee $
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County 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 pe it.
X Date
Signature of Applicant — Owner E]Contractor ElAgent❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee S
Ener Inspection Fee $
9Y P
occ
CONST TYPE
TOTAL FEE $ 1
IIAz
0FEES
IMP
FLOOD
OF
I PARCEL
PD
HD
I ISSUE
This permit is hereby issued under the applicable provi-
sions of the Butte County Code and/or resolutions to do
i
work indicated above for which fees have been paid.
DIRECTOR OF PUBLIC WORKS
By -_ Date
PERMIT EXPIRES Date
Receipt No. /g9.-7�
WNITC-O.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT
O w n e r:
LOCATION
ROOF
MATERIAL
•.. THICKNESS
EXTERIOR WALL
r•
Permit0
ENERGY CERTIFICATION
A.P. #
DESCRIPTION OF INSULATION
MATERIAL Fiberglass
THICKNESS
CEILING
1
BATT"OR BLANKET TYPE—FIBERGLASS
THICKNESS
a LOOSE FILL INSULSAFE III
THICKNESS
FLOOR—ELEVATED
BRAND NAME
THERMAL RES.
BRAND NAME Certineed
THERMAL RES.
BRAND NAME Certineed
THERMAL RES.
BRAND NAME CERTAINTEED
THERMAL RES. 3 (�
::ATERIALFiberglass BRAND NAME Certineed..
�~ THICKNESS
THERMAL RES. _ 1/9.
FLOOR—SLAB
INTERIOR WALL
MATERIAL Fiberglass
THICKNESS•
BRAND NAME Certineed
THERMAL RES.
. r
I HEREBY CERTIFY THAT THE ABOVE INSULATION WAS INSTALLED IN THE ABOVE
BUILDING�IN CONFORMANCE WITH THE STATE OF CALIF. ENERGY REQUIREMENTS. i
HAWKIN I � D.IN dba HASTA INSULATION LIC.#650722
Ihereby certify the—above insula
tion and all required items as shown
on the building department approved plans and attachments have been
installed as required by the State of California Energy Requirements.
All equipment devices and materials
are s ecificallj approved by the Sta
FIRM NAME/OWNER T)
/0 NER (PLEASE PRINT)
s
are of the quality prescribed or
to of Calif.
------5 1 22 i _--- I -S- L-----------
STATE CONT. LIC/
IGNA URE OF ENERAL CONT/OWNER DATE
This certificate must be on file with the Building Dep
and posted within the hitt t di t. prior toFinal
------------------------------------
J3utte
OROVILLE, CALIFORNIA
GENERAL CLAIM
CLAIMANT: Gregory Bickmore
ADDRESS: P.O. Box 9$
CITY & STATE: Stirling City, CA 95978 IMPORTANT:
November 23, 1992 SEE INSTRUCTIONS
DATE OF CLAIM: ON REVERSE SIDE
SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES
DATE
DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT
,Owner has decided not do do work. Permit #92-2405B,
AP#059-085-010, Receipt #115997, dated 7/9/92.
i
.Total Permit Fees Paid ---------------------------------- $30.00
Retain Building Permit Filing Fee--------------- $15.00
Total Permit Fees Retained ------------------------------15.00
TOTAL REFUND DUE ----------------------------------------- $15.00
i
i
I
�
I
TOTAL !
$15
00
I, the undersigned, ]eclare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this
claim is true and correct as stated.
Dated this r � .. day of ,1, , 1 LI , 19� Z et �i �'�iLt !�C ,Califf f 1 f Claimant
J J ,.
Sig a� CS
1, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or de-
livered and that there is a Budget Appropriation a or Specific Board Approval i� (Check o e) fo the me
Dated this.... 23rd November 92 Oroville calif.
day or ............................. 19......, at ..... ..................................................................... ........................
Department Head or Authorize uty
Dept' ....440-002 ................... code ........42..1.0.5.0.0.......................PAYABLE FROM ...........Q;%S.r...a....i..ReJrMit.,5 .......................................... FUND
.............
_
DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY
DEPT. & SUB.
PROJ.
SUB. OBJ.
CLAIM NO.
INV. NO.
INV. DATE
ENCUMB.
GROSS AMT.
F
57i/Z/iNGC�f7 9597€'
1/20/92
SPECIFICATIONS
1. CONCRETE — f c=2000 PSI @ 28 DAYS
2. REINFORCING — ASTM A615, GRADE 40 MIN
3. LAP . SPLICES — 20" MIN _
4. FOOTINGS TO BE EXCAVATED INTO FIRM, UNDISTURBED SOIL
THIS FREE STANDING RETAINING WALL IS DESIGN TO
SUPPORT LEVEL BACKFILL, NO SURCHARGE, AND NO
SUPERIMPOSED LOAD
BACKFILL TO BE NON—EXPANSIVE, GRANULAR MATERIAL.
PROVIDE FOR DRAINAGE BEHIND WALL BY PERFORATED DRAIN
PIPE OR WEEP HOLES THR 0 UGH WALL.
# 4 @ 13" 0. C. HORIZ
# 4 @ 22" 0. C. VERT
UNDISTURBED
SOIL
12"
1 — #4 CONT.
IN FOOTING
6"
T—T
O /
BA CKFILL
O
4' — 0" MAX
a DOWELS TO
MATCH VERT
REINF
Z' CLEAR
9' CLR / U
Ale
12"
MAY OMIT FTG KEY
FOR HEIGHT OF 2'-6"
OR LESS
14
OTHER HEIGHTS OR CONDITIONS REQUIRE ENGINEERING
.Y ..
REINFORCED CONCRETE RETAINING Tf'ALL Rsv DATE scum 3/4*=t--o' DATE: 71 91
BUTTE COUNTY BUILDING DEPARTMENT I DWG: WALL 4 SHT 1 OF 1
......
K , tte un
l?.iV D O. iVATU At W EALTN AMD 5AU
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965-3397
TELEPHONE: (916) 538-7541
FAX: (916) 538-2140
July' 20, 1992
Gregory Lee Bickmore RE: 92-2405
P.O. Box 98 1 A.P. #059-085-010
Stirling City, CA 95978
Dear Mr. Bickmore,
With reference to the above subject and your request for permit refund, we
cannot process this request until we know your proposed plans on the existing
fire damaged residence.
As you know, two living units are not permitted without a Use Permit in an
area zoned "U". The main structure, when remodeled, must be a permitted use
in the zone.
Please contact this office, present plans in duplicate, and make a building
application for work you propose to do. After permit issuance, we will process
the refund request.
Should you have any questions regarding this matter, please contact this office
at (916)538-7541.
JFG:hla
Yours very truly,
06.1bw a-gued.
J.
J.F. Glander,
Manager, Building Inspection
k
a
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 NUMBER
059-085-010
ZONING
U
BUILDING PERMIT
OWNER
GREGORY BICMORE
TELEPHONE
873-1696
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
P.O. BOX 98 STERLING CITY 95978
500.00
CONTRACTOR'S NAME
OWNER
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
500.00
LENDER'S MAILING ADDRESS -
Filing Fee
$ 15,00
Permit Fee
$ 1
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee
$
Penalty
$
BUILDING ADDRESS
17160 MANZANITA
P
Permit fee
$ 30.00
PLUMBING PERMIT
Filing Fee 15.00
Each Trap
5.00
Solar or heat pump water heater
20.00
LOT NO.SUBDIVISION
NAME
PARCEL MAP
Water piping
7.00
Each qas water heater or vent
7.00
USE OF STRUCTURE
SFIV Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home I S I G I W
@ 15.00
• TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work: DEMO
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service ESS
200AOR00V OR LLESS
18.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business(
and Professions Code and my license is in full force and effect.
` License No. Classification
I, as the owner,'or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. Business and Professions Code
for this reason
Main service 200A TO IOOOA)
37.50
NEW CONST. / DWELLING OCCUPM
OR ADDNS. 1 ACC. BLDGS. //
3.64sq.ft.
NEW CONSTRMULTI-OUTLET
NON -REST BRANCH CIRCUITS
@ 5.00
POWAPPARATUS &
(SINGLE OUTLET CIR.
Ex. Occ Up(OUTLETS OR FIXTURES
20 764
FIXED APPLNS. OR
Ex. Occup. OUTLETS IR E51 D.1
3.00
Temporary service
15.00
Mobile Home Facilities
15.00
Misc. Wiring
g
'15.00
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ 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
FiIirig Fee 15.00
Heating
Cooling
g
Hood
6.50
il
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
consecipe a of the granting of this perrmit.
against said Cou2",
XDate / — C%
Signe re of i ant _ Owner❑ Contractor [IAgent ❑
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
I TOTAL FEE $ 30.00
HAz
I DFEES I
IMP
I FLOOD
CDF
PARCEL
I PD
HD
ISSUE
This permit is hereby issued under the
sions of the Butte County Code and/or
work indicated above for which fees
DIRECTOR OF PUBLIC
By
PERMIT EXPIRES Date
applicable provi-
resolutions to do
have been paid.
WORKS
Date
f
Receipt No. /
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
- I
,,�i„ ,., .,� .-z yS �.y,.t �� .-2, 7•...�,,. _3�'�+Ij►�..4�'y'Z%T C^r rlly'����'"i ''�.'�e�tr �7, Cl,y •riu�, 7'rw vrf. ,r yx,
a
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE'=�ROWILItALIFORNIA 95965 - TELEPHONE (916) 538-7541
VI _.
PERMIT APPLICATION DATA SHEET
OWNER V Rf�
Proposed Building Use
o/l y b i Gk".7 0 Asr_
Building Inspector
A.P.No.
i�:S" Date 7 T 5 L
At time permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED BY
1. All items have been submitted . ................. .
2. Plot plans, 3/4 sets, signed by preparer of plans. ..... .................. .
A ' ' 3. Complete plans, 3/4 sets, signed by preparer of plans.
4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . .............
5. Hazardous Material Form . ............................................
6. Energy Design Compliance and supporting documentation . ................. .
7. Statement of Intent for Non -Heated and A/C Buildings . ......................
8. Engineered truss details and layout in duplicate (required prior to plan check). ... .
9. Mobilehome data and manufacturer's installation instructions, 2 sets. ...........
10. Fees of$ ..........................................
11. Impact fees as shown on attached schedule . ..............................
12. California Department of Forestry plan approval/fees. ....................... .
13. Flood elevation letter (100 year flood) by California Engineer . ................. .
14. Sanitation and plot plan approval Health Department . .............
' 15. City of Chico plumbing permit . .........................................
16. Plot plan and business license approval from City of Biggs/Gridley. .............
17. Planning approval for (A) Use: (B) Parking: . ........
18. Contact Land Development about (A) Improvements (B) Drainage.
19. Driveway permit (construction approval required prior to occupancy). . .
20. Pre -inspection for required. o Burilding Inspector (Date)
21. Contractor's license information. (No., Name Style, Classification) . ..............
22. Certificate of Workmans Compensation Insurance . ..........................
23. Owner -Builder Verification (Given to owner , Mail to owner ).
24. Recorded copy of Agricultural Acknowledgement Statement. :.............. .
25. Letter of signature authorization. .
263 Copy of recorded deed of parcel creation and 60 right of way to a public road. .... .
2-7..Lett er of intent on building use . .........................................
28 -Mobilehome utility clearance . ......................................... .
'29'- Documentation of legal access . ........................................
30: bDocumentation of 50% subdivision developed or (A) Road improvements completed
% and (B) Parcel meets zoning area and frontage requirements . ..... :.........
31. Existing violations/expired permits.
32. Plan ch ck li t. ............................
`1
3a.
When you issue the permit, process as follows: Mail to owner. Mail to contractor.
_1Telephone and hold for pickup at office. Deliver with inspector.
Other
Parcel Creation 7 _ 5crZ
Acreage Applicant _ N ate
Copy of Haz=Mat form sent Health Dept. , Fire Dept. Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submitted prior to permit issuance: (Circle new
1. Index permit for above items No._,
2. Additional items required: 0
not checked above).
Contractor, designer, owner, was advised of above required data by _ phon _mail Counter _ ate I
Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date
Plans checked by Date Plans approved by Date
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Works
q,.
COUNTY OF BUTTE - De,partment 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.
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) )'i f�-tJ� 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
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 Nu ber -
Date ? — % 13�2_
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.
PERMIT NO. 4250-74B
P
f .
E
�r
M
MH UTIL.
PERMIT NO
PERMIT EXPIRES / r'/ 'rel `l" `7 S—
OWNER H.D . Counter
' CONTR.
IILOCATION (A P. 59-085-10
608 Manzanita, Stirling City
r
Temp. Power Pole_
Called PG&E
Temp. Elec. Serv._
Called PG&E
Temp. Gas Serv. _
Called PG&E
JOB
FINALED
(Date)
(Signature)
ti
COUNTY OF BUTTE — DEPARTMENT OF: PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING
BUILDING (Cont'd)
PLUMBING
Setback
Firewall
Soil Piping
Forms
Parapets
1st Floor
Main Bldg.
Restroom Finish
2nd Floor
Footings
Windows
3rd Floor
Stemwall
Siding
To out
Slab
Roof Sheathing
Water Piping
Piers
Roofing
Sewer
Garage
Fdn. Vents
Fixtures
Footings
Garage Vents
Water Htr.
Stemwall
Slab
Prov. for physically
handicapped
Heaters
Appliances
Carport
Footings
Conformance of ex.
structure
Gas Piping & Test
Temp. Gas
Slab
Final
Sanitation
Patio
FIREPLACE
Final
Footings
Footing
ELECTRICAL
Masonry Walls
Throat
Rough
Reinf. Steel
Final
Fixtures
Bond Beam
FIRE SPRINKLERS
Motors
Framing
Test
Water Htr.
Stucco
Final
Subpanels
Mesh
MECHANICAL
Grd. Fault Prot.
Scratch
Heating
Service
Brown
Cooling
Temp. Pole
Finish
Ducts
Underground
Interior Lath
Ventilation
Permanent
Door Closer
Final
Final
DATE
P//7/7
s .
011
REMARKS OR CORRECTIONS
,0�
♦P
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WO KS
7 County Center,prive •i ,j Oroville, California 95965
Telephone: 534-4541
APPLICATION AND PERMIT 7�z
BUIL ING
Owner1 CJ /1/ ��
.SQ. FT. OCC. BUILDING VALUATION
Mailing Address . U )3
A..
+r
Telephone o.
Fireplace
Contractor
Total Valuation ��C)
Mailing Address
Permit Fee _.G
Plan Checking Fee&/or Penalty L
Telephone No.
Permit Fee(TOi
Building AddressPLUMBING
No. . @ FEE
PERMIT FILING FEE $2.00
Each Trap 1.50
Repair drainage or vent piping 1:50
Water piping 1.50
Each gas water heater or vent 1.50
A. P. No. — 1 �)
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
Fe
W
��SS //��._
61211tlstion
FireDept. Fire Zone
Use Permit
Building sewer 5.00
EQA
Parking
Plans
I ParcelParcel
eclaration
Ma P
60' R/W
Im r vements
P
Lawn sprinkler system 2.00
Bldg. Plans ". -ed
Pael Approval
P /Approval
Permit Fee $
NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER
ELECTRICAL No. @ FEE
PERMIT FILING FEE $3.00
-S
Main service incl. 1 meter
Additional meters, each 1.00
Single Family ® Duplex ❑ Mobil Home ❑ Others ❑
Sub -panel (12 or less) (more than 12)
Range, Cook -top or Oven 1.00
Water Heater or Space Heater 1.00
Light fixtures [(d
Receps., switches & fix outlets
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
Hood, Ex. Fan or F. A. Furn. Motor 1.00
Evap. cooler, gar. disp. or D.W. 1.00
Air conditioner or heat pump
; Water pump
Mobil Home Facilities 5.00
Temp. Power Pole 5.00
License No. Classification
Misc. wiring
— Z.1 am exempt from the Contractors License Laws of the State of California.
Permit Fee $
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑ I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
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 Workmen's Compensation Laws of
California.
MECHANICAL, No. @ FEE
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
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
TOTAL PERMIT FEE TO
s �
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
X Dat�v
Signature of PPermiteeor Agent
4 Receipt No. .2 6 r ) ;L a
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTO 0 PUBLIC WORKS
By Date
Uilding permit expires Date..............1�`7-y —7?
c r '
1 his set of plans and specifications MUST be
'kept on the job at all times and it is -unlawful to'
make any changes or alterations on same without
written permisson from the Department of Public, ^r
` Works, County of Butte.
17.
TOTE:—Alf Materials & Workmanship Shall be ire
\ccordance , with Recognized Good Practices and '
:)f a quality presc ibed for the Specified use in the
Uniform Building Code, Uniform Plumbing Code, an,'
the National Elec rical Code:
.,f s
;, e s
y g it
e e�
all/1C �•
asleK
rhe Bldg. Setback shall be .5 ft. from BUTTE COUNTY °
side property line and 50 ft. from BUILDING DEPARTMENT
centerline of the road, permi4fing r
Ximum of a 2 ft. eave overhang. r APPROVED
14, D
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BUTTE COUNTY
BUILDING DEPARTMENT
APPROVED
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BUTTE COUNTY
BUILDING DEPARTMENT
APPROVED
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COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
ZZ 7 County Center Drive - Orovllle, California 95965 - Telephone: 916,'536.7541
APPLICATION' AND PERMIT
PERMIT NO.
92-2829
ASSESSOR PARCEL NUMBER
059-085-010
ZONING
U
BUILDING PERMIT
OWNER
GREGORY LEE BICKMORE
TELEPHONE
873-1696
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
P.O. BOX 98 STIRLING CITY 95978
CONTRACTOR'S NAME
OWNER
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee
$ 15,00
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee
$
Penalty
$
BUILDING ADDRESS
17160 MANZANITA STERLING CITY 95978
Permit fee
$
PLUMBING PERMIT
Filing Fee 15.00
Each Trap
5.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME
TOWNSHIP STIRLING CITY
PARCEL MAP
Water piping
7.00
Each qas water heater or vent
7.00
USE OF STRUCTURE
SF ❑ Duplex❑ Mobilehome❑ Other T T
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home I S TGTW
@ 15.00
TYPE OF WORK
New Addition E] Remodel❑ Utilities❑ Installation[) Other ❑
Describe wN� C WIRING
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 200A OR LLE
ESS
18.50
Main service 200ATOI000Al
37.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
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 .Jo. Classification
I, as the Owner, Or my employees with wages as their sole COmpen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044) •
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUP.N\
OR ADDNS. ACC. BLDIT /
3.64sq.ft.
NEW CONSTR ULTI-OUTLET
NON -REST BRANCH CIRC ITS
@ 5.00
(POWAPPARATUS&)
\SINGLE OUTLET CIR.
EX. OCCU po UTLETS OR FIXTURES
20 760
FIXED APPLNS. OR
EX. DCCUp. OUTLETS (RESID.1 EA.�
I 3.00
Temporary service
15.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00 15.00
J—
I
Permit Fee
$ 30.00
—
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.
1 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 1 15.00
Heating
Cooling
g
Hood
6.50
Ventilation
Permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
agai t said County in nse noe f the granting of this permit.
X-�2
Date
Signet a of A li a t — Owner Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or Construct-
ion of structures over 3 stories in heigf .
Mobile Home Installation Fee S
Energy Inspection Fee $
OCC
CONST TYPE
I TOTAL FEE $ 30.00
HAz
1 DFEES I
IMP
I FLOOD
CDF
PARCEL I
PD
I HD
ISSUE .
This permit is hereby issued under the
sions of the Bu to Cont Code and/or
r which fees
F PUBLIC
`^for:,��u
By
PERMTT EXPIRES Date
applicable provi-
�
resolutions to do
have been paid.
WORKS
Date �/31Z
Receipt No.
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
I
N
COUNTY OF BUTTE -
r
OWNS
..s.✓a.aYTn^ �i71 _. a,.y��,s s f, er Yt r+�ra ^ Xf "`,•",
DEPARTM NT;�O '- PUBLIC WORKS -
,.
BUILDING DIVISION
7 COUNTY CENTER DRIVE - OR VIELE,'8ALIFORNIA 95965 - TELEPHONE, ,(9',16) 538-7541
PERMIT APPLICATION DATA SHEET
Proposed Building Use MisC fle, 7_r% . Building Inspector
A. P
C g
No. 5y ���•t/J
Date S Z
At time chi'permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
(// 1 DATE PTCEIVED BY
1. All items have been submitted.
2. Plot plans, 3/4 sets, signed by preparer of plans. a
3. Complete plans, 3/4 sets, signed by preparer of plans . ......................
4. Engineered plans and calcs, "3/4 sets, with wet signature on plans . ............ .
5. Hazardous Material Form . ............................................
6. Energy Design Compliance and supporting documentation . ..................
7. Statement of Intent for Non -Heated and A/C Buildings . ......................
8. Engineered truss details and layout in duplicate (required prior to plan check). ....
9. Mobilehome data and manufacturer's installation instructions, 2 sets. ...........
10. Fees of $ ..........................................
11. Impact fees as shown on attached schedule . ..............................
12. California Department of Forestry plan approval/fees.
13. Flood elevation letter (100 year flood) by California Engineer . ................. .
14. Sanitation and plot plan approval Health Department . .............
15. City of Chico plumbing permit . ..........................................
16. Plot plan and business license approval from City of Biggs/Gridley. .............
17. Planning approval for (A) Use: (B) Parking: . ........
18. Contact Land Development about (A) Improvements (B) Drainage. .......... .
19 Driveway permit (construction approval required prior to occupanc )
y .F're-Inspection requeis-
20. Pre -inspection for required. .. to Building Inspector
(Date)
21. Contractor's license information. (No., Name Style, Classification) . ..............
22. Certificate of Workmans Compensation Insurance . ..........................
23. Owner -Builder Verification (Given to owner , Mail to owner .......... .
_).
24. Recorded copy of Agricultural Acknowledgement Statement. ................. .
p
25. Letter of signature authorization . ....................................... .
26.;, Copy of recorded deed of parcel creation and 60 right of way to a public road. .... .
2T., Letter of intent on building use . ........................................ .
a8" Mobilehome utility clearance . ..........................................
29. Documentation of legal access . ........................................
- 30. Documentation of 50% subdivision developed or (A) Road improvements completed
and
and (B) Parcel meets zoning area and frontage requirements . ...............
' 31. violations/expired permits . ......................................
32. Plan check list . ............................................. `....... .
33.
34.
.
When you issue the.permit, process as follows: Mail to owner. Mail to contractor.
Telephone and hold for pickup at office. Deliver
with inspector.
Other
Parcel Creation
S--//-
--If_Acreage
AcreageApplicant4:�ygate
Copy of Haz-Mat form sent Health Dept. - Fire Dept. Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date
By
The following data must be submitted prior to permit issuance: (Circle new item not checked above).
1. Index permit for above items No.
2. Additional items required: "
Contractor, designer, owner, was advised of above required data by _ phone -mail Counter by _ Date
Contractor, designer, owner, was advised of above required data by _ phone -mail Counter by _ Date
Plans checked by Date Plans approved by Date
Sets of plans on holdhn File cabinet AP folder
Copy - Department of Public Works
COUNTY OF BUTTE - Depattment 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.
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..
—J. 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 work.
3. I have contracted with the following person (firm) to provide the proposed
construction:
Name
Address City
Phone Contractors License No.
4. 'I plan to provide portions of this.work, but I have hired the'following person
to coordinate, supervise, and provide the major work:
_. Name
Address City
Phone Contractors License No.
.5....1 will provide.s.ome.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 ("A4P r4i �6u�
Social Security N&nbeP Q!
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.
A-1 le -
OJ
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Orovllle, Cellfornla 95965 - Telephone: 916.'538-7..541
APPLICATION AND PERMIT
PERMIT NO.
Assess 5-9 NUMBERo 8 S ^01 O
ZONING
L)
BUILDING PERMIT
OWNER
TE E HONE
SQ, FT. OCC. BUILDING VALUATION
OWN 'S MAILI G ADOR SS i
SRI��y C, �� j^9
CONTRACTOR'S NAME TELEPHONE
JL
LJ� /
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is
Filing Fee $ 15.00
LENDER'S MAILING ADDRESS
Permit Fee $
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
Energy Plan Checking Fee $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
Permit fee $
PLUMBING PERMIT Filing Fee
15.00
I -7/16o A�'� `��
Each Trap 5.00
Solar or heat pump water heater 20.00
LOT NO. SUBDIVISION NAME _ ✓ PARCEL MAP
�r
USE OF STRUCTUR
SF ❑ Duplex❑ Mobilehome❑ COther�
SPECIFY
Water piping 7.00
Each qas water heater or vent 7.00
Gas piping system 1 - 5 outlets 5.00
Building sewer 15.00
Mobile Home I S I G JW I @ 15.00
TYPE OF WORK
New J Addition❑ Remodgl❑ Utilities❑ Installation❑ Other
r
Describe work:
Permit Fee $
Contractor
ELECTRICAL PERMIT Filing Fee 15.00
Main service 600V OR LESS 18.50
200A OR LESS
_
Main service 20GATO 1000AI 37.50
CONTRACTORS LICENSE LAW
I declare under penalty perjury
p y of p erjy (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
License ;Jo. Classification
❑ I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST.( DWELLING OCCUP.&) 3.60 sq.ft.
OR ACDNS. ACC. BLDGS. /
NEW CONSTFL MULTI—OUTLET
NON-RESID, BRANCH CIRCUITS.) @ 5.00
/POWER APPARATUS R
(POWER
OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURES 20 76
A
Ex. Occup. OUTLETS IRES r, IRE 3.00
Temporary service 15.00
Mobile Horne Facilities 15.00
Misc. Wiring 15.00
Permit Fee $ 3-0
Contractor
—
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
❑ I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT FiIingFee 15.00
Heating
Cooling
LHood 6.50
_
I 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 ❑
onstruct-
i n OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion
on of structures over 3 stories in height.
Mobile Home Installation Fee S
Ener Inspection Fee $
9Y P
occ
CONSTTYPt
TOTAL FEES 3� o�
HAz
1 0FEES I
IMP
I FLOODcDF
PARCEL
PD
HD
ISSUE
This permit is hereby 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 No.
1
WNITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
r
RESIDENTIAL
(�59-085-10v 92-2149 P,E
k BICKMORE, Gregory
17160 Manzanita, Stirling City
travel trailer utilities
�1a�93
OFFICE COPY
), Address
H GAS
F Meter By ELECTRIC
Meter By
�JOB FINALED (Date) -
Signature
t
Date
I
Date7�.,
r
r
r
RESIDENTIAL
(�59-085-10v 92-2149 P,E
k BICKMORE, Gregory
17160 Manzanita, Stirling City
travel trailer utilities
�1a�93
OFFICE COPY
), Address
H GAS
F Meter By ELECTRIC
Meter By
�JOB FINALED (Date) -
Signature
t
Date
I
Date7�.,
V=OK
O = Not OK
Not
= Not Readyable MOBILE HOMES
Date MOBIL -HOME UTILITIES Plans OK except #'s
o 'ng Requirements -Setbacks -Easements
--So
jjs�Special MH Support Sketch
SP
j,wer; Location -Test -Fall -C/O Concrete
Water; Location -Test -Easement Needed (Sketch)
Electricity; Location-Clearences-Gr -//,WAmp-Concrete
Gas; Location -Test -Wrap: / /"L"ft.
/ P a . or/ /"L"ft./ /"LPG `
7. Well Clearance & Disconnect �j�r (/JBPeN
8. Utility Clearance
Date Card B-1 Gazf 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 Approval
8. Gas and Electricity Tagged
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
5a~I
ZfIf
ViD /It
,//i,, --)e d
HQ.J,)
/114 1,JIA-i .11 V-A'
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s
1. Zoning Requirements -Setbacks -Easements k:
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.-Connectors
Shthg.-Rfg.-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distances-GFI
5. Elec.; Pool Lighting; 15 volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes- Enclosures- 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 UNDERFL OR (Plans) OK except u's
1. ZChing-Setbacks-Easements-Flood-Slope
2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth
3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth
5. Stemwalls, Main; Steel -Bloc kouts-Wrapped
6. Stemwalls, Garage; Steel-Blockouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab; Steel -Wrapped
8. Piers -Fireplace Ftg.-Steel
9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test
11. Water Pipe; Test -Anchor -Regulator -Service Test
12. Electric; Underground
13. Pienums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
15. Access & Ventilation
16. Insulation
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date PLUMBING (Permit),OK except #'s
16. Water Htr.: Vent -Access -Combustion Air -Baffle
--------------------- ------------------------------
17. Water Pipe; Test & Anchor -Nail Protection
18. D.W.V ; Test -Fittings & Anchor -Nail Protection
---------------------- - -----------------
19. Shower Pan; Test, First Floor -Tub Access
20. Test Tub & Shower. Second Floor -Tub Access
------------------- ---------- ------------------
21. Gas Pipe: Size & Anchors
---------- -------------------------------------------------------------
Date Card B_1 --- - Date - Card B-1
-------------- - ------------
Date Card B-1 Date Card B-1
Date ELECTRICAL (Permit) OK except 4's
22. Fixture & Transformer Clearance -Ins. Protection
--------------- ---- ---------------------------------- ----------------------
-- - - 23. Elec_Recept-acles Spacing -Lights & Switches at Doors
------ -------------------------------------- --------
24. Size Boxes & No. of Conductors -Stapled
-----------------------------------------------------------
- - 25. Romex Installed Close to Edge of Studs & C.J.
26. Equip. Ground made up w/Mech. Fastners-Bond Gas & Water
- ---------------------------- ------------------ ----------------------------
27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI
--------------------------------------------------------
28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size r / ga.
------------------Cu or -Al --------------
29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al.
Insulated Neutral ❑ Yes ❑ No
------------------ ---------------------------------
30. Service -Riser Conductors & Ground -Main Disconnect
------------- - ------ - -------------------------------
----------
31. Equip Clearances Panels-Motors-Mech. Equip.
- - ------------------------------- - ------
32. Clothes Closet Light -Shower Light -Spa Light
-------------
33.
-------- 33. Smoke Detector
-------------------------------------------------------------------
-----------------------------------------------------------------------------------
Date
------------------------------------------------
Date Card B-1 Date Card B-1
-
-----------------------------------------------------------------------------
Date Card B-1 Date Card B-1
Date MECHANICAL (Permit) OK except u'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 FRAMING (Plans) OK except #'s
39. Sils. Proper Material & Anchors ,
------- ------- ----------------------------------------------------------------
40. Walls Studs -Nailing. Spacing &'Bracing -Plates -Sound
------------ ----------------------------------------------------------------
41. Bearing Walls over Girders & Floor Nailing
--------------------------------------------------------
42. Draft Stop in Walls (rat proof)
_---- ------------------------------------------------------------------
-------------
43.. -Fire -Stops: Furred Ceilings -Stairs -Chases -Tub
----- ---- ---------------------------------------------------
44. Headers & Beam -Size & Bearing
Mngle & Duplex)
•
Date FRAMING (Continued)
45. Hangers -Post Caps -Anchors -Connectors
46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Rfng.
47. Fireplace Ties or Type A Flue -Fireplace Throat clearance
48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions
50, Garage Fire Protection Framing
Property Line Firewall & Openings
52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits
_ 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers
----------- 55. Siding -Nailing Veneer
56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
57. Glazing Area -Glass Protection -Skylights -Plastic
58. Shear Walls; Nailing -Bolts
59. Insulation -Walls -Ceilings
------------ -------------------
60. Infiltration -Walls -Windows
--------------------------------
Date Card B-1 Date Card B-1
-----------
Date Card B-1 Date Card B-1
Date FINAL (Plans) OK except 14's
61. Ext. Steps -Door & Sidelight Protection -Landings
------------------------- --
62. Smoke Detector
---------------
-------------- -
63. Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage: Above Floor-Ducts-Mech. Protection
---------- ----------------
64. Bedroom Exiting
----------------- ----- - -----
________ 65.__G.F.I. & Bath Fixtures & Tub Access -Spa
66. Elec. Trim & Subpanel: Breaker Sizes & Labels
------ --------------
67. Stairs & Rails
68. Fireplace or Stove: Clearances -Hearth
----------------
69.
------- 69. Elec. Outlets at Wood Panel: Int. & Ext.
--
----------------- ____
----------
70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
71. Elec. Outlets & Receptacles at Kit. Counter
--- ----- ------------- ---
72. Garage Fire Door; Swing -Landing -Closer
-
------------------------------
--------------
--------------------------- 9 --- -
73. A.C. Duct in Gara a - Damper
74. Wtr. Htr.: Vents -Clearance -Comb. Air-Connector-P.R.V.
In Garage: Above Floor-Mech. Protection
75. Plb.. Elec. & Mech. Equip. Listed for Location
---------------------------------
76. Elec. Receptacles in Garage: (G.F.I.)-Romex Protection
------------------
7;. Insulation -Foam -Looked in Attic D Yes
- ------------------------------
78. Guard Rails & Deck Construction -Post Caps
79. Fdn Vents & Crawl Hole Door -Drainage & Wood -Earth
Clearance Looked under Floor D Yes
80. Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No;
Planters ❑ Yes ❑ N_o
---- -- -
81. Stucco Brown -Finish
-- -
82 A.C. Unit Disconnect, Electrical, Plumbing
-----------------------------
83. Vents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to
Openings
84. Water Well; Disconnect, Electrical, Plumbing
85. Exterior Elec. Trim: G.F.I. Receptacle -Underground -
--- --- ---------- -- -------
86. Ventilation Throughout House
- -------------------------------- - ---
87. Glass Protection -
.. - ----------------------------------------------------
88Corrections from Previous Inspections
- - - - - - -- --- --------------------------------------
89. Gas Test -Meters Tagged; Gas Electric
--------------------------------------- -------- ------
90. Water & Sewer Connected -C/O to Grade -HD Approval
91. 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:
COUNTY OF' BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Orovi Ile — Phone: 538-7541'
747..Elliott Road, Paradise— Phone: 872-6307
CORRECTION NOTICE
2�
OWNER— PERMIT NO.
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
M1 ii i 1
— —
r: Date /
Inspector
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Orovidle. Ce111fornia 95965 - Telephone: 916;538-7541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
ZONING
TT
BUILDING PERMIT
OWNER
GREGORY BICKMORE
TELEPHONE
873-1696
SO. FT. OCC.1 BUILDING VA A ION
OWNER'S MAILING ADDRESS
P.O. BOX 98 STIRLING CITY 95978
CONTRACTOR'S NAME
OWNER
TELEPHONE
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee
$ 045 -00 --
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ GV �•
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee
$
Penalty
$
BUILDING ADDRESS
17160 MANZANTIA
Permit fee
t"
$
PLUMBING PERMIT
Filing Fee 15.00
Each Trap
5.00
Solar or heat pump water heater
20.00
LOT NO.
SUBDIVISION NAME PARCEL MAP
�`� „✓ J .P,7 4f
Water piping
7.00
Each qas water heater or vent
7.00
USE OF STRUCTURE,
SF ❑ Duplex❑ Mobilehome[3 Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home@
15.00 no
. TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities V Installation[] Other ❑
Describe work: T.T. UTILITIES
J
Permit Fee
$ 60.00
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 200A OR LESS
18.50 18.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the BUS mess
and Professions Code and my license is in full force and effect.SINGLE
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)
El 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
Main service 200A TO t00oA)
37.50
NEW CONST. / DWELLING OCCUP.&)
1
OR ADDNS. ACC. BLDGS.NEW
3.6asq.ft.
CONSTR MULTI -CUTLET
NON -R ESI BRANCH CIRCUITS)
@ 5•��
POWER APPARATUS &1
OUTLET CIR. I
EXOccu
. Occup(OUTLETS OR FIXTURES
20 76
Ex. Occup. OUTLETS IIRESID IRE A.�
I 3.00
Temporary service
15.00
Mobile Home Facilities
15.00 15.00
Misc. Wiring
-15:00
Permit Fee
$ 48.50
—
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.
91, 1 shal I not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT
Filing Fee 15.00
Heating
Cooling
g
Hood
6.50
Ventilation
permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County ' consequence of the granting of this permit/.
X tipDate — / _
Signa re Ap icant — Owner Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 storiesin height.
Mobile Home Installation Fee S
Energy Inspection Fee $
occ
CONST TYPE -
TO FEE $ 128.50
HAz DFEES
FLoo PARC
HD E
This permit is hereby issued under
sions of the Butte C my Code and/or
work indicated ab for hich fees
D OR PUB IC
By
PER IT EXPIR ate •--
,
the applicable provi-
resolutions to do
have been paid.
WORKS
Date
Receipt No. B U
WHITE-O.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
t BUILDING DIVISION
COUNTY OF BUTTE PARTME.NT�OF PUBLIC WO :,�=
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORN,IA-9E�965 - TELEPHONE (916) 538-7541
PERMIT APPLICATION DATA SHEET -
OWNER���-� ,1'1���.�i !j P.- ��"" //•4/
Proposed Building Use
0
Building Inspector
Date
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
+. RECEIVED By
1, All items h e een submitted. .......yy
2. Plot plan , 3/ sets, signed by preparer orffC ns...... . ...... . �Q . �1
3. Complete ans, 3/4 sets, signed by preparer of plans. . ' ................... .
4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . .............
5. Hazardous Material Form . ............................................
6. Energy Design Compliance and supporting documentation . ................. .
7. Statement:of Intent for Non -Heated and A/C Buildings . ......................
8. Engineereettuss details and layout in duplicate;(�required prior to plan check). ....
9. Mobilehome data and manufacturer's installation instructions, 2 sets. ...........
10. Fees of$ ..........................................
11. Impact fees as shown on attached schedule . ............................. .
12. California Department of Forestry plan approval/fees. ........................
X13. Flood elevation letter (100 year flood by lifornia Engineer. .. .
14. Sanitation and plot plan approva, C Health Department.
15. City of Chico plumbing permit. .. . .................... ge:w,6,r1
16. Plot plan and business license approval from City of Biggs/Gridley. .............
17. Planning approval for (A) Use: (B) Parking: ........
Contact Land Development about (A)
Improvements -(B) Drainage
ge. ......... .
9`DrivewaY Permit (construction approval required Priorooccu ancY)
on*
20. Pre -inspection for �� to Building Ins request---
required. . to Building Inspector (Date)
21. Contractor's license information. (No., Name Style, Classification) . ..............
22. Certificate of Workmans Compensation Insurance . ..........................
wner-Builder Verification (Given to owner ', Mail to owner _). ............
24. Recorded copy of Agricultural Acknowledgement Statement . .................. 'Z
25. Letter of signature authorization . ........................................
Copy of recorded deed of parcel creation and 60 right of way to a public road. .... .
27. Letter of intent on building use . .........................................
28. Mobilehome utility clearance . ......................................... .
ocumentation of legal access . ............. ...................
ocume ation of 50% subdivision-developed=A) oad improvements completed
an` • ) arcel meets zonin re an rontag requirements . ...............
31. Existin , iolations/expired perms ...................................... .
32. Plan check list.; ..t
33. La 1^ I Yl 1 e D a 0 Cl-
�„ N e ........ c.....
34.
When you issue )the permit, process as follows: (/ Mail to owner. Mail to contractor.
Telephone _and hold for pickup at office. Deliver with inspector.
Other � / /
Parcel Creatiorit ?X
Acreage Applicant Date /
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date
Copy of plans sent Health Dept. Fire Dept. Other Date By
The following data must be submitted prior to permit issuance: (Circle new item not checked above).
1. Index permit for above items No.
2. Additional items required:
Contractor, designer, owner; was advised of above required data by _ phone —mail Counter by _ Date
Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter _ Date
Plans checked by Date Plans approved by 42yz Date
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Works
<<i
•Y
TO: Building Department
w� FROM: Encroachment Permit Section
RE: Driveway Clearance
,t l 7�
1. wner r location AP #
y.
Driveway permit has been issued for the above property.
si at
ure. date
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.
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.
A. 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 work.
3. I have contracted with the following person (firm) to provide the proposed
construction:
Name
Address City
Phone Contractors License No.
:..
I .plane to-provide_.portibrs. of t(iis work, but .I have Hired the following per's'on
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 N be 1547Date (o
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and
19832 of -the California Health -and Safety-Code.-
This
afety Code.
This verification must be completed and returned to our office before we are per-
mitted to issue the permit.
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroviller California 95965 - Telephone: 916.538-7541
APPLICATION AND PERMIT
ASSESSOR P CEL NUMB f
/0
Z NI
BUILDING PERMIT
OWNER,^ 1�/
r`J
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OW R' AIL NG ADORE
46
CONTR -CTO N M
TELEPHONE
CONTRACTOR'S MAILING DDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $
LENDER'S MAILING ADDRESS
Filing Fee
$ 15,00
Permit Fee
$
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee
$
Penalty
$
BUILDING ADDRES
Permit fee
$
PLUMBING PERMIT
Filing Fee 15.00
Each Trap
1 5.00
Solar or heat pump water heater
1 20.00
LOT NO. SUBDIVISION NAME PARCEL MAP
Water piping
1 7.00
Each qas water heater or vent
7.00
US OF STRUCTURE
SF ❑ Duplex[]Mobilehome,VCl Other
�C SPECT FY
Gas piping system 1 - 5 outlets
5.00
Building sewer
15.00
Mobile Home G W)
@ 15.00
TYPE OF WORK
New" Addition[ Remodel ❑" Utilit* Installation[] Other ❑
Describe work:
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filing Fee 15.00
Main service 200A OR 00V OR LESS
18.50
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (Check One):
❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license is in full force and effect.
-dLicense.'Jo. Classification
1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
�
r❑ 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
Main service 20CATO 1000AI
37.50
NEW CONST. DWELLING OCCUPM
OR ADONS. ACC. BLDG S.
3.6Qsq.ft.
vi ~
NEW CONSTR ULTI.OUTLET
NON•RESI BRANCH CIRC ITS
@ 5.00
POWER APPARATUS e
SINGLE OUTLET CTR,
EX. OCCU OUTLETS OR FIXTURES
p
20 7154
FIXED APPLNS. OR
EX. Occup. OUTLETS IRESIO.1 EA.)
I 3.00
Temporary service
1 15.00
Mobile Home Facilities
1 15.00 r
Misc. Wiring
9
'15.00
Permit Fee
$
—
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
o Consent to Self -Insure.
q shall not employ any person in any manner so as to become subject
Ithe W. C. laws of California.
No 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 15.00
Heating
Cooling
g
Hood
6.50
Ventilation
permit Fee
$
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in a y /�,ccrue
against said County in consequence of the granting of this perm .
X s r— Date
Signature of Applicant — bwn r [EContractor ❑ Agent
An OSHA permit is required fore ZD tions over 5'0" deep and demolition or construct -
ion of structures over 3 stories in height.
Mobile Home Installation Fee S
Energy Inspection Fee $
occ
co"s" PE
TOTAL FEE $ S
HAz
DFEES
IMP
FLOOD
CDF
PAR EL PO
HD
ISSUE
This permit is hereby issued under the
sions of the Butte County Code and/or
work indicated above for which fees
DIRECTOR OF PUBLIC
By
PERMIT EXPIRES Date
applicable provi-
resolutions to do
have been paid.
WORKS
Date
�^
Receipt No. ``�
WHITE-D.P.W.. YELLOW-ASSCSSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT
—a`tY,;.l�sui�,':�£:li-?!:.sn+�i-4.►/:M.'...•x.�f�t`«'iW.'•+W"�t!'!C�1t�',".'+'t,3.?Yv�maY:wta�: Js
*A1
Location of structur
equipment shall be 3shown
& clear of all easer =rits.
. a
This set of plans andspecifications MUST be
kept on the job at all times and it is unlawful to ii
make any changes or alterations on same woo
gut written permission from the Aopatfwnenir of
Public Works, County of Butte.
"3 NOTE.—AH Materials & Workmanship Shal!Be In 1
/accordance with Recognized Good Prcctic � and
of a quality prescribed for the Specified us in the
Uniform Building, Plumbing & Mechanical Co tis and
the National Electrical Code.
BUTTE COUNTY
E BUILDING DEPARTMENT
' �,P� V EW
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S
"•3ti::'Y2K.t.�..�[s3`"�%:�t��3�t3„4k:�.�;' r.:M.'-rtr.. --.�` ..._.... - •,�.
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PARCEL CHECK LIST AND REQUIREMENTS
Owner Permit No. 5.2 _ 2/ 4�
A. P. No.
Teiephone No. ?T 7 -3 DateZ--
1.' Parcel creation, Map Book Page
Legal . Parcel /Lf
Creation date
60' R/W
- Certificate of Compliance
Other
2: Z` Parcel created by subdivision map prior to July 1, 1949(17-23)
. Parcel size is less than 5 acres
Parcel exempt from.items 3, 4, and 5 and improvement requirements
3. Minimum Parcel Size (must meet zone or)
Parcel meets frontage and area requirements of zone
Parcel does not mee fro an ge an area requirements of zone or
Parcel is merged pursuant to Section.20-180.2
Parcel has vested right to develop
4. Legal Access
X Parcel fronts on publicly maintained road
(Road Name)
Parcel does not front on public maintained road
(Road Name)
Documentation on legal access required
' (must be by Title -Co. or licensed engineer or surveyor)
Documentation on legal access submitted and accepted.
Copy of form sent to Land Development for improvement requirements 1. -Z -Y - p
(Date)
by
Copy of
sent to. Building Department
Road Improvements not Required
Road Improvements Completed and Approved for Building Permit Issuance
Date By
PARCEL CHECK LIST AND REQUIREMENTS
Owner 6veq v�, �e �(� I D�cIa .
Telephone No. ?7-3— % F
Permit No. 1.2 _ �Z Y
-A.P. No. r,9— (3 oto
DateZ--
1. Parcel creation Map.Book Page
Legal Parcel Go ( !Z
gloc k it 2 4 38
Creation date
60' .R/W /6-7 3 3
Certificate of Compliance S
Other
wl�t✓ t-RS� L c✓�lGl.
�" � � � S�v��`7/rc� P-�/r � .�.✓ Toy � LAS y �u �2,,yS c /hn✓u� Tom" /r/Gnn2s
Z` Parcel created by sub ivision map prior to July 1, 1949 (17-23
�ssze � � T G/idly z
Parcel size is less than 5 acres
sv'•
Parcel exempt from items 3, 4, and 5 and improvement requirements
3. Minimum Parcel Size (must meet zone or)
'Parcel meets frontage and area requirements of zone
Parcel does not mee fro a anq/a'rea equirements of zone or
Parcel is merged pursuant to Section 20-180.2
Parcel has vested right to develop
4. Legal Access
�C Parcel fronts on publicly maintained road /h��yagrv,T,Q
(Road Name)
Parcel does not front on public maintained road
(Road Name)
Documentation on legal access required
(must be by Title Co. or licensed engineer or surveyor)
Documentation on legal access submitted and accepted.
Copy of form sent to Land Development for improvement requirements
(Date)
by 1
Copy of f m sent to Building Department
Road Improvements not Required -
Road Improvements Completed and Approved for Building Permit Issuance
Date By
1
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Return to DPW AGRICULTURAL STATEMENT OF AC@iOWLEDMffiNT
FOR RESIDENTIAL DEVELOPMENT
'Section 26-8.1 of the Butte County Code
requires this acknowledgement be recorded
prior to issuance of a building permit,
Rec Fee 5.00
The
property described herein is adjacent
����
to
land or included within an area zoned
for
agricultural purposes, and residents
1
Recorded IOfficial
of
this property may be subject to incon-
Records I
veniences or discomfort arising from the
County of I
use
of agricultural chemicals, including,
Butte I
but
not limited to herbicides, pesticides,
Candace J. Grubbs I
and
fertilizers; and from the pursuit
of
agricultural operations including,
Recorder I
b t
t 1' 't d t 1' 1
2:04pm 29 -Jun -92
92-2862
Rec Fee 5.00
Cash 5.00_
„
U no imi eV Cu ovation, p owing, PURI. XX 1
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.propert y situate in the County of Butte, State of California, described as
follows:
Lot 1-3 of Block Eleven of the Town of Stirling City according to the
official map thereof filed of record in -the office of the County
Recorder of the County of Butte, State of California.
APN # 059-085-010
Date: June 19, 1992 PROPERTY OWNERS:
Gregory iAmore
State of Californi)a On this the 19tWay of June , 19 92 , before me, the
) SS. undersigned Notary Public, personally appeared
County of Butte ) Lee
Gregory/Bickmore
=Sept.
SEAL
Gu WARD Personally known to me. Q Proved to me on the basis
of satisfactory evidence.
NTY o be the person(s) whose name(s) was
CALIFORNIAept. 24, 1993 subscribed to the within instrument and acknowledged that he
executed the same for the purposes therein contained. IN WITNESS
WHEREOF, I hereunto set my hand and official seal.
Present A.P. No.
Notary Fublic
END OF DOCUMENT
PRE -INSPECTION
OWNER:L��a 61ek 2E DATE
LOCATION: l D /��II Z/1N �� �S�S%//� � A.P. #
CONTRACTOR: - ZONING u
PRE -INSPECTION FOR: tkr('6 DH/14A6-67_0 U s G
DATE TO INSPECTOR
PERMIT HISTORY: NONE �AS FOLLOWS: SEE C��D
r
TYPE OF OCCUPANCY
FIELD - INFORMATION
BUILDING USAGE:
TENNANT : W nl hh z
OCCUPIED HAS ELECTRIC ciAS GAS 2HAS SANITATION FACILITIES
[� HEATED -COOLED PERSON CONTACTED
OTHER COMMENTS: ie 5M •/°,41ot r o oe- yore ik rcAeW , VtaeV Mh
Nor -s rRj-cr►.rK"i s� �.� � , Us �✓J� �i �s� ,fL. o a�.-�s � S'
co 40 n S- W 0 • !1 Uoo s v`,e / /z r A/wj;oL e - a e -Ss
) To® 9/h�// of 1l'r� .4°`J /'�" �e-i.I),/1� (X� /7.v+j✓ dip
ACTION RE MMENDED:
M ISSUE Q HOLD FOR
OTHER: / ry o s e- 4,
9'o Ve-W a /d -
kb) -� -9 D..� �s�� ®gam-
BY '� -� '!^G� v DATE
1-5
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to 14,0. �0'1A 1
9pp of,
��11 AP 59-085—
y .D:_ COUNTER Y.I_�IP.._. � %�
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?ermit#:425T0-74B (carport M)
COUNTER, H. D.
5317B* 4897B
505-68B** I,7 0
-085-1
608 Manzanita St., Stirling City
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