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064-620-011
0 j 64-62-11 Wesley Fluegel NIS pri.rd.,ap"p.1000'E.of Nimshew Ridge Rd, app.2 mi.W.of Skyway, Maga Perimit #261-77B,P,E'�,new�hobby shop) 64-62-11 Permit #59-82E(inst.new alec.serv./SF) � I'MO'A ROGOL, Edmund. 59-66B#- 3803B 521-66B*# 32-66P*. 3424P.---- . a 48-66E* -4632E - -- - -M/ off Skyway 2 mi. so. on Nimshew Rd.;, Paradise _ (new; single family) % ( #add carport to exi ting house and construct " detached guest house and work shop) i. *-Oadd -patio 1 5 roof. -- ; f 1 LOT-LiNtADJUSTMENT AP #y (oZo :a �/ OF ti ry 'S r� r i t E I i 0 j 64-62-11 Wesley Fluegel NIS pri.rd.,ap"p.1000'E.of Nimshew Ridge Rd, app.2 mi.W.of Skyway, Maga Perimit #261-77B,P,E'�,new�hobby shop) 64-62-11 Permit #59-82E(inst.new alec.serv./SF) � I'MO'A ROGOL, Edmund. 59-66B#- 3803B 521-66B*# 32-66P*. 3424P.---- . a 48-66E* -4632E - -- - -M/ off Skyway 2 mi. so. on Nimshew Rd.;, Paradise _ (new; single family) % ( #add carport to exi ting house and construct " detached guest house and work shop) i. *-Oadd -patio 1 5 roof. -- ; f 1 LOT-LiNtADJUSTMENT AP #y (oZo :a �/ OF ti ry 'S r� r i �� I �--_I I ----- � I ��• � '®"+v-Rm��PfOre4alTr�'ver7•+arm`w1P•7^"�+-'•'rr('^��ePvw�wryirrr w •..,t%Y.F�+!rir .•.1P�rr,', _;•� V COUNTY OF,�BUTTE — DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATIA ANO PERMIT PERMIT NO. 1) ASSESSOR PARCEL NUMBER („ 192 — // •" ONING (?1-� BUILDING PERMIT OWNER 11 )PA 1. �, ,� L- V v L TELEPHONE AP 73 QJ "L/ SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS ,c; q.5 / Lei O og• / w /�J /0 ,*w .. CONTRACTOR'S NAME // Ow") t' it— TELEPHON' CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER n J• AY UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER - LICENSE NO. Plan Checking Fee .$ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS PLUMBING PERMIT Filing Fee 10.00 L t p Each Trap 2.00 Repair drainage or vent piping 5.00 G Water piping LOT NO. SUBDIVISION NAME / PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF,©f Duplex FJ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other [ Describe work: t laA J ),�_. Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 8001 OR LESS 100 AMP OR LESS — 5.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. (DWELLING OCCUP.y) OR ADDNS. \ ACC. BLDGS. 22 sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- ' sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR I.OUTLET 2.50ea NON•RESID BRANCH CIRC TS NEW CONSTR.IPOWER APPARATUS 6 NON-RESID, %SINGLE OUTLET CIR. Ex. Occup OUTLETS OR FIXTURES 50@25 FIXED AP LNS. 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): ❑ 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 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. f also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. y _� _'? 1 Signature of Applicant — Owner Q 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 $ Q OCCUP. GROUP I TYPE OF CONST, I PARCEL PD I ND ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which n, DIRECTOR OF PUBLIC By I, t Y PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been aid. P WORKS f� ` y Ai 03, Receipt No. %, 4Q _� WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT V COUNTY OF..BUTT-E - DEPARTMENT OF PUBLIC WORKSP RMIT O. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 T APPLICATION AND PERMIT ORPARCEL CEL NUMBER _ NING ASS E S 2 W0;043, —.//• t;04 BUILDING PERMIT WN R TELEPHONE�r�.! Ls &73.-O�� SO. FT. OCC. BUILDING VALUATION W ER'SM`AILI G AD RESS //nO`-NT`RA`C1T�O P 'S N�/� (D vivi a w TELEPHO OE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Flling Feb $ 10,00 LE DER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS PLUMBING PERMIT Filing Fee 10.00 57 ag o`+L Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SFX_ Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 ' . TYPE OF WORK New Addition ❑ Remodel ilities ❑ Installation❑ Other o Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP OR0V OR LESS5.00 Main service EA. ADD'L too AMP 2.50 NEW CONST. /DWELLING OCCUP.y` OR ADDNS, `ACC. BLDGS. / 22 sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) 1, 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 NON -RESIT R BRATCH CIRCTITS 2.50 ea NEw CONSTIR(POWER APPARATUS SJ NON-RESID. (SINGLE OUTLET CIR. Ex. OCCUp OUTLETS OR FIXTURES 25 BAL FXED APPLNS. OR Ex. OCCUp.�OIUTLETS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 /,3-- ,3-- Permit Fee $ —70 ^ Contractor MECHANICAL PERMIT FiIirig Fee 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 $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against aid County in consequea the granrrittg of this permit. Date / — / ,_ 2 -This Ignature 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 $ Jo— OCCuP, GROUP I TYPE OF CONST. PARCEL PD HD IssuE permit is hereby issued under sions of the Butte County Code and/or work indicated above for which TOR OF PUBLIC BY "" - PERM EXPIRES Date' o the applicable provi- resolutions to do fees have been paid. WORKS Dat �2, % �� Receipt No. ��9T�8 ' WNIT!-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS SPECIAL INSPECXION REPORT Owner: i�/✓�'Ir� xi✓v ' - . -- _- - -- --- - A. P. # Address: Date of Inspection Tenant: Building Location: Type of Inspection requested: T71. Housing 2. Financing 4. Other (specify) Present use of building: Inspector v �[ 3. Change of Occupancy to A. Sanitation (Housing)d Lvdi 1. Water closet: dio 2. Lavatory: 3. Bathtub or shower: 4. Kitchen sink: 5. Hot and cold water to fixtures: ' 6. Heating facilities: 7. Natural light and ventilation: 8. Room and space requirements: 9. Bedroom window or door for second exit: 10. Infestation of insects, vermin, or roderits:� 11. Connection to sewage disposal: '12. Connection to water supply: 13. Rubbish and garbage facilitie 14. Comments: C1 P(0 kal-1- B. Structural 1. Piers and footings: W 2. Floor construction: 3. Wall construction: 4. Ceiling and roof construction: 5. Fireplaces: 6. Comments: I IN C. Elect 1. 2. 3. 4. D. Plumb 1. 2. 3. vat* LIC-aL.A..Aa V=..L.3. 4. Comments: A 12 -In /---) -3 o- /o"-d'c-01 4e-- 7-r0gtl frnnti"110d nn harkl E. Other 1. Maintenance and repair: 2. Fire hazards: 3. Safety hazards: 4. Weather protection: 5. Underfloor and attic ventilation: 6. Comments• F. Commercial,Buildings i 1. Roof covering: J 2. Distance to property lines: ' 3. Physically handicapped: 4. Restroom floors and walls: 5.. , Exits 6. Improvements:, 7. Zoning: - 8. Count ents• - G. Field Problems or Violations 1:• Problem or violation (give complete description): 2. What action taken (give complete description): 3. What action recommended: 77A. Information only - file 7-1 B. Hold for tea (10) days, then Wri-,..e letter. C. Write letter. D. Other. a,a,a O (0 0 0 0 \0 Y �•�. BUTTE COUNTY 0 DEPARTMENT OF DEVELOPMENT SERVICES 0 BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS �_'•_�y' c 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OF APPLICATION "PLEASE PRINT CLEARLY" CONTRACTOR OWNER LaWName City I Name nal Ad S �� G%�UC1J cit ) t t.__ E-mail tic. # Z SFs—y Ph73 _ V S- 3 Fax Fax E-mail State License Number CONTRACTOR Name Address//off City Stat Zip�SS,s Phon 73 _ r 3 Fax E-mail tic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Book Fax E-mail Planner State License Number APPLICANT NAME Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X For office use only: Zoning Property Address 5-5 5— Flood Zone Cross Street SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. BP © -'527 V I BIN # LOCATION AP# _ OGS ("'7 'O/ OI:rD Property Address 5-5 5— City V4 A � Cross Street WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or S7=jIv Work: AezeJ /`%T1` Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR SUBMITTAL REQUIREMEN 15 t KAFORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 2 r✓� � Received by: Amount: Bldg jW SRA Receipt #: Sheriff � SMIP Date: a� D Total KCV 0-1 O -V4 SUBMITTAL REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply fora permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. Residential, New, Remodels, Additions, and Accessory Structures: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ .2. 3 Complete sets of plans, signed by the preparer. NO GRAPH PAPER! OR 3 Sets Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation. (Note: Not required for additions to mobile or modular homes.) ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Detached Accessory Building Form, filled out by the property owner (if required). ❑ 8. Sanitation and site plan approval from the Environmental Health Department. ❑ 9. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer. Mobile, Manufactured, or Modular Homes: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2. 2 Data sheets and installation instruction manual. ❑ , 3.. 2 Marriage line information. ❑ 4. 2 Floor plans. , ❑ 5. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation and site plan approval from the Environmental Health Department. ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). Commercial, New, Additions and Remodels: ❑ 1. 4 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ 2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations, with code analysis. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ; ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation (if required). ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Statement of Intent for Non -heated and A/C (if required). ❑ 8. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer. ❑ 9. Letter of intent. ❑ 10. Hazardous Material Forma ❑ 11. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (530) 538-7541. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 6-16-04 H.15.7 �} '�r: $�:'�� ,`g.- 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 delam y in processing and issuing your, building permit. No building perit will be issued until this verification is received. —1. I personally plan to provide the i ajor labor and material for construction of this proposed property improvement: `YES [/ ] NO [ ]. 2. I HAVE j/ ]HAVE NOT [ ] work. "signed an application for a building permit for the proposed 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: S. 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-- DATE: WNERDATE: `D 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.. Butte County Department of Development Services ADMINISTP.ATION ° BUILDING `GIS `PLANNING 7 County Center Drive Oroville, CA 95965 (530) 538-7541 Telephone (530) 538-2140 Facsimile j MRxtRM•varr.��lA:+�Sa. 212- -1-4 C1il Dear Property Owner. An application for a building permit has been submitted in your name listing yourself as the builder of the 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 your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as -contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government 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. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact the Internal Revenue Service (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 "owner -builder" building permit, erroneously implying that the property owner is providing his or ber 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 contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. *ager, ' et C.B.O. ding Inspection NOTE: This Owner -Builder Tnfnrsn%tinn is rPrrnirwi by CPrfinn t oR'in of tho rlif,.rnis WP Ifh %nA cAfPtzr r nriP \num Sarre Add— (1tv. stutr ZaP RFCORDING REQ11FSTED ICY Bidwell Title & Escrow Compam' AND WHEN RFC0RDFD NL\IL TO Ronald L. Enos 5959 Happy Hollow Road tMagalia; CA 95954 2005-0034292 Recorded I REC FEE 1108 Official Records I TAX County of I MUM PREVA 187.8@ Butte I County Clerk-ReJ. eccoorrdderl I 82:MN 17 -Jun -M I Page 1 of 3 tlyder �o. 00220740-003 1'arcelNo. 064-620-011 GRANT DEED . •rl•ns roti�t rt�l(�Isrn:n IIr ttm\\rr.l. •rrrr.l:.� tsi: Ra\\� �o�•IPANY The UndcrsignLA Granton(.) Dwlare(s) Documentary Transfer Tax is S/i/j4 jUa357.50 .� ❑ Ciq/town of 0 computed on full value of interest or property conveyed, or 0 Unincorporated Arca ❑ lidl value less value of liens or encumbrances remaining at the time of sale 0 Monument Fee ofSI0(X) NOEL A VALUABLE CONSIDERATION, receipt ut•which is hereby acknowltslged, Shirley Coats, An Unmarried Woman hereby GRANT(s) to Ronald L. Enos and Valerie M. Enos, Husband and Wife as Joint Tenants the following real property in the ❑ City of 0 unincorporated Area C ouniv of But t e. State of Califurnia: SEE EXHIBIT A ATTACHED HERETO AND MADE A PARI' HEREOF Shirley Coats Document Date: June 1,'2005 State of California County of BUTTE } SS. On .T�jyS ? �Q � hehire me, the undersigned, a Notary Public in and for Said County and %talc, persunally appeared Shirley Coats*** Personally known to me (or proved to me on the basis of wtisfactory 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 hisAter/their authorized capacity(ics), and that by his/her/their signatures) on the instrument the person(s), or the entity upon behalf of which the persons) acted, executed the instrument. WITNESS my h• nd and official scat. I' Signature FOR NOTARY SEAL OR STAMP JANET CLARK COMM. # 1473379 NOTARY PUBLIGCADFORNIA COUNTY Of BUTTE Comm. Expites Mamb 27, 2008 MAIL TAX STATEMENTS TO: Same as Above BT fiGGRM (DEED Order iib.: 00210740-003 EXHIBIT A THE LAND REFERRED TO HEREIN IS DESCRIBED AS FOLLOWS: ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: PARCEL I: BEING A PORTION OF THE SOUTHEAST QUARTER OF SECTION 221 TOWNSHIP 23 NORTH, RANGE 3 EAST, M. D. B. & M., AND MORE PARTICULARLY DESCRIBED AS FOLLOWS: COMMENCING AT THE SOUTHEAST CORNER OF SAID SECTION 22; THENCE ALONG THE EAST LINE THEREOF NORTH 00 01'47" WEST, 888.59 FEET TO THE CENTERLINE OF A 60.00 FOOT ROAD EASEMENT AND THE TRUE POINT OF BEGINNING FOR THE PARCEL HEREIN DESCRIBED; THENCE FROM SAID TRUE POINT OF BEGINNING AND ALONG SAID CENTERLINE SOUTH 890 53'13- WEST, 613.31 FEET; THENCE LEAVING SAID CENTERLINE NORTH 00 01'47" WEST, 250.00 FEET; THENCE NORTH - - 890 53'13" EAST, 613.31 FEET TO THE EAST LINE OF SAID SECTION 22; THENCE " ALONG SAID EAST LINE, SOUTH 00 01'47" EAST, 250.00 FEET TO THE TRUE POINT• OF BEGINNING. ¢ ' TOGETHER WITH ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE COUNTY OF BUTTE, STATE OF CALIFORNIA, DESCRIBED AS FOLLOWS: THE SOUTHERLY 7 FEET OF THE EASTERLY 613.31 FEET OF THE FOLLOWING DESCRIBED PARCEL OF LAND: A PORTION OF THE SOUTHEAST QUARTER OF SECTION 22, TOWNSHIP 23 NORTH, RANGE 3 EAST, M. D. B. & M., AND MORE PARTICULARLY DESCRIBED AS FOLLOWS: COMMENCING AT THE NORTHWEST CORNER OF THE NORTHEAST QUARTER OF THE SOUTHEAST QUARTER OF SAID SECTION 22; THENCE SOUTHERLY ALONG THE WESTERLY LINE OF SAID NORTHEAST QUARTER OF THE SOUTHEAST QUARTER OF SAID SECTION 22, A DISTANCE OF 985 FEET TO A POINT AT THE SOUTHWEST CORNER OF THAT CERTAIN PARCEL OF LAND DESCRIBED IN DEED FROM THOS. H. JACOBS, ET UX TO THOMAS V. PINCKNEY, ET UX, DATED MAY 11, 1937, AND RECORDED JUNE 5,1937, IN BOOK 152, PAGE 476, OFFICIAL RECORDS, SAID POINT BEING THE TRUE POINT OF BEGINNING FOR THE PARCEL OF LAND HEREIN DESCRIBED; THENCE AT A RIGHT ANGLE EAST ALONG THE SOUTHERLY LINE OF SAID PINCKNEY PROPERTY, A DISTANCE OF 435 FEET TO THE SOUTHEAST CORNER OF SAID PINCKNEY PROPERTY; THENCE NORTH ALONG THE EAST LINE OF SAID PINCKNEY PROPERTY AND THE NORTHERLY EXTENSION THEREOF, A DISTANCE OF 745 FEET TO A POINT AT THE MOST SOUTHWESTERLY CORNER OF THAT CERTAIN PARCEL OF LAND DESCRIBED IN THAT CERTAIN AGREEMENT OF SALE FROM THOS. H. JACOBS TO HERBERT E. McDOWELL, ET UX, DATED DECEMBER 1, 1959 AND RECORDED DECEMBER 14, 1959, IN BOOK 1034, PAGE 44, OFFICIAL RECORDS; THENCE EAST ALONG THE SOUTHERLY LINE OF SAID McDOWELL PROPERTY, A DISTANCE OF 885.0 FEET TO A POINT ON THE EAST LINE OF THE NORTHEAST QUARTER OF THE SOUTHEAST QUARTER OF SAID SECTION 22; THENCE SOUTH ALONG THE EAST LINE OF SAID NORTHEAST QUARTER OF THE SOUTHEAST QUARTER OF SAID SECTION 22, A DISTANCE OF 1265 FEET, MORE OR LESS, TO THE NORTHEAST CORNER OF THAT CERTAIN PARCEL OF LAND DESCRIBED IN DEED FROM DALTON ENGELBERG, ET AL, TO DALTON ENGELBERG, ET UX, DATED JULY 20,1964 AND RECORDED SEPTEMBER 11, 1964, IN BOOK 1334, PAGE 556, OFFICIAL RECORDS; THENCE WEST ALONG THE NORTHERLY LINE OF SAID ENGELBERG PARCEL AND ITS WESTERLY EXTENSION THEREOF, A DISTANCE OF 1323.31 FEET, MORE OR LESS, TO THE NORTHWEST CORNER OF THAT CERTAIN PARCEL OF LAND DESCRIBED IN DEED FROM THOMAS H. JACOBS, ET UX, TO JOHN E. TRIONE, ET UX, DATED MAY 11, 1948 AND RECORDED MAY 17, 1948, IN BOOK 420, PAGE 401, OFFICIAL RECORDS, SAID POINT BEING ALSO THE WEST LINE OFTHE SOUTHEAST QUARTER OFTHE SOUTHEAST QUARTER OF SAID SECTION 22; THENCE NORTH ALONG THE WEST LINE OF SAID SECTION, A DISTANCE OF 520 FEET THE POINT OF BEGINNING. AP NO. 064420-011 PARCEL II: A NON-EXCLUSIVE EASEMENT FOR ROAD AND PUBLIC UTILITY PURPOSES OVER A STRIP OF LAND 30.00 FEET 1N WIDTH, LYING CONTIGUOUS TO AND SOUTHERLY FROM THE SOUTHERLY LINE OF PARCEL I -A HEREIN. PARCEL III: A NON-EXCLUSIVE EASEMENT FOR ROAD AND PUBLIC UTILITY PURPOSES OVER A STRIP OF LAND 60.00 FEET IN WIDTH, LYING 30.00 FEET ON EACH SIDE OF THE FOLLOWING DESCRIBED LINE: BEGINNING AT THE SOUTHWEST CORNER OF PARCEL I -A HEREIN; THENCE SOUTH 890 58' 13" WEST, 169.64 FEET TO THE BEGINNING OF A 100.00 FOOT RADIUS CURVE, CONCAVE TO THE SOUTHEAST; THENCE ALONG THE ARC OF SAID CURVE, THROUGH A CENTRAL ANGLE OF 310 47'18" AN ARC DISTANCE OF 55.48 FEET TO THE BEGINNING OF A 100.00 FOOT RADIUS CURVE, CONCAVE TO THE NORTHWEST; THENCE ALONG THE ARC OF SAID CURVE; THROUGH A CENTRAL ANGLE OF 310 47' 18", AN ARC DISTANCE OF 55.48 FEET; THENCE SOUTH 89° 5811311 WEST, 435.00 FEET TO THE CENTERLINE OF NIMSHEW RIDGE ROAD. Department C o u n t y J. Michael Crump, Director Warner C. Phillips, Assistant Director September 8, 2003 Judy Fluegel 5959 Happy Hollow , Magalia, CA 95954 Re: Lot Line Adjustment AP 064-620-011& 028 , Dear Mrs. Fluegel: 14 Works .e LAND DEVELOPMENT DIVISION 7 County Center Drive Oroville, CA 95965 (530) 538-7266 (FAX) 538-7171 BUTTE COUNTY SEP 0 9 2003 DEVELOPMENT SERVICES On September 8, 2003, the Department of Public Works made the finding that the Lot Line Adjustment on the above referenced property is exempt from environmental review, and approved the project subject to the conditions on the attached page. Should you appeal the decision of the Department of Public Works, please submit your appeal, in writing, with the appeal fee of $50.00, to the Clerk of the Board of Supervisors, 25 County Center Drive, Oroville, California, prior to 4:00 p.m., September 18, 2003. The conditions of approval must be met within thirty-six (36) months from the date of approval by the Department of Public Works or the approval will be considered null and void. If you have any questions concerning this matter, please contact this office at (530) 538-7266, Monday through Friday, 8:00 a.m. to 4:00 p.m. Sincerely, Stuart Edell Manager, Land Development Division SE/kp Attachment CC.nvironmental Health Department Building Division L & L Surveying Judy Fluegel, Lot Line Adjustment, AP 064-620-011 & 028, Modifying the common boundary line between two parcels located on the East side of Nimshew Road at Perrier Road, Magalia area. ..Engineer: L & L Surveying/ 1. New lot or parcel lines shall comply with setback requirements of applicable zoning and building ordinances. 2. Deeds and plats (if required) shall be submitted to the Department of Public Works, Land Development Division for checking and approval prior to recordation and shall contain the notes specified below. 3. Provide documentation from a title company of the applicant's choice verifying that any deed of trust affected has been partially re -conveyed or modified to reflect the lot line adjustment and to prevent the creation of any additional lot or ` parcel. 4. Prior to recordation of deeds, provide documentation verifying payment of taxes as required -by Subsection (b) of Section 20-95 of the Butte County Code and as specified in Article 8 of Chapter 4 of Division 2 of Title 7 of the Government Code, commencing with Section 66492. Deed Note (To be placed on any deed to effect lot line adjustment) 'The purpose of this deed is to effect a lot line adjustment as approved by the Butte .County Director of Public Works on The above described lands are to be combined with, and become a part of those lands as described in the deed to as filed for record in Butte. County Official Records at Serial Number Book at Page . No additional lots or parcels are created hereby. The scope of review of said lot line adjustment was limited as specified in Government Code Section 66412(d), and approval of it does not constitute assurance'that future applications for building permits or other land use entitlements on the modified lots or parcels .will be approved by the County of Butte. Plat Note (To be placed on any required Plat) This plat does not constitute a legal description of the lots or parcels depicted and does not show all easements of record on or affecting said lots or parcels. ■ Lot Line Adjustment Conditions of Approval - Butte County ■ 2 November 21, 2003 Coldwell Banker 7020 Skyway Paradise, CA 95969 ATTN: Larry Knifong 'eutie Co LAND OF NATURAL WEALTH AND BEAUTY PLANNING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE • OROVILLE, CALIFORNIA 95965-3397 TELEPHONE: (530) 538-7601 FAX: (530) 538-7785 Re: 100% Rebuild -Burn -down letter for 5959 Happy Hollow Rd., Magalia, CA. (APN 064-620-011). Dear Mrs. DeWees; The above referenced parcel is currently zoned AR -2.5 (Agricultural Residential, 2 '/2 acre minimum). This parcel is a 2.9+/- acre parcel with three residential dwellings which was created before the AR - 2.5 zone, and is considered a legal pre-existing non -conforming parcel. Should the dwellings be catastrophically destroyed they may be reconstructed within one (1) year, provided they will not be placed within the required building setback areas and meet sanitation codes in effect at the time of reconstruction. The setback requirements for the AR -2.5 zoning are 50 feet from the center of the road and 10 feet side and rear yard property lines. This parcel is located within a (SRA) State Responsibility Area high fire hazard designated area. For parcels of one (1) acre or larger the building setbacks for the side and rear yard property lines shall be a minimum of 30 feet. Should you have any further questions, please contact this office between the hours of 8:00 a.m. and 4:00 p.m., Monday through Friday, at 530-538-7977. Sincerely, Larry Painter Planning Technician II CC: Development Services, Building Division N o t$ERMIT NO. 261--77BP E PERMIT EXPIRES OWNER Wesley Fluegel ,CONTR. owner LOCATION (A.P. 64-62-11 N/S pri.rd. app.1000'E.of Nimshew Ridge Rd.,app. 2 mi.W.o,f Skyway, Magalia Temp. Power Pole Called PG&E Temp. Elec-orserv. Called PG&E Tempt*Gas Serv. + Called PG&E JOB FINALED (Date) (Signature) u is COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd) Water Htr. PLUMBING Setback '� Firewall Soil Piping MECHANICAL Forms Parapets r 1st Floor ` Main Bldg. Restroom Finish 2nd Floor Finish Footings Windows 3rd Floor Ventilation StemwaII Siding To out G /' 7 % Slab Roof Sheathing Water Pipift Piers Roofing Sewer " Garage Fdn. Vents Fixtures Footings Stemwa I I Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for physically handica ed Conformance of ex. structure Appliances Gas Piping Temp. Gas & Test Slab Final % 7 I Sanitation Patio FIREPLA bE Final 7 -2- 2-Footin s Footings Footing ELECTRI Masonry Walls Throat Rough —7 9 Relnf. Steel Final Fixtures , Framing Test Water Htr. Stucco f Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Under round Interior Lath Ventilation Permanent Door Closer Final Final DATE REMARKS OR CORRECTIONS (NOTE: An entry must be made on this form each time you visit the job site.) 1 - C COUNTY OF BUTTE — DE.PARTI;AENT OF PUBLIC WORKS 7 County Center Drive -,— UroviIle, California 95965 / �J Telephone:'S34-4541 /«— 7 APPLICATION AND PERMIT ,� L ---,- a..� arc VVUll ly V lJully lu QIIICI upull IIIc above-mentioned property for inspection purposes. x Date Signature of ermitee or Agent 6!2- 97?`7 Receipt No. °2 (�� White-D.P.W. — Yellow -Ass s r i inc-In pector — 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 b n paid. DIRECTO OF UBLIC WORKS p BY i Date_ 'O - % 7 uilding permit expires Date BUILDING Ownere �eGeL �Sl SQ. FT. OCC. BUILDING VAL TION Mailing Address 45'729 AIS A,ei.1 Telephone No. 41 Fireplace Contractor Total Valuation Al 4S, Mai I ing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee Building Address B , ✓ %G �� PLUMBING No. @ FEE PERMIT FILING FEE J$3.00 ,ap o0o F% F, Yz Al, A4 ne-,J `F—Jd Each Trap 3 1 1.50 ,J AG�ro r rf ;v 7-l7 $ WA Repair drainage or vent piping 1.50 Water piping 1.50 ec ✓ HA P.P+t /4ot-Low AA ^ G 4 L t A Each gas water heater or vent 1.50 , A. P. No. — 6— / % Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F S ire Dept. FireZone Use Permit Building sewer 5.00 EQA Parking Plans Parcel Declaration Parcel Ma P 60' R/W Im provemen Lawn sprinkler system 2.00 Bldg. Plans Rec'd arcel Approval Plans .,oval Permit Fee $ /2-00 $ NEW 10_ ADDITION ❑ UTILITIES ❑ OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Mairn service 600V OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2,50 Single Family ❑ Duplex ❑ Mobil Home ❑ Others Main service 100EAMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 pp O %3 D r' !n6 ie NEW CONSTOR ADDNS.. DWELLING OC & %A 2�sgft , Z NEW CONSTR. MULBTI OUTLET NON-RESID, ( BRANCH CIRCUITS) 2.50ea NEW CONSTPOWER APPARATUS &) NON_RESIR. D. (SINGLE OUTLET CIR, CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Ex. Occup(OUTLETS OR FIXTURES)50 @2-90 109 Ex. QCCU FIXED APPLNS. OR P•(OUTLETS (RESID,) EA) 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 $ 2,0 .$ 13 1-C 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. f'�X I certify that in the performance of the work for which this dal 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 $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 �yG TOTAL PERMIT FEE $ C a..� arc VVUll ly V lJully lu QIIICI upull IIIc above-mentioned property for inspection purposes. x Date Signature of ermitee or Agent 6!2- 97?`7 Receipt No. °2 (�� White-D.P.W. — Yellow -Ass s r i inc-In pector — 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 b n paid. DIRECTO OF UBLIC WORKS p BY i Date_ 'O - % 7 uilding permit expires Date BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO, BPO52747 B. C. Building Permit 01-16-04 pg 1 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under Issued Date: 10/05/2005 APN: 064-620-011-000 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. Site Address: 5959 HAPPY HOLLOW RD MAG License Class : License Number: Map Index: Date: Contractor: Description: new hvac (guest house) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that 1 am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: ENOS, RONALD AND VALERIE permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 5959 HAPPY HOLLOW RD signed statement that he or she is licensed pursuant to the provisions of MAGALIA, CA the Contractor's State License Law (Chapter 9 commencing with Section 95954 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).): ❑ 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 (Sec. 7044, Business and Professions Applicant: ENOS, RONALD AND VALERIE Code: The contractors' State License Law does not apply to an 5959 HAPPY HOLLOW RD owner of property who builds or improves thereon, and who does such work himself or herself or through his ocher own employees, MAGALIA, CA provided that such improvements are not intended or offered for 95954 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving 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 Contractors' State License Law does Contractor: not apply to an owner of properly who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ Iam Exempt under Article 3 of a usiness nedrofessio ode 1 Dat --/O—'---'95 Owner: License #: 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 Architect: is issued. Engineer: Ell have and will maintain workers' compensation insurance, as required by Section 3700 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: Total Square Ft: 0 S. F. Policy #: Valuation: $0.00 Census Code: 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, 1 shall 01 / _1 forthwith comply with those provisions. _` Date: Applicant:_ WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation,. damages as.provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is herpbfissue5,.un feftheAplicable provisions of the Butte County Code and/or I hereby affirm that there is a construction lending agency for the is issued 3097 Civ.) Resolutions to b work ind'" a d abov forylich fees have been paid. performance of the work for which this permit (Sec gy; Date: By:_ Name: EXPIRES ON: Address: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, . handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butttee County to enter upon the above mentioned property for inspection purpos re Print Name: I�0-t) A- U (� � �-� Signature: Date: �y� S :5:' 5 Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 owl V .1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION **PLEASE PRINT CLEARLY** OWNER Last a F' Name Addres S� cO�IOZCi CityPO .41 /Q-- S � zj S Pho 3 . Ll Fax E-mail CONTRACTOR' NameQ Addresss � � � • �� � ��/ City State S— P't§9P 7� – 15 Fax E-mail Uc. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City Address SRA City Fax State Zip Phone Book Fax E mail Planner State License Number APPLICANT NAME Name Address City State __TZip SRA Phone Fax E-mail APPLICANT SIGNATURE X CEJ For office use only: Zoning Property AddressCity s19 �ip zy Flood Zone Cross Street SRA Yes No Occ. Type Const Subdivision Name Map Book Page Lot # Planner Date Approved: PERMIT NO. BPo5?7 BIN # LOCATION AP# A� y - 600 - 0// —006 Property AddressCity s19 �ip zy a Cross Street WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or S pe of Work: /,/&w �1�aT 1 6 v3 L!�`— Sq. Footage ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plah checked and other department costs are not refundable. OVER FOR SUBMITTAL REQUIREMENTS I Received by: Amount= --Bldg �L� SRA Receipt #: Sheriff SMIP Date: ,5 Other / Total 0ri a_1 a_ne SUBMITTAL REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply fora permit. INCOMPLETE SUBMITTALS WILL NOT BEACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK Residential, New, Remodels, Additions, and Accessory Structures: ❑ 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPHPAPER! OR 3 Sets Engineered plans (if required) with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation. (Note: Not required for additions to mobile or modular homes.) ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Detached Accessory Building Form, filled out by the property owner (if required). ❑ 8. Sanitation and site plan approval from the Environmental Health Department. ❑ 9. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer. Mobile, Manufactured, or Modular Homes: 0 1. 3 Site Plans, signed by the preparer. NO GRAPHPAPER! ❑ 2. 2 Data sheets and installation instruction manual. ❑ 3. 2 Marriage line information. ❑ 4. 2Tloor plans. ❑ 5. 2 Engineered Tie Downs or Foundation plans. ❑ 6. Sanitation and site plan approval from the Environmental Health Department. ❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required). Commercial, New, Additions and Remodels: ❑ 1. 4 Site Plans, signed by the preparer. NO GRAPH PAPER! ❑ -2. 4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations, with code analysis. ❑ 3. 2 Engineered truss details and layouts (if required) (NO FAXES!). ❑ 4. Letter from Engineer or Architect for truss design review. ❑ 5. 2 Energy compliance design and supporting documentation (if required). ❑ 6. 2 Flood Elevation Certificate, wet -stamped and signed (if required). ❑ 7. Statement of Intent for Non -heated and A/C (if required). ❑ 8. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer. ❑ 9. Letter of intent. ❑ 10. Hazardous Material Form. ❑ 11. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, contact a Permit Application Assistant at (53 0) 538-7541. OVER FOR BUILDING PERMIT APPLICATION K:\FORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 6-16-04 BUTTE COUNTY DEPARTMENT'OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 PERMIT NO, BPO52746 B. C. Building Permit 01-16-04 pg 1 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under Issued Date: 10/05/2005 APN: 064-620-011-000 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. Site Address: 5959 HAPPY HOLLOW RD MAG License Class : License Number: Map Index: Date: Contractor: Description: new hvac (main house) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: ENOS, RONALD AND VALERIE permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 5959 HAPPY HOLLOW RD signed statement that he or she is licensed pursuant to the provisions of MAGALIA, CA the Contractor's State License Law (Chapter 9 commencing with Section 95954 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).): ❑ I, as owner of the properly, 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 Applicant: ENOS, RONALD AND VALERIE Code: The Contractors' State License Law does not'apply to an 5959 HAPPY HOLLOW RD owner of property who builds or improves thereon, and who does such work himself or herself or through his or her own employees, MAGALIA, CA provided that such improvements are not intended or offered for 95954 sale. If however, the building or improvements are sold within one year of completion, the owner -builder will have the burden of proving 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 Contractors' State License Law does Contractor: not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of t usiness arid Pr fe ods Code Date/UJ a 0,5'Owner: License #: 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 Architect: is issued. Engineer: ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 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: Total Square Ft: 0 S.F. Policy #: Valuation: $0.00 Census Code: 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 ^ �/ ` 5 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 (/ 01 forthwith comply with those provisions. 1 I �� r7 Date: O — o S -- V` �j N l Applicant: I WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is here -by issued uhder tKe applic le provisions of the Butte County Code and/or 6tedbov fees have been I hereby affirm that there is a construction lending agency for the . Resolutions to do work for hic paid. performance of the work for which this permit is'issued (Sec 3097 Civ.) /d Date: Name: By: PERMIT EXPIRES ON: Address: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance ofofficial form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purpos D� Print Name r7ni 1� ) GI t✓ �/�lO S Signature: u�nGO/ C Date: ,/0 OSS 1Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor B. C. Building Permit 01-16-04 pg 1 t . t Butte County Department of Development Services eeTrE, "R� N O T E S 7 County Center Drive, Oroville, CA 95965 e (530)538-7601+ vAvw.buttecountyneUdds ecOu"t+• RESIDENTIAL `APN: Permit No. I I 064-620-011 05-2 4 Owner:OS, RONALD- ---- - - - -- site Address: 5959 HAPPY HOLLOW RD, MAGALIA !Cont. -OWNER'- - i Contractor. HVAC Type of Permits SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE DATE JOBFINALED: /2— -7 _O SIGNATURE: `33JC9JL��. .]XVY\YV\Q . =OK 0 = Not OK MANUFACTURED -HOMES MISCELLANEOUS. DATE LjPERMANENT FOUNDATION SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; Fall/C/O-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Clrncs-Grnd Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap Nat Q or LPO Inch Sz Ft Lngth 7 Blckng; Sz-Spacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9. Elec MH Cntnty Test -C ross overs -Breakers -Cl rn cs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -C/O to Grade 12 Gas and Electricity Tagged . 13 Tie Downs Q Foundation Q 14 Exits 15 Cert of Occupancy 16 HUD Label/Insignia Numbers. Serial Numbers DATE D E C K S9C O V E R S`C A R P O R T S `G A R A G E S 1 Zoning -Setbacks -Easements 2 Ftgs; Soils-Sz-Dpth-Spacing-CnnctrsSteel 3 Decks, Girders/Joists-Dcking-Brcing Stairs-Guard/Handrails 4 Wood Awn; Posts -Beams -Rftrs-Cnnctrs-Shthg Frmg-Brcng 5 Alum Awn; Columns-Cnnctns-Splice-Decal-Enclsrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills-AnchrsStuds-Rftrs-Trusses 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls °9 0��c 09 DATE POOLS 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI 5 Elec Pool Lting; 15 volts-GFI 6 Elec Enclsrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w/5'-Crcltng Eqp-Htr 8.Elec Gmdng; Eqp w/5' Crcltng Eqp-Pool Ightg Boxes-Encisrs-pnlboards-Insuitn to Main Conduit 9 Health Dept Apprvl 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Encisr, Fencing -Alarms 13 Bonding, Diving board or Slide p Pool Drawing .=OK 0 = Not OK RESIDENTIAL (Single. & Duplex) DATE JUNDERFLOOR DATE PLUMBING 1 Zoning -Setbacks -Easements -Flood -Slope 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 2 Ftg Main; Soils-Elec Grnd Ftg Dpth 54 Wtr Pipe; Test & Anchr-Nail Prtctn 3 Ftg Garage; Soils-Steel-Elec Grnd Ftg Dpth. 55 DWV; Test Fittings & Anchr Nail Prtctn 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth 56 Shwr Pan; Test, First flr-Tub Acc 5 Stemwalls Main; Steel-BIockouts-Wrapped 57jWlub & Shwr, 2nd fir - Tub Acc 6 Stemwalls Garage; Steel-Blockouts-Wrapped WGas Pipe; Sz & Anchrs 6a Hold Downs and Special Anchrs 59 F. Sprinkler; Test 7 Slab, Steel Wrapped and Gas Piping 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way C/0 -Sewer Test \� \, s` 10 UF, Gas Pipe; Sz Anchrs-Sz Test o° m` 11 Wtr Pipe; Test-Anchrs-Rgltr-Seryice Test 12 Elec Undrgrnd DATE M E H A N I C A L 13 Plenums & Ducts; Cirnc-MaterialSupport-Insultn L@fAC Ducts Insultn & Support 14 Girders-Sills-Anchr Bolts-Joists-Vnts -Cripples 62 V t Fan, Exhaust abv Insultn _ 15 Acc &Vntltn C densate Drain & Ovrflw, Sz & Grade 16 Insulation urnace-Vent Acc-Comb Air Rtrn/Vent 115 Outlet 65 Attic Acc & Pltfrm if Furnace in attic \C 09 0` Z�'1 �eS � S• \C LO \A DATE IFRAMING 17 Sills Proper Materials & Anchrs DATE F I N A L 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 66 Ext Steps -Door & SideLt Prtctn-Landings 19 Bearing Walls over Girders & fir Nailing 67 Smoke Detector 20 Draft Stop in Walls (rat proof) 68 Furnace Vnts-Clrnc-Comb, Air-Cnnctr 21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs In Garage; abv-flr-Ducts-Mech Prtctn 22 Headers & Beams-Sz & Bearing 69 Bedroom Exiting 23 Hangers -Post Caps -An chrs-Cnnctns 70 GFI & Bath Fxtrs & Tub Acc-Spa 24 Ceiling Joist-Rftr Ties -Purl in -Roof Brac-Truss-Shthg 71 GFI Arc Fault 25 Frplc Ties or Type A Flue-Frplc Throat Clrnc 72 Elec Trim & Subpnl, Breaker Szs & Labels 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -ins Baffles 73 Stairs, Guard/Handrails 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 74 Frplc or Stove, Clrnc-Hearth 28 Garage Fire Prtctn Framing -RC Channel 75 Elec Outlets at Wood Pnl, Int & Ext 29 Prprty Line Firewall & Opngs 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clrnc ' 30 Ext Doors -One 3' -Check Garage 3rd Story, 2 Exits 77 Elec Outlets & Rcptcls at Ktchn Counter 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 78 Garage Fire Door; Swing -Landing -Closure 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 79 AC Duct in Garage -Damper 33 Siding -Nailing Veneer 80 Wtr Htr; Vnts-Clrnc-Com Air Cnnctr•PRV; abv fir 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc Mech Prtctn; LPG Appince Undr House 3" drain 35 Glazing Area -Glass Prtctn-SkyLts-Plastic 81 Plmb; Elec & Mech Eqp Listed for Loctn 36 Shear Walls; Nailing -Bolts 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 37 Brace Int/Ext Wall pnls 83 Insultn-Foam-Looked in Attic 38 Insultn-Walls-Ceilings 84 Guard Rails & Deck Cnstrctn-Post Caps 39 Infiltration-Walls-Wndws 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Drnge Planters ❑Yes [:]No Stucco Brown -Finish 1�187 o' o oar m� 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Plmb-Appinc-Frplc-Clrnc to Opngs DATE JELECTRICAL 90 Wtr Well, Dscnnct, Elec, Plmb 40 Fxtr & Trnsfrmr Clrnc-Ins Prtctn 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd 41 Elec Rcptcls Spacing-Lts & Switches at Doors 92 Vntltn thru House 42 Sz Boxes & No Of Cndctrs Stapled 93 Glass Prtctn 43 Romex Installed Close to Edge of Studs & CJ 94 Corrections from previous Inspctns 44E Grnd made up w/Mech Fstnrs 95 Gas Test -Meters Tagged, Gas-Elec erndng Electrode Bond Gas & Wtr 96 Wtr & Sewer Cnnctd-CIO to grade -HD Apprvl 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 97 Energy Cmpinc Cert -Other Certs 47 Subfeed Wire Sz ga ❑CU or [:I AL 98 Address Posted AC Wire Sz ga ❑ CU or ❑ AL 99 Fire Sprinkler 48 Range Circ ga ❑ CU or ❑ AL Oven Circ ga [DCU or ❑ AL Insulated Neutral ❑Yes 0 N o` o``� o' o\s 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp Clrncs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector 41 m : — Q� 0 01 0 INSTALLATION CERTIFICATE ttr 40 (Page 3 of 12) CF -6R Site Address Permit Number 5959 Happy Hollow Road, Magalia, Ca. • An installation certificate is required to be posted at the building site or made available for all appropriate inspections. (The information provided on this form is required) After completion of final inspection, a copy must be provided.to the building department (upon request) and the building owner at occupancy, per Section 10-103(a). • • HVAC SYSTEMS: Heating Equipment- Equip Type (pkg. heat um CEC Certified Mfr. Name and Model - Number # of Identical Systems Efficiency (AFUE, etc.) I zCF-IR value) Duct Location attic, etc. Duct or Piping R -value Heating Load Btu/hr Heating Capacity Btu/hr k (� GTT ,-0-76019,2 `� �O O Gfn�o - �o / n 7!5 O Cooling Equipment Equip Type (pkg. heat um CEC Certified Mfr. Name and Model Number # of Identical Systems Efficiency I (SEER or EER) zCF-IR value) Duct Location attic, etc. Duct R -value Cooling Load Btu/hr Cooling Capacity Btu/hr 1. > symbol reads greater than or equal to what is indicated on the CF -11? value. Include both SEER and EER if compliance credit for high EER air conditioner is claimed. ✓ LJI 1, the undersigned, verify that equipment listed above is: 1) is the actual equipment installed, 2 equivalent to or more efficient than that specified in the certificate of compliance (Form CF -1R) submitted for compliance with the Energy Efficiency Standards for residential buildings, and 3) equipment that meets or exceeds the appropriate requirements for manufactured devices (from the Appliance Efficiency Regulations or Part 6), where applicable. Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR OwnerC, 1'I`��t.� pit P-' S i gn atu re: Date: 1-2 Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY Residential Compliance Forms April 2005 INSTALLATION CERTIFICATE (Page 4 of 12) CF -6R Site Address Permit Number 5959 Happy Hollow Road, Magalia, Ca. Tr) <—n 07 c/ 7 • INSTALLER COMPLIANCE STATEMENT FOR DUCT LEAKAGE • c: INSTALLER COMPOANCE STATEMENT The building was: ✓ OTested at Final ✓ ❑ Tested at Rough -in INSTALLER VISUAL INSPECTION AT FINAL CONSTRUCTION STAGE: �j Remove at least one supply and one return register, and verify that the spaces between the register boot and the interior finishing wall are properly sealed. ❑ If the house rough -in duct leakage test was conducted withodt an air handler installed, inspect the connection points �etweeii the air handler and the supply and return plenums to verify that the connection points are properly sealed. In all joints to ensure that no cloth backed rubber adhesive duct tape is used ✓ ❑ DUCT LEAKAGE REDUCTION Procedures forfield verification and diagnostic testing of air distributions stems are available in RACM A endix RC4 3 NEW CONSTRUCTION: / � � 146a - Duct Pressurization Test Results (CFM @ 25 Pa) Measured Values I Enter Tested Leakage Flow in CFM: Fan Flow: Calculated (Nominal: ✓. ❑ Cooling ✓ ❑ Heating) or ✓ ❑ Measured 2 If Fan Flow is Calculated as 400 cfm/ton x number of tons or as 21.7 cfm/(kBtu/hr) x Heating /G0O Ca acit in Thousands of Btu/hr, enter total calculated or measured fan flow in CFM here: , l ✓ ✓ 3 Pass if Leakage Percentage5 6% for Final or <_ 4% at Rough -in: 100 x Line # 1 / Line # 2 ❑ Pass ❑ Fail ALTERATIONS: Duct System and/or HVAC Equipment Change -Out Enter Tested Leakage Flow in CFM from Pre -Test of Existing Duct System Prior to Duct 4 System Alteration and/or Equipment Change -Out. Enter Tested Leakage Flow in CFM from Final Test of New Duct System or Altered Duct 5 System for Duct System Alteration and/or Equipment Chan e -Out. •d Enter Reduction in Leakage for Altered Duct System 6 (Line # 4) Minus (Line # 5)] —(Only if Applicable) 7 Enter Tested Leakage Flow in CFM to Outside (Only if Applicable) V/ V/ Entire New Duct System - Pass if Leakage Percentage _< 6% for Final or <_ 4% at Rough -in r:7Pass 8 100 x Line # 5 / Line # 2 ❑ Fail TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change- ✓ Out Use one of the following four Test or Verification Standards for compliance: 9 Pass if Leakage Percentage <_ 15% [100 x [ (Line # 5) / (Line # 2)1] ❑ Pass ❑ Fail 10 Pass if Leakage to Outside Percentage:s', 10% [100 x [ (Line # 7) / (Line # 2)]] ❑ Pass ❑ Fail Pass if Leakage Reduction Percentage >_ 60% [100 x [ (Line # 6) / (Line #4)]] I I and Verification by Smoke Test and Visual Inspection ❑ Pass ❑ Fail 12 Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection ❑ Pass ❑ Fail Pass if One of Lines # 9 through # 12 pass ❑ Pass ❑ Fail ✓ 01, the undersigned, verify that the above diagnostic test results were performed in conformance with the requirements for compliance credit. 1, the undersigned, also certify that the newly installed or retrofit Air -Distribution System Ducts, Plenums and Fans comply with Mandatory requirements specified in Section 150 (m) of the 2005 Building Energy Efficiency standards. Installing Subcontractor (CO. Name) OR General Contractor Co.o. Name) OR Owner / � � 146a - Signature: Date: Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY Residential Compliance Forms April 2005 • � AREA Butte County Department of Development Services e�TTF, ' NOTES 7 County Center Drive, Oroville, CA 95965 e _ (530) 538.7681 www.Yuttec%unty neUdds aacOu"s+s 4 I r ' RESIDENTIAL APN: Permit No. Owner: 064-620-011 05-2747 ( —ENOS - -- --- ---- i site Address, _ 5959 HAPPY HOLLOW RD, IvIAGALIA Cont: OWNER Contractor: _ HVAC -- _ _ . _ __ _ _ + �• v _ _ Type of Perm, _- -- '.J 4 O:) 1 i f ' { 1 y s rucrLecn nv SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE HERS T6ST OFF N)A' %Ew pRs-r DRW tl-( (� DATE JOB FINAL�ED: SIGNATURE: \J�'aC���CJ'"c�� ��•��'" —"r � =OK 0 = Not OK MANUFACTURED HOMES MISCELLANEOUS DATE PERMANENT FOUNDATION SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; Fall/C/O-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Clrncs-Grnd Amp -Concrete 6 Yard Gas; Loctn-Test-Wrap Nat ❑ or LPO Inch Sz Ft Lngth 7 Blckng; Sz-Spacing-Marriage Line 8 Gas; MH Test-Demand-Valve-Cnnctr 9 Elec MH Cntnty Test -Crossovers -Breakers -Clrncs 10 Drain; MH Test -Fall -Flex Cnnctr 11 Wtr & Sewer Connected -C/O to Grade 12 Gas and Electricity Tagged 13 Tie Downs ❑ Foundation ❑ 14 Exits 15 Cert of Occupancy 16 HUD Label/Insignia Numbers Serial Numbers DATE ID E C K S'C O V E R S -C A R P O R T S'G A R A G E S 1 Zoning -Setbacks -Easements 2 Ftgs; Soils-Sz-DpthSpacing-Cnnctrs-Steel 3 Decks, Girders/Joists-Dcking-Brcing Stairs-Guard/Handrails 4 Wood Awn; Posts-Beams-Rftrs-Cnnctrs-Shthg Frmg-Brcng 5 Alum Awn; Columns-Cnnctns-Splice-Decal-Enclsrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills-Anchrs-Studs-Rftrs-Trusses 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls o' 4 DATE IPOOLS 1 Setbacks -Easements 2 Soils; Compaction -Structure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFI 5 Elec Pool Lting; 15 volts-GFI . 6 Elec Enclsrs; Conduit Entries -Terminals -Listed 7 Elec Bonding; Metal w/5'-Crcltng Eqp-Htr 8 -Elec Grndng; Eqp w/5' Crcltng Eqp-Pool Ightg Boxes-Enclsrs-pniboards-Insultn to Main Conduit 9 Health Dept Apprvl 10 Plmb; Cir Test-Wtr Supply Test 11 Lt Niche 12 Encisr; Fencing -Alarms 13 Bonding, Diving board or Slide o� ops oa �s o° 0; o,� ��� Pool Drawing d=OK 0 = Not OK RESIDENTIAL (Single. & Duplex) DATE JUNDERFLOOR DATE PLUMBING 1 Zoning -Setbacks -Easements -Flood -Slope 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 2 Ftg Main; Soils-Elec Grnd Ftg Dpth 54 Wtr Pipe; Test & Anchr-Nail Prtctn 3 Ftg Garage; Soils-Steel-Elec Grnd Ftg Dpth. 55 DWV; Test Fittings & Anchr Nail Prtctn 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth 56 Shwr Pan; Test, First flr-Tub Acc 5 Stemwalls Main; Steel -Blockouts-Wrapped 57Te ub & Shwr, 2nd fir - Tub Acc 6 Stemwalls Garage; Steel-Blockouts-Wrapped as Pipe; Sz & Anchrs 6a Hold Downs and Special Anchrs 59 File Sprinkler; Test 7 Slab, Steel Wrapped and Gas Piping 8 Piers-Frplc Ftg-Steel DWV; Fall C/0 Test � p 9 -Fitting -Test -2 -way -Sewer 10 UF, Gas Pipe; Sz Anchrs-Sz Test 11 Wtr Pipe; Test-Anchrs-RgltrService Test DATE IM E C A N [CAL 12 Elec Undrgrnd C Ducts lnsultn & Support 13 Plenums & Ducts; Clrnc-MaterialSupport-Insultn 14 Girders-Sills-Anchr Bolts-Joists-Vnts-Cripples 62 Vee Fan, Exhaust abv Insultn _ 15 Acc & Vntltn �YCo densate Drain & Ovrflw, Sz & Grade 16 Insulation 6NFurnace-Vent Acc-Comb Air Rtrn/Vent 115 Outlet" 65 Attic Acc & Pltfrm if Furnace in attic o S` s J� DATE IFRAMING 17 Sills Proper Materials & Anchrs DATE IFINAL 66 Ext Steps -Door & SideLt Prtctn-Landings 18 Walls Studs -Nailing Spacing & Braces -Plates -Sound 19 Bearing Walls over Girders & fir Nailing 67 Smoke Detector 20 Draft Stop in Walls (rat proof) 68 Furnace Vnts-Clrnc-Comb, Air-Cnnctr 21 Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs In Garage; abv-flr-Ducts-Mech Prtctn 22 Headers & Beams-Sz & Bearing 69 Bedroom Exiting 23 Hangers -Post Caps-Anchrs-Cnnctns 70 GFI & Bath Fxtrs & Tub Acc-Spa 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac-TrussShthg 71 GFI Arc Fault 25 Frplc Ties or Type A Flue-Frplc Throat Clrnc 72 Elec Trim & Subpnl, Breaker Szs & Labels 26 Attic Acc; Sz & Rmx Prtctn-Draft Stop -Ins Baffles 73 Stairs, Guard/Handrails 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 74 Frplc or Stove, Clrnc-Hearth 28 Garage Fire Prtctn Framing -RC Channel 75 Elec Outlets at Wood Pnl, Int & Ext 29 Prprty Line Firewall & Opngs 76 Ktchn, Fxtr & Appinc; Grnd-Air-Gap-Cooking Clrnc 30 Ext Doors -One 3' -Check Garage 3rd Story, 2 Exits 77 Elec Outlets & Rcptcls at Ktchn Counter 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 78 Garage Fire Door; Swing -Landing -Closure 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 79 AC Duct in Garage -Damper 33 Siding -Nailing Veneer 80 Wtr Htr; Vnts-Clrnc-Com Air Cnnctr-PRV; abv fir 34 Stucco Lath -Weep Screed-Fndtn Vnts-Undrflr Acc Mech Prtctn; LPG Appince Undr House 3" drain 35 Glazing Area -Glass Prtctn-SkyLts-Plastic 81 Plmb; Elec & Mech Eqp Listed for Loctn 36 Shear Walls; Nailing -Bolts 82 Elec Rcptcls in Garage (GFI) Romex Prtctn. 37 Brace Int/Ext Wall pnls 83 Insultn-Foam-Looked in Attic 38 Insultn-Walls-Ceilings 84 Guard Rails & Deck Cnstrctn-Post Caps 39 Infiltration-Walls-Wndws 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clrnc Drnge Planters ❑Yes ❑No c 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-Plmb 89 Vnts abv Roof, Plmb-Appinc-Frplc-Clrnc to Opngs 90 Wtr Well, Dscnnct, Elec, Pimb 91 Ext Elec Trim, GFI Rcptcl-Undrgrnd DATE JELECTRICAL 40 Fxtr & Trnsfrmr Clrnc-Ins Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 92 Vntltn thru House 42 Sz Boxes & No Of Cndctrs Stapled 93 Glass Prtctn Al x Installed Close to Edge of Studs & CJ 94 Corrections from previous Inspctns rnd made up w/Mech Fstnrs V 95 Gas Test -Meters Tagged, Gas-Elec g Electrode Bond Gas & Wtr 96 Wtr & Sewer Cnnctd-CIO to grade -HD Apprvl 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 97 Energy Cmpinc Cert -Other Certs 47 Subfeed Wire Sz ga ❑ CU or ❑ AL 98 Address Posted AC Wire Sz ga ❑ CU or ❑ AL 99 Fire Sprinkler 48 Range Circ ga F-1 CU or F-1 AL Oven Circ ga ❑ CU or ❑ AL Insulated Neutral "Yes ❑No 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp Clrncs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector 4�L. S. INSTALLATION CERTIFICATE , (Page 3 of 12) CF - Site Address Permit Number 5959 Happy Hollow Road, Magalia, Ca. • An installation certificate is required to be posted at the building site or made available for all appropriate inspections. (The information provided on this form is required) After completion of final inspection, a copy must be provided to the building ' . department (upon request) and the building owner at occupancy, per Section 10-103(a). 1] HVAC SYSTEMS: Heating Equipment Equip Type k . heat um CEC Certified Mfr. Name and Model Number # of Identical Systems Efficiency� (AFUE, etc.) >_CF -I R. value) Duct Location attic, etc. Duct or Piping R -value I-leating Load Btu/hr Heating Capacity Btu/hr LA ff .01 io Z�jQq � 4 t Cooling Equipment Equip Type (pkg. heat um CEC Certified Mfr. Name and Model Number # of Identical Systems Efficiency i (SEER or EER) 2CF-IR value) Duct Location attic, etc. Duct R -value Cooling Load . Btu/hr Cooling Capacity Btu/hr I 1. > symbol reads greater than or equal to what is indicated on the CF -IR value. Include both SEER and EER if compliance credit for high EER air conditioner is claimed. ✓ 21 I, the undersigned, verify that equipment listed above` is.- 1) is the actual equipment installed, 2) equivalent to or more efficient than that specified in the certificate of compliance (Form CF -1R) submitted for compliance with the Energy Efficiency Standards for residential buildings, and 3) equipment that meets or exceeds the appropriate requirements for manufactured devices (from the Appliance Efficiency Regulations or Part 6), where applicable. Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner �, •�. d Signature: Date: `—Z Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY Residential Compliance Forms 0 April 2005 1 ri • INSTALLATION CERTIFICATE (Page 4 of 12) CF-fiR Site Address Permit Number 5959 Happy Hollow Road, Magalia, Ca. 7 • INSTALLER COMPLIANCE STATEMENT FOR DUCT LEAKAGE INSTALLER COMPPANCE STATEMENT The building was: ✓ Tested at Final ✓ ❑ Tested at Rough -in I�TALLER VISUAL INSPECTION AT FINAL CONSTRUCTION STAGE: Remove at least one supply and one return register, and verify that the spaces between the register boot and the interior finishing wall are properly sealed. ❑ If the house rough -in duct leakage test was conducted without an air handler installed, inspect the connection points between the air handler and the supply and return plenums to verify that the connection points are properly sealed. ❑ Inspect all joints to ensure that no cloth backed rubber adhesive duct tape is used ✓ ❑ DUCT LEAKAGE REDUCTION Procedures for field verification and diagnostic testing of air distributions steno are available in RACM A I.*-RC4 3 enr NEW CONSTRUCTION: � ` CUD Duct Pressurization Test Results (CFM @ 25 Pa) Measured Date: Values 1 Enter Tested Leakage Flow in CFM: Fan Flow: Calculated (Nominal: ✓ ❑ Cooling ✓ ❑ Heating) or ✓ ❑ Measured 2 If Fan Flow is Calculated as 400 cfm/ton x number of tons or as 21.7 cfm/(kBtu/hr) x Heating Ca acit in Thousands of Btu/hr, enter total calculated or measured fan flow in CFM here: �-�"- ✓ ✓ 3 Pass if Leakage Percentage:5 6% for Final or :5 4% at Rough -in: 100 x Line # 1 / Line # 2 ❑Pass ❑Fail ALTERATIONS: Duct System and/or HVAC Equipment Change-Oui Enter Tested Leakage Flow in CFM from Pre -Test of Existing Duct System Prior to Duct 4 System Alteration and/or Equipment Change -Out. Enter Tested Leakage Flow in CFM from Final Test of New Duct System or Altered Duct 5 System for Duct System Alteration and/or Equipment Chan e -Out. (' Enter Reduction in Leakage for Altered Duct System 6 (Line # 4) Minus (Line # 5) — Only if Applicable) 7 Enter Tested Leakage Flow in CFM to Outside (Only if Applicable) 8 Entire New Duct System - Pass if Leakage Percentage <6% for Final or < 4% at Rough -in L3'Pass ❑Fail 1 I00 x A Line # 5 / 00 Line # 2 TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change- ✓ ✓ Out Use one of the following four Test or Verification Standards for compliance: 9. Pass if Leakage Percentage:5 15% [100 x [ (Line # 5) / (Line # 2)]] ❑ Pass ❑ Fail 10 Pass if Leakage to Outside Percentage :5 10% [100 x [—(Line # 7) / (Line # 2)]] ❑ Pass ❑ Fail Pass if Leakage Reduction Percentage >— 60% [100 x [ (Line # 6) / (Line # 4)]] 1 I and Verification by Smoke Test and Visual Inspection ❑ Pass ❑ Fail 2: Pass 'f Sealing of all Accessible Leaks and Verification by Smoke Test and Visual Inspection ❑ Pass ❑ Fail Pass if One of Lines # 9 through # 12 pass ❑Pass ❑ Fail ✓ IV], the undersigned, verify that the above diagnostic test results were performed in conformance with the requirements for compliance credit. I, the undersigned, also certify that the newly installed or retrofit Air -Distribution System Ducts, Plenums and Fans comply with Mandatory requirements specified in Section 150 (m) of the 2005 Building Energy Efficiency standards. Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner � ` CUD Signatur Date: Copies to: BUILDING DEPARTMENT, HERS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY Residential Compliance Forms April 2005