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064-240-030
A.P.64-24-30 64-24-30 1536-90B OLFF; Kenneth a.o� 45 Olivet Drive Maol - _ b' EFTA, D . J.. Permit-1001-72(Utilities for a Mobile CONTR: James Hancock c� Home) 13876 Olivet Dr, Magalia �� Q`G 64-24-30 Jacques DeLanQre 13Ero Olivet, lot 18, Magalia contr-Para.Mod.Conc., Para. Permit #3:967-81P,E(util_",MH)� _ � ELEC.lt-2-$�1.2ooAV -_� GAS U - 2 - 81 N/116,K9, SUPPORT STRUCTURE,REQ.(�w _ COMPACTION TEST REQ: AX0 A 643:2` -39 contr ParMod.ConC., Para . Permit-,--f08--81MHI' Issue 64-24-30 Permit#4612-81B( w o en geck MH) 1 64-24-30 950-89B,P,E,M EFTA, D.J. 13876 Olive -Dr, Magalia (new single family) 1 �� FINALED: -64=24-30`� Permit#127+-69B,P,E,M(new single family) 64-24-30 1:'ermit#.2246789P.,.E(u il,._MH)._.__-_.____ ELEC. GAS SUPPORT STRUCTURE ZQ.COMPACTION TEST RE / 64-2 30 J ContR: Jim fields k Permit#2358-89MHI� 1/ "I Issued ADDITION OPEN DECK) 064-240-030 PERMIT -1127 ZIEL, Dave 13876 Olivet ., Magalia 0 Cont: Bru roderick & Dec epair/MH t✓` , 13176 01,06 Dr. Maga NaL zi elDavid f-,'Skrpa Obit 'StrYim 9 Su0 i Ex M" 00 pex`M iy)AI tic SlAt wa - - - M-M I N } RECORDING REQUESTED BY: AND WHEN RECORDED MAIL TO: BUTTE COUNTY BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE CA 95965 SPACE ABOVE THIS LINE FOR RECORDER USE ONLY NOTICE OF MANUFACTURED HOME (MOBILEHOME) OR COMMERCIAL COACH, INSTALLATION ON A FOUNDATION SYSTEM Recording of this document at the request of the local agency indicated is in accordance with California Health and Safety Code Section 18551. This document is evidence that such local agency has issued a certificate of occupancy for installation of the unit described hereon, upon the real property described with certainty below, as of the date of recording. When recorded, this document shall be indexed by the county recorder to the named owner of the real property and shall be deemed to give constructive notice as to its contents to all persons thereafter dealing with the real property. ZIEL, DAVID E. BUTTE COUNTY BUILDING DIVISION REAL PROPERTY OWNER/LESSOR LOCAL AGENCY ISSUING PERMIT and CERTIFICATE OF OCCUPANCY 7675 SKYWAY 7 COUNTY CENTER DRIVE MAILING ADDRESS MAILING ADDRESS PARADISE BUTTE CA 95969 OROVILLE BUTTE CA 95965 CITY COUNTY STATE ZIP CITY COUNTY STATE ZIP 13876 OLIVET DR B08-2109 530 538-7541 INSTALLATION MAILING ADDRESS, IF DIFFERENT BUILDING PERMIT NO. TELEPHONE NUMBER MAGALIA BUTTE CA 95954 10/24/2008 CITY COUNTY STATE ZIP SI NATURE OF OCAL AGENCY OFFICIAL DATE SAME ✓ NONE UNIT OWNER (if also property owner, write "SAME" DEALER NAME (if not a dealer, write "NONE") SAME NONE MAILING ADDRESS DEALER LICENSE NO. SAME CITY COUNTY STATE ZIP UNIT DESCRIPTION FLEETWOOD 1988 SANDALWOOD / 4602L MANUFACTURER'S NAME DATE OF MANUFACTURE MODEL NAME/NUMBER CAFLJI 7AM09894SW 61'X28' RAD474434/5 SERIAL NUMBER(S) LENGTH X WIDTH INSIGNWLABEL NUMBER(S) REAL PROPERTY LEGAL DESCRIPTION: SEE ATTACHED ASSESSOR'S PARCEL NUMBER: 064-240-030 HCD FORM 433(A) REV 8/91 WHITE— County Recorder CANARY — HCD PINK — Applicant GOLDENROD —Building Dept. Order No. 2423085-78 . Customer No. 13876 OLIVET COURT, MAGLIA EXIBBIT "A" PARCEL I: LOT 18, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "PARADISE PINES UNIT NO. 15', WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON JULY 15, 1971, IN BOOK 38 OF MAPS, AT PAGES 42, 43 AND 44. EXCEPTING THEREFROM ALL MINERALS, OIL, GAS, ASPHALTUM AND OTHER HYDROCARBON SUBSTANCES, WITH PROVISIONS THAT ANY AND ALL MINING OPERATIONS SHALL BE DONE FROM ORIFICES OUTSIDE THE SURFACE AREA OF THE LAND DESCRIBED HEREIN AND THAT NO DAMAGE SHALL BE DONE TO SURFACE OF SAID LAND. PARCEL II: A NON-EXCLUSIVE EASEMENT OVER LOTS A, B AND C(THE COMMON AREA) OF SAID PARADISE PINES UNIT NO. 15., AND THE LOTS DESIGNATED FOR COMMON AND RECREATION AREAS, AS DESCRIBED IN THE DECLARATION OF ANNEXATION FOR UNITS IV, VI„ VIII, X, XI, XII', XIII AND XIV. SIERRA MOBILE SERVICE SIERRA FOUNDATION LIC. NO. 470386 466 CIRCLE DR. 530-534-0599 - OROVILLE, CA 95966 PAY /�c P TO THE - I - ORDER OF l L1:s Qrmrul 0640 i 20251 90-2267-1211 DATE si oo ; DOLLARS 87 Eb bank® �FimStarSavimGu tccdusbank.com C - - u'02025Lu■rt is L2 1122E76i: L5340L40392SO FOUNDATION SYSTEM CERTIFICATE OF OCCUPANCY BUILDING PERMIT NUMBER: B08-2109 Address or location of unit: 13876 OLIVET DRIVE, MAGALIA CA 95954 Legal Description of Real Property: 064-240-030 SEE ATTACHED (x) Mobilehome/Manufactured Home () Commercial Coach Has been affixed to the real property above by installation on a foundation system pursuant to Health and Safety Code Section 18551. Owner's name: ZIEL, DAVID E. Owner's address:7675 SKYWAY, PARADISE CA 95969 INSIGNIA OR HUD NUMBER: RAD474434/5 SERIAL NUMBER OR V.I.N.: CAFLJI7A/B09894SW MANUFACTURER'S NAME: FLEETWOOD YEAR: 1988 OFFICIAL APPROVING INSTALLATION: L. DATE:10-24-2008 PHONE: (530) 538-7541 H.C.D. 513 J R FOUNDATION SYSTEM CERTIFICATE.OF OCCUPANCY BUILDING PERMIT NUMBER: B08-2109 Address or location of unit: 13876 OLIVET DRIVE, MAGALIA CA 95954 Legal Description of Real Property: 064-240-030 SEE ATTACHED (x) Mobilehome/Manufactured Home () Commercial Coach Has been affixed to the real property above by installation on a foundation system pursuant to Health and Safety Code Section 18551. Owner's name: ZIEL, DAVID E. Owner's address:7675 SKYWAY, PARADISE CA 95969 INSIGNIA OR HUD NUMBER: RAD474434/5 SERIAL NUMBER OR V.I.N.: CAFLJI7A/B09894SW MANUFACTURER'S NAME: FLEETWOOD YEAR: 1988 OFFICIAL APPROVING INSTALLATION: L DATE:10-24-2008 PHONE: (530) 538-7541 H.C.D. 513 0DELITY N TIONAL TITLE CO. REC JRDING REQUESTED BY: T.D. Escrow S)services Escrow No. 6056-.)L Title Order No. 242308°-78 When Recorded Mail Document and Tax Statement To: David E. Ziel 2250 B 5th Ave. Oroville, CA 95965 1 998-000791Ia 1 Recorded I REC FEE 10.80 Official Records I TAX 31.35 County Of I CANDACEutte 1. GRUBBS I 09 U M 03 -Mar -1998 I Pagell of 2 GRANT DEED SPACE ABOVE THIS LINE FOR RECORDER'S USE The undersigned grantor(s) declare(s) Documentary transfer tax is $-3/.�Y [ X ) computed on full value of property conveyed, or [ I computed on full value less value of liens or encumbrances remaining at time of sale, 1 Unincorporated Area City of Magalia i FOR A VALUABLE CONSIDERATION, receipt of which is hereby acknowledges , WELLS FARGO BANK, N. A. hereby GRANT(S) to David E. Ziel, . a married man: as his sole and separate property. the following described real property in the City of Magalia I County of Butte, State of California: SEE EXHIBIT "A" ATTACHED HERETO AND MADE A PART THEREOF DATED: February 11, 1998 STATE OF O� "� WE" FARGO NK, N ,A. COM13 OFW �. �) N1 before me, By: �(� - l -1 personally appeared i David A: -Rhodes &dEnod(�> personally known to me (or proved to me on the basis of satisfactory evidence) to be the person(s) whose name(s) is/are subscribed to the within instrument and acknowledged to me that he/she/they executed the same in his/her/their authorized capacity(ies), and that by his/her/their signature(s) on the instrument the person(s), or the entity upon behalf of which the person(s) acted, executed the instrument. Witness my hand and official seal. �. Signature 9 FD -213 (Rev 9/94) MAIL TAX STATEMENTS GRANT D OFFlCULSEAL BARBARA NEWLANDS NOTARY PUBLIC -OREGON COMMISSION NO. 058624 W COMMISSION DM OCT. 17, 2000 DIRECTED 10%14/2006 6:31 FIDELITY TITLE OROVILLE 1 5340709 STATE Of CALIFORNIA • MINOS,_TNANapop'+ ]N ANP MOU81N0 AGENCY Apr � DEPARTMENT OF HOUSING AND C�bMMUNITY DEVELOPMENT � 01vialm of Codas end Standanb . 'Tule Search De.te Printed 08/03/2007 DecaI #: LAN6001 Use Code: Manufacturer; 09534 FLEETWOOD HM Original Price Code: T.radenarne: SANDALWOOD Rating.Year: Model: 4602L Tax Type: ManufacWied Dau:: 12/i6/19R8 . Last ILT Amount: ReRisu-ation %x1:1' Date .l'LT Fee Paid: First Sold Or.:: 07/25/1989 ILT Exemption: Serial Ninber HUD Label / Insipi Length W CAFLJ17A09894SW R-0474434 61' CAEL117RO9894SW RAD474435 61' Record Conditions: PPF Exempt Registered. Owner. DAVID E ZIEL 13876 OLIVET DRIVE MAGALIA, CA 95954 Last Tide Date: 1 I /07/2001 La®t Reg Curti: 11/170001 Rnle/Traosfor .Info: /'rice 528.500.00 Trulsfened on 03/03/1998 Situs Address: Legal Owner-. 13876 6LIVET DRIVE MAGALIA, CA 95954 SINS t..'Ol[I1Ty: BUTTE NO. 567 00 EILEEN L HEWITT SOLE TRUSTFt OF T11E HEWITT TRUST DTD 081892 CIO BUTTE MORTGAGE LOAN CO 2120 LINCOLN ST OROVILLE, CA 95966 1 Last Title Datet 11107/2001 Lion Perfected Oat '10/1712001 10:46:09 Title Searches: FTDELrTY NATIONAL TITLE � 455 ORD DAM BLVD SUITE A I OROVILLE, CA 95065 1 T tie Fik Nol 109458 I F;ND OF TITLE SEARCii $*� BUTTE WUNTY AREA DEPARTMENT OF DEVELOPMENT SERVICES 3 INSPECTION CARD MUST BE ON JOB SITE 24 Hour Inspection Line (IVR) :(530) 538-4365 Office: (530) 538-7541 Fax: (530) 538-2140 Website for Online Permits/Renewal Pavments: www.buttecountv.net/dds Permit No: B08-2109 Issued: 10/16/2008 Address: 13876 OLIVET DR Area: MAGALIA Owner: ZIEL, DAVID E. Applicant: SIERRA MOBILE SERVICE & SUPPLY Permit Type: SFD-Mobile Home RET APN: 064-240-030 Description: EX MH ON PERM FND, EX SITE Flood Zone: None SRA Area: Yes I Front: Ultimate R/W from CL: Rear: SRA: Side: AG: Other: Total Setback from Centerline of Road:+ ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING Inspection Type IVR INSP DATE Setbacks 132 Foundations / Footings 111 Pier/Column Footings 122 Grade Beams 114 Eufer Ground 216 Forms/Steel/Holdowns 122 Do Not Pour Concrete Until Above are Signed Pre -Slab 124 Gas Test House 404 Gas Test Yard 404 Masonry Grout 120 Masonry Bond Beam 119 Underfloor Framing 149 Underfloor Ducts 319 Shear Transfer 136 Under Floor Plumbing 412 Under Slab Plumbing 411 Gas Piping 403 Do Not Install Floor Sheathing or Slab Until Above Signed Holdowns/Straps 122 Shearwall/B.W.P.-Interior 135 Shearwall/B.W.P.-Exterior 135 Roof Nail/Drag Trusses 129 Do Not Install Siding/Stucco or Roofing Until Above Signed Rough Framing 128 Rough Plumbing 406 Rough Mechanical 316 Rough Electrical 208 Gas Piping 403 Shower Pan/Tub Test 408 Fire Sprinkler Test 702 Fire Sprinkler Final 702 Building Fina 802 Electrical Final 803 Mechanical Final 809 Plumbing >~ inal 813 Pool Final 802 Mobile Home Final 802 Ins ection Type I IVR I INSP I DATE Do Not Insulate Until Above Signed Wall Insulation 117 Ceiling Insulation 118 Do Not Cover Until Above Signed T -Bar Ceiling / RC 145 Stucco Lath 142 Stucco Scratch 143 Stucco Brown 144 Swimming Pools Setbacks 132 Pool Plumbing Test 504 Gas Test 404 Pre-Gunute 506 Pool ElecBonding/Light Nitch 502 Pool Fencing/Alarms/Barriers 503 Pre -Plaster 507 Manufactured Homes Setbacks 132 Blocking/Underpining 612 Tiedown/Foundation System 611 Site Utilities/Trench Insp. 137 Gas Test Yard 404 Manometer Test 605 Continuity Test 602 Skirting/Steps/Landings 610 Coach Info Manufactures Name: Date of Manufacture: Model Name/Number: Serial Numbers: Length x Width: Insignia: Filals i Public Works Final 538-7681 Fire Department/CDF 538-6226 Env. Health Final 538-7281 Sewer District Final "PROJECT FINAL 801 rtl -rrolecr anal is a t,ermicate of occupancy for tmesioennai uniy) PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE. IF WORK HAS COMMENCED, YOU MAY PAY FOR A I YEAR RENEWAL 30 DAYS PRIOR TO EXPIRATION Inspector Copy s BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION (IVR): (530) 538-4365 OFFICE: (530) 538-7541 FAX#: (530) 538-2140 ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds FEE INFORMATION DBF MH Plan Check $241.16 DBMSC Mobile Home Permit Fee. $361.74 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires SIERRA MOBILE SERVICE & S 470386 / C47 B / 03/31/2009 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000of Division 3 of the Business and Professions Code, and my license is in full force and effect. X 10/16/2008 Contractor's Signature Date WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. AVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued My Workers' Compensation insurance carrier and policy number are; Carrier: State Fund Policy Number.046-0004257 Exp. Date:01/01/2009 (This section need not a competed if the permit is or one �n reed dollars ($100) or less. ❑I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Q 10/16/2008 Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lender's Address City State Zip Balance Due: $602.90 No: OWNER / BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a peril to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: EI, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). ❑I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code: The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). ❑ I AM EXEMPT under Section B. & P.C. for this Owner's Signature 10/16/2008 Date I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnity, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the property owner or am authorized to act on )he property owner's behalf. ft f_ t D QJa dv 10/16/2008 Owner 0 Contractor OR. Agent for Owner Agent for Contractor FILE COPY PROJECT INFORMATION Site Address: 13876 OLIVET DR Owner' Permit NO: B0$-2109 APN: 064-240-030 ZIEL, DAVID E. Permit type: RESIDENTIAL 7675 SKYWAY Issued Date: 10/16/2008 By KCG Subtype: SFD-Mobile Home RET PARADISE, CA 95969 Expiration Date: 10/16/2009 Description: EX MH ON PERM FND, EX SITE Occupancy: Zoning: RT1 Contractor Applicant: Square Footage: SIERRA MOBILE SERVICE & SUPPLY SIERRA MOBILE SERVICE & Building Garage RemdUAddn 466 CIRCLE DRIVE 466 CIRCLE DRIVE OROVILLE, CA 95966 OROVILLE, CA 95966 Other Porch/Patio Total (530) 534-0599 (530) 534-0599 FEE INFORMATION DBF MH Plan Check $241.16 DBMSC Mobile Home Permit Fee. $361.74 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires SIERRA MOBILE SERVICE & S 470386 / C47 B / 03/31/2009 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000of Division 3 of the Business and Professions Code, and my license is in full force and effect. X 10/16/2008 Contractor's Signature Date WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. AVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued My Workers' Compensation insurance carrier and policy number are; Carrier: State Fund Policy Number.046-0004257 Exp. Date:01/01/2009 (This section need not a competed if the permit is or one �n reed dollars ($100) or less. ❑I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. Q 10/16/2008 Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lender's Address City State Zip Balance Due: $602.90 No: OWNER / BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a peril to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: EI, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). ❑I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code: The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). ❑ I AM EXEMPT under Section B. & P.C. for this Owner's Signature 10/16/2008 Date I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnity, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County to enter the above mentioned property for inspection purposes. I hereby certify that I am the property owner or am authorized to act on )he property owner's behalf. ft f_ t D QJa dv 10/16/2008 Owner 0 Contractor OR. Agent for Owner Agent for Contractor FILE COPY BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION* OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds PLEASE PRINT CLEARLY PERMIT NO. BIN # "When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. OWNER INFORMATION Last Name.-- I C A First Name p#U j p Mailing Address i3 7W L, d E T 1__>A_7 r N £ City M State A Zip Phone Fax E-mail CONTRACTOR Name iE h tA06(_E 6Er2�tCE . Address YGG Ct.kcs-E DQiVE City 01e001L L E State eA Zip %r -f 6 6 Phone53o Say 0599 Fax S30 S -3y 0709 E-mail Lic. # /-/ 70 396 Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City 04 Vt 6-�. E Address Zip 9 s76 6 City Fax 7, , 4 a y 0 7 0-7 State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name Address Y66 !'!R�!-f l�Rt✓E City 04 Vt 6-�. E state CA Zip 9 s76 6 PhoneS3o 5.3y p 5-% `f Fax 7, , 4 a y 0 7 0-7 E-mail APPLICANT SIGNATURE X PROJECT LOCATION AP# 6/ c/ :�[ qo v3 U Property Address 13 6 76 c�A i ver O/P r ✓E City M 0,6 0 J- iA C.' N 9S 9.s -Y WORKER'S COMPENSATION Policy Number Carrier ! n4E A4_ JP. INS. `✓"V O Nhiring anyone other 'Pan licensed contractors, a certificate of worker's compensadoq must be shown at the time of permit issuance. A Address DESCRIPTION OR SCOPE OF WORK: I N S rA AJ- /C E re F/T Fow N DA i �q FT- Living Garage Open Cov i I.D. Structure Built without Permits CQ Proposed Change of Occupancy (Note previous use): For office use only: ; Zoning J Flood Zone I SRA I Yes I No Occ. Type Const. P A v t G. ? 1 F. 13�?6 O�1 �lr r 6�,�.t✓E I„ t 606 210 BUTTE COUNTY BUILDING DIVISION SPR®VE C(���t0ar 10-16-cfb CON K.C-T. Xi2 Foundation System Installation Instructions for California for Ground & Concrete Systems HUD Wind Zone 1, 15 PSF Wind Load Seismic 4 By Tie Down Engineering Xi2 Ground System s 1r Xi2 Concrete System APPROVED Engineer Approval State Approval MANUFACTURED HOMEIMOBTLE HOME FOUNDATION SYSTEM HEALTH AND SAFETY CODE, SECTION 18551 APPROVED SUBJECT TO CORRECTIONS NOTED APPROVAL DOES NOT AUTHORIZE OR APPROVE ANY OMISSIONS OR DEVIATION FROM REQUIREMENTS OF APPLICABLE STATE LAWS AND REGULATIONS State of Califomis Depwtoeat of Ho= ft end Comtnanity Dawdopmeat sY I=, 1�BS AND ARD' aL=MATE o a!_ (swat=)SPAI30. This Plan Appton! Bttphes Page 1 of 8 m C LO 0 0 0 X 2 Foundation System Installation Instructions for California for Ground & Concrete Systems OOOW-- HUD Wind Zone 1, 15 PSF Wind Load Seismic 4 By Tie Down Engineering REQUIREMENTS • These plans and specifications meet the requirements of Title 25 Section 1336.3 Sub Section A and 97 UBC Seismic Requirements, CBC 2001 addition. • Maximum vertical projection at sidewall is 9'. Higher walls may be used when the design loads are adjusted accordingly and approved by HUD. • Main rail spacing must be 75.5" - 99.5" * Except single sections 95" minimum • Additional vertical anchor ties that are unique to a home's design may be required by the home manufacturer. These locations may include shear walls, marriage line ridge beam support posts, and rim plates. The longitudinal component of the Xi2 system replaces end frame ties. Check manufacturers set-up requirements. • Maximum pier height is 48" pier. `Except for single sections 36". • Steel piers must be fastened to the I-beam with clamps provided with steel pier. • Systems must be placed as evenly as possible, no more than 10' from end of home. • Designed for 7:12 roof slope. *Except single sections, (20° - 4.37 in. 12" pitch). Additional Requirements for Concrete Systems • Poured concrete must be 2,500 PSI minimum at 28 days. • Square concrete pads minimum is 18" wide by 12" deep. Round concrete pads minimum is 18" wide by 14" deep. Strip footings minimum is 18" wide by 14' long by 6" deep. * Xi2 components exceed HUD code 3280.306g "Anchoring equipment exposed to weathering shall have a resistance to weather deterioration at least equivalent to that provided by a coating of zinc on steel of not less than 0.30 ounces per square foot of surface coating...." Page 2 of 8 0 0 0 0 Installation of A2 Ground Systems 1. Identify the number of systems to be used on the home using the chart provided. 2. Identify the location where the systems will be installed. 3. Clear all organic matter and debris from the pad site. 4. Place U -bolts through holes in pan provided. 5. Place pad centered under beam with the lateral strut bracket towards the inside of the home. 6. Press or drive pan into ground until level and flush with prepared surface. i 7. Build pier according to State, Local or Home Manufacturers guidelines. (Figure 1) 8. Attach the end of the smaller tube to the inside of pan using U -bolt &nuts provided 9. Attach the flag end of the larger tube to the opposite I-beam using the "J" bolt over the top of the I-beam f; with the nut & washer provided. (Figure 2) 10. Install a minimum of four (#12 x 1 " tek screws) self -tapping screws into the holes provided in the lateral strut so ! that the two tubes are connected together. (Figure 1) 1-3/4" Tube ' Lateral Struts J -Bolt Nut & Washer ®� Strut (flag end) tE;4z 4-TekFi ure 2 Figure 1 Fnd o f No,?1 e 0 11. Install frame bracket clamps to I-beam on in side of block/pier. Do not tighten nuts at this time. 12. Attach longitudinal strut to U -bolt in pan using nuts provided. 13. Insert strut in the frame bracket clamp, attach with nut and bolt. Do not tighten at this time. 14. Pull the frame bracket clamp with the fastened strut outward to remove any slack. 15. Tighten all nuts and bolts on the struts and beam clamps. A, 30336 oao� %/E 49- DOWN ENGINEERING 1 Xi2 Ground Parts Detail Xi2 Ground Lateral System Part Number 59306 Includes: 5' Strut, pad & hardware kit (#59329-1 includes all nuts and bolts). Longitudinal Hardware Kit Part Number 59331 Includes: 2 I-beam brackets & 2 U -bolts with all nuts and bolts. Lateral and Longitudinal Combination Part Number 59333 Includes: 5' Strut, Pad, Longitudinal Strut (#59329), Lateral and Longitudinal Hardware Kit with all nuts and bolts. Struts for Longitudinal Systems Part Strut Pier Height No. Length Up To: 59330-44 44" 4 Blocks or 32" 59330-65 65" 6 Blocks or 48" Ground Longitudinal Hardware Kit Xi2 Ground Longitudinal Strut & Hardware Kit Ground Longitudinal Strut Xi2 Stabilization Pier Placement for Ground or Concrete Xi2 Pier Placement Single Section Home 0 -80' (76' Box) 4 Xi2 Systems Double Section Home 0 -62' 3 Xi2 Systems` 63' - 80' 4 Xi2 Systems *2 Xi2 systems can be placed at either end of the home. Additional Xi2 Pier Placement Triple Section Home 0 -62' 4 Xi2 Systems 63' - 80' 5 Xi2 Systems Page 4of8 TIE DOWN ENGINEERING l Installation of Xi2 Concrete Systems 1. Identity the number of systems to be used on the home using the chart provided. 2. Identify the location where the systems will be installed. 3. Build pier according to State, Local or Home Manufacturers guidelines. 4. Drill two 3/8"x 3" deep holes in the concrete using holes in galvanized bracket as a guide. Attach bracket to concrete pad using 3/8"x3-1/2" wedge anchors provided. Place nut & washer on anchor, leave enough room for 1 to 2 threads showing on top of bolt. Using a hammer, tap the wedge bolts into hole through bracket, leaving nut & washer flush with bracket. Using a 9/16" socket wrench, tighten wedge/anchor bolt, securing bracket to the concrete. 5. Attach the end of the smaller tube to the bracket mounted on the pad, using the grade 5, 1/2" x 2-1/2" bolt/nut provided. 6. Attach the flag end of the larger tube to the opposite I-beam using the "J" bolt over the top of the I-beam with the nut & washer provided. (Figure 1 next page) 7. Install a minimum of four (#12 x 1 " tek screws) self -tapping screws into the holes provided in the lateral strut so that the two tubes are connected together 8. Install frame bracket clamps on I-beam on the inside of block/pier. 9. Insert strut in frame bracket clamp and attach with nut & bolt. Attach opposite end to concrete bracket. 10. Pull the frame bracket clamp with fastened strut outward to remove any slack. 11. Tighten all nuts and bolts on system. Page 5 of 8 4, 30336 TIE 49-0401 DOWN ENGINEERING • 0 L 0 0 0 Xi2 Lateral Concrete Systems Part #59307 Includes: 5' Strut, Bracket, & Hardware Kit #59315-1 with all nuts and bolt. Longitudinal Struts for "Concrete Systems" Part No. Length Pier Height #59013 44" up to 4 Blocks #59015 65" up to 6 Blocks Longitudinal Hardware Kit Part #59263 (Includes 2 sets per kit: I-beam bracket, nuts, bolts and washers) Lateral and Longitudinal Combination Part #59332 Includes: 5' Strut, Longitudinal Strut (#59364), Lateral and Longitudinal Hardware Kit with all nuts and bolts, Nut & Washer Figure 1 Beam Clamp /-' Bracket J -Bolt Lone Xi2 Installation Placement -Beam i 4( v' �1( Longitudinal Strut Xi2 Concrete System end e Home 1V� tt, cb c� Concrete Longitudinal Hardware Kit TIE:DOWN ENGINEERING• 5901 Wheaton Drive • Atlanta GA, 30336CI�G% www.tiedown.com • (404) 344-0000 • FAX (404) 349-0401 DO ----- ----- -- - r'r `! - ------ — -- — - - - ENGINEE Offset Placement Diagrams represent examples of double and triple section offsets. Total size is determined by the length of unit plus offset. Xi2 Stabilization Pier Placement for Ground or Concrete Single Section Home 0 -80' (76' Box) 4 Xi2 Systems Xi2 Pier Placement Double Section Home 0 -62' 3 Xi2 Systems' 63' - 80' 4 Xi2 Systems *2 Xi2 systems can be placed at either end of the home. Triple Section Home 0 -62' 4 Xi2 Systems 63' - 80' 5 Xi2 Systems Page 7 of 8 HCD lv-r-Ae- TIE DOWN ENGINEERING - 0 LO 0 0 0 Hardware Breakdown #59329-1 Hardware for 59306 Lateral System 1 84533Z U -Bolt 1/2-13 x 2.63 x 2.19 thread Beam Clamp Base 1-3/4 zinc 4 10556 Tek Screw #12 x 1 " 1 10631Z J Bolt 1/2 x 5-1/2 grade 5 zinc 2 10640 Push Nut 1/2 1 12107 Flat Washer 1 x2" SS 1 10646Y Hex Nut 1/2-13 grade 5 zinc 2 10519 Hex Nut 1/2" w/ Serr flange #59331 Longitudinal Hardware for 59306 2 59272-1 Beam Clamp Base 4 59272-2 Beam Clamp Top Flange 8 10926 Carriage Bolt 112-12 x 1-1 /4 Carriage Bolt 1/2-12 x 3 full thread Full Thread 10 10646Y Hex Nut 1/2-13 grade 5 zinc 2 10801 Carriage Bolt 1/2-12 x 2-1/2 U -Bolt 1/2-13 x 2.63 x 2.19 Thread 6 10646Y Grade 5 2 84533Z U -Bolt 1/2-13 x 2.63 x 2.19 thread Hex Nut 1/2" w/Serr Flange 1-3/4 zinc 4 10640 Push Nut 1/2 4 10519 Hex Nut 1/2" w/ Serr flange # 59329 Hardware for 59333 Lateral and Longitudinal combination 1 59329-1 Hardware Kit 1 59272-1 Beam Clamp Base 2 59272-2 Beam Clamp Top Flange 4 10926 Carriage Bolt 1/2-12 x 1-1 /4 Carriage Bolt 1/2-12 x 3 full thread 5 10646Y Hex Nut 1/2-13 Grade 5 zinc 1 10801 Carriage Bolt 1/2-12 x 2-1/2 4 Grade 5 zinc 1 84533Z U -Bolt 1/2-13 x 2.63 x 2.19 Thread 6 10646Y 1-3/4 zinc 2 10640 Push Nut 1/2 2' 10519 Hex Nut 1/2" w/Serr Flange #59315-1 Hardware for Lateral System 1 10631Z J Bolt 1/2 x 5-1/2 Grade 5 zinc 1 12107 Flat Washer 1/2" SS 4 10556 Tek Screw #12 x 1 " 2 10646Y Hex Nut 1/2x-13 Grade 5 zinc 1 10826 Carriage Bolt 1/2-12 x 3 Beam Clamp Top Flange Grade 5 zinc #59027 Hardware Kit for 59307 Lateral System 2 59264 3 Way Concrete Bracket 4 10530 Wedge Anchor 3/8 x 3.50 1 59315-1 Hardware Kit #59263 Longitudinal Hardware for 59307 2 59272-1 Beam Clamp Base 4 59272-2 Beam Clamp Top Flange 8 10926 Carriage Bolt 1/2-13 x 1-1/4 2 59272-2 Beam Clamp Top Flange Full Thread zinc 12 10646Y Hex Nut 1/2-13 Grade 5 zinc 4 10801 Carriage Bolt 1/2-13 x 2-1/2 Grade 5 zinc 6 10646Y Grade 5 zinc #59364 Hardware for 59332 Lateral and Longitudinal combination 1 59264 3 Way Concrete Bracket 2 10530 Wedge Anchor 3/8 x 3.50 1 59315-1 Lateral Hardware Kit 1 59272-1 Beam Clamp Base 2 59272-2 Beam Clamp Top Flange 4 10926 Carriage Bolt 1/2-13 x 1-1/4 Full Thread zinc 2 10801 Carriage Bolt 1/2-13 x 2-1/2 Grade 5 zinc 6 10646Y Hex Nut 1/2-13 Grade 5 zinc Page 8of8 --- ---- -- -- o tlanta GA, 30336 1 l,- TIE 61 (404) 349-0401 DOWN Ae- i ,.,ySw.��.vu.'.:+e+'away:.rYr+Sa++yv��c!'}A,I:sv'r'.��`""^7.a?Y,mr-"Y,w•w.�r�cy,tcf�+,},x,+.��++�cef�:s::.. 064-240-030 PERMIT#98-1127 ZIEL, Dave ,i 13876 Olivet Dr., Magalia Cont: Bruce Broderick Deck Repair/MH y I 3 -.. -,-�.R._.-..-^. •f.....,q, ,_ .•.w— '-nT+'T,:,,,�"'�*P+�^ ^r+r�'FC''�r+`�"�'fc, f �:; 9 "x'0""7 _ .T; .. .+ COUNTY OF BUTTE- DEPARTMENTOF DEVELOPMENT SERVICES- BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PER(NIT NO. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 064-240-030 ZONING R1 BUILDING PERMIT OWNER DAVE ZIEL TELEPHONE SO. FT. OCC. BUILDING VALUATION �T�� ` ( O � R • (�(� 1200 OWNERS MAILING ADDRESS 13876 OLIVET DR MAGALIA CA 95954 CONTRACTOR'S NAME BRUCE BRODERICK TELEPHONE CONTRACTOR'S MAILING ADDRESS P 0 BOX 2231, PARADISE. CA 95969 CONSTRUCT IttO{{Nyy��LENDER Fireplace LENDER'! ADDRESS Total Valuation $ ARCHITECT OR ENGINEER NONE LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 29.00 ARCHITECT OR ENGINEER'S MAIUNG ADDRESS Plan Checking Fee $ BUILDINGADDRESS Energy Plan Checking Fee $ PERMIT FEE = 49.M LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ELK Other SPECIFY Each Trap 7.00 - Solar or heat um water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Otherya Describe Work: DECK REPAIR Gas piping system 1- 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 EOOY OR LESS Main Service ZoonoR. S 23.00 LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is j II force and effect. / O License Class LIC. NO. b OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 4as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO I000A 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( & ACC. BIDS. SO 3.5¢FT. NEW CONST. MULTI.OUTLET =.-RES ID I @7.50 POWER APPARATUS 8 SINGLE OUTLET CIR. EX. Occup. OUTLET OR FDTTURES 20 Q '•50 BAL Q .SO Ex. Occup. ouiLEE:Ts AEs o.oFRA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 LE PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) A certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall f w7th comps those provisions. < .o l y X .1/-- ._� / Date �/ ? /� _ Signature -of Applicant - ❑ Owner [WContractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 49.00 HAZ. D. FEES IMP I FLOOD I CDF PARCEL pD HD ISSU This permit is hereby issued under of the Butte County Code and/or indicated.ebove for whi h fees have By tl 14W PERMIT EXPIRES ON the applicable provisions Res lutions to do work en paid. 0/4/98 Date _ 6/4/99 Oata ReceiptNo. 2 3-IM2 WHITE -D. D. S.. B. D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT January 21, 1999 Dave Ziel 13876 Olivet Drive Magalia, CA 95954 Dear Mr. Ziel: RE: Permit Required A.P. #064-240-030 We received a letter from Bruce Broderick concerning a permit he applied for your property. He stated that the work was done by someone other him. A permit is required for the work done. You need to come into our office and apply for a permit within thirty days. If you should have any questions, please contact Scott Rutherford of this office at 538-7541 Your very truly, Mich el C. Vie' a, C.B.O. Manager, Building Inspection MCV:aam utte Count L A N D O F NATU RAL WEALTH A N D BEAUTY BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE • OROVILLE, CALIFORNIA 95965-3397 TELEPHONE: (530) 538-7541 FAX: (530) 538-2140 January 21, 1999 Dave Ziel 13876 Olivet Drive Magalia, CA 95954 Dear Mr. Ziel: RE: Permit Required A.P. #064-240-030 We received a letter from Bruce Broderick concerning a permit he applied for your property. He stated that the work was done by someone other him. A permit is required for the work done. You need to come into our office and apply for a permit within thirty days. If you should have any questions, please contact Scott Rutherford of this office at 538-7541 Your very truly, Mich el C. Vie' a, C.B.O. Manager, Building Inspection MCV:aam tte Count LAND OF NATURAL WEALTH AND BEAUTY 77� BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE • OROVILLE, CALIFORNIA 95965-3397 TELEPHONE: (530) 538-7541 FAX: (530) 538-2140 January 21, 1999 Dave Ziel RE: Permit Required 13876 Olivet Drive A.P. #064-240-030 Magalia, CA 95954 Dear Mr. Ziel: We received a letter from Bruce Broderick concerning a permit he applied for your property. He stated that the work was done by someone other him. A permit is required for the work done. You need to come into our office and apply for a permit within thirty days. If you should have any questions, please contact Scott Rutherford of this office at 538-7541. Your very truly, Michel C. Vielra, C.B.O. Manager, Building Inspection MCV:aam BRODERICK COMPANY General Building Contractor #360432 P.O. Box 2231, Paradise, CA 95967 Phone: (530) 877-6432 Fax: (530) 877-6164 January 19, 1999 Butte County Dept. of Development Services Building Division 7 County Center Drive Oroville, CA 95965 Dear Person, I am canceling the permit dated 6/4/98 for AP# 064-240-030, owner Dave Ziel, 13876 Olivet Dr., Magalia, CA, 95954. The permit was for a deck repair. The owner voided his contract with me by having another carpenter work on the deck without my knowledge or consent. Please close this permit and refund the fee to the above address. Thank you for your attention to this matter. -01678 MM r Received from The Sum ofd For COUNTY pF g TTE- CIAL RECEIP ^ � � O ` < 1 \S t ` ICE R D ART LISSUIN ._ RECEIPT Received: CASH Received By_ CHECK '�9 Title- OAVCO BUSINESS FORMS .BY (916) 743-8511 - - Y COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES BUILDING DIVISION NOTICE Post this job card In a safe conspicuous place. Do not remove until all required inspections are made and building Is approved for occupancy. Plans must be available on the job site. A.P. No. 064-240-030 Owner DAVE ZIEL Contractor BRUCE BRODERICK Permit No. NEW Expires 6/4/99 PERMITTEE MUST CALL FOR INSPECTIONS Piers Underground Conduit Pre-Gunite Underfloor Electrical Underfloor Mechanical Underfloor Framing Slab :Uo Not Install Hoor>or Slab; Until Above Sion,eu " Rough Plumbing Rough Electrical Rough Mechanical Framing Shower Pan Do Not Insulate;Until Above`S gned ....... Insulation Dol �ot over,Untioveigne� Fireplace Footing Do Not Continue Fireplace<Unttl Above Signed ....:...........::.::................... Stucco Lath Scratch and Brown Do Not Cover Until: Above:;Signed .... .. . Sewer Service Water Service Pool Final Plumbing Final Electrical Final Mechanical Final Building or M.H. Final DO NOT OCCUPY UNTIL ALL THE ABOVE IS SIGNED AND THE BUILDING OR MOBILE HOME IS APPROVED FOR OCCUPANCY Addresses. Information`:: . 4= r ns Oroville 7 County Center Dr. 538-7541 538-7636 Chico 1469 Humboldt Rd. 891-2751 891-2834 Revised 7/94 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING DIVISION FOR YOUR CONVENIENCE USE THIS CARD WHEN CALLING FOR INSPECTION 24 HOUR INSPECTION RE SERVICE PHONE NUMBERS: Oroville Office: Chico Office: 91-28 4 (Lines will be out of service 7:30 A.M. to 8:00 A.M.) Please write down your information prior to calling this number. Speak slowly and clearly. Sequence of information required to make inspection request: Building Permit # Owner's Name Job Location Type of Inspection Wanted Date Inspection Wanted PLEASE USE THIS SERVICE FOR ALL INSPECTION REQUESTS For other business contact: Oroville Office - 538-7541 (Mon-Thurs, 8:00 - 4:00) Chico Office - 891-2751 (Mon-Thurs, 8:00-12:00 & 1:00-4:00) BUTTE COUNTY NAME ADDRESS PLEASE POST THIS IDENTIFICATION CARD IN A CONSPICUOUS PLACE AND VISIBLE FROM THE ROAD 12/2/90 A.P.N. (Rev. 12/96) COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 APPLICATION AND PERMIT PERMIT NO. pSgEggpqqqC LNUMB R –030 ZONING Rl BUILDING PERMIT OWNER DAVE ZIII, TELEPHONE SO. FT. OCC. BUILDING VALUATION • 1200 OWNERSMAILING ADDRESS 13876 OLIVET DR, MAGALIA CA 95954 CONTRACTOR'S NAME BRUCE BRODERICK TELEPHONE ' CONTRACTORS MAILING ADDRESS P 0 BOX 2231. PARADISE CA 95969 CONSTRUCTION LENDER MN Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER NONE LICENSE NO. -FilingFee $ 20.00 Permit Fee $ 29.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 13876 OLIVET DR. MAGALIA Energy Plan Checking Fee $ $ PERMIT FEE _ 49.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome EX Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 1 5.00 TYPE OF WORK v New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other . Describe Work: DEM REPAIR Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S I G W1 1 @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service iooaoALEss 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in -full force and effect. License Class Lic. No. ✓ i OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( & ACC. BLDS. SO 3.5¢FT. NEW CONST. MULTI -OUTLET NON-RESID. BRANCH CIRCUITS@7.50 POWER APPARATUS d SINGLE OUTLET CIR. EX. Occup. OUTLET OR FIXTURES 20 Q 100 �,L so Ex. Occup. ouTtEEDTs REESIU.OFR-A 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Policy Number (The above sections need not be completed if the permit is for work of a valuation 04of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall fgrt with comply; w3h tliose provisions. f i X ' �� �' ' ` '� Date _? _ Signature of Applicant - ❑Owner BIContrector ❑Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ �� fY1 HAZ. D. FEES IMP FLOOD I COF PARCEL 1 PD HD IS This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated,a6ove for which fees have been paid. J 6/4/98 �l r l By (:zx, .l P �f 7 Date _ 6 X/9-9— PERMIT EXPIRES ON Date ---+�s. y Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-754�,y /�J J NO, `? S/ (Rev. 12/96) APPLICATION AND PERMIT '/ ASSESSOR PARCEL NUMBER 064-240-030 ZONING R1 BUILDING PERMIT OWNER DAVE ZIEL TELEPHONE SO. FT. OCC. BUILDING VALUATION CONTR . 1200 OWNER'S MAILING ADDRESS 13876 OLIVET DR., MAGALIA CA 95954 CONTRACTOR'S NAME BRUCE BRODERICK TELEPHONE ' CONTRACTOR'S MAILING ADDRESS P 0 BOX 2231 PARADISE CA 95969 CONSTRUCTION LENDER NONE Fire lace P ADDRESS Total Valuation $ ARCHITECT OR ENGINEERLICENSE NONE NO. Filing Fee $ 20.00 Permit Fee $ 29.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS Energy Plan Checking Fee $ PERMIT FEE S 49.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome MX Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK— New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Otherm Describe Work: DECK REPAIR Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service . ' OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter i i 9 (commencing wth Section 7000) of Division 3 of the Business and Professions Code, and my license isJo,4ull force and effect. --� . License Class Lic. No. -�j v/ OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Main Service To 46.00 CCU000A WEE200A NEW CONST. DWELLING OCCUP. OR ADONS. ( a ACC. BLos. SO 3.54 NEW . NON-RCES1ON0. STMULTI-OUTLET 97.50 a soiFWi c oPun� U a. Ex. Occup. OUTLET OR FIXTURES 20 @ 1.00 BAL @ .50 OR Ex. Occup. ouTLEEDTs REESSID.) EA. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE t MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall f with comp those provisions. / / Cy X ►�' __ `v_� __ Date 6 /� _ Signature of Applicant - ❑ Owner Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 49.00 HAZ. D. FEES IMP I FLOOD I COF PARCEL I PD I HD 5SU This permit is hereby issued under of the Butte County Code and/or indicate vEforwh' h fees ha By PERMIT EXPIRES ON I the applicable provisions Res lutions to do work en paid. 6/4/98 Date _ 6/4/99 Date Receipt No. 237062 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 9 PERMIT NO. 2246-89P,E( PERMIT EXPIRES - Z/ Z-3 OWNER SHARON EFTA CONTR. owner ASSESSOR PARCEL 64-24-30 13876 Olivet Dr, Magalia LOCATION ?ojS.62a-c A Temp. Power Pole Called PG&E Temp. E10c. Servlce/;-7:L'�!�— Called PG&E Temp. Gas Service oCV1tVd-P"E. J613-FINALED Signature V = OK 0 = Not OK - = Not Applicable = Not Ready MOBILE HOMES ' MISCELLANEOUS Date MOBILE HOME UTILITIES (Plans) OK except #'s Date DECKS,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s oning Requirements -Setbacks -Easements 1. Zoning Requirements -Setbacks -Easements . Soils; Special MH Support -Sketch 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel Sewer; Location -Test -Fall -C/O -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.- Shthg.-Rfg.-Bracing ectricity; Location-Clearances-Grnd.-/ZCOAmp-Concrete . Gas; Location -Test -Wrap: / /"L"ft. / /"Nat. or/ /"L"ft./3 /"LPG 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors Utility Clearance 7. Elea 8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh Card -81 (j(T' Date 7-zo.$ICard-131 Date 10. Roof; Shthg-Roofing Card -81 Date Card -81 Date 11. Ext.; Steps -Doors -Landings Date MOBtWAOME INSTALLATION (Plans) OK except #'s o Requirements -Setbacks -Easements Card -81 Date Card -131 Date 91f-oo!jags; Size -Spacing -Marriage Line Card -81 Date Card -131 Date as' Test -Demand -Valve -Connector ectricity; MH Test -Crossovers -Breakers -Clearances Date POOLS (Plans) OK except #'s ain; Test -Fall -Flex Connector 1. Setbacks -Easements er; MH Test -Regulator -Connector 2. Soils; Compaction -Structure Stability Ts-Wate—r and Sewer Connected -C/O to 15 e -HD -Approval 3. Pool Structure; Steel -Connections -Thickness - Dead Men -Lining d Electricity Tagged j AeE5xits sp.-S 4. Elec.; Receptacles and Lighting, Distances-GFI 1 ert. of Occupancy 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.;Grounding; Equip. w/5' -circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main in Conduit Dat and -B1 Date Card -B1 d� Z Card -131 Date Card -131 Date 9. Health Department Approval �- 10. Plumb.; Cir. Test -Water Supply Test Card -131 Date Card -131 Date Card -131 Date Card -131 Date / / ��� L�JCiCX•L � � � �J O �� f = UK 0 = NotOK - =Not Applicable •, RESIDENTIAL (Single and Duplex) ' = Not Ready 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-Steel-Elec. Grnd.-/ • P' Ftg. Depth 46. Ong. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. 3. Ftg., Garage; Soils -Steel-/ P' 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-Blockouts-Wrapped 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 6. Stemwalls, Garage; Steel- Blockouts-Wrapped 50. Garage Fire Protection Framing 7. Slab; Steel -Wrapped 51. Property Line Firewall & Openings 8. Piers -Fireplace Ftg.-Steel 52. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 9. D.W.V.; Fall7Fittings-Test-2 way C/O -Sewer Test 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 10. Gas Pipe; Size -Anchors 54. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 11. Water Pipe; Test -Anchors -Regulator -Service Test 55. Siding -Nailing Veneer - 12. Electric; Underground 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 13. Plenums & Ducts; Clearance-Material-Supprt-Ins. 57. Glazing Area -Glass Protection -Skylights -Plastic 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 58. Shear Walls; Nailing -Bolts 15. Insulation 59. Insulation-Walls-Clg. 60. Infiltration-Walls-Wndws Card -B1 Date Card -B1 Date Card -B1 Date Card -B1 Date Card -B1 Date Card -B1 Date Card -B1 Date Card -B1 Date Date PLUMBING (Permit) OK except #'s 16. Water Ht. Vent -Access -Combustion Air; -Baffle Date FINAL (Plans) OK except #'s - -17.- Water Pipe; Test & Anchors -Nail Protection 61. Ext. Steps -Door & Sidelight Protection -Landings 18. D.W.V.; Test-Fttngs & Anchors -Nail Protection 62. Smoke Detector -- 19. Shower Pan; Test, First Floor -Tub Access 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 20. Test Tub & Shower, 2nd Floor -Tub Access 21. Gas Pipe; Size & Anchors 64. Bedroom Exiting 65.G.F.I. & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & Subpanel; Breaker Sizes -Labels Card -81 Date Card -81 Date 67.Stairs & Rails Card -B1 Date Card -B1 Date 68. Fireplace or Stove; Clearances -Hearth 69. Elec. Outlets at Wood Panel; Int. & Ext. Date ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection - % 70. Kit. Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance 23. Elec. Receptacles Spacing -Lights & Switches at Doors 71. Elec. Outlets & Receptacles at Kit. -Counter 24. Size Boxes & No. of Conductors -Stapled - 72. Garage Fire Door; Swing -Landing -Closer 25. Romex Installed Close to Edge of Studs & C.J. - 73. A.C.' Duct in Garage -Damper 26. Equip. Ground,:made up w/Mech. Fastbners-Bond Gas & Water 74. Wtr. Htr.; In Garage; Above Vents-Clearance-.Comb. Comb. Air-Connector-P.R.V.- ' .Protection- 27. 2 Appliance Circuts in Kitchen &Conductor Size/G.F.I. 75, Plb., Elec. &Mech. Equip. Listed for Location 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga. Cu or Al 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral Yes No 77. Insulation -Foam -Looked in Attic ❑ Yes 78. Guard Rails & Deck Construction -Post Caps 30. Service -Riser Conductors & Ground -Main Disconnect 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 31. Equip. Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes Cl No; Planters ❑ Yes ❑ No 33. Smoke Detector 81. Stucco; Brown -Finish Card -B1 Date Card -B1 Date 82. A.C. Unit; Disconnect, Electrical, Plumbing Card -B1 Date Card -B1 Date 83. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Openings. Date MECHANICAL (Permit) OK except #'s 84. Water Well; Disconnect, Electrical, Plumbing 34. A.C. Ducts Insulation & Support 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 35. Vent Fan; Exhaust above insulation 86. Ventilation throughout House 36. Condensate Drain & Overflow; Size & Grade 87. Glass Protection 37. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet 88. Corrections from Previous Inpections 38. Attic Access & Platform if Furnace in Attic 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval 9i. Energy Compliance Certificate -Other Certificates Card -B1 Date Card -B1 Date 92. Roofing Certificate Card -B1 Date Card -B1 Date Card -131 Date Card -B1 Date Card -B1 Date Card -B1 Date Date FRAMING (Plans) OK except #'s 39. Sills, Proper Material & Anchors Card -B1 Date Card -B1 Date 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound Comments at Final: 41• Bearing Walls over Girders & Floor Nailing 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Header & Beam -Size & Bearing MOBILEHOME INSTALLATION ACCEPTANCE �` COUNTY OF BUTTE r ♦DEPARTMENT OF PUBOC WORKS — 7 COUNTY CENTER DRIVE f•` - OROVILLE, CALIFORNIA — 534-4541 PERMIT N0. Address or location of mobilehome _/ r/1�J Owner's nameV Gam! r y�S�/ l� ,S �i i�iz Owner's address Insignia or hud number f / r Manufacturer's name i a Serial number. of V.I.N. icial Approving Insrtollotion � Year of manufacture `y/1 1 v - r;* (Dote) IF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE '. MOBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM. 5138 White -Owner, Yellow - (nstaller,'P ink - D.P.W COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 _ CORRECTION NOTICE 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. Ins Date 7i1i 0 J• PAS COUNTY OF BUTTE`- 2EPA, TMENT OF PUBLIC WORKS' PERMIT N 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCE NUMBE --T1 ZING JZ BUILDING PERMIT OWNERs.T TELEPHONE ll G $Q, FT. OCC. BUILDING VALUATIO OWNER AILING ADDRESS �//��Q / c7 ! CONTRA -_A {� TELEPHONE CONTRAC`TTOORR*S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ �C — Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 32 Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT N SUBDI VISION NAME PA CEL M P / Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex[] Mobilehome Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home ro(G-NI 10.00 ea TYPE OF WORK New ❑ Addition ❑ Re odel ❑ Utilities IR Installation❑ Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 11000 0OR LESS OR LESS 10.00 JC) Main service EA. ADD'L 100 AMP 2.50>7 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 El 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) t� mac} 1, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.y , ACC. SLOGS.h¢Sgft New CONSTP_ UTLET NO N.RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20050t SALO 3o FIXED APPLNS Ex. Occup. OUTLETS ((RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 f Misc. �Yirin 15.00 g Permit Fee $ JV ,^ 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. (j I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement,should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgm"to ,and expenses which may in any way accrue st said Counce of the granting of this permit. _' X Date — Signature of Applicant - O ner ❑ 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 $ TOTAL PERMIT FEE $ OCCUP. CONST.TYP! ISCNO0 'V/agai 111Oo PARCEL PD N0 15suE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for ich R CT UBLIC BY PERMIT EXPIR S Date the applicable provi- resolutions to do fees have been paid. WORKS i Date 7^ } ., D Receipt No. � 6I WNITE-O.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT ti s.y; �6 :'F.7A!t. " 1!,�.7.�..h: R9I�:`. �re.y�gear-y�j��T._> ,�..,-...a;..;.•,+k,.r..v.;�w+.:�".._�vrs+cY. �,li �.�.... COUNTY OF BUTTE - DEPARTM'NT\OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATI'ONµDATA SHEET •� Permit No. OWNER_ J LIC%� A. P. JNo. Proposed Building Use �'.� Building Inspector e,' Date t 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. Energy Design Compliance and supporting documentation ......... 6. Statement of Intent for Non -Heated and AC Buildings .............. 7. Engineered truss details and layout in duplicate (required prior to plan check) 8. Mobilehome installation data including manufacturer's installation instructions....................................................... 9. Fees of $ ........................... 10. Chico Urban Area fees paid ........................................ 11. Park fees paid ..................................................... �-3. 2. School District fees paid ................. Sanitation approval from A4011—'_ _ Health Department ... 7 14. City of Chico plumbing permit ...................................... 15.,Plot, P-lan(aInd business license approval from City of I' !� (see City for other requirements) 16. Planning approval for (A) Use: (B) Parking: ......... 17. Improvements may be required. 18. Driveway permit (construction approval required prior to occupancy) ... 19. Pre -Ins ection for re uired . , , , Pre-Insperequest to p q � Building Inspector (Date) 20. Contractor's license information (No., Name Style, Classification) ....... 21. Certificate of Workmans Compensation Insurance .................... 22. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ........ 23. Recor copy of Agricultural Acknowledgment Statement ............ 24. Le f gnat e authoriz tion ....... .... ...... .. ..�....... . 25 2 When you issue the permit, process as follows: Mail to owner. Mail to contractor. _),v!� Telephone _!73 — 0 and hold for pickup at DAQ office. Deliver w/inspector. Other Copy of plans sent Health Dept., Fire Dept., Other Date W1 The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone_—mail—counter by date Contractor, designer, owner, was advised of above required data by—phone —ma II—counter by date Plans checked by Date Plans approved by I/S Date _ Sets of plans on hold in File cabinet AP folder Copy—DPW TO Buildinct Department FROM: Environmental- Health SUBJECT: Sanitation Clearance m� +azI.� Owner Location. AP# Plan Approved for: Sewage Disposal Y Water Supply /c Hold final for: 'Water Supply Final clearance O.K. for: Water Supply Clearance for bedro m mobile ome. Other ;an T * ,� taria Date BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM (One Form per Building) A.P. Number 'Building Building Department No. School District pa raCity �County �.7C 1 Jurisdiction r. r Property Owner 11 # ,J . Project Location/Address Subdivision - Lot Number Residential Development: Sq. Footage 4� # of Living MHI Addition (Group R) Units Commercial/Industrial: Sq. Footage New Addition (Including Exterior Roofed Areas) 9,z"'Imil y14 6- 1 Build1n=4,,`Department Representative Date ******************************************************************* (Floor Plans reviewed by School.District Personnel) District Id No. eet Aaaress i School District certifies that 9 � e)Z � (Phone Number) City) (State) (Zip has complied with the requirements of Resolution No. by th.e yment of $ � % X17 representing „2�_square feet. '-�School District Representative Date PAID BY CHECK NO. BANK NO PAID BY CASH white -applicant, yellow -building department, pink -school district SCHOOL.FEE (8/88) ®°t3 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS • A 7 C,nunty Center Drive - Oroville, California,95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ,PERMIT N0. ASSESSOR PA L NUMB `I�o Z_ BUILDING PERMIT (4Vfj OW NE TELEPH ONE SO. FT. OCC, BUILDING VXL OWN/ERIS MAI LI G ADO ESS CO ACTOR SNA r' TELEPHON 2,/39r CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 15— ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee ,$ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADORES , Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome® Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G 10.00ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti li 'es ❑ Instal/lla/tt/iiong' nerE] Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service eoov OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): �I am licensed under provisions of Chapt. 9, Div. 3 of the Business/POWER and Professions Code and my license is in full orce land effect. License No. v 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 0 CUP.Ei OR ADDNS. ( ACC. BLDGS. ) , /20sgft NEW CONSTR TI -OUTLET NON-RESID BRANCH CIRC ITS 2,50 ea APPARATUS &) (SINGLE OUTLET CIR. ) EX. Occup OUTLETS OR FIXTURES DAL030 FIXED APLNS. Ex. OCCup. OUTLETS P(RESID.)REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement,should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Venti.lation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against liabilities, judgments, costs, and expense which may in any way accrue against sai County in consequence of th gr ting of this permit. X Date J / eC Signar a of Applicant – Owner El ContractorAgent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct-IREC ion of structures over 3 stories in height. Mobile Home Installation Fee S Energy Inspection Fee $ TOTAL PERMIT FEE $ 0 '-- Occup. CONST.TYIEJ JZ��l FLOOD RCELall This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which OR PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS $� Date '2,r_v Receipt No. � 44-� WHITE-D.P.W.. YELLOW-ASSE730R, PINK -INSPECTOR, GOLDENROD -APPLICANT . . - -A.., .. s .r17lIIN`a. -.T ''s"`tyyj4.Ps'r'^�a. .-r,,s+res'R'^...• _ c--'-.r---P ...+.vi COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION o W 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET C Permit No. OWNER y A. P/No. Proposed Building Use /�L1�%�" Building Inspector Date 9k 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. Energy Design Compliance and supporting documentation ......... 6. Statement of Intent for Non -Heated and AC Buildings .............. 7. Engineered truss details and layout in duplicate (required prior to plan check) 8. Mobilehome installation data including manufacturer's installation instructions....................................................... 9. Fees of $ .......................... 10" Chico Urban Area fees paid ........................................ 0 4 Ile— 1. Par fees paid ..................................................... 12.School District fees paid ................. 13. Sanitation approval from Health Department ... 14. City of Chico plumbing permit ...................................... 15. Plot plan and business license approval from City of (see City for other requirements) 16. Planning approval for (A) Use: (B) Parking: ......... 17. Improvements may be required. 18. Driveway permit (construction approval required prior to occupancy) ... 19. Pre -Ins ection for re ulred .... Pre-Insperequest to p q •Building Inspector (Date) 20. Contractor's license information (No., Name Style, Classification) ....... 21. Certificate of Workmans Compensation Insurance .................... 22. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ........ 3. Recorded copy of Agricultural Acknowledgment Statement ............ lo 24. Letter of signature authorization ..................................... 25. 26. W e ou issue th rs ss as follows: Mail to owner. Mail to contractor. Telephone - and hold for pickup at A9.1 office. Deliver w/inspector. Other Applicant ���� a7i� ��/ C6�� Yom' Date Copy of plans sent Health Dept., Fire Dept., Other Date t The following data must be submitted prior to permit issuapr.-e: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone_—mail—counter by date Contractor, designer, owner, was advised of above required data by—phone —ma ll—counter by date Plans checked by Date Plans approved by 0�5 Date Sets of plans on hold in File cabinet AP folder Copy—DPW BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM, (One Form per Building) A. P. Number r7-1 4 Building Department No. School DistrictPA; 2AA P -,Ci--t��--y = County Neq Jurisdiction Property Owner Gr Jr !OAJ }"" T".... .1�"i, Project Location/Address Subdivision Lot Number Residential Development: .aSq. Footage /...� / I # of Living MHI Addition (Group R) Units Commercial/Industrial: D Sq. Footage New Addition (Including Exterior Roofed Areas) 'Building Department Reprlej, ,6ritative � Datre ******************************************************************* (Floor Plans reviewed by School District Personnel) District Id No.�—��� School District certifies that Y z::_�44AAI (Applicant Name) V (Phone Number) P, 0 . 6b4 �S�'l - (Street Address) PA_A_,0V011'A_ � 60 �5 (City) 0 (State) (`Zip Code) has complied ,with .the�Ilzq r of Resolution No. by the payment of $ a �".'7 -1, of % ��� square feet. Schoo4l District Representative 6 Date j�PAI �l Y HECK NO. REMARKS BANK NO fJ PAID BY CASH Vi('fLC(,C°i.W A SL. '7 A //9 ,�'Y_ 1 I" YCVY%' nom., II �9g4(e /�3 p�I Z) C --tt -L6 I57 ( 4H- 1 �� ��,5�� white -applicant, yellow -building department, pink -school district SCHOOL.FEE (8/88) RESIDENTIAL 64-24-30 , 1536 OB • + v 1E_ FrTA, D. J. I f CONTR: James Hancock f 13876 Olivet Dr, Magalia (MH ADDITION OPEN DECK) i 17 5�/ �U' 4�tor �On�Pi•oSac i JOB FINALE Signature J=OK O=Not OK u -=Not Applicable Not Ready 1tl1 �V� palH MOBILE OOMES ' = Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap: / P L" ft. / /"Nat. or/ /"L"ft./ /"LPG 7. Utilitv 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 ISCELLANE®US Date �--BECKSiCOVERS. CARPORTS. GARAGES. (Plans)OK exceot #'s Footings; Soils -Size -Depth -Spacing -Connectors -Steel Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails Shthg.-Rtg.-Bracing I um ns -Con nections-Spl ice-Deca I -Enc losu res 6 CaLpogs- Windows -Doors .. rc chors-Studs-Rftrs-Trusses a ing-Veneer-Stucco-Mesh - oofing 1/1 Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.;Enclosures; Conduit Entries -Terminals -Listed . 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater '8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures- Pane Iboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 V = -JK O = Not OK - = Not Applicable RESIDENTIAL (Single & Duplex) = Not Ready Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. 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 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 16. Water Htr.; Vent -Access -Combustion Air -Baffle 17. Water Pipe; Test & Anchor -Nail Protection 18. D.W.V.; Test -Fittings & Anchor -Nail Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors Date Card B71 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection 23. Elec. Receptacles Spacing -Lights & Switches at Doors 24. Size Boxes & No. of Conductors -Stapled 25. Romex Installed Closb to Edge of Studs & C.J. 26. Equip. Ground made up w/Mech. Fastners-Bond Gas & Water 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral 0 Yes O No 30. Service -Riser Conductors & Ground -Main Disconnect 31. Equip. Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector Date Card 3-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 34. A.C. Ducts Insulation & Support 35. Vent Fan; Exhaust above insulation 36. Condensate Drain & Overflow; Size & Grade 37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet 38. Attic Access & Platform if Furnance in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except #'s 39. Sils, Proper Material & Anchors 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound 41. Bearing Walls over Girders & Floor Nailing 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Headers & Beam -Size & Bearing Date FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties -Pu rlin -roof Brac-Truss-Shthng.-Rfng. 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing 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, 58. Shear Walls; Nailing -Bolts 59. Insulation -Walls -Ceilings 60. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector 63. Furnace; Vents -Clearance -Comb. Air -Connector - in Garage; Above Floor-Ducts-Mech. Protection 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & Subpanel; Breaker Sizes & Labels 67. Stairs & Rails 68. Fireplace or Stove; Clearances -Hearth 69. Elec. Outlets at Wood Panel; Int. & Ext. 70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 71. Elec. Outlets & Receptacles at Kit. Counter 72. Garage Fire Door; Swing -Landing -Closer 73. A.C. Duct in Garage -Damper 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage; Above Floor-Mech. Protection 75. Pib., Elec. & Mech. Equip. Listed for Location 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection 77. Insulation -Foam -Looked in Attic O Yes 78. Guard Rails & Deck Construction -Post Caps 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 80. Following instld.; Drive ❑ Yes O No; Walks ❑ Yes ❑ No; Planters Cl Yes ❑ No 81. Stucco; Brown -Finish 82. A.C. Unit; Disconnect, Electrical, Plumbing 83. Vents Above Roof; PIbg.-Appliance- Fireplace. -CI earance to Openings 84. Water Well; Disconnect, Electrical, Plumbing 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 86. Ventilation Throughout House 87. Glass Protection 88. Corrections from Previous Inspections 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: (NOTE: An entry must be made each time you visit job site) M M ' COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PE MIT NO. 7 County Center Drive - OroGille, California 95965 - Telephone: 916/538-7541 O APPLICATION AND'PERMIT 11,1 n ASSESSOR PARCEL NUMBER 64-24-30 ZONING RTI BUILDING PERMIT OWNER D. J. Efta TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS P.O. Box 817 Ma alfa 95954 250 open 1250 CONTRACTOR'S NAME James Hancock TELEPHONE 1873-2595 CONTRACTOR'S MAILING ADDRESS P.O. Box 1716 Fireplace CONSTRUCTION LENDER UNKNOWN I Total Valuation is Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ 22.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 15.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 1387 Olivet Permit fee $ 7.00 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ MobilehomepU Other ' SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 0.00 e TYPE OF WORK New ❑ Addition Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: open deck Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions ode and my license is in full force and effect. License No. Classification t� ❑ 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.tk ) New , t CONSTR.(A ULTB OUTLET NON-RESID BRANCH CIRC ITS 2.50 ea .50e (POWER APPARATUS eI SINGLE OUTLET CIR. Ex. OCCup(OUTLETS OR FIXTURES 20050t T eAL030 Ex. �CCUp. OUTLETS FIXED (RESID )REA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Iyirin g 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 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. 1 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 a. said County in sequence of t e granting of this permit. �- X Date I Sre of Applicant / Owner Contractor ❑ Agent El/ APO A 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,$ 47.00 HA CUA PARK SCHL F PAD-1PD HO s This permit is hereby issued under Bions of the Butte County Code and/or work indicated bov for hich fees C R 0 PUBLIC BY - PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Dat� Receipt No. 66116 WNITC-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT ;1 ,w ..ti COUNTY OF BUTTE - DEPART.MlgNfi'O`F PUBL'IC.WORKS - BUILDING DIVISION 7 COUNTY CENTER IDRIVE - OROVILLE, 0AWFORNA 95965 - TELEPHONE: 916/538-7541 R�IIIIT APPLICATION DATA SHEET Permit No. OWNER w S, C r 7,- A. P. No. 0 /—; G� — D3 Proposed Building Use Building Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance;{ DATE RECEIVED APPROVED , 1. All items have been submitted . .................................... `+ 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ '. 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ............... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data incfudMing manufacturer's installation instructions...... . ................................................ 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13. School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ...................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required ... a e�Inspec. request to nspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. _meq 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... ►�� " 24. Recorded copy of Agricultural Acknowledgment Statement ......... r 25. Letter of signature authorization ................................... 26. 27. When issue the permit, process as follows: Mail to owner. Mail to contractor. ne a and hold for pickup at office. Deliver w/inspector. ',Copy of Haz-Mat form sent Healt Copy of plans sent Health Dept. h Dept. __Fire Dept. Air Pollution Date Fire Dept. 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_phone---jnail—counter by ..date Contractor, designer, owner, was advised of above required data by—phone—mall—co ,Gnted;by d�.te Plans checked by ::Z_ Sets of plans on hold in Copy—DPW Date P14ns approved by File cabinet SAP folder TO FROM: SUBJECT: Suildina Department. Environmental Health Sanitation clearance 4a ( - _p d owner Location AP# Plan Approved for: Sewaoe Disposal Water Supply _. ?old f anal for : Water Supply Final clearance O.F. for: Nater Supply clearance for bedroom mobile home. other NOTE - —� - �- Date Sanitarian COUNTY OF BUTTE.- DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroviller California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER Z e-10 —<> c7 ZONING k / BUILDING PERMIT OWNER (� F TELEPHONE ,SQA FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS � / C r C Sp CONT TOR'S AME s TELEPHONE 73- -z si CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENGE UNKNOWN Total Valuation is Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ a 35 - ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 874 1 Permit fee $ PLUMBING PERMIT Filing Fee 10.00 113 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME P RCEL MA Water piping 55.00 Each qas water heater or ven 5.00 USEOF STRUCTURE SF ❑ Duplex❑ Mobilehome,(jJi'/Other SPECIFY Gas piping system 1 - 5 lets 5.00 Building sewer 5.00 Mobile Home ZI S I G W 10.00e TYPE OF WORK New ❑ Addition �emodel[] Utilities ❑ Installation❑ Other ❑ Describe work: /V 2 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 DR LESS 100 OROR LESS 10.00 Main service ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): [po"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.F, � �I�� Classification I ❑ 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) F1 I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) F]I am exempt under Sec. , Business and Professions Code for this reason //EA. LIN OCCUP.N) ADDNS/ oa T 1. DWELG 2yz2sgft NEW CONSTR. ULTI.OUTLET NON.RESID BRANCH CIRCUITS) 2.50 ea POWER APPARATUS D (SINGLE OUTLET CIR x. ccupOUTLETS OR FI URES EO( 20®50C eAL030 FIXED Ex. OCCUp. OUTLETS P SI D.)RE A.) 2.00 Temporary service 10.00 Mobile HomeF i lities 15.00 Misc. 1Virin 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation Penult Fee $ Contrac r 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize 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 ag • st said County in cc sequence of the granting of this permit. f� X --erZ Date S- 6 SIV.ture 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 i CONST TYPE �✓ S� TOTAL FEE $ Hnz CUA PARK SCHL FLD PAR PD Ho ssuE This permit is nereby issued under Bions 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. �/� .(� WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT Complaint Date196 ^; C� Other Date BUTTE COUNTY COMPLAINT FORM OWNER FJ • V F � �a Address H1 ' , Complaint Location X VIOLATION TYPE �] -BUILDING . r V,!- t /)c SS 5- A.P.# D �A/ Zoning 4T t _61- Taken By: _ �ti(wt� Q HEALTH Q PLANNING D .OTHER COMPLAINT: )e c S u I fi w/ ke r t S. l l s �, - 5 To u ay X Z:> boa -- PERMIT HISTORY ON FILE Q NONE AS FOLLOWS: 4ALT knl'I_S 0 6L led - (vi �/ 16 --------------------- •FIELD INFORMATION TENANT: Name u N I:wuw Address Description of Violation u t 1 k Mk $ro�� o n.oln, 1 ku, OTHER COMMENTS: Approx. Bldg./MH Size Approx. Bldg./MH Age (� Under Construction Built By/For-F] Present Owner = Previous Owner = Occupied 0 Has Power Q Has Gas Q Has Sanitation Facilities QWritten Notice Given & Attached Person Contacted /o_4A- w�"A< Describe Action Taken: `% w At" Njk- +b c�AAar-l' ow �% S W U � �� CYIJr�C w �'4'�c � `� "(-S .pfr. i tS af-"� !•¢ u `i ed' -�e� r a,� i • ( 1� ACTION RECOMMENDED: i BY: Ove Complaint Date �� L96 Cr a. 7 I Other .Date BUTTE COUNTY COMPLAINT FORM OWNER Addre Compl VIOLATION TYPE � BUILDING I Q HEALTH COMPLAINT: n�e J '` S b rLA c_f u rp 8e" h Q PLANNING 'De- r 4A � S. . SS.S=--�'/ A.P.# ^�V Zoning 4T I Taken By: 9 = . OTHER PERMIT HISTORY ON FILE Q NONE AS FOLLOWS: AN U *- 4./ 1 1i ✓ 4 led FIELD INFORMATION TENANT: Name Address Description of Violation OTHER COMMENTS: Approx. Bldg./MH Size Approx. Bldg./MH Age Under Construction Built By./For-[= Present Owner Q Previous Owner Occupied 0 Has Power Q Has Gas Q Has Sanitation Facilities QWritten Notice Given & Attached Person Contacted Describe Action Taken: ACTION RECOMMENDED: Information only, file 10 Day Letter Letter Hold for Days Other BY: DATE COMPLAINANT ADDRESS: PHONE NUMBER: OTHER COMMENTS: CLAIMANT: eautd* q J'BuUa OROVILLE, CALIFORNIA GENERAL CLAIM D.J. Efta ADDRESS: P.O. Box 817 CITY & STATE: Magalia, CA 95954 IMPORTANT: DATE OF CLAIM: July 13, 1989 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. (Bldg Permit Appin. i1274-89BPEM, Receipt #37105, dated 4/26/89, A.P. #64-24-30). Building permit fees paid -------------------- $764.50 Retain filing fee ------------------ $10.00 Retain plan checking fee ---------- $246.50 Retain energy plan checking fee ----$15.00 _ Amount retained --------------------------- $271.50 Refund due ---------------------------------------------- $493.00 Plumbing permit fees paid --------------------- $56.00 Retain filing fee ----------------------------- REfund due-----------------------------------------------$ 46.00 Electrical permit fees paid ------------------ $113.20 Retain filing fee ----- ------------------------ $ 10.00 Refund due ---------------------------------------------- $103.20 Mechanical pprmit fpps paid ------------------ 27.00 Retain filing fee ---------------------------- $ 10.00 Refunddue-----------------------------------------------$ 17.00 Refund energy inspection fee paid------------------------ $ 30.00 i TOTAL REFUND DUE $689.20 TOTAL $689 20 I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is true and correct as stated. i Dated this I day of ....... 19 et �12a ✓t I (� Calif. �^ ......................................• ................... .. .. ' Signature of Claimant i 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 [:D (Check one) f the sespe- Dated this .ITtIl. .�1,}1y �;�- ............ ........... day of ...... 1 .............. 1987, at ,Oroville Cetlf. i ...................... . ......�..............................:.:............ �...................... ,'Department Head or Authorized 13eputy Dept• 440-002 Exp. Co4210500 Con.....• FUND. Permits de ............................................ Code ................................................PAYABLE FROM .......... DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSS AMT. jj 1 �. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS ti 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT P RJAIT NO. S PAR EL NUM R ASSE7-' � - %W — 0 ZONING * BUILDING PERMIT OWNER L-F?—� TELEPHONE SO. FT. OC BUILDING VALUATION �" OWN R'S MAILING AIDDDRE 1 7 CO TRACTOR'S- NAME nI TEL EPHON C TRACT 'S MAILING ADDRESS Fireplace I 0 1 1 00n C RUCTION LENDER OV1 C - UNKNOWN Total Valuation $ Filing Fee $ 10,QQ LENDER'S MAILING ADDRESS Permit Fee $ AR ITECT OR ENGINEER LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ J ARC OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 ���%� �� Each Trap2.00 CZ Solar or heat pump water heater 20.00 I LOT I SUBDIVISION NAME ARCEL MAP Water piping 5.00 Q Each gas water heater or vent 5.00 USE OF STRUCTURE SF,J Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 I Building sewer 5.00 Mobile Home Is G W 0.00 ea TYPE OF WORK Newco Addition[] R model❑ Utilities[] Installation❑ Other[] Describe work: - Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW 1 declare under penalty of perjury (check one): F1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ 1, as the owner, am exclusively contracting with licensed contract- ors.(Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING o m ya2sgft OR ADDNS, ACG. BLDGS. NEW CONSTR ML11 82,50 ea NON.RESID .BRA CH CIRCUITS POWER APPARATUS e (SINGLE OUTLET CIR. / Ex. OCCUp\OUTLETS OR FIXTURES 20050t SALO 30 FIXED APPLNS. OR Ex. OCCUp- OUTLETS (RESIO.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. O- 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. MEC LAICAL PERMIT FiIirig Fee 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, juidQM94tri. costs, and expenses which may in any way accrue against said Coun i c of the granting of this permit. q Q X Date ig 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 $ TOTAL PERMIT FEE $ Occup. CONST.TYPC JS7LJFU)7D7LPD I MD ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By. PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. 1,13M WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT Y' COUNTY OF BUTTE - DEPARTMENT OF�PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 OWNER Proposed Building Use PERMIT APPLICATION DATA SHEET Permit No. A. P. No. 42 !�t e!>1`� T r - Building Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . .................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Energy Design Compliance and supporting documentation ......... 6. Statement of Intent for Non -Heated and AC Buildings .............. 7. Engineered truss details and layout in duplicate (required prior to plan check) 8. Mobilehome installation data including manufacturer's installation instructions....................................................... 9. Fees of $ .......................... 10. Chico Urban Area fees paid ........................................ 11. Park fes paid{ 12. noJ-r', � Sc ool Dist ict fees paid ................. 13. Sanitation approval from Health Department ... 4. City of Chico plumbing permit ...................................... 15. Plot plan and business license approval from City of (see City for other requirements) 16. Planning approval for (A) Use: (B) Parking: ......... 17. Improvements may be required. 18. Driveway permit (construction approval required prior to occupancy) ... 19. Pre -Ins ection for re ulred . , , , Pre-Insperequest to p q •Building Inspector 20. Contractor's license information (No., Name Style, Classification) ....... 21. Certificate of Workmans Compensation Insurance .................... 22. Owner -Builder Verification (Given to owner o, Mail to owner o) ........ 23. Recorded copy of Agricultural Acknowledgment Statement ............ 24. Letter of signature author ation ..... . %l�� J6A%S Tv ��a�S J eL 26. -(Date) When you issue the permit, process as follows: Mai).,to owner.,. Mail to contractor. Telephone —06'" and hold for pickup at office. Deliver w/inspector. Other CODV of Dlans The following 1. Index pern 2. Additional _Fire Dept., Other Date Date41'a/9I5 to permit issuance: (Circle new item not checked above). Contractor,dem Igngr, fiWneQwas advised of above required data by_phone__rnail count b date Contractor, designer, owner, was advised of above required data by—phone _mall—counter by date Plans checked by Sets of plans on hold in N Copy—DPW Date Plans approved by File cabinet AP folder 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) `Ie S. 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. iI 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 1 Social Security Number 73 Date Z 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. BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM (One Form per Building) A.P. Number /,C�-4?�-% Building Department No. School District City [::] County Q' Jurisdiction Property Owner „V • Project Location/Address Subdivision Residential Development: � a # of Living MHI Units Commercial/Industrial: J..CL- Lot Number Sq. Footageo- Addition (Group R) CISq. Footage New Addition (Including Exterior Roofed Areas) Representative `,Date ******************************************************************* (Floor Plans reviewed by School District Personnel) District Id No. Jli" { 1,0 (% School District certifies that (ApplicantiName) (Phone Number) (Street Address) (City) (State). (Zip Code) has complied with the requirements of Resolution No. by the payment of $�Qc'��.��o representing 3�ig� square feet. School District Representative `Date PAID BY CHECK NO. / 'i" 'l BANK NO qo ' PAID BY CASH REMARKS: white -applicant, yellow -building department, pink -school district SCHOOL.FEE (8/88) •J Return to DPW AGRICULTURAL STATEMENT OI' ACKNOWLEDGEMENT fi PUR RESIDENTIAL DEVE LOPMENT Section 26-8.1 of the Butte County Code requires this acknowledgement be recorded prior to issuance of a building permit. The property described herein is adjacent 89-012052 Rec Fee 5.00 to land or included within an area zoned I Cash 5.00 for agricultural purposes, and residents Recorded of this property may be subject to incon- Official Record s veni.ences or discomfort arising from the County of 1 use of agricultural chemicals, including, Butte PAM` .v4 but not 'limited to herbicides, pesticides, Candace J. Grubbs 1 and fert:i.lizers; and from the pursuit Recorder 1 of agricultural operations including, 9:56ftm 5 -Apr -89 1 BG 1 but not limited to cultivation, plowing, spraying, pruning, and harvesting which _ occasionally generate dust, smoke, noise, and odor. Butte County has established ;iy;rirul Lural zones which have as a' priority fuse for. productive agr:icul.tura1 purposes, and rosidelli within sa i.d zones 'and on adjacent property should be prepared to accept -such i nc onvell i me r or disconform from normal, necessary farm operations., All that real property 'situate in _the—County of Butte`, State of. California, do srr i hrct'�i�✓' f o 1 ]. o w s : pp,� � Z :,o -f' f F3 Q s s (n-Q.�.}-.. a-�. �-i•.cz�= �.�c..:,, vv�cz� �� 151 107 i. jeJ 800k �� V1itaQs,I 0--t pa -?.o 42, 43 cr..d *4. f-, 4"7Feo, , a a r o 4 a. F X o V 1 S -It, 4:0(,- -Q -may C; - ell" -� 44 sw�o. 44,L -01-1d � cA Z -0-0O , =r. , a.� 44.,.4- ,�,,o d -ate, s tI .ac'-� q-0 v+ 5 r c�1 cza d . j�e co 2_ n Y.,o ni - +c sc G 1 S v E reo S ►vis. r.' f o �l �A Z.o�f S 9 G L'T% Co �o ra.�,a � o � so.�c� P^ . „� �� � � s �-w-# � o a..d sLxs+ s des �ad,l.. �( rz c o�,v.n..o�► 4-�-d 2�ct�o N a�.aa.c as -(�� U�-,r• ��!-s i<, 1/X, TOZZ Date: �G PROPERTY 0 RS: r� State of ) On this the ,.5ZVr_ day of I9,f before mc, SS. the undersigned Notary Public, per onall.y appeared County of j ) 0 - also also MARION L BECKER r-lPersonally known to me. Proved to me on the basis NOTARY M&rAUFORN8A r of satisfactory evidence. Butte County MY Commission Expiros to be the person(s) whose name(s+) r March 12, 1993 ■ subscribed to the within instrument and acknowledged Lhat ®rr,,,r■®r�rrrresar�rrwer9 executed the same for the purposes therein contained. IN WI'I'NI;tiS WHEREOF, I hereunto set my hand and official seal. Present A.P. No. Notary Public 2c /3g76 DLZ-oEv CC) L A N D O F NATURAL WEALTH AND BEAUTY DEPARTMENT OF PUBLIC WORKS o'er tt;ra WILLIAM (Bill) CHEFF, Director =,1 -'_ . z 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 Telephone: RONALD D. McELROY Deputy Director RE: Building Permit No. Expiration Date (A.P. No. F, With reference to the above subject, our records indicate that your Building Permit on the above date. Building permits are valid for one year and should construction be started but not completed by the expiration date of the permit, - the permit shall be renewed for 1/2 the original Building Permit Fee (plus a $10.00 "Filing Fee"). The renewal permit will extend the Building Permit for an additional year from the original expiration date. Should you not renew your permit in a timely manner, it cannot be renewed and all work must cease until a new building permit is issued. If your construction is completed or should you have any questions concerning this matter, please contact the office. For your convenience, we are enclosing a renewal application form and an owner - builder form to be completed and signed by you where indicated and returned to this office together with the fee shown. Please return all copies of the application form. Thank you for your prompt attention concerning this matter. Yours very truly, William Cheff Director of Public Works Glander JFG:aj 4 Chief Building Inspector Attachments: Permit Application Owner -Builder Information Owner -Builder Verification cc: Building Inspector - Chico - 196 Memorial Way/891-2751 Paradise - 747 Elliott Rd./872-6307 Paradise Unified School District July 13'.1989 Mr. and Mrs. D. J. Efta P.O. Box 817 Magalia, CA 95954 Dear Mr. and Mrs. Efta: Attached please find check in th f $2,078.73 for refund of part of the Developer Fees paid on .#64-24-30�alling er your letter, you are not building a permanent structure u ins a mobile home. We are voiding our Certification Form #89-119 B. The square footage difference is listed below.. New Certification # is 89-276. Paid on 2989 sq. ft. @ $1.53 per sq. ft., $4,573/17 Paid on 1599 sq: ft. @ $1.56 per sq. ft., 2,494.44 Refund Sincerely, R/had Sch dt Business Manager Attachment cc:/utte County Building Department j 2.83 $2.,078.73 Board of Trustees Frances D. Main, President John D. Lonom Tom F. McLaughlin, Clerk Marilyn C. Connor, V.P. Dr. Charles Larsen 5665 Recreation Drive Paradise, California 95969 Telephone (916) 872-6400 Richard T. Landess, Ed.D., District Superintendent r Attached please find check in th f $2,078.73 for refund of part of the Developer Fees paid on .#64-24-30�alling er your letter, you are not building a permanent structure u ins a mobile home. We are voiding our Certification Form #89-119 B. The square footage difference is listed below.. New Certification # is 89-276. Paid on 2989 sq. ft. @ $1.53 per sq. ft., $4,573/17 Paid on 1599 sq: ft. @ $1.56 per sq. ft., 2,494.44 Refund Sincerely, R/had Sch dt Business Manager Attachment cc:/utte County Building Department j 2.83 $2.,078.73 Board of Trustees Frances D. Main, President John D. Lonom Tom F. McLaughlin, Clerk Marilyn C. Connor, V.P. Dr. Charles Larsen (,:,v-2L/_�� qs�9s4 414//-, ' X078', n u q w o, co U OAl co UZZ) AP lU =-2 - .� a OWNER ..... �A PERMIT MH UT IL . CLEARANCE DATE INSPECTOR %S ku-& ELECTRIC GAS Support Struc. Compaction Test eq. Service Size Other Load Type Pipe Size Leri th YESI NO YES NO LP�. BUTTE COUNTY.DEPARTMENT OF PUBLIC WORKS 7 County Center'Drive, Oroville, CA PHONE: '538-7541. MOBILEHOME INSTALLATION SHEET 1. Owner's Name: Com.. ok 2. Installer's Name: �k C��` , �/ ✓n�S 3. Is the site currently under permit? Yes ❑ No r (If yes, furnish permit number ) OR Is the site an existing site? Yes No F (If yes, furnish two plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes a No (If no, clarify 5. What is the mobilehome electrical rating? --------------- Amps 6. What is the mobilehome site service rating? ------------- ZG-0 . .. Amps 7. What is the.mobilehome site circuit breaker rating? ----- Amps 8. Is there mobilehome any other electric site service? load to be served by the -------------------------------- Yes No (If yes, identify the load and size: (Load) (Amps) 3/ 9. What is the mobilehome site gas pipe size? -------------- (in.) 10. What is the type of gas service? ------------------- Natural LPG FI- 11. What is the gas pipe length from meter or tank to the mobilehome?-------------------------------- * 12. What is the mobilehome gas demand? ---------------------- 3�% (BTU) *(This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) u MOBILEHOME SUPPORT DATA If other than single wide, Mobilehome Mfr. i �L-Tw C( V&02-1—Year l& O Z� o o furnish Setup Model No. `� Year lq Width Z� (ft.) Box Length 4-0 (ft.) Tagalong or Expando Size ft. x ft. On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of Butte). FOOTINGS (check one) 1-1 1. Wood -pressure treated or foundation grade. 2. Other (s ecify) SUPPORTS (check one) El1. Concrete block.a 2. Other (specify) :�C 05 Pier Footing Sizes and Locations SINGLE -WIDE MULTI -WIDE Liar. 0L ne 1 _ _ -1;1Main Beams line 2r-� Line 1 Piers: Size -Min. ------------ 'k Spacing -Max - -------- From Ends -Max. ------- Line 2 Piers: Size -Min ------------- Spacing-Max - ------------Spacing-Max.--------- r_ n From Ends -Max .------- Line i Roof Load a: Size -Min.---------- -- „x 11V . Location (From Front) - " Line 4 Pier@: Size -Min .------- - rk „ Spacing -Max.--------- r ., From Ends -Max .------- r_ Line 5 goof Loads: I Size-Min.------------ Main Beams — — — — — — — Ino ——Line Tag or Triple Line 1 Openings: Size -Min- ------------------ rk ,r Each Side of Openings With Width Over --------- Line 3 Piers: (Under Bearing Wall only) Size -Min .------------------ rx „ Spacing -Max.--------------- ,- From Ends -Max .------------- '_ r ,x1,x X ,r ''x r, -x n e 5 piers: (Under Hearing Wali@ vniy) Size -Min .------------------ ,rx „ Spacing -Max.--------------- From Ends -Max -------------- Location (From Front)I _ I BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA PHONE: 538-7541 MOBILEHOME INSTALLATION SHEET 1: Owner's Name:,,S I GCI �U-J�-o r�i�T 2. Installer's Name: ��� e��:y 4 C-:� mS 3. Is the site currently under permit? Yes a No (If yes, furnish permit number ) OR Is the site an existing site? Yes a No (If yes, furnish two plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements?Yes No (If no, clarify 5. What is the mobilehome electrical rating? -------------- �C �� Amps 6. What is the mobilehome site service rating? ------------- 0 © Amps 7. What is the.mobilehome site circuit breaker rating? ----- Amps 8. Is there any other electric load to be served by the - mobilehome site service? ------------------------------- Yes � No (If yes, identify the load and size: (Load) (Amps) 9. What is the mobilehome site gas pipe size? -------------- (in.) 10. What is the type of gas service? ------------------- Natural LPG 11. What is'the gas pipe length from meter or tank to the mobilehome?--------------------------------------------- (ft.) * 12. What is the mobilehome gas demand? ---------------------- ) *(This information not .required if pipe length less than 6 £t. on natural gas or less than 50 ft. on LPG.) MOBILEHOME SUPPORT DATA If other than single wide, // Mobilehome Mfr. 6a rrj©o D furnish Setup Model No. �/60 Z L Year ) Width -27 (ft.) Box LengthlOD (ft.) Tagalong or Expando Size ft. x ft. On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of Butte). FOOTINGS (check one)1. Wood -pressure treated or foundation grade. El2. Other (specify) .SUPPORTS (check one)1. Concrete block.1:1 2. Other (specify) ---. Pier Footing Sizes and Locations SINGLE -WIDE Main Beams in Main Beams Tag or Triple :F. Line 1 Piers: y Size-Min.------------ rk Spacing -Max. --------- From Ends -Max. ------- Line 2 Piers: Size -Min ------------- Spacing-Max - ------------Spacing-Max.--------- From Ends -Max.------- Line 3 Roof Loads: Size-Mio.--- - -----� „x „x k ,k a Location (From Front) Line 4 Piers: Size-Min.-------- Spacing-Max .--------- From Ends -Max .------- Line 5 Roof made: Line 1 Openings: Size -Min. ------------------ ,� n Each Side of Openings With Width Over --------- Line 3 Piers: (Under Rearing Wall Only) Size -Min .------------------ „x „ Spacing -Max.--------------- From Ends -Max .------------- �. e 5 Piers: kunaer nearing waaao unayi Size -Min .------------------ , u Spacing -Max.--------------- From Ends -Max .------------- ' Size -Min. ------------ ,.x „ ,k „ ,k „ „x Location (From Front) 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 or6) e� 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,nd provide the major work: Name iA Address z 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 Phon Type of Work n�,n ai n �� /'A V ZIA -- Signed: Property Owner t . Social Security Number Date -7- H — 9"? 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. RESIDENTIAL PLAN CHECKING GUIDE (S.F., DUPLEX & MISC. ONLY) 7/85 OWNER `�� C, •A.P. �J �T14 Bldg. Permit # A . P . # l �- e 3 O GENERAL 1. Zoning requirements: (sideyards and number of permitted living units). 2. Valuation. 3. Plans signed by designer. 4. Energy Design and Compliance. 5. Existing violations on property. PLOT PLAN 1. Complete parcel size and dimensions. 2. Setbacks, sideyards, easements, etc. 3. Other buildings or structures. 4, Grading, fills, drainage. Flood hazard. 6. Special conditions on creation map or compliance document. FLOOR PLAN 1. Complete to scale plan with dimensions. 2. Required windows for light and ventilation (Sec. 1205). 3. Required windows for second exit (Sec. 1204). 4. Skylights (Chapter 34 & Sec. 5207). 5. Human impact glass (Sec. 5406). 6. Required room sizes, ceiling heights (Sec. 1207). 7. G.F.C.I.'s in baths, garage and exterior outlets (Article 210-8). 8. Light fixtures, switches, receptacles, and exterior receptacles for maintenance of mechanical equipment. 9. Locations of water heater, heating and cooling equipment, other electrical or gas equipment, and plumbing fixtures. 10. Garage firewall, door size, and closer (Sec. 503(d)(3)). 11. 1 - 3'0" exterior exit door (Sec. 3304(e)). 12. Fireplace and wood stove location. 13. Smoke detectors (Sec. 1210). STRUCTURAL DETAILS 1. Foundation plan complete enough -:to construct building. 2. Floor construction details complete enough.to construct building. 3. Elevations and wall construction details complete enough to construct building. 4. Roof construction details complete enough to construct building. 5. Fireplace construction details and calcs if necessary. 6. Sufficient data and details to satisfy energy requirements (State Law) (Form 1). MISCELLANEOUS ITEMS TO LOOK OUT FOR 1. Exposure I plywood on exposed locations and overhangs. 2. Stairway details: landings, rise and run, head clearance, handrails (Sec. 3306). 3. Guardrail details (Sec. 1711 & 3306(j)). 4. Brick or stone veneer (Chapter 30). 5. Exterior plaster - weep screeds (Sec. 4706). 6. Proper roof.pitch for roof covering (Chapter 32). 7. Rafter ties or bearing ridge beam. RESIDENTIAL PLAN CHECKING GUIDE (CONT'D) 7/85 MISCELLANEOUS ITEMS TO LOOK OUT FOR (CONT'D) 8. Garage door or porch header sizes. 9. Adequate bracing. 10. Living area over garage - complete 1 -hour separation required on garage side including supporting walls and posts, etc. 11. Two exits on three-story dwellings (Sec. 3303 & see Mezannines 1716). 12. Attic access and ventilation (Sec. 3205). 13. Underfloor access and ventilation (Sec. 2516). 14. Wood stoves, clearances, alcoves.& 1 -hour shafts. 15. Combustion air for fuel burning appliances. 16. Noise requirements on duplexes. 17. Adobe soils - special foundation design. 18. Retaining walls requiring design. 19. Unusual shape, size or split level house requiring lateral design. 40 �)qv� fi Covs -r J -7- CW C` FOC Y�IWAY �01 Ao -res A Uoristruction Assembly Uompliance t-orm CFr3 �S�L�/V�D� �L•/�ylC.� GI�i�/� For Enforcement Agency Use Only Project Tm s V Documentation Ault r/Firm Date Checked By Date General Information I Assembly Type and Number . . . .. . ? . . . . . .• - . . . . . . . . . . . . . . . . . . . . . 2 Framing Type ....... .. . . . . . . . . . . .• .. .. . . . . . .. . .. 3 Framing Size . .. . . . . . . . . . . . . . ... .. . .. . .. . . . . .. . . . . . 2 X,/ 96 -- 4 Framing Spacing . • • • • • • • •\• • • • • • • • • • •• • • • • • • • • • • • • •• %¢ inches S Insulation in Cavity . .. . . . •. . . . . . . ... . . .. . .. . . . . . . ... . . . .. . . . .dF-112-hr/Stu • i Effective R -value of Cavity/Frarrjjng ....:...... ..:.:.... ..... .......:.....-,,� F-h2.hr/Otu Sketch of Construction Assembly List of Construction Components , A; _ B C 0 E� WadSpeafie HC _ Description R -value Weight (Ibtt-2) Heat (Bt dF4b)) . Col C x Col 0 (Btu/F-sf) 33 L -j , -T • ��75- 2 l 2 r' 460&Wim 4 7 8 Total R -Value w/o films . . . . . . . . . . . / Total HC 9 Inside surface air film . . ......... ... Z (i 10 Outside witace air file . ... .. . . . . ?. 7 11 - Total thermal resistance (Rt) . . . . . . . . . . • /� •/� ?•?tQ . 12 U -value (1 / Una 11) . . .. . ..... ... . . L_- Form Revised September 1986 _ - • _ - - ' ' - Page of t � /�` ,�.1 �X � C��, � �c�� �,� i � a� 1 �. �.���Vli�� �..A,�J�1�1G Ca ��f12 •Construction Assembly Compliance Form CF -3 For Enforcement Agency Use Only Project I Me Documentation AuftriFirm Date Cheexed By Date General Information 1 Assembly Type and Number . ? "j:'. . . . . . . ' 2 Framing Type ................. .....:.......:. 0 0 ... 0 0 .. .3 Fnunin9 Size. . . . . . . . .. qtr AP' -- 4 Frwning slpeoing . . . . . . . . . . . . . ".• . 0 . 0 0 0 . . . . . . 0 0 . 0 0 0 0 . 0 • . . . 0 . 0 0 Z7--4fiL Inohes S Insulation in Cavity . . . . . . . .. . . . . . . . .. . . . . . . . .... ... ... .. . _ d F-H2-hr/Stu . ' d Effective R -value of Cavity/Framing ... 0 0 0 0 . '.:' ._ .....:................. /�. °�—"F-tt2fin8tu .L Sketch of Construction Assembly List of Construction Components A B C D E _ Wan Speafie HC ' Description R -value We' ht (Iblh� Heat (BtWF4b) . Col C x Col D (Btu/F-af) t VA 0"doMA92 -eZ&Vr-- 2 /z' 'el- V 12Q�0 P A !� d - ,Taj • a J 8 4 �T ! • 6 _ _ 0 v' '7 8 Total R -Value w/o films , ,. . . . . . . . . . . . ."_ Ila . Total HC ` 9 Inside surface air flim i ti . . ........... 10 Outside surface air file . . . .. .. . . . . • Zl . 17 \ 11 .Total thermal resistance (RJQ •. r - 12 U -value (1 / Urw 11) . . 0 0 0 0 . . . . 0 0 0 0 . r 04:001 9? 44 1 i .. '�.�, _ .. _ :.._ • . .► 00.00. _ A Form Revised September 1986 - - - -_ _ page of tvw4tc P - o r"y (, r /VlW (,VD I o,513 0 631, c o go o. Z5 HAI �5; 2 ` o � ,o HAI �5; 2 ` : O MECHANICAL ENGINEERS TITLE, Glu Y' CLIENT, HEATING/COOLING DESIGN DATA & CRITERIA SHT . OF JOB NO. DATE, BY : TYPE STRUCTURE/USE/Nocc SZ�� cavi, /jL0&Lr. ELEVATION' LOCATION ddl No ���, LATITUDE DESIGN CONDITIONS, SUMMER (COOLING): DEGREE DAYS : OUTDOOR DAILY RANGE 370F: -sem' OUTSIDE: /02 OF db: 9 OF wb: %RH) : S3, Z GRAINS MOISTURE INSIDE : 72? OF db: 4?2, OF wb: %RH) : > GRAINS MOISTURE DELTA T= Z¢oF db: DELTA MOISTURE = GRAINS MEAN AVE . `TEMP . MAX. AVE. TEM : MIN. AVE. TEMP. : WALL COLOR: LIGHT ❑ : MEDIUM L; : DARK ❑ ROOF COLOR: LIGHT ❑ : MEDIUM .Q': DARK Cl WINDOWS : BARE ❑ : BLINDS ❑ : DRAPES ❑ : OTHER REMARKS: SHADING COEFFICIENT: WINTER (HEATING): DEGREE DAYS 2 S7`�: MEDIAN OF EXTREMES INSIDE e 70 OF db: MEA.ti AVE. fl til'. OUTSIDE027 OF db: MAX. AVE. 'Ir:MP. DELTA T=4 -50F db: MIN. AVE. TEMP. REMARKS: ELECTRICAL LOADS: OCCUPANT LOADS: ' : VENTILATION DESIGN: /t� 'gFESS� G. /w No. 13637 r^ REMARKS , c2t �y s�gl�FQIAN1�, 0 E - F CAS\ F CLAIMANT: ADDR ESS: eawd* of i"Outte OROVILLE, CALIFORNIA GENERAL CLAIM D.J. Efta P.O. Box 817 CITY & STATE: Magalia, CA 95954 IMPORTANT: April 27, 1989 SEE INSTRUCTIONS DATE OF CLAIM: ON REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION O,F CLAIM (DESCRIBE FULLY TO AVOID DELAY) I AMOUNT Owner has decided not to do work. (Bldg Permit Appin.3.5p,199BPEM, -2 Receipt #36643, dated 4/4/89, A.P. #644-30). Building permit fees paid ----------------------- $820.75 Retain filing fee-----------------------$ 10.00 Retain plan checking fee---------------- 265.25 Amount retained------------------------------- 290.25 Refund due -------------------------------------------------- $530.50 Plumbing permit fees paid ----------------------- $.58.00 Retain filing fee------------------------------- 10.00 Refunddue--------------------------------------------------$ 48.00 Electrical permit fees paid ---------------------- $119.50 Retain filing fee ------------------------------- $ 10.00 Refund due -------------------------------------------------- $109.50 Mechanical permit fees paid --------------------- $ 24.00 Retain filing fee ------------------------------- $ 10.00 Refunddue ------------------------- =------------------------ 1 .0 Refundenergy inspection fees paid--------------------------$ 30.00 TOTAL REFUND DUE---,---------------------------------------- 732. TOTAL $732 00 Veld, and that this claim is true and correct ga stated. , I, the undersigned, declare under penalty of perjury that the services or articles claimed have been perJolalmant Dated this ..... ........:....... day of .......... ...... 19 .... at Calif. :.. Signatu I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or de- 00 livered and that there is a Budget Appropriation[] or Specific Board Approval a (Check one) fo�Dea-rlm;�ent Dated this 2,%•trh day of Aril 19.89 at Oroville P .................... Calif. .. u;. ..... _......p Head or Authon d De uty Dept. Exp. n nn ��++ Code ................... 4.4Q.-0.02..... Code ...........4210500. PAYABLE FROM .........N.g 15a. . 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. Cr4 LC s 1� cc Tv T -Ot ZS C(l I i OCS COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, Catifoonia 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ERMIT N0. SSE SOR P C NUMBERZO. - G BUILDING PERMIT CFWNER SO. FT. OQr_.J BUILDING VALUATION O E�MAI ADORES . RO \ y c CONTRAO/ TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace / 00, CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee ,$ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 81 N9 611 1Z ift LL Permit fee OO $C1 PLUMBING PERMIT Filing Fee 10.00 Each Trap #1 2.00 Q, Solar or heat pump water heater 20.00 LOT N^ y is SUBDIVISION PARCEL MAP Water piping 5,00 Each qas water heater or vent 5.00 USE OF STRUCTURE SFX Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Cs' fiD Building sewer 5.00 Mobile Home S I G I W 0.00ea TYPE OF WORK New Addition❑ Remodel❑ Utilities[] Installation❑ Other ❑ Describe work: C9 W A a-Yn j Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 j Main service OOOV OR LESS 100 AMP OR LESS 10.00 Main service EA. ADO'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury p y p f y (Check One): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. 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 -Mobile ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLIN N , OR ADDNS. ACC. BLD / /20sgft NEW CONSTI' TI.O NON.RESID BRANCH CIRCUITS 2.50 ea POWER APPARATUS 6 -SINGLE OUTLET CIR. Ex. OCCUp(OUTLETS OR FIXTURES 20990t eAL130 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EAJ 2.00 Temporary service 10.00/D Irp Home Facilities 5. 1 00 Misc. Wiring g 15.00 Permit Fee $ a Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement,. should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating -414 111,011? Coolln g Hood 3.00SCM Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said Count Wsence of the granting of this permit. Q X , Date �/' �1/—�T Signature of Applica — Owner El Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 storiesin height. Mobile Home Installation Fee $ Energy Inspection Fee $ '3 , TOTAL PERMIT FEE $ �S o Oc UP. CONST.TTPEJ J ISCHo L FLOG PARC! PD ND 199UE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. ,36//J WNITE-O.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT..QFwPUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET LL t Permit No. OWNER [f� A. P. No. Proposed Building Use wl d4A z F Building Inspector / f/% Date L `; TG"e'er 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 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. Energy Design Compliance and supporting documentation ......... 6. Statement of Intent for Non -Heated and AC Buildings .............. 7. Engineered truss details and layout in duplicate (required prior to plan check) 8. Mobilehome installation data including manufacturer's installation instructions....................................................... 9. Fees of $ .......................... 10. Chico Urban Area fees paid ........................................ 11. Park fees aid ..................................................... 12. 7, School ;District fees paid ................ . 13. Sanitation approval from t1l 4 /) % Health Department 9 � 14. City of Chico plumbing permit ...................................... 15. Plot plan and business license approval from City of (see City for other requirements) 16. Planning approval for (A) Use: (B) Parking: ......... 17. Improvements may be required. 18. Driveway permit (construction approval required prior to occupancy) ... 19. Pre -Ins ection for re uired .... Pre-Insperequest to p q •Building Inspector (Date) 20. Contractor's license information (No., Name Style, Classification) ...... 21. Certificate of Workmans Compensation Insurance .................... 22. Owner -Builder Verification (Given to owner o, Mail to owner ❑) ........ X23. Recorded copy of Agricultural Acknowledgment Statement ............ UUMI Letter of signature authorization .................................... . When you issue the permit, process as follows: Mail to owner. Mail to contractor. ✓ Telephone5r?% 5_� � and hold for pickup at R�Lloffice. Deliver w/inspector. Other s Applicant ..—( C ` Date �� •�—� 1 Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 4Q 0 2. AdditrDnal items required: r� ff- .L-77� J ow -.�10 Contractor, designer,(QwAr, was advised of above required data by—phone--mall- _4Pcounter by/_k_-JE_- date Contractor, designer, owper, was advised of above required data by—phone —ma ll—counter by date Plans checked by Date Plans approved by Date _ Sets of plans on hold Wh=,__File cabinet AP folder Copy—DPW 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) l)`L. 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 Y\_ 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,/wand provide the major work: Name o ! � 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: `� l Property Owner Social 4fcltygOer (o Date Cf 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 - witted to issue the permit. D. J. EFTA Building Permit 950-89 1. Submit details for water proof deck above T. V. Room 2. Submit Engineer Calcs for 4x10 floor beam supporting roofs -walls -floors 3. Submit Engineer Calcs for pier size and for posts -supporting 4x10 floor beams 4. Submit Engineer Calcs for studs - (2x4) interior bearing walls in excess of 10' long 5. Show beam size and posts on plans - of beam supporting roof system above .2nd floor balcony. Show posts continuous to foundation and pier size Required. 6. Redesign or change rafters to comply with table 25 HR -1 UBC for #2 Doug Fir. (Min 2x10) required. 7. chow method. of rafter ties at ridge app' wall above beam supporting living room rafters 8. -.No:.e lumber and plywood grades on plans 9. Show insulation R. values on plans - (R-30 clas) (R -19 -walls) (R-19 floors),floors - with unheated space below example garage -raised floors Certificate of Compliance: Residential P• .7 - Project Title /,3 Q 7G Project Address Docurnentadon Author Telephone BUILDING DATA Conditioned Floor Area 221VA_ Slab/Raised Floor pd Single Family Detached (SFD) [ ] Single Family Attached (SFA) [ ] Multi -Family (MF) BUILDING SHELL INSULATION Number of Stories Number of Units [ ] Addition Alone [ ] Existing Budding. [ ] Existing -Plus -Addition Component Insulation Location/Comments Type R -Value (attic, to garage, typical, etc.) Wall .............. Wall .............. Roof ............. Jo Roof ............. Floor.............1 Floor ............. Slab Edge ..... GLAZING Shading Devices Climate Zone 11 ��V Building P it # Checked By / Date Enforcernent Agency Use Only Glass Area % Glass Area North Orientation East (single, double) (roue: blind, etc.) (shadescreen, etc.) (yes/no) (metaltwood) Southamr- West North Skylight /t ,3 --, Total 4�� Glazing Area Glass Type Interior Exterior Overhang Framing Type Orientation (sf) (single, double) (roue: blind, etc.) (shadescreen, etc.) (yes/no) (metaltwood) North East ( ) 4�� c S East ( ) South Sou th West West ( ) Skylight....... X4.1 THERMAL MASS Type/Covering Area Thickness (slab/exposed, tile, etc.) (SO (inches) Locadon/Description (kitchen, bath, etc.) HVAC SYSTEMS Minimum Duct Type (fumace, air Efficiency Location Duct Output Manufacturer / Model # conditioner, heat pump) (SE, SEER,HSPF) (attic, etc.) R -Value (Btuh) (or approved equal) N A Zow ooQ Maximum Furnace Heating Output: Btuh HOT WATER SYSTEMS Tank Manufacturer/Model # System Type (storage gas, etc.) Capacity (or approved equal) Special Feature(s) 440 SPECIAL FEAT URESIREMARKS (Add extra sheets if necessary) Mandatory Measures Checklist: Residential MF -IR NOTE: Lowrise residential buildings subject to the Standards must contain these mcasw= regsrdka of the compliance approach used Items marked with an asterisk (•) may be superseded by more stringent compliance requirements listed on the Certificate of Compliance. When this checklist is incorpontrA into the permit documents, the features noted shall be considered by all parties as binding minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. DESCUFTION I DESIGNER I ENFORCEMENT Building Envelope Measures §2.5352(a): Minimum ceiling insulation R-19 weighted average. §2.5352(b): Loose fill insulation manufacturer's labeled R -Value. §2.5352(c): Minimum wall insulation in framed walls R.I 1 weighted average (does not apply to exterior mass walls). §2.5352(k): Stab edge insulation - water absorption rate no greater than 0.3%, water vapor transmission rate no greater than 2.0 perm/inch. §2-5311: Insulation specified or installed mads Caldomia Energy Commission (CEC) quality standards. Indicate type and form. §2.5352((): Vapor barriers mandatory in Climate Zones 14 and 16 only. §2-5317: InfJtration/Exftltation Controls a. Doors and windows belwcen conditioned and unconditioned spaces designed to Emit air leakage. b. Doors and windows certified. c. Doors and windows weathersttippcd: all joints and penetrations caulked and sealed. §2.5352(e): Special inftluation barrier installed to comply with §2-5351 meeuCEC quality standards. §2.5352(d): Installation of Fireplaces 1. Masonry and factory -built ftreplaces have: a. Tight rating, closeable metal or glass door b. Outside au intake with damper and control e. Flue damper and control 2. No continuous bunting gas pilots allowed. HVAC and Plumbing System Measures §2-5352(8) and 2-5303: Space conditioning equipment siring: attach eskuladons. §2-5352(h) and 2.5315: Setback thermostat on all applicable heating systems. • §2-5316(a): Ducts constructed, installed and insulated per Chapter 10, 1976 UMC. §2-5316(b): Exhaust systems have damper controls. §2-5314(c): Gas-fired space heating equipment has intermittent ignition devices. §2.5314: HVAC equipment, water heaters, showerheads and faucets certified by the CEC. §2.5352(i): Water hearer insulation blanket (R-12 or greater) or combined interiorhexvx;or insulation (R-16 or greater): fust 5 feet of pipes closest to tank insulated (R-3 or greater). §2.5312(Excep6on 1): Pipe insulation on steam and steam condensate return & recirculating piping, §2.531R(d): Swimming Pool Heating 1. System has: a. On/off switch on heater. b. Weatherproof instruction plate on heater. e. Plumbed to allow for solar. 2. 75 percent thermal efficiency. 3. Pool cover. 4. Time clock. 5. Directional water inlet. Lighting and Appliance Measures §2.3352(1): Lighting - 25 lumens/watt oe greater for general lighting in kitchens and bathrooms. §2-5314(e): Gas rued appliances equipped with intermittent ignition devices. §2.5314(a): Refrigerators, refrigerator -freezers, frcacrs and fluorescent lamp ballasts certified by the CEC. Indicate make and model number. COMPLIANCE STATEMENT This certificate of compliance lists the building features .and performance specifim6oru needed to comply .with 'Title 24. Chapter 2-53 and Title 20, Chapter 2. Subch3pter4. Article 1 of the California Administrative code- This certificate has been signed by the individual with overall design responsibility and the building owner, who shall retain a copy of it and transmit the certificate to any subsequent purchaser of the building. Designer Building Owner Name: Nunc: T°ttk/Fum: 'rak/Fnn: Addrt=: Addmu: Tek -phone Tckphonc Lie. 0: (signature) (date) '(signature) (date) Documentation Author Enforcement Agency Name: Name: rI&/F=W Agency: Address: Tekpfsonc TO Building Department FROM: Environmental Heal.th-. SUBJECT: Sanitation Clearance Owner Location AP# Plan Approved for: Hold final for: Final clearance O.R. for: Clearance fo NOTE *** Sewage Disposal i bedroom mobile home. Other Anii1, _o4 ?/ i d: P: Water Supply Water Supply Water Supply Date p t-.�- 3967-81P,E PERMIT NO. PERMIT EXPIRES OWNER Jacques DeLangre Para.Mod.Conc., Para. c CONTR. 64-24-30 ASSESSOR PARCEL LOCATION 13876 Olivet, Magalia 'i i a i }1 Temp. Power Pole Called PG&E *01:fi lec. Service { Called PG&E Temp. Gas Service Y r Cal 14d PG&E JOB FINALED (Date) 10 Signature I = OK O = Not OK — = Not Applicable MOBI.LEHOMES = Not Ready i '„ . t { t Date ' MISCELLANEOUS DECKS, COVERS, CARPORTS, ETC. (Plans) U, except # . Date MOBILEHOME UTILITIES (Pla K except #'s 1. Zoning Requirements —Easements 1. Zoning Requirements—Setbacks—Easements '2. Soils; Special MH Support—Sketch 2. Footings; Size—Depth—Spacing—Connectors ewer; Location—Test—Fall- /0—Concrete 3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails ater; Loca 'on—T t— Bement Needed #ketc 4. Wood Awn.; Posts— Beams—Rftrs.—Connec.—Shthg:—Rfg. -Bracing_ 5, Elec ' • y; n—Clearances Grnd: / Amp—Concrete 5. Alum. Awn.; Columns—Connections—Splice—Decal—Enc;os,res 6. Gas; ation-Test—Wrap:/ /"L"ft./ 'Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows—Doors YI-1dr,lity Clearance 7. Elec. Card-BI Date /C)/Card-BI Date Card-BI Date Card-BI Date Card-BI Card-BI Date Card-BI _ Date Card-BI Date Date N4jULfi1If0ME IINATALLATION (Plans) OK except #'s Date _ POOLS (Plans) OK except #'s onin uirements—Setbacks—Easements 1. Setbacks—Easements Owings; Size—Spacing—Marriage Line 2. Soils; Compaction—Structure Stability est—Demand—Valve—Connector lec ' ty; MH Test—Crossovers—Breakers—Clearances 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining 4. Elec.; Receptacles and Lighting; Distances—GFI i Test—Fall—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI 6, ter; W Test—Regul —Connector 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed 7 er and Sewer nected—C/O to Grade—HD Approval 7, Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater s aipe ricity Tagged B. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg. Boxes—Enclosures—Panel boards—Ins. to Main in Conduit ketch 1 •. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test—Water Supply Test Card B-I Date Card-BI Date Card-BI Date Card-BI Date Card B-I Date Card-BI Date i Card-BI Date Card-BI Date a J = OK 0 = Not OK - = Not Apphcable RESIDENTIAtI (Single and Duplex) = Not Ready Date UNDERFLOOR Plans OK exce t#'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 51. 52. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 7. Piers -Fireplace Ftg.-Steel 53. 54. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test _ 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -81 Date Card -BI Date Card -BI Card -BI Date Date Card -BI Date Date Card -BI Date FINAL (Plans) OK except #'s 56. Ext. Steps -Door & Sidelight Protection -Landings Card -31 Date _ Date Card -BI Date PLUMBING (Permit) OK except #'s 14. Water Ht.; Vent -Access -Combustion Air 57. 58. Smoke Detector Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. -Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access _ 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. Stairs & Rails _ 63. Fireplace or Stove; Clearances -Hearth Card -BI Card -91 ' Date Card -BI Date Date Card -BI Date 64. Elec. Outlets at Wood Panel; Int. & Ext. 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except #'s 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 70. Plb., Elec. &Mech. Equip. Listed for Location 22. Size Boxes & No. of Conductors -Stapled 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 23. Romex Installed Close to Edge of Studs & C.J. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. Insulation -Foam -Looked in Attic ❑Yes73. Guard Rails & Deck Construction -Post Caps 25. 2 Appliance Circuits in Kitchen & Conductor Size - 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. 28. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or At, Insulated Neutral []Yes El No Service -Riser Conductors & Ground -Main Disconnect 75. Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters Dyes ❑No 76. Stucco; Brown -Finish _ 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77. A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet _ 30. Clothes Closet Light -Shower Light 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. -- ---------- 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card E-1 Date- Card -BI Date 81. 82. Ventilation throughout House Glass Protection Card E -I Date Card -BI Date Date MECHANICAL (Perrrit) OK except #'s 83. _ Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric _- 31. A.C. Ducts; Insulation & Support 85. Water & Sewer Connected -C/0 to Grade -HD Approval _ 32. Vent Fan; Exhaust above Insulation 86, Energy Compliance Certificate -Other Certificates 33. Condensate Drain & Overflow; Size & Grade _ 34. --35.--Attic ~- Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet Access -& Platform if Furnace in Attic Card -BI .Ca d -BI - -- ---- ------ - - Date _ - Card -B I_ Date Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FRAMING Plans OK except #'s Comments at Final: Sills; Proper Material & Anchors _36. 37. _Walls; 38. 39. 40. _ Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls over Girders & Floor Nailing------ Draft Stop in Walls (rat proof) _ Fire Stops; Furred Ceilings -Stairs -Chases -Tub _ 41. 42. 43. 44. 45 46. 47. Header & Beam -Size & Bearing Hangers -Post Caps -Anchors -_Connectors Cing. Joist-Rftr. Ties-Purlin-Root Brac.-Truss-Shthnq. Rfnq. Fireplace Ties or Type A Flue -Fireplace Throat Attic A_ ccess: Size & Rom_ex Protection -Draft Stop -Ins. Baffles _ Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions Garage Fire Protection Framing _ (NOTE: Anentrymust be made each time youvisit jobsite) COUNTY OF BUTTE � DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTJ0A DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of the California Administrative Code, Title 25, Chapter 5, under permit number `'"��^-��% -5 for the following location:I Owner Owner's Address Mobilehome Mfg. �� �. �"� � Mod Yl�� YearTo Insignia No IV22f1% / V6'0//• /2, , 3 Serial No. G' ► b 0 It is hereby certified for occupancy at the above described location and may be occupied. �. Director of,Public Works �f Date . /, 4A«/ By THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED White -Owner, Yellow -Installer, Pink ! D.P.W. COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS ' 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE BUILDING OR PROPERTY ADDRESS A rqutine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office wh6n correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. GOC/ G�' /�.+.� .r�T , /.-' �.,�.i.i .• �_�' COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memprial Way, Chico — Phone: 8914751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise— Phone: 872-2961, Ext. 57 CORRECTION NOTICE BUILDING OR PROPERTY AD 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. COUNTY OF BUTTE - D�PART�MENT OF PUBLIC WORKS PERM-; NO. 7 County Center.0rive--Oroville, California 95965 - Telephone 916/534-45 APPLICATIDN ANb PERMIT ASSE R ^RCEL IAMB R ZOJ�I'rr1G / BUILDING PERMIT OW R TELEPHONE SQ. FT. OCC.1 BUILDING VALUATION OWN S MAI NG ADDRESS C T AC RAS NAME oN TELEPHONE 7- R_ 7 ONJ-eACTOR'S MA LINt ADD ESS jJ 12 Fireplace CONSTR UC TI LEND R ^ UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADD SS\7 Permit Fee $ ARCHITECT OR ENGINE R LICENSE NO. Plan Checking Fee / $ /,/0-00 Penalty $ ARCHITECT OR ENGIN ER'S MAILING ADDRESS Permit fee $ BUILDING ADD ESS PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO. l SUBDIVISION NAME ` ij— PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF UCTURE SF ❑ Duplex Mobilehome Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation Other ❑ Describe work: or Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 1111 OR LESS 100 AMP OR LESS 5.00 SOY.&OLCJ Xho Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.8i OR ADDNS. ACC. BLDGS. 2�sgft CONTRACTORS LICENSE LAW I declare er penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code a d m license is in force nd effect. Y 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 CONSTR OUTLET 2.50 ea NON.RESID BRANCH CIRC ITS NEW CONSTFL / POWER APPARATUS 61 NON.RESID. %SINGLE OUTLET CIR. so @ zea Ex. Occup OUTLETS OR FIXTURES BAL�1 (FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): n Ttye permit is for $100.00 (valuation) or less. 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. Heating Cooling Hood 3.00 Ventilation permit Fee S 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. also agree to save, indemnify and keep harmless the County of Butte against al iabilities, judg nts, costs,And expenses which may in any way accrue again said Co u y i consequen a of the granting of this per it. 10 X Daae. ignot r of Applicant — er ❑ Contractor U2/Agenr An HA 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 $ TOTAL PERMIT FEE $ �D , OCCUP. GROUP TYPE OF CONST. PARCEL PD ND ISS This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTO OF PUBLIC BY PE EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date// -3_01-11/ / --3—F �� f Receipt No. 56101 WHITE-O.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS //7O 7 County Center Drive — Oroville, California 95965 / E/ Telephonei533-12 ;0, Ext. 259 APPLICATION AND PERMIT BUILDING Owner /�� SQ. FT. OCC. BUILDING VALUATION Mailing Address Z -i 7 S-`� �PG ` e, - Contractor Contractor 132 - Mai I ing Address Building Address- :4—<-- rJ�i r t2 vyte < A. P. No. fLj 7 ",30 Fire Zone Fire Dept. A Sanitation Plans ✓ Fees W. C. L/_ R/W NEW ❑ ADDITION ❑ USE OF STRUCTURE Single Family ❑ Duplex ❑ Others ❑�y 14141-11 � - / / X- / CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: License No. Classification !- t/ i am exempt from the Contractors License Laws of the State of California. WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of r Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. .k I certify that 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 pl'urposes. X -V4 VV� 4 Date 6 `) 7 •Y / / Signature of Permiteee or Agentt', Receipt No. � ID JJ White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant ELECTRICAL PERMIT FILING FEE Main service incl. 1 meter Additional, meters -each Sub -panel 102.or.les4 (more than 12) Range, dryer or water heater Oven, Cook -top or space heater Light fixtures Receps., switches & fix outlets Hood, Ex. Fan or F.A. Furn. Motor Evap. cooler, gar. disp. or D.W. Air conditioner or heat pump Water pump Misc. wiring Permit Fee $1174 MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation //> w 3i"� Permit Fee ntatet Fee t for on rogram Strpng Motion srumenati$0.07/$1000 Evaluation $ TOTAL PERMIT FEE $,2'-�0?,T_ This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OFF PUBLIC WORKS Date Building Permit Expires�Date Fireplace Total Valuation Permit Fee Plan Checking Fee &/or Penalty Permit Fee PLUMBING PERMIT FILING FEE /Z Each Trap Repair drainage or vent piping Water piping Each gas water heater or vent ' ZoningA — Gas piping system 1 - 5 outlets Each additional outlet Planning".4 Building sewer Encroachment Lawn sprinkler system OTHER Q. Permit Fee USE OF STRUCTURE Single Family ❑ Duplex ❑ Others ❑�y 14141-11 � - / / X- / CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: License No. Classification !- t/ i am exempt from the Contractors License Laws of the State of California. WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of r Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. .k I certify that 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 pl'urposes. X -V4 VV� 4 Date 6 `) 7 •Y / / Signature of Permiteee or Agentt', Receipt No. � ID JJ White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant ELECTRICAL PERMIT FILING FEE Main service incl. 1 meter Additional, meters -each Sub -panel 102.or.les4 (more than 12) Range, dryer or water heater Oven, Cook -top or space heater Light fixtures Receps., switches & fix outlets Hood, Ex. Fan or F.A. Furn. Motor Evap. cooler, gar. disp. or D.W. Air conditioner or heat pump Water pump Misc. wiring Permit Fee $1174 MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation //> w 3i"� Permit Fee ntatet Fee t for on rogram Strpng Motion srumenati$0.07/$1000 Evaluation $ TOTAL PERMIT FEE $,2'-�0?,T_ This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OFF PUBLIC WORKS Date Building Permit Expires�Date COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKA,/ 7 County Center Drive — Oroville, California 95965 Telephone: 533-1236, Ext. 259 APPLICATION AND PERMIT DO %.;,), authorize r presentatives of the County of Butte to enter upon the above -me ioned properW for inspection rposes. X Date S Signature of Permitee or Agent Receipt No. 610 — White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS ey; Date 6— �!— 7 Z Building Permit Expires to—� BUILDING Owner SQ. FT. OCC. BUILDING VALUATION Mai I i ng Address 2-,z - -�eG— y Fireplace Contractor Total Valuation Mailing Address �j Permit Fee Plan Checking Fee&/or Penalty Permit Fee $ $ Building Address e� /0`-1 PLUMBING No. @ FEE PERMIT FILING FEE $2.00 / Each Trap 1.50 "" "� Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 �/ A. P. No. — p� -0o ? Zoning —Z Gas piping system 1 - 5 outlets 1.50 V Each additional outlet .50 Fire Zone Fire Dept. anitation Plannin Building sewer 5.00 Ga Plans Fees W. C. R/W Encroachment Lawn sprinkler system 2.00 NEW ❑ ADDITION ❑ OTHER Permit Fee $ 16 a" $ j � S - ELECTRICAL No. @ FEE PERMIT FILING FEE $3:00 oo Main service incl. 1 meter 36 Additional me ers ch 1.00 Sub -panel (more than 12) USE OF STRUCTURE Single Famil ❑ Duplex ❑/ Others ❑ Range, dryer or water heater 1.00 �j t_ hGc� Oven, Cook -top or space heater 1.00 Light fixtures .20025- 16-0 Receps., switches & fix outlets 2Q 025o�S CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Hood, Ex. Fan or F.A. Furn. Motor 1.00 Evap. cooler, gar. disp. or D.W. 1.00 Air conditioner or heat pump Water pump Misc. wiring ®a L' ense No. Classification —+ i am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ 22 WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. y I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE J$3.00 Heating Cooling Ventilation Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State aws relating to building construction, and hereby $$Permit Instrumentctiontrpn a Motion $0.07/$1000 Evaluation $ TOTAL PERMIT PERMIT FEE $ 02 ' authorize r presentatives of the County of Butte to enter upon the above -me ioned properW for inspection rposes. X Date S Signature of Permitee or Agent Receipt No. 610 — White-D.P.W. — Pink -Inspector — Goldenrod -Assessor — Yellow -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS ey; Date 6— �!— 7 Z Building Permit Expires to—� V iv (�51 Or 110 ` S,t6Ac-'K P.O F, I , Tt }NOME t: q Materials & Workm 3nship Shall Se Ac_- r-c!ance w: -;`i Recognized ,in od Practices and .Of a c;uality F- rescribed for the S ocified use in the ►Uniform Building Code, Uniform Plumbing Code, and the National Electrical Code. us( be I �' sT.�r��d '� eG`k`Ca�� ° t0no'book J�s -1W. V� SR' ianSt a�a �S'pS a�a`nd °ra° oE a\\ a rta 5 a° e - \ Vit ° �. f-toY^ t �y s° o��0 B111�D; t'v< APf .. 1 to- ,,� �C,� A'001 USE �U PARTMENT VED a PERMIT NO. 4612-81B PERMIT EXPIRES OWNER J. DeLANGRE CONTR. owner ASSESSOR PARCEL 64-24-30 LOCATION 13876 Qlivet Drive, lot 18,, PPIMMag Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E Temp. Gas Service Called PG&E JOB FINALED (Date) Signature J -='OIC O = Not OK = Not Applicable - MOBILEHOMES * = Not Ready MISCELLANEOUS - Date MOBILEHOME UTILITIES (Plans) OK except p's 1. Zoning Requirements -Setbacks -Easements Date KS, COVERS, CARPORTS, ETC. (Plans) Cii, .:xcept ft 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch _ 2. Footings; Size -Depth -Spacing -Connectors 3. Sewer; Location -Test -Fall -C/0 -Concrete _ 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 5. Alum. Awn.; Columns-Connections-Splice-Decal-Enc,os.res 6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows -Doors 7. Utility Clearance _ 7 Elec. ram Card-Ell'ate 2 ,j_- Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date MOBILEHOME INSTALLATION (Plans) OK except b's 1. Zoning Requirements -Setbacks -Easements _ Date POOLS (Plans) OK except q's 1. Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Electricity; MH Test -Crossovers -Breakers -Clearances _ 4, Elec.; Receptacles and Lighting: Distances-GFI 5. Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/O to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater B. Gas and Electricity Tagged 8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test Card B-1 Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date J = OK O = Not OK - - = Not Applicable RESIDENTIAL. (Single and Duplex) * = Not Ready Date UNDERFLOOR Plans OK except #'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 48. 49. Property Line Firewall & Openings Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection _ 4. Ftg., Porches & Decks; Soils -Steel- / /'' Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 51. 52. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 54. 55. Glazing Area -Glass Protection -Skylights -Plastic Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Care -BI Date Card -BI Date Date FINAL (Plans) OK except q's 56. Ext. Steps -Door & Sidelight Protection -Landings CarJ-BI Dam Date Card -BI Date PLUMBING (Permit) OK except q's 57. 58. Smoke Detector Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meth. Protection 14. Water Ht.; Vent -Access -Combustion Air 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. 62. Elec. Trim & Subpanel; Breaker Sizes -Labels Stairs & Rails 19. Gas Pipe; Size & Anchors 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Catd-BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except p's 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 70. Plb., Elec. & Mech. Equip. Listed for Location 22. Size Boxes & No. of Conductors -Stapled 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 23. Romex Installed Close to Edge of Studs & C.J. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72, Insulation -Foam -Looked in Attic ❑Yes 73. Guard Rails &Deck Construction -Post Caps 25. 2 Appliance Circuits in Kitchen &Conductor Size 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or AI 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral ❑Yes ❑No 75. Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑Yes ❑No 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77, A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet - 30. Clothes Closet Light -Shower Light 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. Water Well; Disconnect, Electrical, Plumbing - 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B I Date Card -BI Date 81. 82. Ventilation throughout House Glass Protection Card B -I Date Card -BI Date Date MECHANICAL (Permit) OK except N's 83. _ Corrections from Previous Inspections 84. Gas Test -Meters Tagged; Gas -Electric 31. A.C. Ducts; Insulation & Support 85. Water & Sewer Connected -C/O to Grade -HD Approval _ 32.__ Vent Fan; Exhaust above Insulation 86, Energy Compliance Certificate -Other Certificates 33. Condensate Drain & Overflow; Size & Grade 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic - _- --- Card -BI Date Card -BI Date rd -BI - _Date - Card -BI Date Card -BI Date Card -BI Date C Date Card -BI Date Card -BI Date Card -BI Date Dat FRAMING(Plans) OK except q's Comments at Final: 36. Proper Material & Anchors 37. 38. 39. _Sills; _ _Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls over Girders & Floor NaiIin_g__ _ Draft Stop in Walls (rat proof) 40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. 42. 43. 44. Header _& Beam -Size & Bearing Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthnp.-Rfng. Fireplace Ties or Type A Flue -Fireplace Throat _ _ 45. Attic Access Size & Rom_ex Protection -Draft Stop -Ins. Baffles 46. 47. Bdrm._Windows or Exiting Doors -Sill Hgt. & Dimensions Garage Fire Protection Framing11 (NOTE:Anentrymust be made each time youvisit jobsite) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS EIRMIT NO. 7 County Center Dfive - Orbville, California 95965 - Telephone 916/534-4 1 V/ APPLICATION AND, PERMIT I ASSESSOR PARC NUMBER a �- 3� ZONING BUILDING PERMIT OWN TELEPHONE 01 I (e S FT. OCC. BUILDING VALUATION OWN -'R73 R' MAILING AD AD ESS^^ ��% L ( Y11 CONTRACTOR'S NAME OV.) til Z IL - ELE HONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ - Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ^ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ %-1J^ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ ^ BUILDING ADDRESS . PLUMBING PERMIT Filing Fee 10.00 �r Each Trap 2.00 Repair drainage or vent piping 5.00 p, Water piping LOT NO. SUB; IQN NA E PARCEL MAP Pl g I Each qas water heater or vent 5.00 Gas piping system 1- 5 outlets USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome�( Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Instal cation ❑ Other Describe work: '�� , Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. y ( DWELLING OCCUP.) OR ADDNS. ACC. SLOGS. 20 sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): El 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) ❑ 1, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEw CONSTR .OU LET 2.50 ea NON.RESID BRANCH CIRC TS NEW -CONSTR (POWER APPARATUS &% NONRESID. SINGLE OUTLET CIR. / a@ soBALI o¢ ExOccup OR FIXTURES . Ex. Occup.(OFIXED APLNSUTLETS OUTTS P(RESID )REA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating Cooling Hood 3.00 Ventilation permit Fee S Contractor 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize 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 Coun in consequence of the granting of this permi . X Date f� Z Sign re of Applicant — Owner ❑ Contractor ❑ Agent ❑ I An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ L/ OCCUP. GROUP I TYPE OF CONST. PARCEL PD I HD ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DI R E0 OF PUBLIC By PE T EXPfRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date 1Z -24—J'/ %L� �0 Receipt No. (off -17 ' WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT M o tA aco0 `lynn I, Z •>•2 al A qz ti y ::•; y LTi y ;s (�NNN --- I i ouoo : g� hI vt: ro $'1 o��O N? ong 4 k � rh i.`. N� V''.l o tA `lynn YAa Z •>•2 al A ti y ::•; y LTi y ;s (�NNN --- I i ouoo : g� kkkk 1� o��O N? ong k � i.`. N� V''.l 11 I N � A z C < < �~ vim, • � ?o � V � � o V>I � O 74 C � vt N a Z AO % r o tA `lynn YAa •>•2 al A ti y ::•; y LTi y (�NNN r�►`l ouoo : g� kkkk 1� o��O N? ong k � N� s;,,. '[ MOBILEHOME SUPPORT DATA II ll If other 'than single wide, .Iol iehonie Mfr. V �1��_ 1� � furnish Setup Model No. �5 - �� Year /9?b ,iidth(ft.) Box Length_�(ft.) Tagalong or Expando Size ft. x ft. (SHOW SUPPORT DETAILS BELOW) )n all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation nanual and structural setup sheets (if not on file with the County of Butte). k11 center supports measured from front of `! .nobilehome unless otherwise specified, r 'A Footings (check one) Single. . � Wood either pressure treated or' j foundation grade. x (ft.)(in:) (in.) (in.) 2. Other (specify) ter support ocations* Center support footing sizes Supports (check one) zY• Y (in .) . 1: Concrete block. 2: Other (specify) (ft.)(in.) (in.) (in.) • r <-----Tagalong or Expando,' show support details. t� (in.) (in.) fi x ;]D-- Typical Support. ( in. (in.) -Footing Size (in'.) (in.) .Max: Pier Spacing.. Max. Overhang (ft.) (in.) (in.) (in.) (ft.)(in.) �j ) BUTTE COUNTY DEPARTMENT BUILDING O VED APPRcenter �3 piers are p other than drawn above, :aw in. -locations, spacing, and dimensions.. F f BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET A.Owner's name'* ' ;nstaller's name: PA DISE MODULAR CONCEPTS, INC. 3. "_ the site currently underNN't � CA. 95� L1 No (916) 877.8541 (If yes, furnish permit number ) OR Is the site an existing site? Yes No (If yea, furnish two (2) plot plans.) 4. Will the mobilehome be located at least 5 ft, away from septic tank and leach fields and clear of all setbacks and easements Yes =~ No (If no, clarify ) 5. What is the mobilehome electrical rat -Ing? ----------------------- Amps 6. i;. _, is thy :aobilehomesit service �t•ing?--------------------- :�:••Amp s 7. trob lehome site circuit breaker .rating? Amps other electric load tc be. servAd by the mobilehome .= r•.. ...----------------------------------------------- Yes l . ,[ No (Ii v( -.q: identify the load ' and size: (Load) (Amps) 9. What is the mobilehome site gaspe ? s _------------------- NAV -; 0. What is ,the type of Natural %-7 LPC .1. What is the gas, pipe length fro tank to the mobilehome? (ft.) .2 -,-.What is the mobilehome gas de d? ------------------------------ . (BTU) (This information not required if pipe length less than 6 ft. on natural gas or less than 50 ft. on LPG.) R. A ku- k COUNTY OF BUTT. D WARTME' WT1 .�FiPUBLIC WORK PE�I�O.,/ 7 County Center Drive - Oroville, Cali•fdrnia 95965'- Telephone 916/5 -4541 APPLICATi$N AND PERMITI/ A SE SOR PA L NUMBER — - ZO NG BUILDR PERMIT O N R T L:EPHONE' SQ. FT. OCC.1 BUILDING VALUATION, O R'S IL rNG MIRESS A C NTRA TOR'S N E , F�LEP ON //) C N RACTO M (LING ADDRESS CFireplace CONSTRUCTION Nk�n UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILINFOADDPESS Permit .Fee $ ARCHITECT OR EN (NEER LICENSE NO. Plan Checking Fee $ ;00 Penalty $ ARCHITECT OR E GINEER'S MAILING ADDRESS Permit fee $ BUILDING ADV S AA A PLUMBING PERMIT Filing Fee 10.00 Each Trap 1 2.00 Repair drainage or vent piping 5.00 Water piping 76,p0 LOT NO. SUBDI ISIOI� NAME PARCEL MAP Each qas water heater or vent 5,00 Gas piping system 1 - 5 outlets USE OF CTURE SF ElDuplex❑ Mobilehome Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities Installation ❑ Other ❑ Describe work: Permit Fee $ O, 0b Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 800V OR LESS100 AMP OR LESS -'5+00- /0,00 Main service EA. ADD'L 100 AMP 2.50 2,,5_0 NEW CONST. (DWELLING OCCUP.y) OR ADDNS. ACC. BLDGS. 22 sq ft CONTRACTORS LICENSE LAW �� I declare u der (penalty of perjury (check one): i am licensed under provisions of Chapt. 9, Div. 3 of the Business and Prce se s Code and m license is in ful force nd effect. y License No. I 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 CONSTR I -OUTLET 2,50 ea NON-RESID BRANCH CIRC TS NEW CONSTR / POWeR APPARATUS 0) NON-RESID, (SINGLE OUTLET CIR. - 500250 Ex. Occup OUTLETS OR FIXTURES, . BAL@1 Ex. Occup.(o UTLETS P(RESID )LNS REA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 S; Oa Misc. Wiring 7.50 Permit Fee $ 3 7,50 Contractor MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. 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. Heating Cooling Hood 3.00 Ventilation permit Fee 3 Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I o agree to save, ind minify and keep harmless the County of Butte against all II bilities, judgments, costs, and ex enses which may in any way accrue agains said County i con equence of t e granting of this permit. Date not r 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 $ TOTAL PERMIT FEE $ 1 OCCUP. GROUP TYPE OF CONST, PA RCE PD o ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which D By �" v� ^ ' PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. IC WORKS Date ��/ Receipt No. Sy � � WHITE-D.P.W., YELLOW -ASSESSOR, PINK-IN9PECTaR, GOLDENROD -APPLICANT AGRICULTURAL STATUHEMf OF ACKNOWLEDGEMENT I'OR RESIDENT LCL DEVrLOPMENT 81-33761 Soct:iun 26-81 of the Butte County Code requires this acknowledgement� be re :. Wig af3gt4Ty _ u NL_{,. vrded prior to issuance of a building permit. sC3h,;e QED BY QQ� 9 ! 'J'Iie property described herein is adjacent to land or included O�� bo � within /- an area uned for agricultural purposes, and residents of I this property may be subject to inconveniences or discomfort arising from L':c_ use of agricultural chemicals, including, but not limited to her LJ pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occa- sionally generate dust, smoke, noise, and odor. Butte County has established agricul- tural zones which have as a priority use for productive agricultural purposes, and resid<:nts within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from•normal, necessary farm operations. All that real property situate in the County of Butte, State of California, du,x ribcd as follows: LOT 18, as shown on that certain Map entitled, "PARADISE PINES UNIT 1511, r@dorded-in the office of the Recorder of the County of Butte, State of California, on July 15, 1971, in Book 38 of Maps, at pages 42, 43, and 44. EXCEPTING THEREFROM all minerals, oil, gas, asphaltum and other hydrocarbon substances with provision that any and all mining operations shall be done from orifices outside the surface area of the land described herein, and that no damage shall be done to the surface of said land. } DaLe: Oct, 16, 1981 PROPERTY OWNERS: JA E S DE LANG E VETTE C. L. DE LANGRE State of Calif. On this the 16th day of October 19 81 SS.. before me, the undersigned Notary Public, personally. County of Butte )appeared JACQUES DE LANGRE AND YVETTE C.L. DE LANGRE OFFICIAL SEAL l jjj��}y KATHY DANCE NOTARY PUBLIC - CALIFORNIA PRINCIPAL OFFICE IN BUTTE COUNTY MY COMMISSION' EXPIRES OCTOBER 5, 1985 known to me to be the person(s) whose name(s) are subscribed to the within instrument and acknowledged that they executed the'same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand -and official seal00. N ary Public o m n Pr�:;ent A.P. QQCUM -__ -- -, =-- -- END OF 1. Ceiling Insulation SCORE CARD Interior Number of stories -144 R -value One Two Three R-0 -103 -49 -32 R-19 -8 -4 -2 R-30 -2 -1 -1 R-38 0 0 0 U -value -5 0.08 - 0.50 -176 -84 -54 0.30 -102 -49 32 0.10 -26 -13 -8 0.08 -18 -9 -6 0.06 -11 -5 -4 0.04 -4 -2 -1 0.02 4 2 1 0.00 11 5 3 2. Wall Insulation 3 R-11 -2 Single- Single - R-19 -1 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 F2 factor 8 15 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 7 0.02 19 14 10 0.00 24 18 12 -23 -1 3 8 3. Raised Floor Insulation 17 16 -20 Insulation in Floor 9 13 Number of stories 15 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 SCORE CARD Interior 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 -58 Number of stories -12 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 7 14 •• Number of Stories -46 R -value One Two Three R-0 0 0 0 R-5 8 5 2 R-7 8 6 3 F2 factor 8 15 22 -37. -9 -3 3 9 15 21 34 0.70 2 2 1 0.60 6 4 2 0.50. 9 6 3 0.40 12 8 4 5. Infiltration (Air Leakage) Specification Points Standard 0 6. Glass Heat Loss Total SCORE CARD Interior Slab Floor U -value East Percent West Skylight .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 8 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) Efrective Percent Gias4 (percent Sim x SC) Effective SCORE CARD Interior Slab Floor %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 1 •1 -2 -1 f3. Shading (Shade Closed) Effective Percent Glass (percent iLawxSC) Effective SCORE CARD Interior Slab Floor Raised Floor %Gless North East 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 4.9 -5 -20 -27 -25 -65 J•• 8 ; J8 -5 r -17 = - 23 -21.. -56 7- -4 -14 -19 -18. 47 16 -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 no • not allowed - 13 7.0 6 9 11 13 9. Interior Thermal Mass SCORE CARD Interior Slab Floor Raised Floor SEER Mass SID60S 1700 Somas 2700 /CFA 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 2.5 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 -7 Exterior Single- Single - -5 -4 -4 Wall Family Family Multi Mass Detached Atuched Family 0.00 0 0 0 5 0.20 3 2 1 14 12 0.40 5 4 3 22 0.60 8 6 4 11.0 0.80 10 8 5 8 1.00 13 10 7 14 1.20 13 12 8 20 1.40 12 13 9 HWR 1.60 10 13 11 4 1.80 10 12 12 Stories 2.00 10 11 13 9 11. Heating System . -4 -4 -3 -2 SE or HSPF 3 3 2-- (assumes ducts in attic) 2 1 Solar Sum of 1-6 1 1 0 -25 or -24 to -14 to -4 to +6 to 16 or SE HSPF less -15 -5 +5 +15 more 0.72 0 0 0 0 0 0 _6.60 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 _0 Effective SE or HSPF 0. (SE or HSPF x duct eMtciency) IE Effective -25 or -24 to -14 to -4to +61o, 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 System SCORE CARD Unit Size (sQ Water SEER 1199 ' 1200 1700 2200 2700 (assume: ducts In attic) or b to Sim of 7-10 f ' "or Type Type less -25 or -24 to 44 to -4 b +6 to 16 or . SEER less -15 3 +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 12.0 15 13 11 9 7 5. .13.0 20 17 14 12 9 6 ' -9 EfredJve SEER IG None -5 (SEER xduct efficiency) 1` -2 -2 Solar 7 5 4 3 Sum of 7-10 POU 3_ Effective -25 or -24 to -14to •4 to +6 to 16 or SEER less -15 •5 +5 +15 more 5.0 -30 -25 -21 -17 -13 -9 6.0 -12 -11 -9 -7 -6 -4 6.6 -5 -4 -4 -3 -2 2 7.0 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 3 Zonal Control Adjustment HWR 9 10 8 7 6 4 3 WSB To (tooling System Installed 4 Stories 2 2 POU 9 One •5 -4 -4 -3 -2 -2 Two + 3 3 2-- 2 2 1 Solar 2 1 1 0 0 Single -Family Detached and Attached Interior MasslCFA I'll t KASS n. nuiKc•..:� t k.l\-I b4.2is: e■ os6d slab) •• .a .� t TYPE I MSS (UIKC , - 0% 5% toy. 15% " Oy- 25% 30% 35% 40% 451/: 50% 55% 60% 66t TOX 75X 8016 85%,90% 95%,100% 105% 1101/. 115% 120% 125• OY. 0 0.2 0.4 0.6 0.8 .1.1` 0-I.S 1.7 1.9 2.1 23' 2.5 2.7 2.9 3.1 3.4 3.6 3.8 4y`41 4.4'4.6 4.8 5 53 101/. •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 2A 3.1 3.3 3.5 3.7 4 4.2 4.4 4.6 4.8 5 5.2 5.4 ti 20% 0.3 0.6 0.8 1 1.2 1.4 1.6 1.8 2 2.2 24 27 29 3.1 3.3 3.5 3.7 3.9 4.1 4.3 4.5 4.8 5 52 5.4 56 30% 0.5 0.7 0.9 1.1 1.4 1.6 1.8 2 2.2 2.4 2.6 2.8 3 3.2 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.3 5.6 58 40Y. 0.7 0.9 1.1 1.3 1.5 1.7 1.9 2.2 2.4 2.6 , 2.8 3 3.2 3.4 3.6 3.8 4 4.3 4.5 4.7 4.9 5.1 5.3 5.5 5:7 5.9 509'- 0.9 1.1 1.3 1.5 1.7 1.9 21 23 25 27 3 3.2 3.4 3.6" 3.8 4 4.2 4.4 4.6 4.8 5.1 5.3 5.5 5.7 5.9 6.1 55% 0.9 1.1 1.4 1.6 1.8 2 2.2 24 2.6 2.8 3 3.2 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.3 5.6 5.8 6 6.2 60% 11.2 1.4 1.7 1.9 21 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 ' S 5.2 5.4 5.6 5.9 6.1 6.3 65% 1.1 11.3 1.5 1.7 1.9 2.2 2.4 2.6 2.8 3 3.2 3.4 3.6 3.8 4 4.3 4.5 4.7 4.9 5.1 53 55 5.7 5.9 6.1 64 707: 1.2 • 1.4 1.6 1.8 2 2.2 2.5 2.7 2.9, 3.1 3.3 3.5 3.7 3.9 4.1 4.3 4.6', 4.8 , 5 52 5.4 5.6 58 6 6.2 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 S.S 5.7 5.9 6.1 6.3 6.5 809/. 1.4 1.6 1.8 2 2.2 2.4 26 2.8 3 3.3 3.5 3.7 3.9 4.1 4.3 4.5 !.7' 4.9 5.1 • 54 5.6 5.8 6 6.2 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 5.9 6.1 63 X65 67 90% 1.5, 1.7 2 2.2 24 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 53 5.5 5.7 5.9 6.2 6.4 66 68 95% I.S. 1.8 2 22 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 6.7 6.9 100% 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 6.5 6.7 7 105% 1.8 2 2.2 2.4 2.6 2.8 3 3.3 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.4 5.6 5.8 6 6.2 6.4 6.6 68 7 110y. 1.9 2.1 2.3 2.5 27 2.9 3.1 3.3 3.6 3.8 4 4.2 4.4 4.6 4.8 5 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 5.7 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 3.7 3.9 4.1 4.4 4.6 4.8 S 5.2 5.4 5.6 56 6 6.2 6.5 6.7 6.9 7.1 7.3 125% 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 Gone n SCORE CARD Unit Size (sQ Water Measures 1199 ' 1200 1700 2200 2700 Heater Credit or b to to' f ' "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 1, '2 POU 8_ _ 5 4 3 3 SE None 37 -24 -18 -15 -12 Solar -1 -1 -1 0 0 HWR -18 -12 -9 -7 -6 -10 POU -18 -12 -9 .6 IG None -5 -3 -2 -2 -2 Solar 7 5 4 3 2 POU 3_ 2 1 1 1 IE None -28 19 -14 -11 -9 Solar 8 5 4 3 3 POU .10 -6 -5 -4 -3 Multi -Family (Individual units) nit Size (61700 Water 6% 700 12W 2200 Heater Credit or b to to or TYPO 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 WSB ' 9 4 3 2 2 POU 9 5 3 2 2 SE None -45 -23 -15 11 -9 Solar 2 1 1 0 0 HWR -23 -12 -8 3 '-5 WSB -25 -13 -8 3 -5 PQU _23 •12 -8 -6 -5 n None -8 -4 -3 -2 1 -2 Solar 6 3 2 1 1 POU 1 _0 0 0. 0 IE None 30 -15 -10 -8 -6 Solar 18 9 6 4 4 POU -8 -4 -3 •2 •2 Interior MasslCFA I'll t KASS n. nuiKc•..:� t k.l\-I b4.2is: e■ os6d slab) •• .a .� t TYPE I MSS (UIKC , - 0% 5% toy. 15% " Oy- 25% 30% 35% 40% 451/: 50% 55% 60% 66t TOX 75X 8016 85%,90% 95%,100% 105% 1101/. 115% 120% 125• OY. 0 0.2 0.4 0.6 0.8 .1.1` 0-I.S 1.7 1.9 2.1 23' 2.5 2.7 2.9 3.1 3.4 3.6 3.8 4y`41 4.4'4.6 4.8 5 53 101/. •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 2A 3.1 3.3 3.5 3.7 4 4.2 4.4 4.6 4.8 5 5.2 5.4 ti 20% 0.3 0.6 0.8 1 1.2 1.4 1.6 1.8 2 2.2 24 27 29 3.1 3.3 3.5 3.7 3.9 4.1 4.3 4.5 4.8 5 52 5.4 56 30% 0.5 0.7 0.9 1.1 1.4 1.6 1.8 2 2.2 2.4 2.6 2.8 3 3.2 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.3 5.6 58 40Y. 0.7 0.9 1.1 1.3 1.5 1.7 1.9 2.2 2.4 2.6 , 2.8 3 3.2 3.4 3.6 3.8 4 4.3 4.5 4.7 4.9 5.1 5.3 5.5 5:7 5.9 509'- 0.9 1.1 1.3 1.5 1.7 1.9 21 23 25 27 3 3.2 3.4 3.6" 3.8 4 4.2 4.4 4.6 4.8 5.1 5.3 5.5 5.7 5.9 6.1 55% 0.9 1.1 1.4 1.6 1.8 2 2.2 24 2.6 2.8 3 3.2 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.3 5.6 5.8 6 6.2 60% 11.2 1.4 1.7 1.9 21 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 ' S 5.2 5.4 5.6 5.9 6.1 6.3 65% 1.1 11.3 1.5 1.7 1.9 2.2 2.4 2.6 2.8 3 3.2 3.4 3.6 3.8 4 4.3 4.5 4.7 4.9 5.1 53 55 5.7 5.9 6.1 64 707: 1.2 • 1.4 1.6 1.8 2 2.2 2.5 2.7 2.9, 3.1 3.3 3.5 3.7 3.9 4.1 4.3 4.6', 4.8 , 5 52 5.4 5.6 58 6 6.2 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 S.S 5.7 5.9 6.1 6.3 6.5 809/. 1.4 1.6 1.8 2 2.2 2.4 26 2.8 3 3.3 3.5 3.7 3.9 4.1 4.3 4.5 !.7' 4.9 5.1 • 54 5.6 5.8 6 6.2 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 5.9 6.1 63 X65 67 90% 1.5, 1.7 2 2.2 24 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 53 5.5 5.7 5.9 6.2 6.4 66 68 95% I.S. 1.8 2 22 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 6.7 6.9 100% 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 6.5 6.7 7 105% 1.8 2 2.2 2.4 2.6 2.8 3 3.3 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.4 5.6 5.8 6 6.2 6.4 6.6 68 7 110y. 1.9 2.1 2.3 2.5 27 2.9 3.1 3.3 3.6 3.8 4 4.2 4.4 4.6 4.8 5 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 5.7 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 3.7 3.9 4.1 4.4 4.6 4.8 S 5.2 5.4 5.6 56 6 6.2 6.5 6.7 6.9 7.1 7.3 125% 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 Gone n SCORE CARD Measures 1. Ceiling Insulation R 30 or R -value [38] U -value [0.030] 2. Wall Insulation R- 0 or R -value [11] U -value (0.098] 3. Raised Floor Insulation (t_ if or R-value[191 U -value [0.037] 4. Slab Edge Insulation 0 or R -value [0] F2 tactor [0.77] 5 Infiltration c.,,.,,t„>,t `•' ` ' 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 Mass 11. Heating System Zonal Control? ( Y / N ) 12. Cooling System Zonal Control? ( Y / N ) 13. Water Heating ' [double] , U -value [0.65] % Total Glass [ 16] Point Scores t7 0 Sum 1 % Glass SC Eff. % Glass . 77 Ide. x s77 z x r 77 /1-3- x III % Glass Sc Eff. % Glass 40,1 x .2r7/ C� ---06 R-2- x = fo MroS' x a7 TYPE 1 MASS AREA © 't COND. -FLOOR AREA T terior Mlss/CFA TYPE 2 MASS AREA = 1f Exterior Wall Mass ND. L OR AREA Sum 7.10 SE or HSPF Duct Efficiency [0.78] Effective SE or [0.72/6.6] HSPF [0.56/5.15] O' x = 0 SEER 19 5] Duct Efficiency [0.74] Effective SEER [7.03] , . 1.p Type el Credit (none] Point rntnl• -Z Certificate of Compliance: Residential .1— P Z 1— pZ Documentation Author Telephone d 4Hr Climate Zone 11 Building Ppmit N 'eV! m a;aed By / Date Enforcement Agency Use Only HVAC SYSTEMS Minimum Duct Type (furnace, air Efficiency Location Duct Output Manufacturer / Model # conditioner, heat pump) (SE, SEER,HSPF) (attic, etc.) R -Value (Btuh) (or approved equal) .71 A/A awoate Maximum Furnace Heating Output: Btuh HOT WATER SYSTEMS Tank Manufacturer/Model # System Type (storage gas, etc.) Capacity (or approved equal) Specal"Feature(s) Mandatory Measures Checklist: Residential MF -1R NOTE: Lowrise residential buildings subject to the Standards must contain these nest= regardless of the compliance approach used Items marked with an asterisk (•) may be superseded by more stringent compliance requirements listed on the Certificate of Compliance. When this checklist is incorporated into the permit document$. the features noted shall be considered by all parties as binding minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. DESCRIPTION I DESIGNER I ENFORCEMENT Building Envelope Measures §2.5352(a): Minimum ceiling insulation R-19 weighed average. §2.5352(b): Loose fill insulation manufacturer's labeled R -Value. ' §2.5352(c): Minimum wall insulation in framed walls R -I 1 weighted average (does not apply to exterior mass walls). §2-5352(k): Slab edge insulation - water absorption rate no greater than 03%. water vapor transmission rate no greater than 2.0 perm/uxh. §2.5311: Insulation specified or installed meets California Energy Commission (CEC) quality standards. Indicate type and form. §2.5352(f): Vapor barriers mandatory in Clinute Zones 14 and 16 only. §2.5317: Infiltration/Exfiltration Controls a. Doors and windows between conditioned and Unconditioned spaces designed to limit au leakage. b. Doors and windows certified. c. Doors and windows weatherstripped; all joints and penetrations caulked and sealed. §2-5352(e): Special infiltration barrier installed to comply with §2.5351 meets CEC quality standards. . §2.5352(d): Installation of Fireplaces 1. Masonry and factory -built fireplaces have: a. Tight rating. closeable metal or glass door b. Outside air intake with damper and control c. Flue damper and control 2. No continuous burning gas pilot allowed. HVAC and Plumbing System Measures 62-5352(8) and 2-5303: Space conditioning equipment sizing: attach calculations. §2-5352(h) and 2-5315: Setback themwsut on all applicable heating systems. • 12-5316(a): Ducts constructed. installed and insulated per Chapter 10. 1976 UMC. §2-5316(b): Exhaust systems have dampercontrols. §2.5314(c): Gas-fired space heating equipment has intermittent ignition devices. §2-5314: HVAC equipment, water heaters. showerheads and faucets certified by the CEC. §2-5352(i): Water heater insulation blanket (R-12 or greater) or combined interior/exterior insulation (R-16 or greater); fust 5 feet of pipes closest to tank insulated (R-3 or greater). 62.5312(Exception 1): Pipe insulation on steam and steam condensate return & recirculating piping. §2-5318(d): Swimming Pool Heating I. System has: a. Onfoff switch on heater. b. Weatherproof instruction plate on heater. e. Plumbed to allow for solar. 2. 75 percent thermal efficiency. 3. Pool cover. 4. Time clock. 5. Directional water inlet. Lighting and Appliance Measures §2-5352(1): Lighting - 25 lumens/watt or greater for general lighting in kitchens and bathrooms. §2-5314(c): Gas fired appliances equipped with intermittent ignition devices. §2-5314(a): Refrigerators. refrigerator -freezers. freezers and fluorescent lamp ballasts certified by the CEC. Indicate make and model number. COMPLIANCE STATEMENT This certificate of compliance lists the building features and performance specifications needed to comply with Title 24, Chapter 2-53 and Title 20. Chapter 2. Subchapter 4. Article 1 of the California Administrative code. This certificate has been signed by the individual with overall design responsibility and the building owner, who shall retain a copy of it and transmit the certificate to any subsequent purchaser of the building. Designer Name: Addmn: Telephone: tic. 0: Y - (sigrtatttr+c) Documentation Author Building Owner Name: Title/Firm- Address: Telephone: - - (data) . _ _ (signature) Enforcement Agency SPECIAL FEATURES/REMARKS (Add extra sheets if necessary) N1: Name: rY 7i1C rltWFUM Agency: Address: Tekphone: Glass `tel// BUILDING DATA North Conditioned Floor Area Number of Stories J?, East Slab/Raised Floor j`-b�S 2 2 �� Number of .Units South 1J 3 Dd Single Family Detiched (SPD) (] Addition Alone West IV /. 6: [ ] Single Family Attached (SFA) [ ] Existing Building Skylight /1 3 [ ] Multi -Family (MF) [ ] Existing -Plus -Addition Total 4�2 9 BUILDING SHELL INSULATION Component Insulation Location/Comments Type_ R -Value (attic, to garage, typical, etc.) Wall .............. Wall .............. Roof ............. �3a Roof ............. Floor ............. Floor ............. Slab Edge..... GLAZING Shading Devices Glazing Area Glass Type Interior Exterior Overhang Framing Type Orientation (SO (single, double) (holler blind, etc.) (shadescreen, etc.) (yesino) (metaliwood) Noah ( ) /3s-' 6 f Nomh East East ( ) South ( ) /33 0 < _ ,,, fj� S 6_ Sou ths-� West West ( ) •_ Skylight....... 41Z_ THERMAL MASS Type/Covering Area Thickness (slab/exposed, tile, etc.) (sf) (inches) Loeadon/Description (kitchen, bath, etc.) HVAC SYSTEMS Minimum Duct Type (furnace, air Efficiency Location Duct Output Manufacturer / Model # conditioner, heat pump) (SE, SEER,HSPF) (attic, etc.) R -Value (Btuh) (or approved equal) .71 A/A awoate Maximum Furnace Heating Output: Btuh HOT WATER SYSTEMS Tank Manufacturer/Model # System Type (storage gas, etc.) Capacity (or approved equal) Specal"Feature(s) Mandatory Measures Checklist: Residential MF -1R NOTE: Lowrise residential buildings subject to the Standards must contain these nest= regardless of the compliance approach used Items marked with an asterisk (•) may be superseded by more stringent compliance requirements listed on the Certificate of Compliance. When this checklist is incorporated into the permit document$. the features noted shall be considered by all parties as binding minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. DESCRIPTION I DESIGNER I ENFORCEMENT Building Envelope Measures §2.5352(a): Minimum ceiling insulation R-19 weighed average. §2.5352(b): Loose fill insulation manufacturer's labeled R -Value. ' §2.5352(c): Minimum wall insulation in framed walls R -I 1 weighted average (does not apply to exterior mass walls). §2-5352(k): Slab edge insulation - water absorption rate no greater than 03%. water vapor transmission rate no greater than 2.0 perm/uxh. §2.5311: Insulation specified or installed meets California Energy Commission (CEC) quality standards. Indicate type and form. §2.5352(f): Vapor barriers mandatory in Clinute Zones 14 and 16 only. §2.5317: Infiltration/Exfiltration Controls a. Doors and windows between conditioned and Unconditioned spaces designed to limit au leakage. b. Doors and windows certified. c. Doors and windows weatherstripped; all joints and penetrations caulked and sealed. §2-5352(e): Special infiltration barrier installed to comply with §2.5351 meets CEC quality standards. . §2.5352(d): Installation of Fireplaces 1. Masonry and factory -built fireplaces have: a. Tight rating. closeable metal or glass door b. Outside air intake with damper and control c. Flue damper and control 2. No continuous burning gas pilot allowed. HVAC and Plumbing System Measures 62-5352(8) and 2-5303: Space conditioning equipment sizing: attach calculations. §2-5352(h) and 2-5315: Setback themwsut on all applicable heating systems. • 12-5316(a): Ducts constructed. installed and insulated per Chapter 10. 1976 UMC. §2-5316(b): Exhaust systems have dampercontrols. §2.5314(c): Gas-fired space heating equipment has intermittent ignition devices. §2-5314: HVAC equipment, water heaters. showerheads and faucets certified by the CEC. §2-5352(i): Water heater insulation blanket (R-12 or greater) or combined interior/exterior insulation (R-16 or greater); fust 5 feet of pipes closest to tank insulated (R-3 or greater). 62.5312(Exception 1): Pipe insulation on steam and steam condensate return & recirculating piping. §2-5318(d): Swimming Pool Heating I. System has: a. Onfoff switch on heater. b. Weatherproof instruction plate on heater. e. Plumbed to allow for solar. 2. 75 percent thermal efficiency. 3. Pool cover. 4. Time clock. 5. Directional water inlet. Lighting and Appliance Measures §2-5352(1): Lighting - 25 lumens/watt or greater for general lighting in kitchens and bathrooms. §2-5314(c): Gas fired appliances equipped with intermittent ignition devices. §2-5314(a): Refrigerators. refrigerator -freezers. freezers and fluorescent lamp ballasts certified by the CEC. Indicate make and model number. COMPLIANCE STATEMENT This certificate of compliance lists the building features and performance specifications needed to comply with Title 24, Chapter 2-53 and Title 20. Chapter 2. Subchapter 4. Article 1 of the California Administrative code. This certificate has been signed by the individual with overall design responsibility and the building owner, who shall retain a copy of it and transmit the certificate to any subsequent purchaser of the building. Designer Name: Addmn: Telephone: tic. 0: Y - (sigrtatttr+c) Documentation Author Building Owner Name: Title/Firm- Address: Telephone: - - (data) . _ _ (signature) Enforcement Agency SPECIAL FEATURES/REMARKS (Add extra sheets if necessary) N1: Name: rY 7i1C rltWFUM Agency: Address: Tekphone: 1. Ceiling Insulation -4 3 -1 0.80 Number of stories 0.70 R -value One Two Three R-0 -103 -49 -32 R-19 -8 -4 -2 R-30 -2 -1 -1 R-38 0 0 0 U -value -90 -37 -26 0.50 176 -84 -54 0.30 A02 -49 32 0.10 -26 -13 -8 0.08 -18 -9 -6. 0.06 -11 -5 -4 0.04 -4 -2 -1 0.02 4 2 1 0.00 11 5 3 2. Wall Insulation -17 -9 -2 Single- Single - 26 -49 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 8 15 22 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 7 0.02 19 14 10 0.00 24 18 12 3. Raised Floor'Insulation 3 8 Insulation In Floor 16 -20 Number of stories 9 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 15 18 12 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 Crawlspace -1 Number of stories -9 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 2 0.70 6.42 17 15 13 11 " Number of Stories 7 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 5. Infiltration (Air Leakage) Specification Points Standard 0 6. Glass Heat Loss Total SC Eff. % Glass Interior Slab Floor Raised Floor U -value %Glass Percent East South .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 3 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 -8 -7 -23 3 0 4 -5 7..Shading (Shade Open) Effective Percent Class (Peft-mit glass x SC) Effective SC Eff. % Glass Interior Slab Floor Raised Floor Mass %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 it 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 16 or Wall Family Family Multi IB. Shading (Shade Closed) Detached Att hed Family Effective Pereatt Class 0 0 0 (Percent glass x SC) 0.20 Effective 1 -12 0.40 5 4 3 %Glass Nott East South West %*ht 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, a -20 - -27 -25 -65 8-5 SE HSPF -17 ` -23 - -21. -56 . 7,1 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 0.56 5.13 0 0 0 0 0 9. Interior Thermal Mass SC Eff. % Glass Interior Slab Floor Raised Floor Mass Stories Stories 1200 /CFA 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 ti 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 7 Exterior Single- Single - +6 b 16 or Wall Family Family Multi Mass Detached Att hed Family 0.00 0 0 0 -17 0.20 3 2 1 -12 0.40 5 4 3 4 0.60 8 6 4 3 0.80 10 8 5 0 1.00 13 10 7' 0 1.20 13 12 8 5 1.40 12 13 9 16 1.60 10 13 11 5 1.80 10 12 12 13 2.00 10 11 13 26 11. Heating System 15 12 8 SE or RSPF 30 26 22 (assumes ducts In attic) 14 9 Sum of 1-6 33 29 24 20 -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 SE Effective SE or HSPF -45 -23 (SE or HSPF x duct efTiciency) -11 Effective -25 or -24 to -14 b 4 to +6 b 16 or SE HSPF less -15 -5 +5 +15 more 1 0.30 2.75 -73 34 -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 0 ' 0 System Type 0 IE None Resistance 10 9 7 6 4 3 Other 6 5 4 3 2 2 12. Cooling System , SC Eff. % Glass Unit Size (sQ Water SEER 1199 1200 1700 2200 2700 (assumes ducts In attic) or b to Sam of 7-10 or Type Type less -25 or -24 to -14 to -4b +6to 16 or SEER less -15 -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 12.0 15 13 11 9 7 5 13.0 20 17 14 12 9 6 _ -12 -9 Effective SEER -6 IG None (SEER x dud efficiency) -3 -2 -2 Sum 017-10 1.3 Solar 7 Effective -25 or -24 to -14 to -4b +6 b 16 or SEER less -15 -S +5 +15 more 5.0 -30 -25 -21 -17 -13 -9 6.0 -12 -11 -9 -7 -6 4 6.6 -5 -4 -4 3 -2 -2 7.0 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 or Zonal Control Adjustment 14 7 10 8 7 6 4 3 9 No Cooling System Installed 3 2 Stories One -5 -4 -4 -3 -2 -2 Two+ 3 3 2 2 2 1 Single -Family Detached and Attached Interior Mass/CFA SC Eff. % Glass Unit Size (sQ Water 1199 1200 1700 2200 2700 Heater Credit or b to to or Type Type less 1699 2199 2699 more SG None 0 0 0 0 0 or Solar 12 8 6 _ 5- 4 HP HWR 8 5 4 3 3 [0.72/6.6] WSB 5 3 3 2 2 I1.7•ui6tC•6. 1i I it.7-U.d .l.bi POU 8 5 4 3_ 3 SE None -37 -24 -18 -15 -12 Solar -1 -1 -1 0 0 HWR -18 -12 -9 -7 -6 3S% WS8 .25 -16 -12 -10 -8 70% POU 48 _ -12 -9 -7 -6 IG None -5 -3 -2 -2 -2 1.3 Solar 7 5 4 3 2 2.1 POU 3 2 1 1 1 IE None -28 19 -14 -11 -9 0.2 Solar 8 5 4 3 3 1.6 POU -10 -6 -5 -4 -3 3.1 Multi -Family (individual 3.5 units) 4 4.2 4.4 4.6 Unit Size (sQ 5 Water 5.4 699 700 1200 1700 2200 Heater Credit or to 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 3 WSB 9 4 3 2 2 4.5 POU 9 5 3 2 2 SE Nbne -45 -23 -15 -11 -9 1.9 Solar 2 1 1 0 0 3.4 HWR -23 -12 -8 -6 -5 4.9 WSB -25 -13 -8 -6 -5 0.9 e4U _23 -12 .8 _._ -6 -5 IG None -8 -4 -3 .2 -2 3.8 Solar 6 3 2 1 1 5.3 POU 1 0 ' 0 0 0 IE None 30 15 -10 -8 -6 2.6 Solar 18 9 6 4 4 4.1 POU -8 -4 -3 -2 -2 Interior Mass/CFA Point System Summary: Climate Zone 11 SCORE CARD Measures 1. Ceiling Insulation 2. Wall Insulation or or R -value I11) U -value [0.098] 3. Raised Floor Insulation or R -value [ 19] U -value [0.037] 4. Slab Edge Insulation S. 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 Mass 11. Heating System Zonal Control? ( Y / N ) 12. Cooling System Zonal Control? ( Y / N ) 13. Water Heating or R -value [0] F2 factor 10.77] cl. -7_-J Type [double] U -value 10.651 % Total Glass (16) % Glass SC Eff. % Glass X = X X X X % Glass SC Eff. % Glass X = X = X X = X TYPE 2 PASS TYPE 1 MASS AREA __ B COND. FLOOR AREA InteriorW ss/CFA TYPE 2 MASS AREA = B Exterior Wall Mass ND. FLOOR AREA X SE or HSPF Duct Efficiency [0.78] Effective SE or [0.72/6.6] HSPF [0.5615.151 I1.7•ui6tC•6. 1i I it.7-U.d .l.bi t TYPE 1 MASS WIMC • 4.2. le: exposed slab) 0% 6% 109E 15% 20Y. 25% 30Y. 3S% 40% 45% 50% 55% 60% 6616 70% 75% 80% 85y- 90% 95% 100% 105% 110y6 11S% 120'/.12S' oy. 0 0.2 0.4 0.6 0.8 1.1 1.3 1.5 1.7 1.9 21 23 2.5 2.1 2.9 3.2 9.4 3.6 3.8 4 4.2 4.4 4.6 4.8 5 5.3 101/6 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 27 29 3.1 3.3 3.5 3.7 3.9 4.1 4.3 4.5 4.8 5 5.2 5.4 56 30% 0.5 0.7 0.9 1.1 1.4 1.6 1.8 2 22 24 2.6 28 3 3.2 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.3 5.6 58 401/6 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 5.5 5.7 5.9 50% 0.9 1.1 1.3 1.5 1.7 1.9 21 23 25 21 3 3.2 3.4 3.6 3.8 4 42 4.4 4.6 4.8 5.1 5.3 5.5 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 3.2 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.3 S.6 5.8 6 6.2 60% 1 1.2 1.4 1.7 1.9 21 2.3 2.5 2.7 29 3.t 3.3 3.5 3.8 4 4.2 4.4 4.6 4.9 ' 5 5.2 5.4 5.6 5.9 6.1 6.3 65% 1.1 1.3 1.5 1.7 1.9 2.2 2.4 2.6 2.8 3 3.2 3.4 3.6 3.8 4 4.3 4.5 4.7 4.9 5.1 5.3 55 5.7 5.9 6.1 6.4 70Y. 1.2 1.4 1.6 1.8 2 2.2 2.5 21 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 6.2 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 5.7 5.9 6.1 6.3 6.5 BOY. 1.4 1.6 1.8 2 2.2 2.4 26 2.8 3 3.3 3.S 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.4 5.6 5.8 6 6.2 64 66 65% 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 5.9 6.1 63 65 67 WY. 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 6.4 66 68 95% 1.6 1.82 2.2 2.5 27 2.9 3.1 33 3.5 3.7 3.9 4.1 4.3 4.6 4.8 5 5.2 5.4 5.6 5.6 6 6.2 6.4 6.7 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 6.5 6.7 7 10S% 1.8 2 2.2 2.4 2.6 2.8 3 3.3 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.4 5.6 5.8 6 6.2 6.4 6.6 68 7 110% 1.9 2.1 2.3 2.5 2.7 2.9 3.1 3.3 3.6 3.8 4 4.2 4.4 4.6 4.8 5 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 5.7 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 3.7 3.9 4.1 4.4 4.6 4.8 5 5.2 5.4 5.6 68 6 6.2 6.5 6.7 6.9 7.1 7.3 125% 21 2.3 2.5 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 2. Wall Insulation or or R -value I11) U -value [0.098] 3. Raised Floor Insulation or R -value [ 19] U -value [0.037] 4. Slab Edge Insulation S. 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 Mass 11. Heating System Zonal Control? ( Y / N ) 12. Cooling System Zonal Control? ( Y / N ) 13. Water Heating or R -value [0] F2 factor 10.77] cl. -7_-J Type [double] U -value 10.651 % Total Glass (16) % Glass SC Eff. % Glass X = X X X X % Glass SC Eff. % Glass X = X = X X = X TYPE 1 MASS AREA __ B COND. FLOOR AREA InteriorW ss/CFA TYPE 2 MASS AREA = B Exterior Wall Mass ND. FLOOR AREA X SE or HSPF Duct Efficiency [0.78] Effective SE or [0.72/6.6] HSPF [0.5615.151 X SEER 19.51 Duct Efficiency 10.74] Effective SEER [7.03] Type [SG] Credit [none] . Point Scores Sum 1-6 Sum 7-10 Point Total: e,�o Certificate of Compliance: Residential Climate Zone 11 Project Tide Building Permit N Project Address Q►edced By /Date Documentation Author Telephone Enforcement Agency Use Only BUILDING DATA Conditioned Floor Area Number of Stories Slab/Raised Floor Number of ,Units [ ] Single Family Detached (SFD) [ ] Addition Alone [ ] Single Family Attached (SFA) [ ] Existing Building [ ] Multi -Family (MF) [ ] Existing -Plus -Addition BUILDING SHELL INSULATION Component Insulation Location/Comments TM R -Value (attic, to garages typical, etc.) Wall .............. Wall .............. Roof ............. Roof ............. Floor ............. Floor ............. Slab Edge..... GLAZING Shading Devices North East South West Skylight Total Glass Area % Glass 1, Glazing Area Glass Type Interior Exterior Overhang Framing Type Orientation (SO (single. double) (roller blind. etc.) (shadescreen, etc.) (yes/no) (metal/wood) North ( ) North ( ) East ( ) East ( ) South South ( ) West ( ) West ( ) Skylight....... THERMAL MASS Type/Covering Area Thickness (slab/exposed, tile, etc.) (So (inches) Location/Description (kitchen. bath, etc.) HVAC SYSTEMS Minimum Duct Type (furnace, air Efficiency Location Duct Output Manufacturer / Model # conditioner, heat pump) (SE, SEER,HSPF) (attic, etc.) R -Value (Btuh) (or approved equal) Maximum Furnace Heating Output: Btuh HOT WATER SYSTEMS Tank Manufacturer/Model # ___System Type.. (storage,..gas,_etc.-)„-,,,C_''apacity—(or approved_equal)-- *Special Feature(s) SPECIAL FEATURES/REMARKS (Add extra sheets if necessary) Mandatory Measures Checklist: Residential MF -111 NOTE: Lowrise residential buildings subject to the Standards must contain these measures regardless of the compliance approach used. Items marked with an asterisk (-) may be superseded by more stringent compliance rcgwrements listed on the Cenificate of Compliance. When this checklist is incorporated into the permit documents, the features noted shall be considered by all parties as binding minimum component perfomtance specifications for the mandatory measures whether they art shown elsewhere in the documents or on this checklist only. DESCRIMON I DESIGNER I ENFORCEMENT I Building Envelope Measures • §2.5352(a): Minimum ceiling insulation R-19 weighted average. §2.5352(b): Loose fill insulation manufacturer's labeled R -Value. • §2.5352(c): Minimum wall insulation in framed walls R-11 weighted average (does not apply to ex to for mass walls). §2.5352(k): Slab edge insulation - water absorption rate no greater than 03%, water vapor transmission rate no greater than 2.0 permlutch. §2-5311: Insulation specified or installed meets California Energy Commission (CEC) quality standards. Indicate type and form. §2-5352(f): Vapor barriers mandatory in Climate Zones 14 and 16 only. §2.5317: Infiltration/Etcfiltration Controls a. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. b. Doors and windows certified. c. Doors and windows weathcrstripped: all joints and penetrations caulked and sealed. §2-5352(e): Special infiltration banriu installed to comply with 62-5331 meets CEC quality standards. §2.5352(d): Installation of Fireplaces 1. Masonry and factory -built fireplaces have: a. Tight fitting, closeable metal or glass door b. Outside air intake with damper and control c. Flue damper and control 2. No continuous burning gas pilots allowed. HVAC and Plumbing System Measures §2-5352(8) and 2-5303: Space conditioning equipment siring: attach calculations. §2.5352(h) and 2-5315: Setback thermostat on all appliable heating systems. §2.5316(a): Ducts constructed, installed and insulated per Chapter 10, 1976 UMC. §2.5316(b): Exhaust systems have damper controls. §2-5314(c): Gas-fired space heating equipment has intermittent ignition devices. §2-5314: HVAC equipment, water beaters, showerheads and faucets certified by the CEC. §2-5352(1): Water heater insulation blanket (R-12 or greater) or combined inwior/exterior insulation (R.16 or greater): fust 5 feu of pipes closest to tank insulated (R-3 or greater). §2.5312(Excep6on p: Pipe insulation on steam and steam condensate return & recirculating piping. §2-5319(d): Swimming Pool Heating I. System has: a. On/off switch on heater. b. Weatherproof instruction plate on heater. c. Plumbed to allow for solar. 2. 75 percent thermal efficiency. 3. Pool cover. 4. Time clock. 5. Directional water inlet Lighting and Appliance Measures §2-53526): Lighting - 25 lumcns/watt or greater for general lighting in kitchens and bathrooms. §2-5314(c): Gas fired appliances equipped with intermittent ignition devices. 62.5314(a): Refrigerators, refrigerator -freezers, freezers and fluorescent lamp ballasts certified by the CEC. Indicate make and model number. COMPLIANCE STATEMENT This certificate of compliance lists the building features and performance specifications needed to comply with Title 24, Chapter 2-53 and Title 20. Chapter 2. Subchapter 4. Article 1 of the California Administrative code. This certificate has been signed by the individual with overall design responsibility and the building owner. who shall retain a copy of it and transmit the certificate to any subsequent purchaser of the building. Designer Name; Address: Telephone: Lic. N: ,� (sitnantrr.) Documentation Author Name: TitWFum: Address: (date) Building Owner Nance: Tideffium:- Address: Telephone: (signature) V Enforcement Agency Name: Atency: Tekpht m sm I