HomeMy WebLinkAbout066-110-049- �_ _'_ f_ .,.... �• 'Y3182 90B`P;EMR-
66
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few:, �"' • r ' ' c .. 1 1 -
SCOTT, Ken
13682 Endicott Circle, Magali
`' Conti-' Marc'Strauss
(new''sf)
f nF6_iin_n_a9 ' 0.-0234
I sr . _
,,,066-1
OHNSON, SAN Y'
`d /
13682 ENDICOT CIRCLE, MAGALIA �r
CONTR: WOOD HEAT & SPAy
:FREE STANDING STOVE & GAS LINE,
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066-110=049 01-0234
JOHNSON, SANDY
13682 ENDICOT CIRCLE, MAGALIA
CONTR: WOOD HE?_T & SPA
FREE STANDING STOVE & GAS LINE
.;
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California' 3'5965 • Telephone (530) 538 -7k -—A
P RMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER 060-110-049
ZONING
BUILDINGPERMIT
OWNER
SANDY JOHNSON
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS
13632 ENDICOT CIRCLE MAGALIA
CONTRACTOR'S NAME TELEPHONE
WOOD, HEAT & SPA 873-2514
CONTRACTORS MAILING ADDRESS
6426 SKYWAY PARADISE95969
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $ 20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS 13682 ENDICOT CIRCLE, MAGALIA
Ener Plan Checking
Energy g Fee $
$
PERMIT FEE $
LOT NO.
SUBDNIS IONS NAME
PARCEL MAP
PLUMBING PERMIT Filing Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
sPEcWv
Each Trap 7.00
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 ❑ Utilifies ❑ Installation ❑ Other ❑
FREE STANDING STOVE & GAS LINE
Describe Work:
Gas piping system 1 -5 outlets 15.00 15.00
Building sewer 15.00
Mobile Home I S I G W @20.00
PERMIT FEE S 35.00
ELECTRICAL PERMIT Fling Fee 20.00
800VOR LE
Main Service 20 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 fLy force and effect.POWER
License Class Lic. NO. 73A-1-318
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.
,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' compensatio insurance carrier and policy number are:
Carrier -5 ou +.4C J ^ "
Policy Number 31 & qfl! u n , "~u---C.,C'j IT
(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
forthwit omply with those provisions.
X Da _ Z G _
Si nature of Applicamt��❑ Owner ❑ Contractor Agent
An OSHA permit is required for excavations over 60"d ep and demolition or construction
of structures over 3 stories in height.
Main Service 200A TO 1000A 46.00NEW
CONST. owELL1NG OCCUP. SO
OR ADDNS. ( a ACC. BLDS. 3.5¢Ft:
INJON-p61D. MULTI -OUTLET @7,50
APPARATUS
& SINGLE OUTLET CSR.
Ex. Occup.OUTLET OR FIXTURES BAS @': o
Ex. Occup.OUTLEEDTS RESISIO°EA 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wirinq 23.00
PERMIT FEE $
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FEE $ 35.00
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. TYPE
TOTAL FEE $ 70.00
H,Z.
D FEES IMP
FLOOD
I CDF
PARCEL
PD
HD
ISSUE
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.
f -
By - 4, ate
,7P'l-
EXPIRES ON -.0 - 5 -I
Date
Receipt No. :514574PERMIT
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
C -
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, Galyforriia 95965 • Telephone (530) 538-7541 PPRMIT.NO.
(Rev. 12/96) APPLICATION AND PERMIT��-
ASSESSOR PARCEL NUMBER 066-110-049
ZONING
BUILDING PERMIT
OWNER SANDY JOHNSON
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
. OWNER'S MAILING ADDRESS
13682 ENDICOT CIRCLE MAGALIA
CONTRACTOR'S NAME TELEPHONE
WOOD, HEAT & SPA 873-2514
CONTRACTORS MAILING ADDRESS
6426 SKYWAY PARADISE 9596
CONSTRUCTION LENDER -
Fireplace
LENDER'S MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Fee
$ 20.00
—Filing
Permit Fee
$
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee
$
BUILDING ADDRESS 13682 ENDICOT CIRCLE, MAGALIA
Energy Plan Checking Fee
$
$
PERMIT FEE
$
LAT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling 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 ❑ Other ❑
Describe Work: FREE STANDING STOVE & GAS LINE
Gas piping system 1 - 5 outlets
1 15.00 15.00
Building sewer
15.00
Mobile Home IS I G
1 @20.00
PERMIT FEE
S 35.00
ELECTRICAL PERMIT
Fling Fee 20.00
600VOR UE
Main Service zo 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 fi4force and effect.
License Class Lic. NO. 3
OWNER -BUILDER DECLARATION 3 JG
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ I, as owner of the property, or my employees with wages as their sole compensation,
will do the work, and the structure is not intended or offered for sale.
❑ I, as owner of the property, am exclusively contracting with licensed contractors
to construct the project.
❑ 1 am exempt under Sec. Business and Professions Code for this
reason
Main Service To
46.00so
WEE200A
CCUOOOA
NEW CONST. DWELLING OCCUP.
OR ADDNS. ( & ACC. BMS.
SO
3.5¢FT.
,tOµq�IDT MULTI -OUTLET
97,50
POWER APPARATUS
8 SINGLE OUTLET CIR.
Ex. Occup. OUTLET OR FDRURES
BAL p 1: a
FIXED A�ID.GEE
Ex. Occup. our
5.00
Temporary Service
23.00
Mobile Home Facilities
20.00
Misc. Wirina
23.00
PERMIT FEE
_
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for workers'
compensation, as provided for by section 3700 of the Labor Code, for the
erformance of the work for which this permit is issued.
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' compens¢tioq insurance care r and policy number are:
Carrier �� -iC -i1 9
MECHANICAL PERMIT
Fling Fee 20.00
Heating
i is
15 00
Cooling
-nn
Hood
6.50
Ventilation
PERMIT FEE
S
Policy Number 3/ &1 - , ✓J iI / T—yGd i
(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
fortb.wi,eomply Nth th9ae provisions.
_2 6
Siodh�ature of A ica ❑ Owner ❑ Contractor
X _ yep
An OSHA permit is required for excavations over 5'0"nd demolition or construction
of structures over 3 stories in height.
Mobile Home Installation Fee
$
Energy Inspection Fee $
Occ
CONST. TYPE
TOTAL FEE $ 70.00
HAZ
D FEES IMP
I FWOD
I CDF
PARCEL
I PD
I HD
I ISSUE
This permit is hereby issued under
of the Butte County Code and/or
indicated above for which fees have
By Yneate
EXPIRES ON
the applicable provisions
Resolutions to do work
been paid.
�!J p
Date
Receipt No. 314574PERMIT
WHITE-D.D.S.-E.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
(Rev. 12/96)
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, Cali?orriio 95965 • Telephone (530) 538-7541
APPLICATION AND PERMIT
PERMIT N0.
ASSESSOR PARCEL NUMBER /{/(/ ///yyy`J .�
`f ( V
ZONING
BUILDINGPERMIT
OWNER C`„
TELEPHONE
SO. FT. OCC. BUILDING VALUATION
OWNERS MAILING ADDRESS / L -J / Pj /J v //�7-
,/7C/•!%^!`/Svl_ L
COMRALTOR'S NAME
1,4rd-1/1& �
TELEPHONE
CONTRACTORS MAULING ADDRESS
_0
CONSTRUCTION LENDER
Fireplace
LENDERS MAILING ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $
20.00
Permit Fee $
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $
BUILDING ADDRESS J �
O Q
C(p� Z `_
�G
Ile
Energy Plan Checking Fee $
$
PERMIT FEE $
LOT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT Fling Fee 20.00
Each Trap 1
7.00
USEOFSTRUCTURE
SF)(Duplex ❑ Mobilehome ❑ Other
SPECIFY
Solar or heat pum water heater
23.00
Water piping
15.00
Each gas water heater or vent
15.00
TYPE OF W RK
New 13 Addition ❑ Remodel ❑ Utilities Installation ❑ Other ❑
Describe Work: >� ���1
Gas piping stem 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
@20.00
PERMIT FEE $
�5---
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service 22000 00 LEss
23.00
�j
RECEIPT #
SRA $
SHERRIF
TOTAL $
Receipt No.
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
Main Service 200A TO t000A
46.00
NEW CONST. DWEWNG OCCUP. 3.SQso
OR ADONS. a ACC. BIDS.
NEW COMT. MULTI -OUTLET
NON•RESID. L 97.50
POWER APPARATUS
a SINGLE OUTLET CIR.
20
Ex. Occup. OUTLET OR FOTTURES aAL ®t.SO
Ex. Occup. oUTLE, IRESS, .OREA 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 FEt $ L%
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
CONST. n?E� TOTAL FEE $ ` D e 4
KAZ.
D. FEES IMP
I FLOOD
I CDF
PARCEL
PO
HD
ISSUE
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.
By Date
PERMIT EXPIRES ON
Te
`RESIDEN IAL
.66-11-49 „ 3182=90B,P,E,Mji
SCOTT, Ken
13682 Endicott Circle, Maga
lia
Contr: Marc Strauss
(new sf )
Address
GAS /
Meter By Date
I ELECTRIC
Meter By Date
I l
E. GASB /
Meter By Date
1 ELECTRIC
i Meter By- Date/—/>"4� ;
JOB FINALED (Date)—
Signature
v=ok
O = Not OK
-=Not Applicable
Not. Ready MOBILE HOMES
' =
Date MOBILE HOME UTILITIES (Plans) OK except #'s '
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support Sketch
3. Sewer; Location -Test -Fall -C/O Concrete
4. Water; Location -Test -Easement Needed (Sketch)
5. Electricity; Location- Clearences-Grnd-/ /Amp -Concrete -
6. Gas; Location -Test -Wrap: / /" L" ft.
/ /"Nat. or/ /" L" ft./ /"LPG
7. Utility Clearance
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date MOBILE HOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements -Setbacks Easements
2. Footings; Size -Spacing -Marriage Line
3. Gas; MH Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
5. Drain; MH Test -Fall -Flex Connector
6. Water; MH Test -Regulator -Connector
7. Water and Sewer Connected -C/O to Grade -HD Approval
8. Gas and Electricity Tagged
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
` )I
MISCELLANEOUS
Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel
3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts-Beams-Rftrs.-Coonectors
Shthg.-Rfg.-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distances-GFI ._
5. Elec.; Pool Lighting; 15 volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes -Enclosures -Panel boards -Ins. to Main in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
J=OK
O = Not OK
= Not Applicable
Not Ready RESIDENTIAL (Single ,& Duplex)
=
Date UNDERFLOOR (Plans) OK except N's
ng -Setbacks -Easements -F d -Slope
Ft ain; Soils-Elec. / " Ftg. Depth
tg., Garage; Soils-Steel-Elec. Grnd.-6e' Ftg. Depth
.'Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth
�5,6temwalls, Main; Steel-Blockouts-Wrapped
06yStemwalls, Garage; Steel-Blockouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab; Steel -Wrapped
8. Piers -Fireplace Ftg.-Steel
.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
10. Gas Pipe; Size -Anchors
L". ater Pipe; Test -Anchor a or- ervice Test
12. Electric; Underground
13. Pienums & Ducts; Clearance -Material -Su ort -Ins.
18/GirdeL"ills-Anchor jiolts-Jo AAs Cripples
15. Insulation
Date /�� Card B-1 Date Card B-1
Date /, Card B-1- S Date Card B-1
Date PLU G (Permit) OK except n's
VVAt�r Htr.; Vent -Access -Combustion Air -Baffle
. Vater Pipe; Test & Anchor -Nail Protection
11-D.W.V.; Test -Fittings & Anchor -Nail Protection
19. Shower Pan; Test, First Floor -Tub Access
20. J,elf'Tub & Shower, Second Floor -Tub Access
. Gas Pipe; Size & Anchors
Date Card B-1 Date Card B-1
Date card B-1 Date Card B-1
Date ELEC ICAL (Permit) OK except It's
. F_Oure & Transformer Clearance -Ins. Protection
Ele : Receptacles Spacing -Lights & Switches at Doors
Si Boxes & No. of Conductors -Stapled
Ro ex Installed Close to Edge of Studs & C.J.
Egoip Ground made up w/Mech. Fastners-Bond Gas & Water
Appliance Circuits in Kitchen & Conductor Size/GFI
28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga.
Cu or Al
29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al.
Insulated Neutral ❑ Yes ❑ No
30 ervice-Riser Conductors & Ground -Main Disconnect
3 quip. Clearances Panels-Motors-Mech. Equip.
32. Clothes Closet Light -Shower Light -Spa Light
Smoke Detector
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date MECH CAL (Permit) OK except H's
A.C. cts Insulation & Support
3 ent Fan; Exhaust above insulation
36. Condensate Drain & Overflow; Size & Grade
37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet
38. Attic Access & Platform if Furnance in Attic
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date FRAMIN (Plans) OK except k's
39 it doper Material & Anchors
4. al tuds-Nailing, Spacing & Bracing -Plates -Sound
4 e 'ng Walls over Girders & Floor Nailing
4 Dra top in Walls (rat proof)
4 imps; Furred Ceilings -Stairs -Chases -Tub
4 eaders & Beam -Size & Bearing
DateR G (Continued)
gars -Post Caps -Anchors -Gonne s
CI g. Joist-Rftr. ties-Purlin ss-Shthng.-Rfng.
47-."Fyeplace Ties or Type A Flue -Fireplace Throat clearance
4 . Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
49-15gj,m. Windows or Exiting Doors -Sill Hgt. & Dimensions
. G ge Fire Protection Framing
,5 . Pro erty Line Firewall & Openings
xt. Doors -One 3' -Check Garage -3rd Story, 2 Exits
53-Stajur*idth-Headroom-Rise-faun-Landing-Fire Protection
54.-plyw on Roof Overhang -Attic Vents -Rafter Outriggers
5 . idiiri"ailing Veneer
5,r!Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
58. Walls; Nailing -Bolts
Insulation -Walls -Ceilings
60. Infiltration -Walls -Windows
Date Card B-1 Date Card B-1
Date Card B- Date Card B-1
Date FINAL (Plans) 6K ex6ept N's
V --4t. Steps -Door & Sidelight Protection -Landings
CW'Smoke Detector
tl%u Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
g4,,8edroom Exiting
F.I. & Bath Fixtures & Tub Access -Spa
lec. Trim & Subpanel; Breaker Sizes & Labels
tairs & Rails
replace or Stove; Clearances -Hearth
lec. Outlets at Wood Panel; Int. & Ext.
rt.Fi . Appliance; Grnd.-Air Gap -Cooking Clearance
Elec.-butlets & Receptacles at Kit. Counter
Garage Fire Door; Swing -Landing -Closer
Z3,-K.C. Duct in Garage -Damper
76eVrtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.
In Garage; Above Floor-Mech. Protection
7�1b., Elec. & Mech. Equip. Listed for Location
7§_Efec. Receptacles in Garage; (G.F.I.)-Romex Protection
7d--Kiulation-Foam-Looked in Attic ❑ Yes
7&,6u-ard Rails & Deck Construction -Post Caps .
7%,Pd-n Vents & Crawl Hole Door -Drainage & Wood -Earth
Clearance Looked under Floor ❑ Yes
80. Following instld.; 9 ' .e ❑ No; Walks CII'las ❑ No;
Planters ❑ ❑ No
�-ucco; Finish
82�A Unit; Disconnect, Electrical, Plumbing
00-V46-ts Above Roof; PIbg.-Appliance- Fireplace. -Clearance to
Openings
84. Water Well; Disconnect, Electrical, Plumbing
a5 --Exterior Elec. Trim; G.F.I. Receptacle -Underground
§§-Vtsntilation Throughout House
7 lass Protection
98-11forrections Uorn Previous Inspections
89. Gas -Meters Tagged; Gas -Electric
dqY- ate Sewer Connected -C/O to Grade -HD Approval
/91. ergy Compliance Certificate -Other Certificates
Dat �-!24 Card B-1 Date Card B-1
Date Card B- Date Card B-1
Date Card B-1 Date Card B-1
Comments at Final:
(NOTE: An entry must be made each time you visit job site)
Owner:
Permit No,
ENERGY CERT IF ICAT ION
13682 Endicott Circle MaQAlin, Ca-
LOCATION
A.P. No.
ROOF
Material
Thickness(inches)
DESCRIPTION OF INSULATION
Brand Name
Thermal Resistance (R Value),__.__,,.,.
EXTERIOR WALL
Material_ Fiberalass
Thickness(inches)
batts
Brand Name
Thermal
Owens- ornina
Resistance(R Value) Rei ,.
3f —
CEILING
Batt or Blanket Type Fiberglass Batts
Brand Name
Owens-Corning
Thickneas(inches)
9z" _
Thermal
Resistance(R Value)— R30 _
Loose Fill Type
Minimum Thicknes
Fiberglass
Brand Name
Number of
Owens-Corning
Bags 1.l; Wt, per bag lb•
R3� 0
(Inches)12 3/4"
Area covered(ft.)
1000
Thermal
Resistance(R Value)
FLOOR, 'ELEVATED
Material Fiberglass Batts
Thickness(inches) 60"
FLOOR, SLAB
Material
Thickness(inches)
Width(inches)
Brand Name Owens-Corning
Thermal Resiatance(R Value)„ R19
Brand Name ------- ! -
Thermal Resistance(R Value)_..,
FOUNDATION WALL
Brand Name
Material
Thickness(inches) Thermal Resistance(R Value)_._;,,,,,..
I hereby certify that the above insulation was installed in the above building
in conformance with the State of California Energy Requirements. .
LOERKE INSULATION CO., INC. 499150
FIRM NAME/OWNER STATE CONTRACTOR'S LICENSE NO,
April 11, 1991
4S1GT1URZE0—F INSTA TION APPLICATOR DATE
I hereby certify the above insulation and all required items as shown on the
Building Department approved plana and attachments have been installed as
required by the State of California Energy Requirements.
All equipment, devices and materials are of the quality prescribed or are
specifically approved by the State of California.
FIRM NAME/OWNER (Please print) STATE CONTRACTORS LICENSE NO,
SIG R OF QENERAL CONTRACTOR OWNER --Z DATE"
THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL
INSPECTION APPROVAL AND A COPY SHALL BE'P,OSTED WITHIN THE BUILDING• f
January 1984
COUNTY OF BUTTE
r
'DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 538-7541
747 Elliott Road, Paradise — Phone: 872-6307
CORRECTION NOTICE
ER
3l ez_
PERMIT NO.
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this.
matter need additional explanation, please contact this office immediately.
Date 11- 3 - Inspector_7��'�`�
CORRECTION NOTICE
OWNER
-7G
RMI T NO.
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
a
r
L� (�
Date /- 9 ` !,� Inspector �
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS,
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 538-7541
747 Elliott Road, Paradise — Phone: 872-6307
CORRECTION NOTICE
OWNER
-7G
RMI T NO.
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately.
a
r
L� (�
Date /- 9 ` !,� Inspector �
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751'
7 County Center Drive, Orovi Ile — Phone: 538-7541' k
747 Elliott Road, Paradise— Phone: 872-6307
CORRECTION -NOTICE
OWNER PERMIT NO.
A routine inspection indicates that the following violations of County Ordinance
exist at the above address and should be corrected. Please notify this office
when correction of work is completed. If you have any question pertaining to this
matter, or need additional explanation, please contact this office immediately. r
L /
Date � —/ T Inspector
f '•`"�"n'p`�Y'�}"�''''Y,�""/�r7' T'�'"'`�`"f'�'7-'�jY{+^)�l"+�''''�3rritti%s�.�a''�yt��•�- .�, . _..:» i �,.^�`�`.�M/r�J1•�,'+.��.-,---••-t`�'°',
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION
7'COLINTY CENTER DRIVE - ORO,V,fbLTE,'CALfFORNIA 95985 - TELEPHONE: 918/538-7541
rhT APPLICATION DATA SHEET
OWNER ,,gg�COPit_'
Proposed Building Use/"�-j �< ���- Building Inspector
11 N
Permit No.
A. P..No.
t�Date
At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance:
DATE RECEIVED APPROVED
All items have been submitted . ...................................
Plot plans in di�ica.te/triplicate, signed by preparer of plans.......
(,(Complete plans in du Lcacat,-e/triplicate, si ng ed 4y preparer. of plans ../L2
4. Complete engineered plans and calcs, with wet signature on plans . .
5. Hazardous Material Form ...........................................
6. Energy Design Compliance and supporting documentation .........
7. Statement of Intent for Non -Heated and AC Buildings ...............
8. Engineered truss details and layout in duplicate (required prior to plan check) /0- T - D y C� -
9. Mobilehome installation data including manufacturer's installation
instructions........................................................
10. Fees of $ ........................
11. Chico Urban Area fees paid ...................................
Park fees paid .....................................................
^9R/4Q,_f_— Sch of District fees paid .............. l b ", —?6
Sanitation approval from Health Department
15. City of Chico plumbing permit .....................................
—16..Plot plan and business license approval from City of
(see City for other requirements)
17. Planning approval for (A) Use: (B) Parking: ......
� �1 -- Improvements may be required. Contact Land Development Section DPW —
�19. Driveway permit (construction approval required prior to occupancy) `
20. Pre -Inspection for required Pre-inspec. request to
Building Inspector (Date)
21. Contractor's license information (No., Name Style, Classifications ...
22. Certificate of Workmans Compensation Insurance ..................
Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) .....
Recorded copy of Agricultural Acknowledgment Statement ......... 7 I—,! - U -
Letter of signature authorization .
�..,r rA� E Aga A iW ��r �..1�t .
When you issue the permit, process as follows: V Mail to owner. Mail to contractor.
Telephone and hold for pickup at office. Deliver w./inspector.
Other
Applicant iyL _54A l Date
Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date
Copy of plans sent" Healthbept. -----,.-Fire Dept. Other Date By.
The following data must be submitted prior t mit is u Ircle new item not checked above).
1. Index permit for above items No. ��
2. Additional items required:
Contractor, designer, owner, was advised of above required data by_phone--nail—counter by ..date
Contractor, designer, owner, was advised of above required data by—phone—mall _ ou er by date
Plans checked by Date Plans approved by Date ' -j?n
Sets of plans on hold in File cabinet AP folder
Copy—DPW
TJ Building Departmen
FROM: Environmental Health
SUBJECT: Sanita-tionClearance "
66 -Lf
` OwnerLocation AP#
Plan Approved for:
Hold final for:
Sewaqe Disposal_ Water Supply
- Water Supply
anal clearance O.R. for: Water Supply
^
Clearance for bedrom mabhpi6q home. Other
NOTE * * *
�— ' Da - e'
SaA to ian
T0: Building Department
FROM: r�bachment Permit Section
, yn�.
9
RE: Driveway Clearance
1t C h h
owner to ation AP #
Driveway permit�� 7�
si ature
has been issued for the above property.
. 9- /6p-- 9d
date
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL NUMBER
66-11-49
ZONING f
kr
BUILDING PERMIT .�
OWNER��++cott
TELEPHONE
873-2247
SO. FT. OCC, BUILDING VALUATION
1500 60000
OWNER'S MAILING MAAIL. NG ADDRESS
6452 Shaw Cir, Ma alfa
473 4 6672
CONTRACTOR'S NAME
Marc Strauss
TELEPHONE
1870 OV
C7 J 10 1875
J
312 en 1560
CONTRACTOR'S MAILING ADDRESS
PO Box 2141 95967-2141
Fireplace JA 1000
CONSTRUCTION LENDER
Sac Savings 893-8900
UNKNOWN
Total Valuation $ 71057
FilingFee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ 349.00
A T I t ek
LICENSE NO.
Plan Checking Fee
$ 174.50
Energy Plan Checking Fee
$ 15,00
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
/3 6V2 EndicottC;�G e
Permit fee
$ 548.50
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
01 2.00 18.00
Solar or heat pump water heater
20.00
LOT NO.SUBDIVISION
17n
NAME
1RPQ(- 42-�J't�-&
PARCEL MAP
G3
Water piping
5.00 5,00
Each qas water heater or vent
5.00 5.00
USE OF STRUCTURE
SF q Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00
Building sewer
1 5.00
Mobile Home S I G I W
10.00e
TYPE OF WORK
New® Addition ❑ Remodel❑ Utilities❑ Installation[] Other ❑
Describe work: 3 RR _
Permit Fee
$4,9.00
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 600V OR LESS
100 AMP OR LESS
10.00
Main service EA. ADD'L 100 AMP
2.50
CONTRACTORS LICENSE LAW
p y I y (check one):
I declare under penalty of perjury )
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license Is In full force and effect.
License No. Classification
El I, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. DWELLING OCCUP.�
OR ADDNS. ( ACC. BLDGS. )
2/20sgft ,
NEW CONSTR.MULTI-OUTLET
NON.RESID BRANCH CIRC ITS
2.50 ea
POWER APPARATUS e
(SINGLE OUTLET CIR. )
Ex. Occup( OUTLETS OR FIXTURES
920 0 50t
A 030
FIXED
Ex. Occup. OUTLETS P(RESID.)LINIS REA.)
2.00
Temporary service
10.00
Mobile Home Facilities
15.00
Misc. Wiring
15.00
Permit Fee
$ -
Contractor
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
5�7 I shall not employ any person in any manner so as to become subject
LP" to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
MECHANICAL PERMIT
Filing Fee 10.00
Heating 80000
116. 6,00
Heat P14mp
Cooling 4 Ton
1 11. 11.00
Hood
1 3.00 1 3.00
Ventilation
3 3, 9.00
,
Permit Fee
$ 39.00
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemnify and keep harmless the County of Butte against
all liabilitie judgments, costs, and expenses which may in any way accrue
against said ounty in consequence of the granting of this permit.
X Date -g�
Signature of Applicant - Owner Contractor ElAgent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 in height.
Mobile Home Installation Fee $
Energy Inspection Fee $ 30.00
occ
IQ
CONST TYPE
TOTAL FEE $ 725.50
HAz
CUA
PARK
scHl
FLD
PAR D
ISSUE
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which fees
DIRECT OF PUBLIC
Ry
PE T EXPIRES Date
the applicable provi-
resolutions to do
have been paid.
WORKS
Date
/ •-���
`stories
Receipt No. JyU l
WHITE-O.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD-APPL I CANT
Gp J/Y�-- "''ZI1 •-� VSII. 1110.
7 County Center Drive - Orovll e, C IifOrnia 95965 - Telephone: 916/538-7541
APPLICATI�ERMIT
ASSESSOR A CEL NUMB TONING
- IC
BUILDING PERMIT
OWNER1,e. WE
SO. FT. OCC. BUILDING
VALUATION
OWNS 'S MAILING ADDRESS n
Lf 5, Z J I'7t4,4 l- tom- , L/ t
Z Z
CONTRACTO 'S NAM
�i4&c. s(T1q1qUSJ
TELEPHONE
q�.y CO J / 575"' 7 C u-
X66 Y i% J
CONTRACTOR'S MAILINGY/J AODRE,SS ����_ / �/
�o
��O
Fireplace
CONSTRUCTION LENDER
ac-J�•� s
UNKNOWN
s9>-gq ao
Total Valuation $ I D
LENDER'S MAILING ADDRESS q
Z� C9H�s�� A0 Ciyl>t.a 5d`
Filing Fee
$
10.00
Permit Fee
$
�yy
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$
Energy Plan Checking Fee
$
`i-00
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$
yg ,�
PLUMBING PERMIT
Filing Fee
10.00
t G�
Each Trap
2.00
Ile
Solar or heat pump water heater
_
20.00
LOT NO.SUBDIVISION
?
NAME
/OV C C �;2
PARCEL MAP
Water piping
1 5.00
O7
Each gas water heater or vent
1 5.00
USE OF STRUCTURE
SF ZJ/"Duplex❑ Mobllehome❑ Other
Gas piping system 1 - 5 outlets
1 5.00
�" d
Building sewer
( 5.00
Mobile Home S I G I W I
I0.00e
SPECIFY
TYPE OF WORK
New Addition❑ Remodel❑ Utilities ❑ Installation❑ Other ❑
Permit Fee
$
(a a
Describe work: �
Contractor
ELECTRICAL PERMIT
Filing Fee
10.00
Main service e00v OR LESS
100 AMP Oil LESS
10.00
/O 6'
Main service EA. ADO'L 100 AMP
2.50
2- -
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑NON-RESID
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-
NEW CONST. ( DWELLING OCCIJ_P.yl
OR AODNS. ACC. BLDGS. ! OD
NEiv CONST Ft. -UL.TI.OUTLE
BRANCH CIRC ITS
POWERArPAn ATUS a
(SINGLE OUTLET CIR.
EX. Occup(OUTLETS OR FIXTURES
Ex. Occup. OUTLETS IFIXED RI ESID IREA.1
a/ 2y:Tsgft
2,50 ea
B20 L0?0
301
2.00
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)
Temporary service
Mobile Home Facilities
Misc. Wiring
9
10.00
t15.00
❑ 1 am exempt under Sec. Business and Professions Code
for this reason
Permit Fee
$
WORKMEN'S COMPENSATION INSURANCE
Contractor
I declare under penalty of perjury (check one):
MECHANICAL PERMIT
FIIIng Fee
10.00
❑ The permit is for $100.00 (valuation) or less.
Heating lgc> L>Oo
( p7.16
❑ 1 have placed on file with the County of Butte Building Department
/ -a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
J-
Cooling
I shall not employ any person in any manner so as to become subject
Hood
3.00
to the W. C. laws of California.
Nonce 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.
Ventilation
permit Fee
Contractor
x`10
$
I certify that I have read this application and state that the above information
Mobile Home Installation Fee
$
Is correct. I agree to comply to all County Ordinances and Stale Laws relating
to building construction, and hereby authorize representatives of the Counlyof
Butte to enter upon the above-mentioned property for Inspection purposes.
1 also agree to save, Indemnify and keep harmless the County of Butte against
all liabilities, judgments, costs, and expenses which may in any way accrue
Energy Inspection Fee
ace CONST TYPE
TOTAL FEE $
HAz CUA PAnx scHl FLo
$ 3a m"
PAR Po
HI Issue
against sal- County in consequence of the granting of this permit.
I I
/Z �+
X r— Dale Q_
Signature of Applicant — Owner5' Contractor ❑ Agent F]
This permit is hereby issued under the applicable provl-
sions or the Butte County Code and/or resolutions to do
work Indicated above for which fees have been paid.
An OSHA permit is required for excavations over 5'0" deep and demolition or construct.
ion bf structures overheight.
3-�stories in
DIRECTOR OF PUBLIC
WORKS
Receipt No. /�/ 3� / '
By Date
WIIITE•O.P,W., YELLOW-ASeESSOR. PINK-INSPECTOn, COLnENnOD-APPLICANT
PERMIT EXPIRES Date
heLul-ll CO -UPW AVkiLUL1UK1►L 9 Q -.4 52 9 4,
FOR RESIDENTIAL DEVELOPMENT
Section 26-8.1. of the Butte County Code"
requires this acknowledgement be recorded
prior to issuance of a building permit.
The property described herein is adjacent 1
Fee
5.00
to land or included within an area zoned j
~qp=045294 Rec
5.`00
for agricultural purposes, and residents
-Cash
of this property may be subject to ancon-.;. I
Recorded
veniences or discomfort arising from the
Official Records
i
use of agricultural chemicals, including, i
1
County Of
but not limited to herbicides, pesticides,
Butte
`
and fertilizers; and from the pursuit
j Candace J. Gr-ubbs
of agricultural operations including,
Recorder
X 1
but not limited to cultivation, plowing,
J 2:26pm "22 -Oct -90 �.
spraying, pruning, and harvesting which
dust, smoke, noise, and
odor. Butte County has established
agricul-
occasionally generate
which have as a priority use for productive
agricultural purposes,
and residents
tural zones
wiLIAn said zones and on adjacent property should be prepared to accept such
inconvenience
or disconform from normal, necessary farm operatigns.
All that 'real property situate in the County
of Butte, State of California,
described as
follows:
Date:
State
County
XP & b6 - //=y7 107 •-' 00
/6l� %o
of ?. I lr' ) On
SS. the
of &1) BAUa.)
PROPERTY
this the day of 19—qn-, before me,
undersigned Notary Public, personally appeared
Personally known to me. 0 Proved to me on the basis
oPtcIALSEAI, of satisfactory evidence.
s MIKE McCABE
-'
NOTARY P(J8LJC-CALIFORNIA to be the person(s) whose name(s) 109OR�-
SANBERNARDIIyOCOUNTV
Mytomm.ExpireiJune28,1991 subscribed to the wlti�in instrument and acknowledged that
executed the same for the purposes therein contained. IN Wl'I'Nl?SS
WHEREOF, I hereunto set my hand and official seal.
Notary Public .
Present A.P. No.
AR—1-70 r -mo cificze- AAA,
END OF DOCUMENT
ur
BUTTE COUNTY -SCHOOLS DEVE•LOPMFNT FEE CERTIFICATION FORM
(One Form per Building)
:b A.P. Number ��--��-�� Building Department No.
School District P_ SZC� City Q County Jurisdiction
Property.Owner !/ AJ <;c er—r7-
-f �.
Project Location/Address 3 z, rAIZ) C- O rr e-- «-
Subdivision Lot Number,
. -
Residential Development:
Sq. Footage
--v
# of Living MHI Addition '(Group R)
✓r Units
i
Commercial/Industrial: a Sq..Footage
New Addition (Including Exterior
Roofed Areas)
wilding D rtment Representative Date
(Floor Plans reviewed.by School.District Personnel)
Distric / Jd No. Q2—
School District certifies that
• !S � - dt
(Applicant ame) (Phone Number)
(Street Address) i
E L� ✓
(Ci ) (State) (Zip Code)
Chacomplied with the requirements of Resolution No.
he ayment of $ �� representing �O square feet..
c oo District Representative Date
PAID BY CHECK NO. /
BANK NO %D
PAID BY CASH
REMARKS:
white -applicant, yellow -building department, pink -school district
SCHOOL.FEE (8/88).-
5/89
RESIDENTIAL PLAN CHECKING GUIDE
(S.F.,•DUPLEX & MISC. ONLY)
Bldg. Permit # 3/
OWNER A.P. # Z9
GENERAL
:��Zvaluation. oning requirements: (sideyards
�-i
lans signed by designer.
:V.. ergy Design and Compliance.
Existing violations on property.
6. Items on data sheet.
PLOT PLAN
and number of permitted.living units).
Complete parcel size and dimensions.
2� etbacks, sideyards, easements, etc.
9! ,Qther buildings or structures.
4!_ -Grading, fills, drainage.
�lood hazard.
special conditions on. creation map or compliance document.
-7,�FAU & FAS road setback.
FLOOR PLAN
Ll omplete to scale plan with dimensions.
-3' Required
windows for light and ventilation (Sec. 1205).
Required windows for second exit (Sec. 1204).
��Skylights (Chapter 34 & Sec. 5207).
Human impact glass (Sec. 5406).
t6:
5/89
RESIDENTIAL PLAN CHECKING GUIDE'
MISCELLANEOUS ITEMS TO LOOK OUT FOR (CONY D)
,Xkterior plaster - weep screeds (Sec. 4706).
,Y -roper roof pitch for roof covering (Chapter 32).
6' Roof covering type - (fire hazard).
8�after ties or bearing ridge beam.
arage door or porch header sizes.
Adequate bracing.
--lB-.-Living area over garage - complete 1 -hour separation required on garage side
including supporting walls and posts, etc.
exits on three-story dwellings (Sec. 3303 & see Mezannines - 1716).
lYA tic access and ventilation (Sec. 3205).
13 UpLderfloor access and ventilation (Sec. 2516).
14 -Combustion air for fuel burning appliances.
—15 -Noise requirements on duplexes.
16--A--dobe soils - special foundation design.
IW- I. taining walls requiring design.
1&-,-U usual shape, size, or split level house requiring lateral design.
1A) -'Flashing at all exterior openings.
S. Infiltration (Air Leakage)
Spadikation Pants
Standard _ 10 "
6. Glass Heat Loss
Taal
Climate Zone 11 ..
y
Interior
1. Ceiling Insulation
U -value
MMS
Percent
Number
of stories
.51 b .41 to
' R -value
One
Two Three
R-0
-1 C3
-49
32
R-19
-8
-4
-2
R-30
.2
.1
.1 .
gT38
0
0
0
8
35
-75
-29
•�tUJafue
0.50
-176
84
-54
32
0.30
-102
-49
-13
0.10
-26
-13
-8
Us
-18
-9
-6.
US
-11
-5
-4
o.C-
-t
-2
.1
O.C2
4
2
1
O.CO
11
5
3
26
-49
-15
2_ Wall Insulation
-1
7
14
Single-
Singte-
-14
-7
Famtry
Family
Multi -
FI -Value
Detached
Attached
Fami'ry
R-0
38
-51
4U
R-11
0
0
0
R-13
2
2
1
R-19
8
6
4
U -value
21
34
-7
0.80
-153
-114
-76
0.50
-91
-68
-46
0.30
.47 •
vo
.24
0.10
0
0
0
0.08
4
3
2
0.06
9
7
5
0.C4
14
11
7
0.02
19
14
10
0.00
24
18
12
9
13
17
3. Raised Floor I mulation
-17
1
Insulation in Floor
10
14
Number of stories
14
R -value
One
Two
Three
' R-0
-17
-8
•5
R-11
3
•2
-1
R-19
0
0
0
t R-30
3
1
1
U-vaiue
-6
7
10
-O.SO
-144 _
-70
-46
0.50
-120
-58
38
0.40
-95
-46
30
0.30
-69
34
.22
0.20
-3
.21
-14 .
0.10
-17
-8
-6
0.08
-11
-6
.4
- 0.06
-6
•3
-2
O.C4
.1
0
0
. 0.02
4
2
1
0.00
10
5
3
Controlled Ventilation Crawlspace
_
+6 to 16 or
Number of stories
less -15 -5 +5
R-vaiva
One
Two
Three
Ra
-11
-7
.5
R-5
-4
.4.
3
R-11
.2
.2
.2
R-19
.1
.2
.2
4. Slab Edge Insulation -
4
- -'
Number of Stories
-_
-
R -value
One
Two
Three
' R-0
0 -
0
0
R-5
8
5
2
R-7
8
6
3
F2 facer
2
less -15 -6 +5
3
X0.90
.4
-3
-1
0.80
-1
.1
0
0.70
2
2
1
0.60
6
4
2
0.50
9
6
3
0.40
12
a -
4 -
S. Infiltration (Air Leakage)
Spadikation Pants
Standard _ 10 "
6. Glass Heat Loss
Taal
Climate Zone 11 ..
y
Interior
Slab Floor Raised Nor---;.'
U -value
MMS
Percent
Sbnes . Stones .
.
.51 b .41 to
.31 to 0.30 or
Glass Single Doude
.60
.50
.40
less
50
-121
-53
-39
-24
•10
4
40
-90
37
-26
-14
3
8
35
-75
-29
-19
-9
1
10
.30
31
-21
-13
-1
4
12
29
-S8
-20
•12
3•
5 •
12
28
-55
-18
-10
•2
5
13
27
-S2
-17
-9
-2
6
13
26
-49
-15
-8
-1
7
14
25
-46
-14
-7
0
7
14
24
-43
-12
•5
1
8
14
23
40
•11
-4
2
8 •
15
- 22
•37
-9
3
3
9
15
21
34
-7
-2
4
10
15
20
31
-6
0
5
10
16
19
-29
-4
1
- 6
11
16
18
-26
3
2
7
12
16
17
•23
-1
3
8
12
17
16
-20
0
4
9
13
17
15
-17
1
6
10
14
17
14
-14
3
7
10
14
18
13
-12
4
8
11
15
18
12
-9
6
9
12
15
19
11
-6
7
10
13
16
19
10
3
9
11
14
17
19
9
.1
10
. 13
15 '
' 17
20
-8
2-
12
14
16:-
18
20
Type Type
fess 1699
11. Heating System '
2699
more
'.SG None
0
7..Shading
(Shade Open)
_
0
or Sciar
(assumes ducts In attic) •.
--Efrective Percent Class
5
4
Sum of 1-6
(per=t %iris
x SC)
3
3
ETe` ve
_
+6 to 16 or
SE HSPF
less -15 -5 +5
+15
more
- 0.72
%Glass
Noah
East South West Skylight
18
5
-18
1 .
4
1
na
16
4
4
2
5 -
'1
na
14
4
0.90
2
5
1
na
-'
12
3
20 18 - ' 15 13
3
5
2
na
11
3
Sciar
3
5
2
na
10
2
less -15 -6 +5
3
5
2
1
9
2
na
3
'S
2
2
8
2
-34 30 '•26 -22
3
5
2
2
7
.1
-4
3
4
2
2
6
1
5.50
3
4
2
3
5
1
less ;1199
2
4
2
3
4
0
0.90
2
3
1
3
3
0
37 32 28 24
1
2
1
3
2
0
3
0
1
0
3
1
.1
Oier
.1
.1
.1
2
0
.1
2. 1
-2
-4
.2
0
na = not allowed
-8
-6
- ,-
Wsa
-25 -13
$. Shading (Shade
Closed)
5
,eQU_23
Erective Percent Class
-8
-6
-5
(Percent Stas x SC)
• -8 4
-3
.2
-1--2
:._. soiar
-
2
% Glass Nods
Esst
South
- We61
Sky6;U
- 18
.14
-• E None
.48
39
34
na
16
•12
6
-42
-59
-55
na
14
-10
.1
-35
-50
s6
na
12
3
AJ
.29
-40
37
na
11
-7
3.4
-26
36
33
na
10
-6
4.8
•23
31
.29.
.74
9
•5
6.3
.20
-27
.25
-65
6
-5
22
-17
-23.
•21..
-56
7
•4
17
-14
.19
-18
.47
6
3
5.1
-11
.15
.14
38'
5
.2
66
.9
-11
.10
-30 .
4
-1
2S
-6
3
-7
•23
3
0
4
__X
.5
-4
•16
2
i
S4.
•1
.2
.1
-9
1.
1
907:
1
1 .:
_ 1
d
MI*
2
26
3
4
' 3
0
9. Interior Thermal Mass
Climate Zone 11 ..
y
Interior
Slab Floor Raised Nor---;.'
SCORE CARD
MMS
Sbnes . Stones .
.
0A One
Two Three One Two Three
3Za or
Interior MassICFA
.4 -2
-1 -4
0.1
-8
-5 3 .1
0
0
0.3
.7
4 ` ' -2 0
1
1
0.5
-6
3 -1 1
1
2
0.7
-5
-2 -1 1
2
2
0.9
-5
-1 0 2
3
3
1.1
-4
-1 1 3
4
4
1.3
-3
0 2 3
4
5
1.5
-3
1 2 4
5
5
20
•1
2 .4 5
6
7
25
0
3 5 7
.7
8
3.0
1
4 6 8
8
9
3.5
2
5 7 9
9
10
4.0
3
6 8 9
10
10
4.5
3
7 8 10
11
11
5.0
4
7 9 it
12
12
5.5
5
8 9 11.
12
12
6.0
5
8 10 12
13
13
6S
6
9 10 12
13
13
7.0
6
9 11 13
13
14
7.5
6
10 11 13
14
14
8.0
7
10 11 13
14
14
8S
7
10 12 13 •
14
15
10. Exterior Wall Thermal Mass
7
Exterior
S'N4. Single -
19 16
13
Wag
7
Famiiy Family
Multi
15
Mau
8
Detac:•1ed Armexsd
F=4
0.00
14
0 0
0
'
0.20
15
3 2
1
1.2
0.40
8 7
5 4
3
3
0.60
21
8 6
4
3.3
0.80
17
10 8
5 •
,
1.00
-2,-
13 10
7
2
1.220
..
13 12
a
:
1.40
1.4
12 13
9
2
1.60
24
10 13
:, 11...
,
1.80
i Unit Size (sQ
10 12
12
139 12M
200
2200
10 11
13
I
to
to
or
Type Type
fess 1699
11. Heating System '
2699
more
'.SG None
0
SE or HSPF
0
_
0
or Sciar
(assumes ducts In attic) •.
6
5
4
Sum of 1-6
8 5
4
3
3
.25 or •24 to -141a d to
_
+6 to 16 or
SE HSPF
less -15 -5 +5
+15
more
- 0.72
6.60
0 0 0 0
0
6
0.75 .6.88
-18
3 3 3 2
2
1
0.80
7.33
8 - 7 6 5
4
3.
0.a5
7.79
13 11 -10 8
7
5
0.90
8.25
17 1513 11
9
7
0.95
8.71
20 18 - ' 15 13
11
8
-5 -3
•2
Errective SE or HSPF
•2
Sciar
7' : 5
(SE or HSPF x dud eMcietey)
3
Effecire •25 or .24 to .14 b -41n
+610 16 or
SE HSPF
less -15 -6 +5
+15 more
0.30
275
-73 bt -56 -47
38
-M
na
3.41
-45 -39 -34 -29
-24
-18
0.40
3.67
-34 30 '•26 -22
-18
.14
0.50
4.58
•10 -9 -8 -7
-5
-4
0.56
5.13
0 0 0 0
0
0
0.60
5.50
5 5 4 3
3
1
0.70
6.42
17 15 13 119
less ;1199
7
0.80
7.33
25 22 19 16
-.13
10 .
0.90
825
32 28 24 20
17
13
1.00
9.17
37 32 28 24
19
15
2
Zonal Control Adjustment
Wsa
System Type
3
2
2
Resistance
10 9 7 6
4
3 t
Oier
SE None
6 5 4 3
2
2
12. Cooling Syst,tla
Climate Zone 11 ..
-_. - --
-. -= .:
SCORE CARD
Measures
_._.....__
Point Scores
SEER
1. Ceiling Insulation
3Za or
Interior MassICFA
(assumes duds In attic)
' ...
Stm of 7.10
U-vaiue (0.0301
-3 or -24 b x-14 to
-410
+6 to
16 or
SEER less
-15 i •6
+5
+15
mace
8.0 •14
.12 -to
-8
3
-4
8.5 •9
•7 -6
-5
-4
3
.
8.9 -5
•4 -4
3
-2
.2
9.0 d
3 '-3
.2
•2
-1
9.5 0
0 0
0
0
0
10.0 4
3 3
2
2
1
10.5 7
6 S.
4
3
2
11.0 10
9 7
6
4
3
120 15
13 11
9
7
5
13.0 -20
17 _ 14 -
12 _
9
6 :
Effective SEER
-
,
(SEER xdua efficiency)
SC
..Eff.'7o GIass
Sun of 7-10
a. North
Effee:•ve-2S or -24 to -1410
-410
+6 b
16 or
SEER lest
.15 S
+5
+15
more
5.0 30
-25 •21
-17
-13
.9 .
6.0 .12
.11 • -9
•7
3
-4 :
6.6 -5
-4 -4
3
.2
2
7.0 0
0 0
0
0
0
8.0 9
8 6
5
4
3
9.0 16
14 12
9
7
5 '
10.0 22
19 16
13
10
7
11.0 26
23 19
15
12
8
120 30
26 22
18
14
9
13.0 33
29 24
20
15
10
Zonal Control Adjustment
1.2
10
8 7
6
4
3
No Cooling System Installed
21
=' Stories
3.1
3.3
15
17
One •5
.4 -4
3
-2
-2,-
Two + 3
3 .; 2
2
2
1
0.6
i
1
1.2
1.4
1.6
1.8
2
22
24
Single -Family Detached
and
Attached
3.3
i Unit Size (sQ
17
Water
139 12M
1700
2200
27W
Heater Credit
• or . j b
to
to
or
Type Type
fess 1699
2199
2699
more
'.SG None
0
0
0
_
0
or Sciar
12 " 8
6
5
4
- HP HWR
8 5
4
3
3
WSS
5 3
3
2
2'
PCU
_ _8 5
4
3
3
SE None
37 -24
-18
-15
.12
'• Solar
-1 .1
.1
0
0
14WR
-18 •12
-9
-7
-6
WSS..
•25 .16
-12
-10'
-8
-POU
-t8 _ -12.
-9
-7
-6
IG None
-5 -3
•2
-2
•2
Sciar
7' : 5
4
3
2
POU
3 _2
1
1
1
IE . None
-28 -19
-14
-11
A
Solar
8 s 5
4
3
3
POU
-10 : -6
-5
-4
.3
Multi-Fami (Indlrldual units)
2
.
. - 1 Unit Size
(t
28
water
699 : 700
1200
1700
2200
Healer Credit
or b
10
In
or
Type Type
less ;1199
1699
2199
more
SG None
0 0
0
0
0
or Soiar
14 7
5
4
3 '
HP HWR
9 . 5
3
2
2
Wsa
9 4
3
2
2
POU
9. 5
3
2
1
SE None
-4.5 ; -23
-15
-11
-9
Solar
2. 1
1
0
0
HWR
--23• .-12
-8
-6
5
Wsa
-25 -13
.8
-6
5
,eQU_23
-12
-8
-6
-5
IG • None
• -8 4
-3
.2
-1--2
:._. soiar
" 6A 3
2
1
1 1
POU
1 _0
-:0
0
0.
-• E None
: 30 -15
-10
-'-8
6
_:.Solar
`18 .'-
6
4
4
- : ort l
%- •A -4
•1
4
.1
Point System Summary:
Climate Zone 11 ..
-_. - --
-. -= .:
SCORE CARD
Measures
_._.....__
Point Scores
; ..... _ .: ...
1. Ceiling Insulation
3Za or
Interior MassICFA
' ...
R -value [381
U-vaiue (0.0301
. TM y PALL
2. Wall Insulation
/ ( or
...
R-value[llj
U -value (0.098]
3. Raised Floor Insulation
q or
'4
R -value [191
U -value [0.037]
Slab Edge Insulation
- or
lt•7011C'�•S1
:
R -value [01
F2 fluor [0.771
t Tyre 1 IgNSS,(rpC
5. Infiltration
a 4.2,
lel exposed Slab)
0
6. Glass Heat Loss
-T) 6 t,
_
Type (doublet
U -value [0.651
96 Total Glass [ 161
Sum 1.6
7.. Shading (Shade Open)
-
,
% G s
SC
..Eff.'7o GIass
_
a. North
_
1
b. East
4.. S x
► '� _
0%
0%
S%
-10%
1S%
20%
251
307.
35%
40% 45%
W%
55%
60x
6Sx
70%
75%
Box
85%
90%
95% 100X. 10S% 1107: 115% 120% 125-
0x
0
02
0.4
0.8
0.8
1.1
13
1.S
1.7
1.9
21
22/
2S
2T
29
32
14
3.8
3.8
4
4.2
4.4
4.6,
4.8
5
S3
10%
0.2
0.4
0.6
0.8
1
1.2
1.4
1.6
1.9
_
21
23
25
21
2.9
3.1
3.3
15
17
4
4.2
1.4
4.6
4.8
S
S 1
5 4
20X,
0.3
0.6
0.8
1
1.2
1.4
1.6
1.8
2
22
24
27
29
3.1
3.3
1S
17
19
4.1
4.3'
4.5
4.8
5
52
5.4
S6
30%
0.5
01
0.9
1.1
1.4
1.6
1.8
2
22
24
26
26
3
32
3.5
11.
3J
4.1
4.3
4.5
4.7
4.9
5.1
5.3
5.6
58
40%
0.7
09
1.1
1.3
1.5
1.7
1.9
22
24
28
28
3
12
3.4
3.5
18
4
4.3
4.S
4.7
4.9
5.1
S.J
-5.5
5:7
5.9
'SOY,
0.9
1.1
1.3
1S
1.7
1.9
2.1
23
2S
27
3
32
14
3.5
3.8
4
42
4.4
4.6
4.8
5.1
5.3
5.5
5.7
5.9
6.1
SS%
0.9
1.1
1.4
1.6
1.8
2
22
24
2.5
28
3
32
3.5
3.7
19
4.1
4J
4.5
4.7
4.9
5.1
53
56
5.8
6
62*
60%
1
12
1.4
1.7
1.9
21
23
2S
2.7
29
3.1
3.3
3.5
3.8
4
4.2
4.4
4.8
4.8 '
5
S.2
5.4
5.6
5.9
6.1
63
65%
1.1
11
1.5
1.7
1.9
22
24
26
28
3
3.2
3.4
36
3.8
4
4.3
4.5
4.7
4.9
5.1
53
5S
5.7
5.9
6.1
64
70%
1.2
1.4
1.6
1.8
2
22
25
21
29
11
13
35
11
3.9
4.1
4.3
4.6
4.8
5
52
5.4
5.6
58
6
62
64
75%
1.3
15
1.7
AJ
21
23
I5
27
3
12
3.4
31
18
4
4.I
4.4
4.6
4.8
5.1
5.3
55
5.7
5.9
6.1
6.3
65
e0'»
1.4
1.6
1.8
2
22
24
26
2.8
3
3.3
1S
17
19
4.1
4.3
4.5
4.7
4.9
5.1
5.4
5.6
5.8
6
6.2
64
66
85%
1.4
11
1.9
21
2.3.
2S
27
29
11
3.3
3.5
11
4
4.2
4.4
4.6
4.8
S
52
S4.
56
5.9
6.1
63
65
67
907:
15
1.7
2
2.2
24
28
26
3
3.2
14
16
11
4.1
41
4.5
4.7
4.9
LI
53
5S
5.7
6.9
6.2
64
66
68
95%-
1.5
1J
2
22
25
27
29
3.1
33
15
17
19
4.1
4.3
4.6
4.8
5
5.2
5.4
5.6
5.8
6
8.2
6.4
67
6.9
100X.
1.7
1J
2.1"
2.3
2S
28
3
12
3.4
16
18
4
42
4.4
4.8
4.9
LI
S.3
55
5.7
5.9
6.1
6.3
65
6.7
1
105%
1.8
2
22
24
26
28
3
13
3.S
3.7
19
4.1
4.3
45
.4.7
4.9
5.1
5.4
S6
5.8
8
8.2
6.4
66
so
7
110%
1.9
21
2.3
2.5
27
29
11
3.3
36
3.8
4
42
4.4
4.6
4.8
5
5.2
5.4
5.7
5.9
8.1
6.3
6.5
6.7
69
7.1
115%
2
22
24
2.6
28
3
32
3.4
3.6
3.8
4.1
4.3
4.5
4.7
4.9
5.1
5.3
5.5
5.7
5.9
62
6.4
6.6
6.8
7
72
120%
2
23
25
2.7
29
3.1
13
3.5
3.7
3.9
4.1
4.4
4.5
4.8
5
5.2
S.4
5.6
58
6
6.2
6.5
6.7
6.9
7.1
73
125%
21
V
25
28
3
3.2
14
3.8
3.8
4
42
4.4
4.6
4J
5.1
5.3
SS
5.7
5.9
6.1
6.3
6.5
6.1
7
7.2
7.4
Point System Summary:
Climate Zone 11 ..
-_. - --
-. -= .:
SCORE CARD
Measures
_._.....__
Point Scores
; ..... _ .: ...
1. Ceiling Insulation
3Za or
' ...
R -value [381
U-vaiue (0.0301
2. Wall Insulation
/ ( or
R-value[llj
U -value (0.098]
3. Raised Floor Insulation
q or
'4
R -value [191
U -value [0.037]
Slab Edge Insulation
- or
:
R -value [01
F2 fluor [0.771
..
5. Infiltration
Standard
0
6. Glass Heat Loss
-T) 6 t,
_
Type (doublet
U -value [0.651
96 Total Glass [ 161
Sum 1.6
7.. Shading (Shade Open)
-
% G s
SC
..Eff.'7o GIass
_
a. North
x
b. East
4.. S x
► '� _
'
c. South
i x
d. West
4% 1 x
e. Skylight
S"` x
8. Shading (Shade Closed)
:., .. a. North _ :.....:.
gra x
-: f _-
Eff. % Glass
• 79. --�-
:_ =.
___b.-
- -- -_ b• East - - ..
t.. x
c. South
x
d. West
x
e Skylight
x
9. Interior Thermal Mass
Inserior WisslCFA
TYPE 1 MASS AREACOND . FLOOR AREA
10. Exterior WaII Mass
2 t
ND. r LOOR OR
COND.
AREA s 9
AREA
0-011,
Sum 1IC
•
11. Heating System
Exterior Wall Mass
�. x
�
Zonal Control? (Y / N)
SE or HSPF
(0.72/6.61
Duct Efficiency 10.781
Effective SE or
HSPF (0-5615. 151
12. Cooling System
x
Zonal Control? ( Y / N)
SE;=R [9.51
Duct Efficiency (0.741
Effective SEER [7.031
13. Water Heating-
-
Type: ISGI
Cn dit
Pnin.tTnt/7L•
-ertificate of Compliance: Resident Climate Zone
MF-1R Checklist: Residential
—
�A SLorr, _ '
sro jeet Tlde *� / �-� d NOT): Lowrise nsidential buildings subject to the Sandsrds mus contain these ersaurs regardless of the rquuv +¢
,p approach used Items marked .nut m asterisk (') may be superseded by more =ngent compliarxx+cQuuvrwpts Gs+rd
i 3 5r a Qflr_6 " Olt fe6t,1 g•• Build i' it # on We Cetiacatc of Compliance. When sna checklist it veorpdrate.3 into the permit documcrim the features rated stall r
/6—,p !L`__ be cowdered by all panto as binding minimum component pcfomance spmrteuiau (or the mandatory measures f
�rojeet Addrm 7� wncoa they art shown cise.hQs in the doaunrnu a on this cloectlia only.
Checked B y / Date d
)ocumenrsdonAuthor Telephone ErdoreeanentAgency Use only DESCRIPTION DFSIGTfF�t EMRCEiIE r
Building En•do{he Measures -
Glass Area 90 Glass • §2.5352(2): Minimnun ceiling insulation R•19 weithted s•eragc.
5 L�i .DIS !G DATA North�� §2.5352(br. L� au inuslatiot marwfacturtr's labeled R•vah,e•
;.>b Number Floor Area 16-6 Number of S tones / East �� • §2-5352(c): Minimum wall insulation in framed wafts R-I I weighted average (does not apply to
exterior mass .rafts).
Slab/Raised Floor RIF Number of -Units � South _�L -_� D
§2.5ior .Saab edge insulation • waw absorption rate nes greater thin 0-3%, ratrt vapor
Single Family Detached (SFD) (] Addition Alone West , 3 uwsmiaaiot rate no grocer than 2.0 pmrVuxb.
]v Single Family Attached (SFA) [ ] Existing Building Skylight §2.5311: Insulation specified or insWkd meets California Energy Commission (tom quality
r standards Indicate type and form.
Multi-Famil [ ] Existing-Plus-Addition Tom _ §2.5352(x): vapor baffiers mandatary in Climate Zones 14 and 16 only.
L ] Y Cr'� 8 -
§2-531'7: tnrdtntion/E:fdvationContols
5a.
II�i G SHELL Iii iSLTLATIOI`I > Doan and wi„daws between conditioned and unconditioned spaces d�gned to omit air
leakage
E. Doors and windows ccrtirtcd
r e. Doors and windows wet erssripped. all joints and pchc=oas caulked and sealed
component Insulation L,ocaiion/eamments
in
TY^e R'Value (at:ie, $ �Erso4 C2I�'I etc.)
12-5352(c): Speciainfiltrationbarrier installed bcomply.vitt 42.5351 meeuCCquatiry I
–
wall.............. – - 12.5352(d): Installation of Firep la=
l 1. Masonry and faaorybuill futplarrs have
Roof.............. ' s Tighcfssting. closable mcnl or glass door
oof c. Flue damper and control b. Outside air intake with damper and control
Roof .............2. No continuous burning gas pilau albd.-e
r
f=loor............. ' HVAC and PlumbintSystemMcasura
i i' §2.5357.(8) and 2-5303: Space conditioning equipment sizing: attach al-da
oor...:.........tioru
A3�e..... j 12-5352(h) and 2.5315: Setback thermos= on al',appliable Mating sysemt.
Edge • §2.5316(2): Ducts eonstnved, installed and in.=U%ed per Ctapetsr 10. 1976 UMC
LAZING Shading Devices §2.5316(b)- EshaL rystiztt: ha.e damper contr9t:_
§2.5314(c): Gas-rued spa¢ heating equipment has intermi=t ignition devices-
Giazin g Area Glass Type Interior Exterior Overhang Framing Type j §2-5314: HVAC equipment. `rater he2t=. sho-crixads and fauces mtirhcd by ft CZ-C.
Orientation (S (siner, double) (Tolle blind, etc.) (shadescrom etc.) (y=hno) (metallwood) 1 12.5352n): Water hrascr insulation bL•snkct (R-12 or growl) aeonbined interiorhs:uior
/� l insutauon (R=16 or grater): first 5 fees of pipes cloxn to Lank insulated (R-3 a greater).
N. o r-,h. ( ) � V '_` L" ( L 12.5312(Facegtion f): Pipe insulation on stem and steam condcn= room k recirculating
Nor-u_h ( ) 1 piping.
East ( ) + � t 1 §2-53188(ddp- Swimming Post He:sing
– rte— p rf : ij 1. S has,r
1.
ff switch on heater.
East ) S ) l b.�th rproofinstrxtionplateonhater.
$oUL`l ( ) y� et l c. Plumbed to allow for solar.
( ) x $, 175percent
7Poc uvctt thermal efrtciescy.
Sol: U1.1 'f
W( ) 4 ;� 5.7imcclock.
West
( ) (► y 5. Dtnxtioral water inlet.
West
Lithtint and Appliance Afe2sures
Skylight....... a t 12.5352(1): Lighting • 25 Iumerts/wau or greater for general ligtning ie kir. m and bathroom
THERMAL MASS -
§Z•5314(c): Gas find appliances equipped with intermittent ignition d-Vices
Type/Covering Area Thickness` §2.5314(a): Refrisentas,refrigcator•frtczers•frte "fluorexerttLim pballastcesiacd
o
(slab/ezosed, tiles etc.) (Sf) (inches)ation%DCSCr1DtlOn (kitchen, bath, etc.) by the C:C Indicate make and model number. • .
�---� COMPLIANCE STATEMENT
i This crstificsie of coanpiial> lists tlr_ burltiiag fcatz;res v pc.-fo;marlce spedficatiofu needed to comply with
Title 24.Oapix. 2-53 and Title 2C, Sub&_i;tt 4. Article I of the California Administrative code 'This .
=tLfic= has b= signed by the individual with oya-Z design respc:sibiliry and ft building owner. who shall
HVAC SYSTEMS I�firLmutn Duct .. _ ... _ retain i copy of it and transmit rix cerdficatc to =y subsequent purdiaser of the building.
Type (furnace, air Efficiency Locadon Duct ..._Output ._.- Manufacturer/Model #
Designer BLuIding Owner
conditioner, heat Dump) (SE. SEER,HSPF) (attic, etc.) R-Value (Btuh) (or acoroved equal)
ir• S b� 5,? AW 117 Aed:�: ,&r=:
Tekp?hor c Tckptwncz
Maximum Furnace Heating Output: Bruh U_ 0:
HOT WATER SYSTEMS Tank Manufacturer/Mod'el# ?
Svste..,n Type (stcr3Re Rus, etc.) Caoacity (or approved equal) Soecial Feavare(s)
(signature) (date) (signaaxrc) (date)
S •��1-3 . Documentation uthor Enforcement Agency
:A Nanw
Ti
SPECIAL FEATURES/REMARKS (Add extra sheets if necessary) tm At
L... -