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HomeMy WebLinkAbout063-310-002�••......-. .. .,.... - ��.�.. 4- rte' , - ..,.... Y ..4 .1M 63=31=02` 4153=90B9P,E,• FISHBACK,' Ba it 4490 -Wild r Tr, Chico' ' ' "'• : ra F 63'L31=,02 5=91B°;Mage :to' GO ,:. . V ,A� �••......-. .. .,.... - ��.�.. 4- rte' , - ..,.... Y ..4 .1M 63=31=02` 4153=90B9P,E,• FISHBACK,' Ba it 4490 -Wild r Tr, Chico' ' ' "'• : ra F 63'L31=,02 5=91B°;Mage :to' GO ,:. . r E ctt ! C .•` . r 1 63-31-02 x-51 E•' 4153 -90B, i 2 ; FISHBACK • � Basil . 4490 Wilder Dr, Chico (garage) T 6CWZo .�. FFICE COP 70 Address � -1 V W i' GAS ' l e �MeterBy U L3 * Date �����p� -/—! 'L'tt ELECTRIC`'`� «k. M" Meter,By-r••• ,Date• » 1, i% WI`h`14 t fpwov" 6 Address GAS YT, Meter By 4a e ELE Meter By U 6 Date OFFICE COPYJUIA� N fj S� GAWK Meter BY Date C� S ELERIC�n ' ' 2 Y 4 Weter By a ' a 1, Oct . �y• Yy Y JOB FINALE Signature Address M..: •fir �•�;µj ` - � � 1 t.. GAS Meter By a ELECTRIC //,,__ _ r Meter By Date L ! S V OFFICE COPY c;¢� Address 4-11-1910w N fj S� GAWK Meter BY Date C� S ELERIC�n ' ' 2 Y 4 Weter By a ' a 1, Oct . �y• Yy Y JOB FINALE Signature J=OK O = Not OK Not = Not Ready MOBILE MOBILE HOMES Date . MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap: / /"L"ft. / /"Nat. or/ /" L"ft./ /"LPG 7. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity: MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 10. Cert. of Occupancy MISC LLANEOUSUF_g_.Lq a Date DECKS, AS; CARPORT P G ES, ns OK except #'s 1. Zonkg-Re4 ments-Setb cks-Ease nts 2. Foot ; Soils-Size-Depth-Spac' g -Connectors -S 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Coonectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mash 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date /- Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.;Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5 -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Date Card B-1 Date Card B-1 Boxes-Enclosures-PaneIboa rds-Ins. to Main in Conduit Date Card B-1 Date Card B-1 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 ✓=OK O=Not OK = Not Applicable ' = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s Date ' FRAMING (Continued). _ 1. Zoning -Setbacks -Easements -Flood -Slope 45. Hangers -Post Caps -Anchors -Connectors 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Rfng. 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 5. Stemwalls, Main; Steel -Block outs -Wrapped 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 6. Stemwalls, Garage; Steel- Bloc kouts-Wrapped 50. Garage Fire Protection Framing 6a. Hold Downs and Special Anchors 51. Property Line Firewall & Openings 7. Slab; Steel -Wrapped 52. Ext. Doors -One T -Check Garage -3rd Story, 2 Exits 8. Piers -Fireplace Ftg.-Steel 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers 10. Gas Pipe; Size -Anchors 55. Siding -Nailing Veneer 11. Water Pipe; Test -Anchor -Regulator -Service Test 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 12. Electric; Underground 57. Glazing Area -Glass Protection -Skylights -Plastic 13. Pienums & Ducts; Clearance -Material -Support -Ins. 58. Shear Walls; Nailing -Bolts 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 59. Insulation -Walls -Ceilings 15. Insulation 60. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 - Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s Date Card B-1 Date Card B-1 16. Water Htr.; Vent -Access -Combustion Air -Baffle Date FINAL (Plans) OK except #'s 17. Water Pipe; Test & Anchor -Nail Protection 61. Ext. Steps -Door & Sidelight Protection -Landings 18. D.W.V.; Test -Fittings & Anchor -Nail Protection 62. Smoke Detector 19. Shower Pan; Test, First Floor -Tub Access 63. Furnace; Vents -Clearance -Comb. Air -Conner - ---- In Garage; Above Floor-Ducts-Mech. Protection 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa Date Card B-1 Date Card B-1 66. Elec. Trim & Subpanel; Breaker Sizes & Labels Date Card B-1 Date Card B-1 67. Stairs & Rails I Date ELECTRICAL (Permit) OK except #'s 68. Fireplace or Stove; Clearances -Hearth 22. Fixture & Transformer Clearance -Ins. Protection 69. Elec. Outlets at Wood Panel; Int. & Ext. 23. Elec. Receptacles Spacing -Lights & Switches at Doors 70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 24. Size Boxes & No. of Conductors -Stapled 71. Elec. Outlets & Receptacles at Kit. Counter 25. Romex Installed Close to Edge of Studs & C.J. 72. Garage Fire Door; Swing -Landing -Closer 26. Equip. Ground made up w/Mech. Fastners-Bond Gas & Water 73. A.C. Duct in Garage -Damper 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage; Above Floor-Mech. Protection 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 75. Plb., Elec. & Mech. Equip. Listed for Location 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes 0 No 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection 77. Insulation -Foam -Looked in Attic ❑ Yes 30. Service -Riser Conductors & Ground -Main Disconnect 78. Guard Rails & Deck Construction -Post Caps 31. Equip. Clearances Panels-Motors-Mech. Equip. 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor O Yes 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector 80. Following instld.; Drive 0 Yes 0 No; Walks ❑ Yes ❑ No; Planters 13 Yes 0 No Date Card B-1 Date Card B-1 81. Stucco; Brown -Finish Date Card B-1 Date Card B-1 82. A.C. Unit; Disconnect, Electrical, Plumbing Date MECHANICAL (Permit) OK except #'s 83. Vents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to Openings 34. A.C. Ducts Insulation & Support 84. Water Well; Disconnect, Electrical, Plumbing 35. Vent Fan; Exhaust above insulation 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 36. Condensate Drain & Overflow; Size & Grade 86. Ventilation Throughout House 37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet 87. Glass Protection 38. Attic Access & Platform if Furnance in Attic 88. Corrections from Previous Inspections 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval Date Card B-1 Date Card B-1 91. Energy Compliance Certificate -Other Certificates Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except #'s Date Card B-1 Date Card B-1 39. Sils, Proper Material & Anchors Date Card B-1 Date Card B-1 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound Date Card B-1 Date Card B-1 41. Bearing Walls over Girders & Floor Nailing Comments at Final: 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Headers & Beam -Size & Bearing each time you visit job site) (NOTE: An entry must be made X COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION ANP PERMIT i�ITNO. ASSESSOR PARCEL NUMBER 70NING BUILDING PERMIT. OWNS Basil Fishback TELEPHONE 345-8794 SQ. FT. OCC.1 BUILDING VALUATION OWNER'S MAILING ADDRESS CA 95076 CON C A ELEPHONE CON OR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ 9736.00 Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER None40 LICENSE NO. Plan Checking Fee ,$ 95 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDR ss 4490 Wi der Drive, Chico Permit fee $ • PLUMBING PERMIT Filing Fee 10.00 Each Trap 3 2.00 6.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 5.00 Each qas water heater or vent 5.00 5.00 USE OF STRUCTUREV SF ❑ Duplex[]Mobilehome,I =Other--� .� .` .._1 SPECIFY Gas piping system 1 - 5 outlets 5.o0 5.00 Building sewer 5.00 5.00 Mobile Home S I G I W 110.00e TYPE OF WORK New ❑ Addition ❑ Remodel nn U ilit'es nn In llation❑ Other ❑X garage-cletac�tec�- �6 x �+ Describe work: Permit Fee $ 36.00 Contractor ELECTRICAL PERMIT Filing Fee 1 10.00 Main service 100 AMS P ORLESS JOC 10.00 10.00 Main service EA. ADD'L too AMP 2.50 CONTRACTORS LICENSE LAW 1 declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST.( DWELLING OCCUP.& A B LOGS.2/z2sgft New 15.60 CONSTR.MULTI -OUTLET NO N•RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS a (SINGLE OUTLET CIR, Ex. Occup(OUTLETS OR FIXTURES 20050Q eALO3o FIXED ETS P(RESID.)REAJ Ex. Occup. 2.00 Temporary service 10.00 10.00. Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ 49.60 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling g Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-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 'nons uence of the granting of this permit. X Date Signature of App rant - Ownerq Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 211.60 HAz I CUA PARK I SCHL I FLD I PAR PD H ISS E This permit is nereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated aboA for which fees have been paid. D EC R OOP LIC WORKS (/4J, By D e IlghlReceipt PER IT EXPIRES ate No. 456 �v r-�3r p0 ,/ s-, WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECT R, GOLDENROD -APPLICANT TO Building -Department FROM: Environ 'ental Health SUBJECT: Sanitation Clearance r � +47 o `,� JIL rD.►.. - Owner Location AP# Plan Approved for: Sewaqe Disposal Water Supply Fold final for: Water Supply Final clearance O.R. for: Water Supply Clearance for bedroom mobile home. Other 9nvr.�«�Jl NOTE * * * -—2y—'r/ Sanitarian Date Jy;i_y,...�, � �.'..,v.U�i�-,1���,�s,..7't..-y.11�'�L(�'w�^1"�-'t .ti.(ry'Li�lr'� b".;..lrl/hST��..,,�rr�^r�-)�j:.yyya'�i'�''/�4Y`.+.Y��i�l'T�=''.•ti(t;gG_.*�,r....`..r..-. �. �.�n..r.: .�. COUNTY OF BUTTE - DEPARrT MENT,OF"PUBLIC WORKS -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 ' PERMIT ARP,LICATION DATA SHEET Permit No. OWNER F -t ;h W dL Zn A. P. No. &3- 31-0Z Proposed Building Use M G%fddud qCl ,a ,Building Inspector " Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . ........................ .......... U 2. Plot plans in duplicate/triplicate, signed by preparer of plans ....... . 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... A 111 7. Statement of Intent for Non -Heated and AC Buildings .. t(D Engineered truss details and layout in duplicate (required prior to plan check) - 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13. -" School District fees paid .............. ' Sanitation approval from 0 'Health Department 1-21: 9 / 15. City of Chico plumbing permit.... s �. �................... 16. Plot plan and business licensia approval from City,of (see City for other requirements) i _� C / 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact La6d Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 26aQ 20. Pre -Inspection for required Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 4203. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... ded copy of Agricultural Acknowledgment Statement ......... Letter of signature authorization ................................... 26 27. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone -87`74 and hold for pickup at O office. Deliver w/inspector. Other ° 31,&33o15 Applicant .Date lob Copy of Haz-Mat form sent Health Dept. Fire Dept -_Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date— ate The The following data must be submitted prior to 1. Index permit for above items No. I- 2. Additional items required: I By— By . it issuance: (Circle new item not checked above). Contractor, designer, owner, was advised of above required data by_phone--.jnall—counter by ..date Contractor, designer, owner, was advised of above required data by—phone _mall—counter by date Plans checked by Plans approved by ,,_Sets of plans on holdin�Lv y,F� a cabinet_ ��rr AP folder Copy—DPW �, Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive-ibroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ��3�42 ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER- '- `'-'"ok- 8� fe �tsLf �a�z TELEPHONE � 345- 8764 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS �u _ %. ,Wu&. &aclt 9507,6 36- O CONTRACTOR'S NAME /U/" TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace �Q�O CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $ ' ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS �� Permit tee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap .00 (,.db Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 S. Each qas water heater or vent 5,00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 5 Ah Building sewer 5.00r),tm Mobile Home I S I G W10.00e =T— TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other Describe work: (O X 24- Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 8000 AMP ORSLESS 10.00 rp CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑I am licensed under p provisions of Cha t. 9, Div. 3 of the Business and Professions Code and my license Is In full force and effect. License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the. work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason Main service EA. ADD'L too AMP 2.50 NEW CONST. DWELLING OCCUPM OR ACDNS. ACC. BLDGS. �5 /ZdsgttNEW CONSTR ULT' -OUTLET NON.RESID BRANCH CIRCUITS) 2.50 ea - /POWER APPARATUS &) (POWOUTLET CIR. Ex. OccU OUTLETS OR FIXTURES p 20@50taALv30 FIXED APLNS EX. OCCUp. OUTLETS P(RESID )R0 EA.) 2.00 Temporary service 10.00 /b Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ U WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury, (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 2 , to HAZ CUA PARK I SCHL I FLD PAR I PD HD ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date Receipt No .:# 645W WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916=538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: . An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed propertyimprovement(yes or no) 2. I (have/have not) h &U_kI signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone _ Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address . Phone Type of Work Signed: � Property Owner Social Security Number � -��/,• �/��/ Date NOTE: This Owner -Builder Verification is sent to you as.required by Sections 19831 and 19832 of the California.Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. t 33 Return to DPW AGRICULTURAL STATEMENT OF ACRNOWAVA J FOR RESIDEINTIAL DEVELOPMENT Section 26-8.1 of the Butte County Code . requires this acknowledgement be recorded r---- - prior to issuance of a building permit. E — 91-0009331. Rec Fee 5.00 The property described herein is adjacent Cash 5.00 to land or included within an area zoned Recorded .. for agricultural purposes, and residents Official Records of this property may be subject to incon- County of ; veniences or discomfort arising from the Butte ; use of agricultural chemicals, including, Candace J. Grubbs''. but not limited to herbicides, pesticides, Recorder and fertilizers; and from the pursuit 11:54am 8 -Jan -91 1 XX of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor: tural zones which have as a priority use for productive within said zones and on adjacent property should be or discomfort from normal, necessary farm operations. 1 Butte County has established agricul- agricultural purposes, and residents prepared to accept such inconvenience All that real .property: -situate in the County of Butte, State of California, described as follows: Date: V g14 Lea PROPERTY OWNERS: 1 Basil R.FisMack �Zr_w,llL. 1\ State of California On this the 8th day of Janaury , 19 91 , before me, the ) SS. undersigned Notary Public, personally appeared County of Butte ) Basil R. Fishback Personally known to me. D Proved to me on the basis of satisfactory evidence. o be the person(s) whose name(s) is ubscribed to the within instrument and acknowledged that xecuted the same for the purposes therein contained. IN WITNESS HEREOF, I hereunto set my hand and official seal. Present A.P. No. --A L \&- <:&��- - Notary Public EN® OF DOCUMENT OFFICIAL SEAL ANGELA K. SMITH NOTARY PUBLIC • CALIFORNIA se = j PRINCIPAL OFFICE IN SAN DIEGO COQ 6191 emmt m" EAP•134 Basil R. Fishback Personally known to me. D Proved to me on the basis of satisfactory evidence. o be the person(s) whose name(s) is ubscribed to the within instrument and acknowledged that xecuted the same for the purposes therein contained. IN WITNESS HEREOF, I hereunto set my hand and official seal. Present A.P. No. --A L \&- <:&��- - Notary Public EN® OF DOCUMENT L ',TOP CHORD 2X4 FIR -LARCH #1 BOT CHORD 2X4 FIR -LARCH #1 WEBS 2X4 FIR -LARCH STANDARD CONNECTOR PLATES MUST BE INSTALLED IN ACCORDANCE WITH REQUIREMENTS OF I.C.B.O. RESEARCH REPORT #2949. ALL PLATES ARE TO BE CENTERED ON THE JOINT, LEFT TO RIGHT AND TOP TO BOTTOM, EXCEPT WHEN LOCATED BY CIRCLE OR DIMENSION. SEE DRAWING 130 FOR "PLATE LOCATIONS ON TYPICAL JOINTS." NOTE;—`2X4 #3 HEM=FIR-OR-BETTER-CONTINUOUS"L'ATERAL BOTTOM CHORD BRACING @ 72" MAX. O.C. REQUIRED. ATTACH WITH 2=16d NAILS. BRACING IS NOT REQUIRED IF A RIGID CEILING IS ATTACHED DIRECTLY TO BOTTOM CHORD. BRACING MATERIAL L BE SUPPLIED ANO ATTACHED AT BOTH_ENDS,TO_ASUI2ABLEPORT BY ERECTION CONTRACTOR, ME -D FROM COMPUTER INPUT (LOADS 6 DIMENSIONS) SUBMITTED BY TRUSS MFR. TC X -LOC L -R: 0.29 5.27 12.00 17.73 23.71 n D BC X -LOC L -R: 0.29 8.18 15..82 23.71 C N SINGLE CUT WEB 0-TC:1.4 I (U) BOTTOM CHORD CHECKED FOR 10 PSF LIVE LOAD. N v TOP-CHORD'SHALL'BE`CATERAL'LY BRACED-WITH'PROPERLY CONNECTED w PURLINS SPACED=AT A MAXIMUM OF 24" 0.C. - O -z N CONNECTOR PLATES DESIGNED FOR GREEN LUMBER PER NDS ru TABLE B.1B. O 12-0-0 112-0-0 0-0 OVER 2 SUPPORTS R-1222# W- 3.50 2-0-0 k/NO. 0043845 *\ Exp.6-30.93 4 S'uTrE 0". Ty R-1222# W- 3.50" v% -r ] PLT. TYP.-ALPINE SEON-- 91590 FURNISH A COPY OF THIS DESIGN TO ERECTION CONTRACTOR D •a4Uw' 'SCALE - 0.2500 0 0 0 0 0 0 **IMPORTANT** ALPINE DULL NOI B W��OR INC. CAM MOVIREmma WARNING ma DESIGN CRS �F 2 --83169 o C - o o OEVIATIGN PNpr TIESE SOMFICATIG6 GN ANT DEVIATION FAM mm aims. me BRAMNS.SEE-GR-79•. OMONS NoaD Tom$ TC LL ' : 0 A E /03/90 0 0 o O TRIS DEMON ON MY PATLRxE TO BUILD THE TRJW IN CON URK&NGE DWENNANr ANO NECaNENOATIG4•4TPIl . EEE . o C o G IV" THE "QUALIlr STANDAM 9098• By TPI. ALPINE CONfEC7OA5 TKIS DESIGN FOR ACOITIONAL SPECIAL PMU- TC OL J 10 . 0 PSF DRWG CAUSA427 90123051 C o C o C o ALPI ANF K~ACTU EO ANON 20 SAUSE GALVANIZED VIM W.ESS OTHMSE Sprt NEMNNO NEOMPEIEMS OF ASTM AMS MCE A. WENT BNACIN G IE0UIPV M. MESS UWANIZU Sort TDP CHM SHALL BE LATbULtr PAMV CA BC OL (U) 5.0 PSF CA -ENG S • � C TRUSS AD410 BOTH AT EAND LOCATE A EH". 9E04M 11107us WE 100 NOWINAL LKESS OTEnlsE sww. SSI- STARCAMS DOWWO VITN APPLICABLE PNOrISIG6 OF WITH Pr ATTACEPLYWOOD OK BO, THCHCAD WITH 9Uc1D cEILINS DR WAClHB AS SPECIFIED GN DEMON. DO NOT #ISE THIS I114DI��I�UI,I Ijl��ll� TOT. LO. 45. 0 PSF D/A LEN. 24-0-0 1.15 PITCH 6-0/ 1 2 4 0 0 o O G Alps up 01ov). DESIGN WITH PIK PETAPDANT TiEA7ED UMEH. ! OUR . FAC . "—TPI - TNUSS PLATE INMITME. NDS - NATIONAL DESIGN SPEC] FICATICH FOR VOW COWTRJCTIDNN SPACING 24.0"3 T Y PE C OM N- - 5/v/flo U-) m iV l/ fur UiMU 2X6 FIRS -LARCH SS BOT CHOM 2X8 FIR -LARCH #I. EXCEPT AS SRDWN WEBS 2X4 FIR -LARCH STANOARLI :01-2X4 FIR-LARM t1 COMIECTOR PLATES HUST BE INSTALLED In ACCORDANCE WITH REOU'RENEMFS OF I.C.B.O. RESEARM REPORT #2949. ALL'PLATES ARE CENTERED ON JOINT UNLESS OT1#RwiSE INDICATED. SEE DAWGS. 130 S 160/.160A -F FOR TYP. PLATE LOCATION DETAILS. SNDTE 2X4 f3 IIEM=FIR OR BETTER CONTINUOUS LATERAL BOTTOM ,CHWITH 22-1�6d NAILBRACS BRACING IS NOT REOUIRED IF ATTACH RISIO CEILING SIS ATTACHED DIRECTLY TO 130TTUM CHORD, BRACING MATERIAit fT0 BE:SUPPLIED AND ATTACHED AT BOTH E DS3 TO A SUITABLE' 'SUPPOArgy ERECTION CONTRACTOR ®):B 4b) THLs truss is designed to on bottom chord at support addltonal uniform load -10 P5F dead Load_ panel aoip of 40 M live load and 5x8 _ rJXs 4X8 2X6 9. %-0-0 R-iawe w- 3.50 - 3X6 �� gds 2X4 8X8 E$514 12-0-0 112-0-0 OYER 2 TC X -LOC L -,R 0.29 4.14 "'7.35 10.97 12.00 12 .00 13.03 86 23.71 BC X -LOC L -R: 10.29 6-65 17._35 16.65 23.71 TOP CHORD SHALL BE LATERALLY BRACED WITH PROPERLY CONNEC PURLINS SPACED AT A 0 XIMUM_OF 2.4' G_C-. e CONNECTOR PLATES DESIGNED FOR GREEN LUMBER PER `MDS TABLE B.18_ ' r 3X6. 8X8 YLT, TYP.-ALPINE SEON--148075 FL41"ISH A COPY OF THIS OI.SIgN TO EIRECTIC 0 0 0 v o XIMPORTANT**WWI aE „iwM d"" DARNING +ouav�� ase C'7 o O O t�,ITsav/ � amwft-lam to a 9EV"rim qp 0 0 o v .,mc tome Ta .a. s�nul>F ro �� b.r-'� . e� m a.� Q O O O MM 6E "Mkltr w v a c�sasll� =MVW lr MO T'/O6�rP91 _ We D O 6'tNtDie AiiF 8r al. amw "as UESM fm �T O O ME Mgw"'Mm sal a Lc{ GtWjazm i7Ei► OBIT BwcDS MVL >�BRIR OBfl- o a aTtae ocst �+ teems °. mum m C ��* + sly ti 6p'� amw •. -Sam r� rnaio mom tE tAn'P L.L. =Ins avwT AM L OrW ='Ot Lsv�T /1T4m TITS $E1 TRMS o aas�l• L aQKM oTTa+rrff acaT. em.al oeie nTTI ase aXVC a. �. �6 ae am Am". a �RT7iL vg a`S.7tn• u6r 1.6E 7101 Q 0 O Ci TAles �rF_181TTUE DCII 41V89 F)E If Tams" iELT& Loom. i �e _ ....,..... W■•rC&J? BUILQ MPAF"E8T APPROVED 00 2Xfi - OQ4i0FESS�� - 41�s v Fob F�0 '� b b' tm rZTr 43 �tgM# W- 3.50- "^"`�"'^ HLv 15_4.7 DESIGN CRIT: UBC TC LL 30.0 PSF TC OL 10.0 PSF CA Bc DL 10.0 PSF IN111®11 TOT -LD. Sd.O PSF iig�Y � _,1 00 ( SPACING I 2� • j ;CALE a 0:2500 F R427--551 TE 03/26/91 WS CAUSM27 9MM O/A LEN. 24-0-0 PITCH 9.0/1 TYPE ATIC-- t7 D C A A! v m L.0 0 0 u a V✓� OROVILLE, CALIFORNIA GENERAL CLAIM CLAIMANT: Tim Gallagher ADDRESS: 1980 Mono Way CITY & STATE: Sonora, CA 95370 IMPORTANT: August 20, 1990 SEE INSTRUCTIONS DATE OF CLAIM: ON REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) I AMOUNT Owner has decided not to do work. Permit #1736-90B,P,E,M, AP#63-31-02 Receipt 59482 dated5/29/90 Total Permit Fees Paid ---------------------------- $253.50 Retain Building Permit Filing Fee------ •10.00- e air Plumbing Permit Filing Fee------ 10.00 Retain Electrical Permit.Filing Fee---- 10.00 Retain ec anica ermit i ing ee 10.00 Total Fees Retained------------------------------- 40.00 IUIAL REFUND DUE ----------------------------------$213.50 TOTAL $213 50 I. the, undersigned, declare under penalty of perjury that the services or articles- claimed he a een pe o � d or deliv ,d and that this claim is true and correct as stated. Dated this..J..- • v....... day of ......... .............• 19 at...... ............... Calif. ... ...... ........:...... ...................... ......... ...... ....... ............ ....... .. . .. ... Signature of Claimant I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or de- livered and that. there is a Budget Appropriation or Specific Board Approval (Check one) for the same. Dated this.......... h , day of ,AUBllS .......... 19 90 at Oroville Calif ,,,, ,,, ,,,,, ......... ....... ............................... ............. .... .... ....... ... ... . ............ ..... D p ment Head or uthorized uty Dept. 440-002 Exp. 4210500 Code ............................................ Code............................................ ..PAYABLE FROM ...........C,.,Onst.. Permits FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSSAMT. ; i ss (21 SA Y� l "� o t'o� ovo 6,v P� � l � J ba7k �.,, tom✓ 2�of j, ��"? '% �1�/, COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT N0. i 7 County Center Drive - Oroville¢Calilorn.ia 9?4%5 - Telephone: 916/538-7541 APPLICAT ION AND PERMIT ASSESSOR PARCEL NUMBER 63-31-002 ZONING U BUILDING PERMIT OWNER Tim Gallagher TELEPHONE 894-8915 S0. FT. OCC. BUILDING VALUATION 1 728 R 69 120.00 OWNER'S MAILING ADDRESS 1161 Palmetto Chico 95926 484 M 6,776.00 CONTRACTOR'S NAME Owner TELEPHONE 170 Cov. 1,700.00 1 624 M 8,736.00 CONTRACTOR'S MAILING ADDRESS Fireplace A 1,000.00 CONSTRUCTION LENDER Sacramento -Savings UNKNOWN 891-8900 Total Valuation $87,332.00 Filing Fee $ 10.00 LENDER'S MAILING ADDRESS 520 Cohasset Rd., Chico 95926 Permit Fee $ 397.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 19$.50 Energy Plan Checking Fee $ 150.00 ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ 620,50 PLUMBING PERMIT Filing Fee 10.00 4490 Wilder Chico Each Trap 111 2.00 22.00 Solar or heat pump water heater 20.00 LOT NO. 2 SUBDIVISION NAME Sierra Foothill 1 & 2 PARCEL MAP .96 - ( Water piping 1 5.00 5.00 Each qas water heater or vent 1 5.00 5.00 USE OF STRUCTURE SF ® Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 1 5.00 1 5.00 Building sewer 1 5.00 9.00 Mobile Home S G W 0.00e TYPE OF WORK New l Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: 3 Bedroom SF Residence W/Additional _ Detached Garage Permit Fee $52.00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP 1 OR ORSLESS 1 10.00 10.00 Main service EA. ADO'L 100 AMP 1 2.50 2.50 CONTRACTORS LICENSE LAW 1 declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification 41, 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 OR A.D.S. ACC. BLDGS. Li6&) X 2+/20sgft 70.90 NEW CONSTR. ULTI-OUTLET 2,50 ea NON•RESID BRANCH CIRC ITS POWER APPARATUS e (SINGLE OUTLET CIR. ) Ex. Occu 20m50e p OUTLETS OR FIXTURES eAL030 FIXED APPLNS. OR Ex. Occup. OUTLETS IRESID.1 EA.) 2.00 Temporary service 00 10.00 Mobile Home Facilities 15.10 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 FiIingFee 10.00 Heating Heat Pump 48 K 116.00 6.00 Cooling 1 6,QQ 6,QQ Hood 3.00 3.00 Ventilation permit Fee $ 25.00 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 County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against aid Count ' ons quen a of the granting of this permit. Q X Date S � L Signature of Applicant - OwneX& Contractor ❑ Agent ❑ An OSHA permit isrequired fore cavotions 07r/ v r '0" deep and demolition or construct- ion of structures over 3 stories n height. Mobile Home Installation Fee $ Energy Inspection Fee $30.00 occ CONST TYPE TOTAL FEE $ $30:9 ALSCH HAz CUA PARK FLo PAR P Ho ISSUE This permit is hereby issued under the applicable sions of the Butte County Code and/or resolutions work indicated above for which fees have been DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date provi- to do paid. S`?[? Receipt No. lg WHITE-D.P. 1r LLO 5 �j.,,N•IHSP OR, GOLDENROD -APPLICANT TO: Building Department FROM: Encroachmfant Permit Section RE: 'Driveway. Clearance t�t-er G'a��a e t��/•��f 1111c. Co 2-3/-0 -2- caner j location AP # Driveway permit /pr✓��� /oaQ'� has been issued for the above property. n b y sign re date TO Buildinc Department FROM: Environmental Health SUBJECT: Sanitation Clearance G 4&j,Ur4� C&.e %3 -Jr 1- a Owner Location AP# Plan Approved for: Sewage Disposal Water Supply Fold final for: Water Supply Final clearance O.K. for: Water Supply Clearance for 3 bedroom meb4pbe home. Other NOTE *� ioDate Sanitarian `, -...T., •�;•a.y6j.'•--•-�.:.�• „a<=l.^r,;i�.,sr•. .'�'n'{�� � .7 ^''r,;,;,i� .i�'i�G�..tr « +.-.- COUNTY OF BUTTE - DEPARTMENT OF, PUPLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVOOW/IL 4, CALIFORNIA 95965 - TELEPHONE: M6/636-7641 " . PERMIT ArPLICATION DATA SHEET ' ' Permit No. OWNER .941.; ' HSR— A. P. No. 3� Proposed"Building Use tJ Building Inspector �is� % Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . .................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered, plans and calcs, with wet signature on plans . . 5. Hazardous Material Form .......................................... - 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ............... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation V10. instructions... ®, .:.................................. -7� **'***...,.,***** **"* Feesof$ 11. Chico Urban Area fees paid ...................................... 2. Park fees paid :....................................... C H I c � School District fees paid ............... �4:Sanitation J approval from C h// ` Health Department (=L- 3L �@!' 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... lop- 19. Improvements may be required. Contact Land Development Section DPW _ Driveway permit (construction approval required prior to occupancy) — 20. Pre -Inspection for required Pre-Inspec.request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... __A Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 26. 27. When y Issue the permit pro ess as follows: Mail to owner. Mail to contractor. 9�' �S V Telephone and hold for pickup at COlc.0 ffi e.Deliver w/inspector. Other �� L' �heAdApplicant to Copy of Haz-Mat form sent Health Dept. Fire Dept. air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new ite notche?cketd.T,above): 1. Index permit for above items No. �'` 2. Additional items required: Contractor, designer, owner, was advised of above required data by—phone ___jnail—counter by ..date Contractor, designer, owner, was advised of above required data by—phone —mal l—counter by date Plans checked by Sets of plans on hold in Copy DPW Date Plans approved by File cabinet AP folder .o Date COUNTY OF BUTTE - Department of Public Works 7 -County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to' avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) A:� 1 2. I (have/have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address .'AtJ- -1 City Phone 'fContractors License No. 4. I plarT to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name /-` Address c%� ~ City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone i Type of Work Signed Property Owner —AOU Social Security Nr�upn,�ierl - - Date � l%L'i NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. eouw*c J3uw OROVILLE, CALIFORNIA GENERAL CLAIM CLAIMANT: Basil Fishback ADDRESS: 11 Vista Dr. CITY & STATE: TO SPI MA RParh, CA Q9Q76 IMPORTANT: DATE OF CLAIM: April 9. 1991 SEE INSTRUCTIONS ON REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT Owner has decided not to do work. Permit #570-91B,P,E,M, AP#63-31-02, Receipt #83534, dated 2/28/91. Total Permit Fees Paid -------------------------------- $144.75 Rptnin RidldinR Permit Filing Fee ----------- Retain Plumbing Permit Filing Fee----------- 10.00 Retain Electrical Permit Filing Fee--------- 10.00 Retain Mechanical Permit Filing Fee--------- 10.00 Total Permit Fees Retained---------------------------- 40.00 TOTAL REFUND DUE -------------------------------------- $104.75 TOTAL 104 V5 I, the undersigned, declare under penalty of perjury that the services or articles cla' ed h ve been performed or delivered, and that this claim is true and correct as stated. 9th April 91 Oroville Dated this .................................. day of ............................. 19......, at................................. Calit..............................................._............................... Signeturc of Claimant I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or de- livered and that there is a Budget Appropriation or Specific Board Approval (Checkone) for the same. Dated this ........ 9th ................... day of „April............ 1991 , at Oroville....... , callt......_......................................................_..................... Department Head or Authorized Deputy D /� /� D• Code .....44n-.0.02 .................. Code .....�?2.iQ QQ......................PAYABLE FROM COTjSt......Permits.................................................. FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSS AMT. OROVILLE, CALIFORNIA GENERAL CLAIM CLAIMANT: ADDRESS: CITY & STATE: DATE OF CLAIM: IMPORTANT: SEE INSTRUCTIONS ON REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT TOTAL I. the undersigned, declare under penalty of perjury that the services or articles claimed have been rformed or dtredthat this claim is true and corre t asstated. e�Dated this Ll ................... day of ,,,�/19 at „{�Calif.B ................. nature of Claimant I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles a ified above have been performed or de- livered and that there is a Budget Appropriation ❑ or Specific Board Approval ❑ (Check one) for the same. Dated this .................................... day of ............................. 19....... at .............................. . Calif..................................................................................... Department Head or Authorized Deputy D ept. Exp. Code ............................................ Code ................................................PAYABLE FROM............................................................................................ FUND DO NOT WRITE BELOW THIS LINE _ AUDITOR'S USE ONLY DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSS AMT. INSTRUCTIONS to CLAIMANTS All claims against the county must be itemized, giving dates and character of service rendered or work performed, quantities, de- scription and unit prices of articles furnished or delivered. Claims must be certified by the claimant and submitted to the De- partment head for approval. Upon approval the Department head will forward claim to County Auditor for payment procedure.. Do not file with the County Auditor first. Claims should be presented to officials for approval immediately upon completion of services requested or material ordered. Claims are paid every Tuesday; however, same must be approved by officials and in Auditor's office before preceeding Wednesday noon. Compliance with above will expedite payment of claim, failure to do so may delay payment considerably. Gh��gec� �,y o�r�e 3�ag(�l COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 Counixenter Drive - Orovllle. California 95965 - Telephone: 916/538-7541 ��_ �:•, APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER -Q9 ZONING61-11 U BUILDING PERMIT OWNER TELEPHONE 345-8794 S0. FT. OCC, BUILDING VALUATION 672 26,880 00 OWNER'S MAILIK-G ADDRESS 11 Vista La Selv Beach CA 5076 CONTRACTOR'S NAME Ownpr TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER .UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 179.50 ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ .7 Energy Plan Checking Fee $ 15.00 ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 4490 Wilder Dr .� Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 8.00 Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME 1 G/ PARCEL MAP �?D Water piping 5.00 5.00 Each qas water heater or vent 5.00 5.00 USE OF STRUCTURE SFU Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 5.00 Building sewer 5.00 5.00 Mobile Home S I G I W 0.00ea TYPE OF WORK New RCS Addition[] Remodel[] Utilities❑ Installation❑ Other ❑ Describe work: 1 bdrm Geer #415390 ga -� - Permit Fee $ 38.00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service eoov OR LESS 100 AMP OR LESS 10.00 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW 1 declare under penaltyof check one): perjury ( ) El am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification. I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors.(Sec. 7044) EJI am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.9� OR ACDNS. ACG. BLDGS. yz2sgft 16.$0 NON-RESID R. BRANCH CIRCUITS 2.50 ea POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occu P OUTLETS OR FIXTURES 20050t a ALO 30 EX. OCCUp. OUT ETS P(RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. byirin g15.00 Permit Fee $ 3 .80 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 10.00 Heating 6 .00 Cooling g 6.00 Hood 3.00 3.00 Ventilation penult Fee $ 25.00 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 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 liabL*es,judgment , and expenses which may in anyway accrueagain t unty in o nce of the granting of this permit. %� Date Sig t re of Applicant - Owner ❑ Contractor ❑ Agent An OSHA permit is required for ex avations over 5'0" deep and demolition or construct. ion of structures over 3 stories i h ' Mobile Home Installation Fee $ Energy Inspection Fee $ 30.00 occ CONST TYPE TOTAL FEE $ E HAz. CUA PARK scHL FLD PA Po I Ho Is E. This permit is hereby issued unaer the applicable provi- sions of the Butte County. Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS BY Date PERMIT EXPIRES Date Receipt No. - - WHITE-D.P.W.. YELLOW -AS [SSOR, PINK-INSP C OR, GOLDENROD -APPLICANT COUNTY OF B ' UTTE DEPARTME'NT.OF PUBLIC WORKS - BUILDING DIVISION i86LINTY CENTER DRIVE - OROVILLE,,,6ALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT ARsift-10--ATION DATA SHEET Permit No. OWNER - A�dl C_ A. P. N o. Proposed Building Use V6 16) (S Building Inspector a�6 r) -t- A At time of permit application, I was advised the following data must be submitted priorto permit processing and/or issuance: DATE RECEIVED APPROVED 1 . All items have been submitted . ..................................... 2. Plot plans in duvfrcg't .Akriplicate, signed by preparer of plans ........ 3. Complete plan's7h-q5rpri(-,,�a:te:)riplicate, signed by preparer. of p.1ans 4. Complete er _ e'd--Pans and caics, wiTH -wet signature on plans 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ............... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions ...................................... V_ 10. Fees of $ C2 �i9 j .3.0. ..................... 11. Chico Urban Area fees 'paid ....................................... �,,e 12. Park fees ... .............................................. 13. — PM ; C -.b Sch I Di trict fees.paid .............. I Sanitation approval from Health Department 26:!E( �e:5 � f 15. City of Chico plumbing permit ...................................... 16. Plot plan and business license approval froTn City of (see City for other requirements) .17. Planning approval for (A) Use:—(B) Parking: . ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy ' 20. Pre -Inspection for required ... Pre-inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classificati 0 n) 22. Certificate of Workmans Compensation Insurance .................. V 23. Owner -Builder Verification (Given to owner 0, Mail to ownerx ..... 24. Recorded'copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 26. 27. When you issue the permit, DrOcess as follows: — Mail to owner. —Mail to contractor. TelE,nhone A49 — A9,3"los—, 1. - d hold for pickup at Oro office. Deliver w/inspector. Oth r ( L7_Qh Es A a r- 11, )1 A P A Applicant— D a t e J 19 /.f Copy of Haz-Mat form sent —HealthDept. _Fi�etlept. ---AirPollution Date Copyofplanssent ___HealthDept. —FireDept. —Other— Date— By The following data must be submitted prior to permit issuance 1. Index permit for above items No. 2. Additional items required: (Circle new item not checked above). Contractor, designer, owner, was advised of above required data by_phontr_%-a*i I —counter by_—'_--i1'f_date Contractor, designer, owner, was advised of above required data by —phone —ma I I —counter by— date Plans checked by Date Plans approved by Date —Sets of plans on hold in Copy—DPW File cabinet _AP folder TO Buildina Department FROM: Environmental wealth SUBJECT: Sanitation Clearance wt S4 4-a/k fj,@.,. �.- C3 31 - Z Owner Location AP# Plan Approved for: Sewage Disposal Water Supply Hold final for: Final clearance O.R. for: Clearance for bedroom mobile home. ., ;A A _ - - . -4-- Water Supply' Water Supply Other 02t L,,,_ 44 eQ-s— - I MOTS *** '64?-23-T� Sanitarian Date IDENTIAL r63-31-02 _ -- - -- — - 985-91B , M -. FISHBACK, Basil 4490 Wilder Dr, Chico (conv garage to 60-640) . qb�/9;� JOB FINALE Signature l 'J OK O = Not OK Not Applicable RESIDENTIAL. (S = Not Ready Date UNDE OR (Plans) OK except tt's a --fon i rwsetbacks-Easements-Flood-Slope 2 g., ' ; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. ., Garage: Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ft rches & Decks; Soils -Steel-/ /Ftg. Depth Stemwalls, Main; Steel -Bloc kouts-Wrapped 6. Ste s, Garage: Steel-Blockouts-Wrapped Hold ns and Special Anchors ab; Steel -Wrapped 8. Pier - ' place Ftg.-Steel D.W.V.; Fall -Fitting -Test -2 Way• - ewer Test 10. Gas Pipe; Size -Anchors 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Insulation Date Card B-1 (/d Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except It's 16. ater Htr. en Access -Combustion Air -Baffle 1 ater Pipe; Testa A chor- rotection (11-VD.W.V.; es Fittings & Anch -Nail Protectio ter Pan; Test, First Floor -Tub Access - 2 . est Tub & Shower, Second Floor -Tub Access 2 as Pipe; Size & Anchors Date Q 1/-%,/ Card B-3/ Date Card B-1 Date Card B-1 Date Card B-1 Date ELECT CAL (Permit) OK except k's 2 ixt & Transformer Clearance -Ins. Protection _ 2 lec. Receptacles Spaci Ligh & Switch Doors _ 24. ize Boxes & No. of Conductors -Stapled _ omex Installed Clo d e t C.J uip. Ground made up w/Meeh. Fastners-Bon as & Water 7. ppliance Circuts in Kitchen & Conductor Size/GFI 2 ee I-A.C. wire size / ga. 2 ange Circ. / ga. Cu or AI -Oven Circ. / / u or Al. In lated Neutral ❑ Yes G -No 3 Se vice -Riser Conductors & Ground -Main Disconnect _ 3 -Equip. Clearances Panels -Motors -Meth. Equip. 32. Clothes Closet Light -Shower Light -Spa Light _ .. Smoke Detector Date Card B-1 1,16 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except s's 34. ucts Insulation & Support n; Exhaust above insulation rain ve ow: ize de 3 5 outlet . Attic a orm if Fur ante in Attic Date/()L/-4I Card B-1 Ll[f Date Card B-1 Date Card B-1 Date Card B-1 _ Date FRAMING (Plans) OK except a's 39.LS -Proper Material &atf%hors 4 tuds-NaiIi pati & B g -Plates -Sound 40 Bearing Walls ov Gir rs Floor Nailing 4 a t Stop in Walls (rat proof) . Fire Stops; Furred Ceilings -Stairs -Chases -Tub aders & Beam -Size & Bearing Ingle & Duplex) Date FRAMING C ued) 45. HangefsrKost C chors-Connectors Ing. Joist-Rftr. ties-Purlin-r Bra <T s-hthng.-Rfng. r place Ties or ype rue- ' eplace Throat clearance 4 ccess; Size & Romex Protection -Draft Stop -Ins. Baffles 49r.Bdrl`ff7Windt wor Exiting Do - ill Hgt imeaeidns 50. Garage Fire Protection Framing 51. Property Line Firewall & Openings 52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers 55. Siding -Nailing Veneer 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 57. Glazing Area -Glass Protection -Skylights -Plastic. 5 hear Walls; Nailing -Bolts \ 59. Insulation -Walls -Ceilings 60. Infiltration -Walls -Windows Date 16 //A9 Card B-1 (/,6 - Date Card B-1 Datelo - 31.91 Card B-1 L/ Date Card B-1 Date FiNA ans) OK except It's Ext. ps-Door & Sidelight Protectio s moke Detector mace; Vents-Clearance-CoConnector- In Garage: Above Floor -Duct r-. Protection 55. .F.1 - Batt fixtures & Tub Ac 6 lec. Trim uan b el; Breaker 's ireplace or Stov tear ce c. O tlets at Wood anel; Int 0R F, ct. & Appliance; Grnd: r 7 ec. OutletscfRece tacles &H 72. 7G,-A`C ct in Garage -Damper \ 14-'atr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In faaraae: Above Floor -Meth. Protection 7YPlb.. Elec. & Mech. Equip. Listed for Location" \ 7 ; ion Insulation -Foam -Looked in Attic O Yes 7 and & Deck Construction -P ps 7e--rd-n. Vents & Crawl Hole Door -Drainage & Woo -Earth Clearance Looked under Floo 80. Following instld.: Drive No; Walks 0 Yes Planters 0 Yes L, No 81, chi cn• Rrnwn F' ti 82. A. 6ratsconnect, Electrical umbing j 8 ents Above Roof; Plbg.- pliance-Firep?e-Clearance to Opepings 8,g/46ater well: Disconnect, Electrigal. Plumbing 8 e ' r Elec. Trim; G. . eceptacle-Underground 8 . entilation Throughout House Gas 90. Wa Sewer Connected- o Grade -HO Approval Allffi�tnerqy Compliance Certificate -Other • ertificates Date 1.7-//`q I Card B-1 VP Date f rS'yG CaidB. 44 J,45 Date -1-1 y -ft Card B-1 VA Date Card B-1 Date /''y{-Q'L Card B-1 Vp Date Card B-1 Comments at Final: J=OK O = Not OK Not = Not Readyable . MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements _ 2 Soils; Special MH Support Sketch _ 3. Sewer; Location -Test -Fall -C/O Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap: / /" L"tt. / /"Nat. or/ /" L"ft./ /"LPG 7. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks Easements _ 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances _ 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval _ 8. Gas -and Electricity Tagged 9. Exits; Insp.-Sketch _ 10. Cert. of Occupancy Date Card B-1 Date Card B-1 _ Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Coonectors Shthg: Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Caroorts: Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except tt's 1. Setbacks -Easements 2 Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater '8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date ~ Card B-1 Date Card B-1 L 1 t � Building Owner A Building Location ENERGY INSTALLATION CERTIFICATE Building Permit #� DESCRIPTION OF INSULATION ROOF r��erll�sS �o.1ri Material Thickness( inches) ) ' EXTERIOR WALL �Cr9 Material - o Thickness(inches i CEILING L Brand Name r Thermal Resistance (R Valu ) 'J- Q Brand Name _ 00PcAS (,3yA ,, , Thermal Resistance(R Value),3� Batt or Blanket Type j Brand Name Thickness(inches) Thermal Resistance(R Value) .. Loose Fill Type Brand Name ./44 /A Minimum Thickness(Inches) Number of Bags--- Wt. per bag lb. Area covered(ft.2) Thermal Resistance(R Value) FLOOR, ELEVATED Material /iJ/tel Brand Name Thickness(inches) Thermal Resistance(R Value) FLOOR, SLAB/ �� lJo -ev, acl�¢,s� ,'_ 1 Material C Brand Name Thickness (inches)__ 1G,1 Thermal Resistance(R Value) .4- Width(inches) FOUNDATION WALL Materiai�Q/7Brand Name Thickness(inches)l/' Thermal Resistance(R Value) '3 I hereby certify that the above insulation was installed in the above building, --- is consistent with -approved building department plans -and attachments-and•con_---- forT with re%�irements of Chapter 2-53 of State of California Energy Requirement NA 1S . F�IR STATE CONTRACTOR'S LICENSE N0. - ff, SIGNA OF INSTALLATION APPLICATOR D&E 1 hereby certify the required features, devices, and equipment, -ab shown on the approved Building Department plans and attachments have been installed and.conform to the appli- ance standards and Chapter 2-53 of the State of California Energy requirements. _ t BUILDING CONTRACTOR/OWNER (Please Print) (FIRM NAME) SIGNATUR BUILDING CONTRACTOR/ OWNER OBJ ' HVAC FIXM NAME/OWNER (Please Print) 1�)A L /0.) STAT CONTRACTOR'S LICENSE NO. A b A� DATE STATE CONTRACTOR'S LICENSE NO. .f IVIA l M SIGNATURE OF'a? AC CONTRACTOR/OWNER DATE THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION AP VAL AND A COPY SHALL BE POSTED WITHIN THE BUILDING. X. SEPTEMBER 1988 r COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, .Paradise, CA - (916) 872-6307 CORRECTION NOTICE OWNER PERMIT NO. A routine in ection indicates that the following violations of Butte County Ordinances exist at the above dress and should be corrected. Please notify this office when correction of work is comple d. If you have any questions pertaining to this matter, or need additional explanation, please c ntact this office immediately. ,*Ito- ' V4�� KeA,4 o, k,6 -f w &AA (�-c+.w. Feel /L��cs�•., !ti�-�;.�c�. t,�--�Q�% %� 0 , I<. � �� Date REV 11/91 Inspector C. Date /Z- of I- 71 Inspector V COUNTY OF BUTTE DEPARTMENT OF PUBLIC'WORKS j 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 538-7541 4_ 747 Elliott Road, Paradise —Phone: 872-6307 CORRECTION NOTICE - C � ic, yi 5 - 96 OWNER PERMIT NO. F A routine inspection indicates that the following violations of County Ordinance exist at�theve address and should be corrected. Please notify this office when cof work is completed. If you have any question pertaining to this matt or need additional explanation, please contact this office immediately. U0 e - a ej- ej - G' S�ii c C. Date /Z- of I- 71 Inspector V COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS a ' 196 Memorial Way, Chico — Phone: 891-2751 ' 7 County Center Drive, Oroville — Phone: 538-7541' a 747 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or ed additional explanation, please contact this office immediately. ' I S-�M I A 4 . i �'T�o�1 i�"z= �t• G � �� Date Inspector ?; li, •� COUNTY OF BUTTE - DEPARTMENT OF1POALIC WORKS 7 doun;,y genter Drive - OrovIIIe, California 95965 • Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBE% 63-31-02 '"' ZONING' U BUILDING PERMIT OWNER Basil Fishback TELEPHONE 345-8794 SO. FT. OCC. BUILDING VALUATION 624 26 16 224.00 OWNER'S MAILING ADDRESS 11 Vista Drive La Selva Beach CA 95076 U 2_41//P. a 0 CONTRACTOR'S NAME None TELEPHONE -'9C� W2, LL JJ �J O CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER None UNKNOWN Total Valuation $ 133,A ca LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee , 6'��O ARCHITECT OR ENGINEER LICENSE NO. I Plan Checking FeeNone 16.25 Energy Plan Checking Fee $ 15.00 ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty ,7 $ Q BUILDING ADDRESS 4490 Wilder Drive, Chico 95928 Permit fee "' $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO.SUBFIVIIS—ION NAME PARCEL MAP ✓r' Water piping ' 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SFIM Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G W O.00ea TYPE OF WORK New Addition❑ Remodel❑ UtilitiesEl Other❑ Describe work: convert garage to'd�D� ( (fie /` (see #4153-90) Permit Fee $00 Contractor ELECTRICAL PERMIT Filing Fee111 OR L Main service 100 AMP ORSLESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the BUSIneSS and Professions Code and my license is in full force and effect. License No. Classification, 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 OCCU/� OR ADDNS. ACC. BLDGS.` P.q) , /20sgft �o NEW CONSTR.NON.RESID BRANCH CIRCITS U TI.OUTLET 2.50 ea (POWER APPARATUS e) SINGLE OUTLET CIR. Ex. Occu o zo®e0a p UTLETS OR FIXTURES eAL030 FIXED APLNS Ex. Occup. OUTLETS P(RESID )KEA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 9 15.00 Permit Fee $ 0 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 f Consent to Self -Insure. I II shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating 116.00 1 6.00 Cooling swamp cooler 1 6.00 6.00 Hood 3.00 1 3.00 Ventilation Permit Fee $ 25.00 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 County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, ' emnify and keep harmless the County of Butte against all liabili s, judg e t , costs, and expenses which may in any way accrue against s i Co u I c qu n f the of this permit Date `� Signa ru a of Applicant — Owner ❑ Contractor ❑ Agent �(17]J J$Ub v An OSHA permit is required for excavations over 5'0" deep and demolition ion of structures over 3 stories in height. I i Mobile Home Installation Fee $ Energy Inspec ion Fe $ 30.00 CONST E TVAL F %S HAz. CUA PARK FL CDF PA PD I 'H I SU This permit is hereby issued under the applicable of the Butte Cou i ty. Code and/or resolutions i . ' ated abov for which fees have been 2� ECT PUBLIC WORKS oq By Dat `�� � provi- to do paid. .•._s Receipt No. 88458/263.75 % A/dam X15° TE-D.P.W., YELLOW- g8 $ P -INSPECTOR„ G D D-APPLICAN {/AP D P RM EXPIRES Date i COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET - Permit No. OWNERb0t�;11 F KS r/a A. P. No. ��— sIl Proposed Building Use S�// Building Inspector Date qr6-01/ At time of permit application, I Was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . .................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans ....... 3. Complete plans in �ca�eI licate, signed by preparer of plans� 4. Complete -engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7 Statement of Intent for Non -Heated and AC Buildings .............. Engineered truss details and layout in duplicate (required prior to plan check) -/—L�S 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ , 11. Chico Urban Area fees pal ......... ' r 12. Park fees paid . , . ... . 13 l Schhool District fees aid ..&..M 14. Sanitation approval from ChIC-O Ai 15. City of Chico plumbing permit............... ...................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW _ Q 19. Driveway permit (construction approval required prior io-occup na cy) W_ 20. Pre -Inspection for required Pre-Inspec. request to Building Inspector (Date) - 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 3. Owner -Builder Verification (Given to owner ❑, Mail to owner..... 4.kecorded copy of Agricultural Acknowledgment Statement ......... r of ign to aut `r' t' ............................... 27. When you issue the permit', process as follows: I Mail to owner. Mail to contractor. Telephone and hold for pickup at of Deliver w/inspector. Other (Applicant AU—.Date A t Copy of Hai -Mat form sent Health Dept. Fir ept. _Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit iss ce: ( e n m c ov 1. Index permit for above items No. 2. Additional items required: — Contractor, des Igner,/dwW, was advised of above required data b pho�en mf—counter �'ate �- Contractor, designer, owner was advised of above required data by p ne-mafl_counter by AJ date (��27141 Plans checked by Date Plans app Dyed" by Date - a Sets of plans on hold in Filecab_inet AP, folder 4 Copy—DPW �, : Y / - ; COUNTY OF BUTTE - DEPARTMENT. -OF PJBLIC WORKS PERMIT NO. 7 County Center Drive - Orovllle, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL•NUMB R� 3 -2- ZONIN u BUILDING PERMIT OWNER , ^ ` f( .9 CLcS\ TELEPHONE SO. FT. OCC. BUILDING VALUATION IL OWNER'S MLING ADDRESS 11 v;s /f- n'Je LA s el0A- ��. CA a , CONTRACTOR'S NAME TELEPHONE - CONTRACTO MAILING ADDRESS FireDlace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 'OOH) LENDER' AILI C ADDRESS Permit Fee $ 1 Z2. ARCHIT _CT OR c.17 ;INEEP,T _ LICENSE NO. Plan Che;;king Fee Energy Plan Checking Fee n $ ��. ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS-75- fJZ �� , !� f 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 2� Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets . 5.00 Building sewer 5.00 Mobile Home S I G JW I 0.00ea TYPE OF WORK New 10 Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: �© V1 i/,d v.f �a i"aA 0 P � CD %6 4� Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 - Main service 100 AMP OR ORSLESS 10.00 Main service EA. ADO'L too AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt.-9, Div: 3 -of the Business and Professions Code and my license is in full force and effect. License No. Classification, ❑ 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- ontract- ors.(Sec. 7044) ors. ❑ 1 am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.6 OR ADONS. ACC. BLDGS. , /22sgft NEW CONSTR. ULTI.OUT LET NON BRANCH CIRC ITS 2.50 ea POWER APPARATUS SINGLE OUTLET CIR.a ) / Ex. Occup\OUTLETS OR FIXTURES 0050 2AL93t eLv3o FIXED APPLNS. Ex. Occup. OUTLETS (RESID )KEA.) 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): _ ❑ The permit is for $100.00 (valuation) or less. a 1'"Ptave`01aced oh"fi(e w)tti the'*Coiinty'-of -BUtte'•BuTding'D'epartm`enf' a Certificate of Workmen's Compensation Insurance or a Certificate - of Consent to Self -insure. --- ---- -- - - ❑ I shall not employ any person in any manner so as to become subject - - to the W. C. laws of California. ------ _ --• -.•------_-•-----•-- Notice to Applicant: If after making this statement,. should you become subject - --to the W-.-C.-provisions-of-the Labor -Code, you -must -forthwith -comply with such- provisions or this permit shall be deemed.revoked. _ .. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating - `---' Cooling 50JAP Cool / .QO Hood - 3.00 Ventilation lt_ee perm - - — -- --$ F -- — ==Q Contractor - I certify that I have read this application and state that the above information is correct. l 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 -inconsequence of -the granting of this`permit.----.-- - = X -Date _ Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ _ An OSHA permit is required for cavations over 5'0" deep and demolition.or construct- ion of structures over 3 stories i height. Mobile Home Installation .Fee ~ Energy Inspection Fee-- ' = -' =_ $'�-- -� occ CONST TYPE - _ TOTAL FEE $ • - = t /� HAZ- - cuA PARK SCHL - FLD CDF� PAR _ - , PD - I HD • - - ISSUE This permit is hereby issued unser sions of the Butte County. Code and/or work indicated above for which a DIRECTOR OF PUBLIC BY PERMIT EXPIRES .Date the applicable provi- resolutions to do fees have been paid. WORKS .. Date Receipt No. � 2163 WHITE-O.P.W., YELLOW-ASSE33 R, PINK -INSPECTOR, GOLD ENROO-APPLICANT r .ate I h .s �s• BUTTE COUNTY SCHOOLS DEVELOPMENT'FEE CERTIFICATION'FORM (One Form per Building) t �. A.P. Number (,PBuilding Department No. y School,. District JIGU City = County Mi Jurisdiction Property Owner Project Location/Address, �-iil9o'` LU(t er &I ��. ato Subdivision Lot �Numb'fer;z Residential Development: ' a Sq. Footage I # of Living MH-I•—Addition "" +. (Group R)' Units fel Commercial/Industrial: t r a'Sq:Footage New Addition (Including`�.Exterior Roofed Areas) ' Building --Department l�Representative Dai• e (Floor Plans reviewed' -by School District Personnel) ` District IdNo. School District certifies that. (Applicant Mame) (Phone Number) 414 to t t. -d (Street Address) l (City) (State) p f ( ip.Code') has complied with the requirements of .Resolution No. by the ayment of $ �3�-�/o� . representing square feet School District Representative" Date PAID BY CHECK NO. RENS BANK NO PAID BY CASH 1' This Certification is -valid only upon the issuance -- -- of a- Butte, County/City of Chico Building Permit - -- prior to 8/5/91:- Building -Permits issued on or after -- 8/5/91 are subject tore -certification and additional school fees of $1:00 per square foot of assessable space. white—applicant, yellow—building department,;,-pink—school district SCHOOL.FEE (8/88) COUNTY OF BUTTE - Department of Public Works 7 County Center Drive; Oroville, CA 95965 Phone:. 916-538-7541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement (yes or no) 2. I (have/have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address . Phone Type of Work Signed: Property Owner Social Secy,rity Nua� r � Date _ "-' NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. RESIDENT IAL0PLAN CHECKING GUIDE -12/90 (S.F., DUPLEX & MISC. ONLY) Bldg. Permit # OWNER /,�Gr hZe4C A. P. # / GENERAL — Plan Checker o L oning requirements: (sideyards and number of permitted living units). Valuation. Plans signed. by designer. ,4! Proper description of work on application. �-.� Existing violations on property. 6 Items on data sheet. (W.C., fees, Health, Developer Fees, License law, etc). Recorded notice of violation. PLOT PLAN f mplete parcel size and dimensions. tbacks, sideyards, easements, etc. her buildings or structures. ading, fills, drainage. ood hazard. ecial conditions on creation map, tible, and foundations). U & FAS road setback. (noise, CDF, fire sprinklers, non -comb - Building or utilities across lot lines (Record form). FLOOR PLAN Complete to'scale plan with dimensionss.° Required windows for light and ventilation (Sec. 1205). Required windows for second exit (Sec. 1204). Skylights (Chapter 34 & Sec. 5207). Human impact glass (Sec. 5406). Required room sizes, ceiling heights (Sec. 1207). GFCIs in baths, garage, kitchen, and exterior outlets (Article 210-8). -Light fixtures, switches, receptacles, and exterior receptacles for main- tenance of mechanical equipment. )Locations of water heater,• heating and cooling equipment, other electrical or gas equipment. Garage firewall, door size, and closer (Seca 503(d)(3)). 3'0" exterior -exit door (sec. 3304 (f). Fireplace and wood stove location, alcoves, and clearance. S§r oke detectors (Sec. 1210). Plumbing fixtures, water closet clearances and shower size. STRUCTURAL DETAILS Standard bracing or engineered design (Table 25V) Unusual shape, size, or split level house requiring lateral design. Foundation plan complete enough to construct building. Floor construction details complete enough to construct building. Elevations and wall construction details complete enough to construct Roof construction details complete enough to construct building. Fireplace construction details and calcs if necessary. — Rafter ties or bearing ridge beam. Garage door or porch header sizes. D- Stud heights. Adobe soils - special foundation design. 2—Retaining walls requiring design. 3 --Special Inspection required. building a1;nA&j RESIDENTIAL PLAN CHECKING GUIDE MISCELLANEOUS ITEMS TO LOOK OUT FOR 12/90 Stairway details: landings, rise and run, head clearance, handrails ;Sec. 3306). _Guardrail details (Sec. 1711 & 3306(j). Brick or stone veneer (Chapter 30). ��Fxterior plaster - weep screeds (Sec. 4706). Proper roof pitch for roof convering (Chapter 32). Roof covering type - (fire hazard). Foam insulation - protection. X36" halls and stairways. Diving area over garage - complete 1 -hour separation required on garage side including supporting walls and posts, etc. Two exits on three-story dwellings (sec. 3303 & see Mezannines - 1716). attic access and ventilation (Sec. 3205). Underfloor access and ventilation (Sec. 2516). Rombustion air for fuel burning appliances - L.P.G. requirements. —Noise requirements on duplexes. Energy design. Flashing at all exterior openings. CDF responsible area requirements. v COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 538-7541 747 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE OWNER 8S-? l PERMIT NO. iZI A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. if you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. 2,111 ` -� u � ni\� Date / �� ' —moi/ Inspector !/ '. 6Llrt-` Certificate of Compliance: Residential Climate Zone 11 Mandatory Measures Checklist: Residential " MF-1R Project Title tf7� Q/ NOTE: Lowrise residential buildings subject bhe tSnnduds must contain these nuasui= Mgardlw of IM torn Unca I gX ! approach used. Items marked with an n this (•)may s i superseded by more stringent compliance features n tdlisted h D Buildin Pemtit M on the Cenifiwte of Compliance. When this chaklist u incorporated into the permit docaments, the feutaes rated sAaU be considered by all parties as binding minimum component performance specifications for the mar dawry measures Project Address i1, f -- �S r ` 4Z whether they are shown elsewhere in the documents or ontbis chocklist only. r (( Checked By / Date DFSCR1P1lON DESIGNER ENFORCEMENT Documentation Author Telephone . Enforcement Agency Use Only Building Envelope Measures BUILDING DATA Glass Area % Glass *§2-5352(a): Minimum ceiling insulation R-19 weighted average. North §2.5352(b): Loose fill insulation manufacturer's labeled R-Value. Conditioned Floor Area Number of Stories East • §2.5352(c): Minimum wall insulation in framed walls R-11 weighted average (does not apply to 3.0 ' exterior mass walls). Slab/Raised Floor Number of Units South 2 7 a •Q §2.5352(k): Slab edge insulation - water a bsorptian rate no greater than 0.356, water vapor West transmission rate no greater than 2.0 permfinch. [ ]Single Family Detached (SFD) [ ]Addition Alone §2.5311: Insulation ified or installed meets California Energy Commission (CEC) quality [ ] Single Family Attached (SFA) [ ] Existing Building Skylight .r i standards. Indicate type and corm. (] Multi-Family (Mn (]Existing-Plus-Addition Tom mi k §2.5352(f): Vapor barriers mandatory in Climate Zones 14 and 16 only. §2.5317: Infiltration/ExRltration controls a. Doors and windows between conditioned and unconditioned spaces designed to limit au BUU,DING SHELL INSULATION leakage. b. Doors and windows cenifned. Component Insulation Loeatiion/Commenits c. Doors and windows weatherstripped: all joints and penetrations caulked and sealed. Type R-Value (aide, to garages, �/isr2. etc.) §-5533stan�� Special infJoation barrier installed to comply with 12-5351 mats CEC quality Wall .............. 6 2-5352(d): Installation of Fireplaces 1. Masonry and factory-built fireplaces have Wall, a. Tight fitting, closeable metal or glass door ROOF ............. b. Outside au intake with damper and control c. Flue damper and with -sem I 2. No continuous bunting gas pilon allowed. Roof ............. _ • Floor t HVAC and Plumbing System Measures Floor ............. §2-5352(8) and 2-5303: Space conditioning equipment siring: attach ealculadoru. Slab Edge ..... §2-5352(h) and 2-5315: Setback thermostat on 217 applicable heating systems. • §2-5316(a): Ducts constructed, installed and insulated per Chapter 10, 1976 UMC. GLAZING Shading Devices §2.5316(b): Exhaust systems have damper controls. t §2-5314(c): Gas-fuel space heating equipment has intermittent ignition devices. Glazing Area Glass Type Interior Exterior Overhang Framing Type 62-5314: HVAC equipment, water heaters, showerheads and faucets certified by the CEC. Orientation (sf) (single, double) (Tolls blind. etc.) (shadesoreen, etc.) (yesmo) (metallyood) §2.5352(1): Water hcater insulation blanket (R-12 or greater) or combined interim4extuior insulation (R-16 or greater): fust 5 feet of pipes closest to tank insulated (R-3 or greater). Nomh 'LCQ _ §2.5312(Exception 1): Pipe insulation on steam and steam condensate return & recirculating North piping. ( ) §2.5318(d): Swimming Pool Heating East ( ) e I r� _ I. System has: East ( ) a. On/off switch on heater. b. Soutf t ( ) _Z /t _ I[ c. Plumbed to alllam on heater. low for solainstruction r. South ( ) 3. Pool ovcr2. 75 percent loertnalcfficiency. West ( ) h1 �/ 5. Directional ( 5. Directional water inlet. West Lighting and Appliance Measures Skylight....... /f I §2-5352(1): Lighting - 25 lumens/watt or greater for general lighting in kitchens and bathrooms. THERMAL MASS §2.5314(c): Gas rued appliances equipped with intermittent ignition devices. Type/Covering Area Thickness §2-5314(a): Refrigerators, refrigerator-freczers, freezers and fluorescent lamp ballasts certified (slab/exposed, tile, etc.) (sf) (inches) Location/Description (kitchen, bath, etc.) by the CEC. Indicate make and model number. COMPLIANCE STATEMENT This certificate of compliance lists ft building features and performance specifications needed to comply with Title 24. Chapter 2-53 and Title 20. Mptcr2. Subclupter4. Article l of the California Administrative code. This certificate has been signed by the individual with overall design reWnsibility and the building owner. who shall HVAC SYSTEMS Minimum Duct 1 retain a copy of it and transmit the certificate to any subsequent purrltaser of the building. Type (furnace, air Efficiency Location Duct Output Manufacturer / Model # Designer Building Owner conditioner, hent urn) (SE, SEER,HSPF) (attic,etc.) R-Value tuh ora roved equal) � g Name: None TukJl=ittn: TitlelFrm: Addrea: Address: -� (/.Grail/ �•� � t . r`., V y Telephone: Tckphon Maximum Fumace Heating Output: Btuh ` Lic• 4: LI-1 HOT WATER SYSTEMS Tank Manufacturer/Model # (�P ��I System T (storage gas, etc.) Capacity or approved equal) Special F to (silts•) (date) (sig ) (d te) S' �• Documentation Author Enforcement Agency SPECIAL FEATURES/REMARKS (Add extra sheets if necessary) Nang: Name: Tide/Fum: Agency: Address: Tekpltonr 1. Ceiling Insulation -4 -3 -1 0.80 Number of stories -1 0 R -value .= One - _ Two Three R-0 -103 -49 -02 R-19 -8 -4 -2 R-30 -2 -1 -1 R-38 0 0 0 1.1 -value Double .60 .50 0.50 -176 -84 -54 0.30 -102 -49 -02 0:10 -26 -13 -8 0.08 -18 -9 -6 O.C6 -11 -5 -4 0.04 -4 -2 -1 0.02 4 2 1 0.00 11 5 3 -20 -12 -3 2. Wall Insulation 12 28 -55 Single- Single - -2 5 Family Family Multi - R -value Detached Attached Family R-0 -68 -51 -34 R-11 0 0 0 R-13 2 2 1 R-19 8 6 4 U -value -43 -12 -5 0.80 -153 -114 -76 0.50 -91 -68 -46 0.30 -47 -36 -24 0.10 0 0 0 0.08 4 3 2 0.06 9 7 5 0.04 14 11 1 0.02 19 14 10 0.00 24 18 12 3. Raised Floor Insulation 16 18 Insulation In Floor 2 7 12 Number of stories 17 R -value One Two Three R-0 -17 -8 -5 R-11 -3 -2 -1 R-19 0 0 0 R-30 3 1 1 U -value -14 3 7 0.60 -144 -70 -46 0.50 -120 -58 -38 0.40 -95 -46 -30 0.30 -69- -34 -22 0.20 43 -21 -14 0.10 -17 -8 -5 0.08 -11 -6 -4 0.06 -6 -3 -2 0.04 -1 0 0 0.02 4 2 1 0.00 10 5 3 Controlled Ventilation Crawispace 9 4 Number of stories 2 R -value One Two Three R-0 -11 -7 -5- R-5 -4 -4 3 R-11 -2 -2 -2 R-19 1 -2 -2 4. Slab Edge Insulation 1.20 3.4 13 Number of Stories 12 R -value One Two Three R-0 0 0 0 R-5 8 5 2 R-7 8 6 3 F2 factor 0.90 -4 -3 -1 0.80 -1 -1 0 0.70 2 2 1 0.60 6 4 2 0.50 9 6 3 0.40 12 8 4 S. Infiltradonf (Airy Leakage) Specification Points = Standard -_- 0 7..Shading (Shade Open) Efreedve Percent Glass (percent Qlao x SC) Effective -14 -48 -69 -64 na %Glass 6. Glass Heat Loss South West Skylight Total 5 1 4 1 LJ -value 16 Percent 2 5 .51 to .41 to .31 to 0.30 or Glass Single Double .60 .50 .40 less 50 -121 -53 -39 -24 -10 4 40 -90 -37 -26 -14 -3 8 35 -75 -29 -19 -9 1 10 30 -61 -21 -13 -4 4 12 29 -58 -20 -12 -3 5 12 28 -55 -18 -10 -2 5 13 27 -52 -17 -9 -2 6 13 26 -49 -15 -8 -1 7 14 25 -46 -14 -7 0 7 14 24 -43 -12 -5 1 8 14 23 40 -11 -4 2 8 15 22 -37 -9 -3 3 9 15 21 -34 -7 -2 4 10 15 20 -31 -6 - 0 5 10 16 19 -29 -4 1 6 11 16 18 -26 -3 2 7 12 16 17 -23 -1 3 8 12 17 16 -20 0 4 9 13 17 15 -17 1 6 10 14 17 14 -14 3 7 10 14 18 13 -12 4 8 11 15 18 12 -9 6 9 12 15 19 11 -6 7 10 13 16 19 10 -3 9 11 14 17 19 9 -1 10 13 15 17 20 8 2 12 14 16 18 20 7..Shading (Shade Open) Efreedve Percent Glass (percent Qlao x SC) Effective -14 -48 -69 -64 na %Glass North East South West Skylight 18 5 1 4 1 na 16 4 2 5 1 na 14 4 2 5 1 na 12 3 3 5 2 na 11 3 3 . 5 2 na 10 2 3 5 2 1 9 2 3 5 2 2 8 2 3 5 2 2 7 1 3 4 2 2 6 1 3 4 2 3 5 1 2 4 2 3 4 0 2 3 1 3 3 0 1 2 1 3 2 0 0 1 0 3 1 -1 -1 -1 -1 2 0 -1 -2 -4 -2 0 na = not allowed 8. Shading (Shade Closed) Efrecdve Pes cent Glass (percent Stas) x SC) Effective %Glaze North E&M South West Skylight 18 -14 -48 -69 -64 na 16 -12 -42 -59 -55 na 14 -10 -35 -50 -46 na 12 -8 -29 -40 -37 na 11 -7 -26 -36 -33 na 10 -6 -23 -31 -29 -74 9 -5 -20 -27 -25 -65 8 -5 -17 -23 -21 -56 7 -4 -14 -19 -18 -47 6 -3 -11 -15 -14 -38 5 -2 -9 -11 -10 -30 4 -1 -6 -8 -7 -23 3 0 -4 -5 -4 -16 2 1 -1 -2 -1 -9 .1 1 1 1 1 -4 0 2 3 4 3 0 na . not allowed 4 6 8 8 9. Interior Thermal Mass Interior SCORE CARD Slab Floor Raised Floor 1. Ceiling Insulation Mass SE or HSPF SbrieS -4 -4 Stories (assumes ducts In attic) JCFA One _ Two Three One Two Three 0.0 -8 -5 -4 -2 -1 -1 0.1 -8 -5 -3 -1 0 0 0.3 -7 -4- -2 0 1 1 0.5 -6 -3 -1 1 1 2 0.7 -5 -2 -1 1 2 2 0.9 -5 -1 0 2 3 3 1.1 -4 -1 1 3 4 4 1.3 -3 0 2 3 4 5 1.5 -3 1 2 4 5 5 2.0 -1 2 4 5 6 7 25 0 3 5 7 7 8 3.0 1 4 6 8 8 9 3.5 2 5 7 9 9 10 4.0 3 6 8 9 10 10 4.5 3 7 8 10 11 11 5.0 4 7 9 11 12 12 5.5 5 8 9 11 .12 12 6.0 5 8 10 12 13 13 6.5 6 9 10 12 13 13 7.0 6 9 11 13 13 14 7.5 6 10 11 13 14 14 8.0 7 10 11 13 14 14 8.5 7 10 12 13 14 15 10. Exterior Wall Thermal Mass less Exterior Single- Single - 4 3 Wall No Cooling System Installed Family Family Multi 0 Mass Solar Detached Attached Family 4 0.00 HP 0 9 0 0 2 0.20 1.5 3 9 2 1 2 0.40 3 5 9 4 3 2 0.60 SE 8 -45 6 4 -11 0.80 59 10 2 8 5 0 1.00 1.9 13 -23. 10 7 -6 1.20 3.4 13 -25 12 8 -6 1.40 4.8 12 -23. 13 9 -6 1.60 n 10 -8 13 11 .2 1.80 2.2 10 6 12 12 1 200 3.7 10 1 11 13 0 11. Heating System SCORE CARD Measures 1. Ceiling Insulation SEER SE or HSPF -5 -4 -4 =(assumet (assumes ducts In attic) In attic) _ - 3 3 Sim of 7-10 Sum of 1.6 2 1 Single -Family -25 or -24 to 1-14 to -25 or -24 to -14 to -4 to +6 to 16 or SE HSPF less -15 -5 +5 +15 more 0.72 6.60 0 0 0 0 0 0 0.75 6.88 3 3 3 2 2 1 0.80 7.33 8' 7 6 5 4 3 0.85 7.79 13 11 10 8 7 5 0.90 8.25 17 15 13 11 9 7 0.95 8.71 20 18 15 13 11 8 9 7 6 Effective SE or HSPF 120 15 (SE or HSPF x duct efficiency) 9 Effective -25 or -24 to -14 to -4 to +610 16 or SE HSPF less -15 -5 +5 +15 more 0.30 2.75 -73 -64 -56 -47 -38 -30 na 3.41 -45 -39 -34 -29 -24 -18 0.40 3.67 -34 -30 -26 -22 -18 -14 0.50 4.58 -10 -9 -8 -7 -5 -4 0.56 5.13 0 0 0 0 0 0 0.60 5.50 5 5 4 3 3 2 0.70 6.42 17 15 13 11 9 7 0.80 7.33 25 22 19 16 13 10 0.90 8.25 32 28 24 20 17 13 1.00 9.17 37 32 28 24 19 15 Zonal Control Adjustment System Type Resistance 10 9 7 6 4 3 Other 6 5 4 3 2 2 12. Cooling Syst•!m SCORE CARD Measures 1. Ceiling Insulation SEER One -5 -4 -4 =(assumet ducts In attic) _ - 3 3 Sim of 7-10 2 2 1 Single -Family -25 or -24 to 1-14 to -4 b +6 to 16 or SEER less 15 1 -5 +5 +15 more 8.0 -14 .12 . -10 -8 -6 -4 8.5 -9 -7 -6 -5 -4 -3 8.9 -5 -4 -4 -3 -2 -2 9.0 -4 -3 -3 -2 -2 -1 9.5 0 0 0 0 0 0 10.0 4 3 3 2 2 1 10.5 7 6 5 4 3 2 11.0 10 9 7 6 4 3 120 15 13 11 9 .7 5 13.0 20 17 14 12 9 6 100% 105% 110% 1159: 120% 125• Solar EffeQive SEER -1 -1 0 (SEER xaud efficiency) 1.1 HWR -18 Sun of 7-10 -9 -7 -6 Effective -25 or -24 to -1410 -4b +610 16 or SEER less -15 -5 +5 +15 more 5.0 -30 -25 -21 -17 -13 -9 6.0 -12 -11 -9 -7 -0 4 6.6 -5 -4 -4 -3 -2 -2 TO 0 0 0 0 0 0 8.0 9 8 6 5 4 3 9.0 16 14 12 9 7 5 10.0 22 19 16 13 10 7 11.0 26 23 19 15 12 8 12.0 30 26 22 18 14 9 13.0 33 29 24 20 15 10 to Zonal Control Adjustment Type less 10 8 7 6 4 3 None No Cooling System Installed 0 0 Stories SCORE CARD Measures 1. Ceiling Insulation R I -W or One -5 -4 -4 -3 -2 -2 Two + 3 3 2 2 2 1 Single -Family Iletached and Attached Unit Size (so Water VI 99 12M 1700 2200 2700 Heater Credit or , to to to or Type Type less ,1699 2199 2699 more SG None 0 0 0 0 0 or Solar 12 8 6 5 4 HP HWR 8 5 4 3 3 WSB 5 3 3 2 2 3OY. POU 8 5 4 3 3 SE None -37 -24 -18 -15 -12 100% 105% 110% 1159: 120% 125• Solar -1 -1 -1 0 0 1.1 HWR -18 -12 -9 -7 -6 2.5 WSB -25 -16 -12 -10 -8 4 POU -18 _ -12 -9 -7 -6 IG None -5 -3 -2 -2 -2 1.4 Solar 7 5 4 3 2 2.9 POU 3 2 1 1 1 IE None -28 -19 -14 -11 -9 0.3 Solar 8 5 4 3 3 1.8 POU -10 -6 -5 -4 -3 3.3 Multi -Family (Individual 37 units) 4.1 Water 4.5 699 Unit Size (SO , 700 1200 1700 ' &0 Heater Credit or b to to a Type Type less 1199 1699 2199 more SG None 0 0 0 0 0 or Solar 14 7 5 4 -3 HP HWR 9 5 3 2 2.` 1.5 WSB 9 4 3 2 2 - 3 POU 9 5 3 2 2 SE None -45 -23 -15 -11 -9 59 Solar 2 1 1 0 0 1.9 HWR -23. -12 -8 -6 -5 3.4 WSB -25 -13 -8 -6 -5 4.8 PQU -23. .112 -8 -6 -5 n None -8 -4 -3 .2 .2 2.2 Solar 6 3 2 1 1 3.7 POU 1 0 -0 0 0 IE None -00 15 -10 -8 -6 1 Solar 18 9 6 4 4 2.5 POU -8 . -4 -3 -2 -2 Point System Summary: Climate Zone 11 SCORE CARD Measures 1. Ceiling Insulation R I -W or R -value 1381 U -value [0.030] 2. Wall Insulation ( or • slnteriorMass/CFA or R-value[191 U -value [0.037] TMS MASS 11.7e0Itlab) t TYPE I MASS (111KC 4.2, ie: exposed slab) 0% S% toy. 15% 20y. 25% 3OY. 3S% 40% 439. •50% 55% 6O% 6914 70% 75% 60% 85y. 90% 95% 100% 105% 110% 1159: 120% 125• Oy. 0 0.2 0.4 0.6 0.8 1.1 1.3 1.5 1.7 1.9 2.1 �3 2.5 2.7 2.9 3.2 3.4 3.6 3.8 4 4.2 4.4 -4.6 4.8 5 53 10Y. 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.9 2.1 2.3 2.5 2.7 2.9 3.1 3.3 3.5 3.7 4 4.2 4.4 4.6 4.8 5 5.2 5.4 20% 0.3 0.6 0.8 1 1.2 1.4 1.6 1.8 2 2.2 24 21 29 3.1 3.3 9.5 37 3.9 4.1 4.3 4.5 4.8 5 52 5.4 56 30% O.S 0.7 0.9 1.1 1.4 1.6 1.8 2 22 2.4 26 2.8 3 3.2 3.5 3.1 3.9 4.1 4.3 4.S 4.7 4.9 5.1 5.3 56 58 401/. 0.7 0.9 1.1 1.3 1.5 1.7 1.9 2.2 24 26 2.8 3 3.2 3.4 3.6 3.8 4 4.3 4.5 4.7 4.9 5.1 5.3 5.S S.7 59 SOY. 0.9 1.1 1.3 1.5 1.7 1.9 21 23 2.5 27 3 3.2 3.4 3.6 3.8 4 42 4.4 4.6 4.8 5.1 5.3 S.S 5.7 5.9 6.1 55% 0.9 1.1 1.4 1.6 1.8 2 2.2 24 2.6 28 3 8.2 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 53 56 5.8 6 62 60% 1 1.2 1.4 1.7 1.9 21 2.3 2.5 2.7 2.9 3.1 3.3 3.S 3.8 4 4.2 4.4 4.6 4.8 5 5.2 5.4 5.6 5.9 6.1 63 65% 1.1 1.3 1.5 1.7 1.9 2.2 2.4 2.6 28 3 3.2 3.4 36 3.8 4 4.3 4.5 4.7 4.9 5.1 S3 55 5.7 5.9 6.1 64 70% 1.2 1.4 1.6 1.8 2 2.2 2.5 2.1 2.9 3.1 3.3 3.5 3.7 3.9 4.1 4.3 4.6 4.8 5 5.2 5.4 5.6 58 6 62 64 75% 1.3 1.5 1.7 1.9 21 2.3 25 2.7 3 3.2 3.4 3.6 3.8 4 4.2 4.4 4.6 4.8 5.1 5.3 5.5 5.1 5.9 6.1 6.3 6.5 80%. 1.4 1.6 1.8 2 2.2 2.4 26 2.8 3 3.3 3.5 3.1 3.9 4.1 4.3 4.S 4.7 4.9 5.1 54 5.6 5.6 6 62 64 66 85% 1.4 1.7 1.9 2.1 2.3 2.5 2.7 2.9 3.1 3.3 3.5 3.8 4 4.2 4.4 4.6 4.8 5 52 54 5.6 59 6.1 63 65 67 90% 1.5 1.7 2 2.2 2.4 26 2.8 3 3.2 3.4 3.6 3.8 4.1 4.3 4.5 4.7 4.9 5.1 53 5.5 5.7 5.9 6.2 64 6668 95% 1A 1.8 2 2.2 2.5 27 2.9 3.1 33 3.5 3.7 3.9 4.1 4.3 4.6 4.8 S 5.2 5.4 5.6 5.8 6 6.2 6.4 67 69 100% 1.7 1.9 21 2.3 2.5 28 3 3.2 3.4 3.6 3.8 4 4.2 4.4 4.6 4.9 5.1 5.3 5,5 5.7 5.9 6.1 6.3 6.S 6.7 7 IOS% 1.8 2 2.2 2.4 2.6 28 3 3.3 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.4 56 5.8 6 6.2 6.4 6.6 68 7 110%. 1.9 21 2.3 2.5 27 29 3.1 3.3 3.6 3.8 4 4.2 4.4 4.6 4.8 S 5.2 5.4 5.7 5.9 6.1 6.3 6.5 6.7 69 7.1 115% 2 2.2 2.4 2.6 2.8 3 3.2 3.4 3.6 3.8 4.1 4.3 4.5 4.7 4.9 5.1 5.3 5.5 S.7 5.9 6.2 6.4 6.6 6.8 7 7.2 120% 2 2.3 2.5 2.7 2.9 3.1 3.3 3.5 3.1 3.9 4.1 4.4 4.6 4.8 S 5.2 5.4 5.6 58 6 6.2 6.5 6.7 6.9 7.1 73 125%. 2.1 2.3 25 2.8 3 3.2 3.4 3.6 3.8 4 4.2 4.4 4.6 4.9 5.1 5.3 5.5 5.7 5.9 6.1 6.3 6.5 6.7 7 7.2 7.4 Point System Summary: Climate Zone 11 SCORE CARD Measures 1. Ceiling Insulation R I -W or R -value 1381 U -value [0.030] 2. Wall Insulation ( or R -value (I I) U -value [0.098] 3. Raised Floor Insulation or R-value[191 U -value [0.037] 4. Slab Edge Insulation 5. Infiltration 6. Glass Heat Loss 7. Shading (Shade Open) a. North b. East c. South d. West e. Skylight 8. Shading (Shade Closed) a. North b. East c. South d. West e. Skylight 9. .Interior Thermal Mass 10. Exterior -Wall plass 11. Heating System{j(,, Zonal Control? (Y,/ N ) 12. Cooling System Zonal Control? ( Y / N ) 13. Water Heating or R -value [01 F2 factor [0.77] Standard - 13 - 0, tandard /3.0, Type [double] U -value [0.65] % Total Glass (161 % Glass SCEff. % Glass ? .7.c X = a•31 .s•a X O X = D % Glass SC Eff. % Glass a.5 X 4 � X _- 5.� x = O X TYPE 1 MASS AREA % InteriorMiss/CFA COND. FLOOR AREA TYPE 2 MASS AREA = 8 Exterior Wall Mass OND. L OR AREA �� X • 3 SE or'HSPF Duct Efficiency 81 Effective SE or [0.72/6.61 HSPF [0-5615. 151 X SEER [9S] Duct Efficiency 10.741 Effective SEER [7.031 5(!;- Type [SG] Credit [none] Point Scores __2 If 0 -+:5 +f Sum 1-6 Sum 7-10 t_ O Point Total: t