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HomeMy WebLinkAbout062-340-02662-34-26 ANTES POTESTIO SIS Oak Dr, app 200' W of Sugar Pine Dr, app � N Sugar Pine Store Berry Creekaa- 77 Permit ##6060 7E (temp pow pole) lot development 62-34-26 Permit # 1-78B,P,E(new s.1ngle family) 2-34-26 Pe ' it 2102- 8B�_ W, (private detached garage) 62-34-26f RICHARD HUBACEK h 163 Oak Drive, Berry Creek , Al ContR: Jim Potestio ` uU Per,mit#2255-88B,.P,E,,M(addition/SF) -A PERMIT NO. o - __..1081-78B,P,E PERMIT EXPIRES OWNER .Tim Pnfpstin CONTR. riwner LOCATION (A.P. 62-34-26 SIS Oak Dr., 150'W.of Sugar Pine Dr., Berry 'C`reek 2/07-->79A/l Temp. Power Pole Called PG&E Temp. Elec. Serv._ Called.PG&E W"IrJ Te p. Gas Serv. Called PG&E 0B FINALED — '4-7 (Date (Signature) e s Temp. Power Pole Called PG&E Temp. Elec. Serv._ Called.PG&E W"IrJ Te p. Gas Serv. Called PG&E 0B FINALED — '4-7 (Date (Signature) c COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING I BUILDING (Cont'd) I PLUMBING Setback ' Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings ,Windows 0 3rd Floor Stemwall Z Siding To out ® , Slab71 Roof Sheaths —% Water PI in — —17T, Piers Roofing Sewer Garage Fdn. Vents "015,712-1 Fixtures Footings StemwaI I Garage Vents Insulation '?S� Water Htr. Heaters Slab Carport Footings Prov. for physica ly handica ed Conformance of ex. structure ATem Appliances Gas Piping &Test . Gas Slab Final Sanitation Patio FIR PLACE Final 05, Footings Footin LECTF0 AL Masonry Walls Throat — .-' ou h ' 10 r Reinf. Steel Final I Fixtures Bond Beam. _ FI E SPRItALkP9 I Motors C/ JlY{:FVI rinai I bubpanels '- Mesh0%C--, ECHANICAL I Grd. Fault Prot Scratch Heatino Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent' Door Closer Final Final -E- MOBILEHOME UTILITIES ------------------ Elec_ Service Elec. Pedestal Water Piping Sewer Gas Piping OBILEHOME INSTALLATION - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS ,4 np . .Vt �8zu4A.-f- Aw, a v C /0, L5 (NOTE: An entry must be made on this form each time you visit the job site.) CERTIFICATIONS .As required by, the State regulationa=-both the builder and the" insulation applicator must -sign a card certifying that,the proper "K" values for all insulation locations have. been izstalle,d. An example of a" certification card, which is furni.shed' by the builder or insulation:applicator is shown in Fig. 13. THIS YS TO CEAfYFY 112+°7 IltaifLATEDfI PASi EES I;i eifitF "Iti CSJNFOmAKi" Wnp 1 CUWK. MEItft R[t i1111f6kSY MIFMIA ADM 41SW,'-ME CLUE. TITLE 250 S'kZ OF CALIFORNIA. I8 THE BUILUIta TFE AT. M o. EXTERIORWALLS 101/ Max�afa�arGl +5�iet�c:r/T}ga Q� CETLINBS Batts: Manufae Gly _ ,(�',Bletaress R Value l / ....... Blore: ManufacQar e� �_�� 7h1ckr ss No. Bays Wt./Bag Sq. Ft. Corenad _ _ _ R Value FLOORS !� '0vManufaewnw 0�(J N dhlejsms-^./Ty¢e R Varus SLA9 ON GRACE Man fa6Caesr k 4hlekiii�s�iyla2 R Value " H1dth oQ Insulati(r:i fncheq_. FOUMAT� l - Manufactm--a ;hoe _s/7r M Valuer GIBE.. R ye LICElISE Nt11 cZ - - 6Y TITLE DkTEo_m/��e�~6.'�:..�—^�---•. IN I COATRACTUR _ x Y LICFI{SE MWER-- BY TITLE DATE --- Fig. 13 814 J COUNTY OF-13UT.TE — DEPARTMENT OF PUBLIC WORKS _ 7 County Center Drive - Oroville, California 95965 Telephone: 534-4541 / APPLICATION AND PERMIT A authorize represen Wh i te- of ttutte to enter upon the purposes. 6 Date 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. DIRECTOR OF PUBLIC WORKS By Date 2 BAing permit expires Date BUILDING Owner SO. FT. OCC. BUILDING VALUATION Mailing Address a e 7lj " Tel ephone N i Contractor 4 ion Mailing Address Fireplace sQo Total Valuation / �► Telephone No. Permit Fee Building Address S Plan Checking Fee&/or Penalty Permit Fee Q$ p -- 16701- 6 PLUMBING No. @ FEE -• PERMIT FILING FEE $3.00 , Each Trap & 1.50 n 9fl3rification Qaly Repair drainage or vent piping 1.50 �.Z r A. P. No. V-2-61' - 2- Zo g Water piping 1.50 ,;S -Q Each gas water heater or vent 1.50 F S� on Fire Dept. Fire Zone Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Plans Parcel"' Declaration �-" Parcel Yap 60' R/W Improveme Each additional outlet .30 Building sewer 5.00 Bldg. PI ec'd i v� Porcel-Approval Plans Approval Lawn sprinkler system 2.00 NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ Permit Fee $ 60 $ /3 Z ELECTRICAL No. @ I FEE PERMIT FILING FEE J$3.00 . 67C) ORLESS 5.00 Main service 100 AMP S Single Family Duplex ❑ Mobil Home ❑ Others ❑ Main service EA. ADD'L 100 AMP 2.50 ` Main service OVER eoov 100 AMP OR LESS 25,00 Main service EA. ADD'L 100 AMP 1.00 NEW CONST. DWELLING OC P. OR ADDNS. ACC. BLDGS. 22sq ft b• 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: NEW CONSTR MULTI.OUT T NON.RESID. BRANCH CIRCUITS) 2.50ea NEWCONSTR POWER APPARATUS 9 NON .RESID. SINGLE OUTLET CIR. Ex. Occup{OUTLETS OR FIXTI1RES 5B L2; FIXED LNS Ex. Occup. ( OUTLETS P(RESID.)REA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 License No. Classification I am exempt from the Contractors License Laws of the State of California. Permit Fee $ �S $ MECHANICAL No @ 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. PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply, to all County Ordinances and State Laws relating to building construction, and hereby Land Development Fee $ Zt -► TOTAL PERMIT FEE $ foS authorize represen Wh i te- of ttutte to enter upon the purposes. 6 Date 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. DIRECTOR OF PUBLIC WORKS By Date 2 BAing permit expires Date 7 • RESIDENTIAL PLAN:, CHECKING GUIDE (S.F., DUPLEX, & MISC. ONLY) C/Bldg. OWNER A. P. 0oning requirements (sideyards and parking). Valuation. E. or Architect (if required). B. PLOT PLAN �� Complete parcel size and dimensions. lam: Setbai**, sideyards, easements, etc. Other buildings or structures. Grading, fills, drainage. Permit # D �k 4,? C. FL OR PLAN Complete to scale plan with dimensions. Required windows for light and ventilation (Sec. 1405). Required windows for second exit (Sec. 1404). Allowable glazing for energy requirements (20% max. per.State law). Human impact glass (Sec. 5+06). Required room sizes, ceiling heights (Sec. 1407). G.F.C.I.'s in baths and exterior outlets (Sec. 210-8). ,�' Light fixtures, switches, receptacles, and exterior receptacles for maintenance of mechanical equipment. 2 --loo, Locations of water heater, heating & cooling equipment, other electrical or gas equipment, and plumbing fixtures. Garage firewall, door size, and closer (Sec. 503(d)(4)). Al 1 - 3'0" exterior exit door (Sec. 3303d). Fireplace location. Smoke detectors (Sec. 1413). D. ST CTURAL- DETAILS Foundation plan complete enough to construct building. Floor construction details,complete enough to construct building. 5��levations and wall construction details complete enough to construct Roof construction details complete enough to construct building. Fireplace construction details and calcs if over one-story in height: Sufficient data and details to satisfy energy insulation requirements building. (State law). E. MISGELIANEOUS ITEMS TO LOOK OUT FOR CCX plywood on exposed locations and overhangs. Stairway details (Sec. 3305). Guardrail details (Sec. 1716). Brick or stone veneer (Chapter 30). C%Exterior plaster - weep screeds (Sec. 4706 & 4708). ;;;..-,-Proper roof pitch for roof covering (Chapter 32). Rafter ties or bearing ridge beam. Garage door or porch header sizes. Adequate bracing. ®. Living area over garage - complete 1 -hour separation required including supporting walls and posts, etc. l�. Two (2) exits on three-story dwellings (Sec. 3302). /oY/-�� Z, PERMIT NO. 2102-78B,E PERMIT EXPIRES'x// OWNER James"Potestio CONTR. owner LOCATION (A.P. 62-34-26 s/s Oak Dr. app. -200' W. of Sugar -Pine Dr. approx. 4 mi..N.,of Sugar Pine Store Berry CC r Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Called PG&E JOB FINALED (Date) f (Si ature ' COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS . BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) PLUMBING Setback ✓- f . Firewall Soil Piping Forms Pirapets 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 IL Fdn. Vents Fixtures Footings 1> Stemwa 11 Garage Vents Insulation Water Htr. Heaters Slab Carport Footings s Prov. for physically handicappedy Conformance of ex. structure Appliances Gas Piping & Test- est"Footin Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footina ELECTRICAL Masonry Walls Throat 49 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 MOBILEHOMEUTILITIES ------------------ Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping 11�LEHOME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS x " (NOTE: An entry.must be made on this form each time you visit the job site.) 1 C®UNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive — Orciville, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT cVDa-78 AA� J BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address 1Telephone Y� No. 561- 17 9 q Contractor Mai I ing Address Fireplace Total Valuation ,� Q Telephone No. Permit Fee Building Address .i / f�b�W O Plan Checking Fee&/or Penalty Permit Fee . CD Q( 44,3Z , � ;!f PLUMBING No. @ FEE PERMIT FILING FEE $3.00 Each Trap 1.50 rQ, Repair drainage or vent piping 1.50 A. P. No. �p�—, '^ �� Zoning & Planning Water piping 1.50 Each gas water heater or vent 1.50 F/sl Sa6 ion Fire Dept. Fire Zone' Use Permit Gas piping system 1 - 5 outlets 1.50 EQA Parking Parcel Plans Declaration Parcel Map 60' R/W Improve is Each additional outlet .30 Building sewer 5.00 � /� Bldg. Ons Rec'd Parcel A proval Plans Approval Lawn sprinkler system 2.00 NEW ADDITION ❑ UTILITIES ❑ OTHER ❑ Permit Fee $ $ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 3,0 Main service 100 AMP OR001 OR SLESS 5.00 Single Family ❑ Duplex ❑ Mobil Home ❑ Others Main service EA. ADD'L 100 AMP 2.50 /✓ Z��L 2 Z ` k ` ` Main service OVER P O 25,00 100 AMP OR LESS Main service(( EA. ADD'L 100 AMP 1.00 NEW CONST. OWE L OR ADDNS. 1 ACC, CUP. Y1 22 sq ft O 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 of: TLhT NEW CONSTR MRL CH CIRCUITS) NON.CRESID.ONST ( BRANCH CIRCUITS) 2.50ea NEW CONSTR. (POWER. APPARATUS.6, NON.RESID. SINGLE OUTLET CIR, Ex. OCCUp(OUTLETS OR FIXTIIRES g 1� 01 FIXED Astyle Ex.Occup.(OUTLETSPLNS (RESID)REA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $J.1.610 $ MECHANICAL No. @ 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. certify that in the performance of the work for which this fV permit is issued I shall not employ any person in any manner s to become subject to the Workmen's Compensation Laws of alifornia. PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representativesof County of Butte to enter upon the above-mentione property f ins ctio purposes. I� X ate �0 ignatur f Permitee or Agent Receipt No. White-D.P.W. — Y low -Assessor — Pink-Insoector — Goldenrod-Aoolicant Land Development Fee $ TOTAL PERMIT FEE $ 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 be paid. DIRECTOR F UBLIC WORKS By Date �il11Q Dermit eXDIreS Date J NOTE: ----:All Materials & Workmanship 'Shall Be in this set of plans and sp.ecifica}lons MUST ba e kept on the job at. al( timss Accordonr:e iwl_Y V'!*+h Rt`. non:7e:d ,. Goad . P,"-!rtice5 . and make any. chap ges and.it is unaaw�T' p or alterations ti < of a . aur..lit�� nrescril,e- •'tor the Specified use in the written permisson on same without from the Uniform Buildinq, Plumbinq & Machanical Codes and Works _ Depart ment of. Public the National Electrical Code. e• ;. The , Setback. shall be 5 ft. from the sick pc-uperiy line and. 50 ft. from the 1 ceniteriine of the road, permitting a maxi- mum of a 2 ft. eave overhang but entirely location bzWd- outut of all easements. per Butte rCounty� Heal h Deptt to be . Re- - • quire ents. 171y r Bio -''e .BUTTE COUNTY BUILDING DEPARTMEN" APPROVED- �Z -34' z� J A -M S ?a -r G- <---,T 10 �vowt- 3l?z-,'I % P ill& 1t� 2x� 44 11 06.1 _�....- Ji 6 1 eg 4 ?-e a Z�� h,1 M Dr- he2�v � o C 2 X z¢ ,C7 Z () o o< m .� 1 N ' ( �i'y plc fit. 2x¢ Mo u� ;o Z . o�a..79 7,7 a / //_a3-77 f COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Centel Drive — Oroville, California 95965 4 Telephone: 534-4541 r APPLICATION AND PERMIT above-mentioned property for. inspection purposes. X i i1 . Date Signature of Permitee or Agent, Receipt No. r r lnis 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. DIRECTOR OF PUBLIC WORKS By White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant I Building permit expires Date Date BUILDING Owner �� SQ. FT. I OCC. BUILDING VALUATION Mailing Address :_.rt 01I r r t IJ L C �� IC i 1' Telephone No. ?ice— y(4 1) Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee Building Address ,rj 5 �j-� k � r �Pa�bv �—,..0 � PLUMBING No. @ FEE PERMIT FILING FEE $3.00 r t r t,�^:: �1 h C t) r "a .� n `rT+ J ��•l Each Trap 1.50 l r v" r n & r to Repair drainage or vent piping 1.50 Water piping 1.50 `� to 1 >r Q t -p W3 ('C�_ Each gas water heater or vent 1.50 1 ^ _ A. P. No. lar -t 7 rt h i Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fees -W.0 Sanitation' FireDept. Fire Zone Use Permit Building sewer 5.00 EQA PPlans Declaration Parcel Map 60' R/W Improvements Lawn sprinkler system 2.00 Bldg. -Plans Rec'd—• Parcel Approval Plans Approval Permit Fee $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ® ELECTRICAL No.1 @ FEE PERMIT FILING FEE 1 $3.00 ;•� + �)t4.J!►1 'ti i"'D "� Main service 600V OR LESS 100 AMP OR LESS 5.00 t Main service EA. ADD'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home ❑ Others 0 Main service 1100EAMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 M'1 A.� \ v`"^�� n�7 WN ;rn NEW CONST OR ADDIS. (ACCLBLDGS.LING CCUP. &\ 20sgft NEW CONSTR. MULTI.OUTLET NON.RESID. (BRANCH CIRCUITS) 2.50ea - NEW CONSTR. POWER APPARATUS &) NON.RESID. (SINGLE OUTLET CIR. 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: Ex. Occup(OUTLETS OR FIXTURES)@ BAL@1 FIXED APPLNS. Ex. Occup. ( OUT ETS ((RESID.)REA) 2.00 Temporary service 10.00 ,0 V Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 0 I 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 certifythat 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.1 @ I FEEPERMIT FILING FEE J$3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby TOTAL PERMIT FEE s above-mentioned property for. inspection purposes. X i i1 . Date Signature of Permitee or Agent, Receipt No. r r lnis 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. DIRECTOR OF PUBLIC WORKS By White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant I Building permit expires Date Date COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS " ' 1 °• 7 County Center Drive — Oroville, California 95965 Telephone: 53'4-4541 't APPLICATION AND PERMIT Af /4( RecWt No. ► l�Y4I G'•- ( V 1-2,: - White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant B4i�lg permit expires Date - l% ! 2i BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mailing Address �� 1 Telepho .No. 4 Fireplace Contractor ►1evr— Total Valuation Mailing Address Permit Fee Plan Checking Fee&/or Penalty Telephone No. Permit Fee Building Address 3t5 ��k r'a �-�a � PLUMBING No. @ FEE PERMIT FILING FEE $3.00 (1 W S ` I bQ 1144 Each Trap 1.50 S S ri Repair drainage or vent piping 1.50 Water piping 1.50 QV T t` tA Each gas water heater or vent 1.50 / �_� �v A. P. No. to Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 Fe . 66r>rtatfoTf FireDept. FireZone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W Improvements P Lawn sprinkler system 2.00 Parcel Approval I Plans Approval Permit Fee $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ® ELECTRICAL No.1 @ FEE PERMIT FILING FEE $3.00 Soo �r� e9 V� `• Main service 600v OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home ❑ Others Main service OOEAMP OR ESS 25.00 Main service EA. ADD'L 100 AMP 1.00 `f��� 0 VY\ V NEW CONST. ADWELLING OCCUP, & OR ADDNS. ) 2�sgft NEW CONST L NON.RESID, (MULTI -OUTLET BRANCH CIRCUITS) 2.50ea NEW CONSTPOWER APPARATUS&,l NON- R. RESID. (SINGLE OUTLET CIR. 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: Ex. Occup(OUTLETS OR FIXTURES)50 @250 109 Ex. OCCU FIXED APPLNS. OR P•(OUTLETS (RESID,) EA) 2.00 Temporary service 10.00 �' Q Mobile Home Facilities 15.00 License No. Classification Misc. Wiring 6.25 1 am exempt frcm the Contractors License Laws of the State of California. Permit Fee $ 1160 $ 1 ty 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 cVl certify that in the performance of the work for which this ermit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of Cal i forni a. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation L2O Hood Permit Fee $ $ 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representativ s f the Co my of Butte to enter upon the a �-m inned prop ty r insp t on purposes. X DateW-4-77-14 gnature of Permltee or Agent 11 l TOTAL PERMIT FEE 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. DIR T R OF PUBLIC WORKS `.�._/ btaAq B ��flDate /IASA-) RecWt No. ► l�Y4I G'•- ( V 1-2,: - White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant B4i�lg permit expires Date - l% ! 2i (,PERMIT No. 2255-88B,P,E,M r PERMIT EXPIRES OWNER RICHARD HUBACEK CONTR. Jim Potestio ASSESSOR PARCEL 62-34-26 LOCATION 163 Oak Drive, Berry Creek S Y t N �1 5 ?11 F1 • t{ jr 7t ' i Temp. Power Pole / 'i. Called PG&E c Temp. Elec. Service Called PG&E Temp. Gas Service :1 .Called PG&E ' JOB FINALED (Date) Signature ' 1 ,5 y s = OK 0 = Not OK yable MOBILE HOMES F = Not Applicable MISCELLANEOUS Date MOBILE HOME UTILITIES (Plans) OK except #'s Date DECKS, COVERS,CARPORTS,GARAGES, (Plans)OK except #'s 1. Zoning Requirements-Setbacks-Easements 1. Zoning Requirements-Setbacks-Easements 2. Soils; Special MH Support-Sketch 2. Footings; Soils-Size-Depth-Spacing-Connectors=Steel 3. Sewer; Location-Test-Fall-C/0-Concrete 3. Decks; Girders and/or Joists-Decking-Bracing-Stairs-Rails 4. Water; Location-Test-Easement Needed (Sketch) 4. Wood Awn.; Posts- Beam s-Rftrs.-Connec.- Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp-Concrete 5. Alum. Awn.; Columns-Connections-Splice-Decal-Enclosures 6. Gas; Location-Test-Wrap: / /"L"ft. / /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows-Doors 7. Utility Clearance 7. Elec. 8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing-Veneer-Stucco-Mesh Card-131 Date Card-131 Date _ . 10. Roof; Shthg-Roofing Card-61 Date Card-131 Date 11. Ext.; Steps-Doors-Landings Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements-Setbacks-Easements Card-131 Date Card-131 Date 2. Footings; Size-Spacing-Marriage Line Card-61 Date Card-81 Date 3. Gas; MH Test-Demand-Valve-Connector 4. Electricity; MH Test-Crossovers-Breakers-Clearances Date POOLS (Plans) OK except #'s 5. Drain; MH Test-Fall-Flex Connector 1. Setbacks-Easements 6. Water; MH Test-Regulator-Connector 2. Soils; Compaction-Structure Stability 7. Water and Sewer Connected-C/0 to Grade-HD Approval 3. Pool Structure; Steel-Connections-Thickness- Dead Men -Lining 8. Gas and Electricity Tagged 4. Elec.; Receptacles and Lighting, Distances-GFI ' 9. Exits; Insp.-Sketch 5. Elec.; Pool Lighting; 15 volts-GFI 10. Cert. of Occupancy 6. Elec.; Enclosures; Conduit Entries-Terminals-Listed 7. Elec.; Bonding; Metal w/5'-Circulating Equip.-Heater 8. Elec.;Grounding; Equip. w/5'-circulating Equip.-Pool Lghtg. Boxes-Enclosures-Panel boards-Ins. to Main in Conduit Card-81 Date Card-61 Date Card-81 Date Card-131 Date 9. Health Department Approval 10. Plumb.; Cir. Test-Water Supply Test Card-131 Date Card-61 Date Card-81 Date Card-131 Date 'v = OK 0=Not OK - = Not Applicable = Not Ready Date .UNE*1 RESIDENTIAL (Single and Duplex) W FLOOR (Plans) OK except #'s t?IeTtg., Main; Soils-Steel-Elec. Grnd.-/7X /" Ftg. De 3. Ftg., Garage; Soils -Steel-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /"Ftg. Del temwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel- Blockouts-Wrapped 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel NI-D.W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test b10'GaPipe; Size -Anchors OT�Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric; Underground 3 enums & Ducts; Clearance-Material-Supprt-Ins. O'Gfrders-Sills-Anchor Bolts -Joists -Vents -Cripples 15. Insulation Card -Bl= Date�f-'�f Card -B1 Date Card -B1 Datdir /2 N Card -B1 Date Date PLUMBING (Permit) OK except #'s Ht. Vent -Access -Combustion Air -Baffle Wa r Pipe; Test & Anchors -Nail Protection W.V.; Test-Fttngs & Anchors -Nail Protection _ mower Pan; Test, First Floor -Tub Access Test Tub & Shower, 2nd Floor -Tub Access Gas Pipe; Size & Anchors Card -81 Date Card -B1 Date Card -B1 Date Card -B1 Date Date ELECTRICAL (Permit) OK except #'s 22. F ure & Transformer Clearance -Ins. Protection . Ejoc. Receptacles Spacing -Lights & Switches at Doors Si Boxes & No. of Conductors -Stapled ga9ex Installed Close to Edge of Studs & C.J. quip. Ground made up w/Meeh. Fasteners -Bond Gas & Water �2�?Rgpliance Circuts in Kitchen & Conductor Size/G.F.I. 2 feed Wire. Size / / ga. Cu or AI-A.C. Wire Size / /ga. Cu or Al ange Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral Yes No 4J&. -Riser Conductors & Ground -Main Disconnect Equip. Clearances Panels-Motors-Mech. Equip. �2idthes Closet Light -Shower Light -Spa Light 15KSmoke Detector Card -61 Date Card -B1 Date Card -B1 Date Card -B1 Date Date ME NICAL (Permit) OK except #'s 6,12"Ducts Insulation & Support Vent Fan; Exhaust above insulation 36. Condensate Drain & Overflow; Size & Grade 37. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet 38. Attic Access & Platform if Furnace in Attic Card -B1 Date Card -B1 Date Card -B1 Date Card -B1 Date Date F9,44MING (Plans) OK except #'s 9. ' s, Proper Material & Anchors WK_VAf1s Studs -Nailing, Spacing & Bracing—Plates-Sound geg-ring Walls over Girders & Floor Nailing Qlaff Stop in Walls (rat proof) 42"Fi Stops; Furred Ceilings -Stairs -Chases -Tub Header & Beam -Size & Bearing Date NG (Continued) gds -Post Caps -Anchors -Connectors ). Joist-Rftr. Ties-Purlin-Roof Brac.-Tr 4 97. Fir lace Ties or Type A Flue -Fireplace Throat Clearance 41"Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 4Ttdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions -6-C3>rage Fire Protection Framing ro erty Line Firewall & Openings Ext. Doors -One 3' -Check Garage -3rd story, 2 exits Width -Headroom -Rise -Run -Landing -Fire Protection lywood on Roof Overhang -Attic Vents -Rafter Outriggers 4iding-Nailing Veneer Mesh -Drip Screed -Fd. Vents-Underflr. Access . Glazing Area -Glass Protection -Skylights -Plastic 66�Shear Walls; Nailing -Bolt 59, Insulation-Walls-Clg. 60. Infiltration-Walls-Wndws Card-Bo5r Date Card -B1 Date Card -B1 Date Card -B1 Date Date FIyAL (Plans) OK except #'s Eft. Steps -Door & Sidelight Protection -Landings 4rWrSmoke Detector urnace; Vents -Clearance -Comb. Air-Connector- In,Garage; Above Floor -Ducts -Meeh. Protection CBB Broom Exiting G. .I. & Bath Fixtures & Tub Access -Spa ,0513"'E!PelTrim & Subpanel; Breaker Sizes -Labels P,11§'rs & Rails Fireplace or Stove; Clearances -Hearth lec. Outlets at Wood Panel; Int. & Ext. -rl7 it. Fiat. & Appliance; Grnd. -Air Gap -Cooking Clearance -74-f to -Outlets & Receptacles at Kit. Counter _Z2 --Garage Fire Door; Swing -Landing -Closer _23-A-t"1)Uct in Garage -Damper _W4-tltltr-tytr:; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor -Meeh. Protection Ib., Elec. & Mech. Equip. Listed for Location .c�f3"'ETe—" Receptacles in Garage; (G.F.I.)-Romex Protec. nsulation-Foam-Looked in Attic ❑ Yes "U -Rails & Deck Construction -Post Caps P!Crdm Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 80. Following instld.; Drive •❑ Yes 12~No;-Walks ❑ Yes d3 -Wo; Planters ❑ Yes ❑ No ucco;'Brown-Finish C. Unit; Disconnect, Electrical, Plumbing ,43 -Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opg.pings. 4<`WaJer Well; Disconnect, Electrical, Plumbing xterior Elec. Trim; G.F.I. Receptacle -Underground Ve tilation throughout House Glass Protection Co sections from Previous Inpections G Test -Meters Tagged; Gas -Electric V�r & Sewer Connected -C/0 to Grade -HD Approval Energy Compliance Certificate -Other Certificates --FZ7RooTing Certificate Card -131 W Date/,2-Card-B1 Date Card -B1' Date Card -81 Date Card -B1 Date Card -B1 Date Comments at Final: (NOTE: An entry must be made each time you visit job site) C .• �, -- E'. N E LOCATION ROOF Material Thickness (inches)__ G C1 RT:I:FIC,A_T10.N DESCRIPTION OF INSUI.,ATION EXTERIOR WALL Material Fiberglasss Thickness(inches) 3 , CEILING Batt. or Blanket Type._ Fiberglass Thickness(inclies) /Q " Loose Fill Type Fiberglass—� Minimum ThicknesWriches)� Area'covered(ft. ) FLOOR, EMWATED Materia L_ Fiberqlass Th i.ckness(inches) FLOOR, S:'..A13 Material Thickness(incles)_ — _ Width(inches) FOUNDAT,ioN WALL Material _ Thickness (inches) A.P:Teo. Brand Name_ Thermal Resistance (R Value) Brand Name CertainTeed, Thermal Resistance(R Value) Brad Name CertainTeed Thermal. Resistance(R Value) Brand Name CertainTeed Number of Bags Wt. per bag 25 lb. Thermal Resistance(R Value) Brand Namc CertainTeed Thermal Resistance(R Value) Brand Name Thermal Resistance(R Value) Brand Maine Thermal Resistnilce(R Vnlue) I hereby certify that the above insulation was installed in the above bu1.lding in confonnance with the State of California energy Requdrements. Hawkins Insulation Co.', Inc.' 378407 1-1:6111 NAME/OWNER S'fATF. CO ' CTOR'S LICENSE NO. SIGMATURI: -Ir INSTALLATION APPLICATOR DATE /E —" I hereby certify the above ilisulation and all required items as shown on the Building Department approved plans and attactmients have -been installed as required by the State of California Energy Requirements. All equipment, devices and materials are of the quality prescribed or are specifically approved by the State of California. F I.RM W11VOWNE'R 1, se print) - STATE COcrrRAC'TOR's —LICE SI 1.10. r�J O SI(, '1' 1: O� 0ENElt CONl'RAC'1.O1. OWNER DA'1'I; i THIS CUTIFICATL' MUST BE ON FILE WITH THE BUILDING DEPARTME11fr PRIOR TO FIIIAI INSPECTI.ON APPROVAL AND A COPY SHALL BE POSTED WITHIN THE BUILDING . January 1984 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION -4;.t, . 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541_ OWNER I PERMIT APPLICATION DATA SHEET k % 1 IAC / //, Ae'l o e k _ NA. • 61V - - Proposed Building Use % Xl Building Inspector Date /J At time of permit application, I was advised the following data must be submitted prior to permit processing an�1. lor issuance: DATE RECEIVED APPROVED All items.have been submitted. . . .` . . 2. Plot plans in duplicate./triplicate, signed by preparer ofplans. . A 3. Complete plans in duplicate./triplicate, signed by preparer of plans. 4. Complete engineered plans and calcs, with wet signature on plans. 5. Plans with Energy Design Compliance Statement. . . . . . 6. School District "Fees Paid" Stamp on Floor Plan. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . . 9. Letter of signature authorization. . . . . . . . . . . 10. Sanitation approval from Health Dept. . . 11. Planning approval for (A) Use: (B) Parking: . 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner[], Mail to owner ❑ ) _15. Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . . . Pre-Inspec.request to (Dote) .1 17. Pre -Inspection for Required. Building Inspector 18. Recorded copy of Agricultural Acknowledgment Statement, r 19. Driveway Permit. { 20. Plot plan approval from city of 21. Engineered trusses in duplicate (required prior to plan check). 22. When you issue the p r�y it, �rocs as follows: Mail t owner, Mail to contractor. Telephone ? f/' and hold for pickup a4Lr0 office, Deliver w/inspector. Other - n ', Permit No A p p I icantAk7 CC% De'� Copy of plans sent Health Dept., Fire ad`pt., Other Date The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: 1 Contractor, designer, owner, was advised of above required data by_phone--oaiI—counter by date Contractor, designer, owner, was advised of above required data by—phone —mai l_counter by date Plans checked by Sets of plans on hold in Copy—DPW Date Plans approved by File cabinet AP folder Date L TO Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance caner. Loca i 1 d AP# Plan Approved for.: Sewage Disposal _ Water Supply Hold final for: Water Supply Final clearance O -.R. for: Water Supply Clearance for i e ome `—� ^�'�- 7W NOTE * * * Sanitarian J COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS ERMI L / 7 County Center Drive - Oroville. California 95965 - Telephone: 916/538-754 APPLICATION AND -PERMIT AS ES OR P�r L NB R ZONIN BUILDING PERMIT OWNIYU Y"nlTELE Ho SO. FT. Ocrl. BUILDING VALUA ON OW E 'S MAILI AD ESS G In CO TR CTOR'S N M ` c TELEPHONE CONTR CTOR'S MAIL G ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation I $ 116, Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ if, sfl ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ a Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS r Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5,00 USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00 ea TYPE OF WORK New ❑ Addition% Remodel ❑ Utilities ❑ Installation❑ Other ❑ i Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP ORSLESS 10,00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW declare under penalty of perjury (Check one): j 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. `�`��'-S% y 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 OC OR ADDNS. ACC. BLDGS. 1h Uq ft , NEW CON5TR MULTI -OUTLET NON.RESID BRANCH CIRCUITS) 2,50 ea /POWER APPARATUS eJ (SINGLE OUTLET CIR. EX. OCCU p OUTLETS OR FIXTURES 5AL06AL930so FIXED EX. OCCup. OUTLETS PLNS IRESID.IREA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring . g 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. 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. MECHANICAL PERMIT Filing Fee 10.00 Heating : 1 Cooling g -© Hood 3.00 ,--- Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, in ify and keep harmless the County of Butte against all abilities, judgme ts, �escaeexpenses which may in any way accrue agn sal County i co the granting of this permi . ` X Date lJ_ 4d' Sigf Applicant — Owner ❑ Contracto'Z Agent ❑ Anermit is required for excavations over 5'i)" deep and demolition or construct- ioures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ o euP. CONST.TYP ecNOOL P o ARCEL PD ND ISSUE This permit is hereby issued under sions of the Butte County Code and/or work Indicated above for which DIRECT OF PUBLIC BY / P IT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date —22� — `Z Receipt No. WHITE-D.P.W., YELLOW-ASSC OR. PINK -INSPECTOR, GOLDENROD -APPLICANT NST1?E0`VtTH O21oIN;,L DOCtI!,vkENT aa -022134 AP NO. 62-34-26 1. 62-34-25/ 62-34-27 NOTICE OF CONSTRUCTION AFFECTING ADJOINING PROPERTY The undersigned, RICHARD HUBACEK and LISA HUBACEK do hereby declare as follows: 1. I am, (We are), the owner(s) of that certain real property situated in the County of Butte, State of California, described in attached Exhibit A. 2. I, (We), intend to apply to the County of Butte for a.building permit and, pursuant to said permit, to construct improvements on the said property. I, (We), do hereby place all subsequent purchasers and encumbrancers on notice that such improvements will be constructed over a parcel or lot lines) as described in the above noted Exhibit A. and that subsequent purchasers and encumbrancers should be aware of the location of such improvements. 3. So long as such improvements remain, said parcels or lots cannot -be sold separately. DATED: July 6, 1988 i�T:ature of owner of record STATE' OF CALIFORNIA SS. C01 FY OF BG"ITE �&j ignature of oti&r of recon �m July 6, 19 88 , before me, the undersigned, A Notary Public in %11111 for tate State of California, residing therein, duly commissioned and sworn, K r • .r2:i 11 appeared RICHARD HUBACEK & LISA HUBACEK r:ie to be the person whose name subscribed to the within instrument ar,d ack.:tow•ledged that THEY executed the same. W1 T\. rrjy hand _and offiral seal. ■iii■m■milli NNE' ■i■■■■■■■■■d ' ANGELA D. MASTELOTTO e ■ ■ NOTARY PUBLIC -CALIFORNIA Is ■ `� Butte county ■ ■ My Commission Expires Sept. 7,1990 � LD 1540 (5/88) Name Ttyped or print DESCRIPTION r ALL THAT CERTAIN REAL" PROPERTY SITUATE IN THE STATE OF CALIFORNIA, COUNTY OF BUTTE, DESCRIBED AS FOLLOWS: LOT® M ;W 124, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "PONDEROSA PINES SUBDIVISION", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON MARCH 4, 1963, IN BOOK 30 OF MAPS, AT PAGE(S) 1, 2 AND 3. DESCRIPTION: All that certain real property situate in the County of Butte, State of California, described as follows: Lot 123, as shown on that certain Map entitled, "PONDEROSA PINES SUBDI- VISION", which Map was filed in the Office of the Recorder of the County of Butte, State of California, on March 4, 19632 in Book 30 of Maps, at Pages 1 and 2. G 5`� - FORM 7 ADDITIONS TO RESIDENTIAL BUILDINGS ENERGY SHEET PACKAGE "A", (Additions) Owner Climate Zone Permit # O?e? Sr Floor Area 0 The following data showing mandatory and required features of Package "A" shall be installed for additions to dwellings. Additions to dwellings include room additions, converting garages and patios to living areas, house moves that add footage and attic conversions, and any space that is existing non -conditioned space that is converted to conditioned space. Remodeling of existing conditioned space is not included. 9 APPLIES TO NEW AREA ® CEILING o WALL FLOOR SLAB • GLAZING it SHADING SOUTH - OPTIMUM OVERHANG ZONE 11 R-30 R-11 R-11 R-7 U-.65 (Dual) or .36 Shading Coefficient WEST .36 Shading Coefficient LOOSE FILL INSULATION (Density) ONE #6 R 3" R- 9 Rf 1 P-7 U-.6 (Dual) INFILTRATION CONTROL (Weatherstrip doors, certified windows, caulking) VAPOR BARRIER (Zone 16) DUCTS PER UNIFORM MECHANICAL CODE - Ch. 10 LIGHTING KITCHEN & BATH NOT LESS THAN 25 LUMENS/WATT MAXIMUM GLAZING 16% OF -AREA PLUS REMOVED GLAZING NEW HEATING, VENTILATING, AIR CONDITIONING AND HO's`-FYSTEMS IN i A� N CONJUNCTION WITH AN ADDITION SHALL BE INSTALL ON BACK OF THIS SHEET. OTHER 12/85 *1 HEATING, VENTILATING, AIR CONDITIONING SYSTEM (A) Heating ❑ Central Gas Furnace % (brand and model number) SE Btu/hr (heating capacity) ❑ Heat Pump (brand and model number) ACOP Btu/hr (heating capacity at 47°F) ❑ Active Solar type (liquid or air) Collector brand and ft2 model number solar fraction collector area collector - orientation collector tilt rated y -intercept rated slope ❑ Other (describe) *1 (B) Cooling ❑ Electric Air Conditioner . (brand and model number) (seasonal EER) Btu/hr (cooling capacity at 95°F) ❑ Electric Heat Pump EER Btu/hr (cooling capacity at 95°F) ❑ Other (describe) DOMESTIC WATER SYSTEM ❑ (A) Gas Only Gallons (brand and model number) (tank size) Q Heat Pump w/Electric Backup (brand and model number) Gallons 2 (tank size) Q * Active Solar (collector brand and model number) (rated y -intercept) (rated slope) (solar fraction)' ft (backup heater type, brand and model number) (collector area) (collector orientation) (collector tilt) ❑ Location of Solar Panels ❑ Other (Describe) *1 Submit documentation of sizing heating and cooling equipment by Manual J, sizing charts (form #4) or other approved methods, section 2-5352(g), and fill out the following. Heating: Winter design temperature °, elevation ', heating load BTU elevation factor x heating load - maximum outlet capacity gas furnace BTU Cooling: Summer design temperature °, cooling load BTU *2 Submit T.I,P.,S.E. chart'or other approved system (form X65) to document sizing of solar panels. ® DESIGN COMPLIANCE STATEMENT: The above building design meets the requirements of Title'24;'Part 2, Chapter 2-53 of the Cal ornia Administra n Code. to Lam- � SI A URE OF BUILDING DESIGNS OR APPLICANT 9 .r 1