HomeMy WebLinkAbout064-260-025<1! - _ --- - ' -- --64-26-25' 1� A
Albert Lynch _ - --- --
395 Ponderosa Way,lot 37,PP#15,Magalia
contr:Triple"8," CustomHomes, Paradise
Permit #3881-76B,P,E,M(new single
family) �
vn'1126 -2
a
l
64-26-25
Permit #3468-78B(addd awning/SF)
a-064-260-025, . PERMIT#97-1554
'NAZARETTA, Randy,.
6234 Ponderosa Way, Magalia
Add Den/SF q
Slav► �„ �� I c: ��� , ZD ' /�
064-260-025 02-2153
NAZAREITA, RANDY
6234 PONDEROSA WAY, MAGALIA
CONT: JIM WATTS
WATER HEATER
064-260-025 02-2392
NAZARETTA, RANDY EFUN
6234 PONDEROSA, MAGALIA
CONT: JAMES WATTS
REPLACE WATER HEATER
Cfll d' �] COI
KABUILDING\REFUND COUNTY OF BUTTE
Oroville, California
GENERAL CLAIM
CLAIMANT: Mr. James R. Watts
ADDRESS: 40 Regent Lane
CITY & STATE: Chico Ca 95973
DATE OF CLAIM: 10/11/2002
IMPORTANT: SEE INSTRUCTIONS ON REVERSE SIDE
SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES
DATE
DESCRIPTION OF CLAIM DESCRIBE FULLY TO AVOID DELAY
AMOUNT
CLERICAL ERROR, DUPLACATE PERMIT. (AP#064-260-025, BP#02-2392, RECEIPT #360768, DATED 8-30-
02, OWNER: RANDY NAZAP.ETTA.
Total amount paid
$ 35.
00
Total amount to be retained
0
TOTAL
$ 35.
00
I, the undersigned, declare under penalty of perjury that the services or articles cl, ime have been performed'o—r'Wlelivere , and that this claim is true and
correct as stated.
Dated this �� day of Calif:
Signature of Nimant
I, the undersigned, hereby certify that, to the best of my knowledge, the servvicep,r is s ecified abovWffkye bee performed or delivered and that there
is a Budget Appropriation I I or Specific Board Approval I I (Check one) for We' sa e.
Dated this day of i1 �%� , 2000 , at -0 �y�Calif.
artment H ad or Authorized Deputy
Dept. Code 440-00.1 Exp. Code 4210500 for $35.00 PAYABLE FROM CO STRUCTION PERMITS
Dept. Code 0100 Exp. Code PAYABLE FROM
Dept Code Ex . Code PAYABLE FROM
FUND
FUND
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.
COUNTY OF BUTTE
Oroville, California
GENERAL CLAIM '
CLAIMANT:. R1)7,rg .... !.. (J-11 -7 S • • .1;
ADDRESS: --410
CITY & STATE: c: Cd IC 5?,5 -973
DATE OF CLAIM:
IMPORTANT. • SEE INSTRUCTIONS 6N REVERSE SIDE
SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERV/CES
DATE
DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY)
AMOUNT
z
P1, 101,41-
P,�I" / f
TOTAL
I, the undersigned, declare under penalty of perjury that the services or articles claimed have bee pe o. ed or delivered, and t t this claim is true an
as stated.
C��� _ Z �/76/ "� Calif. f
Dated this day of , 20U at
Signature of Claimant
I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles ied above have been performed or delivered and that t
Budget Appropriation [ I or Specific Board Approval [ I (Check one) for the same.
Dated this day of 20___, at Calif.
Department Head or Authorized Deputy
Dept. Code Exp. Code PAYABLE FROM
Dept. Code Exp. Code PAYABLE FROM
Dept Code Ex . 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.
INSTRUCTIONS TO CLAIMANTS
All claims against the county must be itemized, giving dates and character of service rendered or work
performed, quantities, description and unit prices of articles furnished or delivered.
Claims must be certified by the claimant and submitted to the Department head for approval. Upon approval
the Department head will forward claim to County Auditorfor payment procedure. Do not file with the County
Auditor first.
Claims should be presented to officialsfor approval immediately upon completion of services requested or
material ordered.
Compliance with above will expedite payment of claim, failure to do so may delay payment considerably.
CLAIMANT'S NAME
MAILING ADDRESS
REF
ASSESSOR PARCEL #:
RECEIPT NUMBER(S)
Reauest a refund of fees paid on the above receipt number(s) for the following reasons:
Please eefuro any applicable fees in the following categories: (Check those categories
which you wish to have refunded.)
J) Building Permit Fees ( ) Sheriff Fees
( ) SRA Fees'(CDF Fire Planning) (')' Urb`an Area Fees
Disposition of Plans'
( ) Plans retumed to me at counter
( ) Please mail plans to me at above address.
( ) Please dispose of plans.
SIGNATU
PLEASE DATE AND SIGN THE ATTACHED COUNTY OF BUTTE GENERAL CLAIM
FORM. DO NOT COMPLETE ANY OTHER INFORMATION ONTHAT FORM.
FOR BUILDING DIVISION USE.
Receipt Information: .
Number:
Date:
Issued To:
Amount:
_ Fees Retained:
Processing Fee:
�j Bldg Filing Fee:
Plbg Filing Fee:
Elec Filing Fee:
....Mech Filing Fee
-Energy P/C Fee:
Plan Check Fee:
Inspection Fee:
SRA Fee:
Total Amount Retained
TOTAL REFUND DUE
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION,,
7 County Center Drive •9 Oroville, California 95965 - Telephone (530) 538-7541., PERMIT NO
APPLICATIO'
ASSESpep.. MANDPERMIT
Mal!ey
77
OWNER
OWNEWS MAILING ADDRESS, r rw
C9NTRAC
R'S ME
TELEPHONE
CONTRACTOR'S MAILING ADD
CONSTRUC ON LEND
S , ' '
U
CONSTRUCTION LENDER
LENDER'S MAILING.ADDRESS .
ARCHITECT
RCHITECT OR, ENGINEER
LICENSE No.
ARCHITECT OR ENGINEERSMAILING ADDRESS
LJILDINGADDRESS�
LOT NO. SUBDIVISION'S NAME
PARCEL MAP
E'.',�1J.DIVISION'.-ME
USEOFSTRUCTURE
SF=" 'Duple*XL b Mobilehome 0 Other
SPECIFY,
TYPE OF WORK
New
0 0 Remodel o Utilities 0 Installation 13 Other ❑
Describe Work;,
7'
LIC 'D ECLARATION
CONTRACTOR'S
I'heireby a - tfirni under �penalty of, perjury that I am licensed under provisions Of Chapter
9 (commencing with Section 7000) of Division 3'of the: Business and Professio
and my licefiso,',ii in full force and effect. ns Code,
License C,16w Lic. No.
OWNER -BUILDER DECLARATION
1 -hereby, affirm under penalty Of Perjury that I and exempt from the Contractors License
Law for the foll6v;ing reason:
0 1, As owner 8f th-e property, or my employees with wages as.thei
will do the:Work r sole c ?nsation,
I , and structure is not intended or offeredsale':
O� 'I, as owhEI�!of'th� property, am ex for. sate.
t] I T 't the,
clusively.conti�acting -with licensed'
to construct contractors
aryi.Eixernit under Sec.
re Business and Professions Code for this
ason
vvu1H1KtH.S' COMPENSATION DECLARATION
-1 hereby affirm�urider penalty of perjury one of the following declarations:
❑ I have And will maintain a certificate of consent to self -insure 'for,workers'
compensation,,,'as� :provicled, for by section 3 . 760. of the Labor perl`Ormahce of the, work for which this permit it, issued. Code, for the
I have and:Will:rrialintain Workers' co
mpensation, Insurance, as required by Section
3700 of the Labor bode, for the performance.of work for which this perm�it is issued.
My Workerg' 6,Ompens ! ation insurance carr I ier and Policy number are:
Carrier
Policy' Number.
(The above:sectionsneed not be completed, if thek permit
un'6red'dollars ($100) or less.) is for work of a valuation
of one hi
O I certify that din the I Performance of the work for which this permit is issued, I shall
0
inot'empioyi Any person in any manner so as to become subject tp,Wbrkers'
compensation laws of California, and
agree th
workers' ' ' at if, I should become s to the
'Cornpen'§abon Provisions of section.3700 of the Labor Code le I shall
Z
MP! 'W. h those provisions
y: 4
BUILDING
---T----
SQ. FT. OCC
E
Total' Valuation Uat'On
5.01
Filing Fee
5.01
Permit Fee
$
Plan Checkina Fee
RChecking
"FEE
$
PI C
Energy: Plan Fee
$
ELECTRICAL •PERMIT
'Filing Fee
P MI
PERMIT
$
PLUMBING PERMIT
`,FilihI4.
Each ach Trap
7-0
Solar or heat pump water heater
F3_.0
tach gas water heater or vent
Ventilation
Mobile
Energy
5.01
Gas piping system 1 -5 outlets
5.01
Building sewer
5.0(
Mobile Home S G W
@ 0.0(
PERMIT FEE
ELECTRICAL •PERMIT
'Filing Fee
Main Service 600v OR LESS
200A OR LESS
23.Qd
Main Service 200A TO 1000A
0.00
NEW CONST
OR DWELLING OCCUP.
ADDNS. & ACC BLDS
I so
NOISI41�iii.NEW MLILTI-OLTLET
SR
•
@?7.50
GPOWER APPARATUS
OUTLET CIR.
Ex. Occup. OUTLET OR
20 -too.
FIXED APP LNS. OR
Ex.. Occup.
SAL
OUTLETS (RESID.) EA
5.00
Temporary Service
�23 1 :00
Mobile Home Facilities
.
2 0.00.
Misc.- Wirina
PERMIT FEE $
MECHANICAL PERMIT
Filing Fee
Heating
,00ling
Hood
:6.50
PERMIT FEt
Home, Installation Fe) $
Inspection Fee
Occ. CONST. TYPE
TOTAL FEE $
This permit is hereby Issued under the apl
XDaI -
w io :thB�tte C
e uounty. Code and/or Reso
te lL
Signature U indicated above for which fees have been
Owner EJ Contractor ET A6_ent___
An OSHAPermit equire&fot excavations over 5'W deep And demolition or'Cbristruction
of structures overIitori ...
es.ln height..
By Date
Receipt No. q
WHITE.'
I CANARY ASSESSOR PINK INSPECTORt.GOLDEN ROOPERMIT EXPIRES ON
-A.P,�LICANT
(bwq,
20.00
20.00
00
20.00
,
to do`work
t
QFILE
October 11, 2002
Mr. James R. Watts
40 Regent Lane
Chico CA 95973
RE: AP # 064-260-025
.Building Permit # 02-2392
Dear Mr. Watts:
You are due a refund from our office. Please find attached a general claim form ready for
signature.
Please sign only where indicated and return to this office so that we may process your refund.
Should you have any questions concerning this matter, please contact me at (530)538-7541.
Yours very truly,
i
Tammie Powell
Plans Applicant Assistant
attachment
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 7,,-;M }y
•
(Rev. 12/96) APPLICATION AND PERMIT �(J
ASSESSOR PARCEL NUMBER - (\ ^
(/ (,
ZONING
BUILDING PERMIT
OWNER
n r► r� %� �0 2 /dot l rT
TELEPN
� -7 E- 2345 -
SO. FT. OCC. BUILDING VALUATION
OWNERS MAIUNG ADDRESS 0
2-;q P5,jil!6^95ei
CONTRACTOR'S -ME <"- � �
TELEPHONE
CONTRACTORS MAID ODRESS F//J
��� 7_
6
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Flin Fee $ 20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDINGADDRESS i� y�
Energy Plan Checking Fee $
PERMIT FEE $
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
PLUMBING PERMIT Fling Fee 20.00
Each Trap 7.00
USEOFSTRUCTURE
SF,I(Duplex ❑ Mobilehome ❑ 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 ❑ Other
Describe Work: W�J-�N tj�/,�r4ti•/ n �`L.�
Gas piping system 1 - 5 outlets 15.00
Building sewer 15.00
Mobile Home ISI GI W1 920.00
PERMIT FEE $
ELECTRICAL PERMIT Filing Fee 20.00
Main Service '.".A' OR LESS 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 i ull fore nd effect.
License Class Lic. No.
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, forthejArformanceof work for which this permit is issued.
My workers' compensation i ur ce carder -and' policy number are:
Carrier e 6616
Main Service To 46.00SO
WEL200A
cCU000A
NEW CONST. DWe11NG OCCUP. SO
OR ADDNS. ( 8 ACC. S.3.5¢x.
ON-R6IU ' BRANC MULTI.OTLETU@7,50
NON-'..ITS
8 PSINGOUTLET OWELER APPARATUCIRS .
zoo ,.00
Ex. Occup. OUTLET OR FIXTURES BAL O .50
Ex. Occup. ouTLEE°rs RRE.,6.) APPLM 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE S
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Policy Number inrmii
(The above sections need not be comple ed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 1 certify that in the performance of the work for which this permit is issued, I shall
;te y any person in y manner so as to become subject to workers'
tion la Ca1'rfo ia, and agree that if I should become subject to the
ompensati n p visions of section 3700 of the Labor Code, I shall
om ly wit o isns.
X Date �j''
Siplica t - ❑Owner ontractor ❑Agent
Anis required for excavations over 5'0" deep and demolition or constructiont��r 3 stories in height.
Mobile Home Installation Fee I $
Energy Inspection Fee $
Occ CONST. TYPE It
TOTAL FEE W
HAz.
D. FEES IMP FLOOD CDF PARCEL Po HD 5 U
This permit is hereby issued underthe applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated above for which fees have been paid.
By Date fit.
PERMIT EXPIRES ON Com'
I pw
Receipt No.
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
I%
4
064-260-025 02-2392
NAZARETTA, RANDY
6234 PONDEROSA, MAGALIA
CONT: JAMES WATTS }
REPLACE WATER HEATER
r
..F;, :*""""l�InF` -•-;i.,q�,...;-,f,,►+„q,.•,.,...-.�,Q., :� r` .. I''?i:::.4f'`i�c•.•r.,• .,.�, ..�. .9s -a+-•q•. ba!r -^IrcR�'R^,„phi lri:'c
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 • Telephone (530) 538-7541 n7-y�}►
(Rev. 12/96) APPLICATION AND PERMIT [.�
ASSESSOR PARCEL NUMBER
O
ZONING
BUILDING PERMIT
OWNER
n� ^
� � h/ q r
TELFPHi
f -23=x..,
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS
W
CONTRACTOR'S NAME r� Ar TELEPHONE 'y
F•�
CONTRACTORS MAIUNG DRESS
1:,A” T04/I,/. U
CONSTRUCTION LENDER
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filen Fee $ 20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS (27 d
Energy Plan Checking Fee $
$
PERMIT FEE $
LOT NO.
SUBONISIONS NAME
PARCEL MAP
PLUMBING PERMIT Filing Fee 20.00
Each Trap 7.00
USEOFSTRUCTURE
SF A< Duplex ❑ Mobilehome ❑ 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 ❑ Other
Describe Work: W 4 C c~ Ae q r qir/ A fit
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
R LES
Main Service 2o.A OR LESS 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 Jull force and effect. /
License Class 1 Lic. No. �p
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, army 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 To ,000A 46.00
NEW CONST. DWELLING GCS. SO
WE
OR ADDNS. ( a Acc. BLDs. 3.5¢Fr:
NON g6lp, MULTI.OUTL. @7,50
POWER APPARATUS
a SINGLE OUTLET CIR.
OUTLET OR FIXTURES
EX. Occu s20 x':50
FLXED APPLNS. OR 5.00
Ex. Occup. ourLETs RESID. EA
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE S
WORKERS' COMPENSATION DECLARATION
I 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 theiYerformance of work for which this permit is issued.
My workers' compensation in ur ce carrj&L.and policy number are:
Carrier �7 �/l G fU/✓p
Policy Number'. — � G
(The above sections need not be comple ed if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 1 certify that in the performance of the work for which this permit is issued, I shall
-,-not employ any person in atny manner so as to become subject to workers'
co �pensation laws o(California, and agree that if I should become subject to the
workers' compensatidn pi;ovislons of section 3700 of the Labor Code, I shall
Iith comply wit ose prow nIS
fo2172
X fj Date
Signature f Applica t - ❑ Owner IZI�,Contractor ❑ Agent
An OS p mit is required for excavations over 5'0" deep and demolition or construction
of stcuctures{over 3 stories in height.
MECHANICAL PERMIT Filing Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ '2 roe,
D. FEES IMP FLOOD
CDF
PARCEL PD HD 5 U io
�HAZ-
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.
.(� J
ey Date
PERMIT EXPIRES ON
'Date '
Receipt No. a
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 (530) 538-754y�, P Kt.
(Rev.12/96) APPLICATION AND PERMIT tel/
ASSES r ✓MB6j r, / J J
+ , V !//�_
ZONING
BUILDING PERMIT
OWNER ` �����A v
flVr L /V
��
TEWE
L 6
SO. FT. OCC. BUILDING VALUATION
OWNER'S MAILING ADDRESS 0
L ih,�r c� e�►-o s LJ
CONTRACTQR'S NAME
TELEPHONE
CONTRACTOR'S MAILING ADD SS
C,✓ C
CONSTRUCTION LENDER
Fireplace
LENDER'S MAIUNG ADDRESS
Total Valuation Is
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $
20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS L 3N • 4_A Vs )4L L✓5
Energy Plan Checking Fee $
$
PERMIT FEE S
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP,
PLUMBING PERMIT
Filing Fee 20.00
Each Trap
7.00
USEOFSTRUCTURE
SF Duplex ❑ Mobilehome ❑ 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 ❑ Othh 1.4—
Describe Work: �1 �f" rte' t4a
Gas piping system 1 - 5 outlets
15.00 r
Buildingsewer
15.00
Mobile Home ISI GI W1
920.00
PERMIT FEE S
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service 'O.AOR'SS
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 II f�((ce and effect. ����+-2
License Class`tJ cp Lic. No. (
OWNER -BUILDER DECLARATION
1 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 astheir 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 permitis issued.
My workers' compensaIfioryInsuraQSAcarrier and policy number are:
Carrier �' y 1,511lb
Policy Number -
(The above sections need not a comple d if the permit is for work of a valuation
of one hundred dollars ($100) or less.)
❑ 1 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'
mpensation laws of Calif nia, and agree that if I should become subject to the
wo ers' compensation ovisions of section 3700 of the Labor Code, I shall
forth ith com ith tho provisions. -
Date ✓
n ur of Applicant - ❑ Owner ontractor ❑ Agent
S A ermit is required for excavations over 5'0" deep and demolition or constructionuctures over 3 stories in height.
LAn
Main Service zooA To L000A
46.00
NEW CONST. OW %NG OCCUP. SO
OR ADONS. ( a ACC. BLDs. 3.50FT:
NON•REOSID. MULT,-OUTLET 97.50
POWER APPARATUS
a SINGLE OUTLET CIS.
0
EX. Occup. OUTLET OR FOLTUREs BAL @ I.00
. 0
FIXED APPLNs. OR
Ex. Occup. oun. RE.SID, EA 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE $
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood
6.50
Ventilation
PERMIT FEE $
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $
HAZ.
p, FEES IMP FLOOD COF PARCEL PD MD'
SUE
This permit is hereby issued under the applicable
of the Butte County Code and/or Resolutions
indicated above for which fees have been
By ' Date
PERMIT EXPIRES ON
provisions
to do work
paid.
gfe
Receipt No. 6
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
RESIDENTIAL 10 f\,
064-260-025 PERMIT#97-1554
NAZARETTA, Randy
PERMIT1 6234 Ponderosa -Way, Magalia
Add Den/SF 4
PERMIT 1 7 / 9s"
OWNER
CONTR.
ASSESSOR PARCEL
LOCATION
. J
Temp. Power Pole
Called PG&E
Temp. Elec. Service
Called PG&E
5 Temp. Gas Service
Called PG&E
JOB FINALED (Date) Q _
Signature v
V=OK
0 = Not OK
NottReady MOBILE HOMES
Date MOBILE HOME UTILITIES (Plans) OK except #'s
1. Zoning Requirements - Setbacks - Easements
2. Soils; Special MH Support Sketch
3. Sewer, Location -Test -Fall -00 -Concrete
4. Water, Location -Test -Easement Needed (Sketch)
5. Electricity; Location-Clearances-Gmd-/ /Amp, -Concrete
6. 'Gas; Location -Test -Wrap; / A-fL
/ /Nat or/ /`LYL/ /LPG
7. Well Clearance & Disconnect
8. Utility Clearance
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements- Setbacks Easements
2. Footings; Sme-Spacing-Marriage Line
3. Gas; MH Test DemamWalve-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. Tie Downs -Type -Installation Cert.
10. Exits; Insp.-Sketch
11. Cert of Occupancy
Date
12. Permanent Foundation Only: License Decal
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
MISCELLANEOUS
Date
DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils-Size-DepthSpacing-Connectorssoeel
3. Decks; Girders and/or Joists4)ecidng-BracngStairs-Rails
4. Wood Awn.; Posts-Beams-Rftrs.-Connectors
Shthg.-Rfg.-Bracing
5. Alum. Awn.; Columns-ConnectionsSplice-Decal-Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg.; Sils-AnchorsStuds-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext; Steps -Doors -t endings
12. Braced Wall.Panels
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. Pod Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distance-Gll
5. Elec.; Pod Lighting;.15 Volts-GFI
6. Elec.; Enclosures; Conduit Entries-Terrninals4.isted
7. Elec.; Bonding; Metal w/6 -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5 Circulating Equip. -Pool Lghtg.
Boxes-Endosures-Panelboards-Ins. to Main in Conduit
9. Health Department Approval
10. Plumb.: Cir. Test -Water Supply Test
11. Light Niche
Date
Card B-1 Date Card B-1
Date
Cana B-1 Date Card B-1
V = ..No OK RESIDENTIAL
'= Not Applicable
= Not Ready
Date_"
OR (Plans) OK except ft
1. Zoni etbacks-Easments-FloodSlope
�3i I'? Main; Soils-Elec. Gmd. / /" Ftg. Depth
UV 3. Ftg. Garage; Soils-Steel-Elec. Gmd/ P Ftg. Depth
4. Ftg. Porches & Decks; SoilsSteel-/ P Flg. Depth
5. Stemwalls, Main;,Steel-Blockouts-Wrapped
6. Stemwalls, Garage; Steel-BlockoutsWrapped
6a. Hold Downs and Special Anchors .
7. Slab, Steel -Wrapped
8. Piers -Fireplace Ftg.-Steel
9. D.W.V.; Fall -Fitting -Test 2 Way C/O -Sewer Test
10. UF. Gas Pipe; Size Anchors - Yard Gas Piping; Size Test
11. Water Pipe; Test -Anchors -Regulator -Service Test
12. Electric Underground
13. Pienums & Ducts; Clearance -Material -Support -Ins.
14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
15. Access & Ventilation
16. Insulation
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date PLUMBING (Permit) OK except #'s
17. Water Htr.; Vent -Access -Combustion Air Baffle
18. Water Pipe; Test & Anchor -Nail Protection
19. D.W.V.; Test Fittings & Anchor -Nail Protection
20. Shower Pan; Test, First Floor -Tub Access
21. Test Tub & Shower, Second Floor -Tub Access
22. Gas Pipe; Sae & Anchors
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date ELECTRICAL (Permit) OK except #'s
23. Fixture & Transformer Clearance -Ins. Protection
24. Elec. Receptacles Spacing -Lights & Switches at Doors
25. Size Boxes & No. of Conductors Stapled
26. Romex Installed Close to Edge of Studs & C.J.
27. Equip. Ground made up w/Mech Fastners-Bond Gas & Water
28. 2 Appliance Circuts in Kitchen & Conductor Size GFI
29. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or Al
30. Range Circ. / / ga Cu or AI -Oven Circ. / / ga Cu or AI
Insulated Neutral 0 Yes 0 No
31. Service -Riser Conductors & Ground -Main Disconect
32. Equip. Clearances Panels -Motors -Meth. Epuip.
33. Clothes Closet Light -Shower Light -Spa Light
34. Smoke Detector
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date MECHANICAL (Permit) OK except ft
35. A.C. Ducts Insulation & Support
36. Vent Fan, Exhaust above insulation
37. Condensate Drain & Overflow, Size & Grade
38. Fumance-Vent Access -Comb. Air -Return Air Vent 115 outlet
39. Attic Access & Platform if Furnace in Attic
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date FRAMING (Plans) OK except #'s
40. Sits Proper Materials & Anchors
41. Walls Studs -Nailing Spacing & Braces -Plates -Sound
42. Bearing Walls over Girders & Floor Nailing
43. Draft Stop in Walls (rat proof)
44. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
45. Headers & Beams -Size & Bearing
(Single & Duplex)
Date FRAMING (Continued)
46. Hangers -Post Caps -Anchors -Connectors
47. Cling. Joist-Rftr. Ties-Purlin-roff Brac.-Truss-Shting.-Ring.
48. Freplace Ties or Type A Flue -Fireplace Throat clearance
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
50. Bdnn. Windows or Exiting Doors -Sill Hgt. & Dimensions
51. Garage Fire Protection Framing
52. Property Line Firewall & Openings
53. Ext Doors -One 3 -Check Garage 3rd Story, 2 Exits
54.' Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
55. on Roof Overhang -Attic Vents -Rafter Outriggers
Siding -Nailing Veneer
57. Stucco Mesh -Drip Screed -Fd. Vents-Underfir. Access
58. Glazing Area -Glass Protection -Skylights -Plastic
59 Shear Walls; Nailing -Bolts
60. Brace Interior / Exterior Wall Panels
61. Insulation -Walls -Ceilings
62. Infiltration -Walls -Windows
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date FINAL (PI ) OK except #'s
X/' t S oor & Sidelight Protection -Landings
60/Slmoke Detector
entsClearan om Y-Conector-
In G s- ech. Protection
Ong.
ures u cress- pa
68 ubpanel, Breaker Sizes & Is
7
71 FIS nutlet% at Wncxi P Int. & Ext.
_GaFt-..00king Clearance
73 e s eceptcales at Kit. Counter
ZS -Gera nding.Closure
�namper ..
76 Wir,
earartce-Comb. Air Connector-P.R.V.
In .Gara e; Above Floor -Meeh. Protection
quip. Listed for Locati
` ece tacles m ara a (G.Fl.)- ex Protection
r
i s & Deck Construction -Post Caps
rawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor 0 Yes
nve es"0'NonNalks O'Yes 0 No/Planters 0 Yes 0 No
83 Stucco Brown-Finisb_-
Electrical-Plumbing
Appliance -Fireplace -Clearance to Openings
t -Electrical. -Plumbing
87. Exterior Elec. Trim G.F.I.-Receptacle-Underground
ht House- --
lass Oon
20r<o-rrections from Previous Inspections
Tagged; Gas-Eieclria-
ewer Connected -C/O to Grade -HD Approval
47 -,2b4M Energy Compliance Certificate -Other Certificates
Date Card B-1 Fj Date Card B-1
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Comments at Final:
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
411 Main Street, Chico, CA - (916) 891-2751
7 County Center Drive, Oroville, CA - (916)538-7541
CORRECTION NOTICE
A4Z14Qft 14
OWNER PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please notify this office when correction of work
is completed. If you have any questions pertaining to this matter, or need additional explanation,
please ontact this office immediately.
as r- r
&'4'V /7-'(
Date �d 2[ Inspector
f
REV 10192
CERTIFICATION OF INSULATION %7` 1s�Y
ADDRESS OR TRACT
SACRAMENTO INSULATION CONTRACTORS
J� ,• Lf f LOT #
❑ P.O. BOX 854, WEST SACRAMENTO, CA 95691 LIC. #202026
3243 INDUSTRIAL DRIVE, YUBA CITY, CA 95993 LIC. #202026
P.O. BOX 9651, FRESNO, CA 93793-9651 LIC. #202026
c
❑ P.O. BOX 1631, RENO, NV 89505 LIC. #10675
❑ 3326 A PONDEROSA WAY, LAS VEGAS, NV 89118 LIC. #10675
DATE INSULATION COMPLETED
m CEILINGS
•�•
( SQUARE FEET)
(! SQUARE FEET)
( SQUARE FEET)
TYPE OF INSULATION
TYPE OF INSULATION
TYPE OF INSULATION
MATERIAL
MATERIAL
MATERIAL
FIBERGLASS
FIBERGLASS
FIBERGLASS
FORM
FORM
FORM
BATTS'
BATTS & BLOW
BATTS
MANUFACTURER'S PRODUCT I.D.
MANUFACTUI ER'S"PRODUCT I.D.
MANUFACTURER'S PRODUCT I.D.
MANUFACTURER
MANUFACTURER
MANUFACTURER
OCF
OCF
OCF
BAGS
R - VALUE
APPLIED
R - VALUE
APPLIED
MIN. INSTALLED
R - VALUE
APPLIED
INSTALLED
THICKNESS
INSTALLED
THICKNESS
WEIGHT PER
SQUARE FOOT
INSTALLED
THICKNESS
KNEE WALLS IF R -VALUE IS OTHER THAN WALLS ABOVE
MATERIAL
FORM
R VALUE
MANUFACTURER
FIBERGLASS
BATTS
OCF
AIR INFILTRATION SEALANT
MATERIAL
MANUFACTURER
W R GRACE
THIS IS TO CERTIFY THAT INSULATION AND/OR SEALANT HAS BEEN INSTALLED IN CONFORMANCE WITH APPLICABLE CODES,
MATERIAL STANDARDS AND REGULATIONS.
SIGNATURE -INSULATION CONTRACTOR
TITLE
MANAGER
DATE
(r
7
��
SIGNATURE -GENERAL CONTRACTOR
TITLE
DATE
REMARKS:
SIC -303 ATTIC COPY
..:yy , r,r., . ,',ly y„ "i •.. �.*, � ,;S k�� .�� ,a-."S�"�`1,C�r" �"ir• i"��Ltr��. ;,,—,, J K.,}4 s�J�"
'SCO; NTY OF BUTTE DEPARTMENT OFDEVELOPMENT SERVICES -BUILDING DIVISION
r' 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE (916) 538-7541
PE"IT APPLICA TION DA TA SHEET
OWNER: ASSESSORPARC ER:
Proposed Building Us . Building Inspector: Date: -� 3 -9
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
Date Received By
❑ 1. All items have been submitted --------------------------------------------------------------------------------------
02. Plot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------
❑ 3 . Complete plans, 3/4 sets, signed by the preparer of plans. -----------------------------------------------------
114. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. --------
❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------ `
❑ 6. Energy Design Compliance and supporting documentation. ----------------------------------------------------
117.
---------------------------------------------------
❑7. Statement of Intent for Non -Heated and A/C Buildings. ---------------------------------------------------------
❑ 8. Hazardous Material Form.------------------------------------------------------------------------------------------
f
ufactured Home data and installation instructions including Tie Down Specifications. ------------------
s of $ ��• 00------------------------------------------------------------------------------------- — °�Z2 7 FZact fees as shown on the attached schedule. - ----- ----- --------------------
; a
ifornia Department of Forestry plan approvaU � -�7-f�----------------------
. Flood elevation certificate. ------------rr------__-----------
------------
Sanitation and plot plan approval �h� Health Department.
❑ 15. City of Chico plumbing permit. ---------------------------------------
❑ 16. Plot plan and business license approval from the City of Biggs. ---
1117.
--
❑17. Planning approval for (A) Use: (B) Parking:
❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel.
❑ 19. Encroachment Permit for driveway (construction approval prior to occupancy). --
020. Pre -inspection for
required Request to Building Inspector on
p21. Contractor's license information. (Number, Name°Style, Classification). ------------------------
022. Workers' Compensation carrier and policy number. --';--------------------------------=-----------
023. Owner -Builder Verification (Given to owner ❑, Mailed to owner 0) - --------------------------
��f signature authorization. ---------------------------------------------------------------------
Recorded copy of Agricultural Acknowledgment Statement. --------------------------------------
❑26. Letter of intent on building use. -----------------------------------------------------------------------
❑27. Manufactured Home utility clearance. ---------------------------------------------------------------
❑28. Existing violations and/or expired permits. ----------------------------------------------------------
029. ❑433'A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $
030. Other:
When you issue the permit, process as follow ail to owner, []Mail to contractor.
❑ Telephone
and hold for pickup at
Applicant: _
Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air
Copy of plans sent ❑ Health Department, ❑ Fire Departmekrt, q Olher:
inspector.
I Pz p7
(Date)
1. Index permit application for the above items numbered: � 7 I ` IN
❑ Plan Check List
2. Additional items required: 7.
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by o phone; ❑ •mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date:
Contractor, designer, owner, was secyef a above required data by ❑ phone, 11mail, ❑ Building Div'si n counter, by Date:
Plans reviewed by: Date: Plans approved by: Date:
Sets of plans on hold in Plan Cabinet, ❑ A.P. folder. Note transfer by: Date:
Yellow Copy - Department of Development Services, Building Division.
TO: Building Department
FROM: - Environmental Health
SUBJECT: Sanitation Clearance
F.H. I)SE ONLY
ri„t Han n l.,ched
seilt w ii.u. 7-L4 - s7
n eZ9 y
ner/Location
Plan Approved for: Sewage Disposal G,Wate` Supply: Public_
Clearance for
final for:
Final clearance O.K. for:
NOTE;
At _R
r Hs
Environmentaleal h Spe ialist
8/92
AP1#
Private Well
zS
, 7 �-
D to
y
COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-754P �7-/O,
RM T NO
(Rev. 12/96) APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
ZONINGl
BUILDING PERMIT
OWNER
AN
TELEPHONE
-2369
SQ. FT. OCC. BUILDING VALUATION
248 R
OWNERS HARING ADDRESS
2
CONTRACTORS NAME
TELEPHONE '
CONTRACT'OR'S MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'SMAILING ADDRESS
'
Total Valuation 3
2
ARCHITECT OR ENGINEER
LICENSE No.
—$
Filing Fee
$ 20.00
Permit Fee
$ 153.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$ 99.45
BUILDING ADDRESS 6934 PONDERnSA WAY, MA(-,AT.TA
Energy Plan Checking Fee
$ 23.00
$
PERMIT FEE
$ 295.45
LOT NO.
SUBDIVISION'S NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF a Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00
Each as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition)R Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: DEN
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home ISI GI W
@20.00
PERMIT FEE
$
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service 200AOOR LESS
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.PSINGOW
License Class Lic. No.
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law f r the following reason:
,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.
as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
C'J I am exempt under Sec. Business and Professions Code for this
reason
Main Service 200A To I000A
46.00
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( a ACC. BLDS.
SD
3.5QFT.
NON -R SNEW rIDT S.MULTI-O RCET
@7.50
a E OVTLET ERLAPPAruruS
CIR.
Ex. Occup. OUTLET OR FIXTURES
20 Q I.00
BAL @ .50
Ex. Occup. ouxTLEEDTS RESDOEA
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wirina
23.00
PERMIT FEE
$ 28.70
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
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'HAZ.
compensation laws of California, and agree that if I should become subject to the
workers' c pensation provisions of section 3700 of the Labor Code, I shall
forth mply with those provisions.
Q
X Date ZZ�=12
Signatur of plica wrier ❑ Contractor ❑ Agent
An OSH per its requi a for excavations over 5'0" deep and demolition or construction
of structures o e 3 sto a in height.
MECHANICAL PERMIT
Filing Fee 20.00
Heating FXJCOd C(LALtj 110
Cooling
Hood 6.50
Ventilation
PERMIT FEti $
Mobile Home Installation Fee $
Energy Inspection Fee $ 4-6.0-0
CONST. TYPE
TOTAL FEE $ 370.15
Vhp
F S
IMP O D
CDF
pARCE
PD ISSUE
it is hereby issued under
utte County Code and/or
indicated above for which fees have
B
PERMIT EXPIRES ON
I
the applicable provisions
Resolutions to do work
been paid.
G
ate - —<
Date
Receipt No. ��� y��
WHITE-D.D.S.-B.D. CANARY -AS OR PINK -INSPECTOR GOLDENROD -APPLICANT
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: YE" NO[ ].
2. I HAVE(r 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: CONTRACTOR'S LICENSE NO.
4. I plan to provide portions of this work, but I have hired the following person to
coordinate, supervise, and provide the major work:
NAME:
• ADDRESS: CITY:
PHONE: CONTRACTOR'S LICENSE NO.
5. I will provide some of the work but -I have contracted (hired) the following persons to
provide the work indicated:
NAME ADDRESS PHONE TYPE OF WORK
SIGNED:
PROPERTY OWNER:
SOCIAL SECURITY
DATE:
NOTE: This owner -Builder Verification is required by Section 19831 and
19832 of the California Health and Safety Code.
This verification must be completed and returned to our office before
we are permitted to issue the permit.
May 1995 2.26
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself as the builder of
property improvements specified.
For your protection, you should be aware that as "owner -builder" you are the responsible party of record
on such a permit. Building, permits are not required to be signed by property owners unless they are personally
performing their own work. If your work is being performed by someone other than yourself, you may protect
yourself from possible liability if that person applies for the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California and to have a
business license from the city or county. They are also required by law to put their license number on all permits
for which they apply.
If you plan to do your own work, with the exception of various trades that you plan to subcontract, you
should be aware of the following information for your benefit and protection:
0 If you employ or otherwise engage any persons other than your immediate family, and the work (including
materials and other costs) is 5300 or more for the entire project, and such persons are not licensed as
contractors or subcontractors, then you may be an employer.
0 If you are an employer, you must register with the State and Federal Governments as an employer and you are
subject to several obligations including state and federal income tax withholding, federal social security taxes,
workers compensation insurance, disability insurance costs, and unemployment compensation contributions.
0 There may be financial risks for you if you do not carry out these obligations, and these risks'are especially
serious with respect to worker's compensation insurance.
0 For more specific information about your obligations under Federal Law, contract the Internal Revenue
Seivice (and, if you wish, the U.S. Small Business Administration). For more specific information about your
obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial
Accidents.
If the structure is intended for sale, property owners who are not licensed contractors are allowed to
perform their work personally or through their own employees, without a licensed contractor or subcontractor, only
under limited conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an "ownerbuilder"
building permit, erroneously implying that the property owner is providing his or her own labor and material
personally. Building permits are not required to be signed by property owners unless they are performing their own
work personally.
Information about licensed contractors may be obtained by contracting the Contractors State License
Board in your community or at 1020 N Street, Sacramento, CA. 95814.
Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm
that you are aware of these matters. The building permit will not be issued until the verification is returned.
Sincerely,
Michael C. Vieira, C.B.O.
Manager, Building Inspection
NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code.
Mav 1995 1 17
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES- BUILDING DIVISION
7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 � 7 /?P?V NO.
(Rev. 12/96) APPLICATION AND PERMIT
ASSESSORPARCELNUM ER
- 21o0 -D�"
ZG NG
0�-T
BUILDING PERMIT
OWNER
LEPHONE
3- S
SO. FT. OCC. BUILDING VALUATION
2 R=3
OWNERS MAILING
WU
CONTRACTOR'S NAME
TELEPH
CONTRACTORS MAILING ADDRESS
CONSTRUCTION LENDER
Fireplace
LENDER'S MAIUNG ADDRESS
Total Valuation $ 13
,
ARCHITECT OR ENGINEER
LICENSE NO.
Flln Fee
$ 20.00
Permit Fee
$ /f�D
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$ - 45
BUILDING ADDRESS 3/ 4
`ly
Energy Plan Checking Fee
$ .00
PERMIT FEE
$ 5
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
Each Trap
if 7.00
USEOFSTRUCTURE
SF-J� Duplex ❑ Mobilehome ❑ Other
SPECIFY
Solar or heat pump water heater
23.00
Water piping
15.00
Each gas water heater or ver)(
15.00
TYPE OF WORK
Utilities ❑ Installation O Other ❑
New ❑ Addition 3� Remodel ❑ / es
Describe Work: � �Q r
Gas piping system 1 - 5 ou is
15.00
Buildingsewer
15.00
Mobile Home I S I G
920.00
PERMIT FEE
$
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service .OA OR LESS
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.
OWNER -BUILDER DECLARATION
1 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
I 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
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.)
❑ 1 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
forthwith comply with those provisions.
X Date
Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 50" deep and demolition or construction
of structures over 3 stories in height.
Main Service 200A TO 1000A
46.00
NEW CONST. DWELLING OCCUR s0
OR ADONS. ( a ACC. BLDS. 3.5¢FT. ,tO
NEW CONST. MULTI.OUTLET
NON-RESID. @7.50
POWER APPARATUS
8 SINGLE OUTLET CIR.
EX. Occup OUTLET OR FIXTURES BAL @ 1_S0
Ex. Occup. OF�SPR .) E. 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE $ 02$•
MECHANICAL PERMIT Filingfee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEIE $
Mobile Home Installation Fee $
Energy Inspection Fee $ C)O
OCC
3
CDNST. PE
TOTAL FEE $ 3 --?o
HAZ.
D. FEES IMP
FLOOD
cOF PARCEL
I PO
HD
I ISSUE
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
By
PERMIT EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
Date
pato
Receipt No. A oiR � 302
WHITE -D.D.S.-E.D. -CANARY-ASSESSOR PINK -INSPECTOR GOLCENROD-APPLICANT
lrsyr�(••, `t'"'"j'��'�•'i�.'."''�"".'¢•t''`.X"'°r'"�''r`""R6".�i�'-A'`'�'.'..'.r'"'.�'�.'"r�r�'Y7'"'-`""�'�_,!.r aril'°�*'"?'''^�sir.�"tr�r�'4:17,.Sikes-r�'r�i4t'2I,.i°`�..:�$.�.�-7��{�r;�+?�t('+r":r:'Y
x
BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One form per Building)
School District. Building Department No.
i
A.P. Number
Property Owner
Property Location/A
(�(p�j-o�lDlJ'�15 Jurisdiction: City County
Subdivision Lot No.
r 'tel
Residential Development � � Sq. Footage 8
No of iving Mobile Home Addition (Group R)
Commercial/Industrial
Units Installation
Sq. Footage
New Addition
Building Department Representative
(Floor Plans reviewed by School District Personnel)
(Including Exterior
Roofed Areas)
'1-a3-�l �-
Date
District Identification No: 9 �— `' % ti
�Z{ ` School District certifies that
iY� U (Applicant)
6 Z�>
(Street Address) (Phone Number)
�j
(City) V (State) (Zip Code)
has complied with the requirements of Resolution No. K by payment of $ O
representing, Q` square feet. B 2926 $
LL MITIGATION $
School District Representative Date
Paid by Check # Remarks:
Notice: You may protest the imposition of the fees -identified above by submitting a written protest to the District, in compliance with
Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit
you from challenging the imposition of the fees in any court action.
If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is
notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA);
this project may be subject to additional school fees to fully mitigate its impact on the school district's schools.
White (applicant), Yellow (building department), Pink (school district) feeform.xls (2/97)dmm
MOTE. ---RA Mai
Accordance with
of o quality press
Uniform Building,
fAe NaNaft l £BSc,
i hts ct�'1 bt r�rr
&W on the job w
make any changes
fflitim rmissio�n
REViE'
BUTTE CO
CALIF. DEPT
D BY
IE DEPT.
[] approved as shill i- UZI
approved with conditions
per attached sheet. 7,
S�gnrtLre
Date
0
ALL STRUCTURES AND C9/G,�8�3-Z3G�
OVERHANGS SHALL gE EQUIP
A SET CLEAR OF ALL
1NCLUD(Np
. p -BACK OF U ,� ALL EASEMEN
'FROM
`�` FROM THE SIDE ��
CLEAR
LE F7: FROM HE REAR PROPERTYANO
CLEAR OF THEROAD CENTERLINE LINES BE
// FORA 2 STRUCTURES AND UVE SHALL BE
2 -GO OQ EAVE OVERHANG. EQUIPMENT EXCEPT
'n
R` n3
MEM- RIGA(., MECHAMtCAL., AND PLUMB�) I �e. ��''^�' ` �•' c.;:.`<:..''.!�• ` c._�: :! �!-�',�`� � �&
100N UCTCV( NOT PLAN CHECKED
; �� �- .r• , �.s.- �-[
-qS4 ALL COI{RPLY 1P.11
In CURRENT EDITION VC
Of NEC, UMC ANO UPC. Ar�PRO D
I7-155
grvr
�•'�� I J — 6XZti
/
I —
I
I
1
I
'
/
y
8--f
r
1
I II
I II
��-
1
I
1
'
I _
�-13'.6{•
Is Wo, unship Shan be w
'
NOPrtl
cognize ood Pracu
/
ad for h Secified we in *9
bi q onical CQ" a ll!
I
I
The attached Fire Safe
/
requirements must be cam
— — —
— —
—� /�6•
as specified and approved
by C.D.F.
I
nd specitic-r. 100 MUST d�
I tirhes
zz•o-
/ Or rL-AN
k
and it is unlawsul
alt(rations on same withW
J
-20
m ® -- —
- -
- -
7-20'97
D BY
IE DEPT.
[] approved as shill i- UZI
approved with conditions
per attached sheet. 7,
S�gnrtLre
Date
0
ALL STRUCTURES AND C9/G,�8�3-Z3G�
OVERHANGS SHALL gE EQUIP
A SET CLEAR OF ALL
1NCLUD(Np
. p -BACK OF U ,� ALL EASEMEN
'FROM
`�` FROM THE SIDE ��
CLEAR
LE F7: FROM HE REAR PROPERTYANO
CLEAR OF THEROAD CENTERLINE LINES BE
// FORA 2 STRUCTURES AND UVE SHALL BE
2 -GO OQ EAVE OVERHANG. EQUIPMENT EXCEPT
'n
R` n3
MEM- RIGA(., MECHAMtCAL., AND PLUMB�) I �e. ��''^�' ` �•' c.;:.`<:..''.!�• ` c._�: :! �!-�',�`� � �&
100N UCTCV( NOT PLAN CHECKED
; �� �- .r• , �.s.- �-[
-qS4 ALL COI{RPLY 1P.11
In CURRENT EDITION VC
Of NEC, UMC ANO UPC. Ar�PRO D
I7-155
261-011
6,-10„ o
z----
Of
"
ROP05W MN
ll
COMpU1U
r �C
or ictr 1-011-4
J
keIr
n .G alb
—10' -10"
W
nsfall smoke detecto�per
0
t �
mpko0M # I� ��-
EX1511NG i
zM
a�
'I2
V
Q
ll�l roller sl�ual� Iletwre,C� a�-
OLl( w I in d o U 1 n add o
�in a4- i ha I
Lx-
FOR FLAN
1/411"11
1-21-91
OWNER/SIGNED
NAZAffTTA W5117ENCE
6234 I'ONt7ER05A WAY
MAGALIA, CA.
9595h
(916)893236
v
5KC5.
MAf CMIN6 W/ P-50 IN51.
5LA13 FLOOR, WA L51? -13
IN51. &I, WIN19OW5 IN 1-101,15�
1"0 MAO? W/ MII,6AW
VINYL LOW -e WINPOW5.
;riot
&"o .0 cc4c1 e
—151-611
�xk� nc� ►rne�^ha� co -Q
�►�'� �u S-i-� `mac, 4o n
nsfall smoke detector per cove
O
0
�XI51lOWOOM
Color Code
Blue:: w -En gneering�
GVen0Yace"d Walls
PMWFir�eL','-alls�,J
elloly�,P ortant
P
K-13 IN5LLA11ON
2 X h 51UV @ 16" O.C.
12" FROM IOCOMR5MCHOR Pat., 6' -O" O.C.
IN51LA11ON 2 X l7 P.P.t. 5� 1. 6"X6" #10 X #10
y °
I=1II. ,. I . .q :Id
.I 11=1 _III—I I :• a a I I 1=f11=i 11= 4" RAVEL
PayefI• ew mem"
-T=11 V
N illll� e �. •� � • .. ��IIII,,T=
W. C FAPNG F0011NG
5(AE: I" - I' -O'
evm O
Butt
APffl�-OVED
I
1
1
I
I
N
v
`R
1
C1
t'Cl
j•
I' •
I•.
I
I.
I;
I'
I
1
1
I
I
f ;
r ;
1
44,
I
I PATIO
I
Cd
tea• "
M
COVERED
DECK
1_ — — — — — — —
1.232.0'
Flr.o floor$ 1.232.0•
Se.1.1 1' 1.0'
First. floor$
Tool .r..8 1.232.0'
CDF FIRE SAFE REQUIREMENTS
AP# PERMIT # NAME
Under authority of PRC 4290, the following checked items are required
by the Butte County Fire Department and are made a part of this permit.
These requirements are minimums and will be superseded by Butte County
local regulations which equal or exceed these standards. Field
inspections will be made by the Butte County Building Department for
compliance.
[� 1272.00 Maintenance of Defensible Space. To ensure continued
maintenance of properties in conformance with these
standards and measures and to assure continued avail-
ability, access and utilization of the defensible space
provided for in these standards, annual maintenance
must be provide for by the land owner.
Driveway Standards
[ ] 1273.02 Surface. All driveway surfaces and structures (bridges,
1273.07 culverts and other appurtenant structures which supple-
ment the roadway bed er shoulders) shall provide unob-
structed access to conventional drive vehicles, includ-
ing sedans and fire apparatus weighing up to 40,000
pounds.
[ ] 1273.03 Grade. Not to exceed 16 percent unless paved.
1273.04 Driveway Radius
[ ] 1. No roadway shall have a horizontal inside radius of
curvature of less than 50 feet and additional sur-
face width of 4 feet shall be added to curves of 50-
100 feet radius; 2 feet to those from 100-200 feet.
[ ] 2. The length of vertical curves in roadways exclusive
of gutters, ditches and drainage structures designed
to hold or divert water shall be not less than 100
feet.
[ ] 1273.05 Turnarounds. If required, will have a minimum turning
radius of 40 feet from the center of the road.
[ ] 1273.05 Turnouts. Shall be a minimum of 10 feet wide and 30
feet long with a minimum 25 foot taper on each end.
[ ] 1270.10 Width. All driveways shall provide a minimum 10 foot
traffic lane and unobstructed vertical clearance of 15
feet along its entire length.
Page 1 of .1'.
AP # PERMIT # NAME
[ ] 1273.10 Turnouts. Driveways exceeding 150 feet in length, but
less than 800 feet in length, shall provide a turnout
near the midpoint,of the driveway. Where a driveway
exceeds 800 feet, turnouts shall be provided no more
than 400 feet apart.
[ ] 1273.10 Turnaround. A.turnaround shall be provided at all
building sites on driveways over 300 feet in length and
shall be within 50 feet of the building.
1273.11 Gates
[ ] 1. Gate entrances shall be at least two feet wider than
the roadway it serves.
[ ] 2. The gates must be located at least 30 feet from the
roadway and shall open to allow a vehicle to stop
without obstructing traffic on that roadway.
[ ] 3. Where a one-way road with a single traffic lane
provides entrance, a 50 foot turning radius shall be
used.
Fuel Modification
1276.01 Setback for Structure Defensible Space.
[ ] 1. All parcels 1 acre aid larger shall provide a mini-
mum 30 foot setback for buildings and accessory
buildings from ul] property lines and/or the center
of the road.
[A] 2. For parcels less than 1 acre, local jurisdiction
shall provide for the same practical effect. See
Other Requirements below.
[�] 1276.02 Disposal of Vegetation and Fuels. Disposal, including
chipping, burying, burning or removal to a landfill site
approved by the local jurisdiction, of flammable
vegetation and fuels caused by site development and
construction, road and driveway construction and fuel
modification shall ba completed prior to completion of
road construction �,r fi:ial inspection of a building
permit.
Page 2 of 3
r7
i
z� �2� ��-� _Y_ N�� ✓6�oY
AP # PERMIT # NAME
Other Requirements
[ ] If Building Setback is 15 to 30 Feet:
Class A or B roof
Enclosed eaves ,
[ ] If Building Setback is Less Than 15 Feet
Choose any 3 of the following:
- Metal or no doors on side toward property line with insuffi-
cient setback
- Class A or B roof with enclosed eaves
- Interior automatic sprinkler system per NFPA 13D
- Glass area not to exceed 1_0% of wall area toward property
line with insufficient setback
- Siding from the following list:
Stucco -.3 coat
Hardi-Board or Plank
Masonry
Masonry veneer
Metal
Other Butte County,Fire Department approved materials
Date Signature
Page 3 of 3
TABLE OF CONTENTS IDD VTOC
Project Title.......... NAZARETTA ADDITION Date........ 07/22/97
Project Address........ 6234 PONDEROSA *******
MAGALIA *v4.50*
Documentation Author... Robert A..Mangrum ******* Building Permit #
Paradise. Mechanical
56.55 Almond Street Plan Check / Date
Paradise, CA 95969
916-877-8882 Field Check/ Date
Climate Zone........... 11
Compliance Method...... MICROPAS4 v4.50 for 1995 Standards by Enercomp, Inc.
MICROPAS4 v4.50 File-1GORDAN Wth-CTZ11S92 Program -TOC
User#=MP1342 User -Paradise Mechanical Run-GORDAN COMPLY 24
TABLE .OF CONTENTS
Report
Page
FORM CF -1R ................ 1
FORM MF -1R... 3
FORM C -2R ................. 5
HVAC SIZ.ING....... ....... _ 8
BUTTEL. OMMTV
CERTIFICATE OF COMPLIANCE: RESIDENTIAL Page 1 CF -1R
Project Title.......... NAZARETTA ADDITION Date........ 07/22/97
Project Address........ 6234 PONDEROSA *******
MAGALIA *v4.50*
Documentation Author... Robert A. Mangrum ******* Building Permit #
Paradise Mechanical
5655 Almond Street Plan Check / Date
Paradise, CA 95969
916-877-8882 Field Check/ Date
Climate Zone........... 11
Compliance Method...... MICROPAS4 v4.50 for 1995 Standards by Enercomp, Inc.
MICROPAS4 v4.50 File-1GORDAN Wth-CTZ11S92 Program -FORM CF -1R
User#-MP1342 User -Paradise Mechanical Run-GORDAN COMPLY 24
GENERAL INFORMATION
Conditioned Floor Area..... 249 sf
Building Type .............. Single Family Detached
Construction Type ......... Addition Alone
Building Front Orientation. Front Facing 18 deg (N)
Number of Dwelling Units... 1
Number of Stories.......... 1
Floor Construction Type.... Slab On Grade
Glazing Percentage......... 21.7 a of floor area
Average Glazing U -value.... -0.5 Btu/hr-sf-F
BUILDING SHELL INSULATION
Component
Frame
Cavity Sheathing Insul Assembly
Type
Type
R -value R
-value R -value U -value
Location/Comments
Wall
Wood
R-13
R-0 R7.13
0.088 LEFT WALL, BACK WALL
RIGHT WALL
Roof
Wood
R-11
R-19 '.R-30 q
0.031 ATTIC .
Floor
Wood
R-19
R-0 &.,R-19
0.037 RAISED FLOOR
FENESTRATION
# of Interior
Over -
Area U-
Pan- Shading/
Exterior hang/
Framing
Orientation
(sf) Value
es Description
Shading Fins
Type
Window Left
(E)
9.0 0.500
2 RO11er`Wht
None Yes
Vinyl
Window Left
(E)
15.0 0.500
2jR;oltller.„;Wht",
None Yes
Vinyl
Window Back
(S)
15.0 0.500
2Ro14 "er7Wlit
None Yes
Vinyl
Window Right (W)
15.0 0.500
2 Roller;{Wht�,
None Yes
Vinyl
. 711-
THERMAL MASS
Area Thickness
Type
Exposed
(sf) (in)
Location/Comments
SlabOnGrade
No
249 3.5
SLAB FLOOR
CERTIFICATE OF COMPLIANCE: RESIDENTIAL Page 2 CF -1R
Project Title.......... NAZARETTA ADDITION Date........ 07/22/97
MICROPAS4 v4.50 File-1GORDAN Wth-CTZ11S92 Program -FORM CF -1R
User#-MP1342 User -Paradise Mechanical Run-GORDAN COMPLY 24
HVAC SYSTEMS
Minimum Duct
Equipment Type Efficiency Location
Furnace 0.750 AFUE Attic
ACPackage 9.50 SEER Attic
Duct Thermostat
R -value Type
R-4.2 Setback
R-4.2 Setback
SPECIAL FEATURES/REMARKS
COMPLIANCE STATEMENT
This certificate of compliance lists the building features and performance
specifications needed to comply with Title -24, Parts 1 and 6 of the
California Code of Regulations, and the administrative regulations to
implement them. This certificate has been signed by the individual with
overall design responsibility. When this certificate of compliance is
submitted for a single building plan to be built in multiple orientations,
any shading feature that is varied is indicated in the Special Features/
Remarks section.
DESIGNER or OWNER
Name.... R,and.y - Nazaxetta
Company.
Address. 6234 PONDEROSA
MAGALIA, CA 95954
Phone... 895-0285
License.
Signed.. 7�ZSi%
(date)
ENFORC ENT AGEJY
Name....
Title...
Agency..
Phone...
Signed..
(date)
DOCUMENTATION AUTHOR
Name.... Robert A. Mangrum
Company. Paradise Mechanical
Address. 5655 Almond Street
Paradise, CA 95969
Phone... 916-877-8882
Signe
' (date)
MANDATORY MEASURES CHECKLIST: RESIDENTIAL, Page 3 MF -1R
Project Title.......... NAZARETTA ADDITION Date........ 07/22/97
P t Add 6234 roPONDER 0S
*******
�ec ress........ A
MAGALIA *v4.50*
Documentation Author... Robert A. Mangrum ******* Building Permit #
Paradise Mechanical
5655 Almond Street Plan Check / Date
Paradise, CA 95969
916-877-8882 Field Check/ Date
Climate Zone........... 11
Compliance Method...... MICROPAS4 v4.50 for 1995 Standards by Enercomp, Inc.
MICROPAS4 v4.50 File-1GORDAN Wth-CTZ11S92 Program -FORM MF -1R
User#-MP1342 User -Paradise Mechanical Run-GORDAN COMPLY 24
Lowrise residential buildings subject to the Standards must contain these
measures regardless of the compliance approach used. Items marked with an
asterisk (*) may be superseded by more stringent compliance requirements listed
on the Certificate of Compliance. When this checklist is incorporated into the
permit documents, the features noted shall be considered by all parties as
binding minimum component performance specifications for the mandatory measures
whether they are shown elsewhere in the documents or on this checklist only.
BUILDING ENVELOPE MEASURES
Design- Enforce-
er ment
*150(a): Minimum R-19 ceiling insulation. v
150(b): Loose fill insulation manufacturers labeled R -Value.
*150(c): Minimum R-13 wall insulation in framed walls
(does not apply to exterior mass walls).
*i50(d): Minimum R-13 raised floor insulation in framed floors;
minimum R-8 in concrete raised floors.
150(i): Slab edge insulation - water absorption rate no greater
than 0.30, water vapor transmission rate no greater than 2.0
perm/inch.
118: Insulation specified or installed meets CEC quality
standards. Indicate type and form.
116-17: Fenestration Products, Exterior Doors and Infiltration/
exfiltration controls
a. Doors and windows between conditioned and unconditioned
spaces designed to limit air leakage.
b. Manufactured fenestration products have label with
certified U -value, and infiltration certification.
c. Exterior doors and windows weatherstripped; all joints
and penetrations caulked and sealed.
150ng): Vapor barriers mandatory in Climate Zones 14 and 16
only.
Special infiltration barrier installed to comply with
Sec. 151 meets CEC quality standards.
150(e): Installation of Fireplaces, Decorative Gas Appliances
and gas logs
1. Masonry and factory -built fireplaces have:
a. Closeable metal or glass door
b. Outside air intake with damper and control
c. Flue damper and control
2. No continuous burning gas pilots allowed.
TTQ0kM'Y
APPROVED
MANDATORY MEASURES CHECKLIST: RESIDENTIAL, Page 4 MF -1R
Project Title.......... NAZARETTA ADDITION Date........ 07/22/97
MICROPAS4 v4.50 File-1GORDAN Wth-CTZ11S92 Program -FORM MF -1R
User#-MP1342 User -Paradise Mechanical Run-GORDAN COMPLY 24
SPACE CONDITIONING, WATER HEATING AND PLUMBING SYSTEM MEASURES
Design- Enforce-
er ment
110-13: HVAC equipment, water heaters, showerheads and faucets
certified by the CEC.
150(i): Setback thermostat on all applicable heating systems. .�
.150(j): Pipe and Tank insulation
1. Indirect hot water tanks (e.g., unfired storage tanks or
backup solar hot water tanks) have insulation blanket (R-12
or greater) or combined interior/exterior insulation (R-16
or greater).
2. First 5 feet of pipes closest to water heater tank, non -
recirculating systems, insulated (R-4 or greater).
3. All buried or exposed piping insulated in recirculating
sections of hot water system.
4. Cooling system piping below 55 degrees insulated.
5. Piping insulated between heating source and indirect
hot water tank.
*150(m): Ducts and Fans
1. Ducts constructed, installed and sealed to comply with UMC
sections 1002 and 1004; ducts insulated to a minimum
installed value of R-4.2 or ducts enclosed entirely within
conditioned space.
2. Exhaust fan systems have backdraft or automatic dampers.
3. Gravity ventilating systems -serving conditioned space have
either automatic or readily accessible, manually
operated dampers.
114: Pool and Spa Heating Systems and Equipment
1. System is certified with 78o thermal efficiency, on-off
switch, weatherproof operating instructions, no electric
resistance heating and no pilot light.
2. System installed with:
a. At least 36 inches pipe between filter and heater for
future solar heating.
b. Cover for outdoor pools or outdoor spa.
3. Pool system has directional inlets and a circulation
pump time switch. �►�
115: Gas-fired central furnace, pool heater, spa heater or
household cooking appliance have no continuously burning
pilot light (Exception: Non -electrical cooking appliance
with pilot < 150 Btu/hr.).
LIGHTING MEASURES
Design- Enforce-
er ment
150(k): 40 lumens/watt or greater for general lighting in
kitchens and rooms with water closets; and recessed ceiling
fixtures IC (insulation cover) approved.
M�
COMPUTER METHOD SUMMARY Page 5 C -2R
Project Title.......... NAZARETTA ADDITION Date........ 07/22/97
Project Address........ 6234 PONDEROSA *******
MAGALIA *v4.50*
Documentation Author... Robert A. Mangrum ******* Building Permit #
Paradise Mechanical
5655 Almond Street Plan Check / Date
Paradise, CA 95969
9167877-8882 Field Check/ Date
Climate Zone... ...... 11
Compliance Method...... MICROPAS4 v4.50 for 1995 Standards by Enercomp, Inc.
MICROPAS4 v4.50 File-1GORDAN Wth-CTZ11S92 Program -FORM C -2R
User#-MP1342 User -Paradise Mechanical Run-GORDAN COMPLY 24
GENERAL INFORMATION
Conditioned Floor Area.....
Building Type ..............
Construction Type .........
Building Front Orientation.
Number of Dwelling Units...
Number of Building Stories.
Weather Data Type..........
Floor Construction Type....
Number of Building Zones...
Conditioned Volume.........
Footprint Area .............
Ground Floor Area..........
Slab -On -Grade Area.........
Glazing Percentage.........
Average Glazing U -value....
Average Ceiling Height.....
249 sf
Single Family Detached
Addition Alone
Front Facing 18 deg (N)
1
1
ReducedYear
Slab On Grade
1
1992 cf
299 sf
299 sf
249 sf
21.7 % of floor area
0.5 Btu/hr-sf-F
8 ft
RUM" .Wriv
ii Ui, rAarei.� " AM .1
MICROPAS4 ENERGY USE SUMMARY
Energy Use
Standard
Proposed
Compliance
(kBtu/sf-yr)
Design
Design
Margin
Space Heating...........
4.19
4.08
0.11
Space Cooling..........
25.36
24.92
0.44
Total 29.55
29.00
0.55
*** Water Heating not
calculated ***
GENERAL INFORMATION
Conditioned Floor Area.....
Building Type ..............
Construction Type .........
Building Front Orientation.
Number of Dwelling Units...
Number of Building Stories.
Weather Data Type..........
Floor Construction Type....
Number of Building Zones...
Conditioned Volume.........
Footprint Area .............
Ground Floor Area..........
Slab -On -Grade Area.........
Glazing Percentage.........
Average Glazing U -value....
Average Ceiling Height.....
249 sf
Single Family Detached
Addition Alone
Front Facing 18 deg (N)
1
1
ReducedYear
Slab On Grade
1
1992 cf
299 sf
299 sf
249 sf
21.7 % of floor area
0.5 Btu/hr-sf-F
8 ft
RUM" .Wriv
ii Ui, rAarei.� " AM .1
COMPUTER METHOD SUMMARY Page 6 C -2R
Project Title.......... NAZARETTA ADDITION Date........ 07/22/97
MICROPAS4 v4.50 File-1GORDAN Wth-CTZ11S92 Program -FORM C -2R
User#-MP1342 User -Paradise Mechanical Run-GORDAN COMPLY 24
BUILDING ZONE INFORMATION
W
a !� `fix
Floor
# of
Vent Special
Area
Volume
Dwell Cond-
Thermostat Height Vent Area
Zone Type
(sf)
(cf) Units itioned
Type (ft) (sf)
HOUSE
Residence
249
1992 1.00 Yes
Setback 2.0 n/a
OPAQUE SURFACES
Area
U-
Insul Act Solar
Form 3 Location/
Surface
(sf)
value
R-val Azm Tilt Gains
Reference Comments
HOUSE - New
1 Wall
120
0.088
13 108 90 Yes
W.13.2X4.16 LEFT WALL
2 Wall
95
0.088
13 198 90 Yes
W.13.2X4.16 BACK WALL
3 Wall
129
0.088
13 288 90 Yes
W.13.2X4.16 RIGHT WALL
4 Roof
249
0.031
30 n/a 0 Yes
R.30.2X4.24 ATTIC
5 Floor
50
0.037
19 n/a 0 No
FC.19.2X8.16 RAISED FLOOR
FENESTRATION SURFACES
# of
Vent
SC SC Interior
Area
Pan-
Frame
Open U- Act
Glass Int Shading/
Surface
(sf)
es
Type
Type value Azm
Tlt Only Shade Description
HOUSE - New
1 Window
9.0
2
Vinyl
Slider 0.500 108
90 0.88 0.40 Roller.Wht
2 Window
15.0
2
Vinyl
Slider 0.500 108
90 0.88 0.40 Roller.Wht
3 Window
15.0
2
Vinyl
Slider 0.500 198
90 0.88 0.40 Roller.Wht
4 Window
15.0
2
Vinyl
Slider 0.500 288
90 0.88 0.40 Roller.Wht
OVERHANGS AND SIDE FINS
Window-
Overhang
Left Fin Right Fin -
Area
Left Rght
Surface
(sf)
Hght
Wdth
Dpth Hght Ext Ext
Ext Dpth Hght Ext Dpth Hght
HOUSE - New
1 Window
.9.0
3.0
3.0
2.0 0.0 n/a n/a
n/a n/a n/a n/a n/a n/a
2 Window
15.0
3.0
5.0
2.0 0.0 n/a n/a
n/a n/a n/a n/a n/a n/a
3 Window
15.0
3.0
5.0
2.0 0.0 n/a n/a
n/a n/a n/a n/a n/a n/a
4 Window
15.0
3.0
5.0
2.0 0.0 n/a n/a
n/a n/a n/a n/a n/a n/a
W
a !� `fix
i
COMPUTER METHOD SUMMARY Page 7 C -2R
Project Title.......... NAZARETTA ADDITION Date........ 07/22/97
MICROPAS4 v4.50 File-1GORDAN Wth-CTZ11S92 Program -FORM C -2R
User#-MP1342 User -Paradise Mechanical Run-GORDAN COMPLY 24
Mass Type
HOUSE - New
1 S1abOnGrade
THERMAL MASS
Area Thick Heat Conduct- Surface
(sf)• (in) Cap ivity R -value
249 3.5
System Type
HOUSE
Furnace
ACPackage
Location/Comments
28.0 0.98 R-2.0 SLAB FLOOR
HVAC SYSTEMS
Minimum Duct Duct Duct
Efficiency Location R -value Efficiency
0.750 AFUE Attic R-4.2 0.830
9.50 SEER Attic R-4.2 0.810
SPECIAL FEATURES/REMARKS
i
HVAC SIZING Page 8 HVAC
Project Title.......... NAZARETTA ADDITION Date........ 07/22/97
Project Address........ 6234 PONDEROSA *******
MAGALIA *v4.50*
Documentation Author... Robert A. Mangrum ******* Building Permit #
Paradise Mechanical
5655 Almond Street Plan Check / Date
Paradise, CA 95969
916-877-8882 Field Check/ Date
Climate Zone....... ... 11
Compliance Method...... MICROPAS4 v4.50 for 1995 Standards by Enercomp, Inc.
MICROPAS4 v4.50 File-1GORDAN Wth-CTZ11S92 Program -HVAC SIZING
User#-MP1342 User -Paradise Mechanical Run-GORDAN COMPLY 24
GENERAL INFORMATION
Floor Area .................
Volume .. ..................
Front Orientation..........
Sizing Location............
Latitude ...................
Winter Outside Design......
Winter Inside Design.......
Summer Outside Design......
Summer Inside Design.......
Summer Range ...............
Interior Shading Used......
Exterior Shading Used......
Overhang Shading Used......
Latent Load Fraction.......
249 sf
1992 cf
Front Facing 18 deg
PARADISE
39.8 degrees
30 F
72 F
99 F
75 F
34 F
Yes
Yes
Yes
0.30
HEATING AND COOLING LOAD SUMMARY
(N)
Sensible Load .................... 4432 5214
Latent Load ...................... n/a 1564
Minimum Total Load 4432 6778
Note: The loads shown are only one of the criteria affecting the selection
of HVAC equipment. Other relevant design factors such as air flow
requirements, outdoor design temperatures, coil sizing, availability of
equipment, oversizing safety margin, etc., must also be considered.' It is
the HVAC designer's responsibility to consider all factors when selecting
the HVAC equipment.
LO TTE OCHMIs l
Heating
Cooling
Description
(Btuh)
(Btuh)
Opaque Conduction and Solar......
1678
1018
Glazing Conduction ...............
1134
648
Glazing Solar ....................
n/a
560
Infiltration .....................
1217
414
Internal Gain ....................
n/a
2100
Ducts ............................
403
474
Sensible Load .................... 4432 5214
Latent Load ...................... n/a 1564
Minimum Total Load 4432 6778
Note: The loads shown are only one of the criteria affecting the selection
of HVAC equipment. Other relevant design factors such as air flow
requirements, outdoor design temperatures, coil sizing, availability of
equipment, oversizing safety margin, etc., must also be considered.' It is
the HVAC designer's responsibility to consider all factors when selecting
the HVAC equipment.
LO TTE OCHMIs l
ch.""co,
/� /may: �j
ch.""cop calYfC mja
NoPrn
APPROVED i9f'�'�873�23C'S
Butte County.
Environmental HeM
7- Z-7- s7
Date
Signa re
l
'PERMIT NO. 3468-78B
t
PERMIT EXPIRES
OWNER A. Lynch
:CONTR. owner
64-26-25
,LOCATION (A.P. )
395 Ponderosa Way, lot 37, PP#15, Magalia
Temp. Power Pole
Called PG&E
Temp. Elea Serv.
Called PG&E
Temp. Gass S�erv.
Call epG&E
FINALEI
9 `9
to
(Si ture)
Setback
Forms
Main Bldg.
Footings
StemwaI I
Slab
Piers
Garage
Footings
Stemwa I I
Slab
Carport
Footings
Slab
Patio
Footings
Masonry Walls
Reinf. Steel
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
BUILDING BUILDING (Cont'd)
PLUMBING
Firewall
Soil Piping
Parapets
1st Floor
Restroom Finish
2nd Floor
Windows
3rd Floor
Sidinq
To out
Roof SheathingWater
Piping
Roofing
Sewer
Fdn. Vents
Fixtures
Garage Vents
Insulation
Water Htr.
Heaters
Prov. for physically
handica ed
Conformance of ex. , .
structure
Appliances
Gas Piping &Test
Temp. Gas
Final
Sanitation
(REPLACE
Final
Final
Test
F
ELECTRICAL
Stucco
Final
Subpanels
Mesh
MECHANICAL
Grd. Fault Prot.
Scratch
Heating
Service
Brown
Cooling
Temp. Pole
Finish
Ducts
Underground
Interior Lath
Ventilation
Permanent
Door Closer
Final
Final
MOBILEHOME UTILITIES ------------------
Elec- Service
Elec. Pedestal
Water Piping
Sewer
Gas Piping
MOBILEHOME INSTALLATION - - - - - - - - - - - - - -
Support
Elec. Continuity
Water Piping
Drainage
Gas Piping
DATE
REMARKS OR CORRECTIONS
(NOTE: An entry must be made on this form each time you visit the job site.)
COUNTY OF BUTT DEPARTMENT OF PUBLIC WORKS
7 County Center Drive • — Oroville, California 95965
Telephone: 534-4541�j„ y
APPLICATION AND PERMITAA
W.
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
Date
i noturPermit e o Agent
Receipt No. ' �" ,(,
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF Pl tDC WORKS
By nate �,
Building permit expires Date
BUILDING
Owner A. C,
SO. FT. OCC. BUILDING VALUATION
O
Mailing Addres Q 0 jqCr,06 O $ /¢
le one No.
Contractor Q
Mailing Address
Fireplace
Total Valuation V t1
Telephone No.
1
Permit Fee
Building Address 007a* ASA �
PlanFee&/or Penalty
ng
Permit ee
t Fee
_
0 .� % �!�fS
PLUMBING No.1 @ FEE
PERMIT FILING FEE $3.00
Each TraD 1.50
Repair drainage or vent piping 1.50
a� _ n / �`S- .
A. P. No. T AL b
Zoning &Planning
Water piping 1.50
Each gas water heater or vent 1.50
F
W S�
Fire Dept.
Fire Zone
Use Permit
Gas piping system 1 - 5 outlets 1.50
EOA
Parking
Plans
Parcel
Declaration
Parcel Map
60' R/W
Improveme s
Each additional outlet .30
Building sewer 5.00
Bldg.ons Recd
Parcel Approval
Plans Approval
Lawn sprinkler system 2.00
NEW 6DDITION UTILITIES ❑ OTHER ❑
Permit Fee $
$
.w i) (elqe
ELECTRICAL No. @ I FEE
PERMIT FILING FEE $3.00
00V OR
Main service 100 AMP ORSLESS 5.00
Single Family Duplex ❑ Mobil Home ❑ Others ❑
Main service EA. ADD'L too AMP 2.50
,
,yr
Main service OVER e O 25.00
100 AMP OR LESS
Main service EA. ADD'L 100 AMP 1.00
OR ADDNSNEW T // %ACCDWE•BLDGS.LING CGUP. Y1 2¢sgft
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
style of:
NEW coNSTR ULTI.OUTL T 2.50ea
NON-RESID BRANCH CIRCUITS/
NEW CONSTR. (POWER APPARATUS 8
NON-RESID. `SINGLE OUTLET CIR.
EX. OCcuD{OUTLETS OR FIXTURES BAL@1
FIXED APLNS
Ex. OCCup. OUT ETS P(RES(D,)REA) 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
License No. Classification
Misc. Wiring 6.25
I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
$
MECHANICAL No @ FEE
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑I have placed -on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
I certify that in the performance of the work for which this
permit is issued I shall not employ any person in any manner
so as to 'become subject to the Workmen's Compensation Laws of
California.
PERMIT FILING FEE $3.00
Heating
Cooling
Ventilation
Hood 2.00
Permit Fee $
$
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
Land Development Fee
$
TOTAL PERMIT FEE
$
authorize representatives of the County of Butte to enter upon the
above-mentioned property for inspection purposes.
Date
i noturPermit e o Agent
Receipt No. ' �" ,(,
White-D.P.W. - Yellow -Assessor - Pink -Inspector - Goldenrod -Applicant
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTOR OF Pl tDC WORKS
By nate �,
Building permit expires Date
e
PERMIT NO. 3881-76B,P,E,M
PERMIT EXPIRES
OWNER Albert Lynch
CONTR. Triple "S" Custom Homes, Paradise
LOCATION (A.P. 64-26-25 )
395 Ponderosa Way, lot 37, PP#15, Magalia
6
b .
i
J
A
Temp. Pow Pole
t; Called G&E
Temp. E c. Serv.
Cal d PG&E 7i
Temp Gas,( rr
ailed PG&E
J B
INALED
(Dat C
(Signature)
• V
Fiber,. Glass Insulation
BUILDERS INSULATION STATEMENT
BLOWN INSULATION
Manufacturer's minimum thickness to provide the level of insulation
resistance (R) Values as shown:
" R Values are determined in accordance with ASTM C-687 C-236.
Conforms to Federal Specification HHI-1030A.
This insulation has been installed in conformance ' the above recom-
mendations to provide a value of R us' bags of insula-
tion to cover— square feet of are
Insulation Contractor (Sign) / \Builder (Sign)
Company N� Company Name
BATTS AILD BLANKET
R
INSULATION
R
INSULATION
VALUE
THICKNESS
VALUE
THICKNESS
R-22
61/2"
R-13
35/8"
R-19
6"
R-11
31/2"
Date
Meets Federal
Specification HHI-521E
Fiber glass batts or rolls have been installed in accordance With the
manufacturer's �� recommendation to provide an R -Value of� in the
ceiling,�Lin the exterior walls,2e�in the floor or craw pace
perimeter.
:��)
7MPLE "S" CUSTOM HOME BUILDERS
In n (,fflycto i 1 18eCMOM
Paradise, Ca. 95969 HOME BUILD
8084 Skyway Ph�;�,��1
Company Name CofttMSVa1M 959 9
b
CSG -32-11-C Date
\ 21.44•f k,4
CERTAIN -TEED PRODUCTS CORPORATION. P.O: BOX 860, VALLEY FORGE, PA. 19482
CERTAINIHO
s
COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS
BUILDING INSPECTION RECORD
DA TE REMARKS OR CORRECTIONS
nez.,�
(NOTE: An entry must be made on this form each time you visit the job site.)
N
BUILDING
BUILDING (Cont'd)
PLUMBING
Setback
-%� /�
Firewall / --7 &
Soil Piping
Forms
-
Parapets
1st Floor _ -7.
Main Bldg.
, 'Z 6 G ice`"
Restroom Finish
2nd Floor
Footings
Windows • 2 el -_7.6
3rd Floor
Stemwall
Siding _ �-7
To out
Slab
Roof Sheathing 8.�`
Water Pi in
Piers
Roofing - 1 -0 .- 7 6
Sewer
Garage
Fdn. Vents
Fixtures
Footin s
-�G J
Garage Vents
Water Htr.
Stemwall
..-� "p-
Insulation i .—ZG
Heaters
Slab
Prov. for physically
Appliances
handica ed
Carport
Conformance of ex.
Gas Piping &Test --�
Footings
-
structure
Temp. Gas
Slab
Final
Sanitation
Patio
�- --- .
FIREPLACE
Final Z1, Z (o
Footings
Footing ir_�
ELECTRICAL
Masonry Walls
Throat c
Rough 2 -76 {r✓
Reinf. Steel
Final L -- 7
Fixtures --
Bond Beam
FIRE SPRINKLERS
Motors
Framing (9 - S —7 C
Test
Water Htr. - Z
Stucco
Final p
Subpanels
Mesh
MECHANICAL
Grd. Fault Prot. -76
Scratch
Heating ,� .� 7
Service
Brown
Cooling-
Temp. Pole -�-
Finish
Ducts
Underground
Interior Lath-
Ventilation
Permanent "Po'- 7!a
Door Closer
OeV
" Final % /� -�_ /., f_ z92*
Final -2 /_ r 7 !�
DA TE REMARKS OR CORRECTIONS
nez.,�
(NOTE: An entry must be made on this form each time you visit the job site.)
N
f.
COUNTY OF BUTTE -' • DRTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 —76
Tel ephonel.- 534-4541 a /
Tel
APPLICATION AND PERMIT
BUILDING
Owner T- N LA
SO. FT. OCC. BUILDING VALUATION
�?_ :r
Mailing Address
4^ -
Telephone No.
Fireplace
R
Contractor p e sRS
Total Valuation
//��
Mailing Address WAy A4 A A-PJ5�
Fee ^
Permit Fee (� p
Planit
ng Fee &/orPenalty
Telephone No.
y7_9
Permit Fee V
QU
Building Address 35./C D v w
PLUMBING No. @ FEE
PERMIT FILING FEE $3.00
MA ,e,
Each Trap 1.50 Z
A 0 7` 3 7 i"
Repair drainage or vent piping 1.50
Water piping 1.50 �.
Each gas water heater or vent 1.50
A. P. No. Y .2 G •
Zoning & Planning
Gas piping system 1 - 5 outlets 1.50
Each additional outlet .30
F
Fire Dept.
Fire Zone
Use Permit
Building sewer 5.00
EOA
Parking
Plans
Parcel
Declaration
�fcel
60' R/W
Improvem s
Lawn sprinkler system 2.00
Bldg. I:F� Rec'd
,/
Pa cel Approka
Plans Approval
Permit Fee $
PqA
NEW ADDITION ❑ UTILITIES ❑ OTHER ❑
ELECTRICAL No.1 @ FEE
PERMIT FILING FEE $3.00 .^
Main service incl. 1 meter
Additional meters, each 1.00
Sub -panel (12 or less) (more than 12)
-
Single Family Duplex ❑ • Mobil Home ❑ Others ❑
Range, Cook -top or Oven 1.00
Water Heater or Space Heater 1.00
Light fixtures b a 10
Receps., switches & fix outlets
CONTRACTORS LICENSE LAW
I am licensed under the provisions of Chapter 9, Div. 3, of the
State of California Business & Professions Code under the name
styI of: i, .11,
S is v5;te, ow �i.. L pti�.s
Hood, Ex. Fan or F.A. Furn. Motor 1.00
Evap. cooler, gar. disp. or D.W. 1.00
Air conditioner or heat pump
Water pump
Mobil Home Facilities 5.00
�.�"0/,
Temp. Power Pole 5.00
l7
License No. oo �9 Classification -8 Z�fC171O
Misc. wiring
❑ I am exempt from the Contractors License Laws of the State of California.
Permit Fee $
MECHANICAL No. @ FEE
WORKMEN'S COMPENSATION INSURANCE
1 am aware of the provisions of Section3700 of the California Labor
Code which requires every employer to be insured against liability
for Workmen's Compensation.
❑I have placed on file with the County of Butte a certificate of
Workmen's Compensation Insurance.
®I certify that in the performance of the work for which this
permit .is issued 1 shall not employ any person in any manner
so as to become subject to the Workmen's Compensation Laws of
California.
PERMIT FILING FEE $3.00.3-
Heating
Cooling .-
Ventilation
Hood 2.00
Permit Fee $ 775,
$ TI
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.
X Date , �a
Signature of Permitee or Agent
ene-
Receipt No.
White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant
TOTAL PERMIT FEE 1$1071
This permit is hereby issued under the applicable provisions of
the Butte County Code and/or resolutions to do work indicated
above for which fees have been paid.
DIRECTO PUBLIC WORKS
By F Date7^ 7-/'- 7
ui Iding permit expires Date