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063-030-007
i a� v �g.}� a f 'a•§ r rbn.* �'w+= r -.any � � '.: " - `': a. 1, 063-03 `0'007 •a a .t: `.1.,�. .Y i •'� "S r HANSEN/GARDUNO j l `` ,j ,r ;Hartley Drive>'FR- 063- ,P3-0-007 `063 03-0-007_ 93-1536•; BMI _ GARDUNO '&•-HANSEN HARTLEY:DR, FOREST RANCH l.~ CONTR '.MICHAEL LEE •X, 0 �_' 3/#1qy cam l RIMUTIAL 063-03-0_007 GARDUNO & HANSEN y7�9 HARTLEY 93-1536 BpEM wICONS ; ,1ICHAEL LEE FOREST RANCH NE6d SF x� 9d ^� 3-3 .-q O . �T— • � O�FI�CEE CO f re � Address r d GAS h F Meter By Date I i ELECTRICy i . Meter By JJX _Date���/1 OFFICE COPY 3—X5 {o Address GAS � J Meter By �j is Date ELECTRIC Meter By Date V=OK d y O = Not OK Not A = Not Ready ble MOBILE HOMES -Date/Initials- MOBILE HOME UTILITIES (Plana) OK except #'a 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O Concrete 4. Water; Location -Teat -Easement Needed (Sketch) 5. Electricity; Location-Clearences-Grnd-/• /Amp -Concrete 8. Gas; Location -Teat -Wrap: / /"L"ft. / /"Nat. or/ /" L"ft./ /"LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date/Initials MOBILE HOME INSTALLATION (Plans) OK except #'a 1. Zoning Requirements -Setbacks Easements , 2. Footings; Size -Spacing -Marriage Line 3.. Gas; MH Teat -Demand -Valve -Connector ' 4. Electricity; MH Teat -Crossovers -Breakers -Clearances ` ' S. Drain; MH Test -Fall -Flex Connector 8. 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 MISCELLANEOUS Date/lnitiaO 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-Beams-Rftm.-Connectors ' Shthg.-Rfg.-Bracing \ 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 8. 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 i Date/Initials POOLS (Plans) OK except #'a 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 8. 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 , J MISCELLANEOUS Date/lnitiaO 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-Beams-Rftm.-Connectors ' Shthg.-Rfg.-Bracing \ 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 8. 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 i Date/Initials POOLS (Plans) OK except #'a 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 8. 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 , V=OK O = Not OK - = Not Applicable = Not Ready RESIDENTIAL (Single & Duplex) Date/Initials UNDERFLOOR (Plans) OK except #'s I-AfIfA7 /'I Lr f" . m; Soils-Elec. Grnd.-/ ' P' Fig. Depth Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth mwalll, Main; Steel-Blockouts-Wrapped 6s. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers fireplace Fta.-Steel LA3'W.V.; Fall -Fust -2 Way CLO --ewer Test 10. UF. Gas Pipe; Size -A ors -yard gas piping: size -teat it -wafer Pipe; - nchor-Regulator-Service Test 412 12. El e ric; Underground 11 VI 1 ienums & Ducts; Clea ce-Material-Su -Ina. � -� 14. rs-Sills-Anchor B -Joists-Ven p ` ,,n )cf3 15. Access & Ventilation 16' Insulation Date/Initials PLUMBING Permit OK except #'s 16. r Htr. Ac s -Combustion Air -Baffle W ter Pipe; T & Anchor- ail Prot! titin 1 V.; Test -Filings nchor- i Protection hower Pan; First Floor -Tub Access 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size -& Anchors '3129 y v Date/initials ELE ICAL Permit OK except #'s Fixtyre & Transformer Cleara -Ins. Protectio ".9c -Receptacles Spac -Ligh witc es at Doors 24. Size�Boxes & No. of Conductors -Stapled Amex Installed Close to Edge of Studs & C.J. 6. Equip. Ground made up w/Meeh. Fastners and Gas & WgIar 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI 28.eed-NF ga. u o - . Wire Size / / ga. Cu or 2 e Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. ! orated Neutral ❑ Yes ❑ No . S�-Riser Conductors & Ground -Mein Disconnect 31'Eyip'Clearances Panels -Motors -Mach. Equip. 3 . lothes Closet Light -Shower Light -Spa Light . Smoke Detector �a yy Date/Initials MECHANICAL (Permit) OK except #'s 34. A.C.._Ducts Insulation & Support 3lt n; Exhaust above insulation 36-5D ndensate Drain & Overflow; Size & Grade 37. Furnanc - en • Access -Comb. Air -Return Air Vent -115 outlet 60Attic Access & Platform if Furnance in Attic 3�19Ny Date/Initials FRAMING Plans OK except #'s 3 . Sil roper Material & Anchors 40e"Walls Studs -Nailing, Spacing & Bracing -Plates -Sound 41. Bearing Walls over Girders & Floor Nailing 42. Draft Stop in Walls (rat proof) "Fce Stops; Furred Ceilings -Stairs -Chases -Tub 44/Headers & Beam -Size & Bearing Date/Initials FRAMING (Continued) 45. Hange -Post Caps chore -Connectors 48. Cing. Joie -Rftr. s-Purlin-roof Brac-Truss_Shthn .-Rfng. 47. Fireplace Ties or Type ue-Firepla Throat glearanc! 4 is Access; Size,& Romex Protection-Drq"top-In$rB'aHIs$ 49. Bdrm Winbd1 vs or Exitina Doors -S at. & Dim cions 5 _ 50.-eGarage Fire Protection Framing 51. Property Line Firewall & Openings 52. E"oors-One 3' -Check Garage -3rd Story, 2 Exits i 5i�itairs; Width -Weedr om-RIse.R -Landing-Fife'Protection 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers 55. Siding -Nailing Veneer 56. Stucco Mas -Drip Screed -Fd. Vents-Underflr. Access 57. Glai rea-Glass Protect -Skylights-Plastic 58. Shear Walls; Nailing -Bolts S 59. Insulation -Walls -Ceilings u 60. Infiltration -Walls -Windows 30 41 V Date/Initials FINAL (PjAftsTOK except #'a 8 t. Ste Door & Sidelight Protec on -Land a 6 oke Petector 6 nate; Ve earance-Comb. Air-Connector- In-9arage; Above door -Ducts -Meth. Protection (66:5,ee6. Trim & iubDetr(:breaker Sizes ALLabelrO or Stove; 6tt:te utlets at Vft5d Panel; Int. & Ext. 7 . ext. ppliance; Grnd.-Air ng Clearance 7<'_EAec-0_utlets & R to at Kit. Counter 73�K.C. Duct in Garage -Damper 7 r.; Vents -Clearance -Comb. Air nector-P. . . In Garage; Above Floor -Meth. Protection 7 ec. & Mach. Equip. Lis oce c.jteceptacies In Garage (G Romex Pr ction ulation-Foam-Looked in At s !L uard s & Deck Constructi -Post a Vents & Crawl Hole Door -Drainage & -Earth Clearance Looked under Floor es .8 Ilowing instld.; Drive ❑ No; Walks Me9es m No; Pla_njgrs ❑ Yes o uc B - inish e lumping e"ents Ab MRoof; PI -Appliance-Flrepla : Clearance to 80eVV ell; Disconnect, El!.qftal, Plumbing t!bE e r Elec. Trim; G. .. Receptacle -Underground 8b*'_Ve_aJ letion Throughout House Previous I 90. Water ewer Connected-QA6't'o Grade -HD Approval 9Lea'erg Com fiance Certificate -Other Certificates Comments at Final: 7123 ffltj 4 .HEAT -N - May 12,1994 Dear Marla Hansen, We have considered your request to install your Heat-N-Glo ST 42 GTV with a clearance that is not consistent with our installation manual. The situation you described on the phone involved protrusions of 7 1/4 inches and 8 inches of a noncombustible material that runs perpendicular to the glass openings on either side of the fireplace. (See diagrams 1 and 2 --Locations A,C,D,F) These protrusions are acceptable for the following reasons: 1) The framing around the fireplace is done entirely witli metal studs 2) The metal studs are covered with sheetrock 3) All surfaces. that protrude into the room further than the fireplace (Items A,B,C,D,E,F in diagrams 1 and 2) are covered with a noncombustible tile. Also described was a clearance to a protrusion above the glass opening. Our manual will state that you need to measure up 12 inches from-tlie bottom of the hood to the protrusion. At that point the protrusion can extend out from the unit (fireplace) up to 8 inches. It appears you have met this clearance. Because the fireplace is surrounded by noncombustible material this installation is acceptable. Any deviations from the installation manual (other than those stated specifically in this letter) are not approved by Heat-N-Glo. Note: Since this fireplace is in a -living room and a bedroom it must adhere to the National Fuel Gas Code ANSI Z223.1/NFPA 54 - (current edition) The Uniform Mechanical Code - (current edition) and Local Building Officials for the options allowed in obtaining an effective bedroom volume of unconfined space. Sinc ly, Gregg Achman Gas Engineering Manager Page 1 of 3 HEAT-IST-GLO Fireplace Products, Inc. • 6665 West Highway 13 •Savage, Minnesota 55378 • (612) 890-8367 7:;, 3c f5 GI A/A Rfug.-1 �vir�ant9 Porf�a,� %// %[ta5[U Is" ao S7 yA �T rr G 2y ��' '-,, f'���'*cn��r►.T�' .:n.,,sw�„e.�•,,,_.4; ,.-. .._-...,.•.... ti. �,.�+y...,,._ .w .,. .x..�!^�, j.e .,-�«�e��!� ; .�.sT .. . - • � � .. yy �:. �' a + pr ... � .,� � � � /"' 1/./ i Yf- it '! 7 r, . .. � .. �� � � �,� - � r t i .^ ... ~ t -�� i •-• � " - �, - ., v �`; ., t � � � � ' r ; .i , "�M��:..--rJ".r•. r :i :.i'ii i ..• '.Y, `.. _7 -W.. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS. 7 County Center Drive - Oroville, California 95965 - Telephone: 916,'538-7541 APPLICATION AND PERMIT JERMIT N0. ASSESSOR PARCEL NUMBER 063-030--007 ZONING R-1 BUILDING PERMIT OWNER Lloyd Garduno/Merla Hansen TELEPHONE 342-3760 SO. FT. OCC. BUILDING VALUATION 2387 R 128 898.00 OWNER'S MAILING ADDRESS 848 Mornin home iCt.. Chico 95926 616 M 11,088.W CONTRACTOR'SNAME Michael Lee TELEPHONE 343-2219 454/259 v/ 5002.00//1.673.00 489 Unfin 16 626,. W' CONTRACTOR'S MAILING ADDRESS 1388 "M" Longfellow, Chico 95926 Fireplace A 1,500.06 CONSTRUCTION LENDER Tehama County BAnk UNKNOWN Total Valuation $165 687.00 F i l i n Fee 15.00 g $ LENDER'S MAILING ADDRESS Permit Fee $ 828.50 ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ 416.25 Energy Plan Checking Fee $ 20.00 ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ 279.75 PLUMBING PERMIT Filing Fee 15.00 4719 Hartley Dr., Forest Ranch Each Trap 1 5.o0 65.00 Solar or heat pump water heater 20.00 LOT NO. 10 SUBDIVISION NAME NOrthwoods Subdivision PARCEL MAP 23--18 Water piping 1 7.00 7.00 Each qas water heater or vent 1 7.00 7.00 USE OF STRUCTURE SF[A Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 1 5.001 5.00 Building sewer 1 15.00 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New I1 Addition ^ Remodel Cl Utilities ❑ Installation❑ Other ❑ Describe work: k@w 3 Bedroom Single Fetidly _ Permit Fee $114.00 Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200AORLESS 1 18.50 18.50 Main service 200ATO1000Al 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury p y p l 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 Ao. 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 Iicensed.contract ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING occ� - ZOr, OR ADDNS. ACC. BLDGS. 3.64 sq.ft. ., NEw CONSTF MULTI -OUTLET NON.RESID BRANCH IRC ITS @ 5.00 POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 @ 760 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) I 3.00 Temporary service 1 j 15.00 15.00 Mobile Home Facilities 15.00 Misc.Wiring 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. © 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 1 9. 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 said./Count in cgnsequence of the granting of this permit. . ✓ r (� X - hG / Date Signature of Applicant - Owner 2 Contractor ❑ Agent 1:1^iT�i'10 An OSHA permit is required for excavations over deep and demolition or co struct- ion of structures over stories in heAlp. Mobile Home Installation Fee $ Energy Inspection Fee $ 40.00 0_1� 3 CONST TYPE Vu TOTAL FEE $1.652.25 HAz 1 DFEES IMP -- I FLOOD v COF PARCE ✓ ISSUE This permit is hereby issued under the applicable provi- sions of t Butte oun y Code and/or resolutions to do is in , ated a o r ich fees have been paid. R O B I WORKS Date 3 3 PE MIT EXPIR S Date 301c Receipt No/C 1 / / _ - . WHITE-D.P.W., YELLOW-ASSE330R, K-INSPEC . GOLDENROD -APPLICANT Insulation Certificate _/1171 � �v i EST City County Subdivision Lot Nwnber Description of installation ROOF _ -M�alceal BrandName Thickhe`ls (inches) ,M=Re iit=(R-Value) k, CI- —I NG 4 ' FIBERGLASS 9.1 B , au or Bjtjk2ypeBrand fT Name CERtAINTEED `�V -!bicknei�4tnch�Th ) 44 ermal Resistance (R -Nalene) 3!> ' Loose FdlType INSULSAFE III Brand Name CERTAINTEED.- 1-w Contractor's minimum installed weight/ft" lb MWmurnthickness niches Manufacturer's installed weight per square foot to acheive"`Thermal Resistance (R -Value) EXTERIOR WALL Material Thickness RAISED FLOOR Material # FIBERGLASS Ijbicknm (inches) 0 -SLAB FLOOR Material Thickness (inches) Width (inches) FOUNDATION WALL FIBERGLASS 'Mit;kricss (inches) BrandName CERTATNTERN Thermal Resistance (R -Valve,) 4 Brand Name ",rCERTAINTELL, Thermal Regfiiiince (11 -Value) Brand Name Thermal'Iesistance (R-Valur) Brand Name CERTAINTEED Thermal Resistance (11-Valge) Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residerkial buildings contained in Title 24 of the California Administrative Code. ' I General Contractor (Builder) Signak= and Title SHASTA -INSULATION b -Co T( cion wuller) Sign a tun and Tile Licauc Number Dam 272941 Due — r COUNTY OF BUTTE t BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES i 1469 Humboldt Road, Chico, CA - (916) ,891-2751 . 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE OWNER — PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work completed. If you have any questions pertaining to this matter, or need additional explanation, prl� se contact this office immediately. Date J REV 10/9 Inspector U 6 1QU2 COUNTY OF BUTTE ' BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES . '1469 Humboldt Road, Chico, CA - (916) 89.1-2751 7 County Center Drive, Croville, CA - (916)*•538-7541 k 747 Elliott Road, Paradise, CA - (916) 872-6307. 7 . '4 CORRECTION NOTICE 9131- OWWEAPERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at' 4 the above a dress and should be corrected. Please notify this office when correction of work is PI= d. If you have any questions pertaining to this matter, or need additional explanation, -' '- please ntact this office immediately. V 1 ki�, 6.Q_ w CI UVG 1 -3 S'S en -b f(►(e,� , _ n 8 Date Inspector REV 10192 ZVI - 'g, ,4 � � 7� 2 fA° c �,�-Q T .A— A �/.� ////L AIAA/%1 //1/A � a1 `�: LS" /%1..�..i /� L6 •/�Ai . .�I� /f it COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916.'538-7541 APPLICAT104AND PERMIT PERMIT NO. 3 24 ASSESSOR PARCEL NUMBER 063-030-007 ZONING R-1 BUILDING PERMIT OWNER Lloyd Garduno/Marla Hansen TELEPHONE 342-3760 SO. FT. OCC. BUILDING VALUATION 2 387 R 128,898.00 OWNER'S MAILING ADDRESS 848 Morninghome Ct., Chico 95926 616 M 11 088.00 ACTOR'SNAME CONTRACTOR'S Michael TELEPHONE 343-2219 454 259 ov 0 5 902.00 1 673.00 489 Unfin 16 626.00 CONTRACTOR'S MAILING ADDRESS 1388 "M" Longfellow, Chico 95926 Fireplace I A 1,500.00 CONSTRUCTION LENDER Tehama County BAnk UNKNOWN Total Valuation $165.687.00 FilingFee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ 0 ARCHITECT OR ENGINEER LICENSE No. Plan Checking,Fee $ 416.25 Energy Plan Checking Fee $ 20.00 ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee PLUMBING PERMIT FilingFee 15.00 4719 Hartley Dr., Forest Ranch Each Trap It 5.00 65.00 Solar or heat pump water heater 1 20.00 LOT NO. 10 SUBDIVISION NAME NOrthwoods Subdivision PARCEL MAP 23-18 Water piping 1 7.00 7.00 Each pas water heater or vent 11 7.001 7,00 USE OF STRUCTURE SF [X Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 11 5-001 5,00 Building sewer 1 15.00 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New ["Xi Addition LJ Remodel ❑ Utilities ❑ Installation[^) Other ❑ Describe work: New 3 Bedroom Single Family Permit Fee $ 114.00 Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A OR LESS 1 18.50 18.50 Main service 200A TO 1000A1 37.50 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 F1 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) [2-* -1, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCC -Vo OR ADDNS. ( ACC. SLOGS. J�J�Jl 3.60 sq.ft. 105.00 NEW CONST R. ULT' -OUTLET, �iO S.00 NON-RESID BRANCH CIRC ITS POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 @ 76 FIXED APLNS. Ex. Occup. OUTLETS P(RESID,)REA.1 I 3.00 Temporary service 11 15.00 15.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $153.50 - 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. F-]--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 FilingFee 1 15.00 Heating 119.001 9.00 Cooling 1 16.5C 16.50 Hood 1 6.50 6,50 Ventilation 4 4.50 18.00 penult Fee $ 65.00 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 sai ounty in c sequence of the granting of this permit. X c� Date �/� Signature p Contractor ❑ Agent ❑ $i nature of A licanr - owner An OSHA permit is required for excavations aver " deep and demolition or co trUCt- Lion of structures over stories in he' Mobile Home Installation Fee S Energy Inspection Fee $ 40.00 o C 3 C°ON�STTYPE V TOTAL FEE $1,652.251 HAz 1 DFEES IMP -� FLOODCDF %I-' PARCEL PD ISSUE This permit is hereby issued under sions of t -Butte oun y Code and/or in ated o r Ich fees R B I PE MIT EXPIR S Date the applicable resolutions have been WORKS Date provi- to do paid. 2 �7 f'C� l 3� j Receipt No.9 ._ r WHITE-D.P.W.. YELLOW -ASSESSOR, x-IlISPECT , GOLDENROD -APPLICANT ."., I CO e NWt'4MAILING•AUUn -- u. T r , NTRA TOR'S,4N A�A NTRACTOR'S MAILING AODRESS� n A u S. _ .. ,•" /_o n�G r�ir_.o w C'fH co �ii4 . G-. N3fit.UCTION LEND, V ',NOER'S MAILING ADORES ' L1 ICHITECT OR ENGINEER ' tCHITECT OR ENGINEER'S MAILING ADDRESS JILOING AOORESS IAL IF, PUBLIC WORKS�F ra - l -,•Telephone:�91G 53� 7541 . `"�`p �"��.• r�'�BUILDING PERMI BUILDING VALUAT V SO: FT s OCC d z 8 g O Total Valuation $ COUNTY OF BUTTEZ,-DEP Filing Fee 7 County Center Drive°0lovllle, C Permit Fee�i APP jPATII ND. .Plan Checking Fee 5 S SSOR PA�R/.CEL 0q v; ZON Penalty ,A Permit fee $ PLUMBING PERMIT NWt'4MAILING•AUUn -- u. T r , NTRA TOR'S,4N A�A NTRACTOR'S MAILING AODRESS� n A u S. _ .. ,•" /_o n�G r�ir_.o w C'fH co �ii4 . G-. N3fit.UCTION LEND, V ',NOER'S MAILING ADORES ' L1 ICHITECT OR ENGINEER ' tCHITECT OR ENGINEER'S MAILING ADDRESS JILOING AOORESS IAL IF, PUBLIC WORKS�F ra - l -,•Telephone:�91G 53� 7541 . `"�`p �"��.• r�'�BUILDING PERMI BUILDING VALUAT V SO: FT s OCC d z 8 g Describe work. ELECTRICAL PERMITES Fili Fee Main service 200A OR LESS 18.50 M • service 200ATO10o0AI 1 37.50 aln CONTRACTORS LICENSE LAW -r� I declare under penalty of. perjury (check one): FTI 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 contra bt- ors. (Sec. 7044) ❑ I am exempt under Sec. Business and Professions Code • for this reason O Total Valuation $ Solar or heat pump wat Filing Fee $ Permit Fee�i $ ND. .Plan Checking Fee 5 S Energy Plan Checking Fee $ 2 ' Penalty $ Permit fee $ PLUMBING PERMIT Filing Fee C..... T.•�n_ 3 5.001 Describe work. ELECTRICAL PERMITES Fili Fee Main service 200A OR LESS 18.50 M • service 200ATO10o0AI 1 37.50 aln CONTRACTORS LICENSE LAW -r� I declare under penalty of. perjury (check one): FTI 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 contra bt- ors. (Sec. 7044) ❑ I am exempt under Sec. Business and Professions Code • for this reason NE w coNST. DWELLING o cLI �4 OR ADONS ACC. BLOGS.F;7J� I NEW CONSTM UL71 OUTLET NON.RESID BRANCH.CIRC ITS Solar or heat pump wat w.UV FIXED APPLNS. OR 1 Ex. Occup. OUTLETS IRESID.1 EA./ SUBDIVISION NAME' Mobile Home Facilities Water piping 7.00 Permit Fee PARCEL MAP 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 v ;�/ dlS/17 6v 23' Each qas water heater or vent 5.00 Ventilation Permit Fee Contractor Gas piping system 1 - 5 outlets Mobile Home Installation Fee Ener Inspection Fee SZ gy v USE OF STRUCTURE Building sewer 15.00 SF 4g/,"Duplex❑ Mobilehome❑ Other II Mobile Home S G W @ 15.00 SPECIFY TYPE OF WORK 77 New;_; �t Addition _ Remodel;__ Utilities L� Installation[ Other ❑ Permit Fee $ Contractor Describe work. ELECTRICAL PERMITES Fili Fee Main service 200A OR LESS 18.50 M • service 200ATO10o0AI 1 37.50 aln CONTRACTORS LICENSE LAW -r� I declare under penalty of. perjury (check one): FTI 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 contra bt- ors. (Sec. 7044) ❑ I am exempt under Sec. Business and Professions Code • for this reason NE w coNST. DWELLING o cLI �4 OR ADONS ACC. BLOGS.F;7J� I NEW CONSTM UL71 OUTLET NON.RESID BRANCH.CIRC ITS POWER APPARATUS e� � SINGLE OUTLET CIR. Ex. OCCUp\OUTLETS OR FIXTURES FIXED APPLNS. OR 1 Ex. Occup. OUTLETS IRESID.1 EA./ Temporary service Mobile Home Facilities Misc. Wiring 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. ❑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 Heating - Vp Cooling Hood 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 f h tin of this permit. Mobile Home Installation Fee Ener Inspection Fee SZ gy occ CONST TYPE TOTAL FEE HAZ DPEES IMP L' COf 1 15.00 S F` 15.00 alnst said County In consequence o t e gran g � I Al This permit is hereby issued under the applicable provi- Date sions of the Butte County Code and/or resolutions to do 7�AApplicant — Owner ❑ Contractor 0 Agent ❑ work indicated above for which fees have been paid. mit is requ'red For excavati s over 5'0" d p and demolition or construct- DIRECTOR OF PUBLIC WORKS res over 3 cries In heightBy Date Receipt No�� PERMIT EXPIRES Date WNITL•D.P. W.. TELL W-ASDESSOR. P •INSPECTOR. GO NROD-AP►LICAMT II alnst said County In consequence o t e gran g � I Al This permit is hereby issued under the applicable provi- Date sions of the Butte County Code and/or resolutions to do 7�AApplicant — Owner ❑ Contractor 0 Agent ❑ work indicated above for which fees have been paid. mit is requ'red For excavati s over 5'0" d p and demolition or construct- DIRECTOR OF PUBLIC WORKS res over 3 cries In heightBy Date Receipt No�� PERMIT EXPIRES Date WNITL•D.P. W.. TELL W-ASDESSOR. P •INSPECTOR. GO NROD-AP►LICAMT J COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. ,.� 7 County Center Drive - Oroville, California 95965 - Telephone 916 538-7541l /S - I0 APPLICATION AND PERMIT l ASSESSOR PARCEL NUMBER # p63 -- pj 0 O_ ZONIN BUILDING PERMIT OWE o £•� • TELEPHONE 3-376 SO. FT. OCC. BUILDING VALUATION 3 8 WNER' MAILING ADDRESS � C ftNTRACJCI T/ /!-CSL. NAM �E� EPHO E /� 3L(LJ3 r'�) 2 ®� Z V Z_ �7 V�-�✓F �� CONTRACTOR'S MAILING ADDRESS Gj¢, S f Z.,� 1398Lon0G,=*Sz"wL' ,C® 9 Fireplace d C) CONS-UCTION LEND/ER UNKNOWN Total Valuation Is Fee $ 15.00 LENDER'S MAILING ADDRESS/Filing Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. -Plan Checking Fee $ - Energy Plan Checking Fee $ "Z ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS i Permit fee $ 2 1. 2 PLUMBING PERMIT Filing Fee 15.00 n A Each Trap & 5.00 raaew- /f1%JC_ Solar or heat pump water heater 1 20.00 LaT NO. a SUBDIVISION NAME n C7 !.r/U J v 1�/c�(SIOW PARCEL MAP IEL23� Water piping 7.00 Each gas water heater or vent 7.00 "'7 ,�� USE OF STRUCTURE SFS► Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00, C� Mobile Home S I G I W @ 15.00 TYPE OF WORK New/ Addition _ Remodel❑ Utilities ❑ Installation❑ Other ❑ Describe work: 341J�21 Permit Fee $ Contractor ELECTRICAL PERMIT Filin Fee 15.00 Main service 600VORLESS 18.50 -- 200A OR LESS Main service 200A TO 1000AI 7.50 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 i7.) 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 O . 3.66 sq.Jt. OR ADONS. ( CUPQ ACC. BLDGS. � �O6— NEW CONSTR ULTI.OUTLET @ 5.00 NON-RESID BRANCH CIRCUIT POWER APPARATUS e (SINGLE OUTLET CIR. ) Ex. Occup(OUTLETS OR FIXTURES A20 @ 46d FIXED APPLNS. OR Ex. Occup. OUTLETS (RES, D.J EA I 3.00 Temporary service 15.00 �— Mobile Home Facilities 15.00 Misc. tiyirin g 15.00 Permit Fee $ 5-3 — 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 Filing Fee 15.00 Heating 0-1 Lp v - Cooling �► Hood 6.50 b I Ventilation ' Q "= permit Fee L2ntractor 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 ❑ - An OSHA permit is requ'red for eXcavati s over 5'0" d p and demolition or construct- ion of structures�o+ver 3 ones in height Mobile Home Installation Fee S Energy Inspection Fee $ Occ CONST TYPE ITOTAL FEE $ HA2 0FEES I IMP LOGO CDF PARCEL PD HD SSUE 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 �OC� 1� �2 �' ��% Receipt No/ WHITE-O.P.W.. •ELL W -ASSESSOR. P •INSPECTOR. GO O HROO-APPLICANT I t F.H. USF: ONLY I'lui flan Auachc([ 1:1,,4)rflan Auacht _ Scat tri Ii. 1). TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Location / AP# Plan Approved for: Sewage Disposal Water Supply: Public t/ Private Well Clearance for '_?_ bedroom r home. Other Hold final for: uult- IVGD�p �r� Final clearance O.K. for: 2.0 NOTE: Environmental Health Specialist 8/92 Z—l7-5;Y Date T0: Building Department FROM: Encroachment Permit Section RE: Driveway Clearance 3 �� 3°07 loaatio owner has been issued for the above,property. Driveway permit date._ si ature COUNTYOF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION ." 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA95965 - TELEPHO E(9116)M8-7541 PERMIT APPLICATION DATA SHEET OWNER L / O y d , 64a e !14 A. P. No. -ta ✓� - C�, c'`�'i Proposed Building Use /*v✓ Building Inspector �- . Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: 1. DATE RECEIVED All items have been submitted. • C�24-72� BY 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. 8. Statement of Intent for Non -Heated and A/C Buildings. �� t Engineered truss details and layout in duplicate (requiredi to plan cec cl'f ... . gf Mobilehome to manufacturer's installation ' . tructions, 2 sets. ........... Tq,--Fees of $......................... 1. Impact fees as shown on attached schedule. ............................. . 12. California Department of Forestry plan approval/fees. ....................... . 3 ----�J 4. Flood elevation letter (100 year flood) by California Engineer.................. Sanitation and plot plan approval i:Q//rG Health Department. ........ . City Chico 15. of 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. ......... . J'9. Driveway permit (construction approval required prior to occupancy). .. . ,5 P'�"aapp 20. Pre -inspection for required. .. to sui�ding Inspector nsped (Date) 21. Contractor's license information. (No., Name Style, Classification) . ............. 22. Certificate of Workmans Compensation Insurance . .......................... 11 23 -Owner -Builder Verification (Given to owner, Mail to owner _ )............ 24. Recorded copy of Agricultural Acknowledgement Statement...................... L 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 . .......................................... 1_ 29. Documentation of legal access . ....................................... . 30. Documentation of 50% subdivision developed or (A) Road improvements completed Xr� and (B) Parcel meets zoning area and frontage requirements. 31. Existing violations/expired permits . ...................................... —P1.811 geek list . ..................................................... 33. 34. WVoyou issue the aormit, process as follows: Mail to owner. Mail to contractor. ((// Telephone] i - )s7, and hold for pickup at 4C A/01 e e'a office. Deliver with inspector. Other Parcel Creation Acreage Applican 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 priorp it issuance: (Circle new item not checked above). 1. Index permit'for above items No. 2. Additional items required: tracto esigne ner as advised of above required data by phone — mail Counter b — Date? :(3 -Contractor, designer, owner, was advised of above required data by _ phone _ ma' C unter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold inyFi� et AP Copy - Department of Public Works VP 3 COUNTY OF BUTTE - DEPARTrff•NT OF PUBLIC WORKS - BUMDING DIVISION 7 COUNTY =frER Mrs—= - OROVILLE, CALIFORNIA 95963 - Tr'"LEMME (916)5387541 POS r"'D BUILDING . USE - A. P. SE A.P. NO. 40~-03-- v0 7 DATE REC. DATE REC Sciiovl Distr :.c Fees ,�, .......... ' ...... .3� -¢rl (paid at District Office �, , Cl- e.--i:ff Fels (paid at, Building Department) Residential ......... uni t amt. ; Commercial( per sq . f t .) I sq.ft. amt., 3. Urban Area Fees (paid at Building Department Residential (per unit) I units amt. Commerical( per sq .'f t.) 1 4 sq.ft. amt. - 4. Re=eatj.on Distr7.ct Fees (paid at District Office) .......................... S. Drainage Dist mac- Fees (Ccatac- Land Development) 6. Other J y 3 cis s Ls�s r 7. Other time of permit application, I was advised the above fees are required to be paid pr--':-: issuance of the permit. LICANT ..G��� �v` �--: DATE 5 12c1c'7 }}F;LAO*W+:N" ('r'v-i.' "t'7`•"t;'p"�J% "'tlrW�r4 `r: ,�s^kGfi'r.-c' ''C?jbfi��"',,q,'".aln ii a..:si•.'-"+«iPs'w;'^',„✓�""'+tis��'p'�.:�'� a2i� "h S�'+ ,a'�,+ r'.+wSi i•t.�y..a�e1M^.w BUTTE COUNTY SCHOQLS .IMPfACT FEE CERTIFICATION FORM { (One Form Per Building) School District C' 0 G .-=� Building Department No. C- 6L A.P. Number -3 d 3 ' 007) Jurisdiction 0 City county Property Owner Property Location/Address �e e J X'a wc- Subdivison N09 P 0 01.9 Lot No. Residential Development Sq. Footage 7 No. of Living MHI Addition (Group R) Units JI Commercial/Industrial Qo yS'qootage New •,r-. ,,,AAddition (Including Exterior Roofed Areas) - 119 --5 Build ment Representative Date (Floor Plans reviewed by School District Personnel) ` District Identification No. �303�8 61 CO Vn I F/ E- School District certifies that 1713 (Street Address) . 3'+2-01S (Phone (City) (State) (Zip Code) has complied with the requirements of Resolution No. representing Q,3 97 square feet. School D Paid by Check Number . Remarks: Bank Number CID -"� 1, y Paid by Cash by payment of $v—, 5.5� 6o Date 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) RESIDENTIAL PLAN CHECKING GUIDE 8/91 (S.F., DUPLEX '& MISC. ,ONLY) ' r Bldg. Permit # OWNER /",,'A?,bUj J C) F-tAIJSEN A.P. # T GENERAL Plan Checker 2 K 7 23 3 toning requirements: (sideyards and number of permitted living units). luation. GotzQE� � ans signed ,by designer. u Proper description of work on application. misting violations on.property. Items on data sheet. (W.C., fees, Health,,Developer Fees, License law, etc). --corded notice of violation. PLOT PLAN lL,"C'omplete parcel size and dimensions. 2+' --Setbacks, sideyards, easements, etc. 3�er buildings or structures. 4. ading, fills, drainage. 51' Flood hazard. ficial conditions on creation map, (noise,.CDF, fire sprinklers, non-comb- ustible, and foundations). & FAS road setback. g or utilities across lot lines (Record form). FLOOR PLAN 1J�Gomplete to scale plan with dimensions. � quired windows for light and ventilation (Sec. 1205). Lrquired windows for second exit (Sec. 1204). /Skylights (Chapter 34 & Sec. 5207). ' truman impact glass (Sec. 5406). K Required room sizes, ceiling heights (Sec. 1207). �FCIs in baths, garage, kitchen, and exterior outlets (Article 210-8). ight fixtures, switches, receptacles, and exterior receptacles for main- tenance of mechanical equipment. 9Ao ations of water heater, heating and cooling equipment, other electrical gas equipment. 1 G r e firewall, door size, and closer (Sec.,503(d)(3)). 11. 3'0" exterior exit door (sec. 3304 (f). 1 i,eplace and -wood stove location, alcoves, and clearance. 1 -.oke detectors (Sec. 1210). 1 Plumbing fixtures, water closet clearances and shower size. STRUCTURAL DETAILS 1. Standard bracing or engineered design (Table 25V) Visual shape, size, or split level house requiring lateral design. erestory requiring balloon framing and/or engineering. e story building requiring engineered calculations and plans. ~SEl�ndation plan complete enough to construct building. 6.4-/— Floor construction details complete enough to construct building. Y levations and wall construction details complete 8. Roof construction details complete enough to eplace construction details and calcs if. re;Gar ter ties or bearing ridge beam. age door or porch header sizes. lZ-55ud heights. 13.-44obe soils - special foundation design. paining walls requiring design.. dial Inspection required. enough to construct building construct building. necessary. 8/91 3 RESIDENTIAL PLAN CHECKING GUIDE o MISCELLANEOUS ITEMS JO LOOK OUT FOR Stai rway:details: landings, rise and run, head clearance, handrails Sec. 3306). Guardrail details (Sec. 1711 & 3306(j). ,mak or stone veneer (Chapter 30). error plaster - weep screeds (Sec. 4706). ` Til J_ -roper roof pitch for roof convering (Chapter 32). hof covering type - (fire hazard). oam insulation - protection. halls and stairways. 9. Living area over garage - complete 1 -hour separation required on garage side including supporting walls and posts, etc. o exits on three-story dwellings (sec. 3303 & see Mezannines - 1716). IVtic access and ventilation (Sec. 3205). lderfloor access and ventilation (Sec. 2516). lY Co stion air for fuel burning appliances - L.P.G. requirements. . Noise requirements on duplexes. 4�ergy design. 1 F at all exterior openings. . CDF responsible area requirements. CERTIFICATE -OF- COMPLIANCE: -RESIDENTIAL --------------------Page -1----------CF-1R Project Title.......... LLcY+o tv4/L0%JnJ0 Date........ 07/27/93 Project Address ........ �o,2s?s�- �1�a-, , CIA, --------------------- , Documentation Author... J. PETERSON 1 Building Permit # Company ................ JIM PETERSON tZ 1,0-' 7-2- moi Telephone .............. (916) 343-7250 Plan Check / Date Compliance Method...... MICROPAS4 by Enercomp, Inc. Field Check/ Date ' Climate Zone........... 11 --------------------- MICROPAS4 v4.01 File-RC2371BC Wth-CTZ11S92 Program -FORM CF -1R User#-MP0400 User -JIM PETERSON Run -Typical House ------------------------------------------------------------------------------- GENERAL INFORMATION Conditioned Floor Area 2371 sf� Building Type .............. Single Family Detached Construction Type ......... New / Building Front Orientation. Front Facing 180 deg (S) Number of Dwelling Units... 1 Number of Stories.......... 1 Floor Construction Type.... Raised Floor (Package E) BUILDING SHELL INSULATION Component Insulation Assembly Area Type R -value U -Value Location/Comments ------------- Wall ---------- R-19 } � -------- 0.065 ---------------------------------------- METAL FRAMING B - COUNTS Roof R-38 ] 0.029 ATTIC Door R=OJ 0.330 Solid Wood BUILDING DEPARTM9fv, Floor R 1'9D / 0.037 METAL FRAMING FENESTRATION APPROVED ------------ Type ------------ InteriorVert InteriorHorz Over- hang/ Framing Fins Type None Metal None Area U- # of Interior Exterior Orientation Metal (sf) Value Panes ----- Shading ---------- Shading -------- ------------------- Door Front (S) ----- 10.0 ----- 0.770 2 Drapes.Std None Window Front (S) 116.0 0.720 2 Drapes.Std None Window Front (S) 14.0 0.870 2 Drapes.Std None Window Left (W) 30.0 0.870 2 Drapes.Std None Window Back (N) 24.0 0.870 2 Drapes.Std None Window Back (N) 18.0 1.400 2 Drapes.Std None Window Back (N) 48.0 0.720 2 Drapes.Std None Type ------------ InteriorVert InteriorHorz Over- hang/ Framing Fins Type None Metal None Metal None Metal None Metal None Metal None None None Metal THERMAL MASS ------------ Area Thickness Exposed (sf) (in) Location/Comments -------------- --------------- ------------------------ Yes 184 1.0 Tile Walls Yes 230 1.0 Tile Floor i CERTIFICATE OF COMPLIANCE: RESIDENTIAL Page 2 CF -1R Project Title.......... Date........ 07/27/93 MICROPAS4 v4.01. File-RC2371BC Wth-CTZ11S92 Program -FORM CF -1R User#-MP0400 User -JIM PETERSON Run -Typical House -------------------------------------------------------------------------------- HVAC SYSTEMS Minimum Duct Duct Thermostat Equipment Type Efficiency --------------------------- Location ------------- R -value ------- Type ------------ Furnace 0.780--AFUE Attic R-5.6 Setback ACSpl it ":�'1,2-: 00 -SEERS Attic R-5.6 Setback WATER HEATING SYSTEMS Number Tank External in Energy Size Insulation Tank Type Heater Type Distribution Type System Factor (gal) R -value ------------ ----------- ------------------- -------------- ------ ---------- Storage Gas Standard 1 0.525 EF 50 R- 12 SPECIAL FEATURES/REMARKS ------------------------ a CERTIFICATE OF COMPLIANCE: RESIDENTIAL Page 3 CF -1R Project Title.......... Date........ 07/27/93 MICROPAS4 v4.01 File-RC2371BC Wth-CTZ11S92 Program -FORM CF -1R User#-MP0400 User -JIM PETERSON, Run -Typical House 1 ------------------------------------------------------------------------------- COMPLIANCE STATEMENT -------------------- This certificate of compliance lists the building features and performance specifications needed to comply with Title -24, Parts 1 and 6 of the California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the individual with overall design responsibility. When this certificate of compliance is submitted for a single building plan to be built in multiple orientations, any shading feature that is varied is indicated in the Special Features/ Remarks section. Name.... Company. Address. Phone... License. DESIGNER or OWNER J. PETERSON 341 BROADWAY #207 CHICO CA. 95928 (916) 343 7250 Signed. (date) ENFORCEMENT AGENCY Name.... Title... Agency.. Phone... Signed.. (date) DOCUMENTATION AUTHOR Name.... J. PETERSON Company. JIM PETERSON Address. 341 BROADWAY #207 CHICO, CALIFORNIA Phone... (916) 343-7250 Signed.. c (date) MANDATORY MEASURES CHECKLIST: RESIDENTIAL Page 1 MF -1R Project Title.......... Date........ 07/27/93 Project Address..... --------------------- Documentation Author... J. PETERSON ; Building Permit # ; Company ................ JIM PETERSON ' Telephone .............. (916) 343-7250 ; Plan Check / Date Compliance Method...... MICROPAS4 by Enercomp, Inc. ; Field Check/ Date Climate Zone........... 11 --------------------- MICROPAS4 v4.01 File-RC2371BC Wth-CTZ11S92 Program -FORM MF -1R ; User#-MP0400 User -JIM PETERSON Run -Typical House ------------------------------------------------------------------------------- Lowrise residential buildings subject to the Standards must contain these measures regardless of the compliance approach used. Items marked with an asterisk (*) may be superseded by more stringent compliance requirements listed on the Certificate of Compliance. When this checklist is incorporated into the permit documents, the features noted shall be considered by all parties as binding minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. BUILDING ENVELOPE MEASURES -------------------------- Design- Enforce- er ment *150(a): Minimum R-19 ceiling insulation. 150(b): Loose fill insulation manufacturers labeled R -Value. *150(c): Minimum R-13 wall insulation in framed walls (does not apply to exterior mass walls). *150(d): Minimum R-13 raised floor insulation in framed floors; minimum R-8 in concrete raised floors. 150(1): Slab edge insulation - water absorption rate no greater than 0.3%, water vapor transmission rate no greater than 2.0 perm/inch. 118: Insulation specified or installed meets CEC quality standards. Indicate type and form. 116-17: Fenestration Products, Exterior Doors and Infiltration/ exfi'ltration controls a. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. b. Manufactured fenestration products have label with certified U -value, and infiltration certification. c. Exterior doors and windows weatherstripped; all joints and penetrations caulked and sealed. 150(g): Vapor barriers mandatory in Climate Zones 14 and 16 only. 150(f): Special infiltration barrier installed to comply with Sec. 151 meets CEC quality standards. 150(e): Installation of Fireplaces, Decorative Gas Appliances and gas logs 1. Masonry and factory -built fireplaces have: a. Closeable metal or glass door b. Outside air intake with damper and control c. Flue damper and control 2.'No continuous burning gas pilots allowed. MANDATORY MEASURES CHECKLIST: RESIDENTIAL Page 2 MF -1R ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- Project Title.......... Date........ 07/27/93 ------------------------------------------------------------------------------- ------------------------------------------------------------------------------- MICROPAS4 v4.01 File-RC2371BC Wth-CTZ11S92 Program -FORM MF -1R User#-MP0400 User -JIM PETERSON Run -Typical House ------------------------------------------------------------------------------- SPACE CONDITIONING, WATER HEATING AND PLUMBING SYSTEM MEASURES -------------------------------------------------------------- Design- Enforce- er ment 110-13: HVAC equipment, water heaters, showerheads and faucets certified by the CEC. 150(1): Setback thermostat on all applicable heating systems. 150(j): Pipe and Tank insulation 1. Indirect hot water tanks (e.g., unfired storage tanks or backup solar hot water tanks) have insulation blanket (R-12 or greater) or combined interior/exterior insulation (R-16 or greater). 2. First 5 feet of pipes closest to water heater tank, non - recirculating systems, insulated (R-4 or greater). 3. All buried or exposed piping insulated in recirculating sections of hot water system. 4. Cooling system piping below 55 degrees insulated. 5. Piping insulated between heating source and indirect hot water tank. *150(m): Ducts and Fans 1. Ducts constructed, installed and sealed to comply with UMC sections 1002 and 1004; ducts insulated to a minimum installed value of R-4.2 or ducts enclosed entirely within conditioned space. 2. Exhaust fan systems have backdraft or automatic dampers. 3. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. 114: Pool and Spa Heating Systems and Equipment 1. System is certified with 78% thermal efficiency, on-off switch, weatherproof operating instructions, no electric resistance heating and no pilot light. 2. System installed with: a. At least 36 inches pipe between filter and heater for future solar heating. b. Cover for outdoor pools or outdoor spa. 3. Pool system has directional inlets and a circulation pump time switch. 115: Gas-fired central furnace, pool heater, spa heater or household cooking appliance have no continuously burning pilot light (Exception: Non -electrical cooking appliance with pilot < 150 Btu/hr.). LIGHTING MEASURES ----------------- Design- Enforce er ment 150(k): 40 lumens/watt or greater for general lighting in kitchens and rooms with water closets; and recessed ceiling fixtures IC (insulation cover) approved. 41 COMPUTER METHOD SUMMARY Page 1 C -2R Project Title.......... Date........ 07/27/93 Project Address..... --------------------- Documentation Author... J. PETERSON Building Permit # ; Company ................ JIM PETERSON Telephone .............. (916) 343-7250 ; Plan Check / Date Compliance Method...... MICROPAS4 by Enercomp, Inc. Field Check/ Date ; Climate Zone........... 11 --------------------- MICROPAS4 v4.01 File-RC2371BC Wth-CTZ11S92 Program -FORM C -2R ; User#-MP0400 User -JIM PETERSON Run -Typical House ; ------------------------------------------------------------------------------- ---------------------------- ---------------------------- MICROPAS4 ENERGY USE SUMMARY = Energy Use Standard Proposed Compliance = _ (kBtu/sf-yr) _-=------------------------------- Design Design ---------- Margin = ---------- - = Space Heating.......... 13.49 11.91 1.58 = - Space Cooling.......... 12.72 10.67 2.05 = = Water Heating.......... 10.75 10.85 -0.10 = = Total 36.96 33.43 3.53 = _ *** Building complies with Computer Performance GENERAL INFORMATION ------------------- Conditioned Floor Area..... Building Type. ............. Construction Type ......... Building Front Orientation. Number of Dwelling Units... Number of Building Stories. Weather Data Type.......... Floor Construction Type.... Number of Building Zones... Conditioned Volume......... Footprint Area ............. Ground Floor Area.......... Slab -On -Grade Area......... Glazing Percentage......... Average Ceiling Height..... 2371 sf Single Family Detached New Front Facing 180 deg (S) 1 1 FullYear Raised Floor 1 18968 cf 1820 sf 1820 sf 0 sf 11 % of FA 8 ft (Package E) COMPUTER METHOD SUMMARY Page 2 C -2R Project Title.......... Date........ 07/27/93 MICROPAS4 v4.01 File-RC2371BC Wth-CTZ11S92 Program -FORM C -2R User#-MP0400 User -JIM PETERSON Run -Typical House ------------------------------------------------------------------------------- BUILDING ZONE INFORMATION Floor # of Vent Special Area Volume Dwell Cond- Thermostat Height Vent Area Zone Type (sf) ----------------------- (cf) Units itioned Type --------- ------------------------ (ft) ------ (sf) --------- HOUSE R-val ----- Azm --- Tilt ---- Residence 2371 18968 1.00 Yes Setback 8.0 n/a OPAQUE SURFACES FENESTRATION SURFACES --------------------- Area U- Insul Act Solar Form 3 Location/ Surface -------------- (sf) ------ value ----- R-val ----- Azm --- Tilt ---- Gains Reference Comments HOUSE Glass Int Shade Surface ----------- ----- ------------ ---------------- Type ------ 1 Wall 485 0.065 R-19 180 90 Yes MTL.19.2X6. METAL FRAMING 2 Wall 80 0.065 R-19 180 90 Yes MTL.19.2X6. METAL FRAMING 3 Wall 240 0.065 R-19 270 90 Yes MTL.19.2X6. METAL FRAMING 4 Wall 485 0.065 R-19 0 90 Yes MTL.19.2X6. METAL FRAMING 5 Wall 128 0.065 R-19 0 90 Yes MTL.19.2X6. METAL FRAMING 6 Wall 240 0.065 R-19 90 90 Yes MTL.19.2X6. METAL FRAMING 7 Wall 80 0.065 R-19 90 90 Yes MTL.19.2X6. METAL FRAMING 8 Roof 2371 0.029 R-38 0 0 Yes R.38.2X12.16 ATTIC 0.78 9 Door 20 0.330 R-0 180 90 Yes None Solid Wood 10 Floor 1820 0.037 R-19 0 0 No MTL.19.2X816 METAL FRAMING FENESTRATION SURFACES --------------------- SC SC Interior Area # of Frame Open U- Act Glass Int Shade Surface ----------- (sf) ----- Panes ----- Type -------- Type ------ value ----- Azm --- Tilt ---- Only ----- Shade ----- Description ------------ HOUSE 1 Door 10.0 2 Metal Slider 0.77 180 90 0.88 0.78 Drapes.Std 2 Window 10.0 2 Metal Fixed 0.72 180 90 0.88 0.78 Drapes.Std 3 Window 18.0 2 Metal Fixed 0.72 180 90 0.88 0.78 Drapes.Std 4 Window 18.0 2 Metal Fixed 0.72 180 90 0.88 0.78 Drapes.Std 5 Window 6.0 2 Metal Fixed 0.72 180 90 0.88 0.78 Drapes.Std 6 Window 6.0 2 Metal Fixed 0.72 180 90 0.88 0.78 Drapes.Std 7 Window 14.0 2 Metal Slider 0.87 180 90 0.88 0.78 Drapes.Std 8 Window 6.0 2 Metal Fixed 0.72 180 90 0.88 0.78 Drapes.Std 9 Window 4.5 2 Metal Fixed 0.72 180 90 0.88 0.78 Drapes.Std 10 Window 4.5 2 Metal Fixed 0.72 180 90 0.88 0.78 Drapes.Std 11 Window 4.5 2 Metal Fixed 0.72 180 .90 0.88 0.78 Drapes.Std 12 Window 4.5 2 Metal Fixed 0.72 180 90 0.88 0.78 Drapes.Std 13 Window 4.5 2 Metal Fixed 0.72 180 90 0.88 0.78 Drapes.Std 14 Window 4.5 2 Metal Fixed 0.72 180 90 0.88 0.78 Drapes.Std 15 Window 4.5 2 Metal Fixed 0.72 180 90 0.88 0.78 Drapes.Std 16 Window 4.5 2 Metal Fixed 0.72 180 90 0.88 0.78 Drapes.Std 17 Window 15.0 2 Metal Slider 0.87 270 90 0.88 0.78 Drapes.Std 18 Window 15.0 2 Metal Slider 0.87 270 90 0.88 0.78 Drapes.Std 19 Window 8.0 2 Metal Slider 0.87 0 90 0.88 0.78 Drapes.Std 20 Window 18.0 2 None Fixed 1.40 0 90 0.88 0.78 Drapes.Std 21 Window 12.0 2 Metal Fixed 0.72 0 90 0.88 0.78 Drapes.Std COMPUTER METHOD SUMMARY Furnace 0.780 AFUE Attic Page 3 C -2R Project Title.......... 12.00 SEER Attic R-5.6 0.823 'Date........ 07/27/93 MICROPAS4 v4.01 File-RC2371BC Wth-CTZ11S92 Program -FORM C -2R ------------------------------------------------------------------------------- User#-MP0400 User -JIM PETERSON Run -Typical House FENESTRATION SURFACES --------------------- SC SC Interior Area # of Frame Open U- Act Glass Int Shade Surface ----------- ----- (sf) Panes ----- Type -------- Type ------ val•ub ----- Azm --- Tilt ---- Only ----- Shade ----- Description ------------ 22 Window 12.0 2 Metal Fixed 0.72 0 90 0.88 0.78 Drapes.Std 23 Window 12.0 2 Metal Fixed 0.72 0 90 0.88 0.78 Drapes.Std 24 Window 12.0 2 Metal Fixed 0.72 0 90 0.88 0.78 Drapes.Std 25 Window 6.0 2 Metal Slider 0.87 0 90 0.88 0.78 Drapes.Std 26 Window 4.0 2 Metal, Slider 0.87 0 90 0.88 0.78 Drapes.Std 27 Window 6.0 2 Metal Slider 0.87 0 90 0.88 0.78 Drapes.Std 28 Window 8.0 2 Metal Fixed 0.72 180 23 0.88 , 0.78 Drapes.Std 29 Window 8.0 2 Metal, Fixed 0.72 180 23 0.88 0.78 Drapes.Std Area Thick Mass Type (sf) (in) --------------- ------ ----- HOUSE 1 InteriorVert 184 1.0 2 InteriorHorz 230 1.0 THERMAL. MASS ------------ Heat Conduct- Surface Cap ivity R -value Location/Comments ---- -------- -------- -------------------------- 24.0 0.67 R-0.0 Tile Walls 24.0 0.67 R-0.0 Tile Floor HVAC SYSTEMS WATER HEATING SYSTEMS --------------------- Number• Tank in Energy Size Tank Type Heater Type Distribution Type System Factor (gal) ------------ ----------- ------------------- -------------- ------ 1 Storage Gas Standard 1 0.525 50 SPECIAL FEATURES/REMARKS ------------------------ External Insulation R -value R-12 Minimum Duct Duct Duct System Type ---------------- Efficiency ------------ Location ------------- R -value ------- Efficiency ---------- HOUSE Furnace 0.780 AFUE Attic R-5.6 0.837 ACSplit 12.00 SEER Attic R-5.6 0.823 WATER HEATING SYSTEMS --------------------- Number• Tank in Energy Size Tank Type Heater Type Distribution Type System Factor (gal) ------------ ----------- ------------------- -------------- ------ 1 Storage Gas Standard 1 0.525 50 SPECIAL FEATURES/REMARKS ------------------------ External Insulation R -value R-12 STE�C, 0 n M E M 0 T 0 F I L E A.P. No. Permit Date: z This memo is entered into the file by John R. Henry, Plan Check Engineer V 1 /6 13 . TZ) Load Case Results it load X-displ Y-displ Z-displ 'X-rot'n Y-rot'n Z-rot'n no case in in in radians " radians 1 1 0.0000 0.0000 0.0000 BECKER RES. _.00259 -.00055 2 1 " VERANDA FRAME 0.0000 60029:6 7.00120 -.00073 3 * ANALYSIS HISTORY *** -.0436 .0456 0.0000 .00040 Structure Degrees of Freedom .................. 48 1 -.0446 .0010 Structure Half -Bandwidth ...................... 48 -.00001 5 1 Structure Stiffness Elements .................2304 -.1261, .00122 -.00312 -.00016 Member with�makimum half-bandwidt-h .... ... ..9 -.0192 .0871 -.1261 Number of Support Joints and Springs ....:.......4 a 7 1 -.0861 Number of Unstable Degrees of Freedom........... 3 .00281 -.00001 8 1 ***_'SUPPORT REACTIONS *** r f -.1261 Load Case. Results_ 9 1 -.0218 it load F (X) F (Y) F (Z) M (X) M (Y) M (Z) no case kips kips kips k -ft k -ft k -ft 1 1 0.000 0.000 1.260 0.000 0.000 0.000 2 1 0.000 0.000 1.260 0.000 0.000 0.000 3 1 0.000 0.000 1.260 0.000 0.000 0.000 4 1 0.000 0.000 1.260 0.000 0.,000 0.000 ------------------------------------------------------o------------------------- *** JOINT DISPLACEMENTS *** Load Case Results it load X-displ Y-displ Z-displ 'X-rot'n Y-rot'n Z-rot'n no case in in in radians •radians radians 1 1 0.0000 0.0000 0.0000 -.00083 _.00259 -.00055 2 1 .0010 .0446 0.0000 60029:6 7.00120 -.00073 3 1 -.0436 .0456 0.0000 .00040 .00217 -.00033 4 1 -.0446 .0010 0.0000 -.00151 -.00025 -.00001 5 1 .0425 .0202 -.1261, .00122 -.00312 -.00016 6 1 -.0192 .0871 -.1261 .00376 .00058 -.00049 7 1 -.0861 .0254 -.1261 -.00153 .00281 -.00001 8 1 -.0244 -.0415 -.1261 -.00349 -.00085 -.00035 9 1 -.0218 .0228 -.0114 0.00000 0.00000 0.00000 S -FRAME Linear Elastic analysis results Str No. 02 29 Jun 93 3=31 pm ;A 2.Dv ►Qo IFAQs DN I Zc� o 4:772 Goss g�c--rc oe�� Z-7 L ►may --cry` c ,� C GB ck -C95S Z v. 7,- I7 f.Z 3% d,c p �� $ 3`'� (2`'0 ietLp4 rn .-.tg DPW AGRICULTURAL STATEMENT OF AMOWLEDGM�O1T FOR RESIDENTIAL DEVELOP.' NT Secfiion 26-8.1 of the Butte. County Code= requires .this acknowledgement -be rec6rded prior to issuance of a building permit. ' The-, property described herein 'is adjacent 'or 93-0221631 Rec Fee to .land 'included within - an area zoned - I Check for agricultural purposes, and residents Recorded I of .-'this. property may be subject to incon- Official 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 Recorder I of . agricultural operations including, U 11:57am 1 -Jun -93 I PUBL 8. 00 8.00 XX 2 ut not lima ted to cultivation, p?::owing,- spraying, pruning, and harvesting which occasionally generate dust, -smoke, noise, and odor. Butte County has established agricul- tural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: the real property in the City of unincorporated- area County of BUTTE , State of QJifomia, described as Lot 10, as shown or that certain map�'entitled, "Norinwoods Subdivision Unit tio. V, which was recorded in the Office of the Recorder of the County of Butte, State of Caiifomia, on August 18, 1958, in Book 23 of Maps, at page(s) 18. Date: � �' 7 3 PROPERTY Ot, T ERS : State of �) On this the day day of Q V 19�-�, before me, the /--? ) SS. undersigned Notary Public, persahally appeared County of Personally known to me.Ao Proved to on the basis G.^?'IC��L S^:�: ,Proved evidence. '��LT ). ;Ill ;> to be the person(s) whose name(s) _ :ror;;i:: r__uc cap.. ear;w a subscribed to the within instrument and acknowledged that V oui7[" r1U,%JIy_ executed the same for the purposes therein contained. IN WITN- S �. uc;re� «.,.r. 10, ;SS3i WHEREOF, I hereunto set my hand and official seal. Present A.P. No. ') Notary Public Ij ACKNOWLEDGMENT r State of County of On �% �' �/ 3 before me,/r' GATE NAME, TITLE OF OFFICER - E.G. "JANE DOE, NOTARY � BLIC" personalty appeared- / NAME(S) OF SIGNEFf(S) ❑ personally known to me • OR• roved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized OFFICu1L SI•;AL capacity(ies), and. that by his/her/their HILL signature(s) on the instrument the person(s� -'? N'CTARY ^i'81 iC • CALIFORNIA or the entity upon, behalf of which the 'O; ;QTY acted, executed t i Ni:v Crmm ,_;tp;r�g friar. 10, 1 995 person(s), the instrument. OPTIONAL SECTION CAPACITY CLAIMED BY SIGNER Though statute does not require Notary to fill in the data below, doing so may prove invaluable to persons relying on the document. P<-NDIVIDUAL(S ) ❑ CORPORATE OFFICER(S) w' ess my hand and official al.. . _ r SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(IES) - �C`��.�> S!GNATURE OF NOTARY THIS CERTIFICATE MUST BE ATTACHED TO OPTIONAL SECT19N C _ THE DOCUMENT DESCRIBED AT RIGHT: Title or Type of Document/=K-/ `� / �7 �J� Com, �Z�s✓Lu` Number of Pages_ Date o Dotmer Though the data requested here is not required.by law. • , -, it could prevent fraudulent reattachment of this form. Signers) Other than Named Above y! ^� —7 P7ODORRin. Gln. mr-Ilnrnnnnnnrnnrnrnnnrnnrnnnnr_ n ------------------ (12/92) —r_,----- — (12/92) TME(S) ❑ PARTNER(S) ❑ LIMITED ❑ GENERAL ❑ ATTORNEY-IN-FACT ❑ TRUSTEE(S) ❑ GUARDIAN/CONSERVATOR ❑ OTHER: w' ess my hand and official al.. . _ r SIGNER IS REPRESENTING: NAME OF PERSON(S) OR ENTITY(IES) - �C`��.�> S!GNATURE OF NOTARY THIS CERTIFICATE MUST BE ATTACHED TO OPTIONAL SECT19N C _ THE DOCUMENT DESCRIBED AT RIGHT: Title or Type of Document/=K-/ `� / �7 �J� Com, �Z�s✓Lu` Number of Pages_ Date o Dotmer Though the data requested here is not required.by law. • , -, it could prevent fraudulent reattachment of this form. Signers) Other than Named Above y! ^� —7 P7ODORRin. Gln. mr-Ilnrnnnnnnrnnrnrnnnrnnrnnnnr_ n ------------------ (12/92) —r_,----- — (12/92)