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HomeMy WebLinkAbout068-360-136i8-36-T36 45=90 James & DianeCarter 22 ,Foxridge Rd 'Oroville Ag_ Exem t ' ' .farm. im .lements "rain hay,oran es 68-36=136 ✓ 1166- B,P, ,M 68-36-136 �. (n Permit#344,3-90B,P,E,Ml CARTER, Jay (new sf - 60/640) 22 Fox.Ridge Rd, Me (new sf 60/640) 068.-360-136: PERMIT#95-1822 I� k= CARTER, Jay, 24 Fox Ridge Rd.- Orovi.11e a .New 60/640 Dwell-ng; 068-360-136 03-3021 GALVAN, FRANK 22 FOXRIDGE RD, OROVILLE Cont: DAVE HATFIELD CONST INSTALL ELEC TO FIRE SPRI. L1 2 - .� � o) �/ �� a� RESIDENTIAL 68-36-136 - - 1165-90B,P,E,M. CARTER:, Jay 22 Fox, Ridge Rd; Oroville (new•�sf) S� 7- V J/j f D `a 'Ve.GGT_ 5. A OFFICE COPY 'Address GAS Meter By Date - -3/ ELECTRIC Meter i OFFICE COPY Address • E E ��LDate ELECTRIC ` Meter By Date ,O 2 JOB FINALED ( e — Signature J=OK O=Not OK Not = Not Ready MOBILE MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O Concrete 4. Water; Location -Test -Easement Needed (Sketch) - 5. Electricity; Location-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 r MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK ex F tt #'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 1 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-PaneIboards- Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test IDate Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 C3 } 1. . J . V=OK O=Not OK 1, = Not Applicable Not Remy RESIDENTIAL (Single ' = Date LINDE OOR (Plans) OK except #'s r o ing-Setbacks- Ease ments-Flood-Slope tg. Main; Soils-Elec. Grnd.- U' Ftg. Depth g., Garage; Soils -Steel- rnd.-/)%(;� Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel -Block outs -Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped old Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel .V.; Fall -Fitting -Test -2 Way C/O -Sewer Test a- Gas P' , Size -Anchors 1 a r Pipe; Test -Anchor -Regulator -Ser ce Test ; Underground 13. PienL Ims & Ducts; Clearance -Material -Support -Ins. 1 irders-Sills-Anchor Bolts -Joists -Vents -Cripples 15. Insulation DateCard B-1 Date Card B-1 Date ,( Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 16. Water Htr.; Vent -Access -Combustion Air -Baffle 17. Water Pipe; Test & Anchor -Nail Protection %".W.V.; Test -Fittings & Anchor -Nail Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRI L Permit OK except #'s fixture & Transformer Clearance -Ins. Protection ec. Receptacles Spacing -Lights & Switches at Doors ,_14-T'ize Boxes & No. of Conductors -Stapled ex talled Close to Edge of Studs & C.J. qui round made up w/Mech. Fastners-Bond Gas & Water A fiance Circuts in Kitchen & Conductor Size/GFI Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 2L9-ft-nge Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Ins ed Neutral 0 Yes ❑ No ervic iser Conductors & Ground -Main Disconnect quip. Clearances Panels-Motors-Mech. Equip. 3g,etothes Closet Light -Shower Light -Spa Light moke Detector DateU 7-6:40 Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 34. A.C. Ducts Insulation & Support 35. Vent Fan; Exhaust above insulation 36. Condensate Drain & Overflow; Size & Grade 37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet 38. Attic Access & Platform if Furnance in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except #'s 3 Sils, Proper Material & Anchors 4a.-*a1l Studs -Nailing, Spacing & Bracing -Plates -Sound ea!' ng Walls over Girders & Floor Nailing ra Stop in Walls (rat proof) ire tops; Furred Ceilings -Stairs -Chases -Tub eaders & Beam -Size & Bearing &' Duplex) Date ERAMING (Continued) rs5. Hanger - ost craps-Ancnors-connectors ng. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Rfng. fireplace Ties or Type A Flue -Fireplace Throat clearance is Access; Size & Romex Protection -Draft Stop -Ins. Baffles drm . Windows or Exiting Doors -Sill Hgt. & Dimensions arage F' a Protection Framing ropEFty Line Firewall & Openings 62-Sxt. Doors -One 3' -Check Garage -3rd Story, 2 Exits 5 h -Head, oom-Rise-Run- Land ing-Fire Protection U41y'y_o.od on Roof Overhang -Attic Vents -Rafter Outriggers iding-Nailing Veneer ip Screed -Fd. Vents-Underflr. Access la ' Area -Glass Protection -Skylights -Plastic. Shp Walls; Nailing -Bolts nsulation-Wal ls-Ceilings 60. Infiltration -Walls -Windows Date// ?_J;_,fU Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL P ns) OK except #'s xt. 9!2s -Door & Sidelight Protection -Landings 6a. -Sim -oke Detector urnace; Vents -Clearance -Comb. Air -Connector - In Garaqe: Above Floor-Ducts-Mech. Protection Bath Fixtures & Tub .67 EIS & Subpanel; Breaker Sizes & Labels 158-Firepl a or Stove; Clearances -Hearth lec. oitlets at Wood Panel; Int. & Ext. it.Fixt._ & Appliance; Grnd.-Air Gap -Cooking Clearance 7_e—c. Outlets & Receptacles at Kit. Counter 7 age Door; Swing -Landing -Closer 73e<._ C. Duct in Garage -Damper tr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Gara � - bove Floor-Mech. Protection , Elec. & Mech. Equip. Listed for Location Elecjtacles in Garage; (G.F.I.)-Romex Protection nsulation-Foam-Looked in Attic 0 Yes 7 and Rails & Deck Construction -Post Caps 7 n. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 80- Following mstld.; Drive as 0 No; Walkses ❑ No; Planters ❑ Yes 0 No "h Unit; ciaconnect, Electrical, Plumbing Sa-Jeeffis"Above Roof; Plbg.-Appliance-Fireplace.-Clearance to Openings ater Well; Disconnect, Electrical, Plumbing xterior rim; G.F.I. Receptacle -Underground e ation Thp2ughout House lass Prote ion 88. Lorrefrom Previous Inspections 80 -lis T t -Meters Tagged; Gas -Electric 90. r & Sewer Connected -C/O to Grade -HD Approval rgy Compliance Certificate -Other Certificates Date7:(-Card B-1 Date Card B -1 - Da S� Card 13-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: (NOTE: An entry must be made each time you visit job site) kV E'Y:;r'E'=0Y TE,-ECQF'IER 7818 -91 2:E4PM 916 888 8842 - FEB 07 ' v 1 1'E:01 i=F'Ch-h'ETT SALE' � i 0 -.SSE' -884E • 350 LINCOLN WAY • AUBURN, CALIFORNIA 95603 (916) 885-3284 February 7, 1991 9165332623.•# 1 P.1 1 LICENSE NO. 292730 • To whom it may concern! This is tQ certify that all the shower door glass t and—the—rain- .glass used at,,the_ J. Carter job is tempered safety glass. Sincer ly Douglas D. Crockett e i Owner t r i t t + 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 -- 00jzTCX-fz- 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. X7 - Date— 7 - Date V f — / Inspector ��" „ _s,1'^�.w�+.v,-+,•.. �.� ...w'�'.:�A”F��a�SA[.+1+,'g=:F.r:-,�yP-"r"4►..-.:++r--..rcc.:��-Y..w•"*"'YlFi"r*^'.r^.�"""�-1I COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile - Phone: 538-7541 747 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE- - OWNER PERMITrNO'• A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or ed additional explanation, please contact this office immediately. D&'j C� !.4 T/ / rt sv R ATP /2 oar Date _/IA Z���U Inspector .._,1i"'s3.%" -;--.y 6=.r ..: _:.�:. �-•-�,ar���:F. ni'6►-.r` =�?=t'��.'��+�"Q=`s„'-''ti�`='fi!aW�++^�ir-s,�tirer^twl':^n: r _ COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way,.Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 5387-7541' a_ . 747,EIIiott 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. i • �. w: ♦•/YwVr _ v�+�r.9 _ R^v.w..C'�Yf{V.� rf^ra —vns .V/� M•v.V.MFY �wwsiF^"+Ya COUNTY OF BUTTE DEPARTMENT OF PUBLIC-WORKS, . i 196 Memorial Way, Chico — Phone: 89172751 7 County Center Drive, Oroville — Phone: 538-7541•. t 747 Elliott Road, Paradise— Phone: 872-6307 O itECTION 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. t, 1�. Date �� Inspector ENERGY CERTIFICATION z, LOCATIOW A. P. NO. ROOF MATERIAL_ BRAND NAME THICKNESS THERMAL RESISTANCE f,(R VALUE) EXTERIOR WALL MATERIAL FIBEGLASS BRAND NAME CERTAINTEED_ THICKNESS (INCHES) THERMAL RESISTANCE (R VALUE CEILING + BATT OR BLANKET TYPE FIBERGLASS BRAND NAME CERTAINTEED THICKNESS k O THERMAL RESISTANCE (R VALUE) 3 I-OOSE FILL TYPE_ FIBERGLASS BRAND NAME CERTAINTEED MINIMUM THICKNESS(INCHES) -- NUMBER OF BAGS _WT-` PER BAG EO LB _ -AREA COVERED (SQ F_T) THERMAL' RESISi•�ANCE (R VALUE)' FLOOR, ELEVATED rt MATERIAL FIRER LASS BRAND NAME CERTAINTEED THICKNESS (INCHES) � THERMAL RESISTANCE (R, 'VALUE) L FLOOR, SLAB MATERIAL _ BRAND NAME THICKNESS (INCHES) THERMAL RESISTANCE (RVALUE) FOUNDATION WALL MATERIAL 'BRAND NAME THICKNESS (INCHES) THERMAL RESISTANCE (R VALUE) I HEREBY CERTIFY THAT THE ABOVE INSULATION WAS ABOVE BUILDING IN CONFORMANCE WITH THE STATE OF REQUIREMENTS. HAWKINS INSULATION 379407 FIRM NAME/OWNER INSTALLED IN THE CALIFORNIA ENERGY i. S; i STATE CONTRACTOR'S 4LICENSE NO. 11 SIGNATURE DA� E I HEREBY CERTIFY THE ABOVE INSULATION AND ALL REQUIRED LITEMS AS SHOWN ON THE BUILDING DEPARTMENT APPROVED PLANS AND ATTACHMENTS HAVE BEEN INSTALLED AS REQUIRED BY THE -:STATE OF CALIFORNIA ENERGY REQUIREMENTS. . S ALL EQUIPMENT, DEVICES AND MERTIALS ARE SPECIFICALLY APPROVED BY THE S' F NAM /OWN R SIIGNATURE GEN. CONTRACTOR/ OWNER ARE OF THE QUALITY PRESCRIBED OR 'ATE OF CALIFORNIA. STATE CONTRACTOR'S 4LICENSE NO. DATE COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT N0. ASSESSOR PARCEL NUMBER 68-36-136 ZONING BUILDING PERMIT OWNER Jay Carter TELEPHONMES0. 533-9199 FT. OCC. BUILDING VALUATION 30 R 89,200 OWNER'S MAILING ADDRESS P.O. Box 1862 Oroville 95965 658 M 9,212 CONTRACTOR'S NAME same TELEPHONE 456 Cov 4,560 0 CONTRACTOR'S MAILING ADDRESS Fireplace A 11000 LENDER CONSTRUCTION$ none UNKNOWN C Total Valuation 103,972 FilingFee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 443.00 ARCHITECT OR ENGINEER none LICENSE NO. Plan Checking Fee $ 221.50 Energy Plan Checking Fee $ 15.00 ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 22 Fox Ridge Rd. Permit fee $ 689.50 PLUMBING PERMIT Filing Fee 10.00 Each Trap 111 2.00 22.00 Oroville Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PC L MAP 11449..91/ Water piping 5.00 5.00 Each qas water heater or vent 5.00 5.00 USE OF STRUCTURE SF UX Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 5.00 Building sewer 5.00 5.00 Mobile Home S I G I W 10.00 e TYPE OF WORK NewJR Addition[] Remodel❑ Utilities❑ Installation❑ Other F-1 Describe work: 2 BE _ Permit Fee $ 52.00 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 1 declare rider penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professio s Code and my license is in full force and effect. -7 'J .��� / Classification License No. -- - �,. 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 OCf$&$ ) OR ADONS. ACC. BLDGS. / 2YzQsgft NEW CONSTR. MULT'-OUTLET NON•R ESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS &) (SINGLE OUTLET CIR. ) t. EO x. ccup(OUTLETS OR FIXTURES OF 2ALO 30 SL@ FIXED APLNS. EX. OCCUp. OUT LETS P(RESID )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. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating 100,000 6.00 NAT. GAS Cooling 3T 6.00 g Hood 3.00 3.00 Ventilation 2 3,00 6,00 permit Fee $ 31 .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. 1 also agree to save, indemnify and keep harmless the County of Butte against all li 'lities, judgm ts, costs, and expenses which may in any way accrue ag st aid County cons a -of the granting of this permit. Date ! ign7tre of pplica r - OWner�CDnrrocror'`Agent An A permit is required For excavations over 5'0" deep and demolition or construct- ion ructures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ 30,00 o CONST_ T PE U GG TOTAL F t $ 1897.20 HAz CUA P=RK sc F D P PD Hq IssU� ✓ This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. q,,,,DIRECTO OF PUBLIC WORKS BY Date PE T EXPIRES Date Receipt No. WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - proville,'California 95965 - Telephone: 916;'538-7541 APPLICATION AND PERMIT ASSESSOR PARCE NUMBE ZONING BUILDING PERMIT oELEPHONE �Y\ �c r - P. FT. O C. BUILDING VALUATION O ER•S Al NG ADOO�E� � �� � - � ^,S`96 %T'RAC TO R'S NAMETELEPHONE- / V CONTRACTOR'S MAILING ADDRESS Fireplace � FireTota D CO TRUCTION LENDER UNKNOWN Valuation I S Filing Fee ,S 10 00 LENDER'S MAILING ADDRESS Permit Fee g ARCH TECT OR ENGINEER LICENSE NO. Plan Checking Fee g Energy Plan Checking Fee AR H E T OR ENGINEER'S MAILING ADDRESS Penalty g BUILDING ADDRESS /jam ® / l Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 (/1© I/-. Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME - PARCEL MAP Water piping 5.00 (19 Each qas water heater or vent 5.00 USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 10.00 e TYPE OF WORK New 7r Addition ❑ Remodel 0 1 Utili es InstallationF. OtherD Describe work: .J Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 VAMP ORSLESS 10.00 )0. Main service EA. ADO' L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of .perjury (Check One): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ 1, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. c OR ADDNS. ( S. �Z¢s Qft NEW CONSTR UL I. TLET NO N•RESID BRANCH CIRC 'ITS 2.50 ea (POWER APPARATUS e) SINGLE OUTLET CIR, Ex. Occup(OUTLETS OR FIXTURES 2ALO 30 eALoaoc FIXED PLNS EX. Occup. OUT EASPRESIC.)REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building DepartmentS a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating 60oj Q Coolin g DO Hood 3,00 Ventilation permit Fee ; Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee g occ CONST TYPE TOTAL FEE $ ALSCHLIFLO HAZ CUA PARK I PAR Po Ho ISSUE Th's permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date Receipt No. WHITE-O.P.W.. YELLOW -ASSESSOR. PINK-INSPf.CTOR. G0L0ENR00-APPLICANT '" zs �Y� "'k{�4 e'r`i-ais+s•-7 `'7� 91"E + .. qpl" +s �y r COUNTY OF BUTTE - DEPARTll OF, PUB4 1C WORKS - BUILDING DIVISION ; t � 7 COUNTY CENTER DRIVE-'OROVILLE-CALIFORNIA 95965 - TELEPHONE: 916/538-7541 • 1 f PERMIT APPLICATION DATA SHEET ; - X - 1 Permit No. s OWNER G' In 'F�. A. P. No. Proposed Building' se 1& 112 Building Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted. 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ............... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10.. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12: Par fees paid. _ ................................................ ((�c�� ✓� thool Dist iF- t fees paid .4Sanitation approval from __401Z ; — Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval Jrom City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... l 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. . Owner -Builder Verification (Given to owner o, Mail to owner ❑) ..... 2 . Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 26. 27. When you issue the permit, process as follows: Ma' to owner. Mail to contractor. Telephone S -g/99' and hold for pickup at office. Deliver w/inspector. ), Other t A p p I i - ant L Date d Copy of Hez-Mat form sent Health Dept.Ire Dept. Air Pollution Date Copy of plans sent _Health Dept. Fire Dept. Other Date By The following data must be submitted prior to perm' is uance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was'advised of above required data by_phone---nail—counter by ..date Contractor, designer, owner, was advised of above required data by —phone _maII—counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW RESIDENTIAL PLAN CHECKING GUIDE (S.F., DUPLEX & MISC. ONLY) . i Bldg. Permit # 90 OWNER f 'A. P. # — GENERAL �oning requirements:. (sideyards Valuation. '6. /Plans signed by designer. .4. Energy Design and Compliance. Existing violations on property. Items on data sheet.. and number: of permitted living units). PLOT PLAN Complete parcel size and dimensions. Setbacks, sideyards, easements, etc. Other buildings or structures. �-Grading, fills, drainage.. Flood hazard. .Special conditions on. creation map or compliance document. P'.'--FAU & FAS road setback. FLOOR PLAN �1�/Complete to scale plan with dimensions. v2: Required windows for light and ventilation (Sec. 1205). �equired windows for second exit (Sec. 1204). kylights (Chapter 34 & Sec. 5207). (Er-5uman impact glass (Sec. 5406). .•equired room sizes, ceiling heights (Sec. 1207). GFCIs in baths,—garage,—and exterior outlets (Article 210-8). Light fixtures,*switches, receptacles, and exterior receptacles of mechanical equipment. '`Locations of 'water heater, eating and cooling equipment other ,,.gas equipment, and plumbing fixtures. cl,. arage firewall, door size, and closer (Sec. 503(d)(3)). ttT 3'0" exterior exit door (Sec. 3304(e)). fireplace and wood stove location, alcoves, and clearance. Smoke detectors (Sec. 1210). 5/89 for maintenance electrical or STRUCTURAL DETAILS Foundation plan complete enough to construct building.. Xoor construction details complete enough to construct building. Elevations and wall construction details complete enough to construct building. [Roof construction details complete enough to construct building. (Fireplace construction details and talcs if necessary. MISCELLANEOUS ITEMS TO LOOK OUT FOR. X�tairway details: landings, rise and run, head clearance, handrails (Sec'. 3306). J2.Guardrail details (Sec. 1711 & 3306(j)). Brick or stone veneer (Chapter 30). ' 5/89 RESIDENTIAL PLAN CHECKING GUIDE MISCELLANEOUS ITEMS TO LOOK OUT FOR (CONT'D) Ro xterior plaster - weep screeds (Sec. 4706). roper roof pitch for roof covering (Chapter 32). of covering type - (fire hazard). Rafter ties or bearing ridge beam. arage door or porch header sizes. 4!_Adequate bracing. -k®' Living area over garage - complete 1 -hour separation required on garage side including supporting walls and posts, etc. -tT— —Two exits on three-story dwellings (Sec. 3303 & see Mezannines - 1716). �2'--Attic access and ventilation (Sec. 3205). 45,Underfloor access and ventilation (Sec. 2516). ". Combustion air for fuel burning appliances. k5'.�Noise requirements on duplexes. 46'.—Adobe soils - special foundation design. -L7-'Retaining walls requiring design. I'��IJnusual shape, size, or split level house requiring lateral design. +9-. Flashing at all exterior openings. I v BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM (One Form per Building) A.P. Number �,h -� Building Department No.� School Districtoro l_/(-091 City D County ® Jurisdiction Property Owner Project Locati Subdivision Residential Development: a Sq. Footage,,.,. # of Living MHI Addition M oup R) Units- Commercial/Industrial,: Buil D New nt Representative Sq. Footage Addition (Including Exterior Roofed Areas) Date ******************************************************************* (Floor Plans reviewed by School District Personnel) District Id No. �8S �.4-A_7,y� �o_ j��„oma, ,, ,� School District certifies that U (A3pplicant`Name) (Phone Number) d J(1 L 6 dae, ?& a l (Street Addrdss) &h, Id 4S�G (City) (State) (Zip Code) has, complied with the requirements of Resolution No. by the payment of $ ���5 y/ representing aoZ.X� square feet. J-XX/9 e) "School Dis Ad/lt Representative Ddte PAID BY CHECK NO., - \ BANK NO 11-3S-- , PAID BY CASH REMARKS: white -applicant, yellow -building department, pink -school district SCHOOL.FEE (8/88), F Return'to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT 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 to land or included within an area- zoned for `agricultural purposes, and residents of this property may be subject to incon- veniences or discomfort arising from the use of agricultural chemicals, including, but not limited to herbicides, pesticides,. and, fertilizers; and from ,the, pursuit of agricultural operations including,, but not limited to cultivation, plowing,. spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, ,and odor. Butte County has established agricul- tural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience. or disconform from normal, necessary farm operations. All that 'real property situate in the County of Butte, State of California, described. as follows: Date: April 26, 1990 PROP RTY OWNERS: ( State of California SS. County of Butte ) On this the 26th day of April 19 90 before me, the undersigned Notary Public, personally appeared Diane G.. Carter OFRMALSM Personally known to me. E] Proved to me on the basis. SANDY A. STACK • of satisfactory evidence. NOTARY PUBLIC -CALIFORNIA. o be the ersonO,whose name( •is Pdncoat Offim to BUTTE county P CommiestonEx res DEC. IM ubscribed to the within instrument and acknowledged that she IV COP xecuted the same for the purposes therein contained.- IN W1TNL5S` WHEREOF, I hereunto set my hand and official seal. Present A. P. No. (O ~�� 1b, otary Public v=OK. t O = Not OK Not = Not Readyable MOBILE HOMES, Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap: / P L" ft. / /"Nat. or/ /" L"ft./ /"LPG 7. Utilitv Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD. Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 10. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS . Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK exk2pt #'s . .t 1. 'Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders ;end/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; _Rosi@rBeams-Rftrs.-Coonectors 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 -Pane Iboards- Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 t ( I r� t t t 4 J=OK O = Not OK - = Not Applicable Not Ready, ' RESIDENTIAL (Single ' =� & Duplex) ' Date ONDERFLOOR (Plans) OK except #'s Date � 4 FRAMING (Continued) 1. Zoning -Setbacks -Easements -Flood -Slope 45. Hangers -Post Caps -Anchors -Connectors 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 46. Cing. Joist-Rftr. ties -Pu rlin-roof Brac-Truss-Shthng.-Rfng. 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 48. Attic Access; Size & Romei Protection -Draft Stop -ins. Baffles 5. Stemwalls, Main; Steel -Blockouts-Wrapped 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 50. Garage Fire Protection Framing 6a. Hold Downs and Special Anchors 51. Property Line Firewall & Openings 7. Slab; Steel -Wrapped 52. Ext. Doors -One T -Check Garage -3rd Story, 2 Exits 8. Piers -Fireplace Ftg.-Steel 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers 10. Gas Pipe; Size -Anchors 55. Siding -Nailing Veneer 11. Water Pipe; Test -Anchor -Regulator -Service Test 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 12. Electric; Underground 57. Glazing Area -Glass Protection -Skylights -Plastic 13. Pienums & Ducts; Clearance -Material -Support -Ins. 58. Shear Walls; Nailing -Bolts 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 59. Insulation -Walls -Ceilings 15. Insulation 60. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s Date Card B-1 Date Card -B-1 16. Water Htr.; Vent -Access -Combustion Air -Baffle Date FINAL (Plans) OK except #'s 17. Water Pipe: Test & Anchor -Nail Protection 61. Ext. Steps -Door & Sidelight Protection -Landings 18. D.W.V.; Test -Fittings & Anchor -Nail Protection 62. Smoke Detector 19. Shower Pan; Test, First Floor -Tub Access 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa Date Card B-1 Date Card B-1 66. Elec. Trim & Subpanel; Breaker Sizes & Labels Date Card B-1 Date Card B-1 67. Stairs & Rails Date ELECTRICAL (Permit) OK except #'s 68. Fireplace or Stove; Clearances -Hearth 22. Fixture & Transformer Clearance -Ins. Protection 69. Elec. Outlets at Wood Panel; Int. & Ext. 23. Elec. Receptacles Spacing -Lights & Switches at Doors 70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 24. Size Boxes & No. of Conductors -Stapled 71. Elec. Outlets & Receptacles at Kit. Counter 25. Romex Installed Close to Edge of Studs & C.J. 72. Garage Fire Door; Swing -Landing -Closer 26. Equip. Ground made up w/Mech. Fastners-Bond Gas & Water 73. A.C. Duct in Garage -Damper 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage; Above Floor-Mech. Protection 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 75. Plb., Elec. & Mech. Equip. Listed for Location 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection 77. Insulation -Foam -looked in Attic ❑ Yes 30. Service -Riser Conductors & Ground -Main Disconnect 78. Guard Rails & Deck Construction -Post Caps 31. Equip. Clearances Panels-Motors-Mech. Equip. 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector 80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No Date Card B-1 Date Card B-1 81. Stucco; Brown -Finish Date Card B-1 Date Card B-1 82. A.C. Unit; Disconnect, Electrical, Plumbing Date MECHANICAL (Permit) OK except #'s 83. Vents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to Openings 34. A.C. Ducts Insulation &Support 84. Water Well; Disconnect, Electrical, Plumbing 35. Vent Fan; Exhaust above insulation 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 36. Condensate Drain & Overflow; Size & Grade 86. Ventilation Throughout House 37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet 87. Glass Protection 38. Attic Access & Platform if Furnance in Attic 88. Corrections from Previous Inspections 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval Date Card B-1 Date Card B-1 91. Energy Compliance Certificate -Other Certificates Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except #'s Date Card B-1 Date Card B-1 39. Sils, Proper Material & Anchors Date Card B-1 Date Card 8-1 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound Date Card B-1 Date Card B-1 41. Bearing Walls over Girders & Floor Nailing Comments at Final: 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Headers & Beam -Size & Bearing each time you visit job site) (NOTE: An entry must be made COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 538-7541 747 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE C rz-�-c i2 3Vg3 5� (OWN:EIR PERMIT NO. ; A troufine 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 -3 matter, (or meed additional explanation, please contact .this office immediately. „. 3 0(1/3-;v /Ziz- f'l/G Gc� � P/�L /G i4 T/ t�f•• Date d �� Inspector COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 5313-75411 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE, 4EA 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 u ha any question pertaining to this matter, or need additional explanation, yon, plea s Lontact this office immediately. it 60 fiel 0 eakl '-'4- 57 -r /,I., - Date Inspector r ' COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - P RMIT NO. 1 7 County Center Drive - Or6vil(e;-56fornia 95965 - Telephone: 916/538-7541 APPLICATWN AND PERMIT ASSEDSOR PARCEL NUMBER 68-36-136 ZONING BUILDING PERMIT OWNER - - Jay Carter TELEPHONE 533-9199 SO. FT. OCC. BUILDING VALUATION 636 R 25,440 OWNER'S MAILING ADDRESS - P.O. Box 1862 Oroville 95965 92 cov 920 CONTRACTOR'S NAME same TELEPHONE , - CONTRACTOR'S MAILING ADDRESS Fireplace 1 A 1,000 ! CONSTRUCTION LENDER none UNKNOWN Total Valuation I $ 27,360 LENDER'S MAILING ADDRESS a Filing Fee $- 10.00 Permit Fee $ 184.00 ARCHITECT OR ENGINEER none LICF_NSE NO. Pian Checking Fee $ 92.00 . EnergyPlan Checking Fee 15.00 ARCHITECT OR ENGINEER'S MAILING ADDRESS - Penalty $ BUILDING ADDRESS 22 Fox Ridge Rd. Permit fee $ 301.00. PLUMBING PERMIT Filing Fee 10.00 Each Trap 2,00 Oroville Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME • PARCEL MAP Water piping 5.00 5.00 Each qas water heater or vent 5,00 5,00 USE OF STRUCTURE SF [ Duplex❑ Mobilehome❑ Other SPECIFY - Gas piping system 1 - 5 outlets 5.00 5-00 Building sewer 5.00 Mobile Home S I G W 10.00 e TYPE OF WORK New U Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work:- 60/640 (replaces #1166-90) Permit Fee $ 38-00 Contractor ELECTRICAL PERM4TF,ling Fee 10.00 ' Main service 100 AMP V OR LESS RSLES10.00 10.00 CONTRACTORS LICENSE LAW 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 �l force andel effect. License No. a,=y_ S Classification /T �+ - l..-. ElI, as the owner,. or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) . ❑ I am exempt under Sec. , Business and Professions Code for this reason Main service EA. ADD'L 100 A2.50 NEW CONST. DWELLING OCC OR ACDNS. ( ACC. BLDGS.20SgftI NEW CONSTR ULTI-OUTLET NON-RESID BRANCH CIRC 2.50 ea (POWER APPARATUS &) (SINGLE OUTLET CIR, Ex. Occup(OUTLETS OR FIXTURES' BALO 50 Ex. Occup. OUTLETS PL IRESID.IREA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ 90 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): a ❑ The permit i,s for $100.00 (valuation) or less. I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance•or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating 6.00 nat gas Cooling g 6.00 Hood 3,00 3.00 Ventilation permit Fee $ 25.00 Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property.for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all li I les,' judg ts, costs, and expenses which may in any way accrue aga st id Coun 1 coon equence of the granting of this permit. X l V j �-� /Date Ign ure of.Appliccnt — Owner Contractor IJ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ 30.00 c c0N PE TOTAL FEE $ .429.9 HAZ cuA PARK SCH FL PAR,4-113 PJ ISSUE This permit is Hereby issued under sions of the Butte County Code and/or work indicated above for which By f DI OF PUB f PERMIT EXPIRES ate , the applicable provi- resolutions to do fees have been paid. IC WORKS - Date Receipt No. 73867-429.90 WHITE-D.P.W% YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT �, r t.rr �"m.., +�>•,*� :;Y,/�y . �ii'ti'1ri�?� - f-rt`"'ry� ..�' �;u,�'�'7n•Jy,���' .y '^Y..;•r.•�"Y;-.cKa^�', ti��„'. �i."' l.J COUNTY OF BUTTE - DEPA"*R41 M .T; OF PUBLIC WORKS -BUILDING DIVISION S „t 7 COUNTY CENTER DRIVE O,ROVILL�, 6AIFORNIA 95965 -TELEPHONE: 916/538-7541 / d PERMIT- APPLICATION DATA SHEET --�— Permit No. C/ 0 VP:,01( t^ �Et ✓^ P. �O �� OWNER o. Proposed Building Use Bui Iding Inspector Dat At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been. submitted . ........................ 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ............... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13. School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec.request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 26. r 27. Wheryyou issue the perm t,jr7yq,as follows: Mail o owner. Mail to contractor. 3 — �✓`� Telephone J and hold for pickrup at ce. Deliver w/inspec%'. Other 1 r Date ( .o i 4pp_114c nt �+_.— 9 Copy of Hdz-Mat form sent Health Dept. Fire D pt. Air Pollution Date Copy of plans sent Health Dept. FI -e-0ept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: s. . \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 —ma ll—counter by date Plans checked byDate10- / Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive-'Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASS SOR Q,ARCEL NUMBER ' ,J{(/9 ZONI BUILDING PERMIT Ow TELEPHO E S0. 0 C. BUILDING VALUATION jFT. d OWN R' MAILINADORES% Q rot/,, Y Y0 141T NATELEPHONE CONTRAC OR'S MAILING ADDRESS ' Fireplace I o0eD C2_77�UCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ LQ ARCHI ECT OR ENGINEER 1 110 LICENSE NO. Plan Checking Fee $ Energy Plan. Checking Fee $ %L5 ARCHITECT ENGINEER'S MAILING ADDRESS ' Penalty $ BUILDING ADDRE — Permit fee $ 0621 PLUMBING PERMIT Filing Fee 10.00 h' Each Trap 2.00 r Vr (a Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME - PARCEL MAP Water piping ' - , - 5.00 Each,gas water heater or vent 5.00 ' t2 d USE OF STRUCTURE SF Duplex[ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 ,S, Building sewer 5.00 LS 06 Mobile hlolne S G W 10.00e TYPE OF WORK New Addition ❑ Remodel❑ ilities Installation❑ Other ❑ Describe work: _ Permit Fee $ 00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service IOOV OR LESS 00 AMP OR LESS 10.00 Main service EA. ADO'L 100 AMP 2.50 CONTRACTORS LICENSE LAW 1 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- 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. DWELLINGoCCUP.N OR ADDNS. ( ACC. DGS. hQSQ it �• NEW CONSTR. U '-OUTLET BRANCH CIRC ITS 2.50 ea POWER APPARATUS e\ (SN E OUTLET CIR, / Ex. OCCUp(OUTLETS OR FIXTURES e� P30 FIXED APL 9 Ex. OCCup. OUTLETS (RESID IREA.) 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..60 ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California.Ventilation 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 o 2 Q y- a Cooling Hood 3.00 Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature of Applicant.7 Owner❑ Contractor ❑ Agent ❑ An OSHA permit is. required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TTPE TOTAL FEE $ E HAz CUA PARK $CHL PAR PD HD` ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date Receipt No...•7_367•... WNIT [•D. P,W„ TCI IOW•A99 C330R, PINK -INSPECTOR. GOLDENROD -APPLICANT .5/89 RESIDENTIAL PLAN CHECKING GUIDE . (S.F., DUPLEX & MISC. ONLY) Bldg. Permit OWNER - �. �i�s ) A. P. # GENERALZ Zoning requirements: (sideyards and number of permitted living units). Valuation. —3—.'Plans signed by designer. z ; 4. Energy Design and Compliance. - Existing violations on property. -6—. Ilems on data sheet. ;r - PLOT PLAN Complete parcel size and dimensions. . Setbacks, sideyards, easements, etc. Other buildings or structures. Grading, fills, drainage.' • Flood hazard. • Special conditions on creation map or compliance document. FAU & FAS _road setback. _ FLOOR PLAN ' omplete to scale plan with dimensions. equired windows for light and.ventilation (Sec. 1205). Required windows for second exit (Sec. 1204).:. _Skylights (Chapter 34 &,Sec. 5207). Human impact glass (Sec. 5406). ired room sizes, ceiling heights (Sec. 1207).- GFC s in baths, garage; and exterior outlets (Article 210-8). ight.fixtures, switches, receptacles, and exterior receptacles for maintenance of mechanical Locations of C mer ating and cooling equipment, other electrical or as.equipment, and plumbing fixtures. .Garage firewall, door size, and -closer (Sec. 503(d)(3)). . 1--3'0" exterior exit door (Sec. 3304(e)). eplace and wood stove location, alcoves, and clearance. Smoke detectors (Sec. 1210).. STRUCTURAL DETAILS foundation plan complete enough.to construct building. 2. Floor construction details complete enough to construct building. evations and.wall construction details complete enough to construct building. Roof construction details complete enough to construct building. fireplace construction details and calcs if necessary. MISCELLANEOUS ITEMS TO LOOK OUT FOR Stairway details: landings, rise and run, Guardrail details (Sec..1711 & 3306(j)). rick or. stone veneer (Chapter 30). head clearance, handrails (Sec. 3306). K • 5/89 RESIDENTIAL'PLAN`'CHECKING GUIDE F MISCELLANEOUS ITEMS TO LOOK OUT FOR (CONT'D) rxterior plaster - weep screeds (Sec. 4706). Wiper roof pitch for roof covering (Chapter 32). �6f covering type - (fire hazard). . Rafter ties or bearing ridge beam.. — Garage door or porch header sizes. requate bracing. Pf Living area over garage - complete 1 -hour separation required on garage side Including supporting walls and posts, etc. o exits on three-story dwellings (Sec. 3303 & see Mezannines - 1716). is access and ventilation (Sec. 3205). nderfloor access and ventilation (Sec. 2516). ombustion air for fuel burning appliances. ' N ise requirements on duplexes. dobe soils - special foundation design. Retaining walls requiring design. usual shape, size, or split level house requiring lateral design. Flashing at all exterior openings. SGS- Wil" •4. BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM (One +Form per Building) A.P. Number'" - /. Building Department No. ....�.. School District�f(9V1� (1t)fj'City Q County W Jurisdiction Property Owner Tro V Crx r ,f6 1 f Project Location/Address r,�� ICU Subdivision Residential Development: P I a # of Living MHI Units Commercial/Industrial: U Lot Number aSq. Footage Addition (Group R) DSq. Footage New Addition (Including Exterior Roofed Areas) Building -Department Representative `C Date (Floor Plans reviewed by School District Personnel) District Id No. School District certifies that ('Applicant Name) - (Phone Number) (Street Address) ('0'"14k (City) (State) (Zip Code) has complied with the requirements of Resolution No. �?6%-/� by the payment of $ �.s representing square feet. a, 4. -j ayj, �.� %/�� School Dist'"'t Representative Date PAID BY CHECK NO. /�-� REMARKS: BANK NO 3 PAID BY CASH white -applicant, yellow -building department, pink -school district SCHOOL.FEE (8/88) n 0 N } STATE OF CALIFORNIA Butte }ss. COUNTY OF } On April 26, 1990 before me, the undersigned, a Notary Public in and for said State, personally appeared James T ... Car personally known to me (TG44Sp4A��gPSlh��4s1�t?ttq Maloi MOMOM to be the persorQe) whose name(;kis/jMsub- scribed to the within instrument and acknowledged to me that hE=eMff executed the same. °D WITNESS my hand and official seal. m ors `° i Signature +. • OFFICIAL SEAL SANDY A. STACK NOTARY PUBLIC -CALIFORNIA Principal Offlos in Bum County P Commission Ex IEa DEC 71993 p ® • ® 0 • '• • WO • 4p,• 0 • • (This area for official notarial seal) AFFIDAVIT OF COMPLIANCE WITH COUNTY CODE SECTION 24-202 (A)(3) , TO BE RECORDED BY OWNER (ADDITIONAL DWELLING IN SINGLE FAMILY RESIDENTIAL ZONES) Applicant _'�psrylEs -- C, � Date 4-5-0/0 Zone AP .# 133 - / Building Permit # I, l do -declare, that the dwelling (Building Permit # ) at'address (present) -4-cx r i d . on AP # rn — s intended for the sole occupancy of one adult or two adult persons who are 60 years of age or over, and the area of floor space of the dwelling unit does not exceed 640 square feet. Said property is more particularly described in Exhibit "A" attached hereto. I also understand that violations of these provisions are subject to the penalties provided in Section 24-63.1 of the Butte County Code. Signed `1/L4 . Dated Yt. TTE = DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTE i :;IVE - OROVILLE, C,^,;LIfj2RNIA 95965 - TELEPHONE: (916) 538-7511 AGRICULTURAL BUILbiNG EXEMPTION PERMIT PERMIT NO. Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticulutral products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a place used by the public. ASSESSOR PARCEL NO.- J� / ! C> FLOOD ZONING AK P.D.ROOFING OWNER T OZ PHONE NO. DRESS OWNE;No�2 I LOCATION OF BUILDING D�le1 ,fid USE OF BUILDING SIZE OF STRUCTURE TYPE OF CONSTRUCTION: WOOD FRAME STEEL CONCRETE OTHER (Specify) TYPE OF SIDING ROOF COVERING FLOOR TYPE >axoo fE � G EtC ESTIMATED COST CONSTRUCTION 460® $ AG Buildings shall comply with the building front, side, and rear yard requirements of the applicable County Ordinances as followss-,.,o , ^�M � Ay �r `v Ir i FRONT SIDES REAR AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a mobilehome, and 23 feet from a commercial building. AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a mobilehome, and 40 feet from a commercial building. I declare under penalty of perjury that the building will be used as stated above and the proposed use conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Department of Public Works and will obtain any necedsary permits, inspections, and approvals to comply with the requirements in effect at that time and before occup Y. Date Z 9� Signature of Ow er Permit F e - $25.00 The above described Building is exempt from a building permit. Receipt No. 6'10'-s Director of Public Works By White - DPW, Yellow - Assessor, Pink - B.I., Goldenrod - Applicant FLOOD PARC P.D.ROOFING ISSUE I I Director of Public Works By White - DPW, Yellow - Assessor, Pink - B.I., Goldenrod - Applicant COUNTY OF BUTTE - DEPARTMENT 0 P'UBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE--OROVIi&-%9ALURNIA 96966 - TELEPHONE: 916/636-7641 PERMIT APPLICATION DATA SHEET Permit No. �r OWNERS 1/ A. P. No. �y" "�3t Proposed Building Use,Id.4 Building Inspector Date 4 �� ti At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: i DATE RECEIVED APPROVED 1. All items have been submitted. .......... 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form ........................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ............... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13. School District fees paid .............. 14. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 26. 27. When you issue the permit process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at 2 of ice. Deliver. w/inspector. Other / Appli nt __A(.Date Copy of Haz- Mat form sent Health Dept. ire D pt. Air Pollution Date )' Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new 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—naiI—counter by ..date Contractor, designer, owner, was advised of above required data by_phone_mall_couriter by date 4t t Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet J AP folder ___ Copy—DPW COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE 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. Date—/ // y ` //�� Inspector i 6) 11111, Y CcnLet. UI'iVC, Ih_uvi I1 CAA 95965 ('hone: 916-538-714.1 Ef:fectivc 9/16/91 BUILDING PERMIT FEES The determination of value or valuation for Lite purpose of establishing fees for new construction shall be made using Lite most recent ed'i.tion of the Building Valuation Data Chart, as published in "The Building Standards Magazine" published by the International Conference of Building Officials, rounded off to the nearest dollar. The determination of value or valuation for other than new construction shall be made by the Building Official based upon a reasonable estimate of the cost of. construction. The valuation for new and other construction shall be the total value of all construction work for which a permit is issued as well as finish work, painting, roofing, electrical, plumbing, heating, air conditioning, and other permanent work or equipment. The building permit fees for factory -built housing shall be computed in the same manner as for regular building construction except that the fee shall be one-half (1/2) of the building permit fee determined by the following table. In addition to the following building permit fees, a $15.00 filing fee and a plan checking fee of one-half (1/2) the building permit fee ($20.00 minimum) will be charged. $1.00 to $500.00 ------------ $ 15.00 $12,001.00 to $13,000.00 ---- $120.00 $501:00 to $600.00 ---------- $ 16.50 $13,001.00 to $14,000.00 ---- $127.50 $601.00 to $700.00 -------'$ 18.00 $14,001.00 to $15,000.00 ---- $135.00 $701.00 to $800.00 --------- $ 19.50 $15,001.00 to $16,000.00 ---- $142.50 $801.00 to $900.00 ---------- $ 21.00 $16,001.00 to $17,000.00 --- $150.00 $901.00 to $1,000.00 ------- $ 22.50 $17,001.00 to $18,000.00 --- $157.50 $1,001.00 to $1,100.00 ----- $ 24.00 $18,001.00 to $19,000.00 ---- $165.00 j $1,101.00 to $1,200.00 ------ $ 25.50 $19,001.00 to $20,000.00 ---- $172.50 $1,201.00 to $1,300.00 ---- $ 27.00 $20,001.00 to $21,000.00 --- $180.00 $1,301.00 to $1,400.00 ----- $ 28.50 $21,001.00 to $22,000.00 ---- $187.50 $1,401.00 to $1,500.00 ----- $ 30.00 $22,001.00 to $23,000.00 ---- $195.00 $1,501.00 to $1,600.00 ----- $ 31.50 $23,001.00 to $24,000.00 --- $202.50 $1,601.00 to $1,700.00 ------ $ 33.00 $24,001.00 to $25,000.00 ---- $210.00 $1,701.00 to $1,800.00 ----- $ 34.50 $25,001.00 to $26,000.00 --- $216.50 $1,801.00 to $1,900.00 ---- $ 36.00 $26,001.00 to $27,000.00 ---- $223.00 $1,901.00 to $2,000.00 ---- $ 37.50 $27,001.00 to $28,000.00 ---- $229.50 $2,001.00 to $3,000.00 ----- $ 45.00 $28,001.00 to $29,000.00 ---- $236.00 $3,001.00 to $4,000.00 ------ $ 52.50 $29,001.00 to $30,000.00 ---- $242.50 $4,001.00 to $5,000.00 ------ $ 60.00 $30,001.00 to $31,000.00 ---- $249.00 $5,001.00 to $6,000.00 ------ $ 67.50 $31,001.00 to $32,000.00 ---- $255.50 $6,001.00 to $7,000.Ob ------ $ 75.00 $32,001.00 to $33,000.00 ---- $262.00 $7,001.00 to $8,000.00 ------ $ 82.50 $33,001.00 to $34,000.00 ---- $268.50 $8,001.00 to $9,000.00 ------ $ 90.00 $34,001.00 to $35,000.00 ---- $275.00 $9,001.00 to $10,000.00 ----- $ 97.50 $35,001.00 to $36,000.00 ---- $281.50 $10,001.00 to $11,000.00 ---- $105.00 $36,001.00 to $37,000.00 ---- $288.00 :v eowd*, J. . a OROVILLE, CALIFORNIA GENERAL . CLAIM ` CLAIMANT:' ADDRESS: CITY 8 STATE: 'IMPORTANT: SEE INSTRUCTIONS ` DATE OF CLAIM: ON REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR ";SERVICES ` DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY` TO AVOID DELAY) �• AMOUNT • � t TOTAL ~services ' I, the , undersigned, declare under penalty of perjury that the or articles claimed heve,been� f5rtned r delivered, and 'that this ^ - claim is true and correct as stated. r- Dated this `• day of •,Sr 19et alif. .... ............................ --... - .................... ....... .............. .....��,.. .. .................... .. ................... ' / Signature of •Claimant - ' I. the undersigned, hereby certify that,Fto the best of my knowledge—:the services or articles specified above have been performed or de - livered, and that there is a Budget Appropriation (� or Specific Hoard Approver (Check one) for'the same. - 1 ............. ............................, ....... .................... • Dated this ....................... day. of 19 at ....,.. , Calif...........................................".-.................................. :...... _ - - - '• Department Head or Authorized Deputy - Dept. _ Exp. - .Code ............................................ Code .................,.............................PAYABLE FROM............................................................................................ FUND DO NOT WRITE BELOW THIS LINE — AUDITOR'S USE ONLY DEPT. & SUB. PROD. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSS AMT. INSTRUCTIONS IU CLAIMANTS All claims against the county must be itemized, giving dates and character of service rendered or work performed, quantities, de- scription and unit prices of articles furnished or delivered. . Claims must be certified by the claimant and submitted to the De- partment head for approval. Upon approval the Department head will forward claim to County Auditor for payment procedure.. Do not file with the County Auditor first. Claims should be presented to officials for approval immediately upon completion of services requested or material ordered. Claims are paid every Tuesday; however, same must be approved by officials and in Auditor's office before preceeding Wednesday noon. Compliance with above will expedite payment of claim, failure to do so may delay payment considerably. &Unfa- -r3u .- . OF OROVILLE, CALIFORNIA GENERAL CLAIM CLAIMANT: Jay Carter ADDRESS: P.O. Box 1862 CITY & STATE: Oroville, CA 95965. IMPORTANT: October 2, 1990 SEE INSTRUCTIONS DATE OF CLAIM: ON REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT Owner has decided not to do work. Permit #1166-90B,P,E,M, Receipt #64090, dated 4/18/90. Total Permit Fees Paid -----------------------=----'--$429.90 Retain Plan Checking Fee -------------------- $92.00 Retain Energy Plan Checking Fee------------- 15.00 Retain Building Permit Filing Fee----------- 10.00 Retain Plumbing Permit Filing Fee -----------!-0-.00 Retain Electrical Permit Filing Fee--------- 10.00 Retain Mechanical Permit Filing Fee --- ;.-----10.00 Total Permit Fees Retained--------------------------- 147.00 . TOTAL REFUND DUE------------------- ;' ` TOTAL $282 90 I, the undersigned, declare under penalty of perjury that the services or articles claimed have been peyfoed or delivered, and that this claim is true and correct as stated. %� Datedthis /�% day of Qe 19 �0, at jlifC?.P., �i . a fi....,,r............................................ igneture of Claimant I. the undersigned, hereby certify that, to the. best of my knowledge, the services or articles specified above have been performed or de- livered and that there is a Budget Appropriation O or Specific Board Approval ❑ (Check one) fo he same. Dated this,,,,,2nd...................... day of .....October._, 1990 at Oroville Canf. ............................... /...... ..... ................ epartment Head or Authoriz eputy Dept. Exp. < .. . Code — Code Q5 n PAYABLE FROM ' COn tructi.on Permits �k�kQ...QQ2..................... ...4��51 1.Q.N............................................................................................................. FUND DO NOT WRITE BELOW .THIS LINE — AUDITOR'S USE ONLY DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. iNO. INV. DATE ENCUMB. GROSS AMT. / 1 C/Vetj 6 PA mads. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovil)e„California 95965 - Telephone: 916/538-7541 APPLICKTION-AND PERMIT j PEER/MIT NO. ASSESSOR PARCEL NUMBER 68-36-136 ZONING BUILDING PERMIT OWNER Jay Carter TELEPHONIE 533-9199 SO. FT. OCC. BUILDING VALUATION 636 R 25,440 OWNER'S MAILING ADDRESS P.O. Box 1862 Oroville 95965 92 CON, 920 CONTRACTOR'S NAME owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace I A = 1,000 CONSTRUCTION LENDER none UNKNOWN Total Valuation $ 27,360 Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 184.00 ARCHITECT OR ENGINEER none LICENSE NO. Plan Checking Fee $ 2.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS'15,00 Penalty $ BUILDING ADDRESS 22 Fox Ride Rd. Permit fee $ 301.00 PLUMBING PERMIT Filing Fee 10.00 Each Trap 4 2.00 Oroville Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME . PARCCEL MgP II��L Water piping 5.00 Each pas water heater or vent 5.00 USE OF STRUCTURE SF 9 Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G W 10-00ea TYPE OF WORK New RR Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: 600640 _ Permit Fee $ 38-00 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 I declare under penalty of perjury (Check One): ©< am licensed under provisions Of Chapt. 9, Div. 3 of the Business and Profesg,pns Code and my license is in full force and effect. / YY S934-23 License No. J�k��J 7 Classification �— �� ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. (DWELLING occ) .eke OR ADDNS. ACC. BLDG S. 2y2¢sgft NEW CONSTR.MULTI-OUTLET NON-RESID BRANCH CIRC ITS 2,50 ea POWER APPARATUS & (SINGLE OUTLET CIR. Ex. Occup(ou XED TS OR FIXTURES z0@s0a aAL030 PR Ex. Occup. OUTLETS IRESID 1EA.1 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. 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. Z].,,.�hali not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating 6.00 NAT. GAS Cooling 6.00 Hood 3.00 3.00 Ventilation permit Fee $ 25.00 Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County or 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 i'ities, Judgments, costs, and expenses which may in any way accrue a i t said my in co sequence of the granting of this per it // v 'Date S 1nature 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 lin height. Mobile Home Installation Fee $ Energy Inspection Fee $ 30.00 c c NST TYPE ��/ TOTAL FJEE $ 429.90 HAz CUA PARK scH FLD A PDJK1 Issu This permit is hereby issued under sions of the Butte County Code and/or work indicated ab e f r which fees I TO OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date��^ '2- Receipt No. C� / WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT PERMITAPPLICATION DATA SHEET VISION / �1 Permit No. ¢ OWNER�qr A. P. No. Proposed Building Use Building Inspector 42V Date At time of permit application, I was advised 'the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . ........................ .......... 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by'preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ............... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... C1312. Parkes paid .................................. . `�'ro ► r(� �c�n� S hoot Distri�jt fees paid .............. Sanitation approval from —(� 0(9 L/i �/ a 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 .................. W. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) .... . zff�,24. Recorded copy of Agricultural Acknowledgment Statement ......... Lett%of ig nature authorization ..........:....................... . 26. (o OZ 0 E D r lf� t? 1 0 27. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephonei�131(% 9�_ and hold for pickup at CIM office. Deliver w/in'spector. Other 1___71 lr;— r Copy of Haz-Mat form sent Health.Dept. Fire Dept. _ Copy of plans sent Health Dept. -/—Fire Dept. —Other The following data must be submitted prior to permit issuance 1. Index permit for above items No. 2. Additional items required: Date_z_'�/' Ol/O T it Pollution Date' pf:�-' ,/D,ateO By — w item�not chgckedabove). Contractor, designer �,wneras advised of above required data by—phone _ n_ aiI—counter by---!;5..date SJ / Contractor, designer, owner, was advised of above required data by —phone _maII—counter by date Plans checked by Date Plans approved by Date �a Sets of,plans on hold in File cabinet AP folder 4 Copy—DPW l91 N 0 1h(Rev.12/96) 1 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 o APPLICATION AND PERMIT CZE"�5gko� u ASSESSOR PARCEL NUMBER 068-360-136 ZONING 1 BUILDING PERMIT TELEPHONE SQ. FT. OCC. BUILDING VALUATION .OWNERS MAILING ADIfREP 22 FMIDGE ED, 01ROVITTE 95966 CONTRACTOR'S NAME TELEPHONE CONTRACTORS MAIUNG ADDRESS ERMO DR, OR 9596r, -01.111-1-F CONSTRUCTION LEND ER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS 2DROVE Energy Plan Checking Fee $ $ PERMIT FEE S LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY 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 ❑ Utilities ❑ installation ❑ Other ❑ Describe Work: INSTALL ELECTRIC TO SUPPLY WATER SPRINKLERS—ADD CIRCUIT Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I s I G w 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service '"a, OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class C � Lic. No. iJ �(0 D 1 � O NER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST. DW EWNG OCCUP. OR ADDNS. ( s qCC. eLns. s° 3.5¢FT; Ipµq°ESID. MULTI.OUTLET 97.50 POWELER APPARATUS 8 SINGOUTLET CIR. OUTLET OR FDLTURES Ex. Occup.SAL p ,50 Ex. Occup. o EEDTSA R °� 1 1 5.00 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 J_ PERMIT FEE $ 25.00 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permitis issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) �I I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X Date %� -��— d Signature of pp' nt - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavatio ver 5'0" and demolition or construction of structures in i Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE S Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 25.00 HAZ. IMP FLOOD IS E • permit is hereby issued under the applicable provisions of Butte unty Code and/or Resolutions to do work in ed a e f i h fees have been paid. B Date PERMIT EXPIRES ON D Dat ., I COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive -Oroville, California95965•Telephone (530) 538-7541©Z , . (Rev.12/96) APPLICATION AND PERMIT J (� ASSESSOR PARCEL NUMBER 0 ,) / TONING BUILDING PERMIT OWNER .4 If }}7. ���/� TELEPHONE SQ. FT. I OCC. BUILDING VALUATION R ��rm CONSTRUCTION LENDER LENDER'S MAILING ADDRESS ARCHITECT OR ENGINEER ARCHITECT OR ENGINEER'S MAILING ADDRESS BUILDINGADDRESS .If �—/ i , Y_ LOT NO. I SUBDIVISION'S NAME USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other TYPE OF WORK New ❑ Addition ❑model ❑ U61�s ❑ Installation 13H i ,, PERMIT FEE PAID $ SRA $ SHERIFF $ OTHER $ AMOUNT RECEIVED $ DATE RECEIVED 0// O RECEIPT L■ Total Valuation is PERMIT FEE S Filing Fee $ 20.00 Permit Fee • $ Main Service Plan Checking Fee $ Main Service Energy Plan Checking Fee $ NEW CONST. OR A.M. DwEu�1G OXx:UP. 8 ACC. BLcc $ NEW COW . / NN O.amin _ 1 PERMIT FEE $ PLUMBING PERMIT Fling Feel 20.00 Each Trap 1 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S G I W I I 1 @20.00 Ex. OCCU . OUTLET OR FIXTURES PERMIT FEE S ELECTRICAL PERMIT I Filing Feel 20.00 23.00 Bon os ft:s 1 23.00 Main Service 23.00 I ROOD Main Service 200A TO 1000A 46.00 NEW CONST. OR A.M. DwEu�1G OXx:UP. 8 ACC. BLcc 3.5ttso NEW COW . / NN O.amin _ 1 �o ULTI.OUTLET . �O 7.50 Ex. OCCU . OUTLET OR FIXTURES aAL @ .so Ex. Occu D=APPLN o0 01A. � 5.00 S ` Temporary Service 23.00 Mobile Home Facilities 20.00 Wisc. Wiring 23.00 I ROOD I CDF PERMIT FEE $ r MECHANICAL PERMIT Filing Fee 20.00 Hood 6.50 Ventilation PERMIT FES S Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ HAZ. I D. FEES I IMP I ROOD I CDF FPARcEL I PD I HD I 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 Date COUNTY OF BUTTE Oroville, California GENERAL CLAIM CLAIMANT: ADDRESS: CITY & STATE JAY CARTER P.O. BOX 884 OROVILLE, CA 95965 DATE OF CLAIM: 8/6/96 SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERV/CES IMPORTANT. - SEE INSTRUCTIONS ON REVERSE SIDE DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT B.P.#95-1822, AP.#068-360-136 RECEIPT 180761 & 180944 OWNER : JAY CARTER TOTAL AMOUNT PAID.....................................$1026.40 RETAIN REFUND PROCESSING FEE ................. 25.00 RETAIN FILING FEES ...........................$ 80.00 RETAIN ENERGY P/C FEE ........................$ 23.00 RETAIN PLAN CHECK FEE ........................$239.85 RETAIN SRA PLAN CHECK ........................$ 43.00 TOTAL AMOUNT RETAINED .............................$ 410.85 TOTAL AMOUNT TO BE REFUNDED.. TOTAL $615 .55 I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is true and correct as stated. c� Dated this �l day of -L� 19 /at c._i'%r�r"` r: (_r% Calif.` V Signature of Claimant c I, the undersigned, hereby certify that, to the best of my knowledge, the services or articl specified abo a ha been performed or delivered and that there is a Budget Appropriation I I or Specific Board Approval I I (Check one) for t e Dated this 6TH day of AUG. , 19--6at OROVT_LLR Calif. epartment Head or Authorized Deputy 440-002 4210500F CONSTRUCTION PERMITS Dept. Code Exp. Code AA PAYABLE F OM FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSS AMT. r FOR BUILDING DIVISION USE: Receipt Information: Number: Date: Issued. To: Amount: $ Fees Retained: - Processing Fee: $ ✓Bldg Filing Fee $ • VPlbg Filing Fee $ oZ0•Do %/E1 e Fi ling `Fee $ O i/Mech Filing Fee $ o2y • Od r/ Energy P/C Fee $ CAI. c� V/P1 an Check Fee .. ✓ S. PA Pc4nl CFtIL� o o 0 ti Inspection Fee $ 4 Total Amount Retained TOTAL REFUND DUE �- 3° �� r ^REFUND CLAIM APPLICATION CLAIMANT'S NAME _ ,4 v� �Q r 2 Y' MAILING ADDRESS 0 ASSESSOR PARCEL # J 6 S — 3 -?(a PERMIT # RECEIPT NUMBER(S) -J�� %/_1' Request a refund of fees paid on the above receipt number(s) for the following reasons: 6,z::8rz 4,� eo &S C//cam/ Please refund any applicable fees in the following categories: (Check those categories which you wish to have refunded.) [� Building Permit Fees [ ] Sheriff Fees [ ] SRA Fee (CDF Fire Planning) [ ] Urban Area Fees Disposition of plans: [ ] Plans returned to me at counter. [ ] Please mail plans to me at above address. [ ] Please dispose of plans. SIGNATURE DATE COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541,0 ,. /oP�T NO. APPLICATION AND PERMIT O ASSESSORPARC0.NUMBEA ZONING BUILDING PERMIT OWNER �' TREP4074E 5" 3 SO. FT. OCC. BUILDING VALUATION - OWNERSJ , D SS �� �,I�vli �� ` (JV YTELEPHONE CONTRACTOR'S NAME S33 CONTRACTOR'S MA LINO ADDRESS Fireplace CONSTRUCTION LENDER UNI(NOWN Total Valuati n $ Filing Fee 20.00 $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ Q ARCHITECT OR ENGINEERS MAILING ADD ESS Penalty $ o BUILDING ADDRESSj^ B'Z� l PERMITFEE $ PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7.00 ' LOT NO.SUBDNISION'S NAME PAR Solar or heat pump water heater 23.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 100 Each gas water heater or vent 15.00 6 Gas p 9 Y piping In system 1 - 5 outlets 15.00 ' S DO Building sewer 15.00 , TYPE OF WORK New Addition ❑ Remodel ❑ U'lities ❑ Installation ❑ Other ❑ Describe Work: tJ Mobile Home S G W 920.00 PERMITFEE $ D Contractor ELECTRICAL PERMITFilin Fee 20:00 Main Service 200OR LESS ( 20O 00AoR LEss ) 23.00 D Main Service ( 200A To 1000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class - Lic. No. so 6193'1 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 NEW CONST. DWELLING OCCU OR ADONS. ( a ACC. BUDS. SD. 3.5¢ NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) �. 97.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CIA. Ex. Occup. ( OUTLET OR FUTURES ) 20 Q 1.00 BAL .30 Ex. Occup. ( OUTLETS PRESID.)e,a) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor v WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 Heating IL ©O Cooling�D Hood 6.50 Ventilation PERMITFEE $ _ Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall o hwith cc ly with those provisions. X Date ll Sign r of Ap licant - [ Owner Contractor ❑Agent Ot An OSH permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in he'ght. Mobile Home Installation Fee $ 0 Energy Inspectio Fee$ c Ns PE TOTAL FEE HAZ. D. FEES IMP _ FLOOD DF P 0. PO HD SUE This permit is hereby issued under the of the Butte County Code and/or Resolutions indicated above for which fees have BY PERMITEXPIRESON applicable provisions to do work been paid. Date (Date) rRNo. 87Q, Q� .D.S.• .D. CANARY -ASSESSOR K -INSPECTOR GOLDENROD -APPLICANT ,'1 ��.,'+A.,,"N�'IT�tI'YF,�+iir�'l�'"�T'�"`�'R'Ri"'`v".�3� :i"'F''7if�'y"�""'•`NqI"•-I7���wt'I++�4�.i'i�v�t'i"'y�,}�' ,t°'t'hk*1a� lfl"�X.�-„�1�r.�y,�'1r��rM 5�'�n'�?r�r'.Y. -C.OU:NTYOF BUTTE - DEPARTMENTOF DEVELOPMENTSERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541 A4{ ON DATAPERMIT APPLICTSHEET NER 1i . s, t,� w t (� e y4x i C;,,7 - A. O. �s� NProposed:Building Use. . rBuildin' Irispector -Date At time of permit application, I a advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY All items have been submitted. . ~1 Plot plans; 3/$ set's; signed Liy preparer of plans. . . 3. Complete plans, *4 sets, signed by preparer of plans. :.................... . 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. i tHazard 5.us Material Fornc-. ... Er µsg CorfPneIia ;�nd suplotiri9 -7........ . ;Statement of Intent for Non -Heated and A/C Buildings . ..............1....... . 8. Engineered.truss details and layout in duplicate (required prior to plan check). . b'Ih A S^' ,,_• o i . f t ' ' tllt• ' t fp 2 te ome a a an eua ure s insaa 1 rins, se s. ees � s gs ' Impact fees as shown on attached schedule. . . i. 12: alifornia Department of Forestry plan approval/ es.i✓�?!D...�3 .9 ` Flood elevation letter (100'year floo� by Cppfornia En ineer. ........ �—- 4. Sanitation and plot plan approval &6Vi((,o Health Department. 15. City of Chico plumbing permit. ..... �...:.. �`.. 3'.. . f=16: Plot plan and business license approv. / om City of Biggs/Gridley........, .'..... r -Planning a rov le se: fi 'Contact:L .Development abou (A) Improverien� rtB) Drainage. . 19. Driveway permit (constructs pproua�required prior to occupancy.) .. . ` ... . ^ Ire -Inspection request Pre -inspection for required`lnspeorr (Date); 21 Contractor's license information. No., Name Style, Classification). .: ` 22:' Certificate of Workmans Compensation lnsurance� >� ` `�-...,._'...... ' ..... a, r }K Owner-Builder Verification (Given to owner jMail to owner _). ......... . Owner ed copy of Agricultu,al,Acknowledgemenf`Statement. ...... Letter,of signature authorization. .......... r ........... f r _,. 'r"......... 26.E Copy, of'recorded deed of parcel creation and 60 right of way to a public road. ..... j I 27. Letter of intent on building use. .. ............................. Mobilehorne utility'clearance. 29. Documentation of legal access. ......:.........:........:.. .:....... l - 30..Documjentation of 50% subdivision developed or (A) Road improvements.,completed ' -4, and (B) Parcel meets zoning area and frontage requirements. .E' . ... . 31. Existing violations/expired permits . ........................ ....... ....... 32. Plan check list. ......I ............................. !/ .............;.. � - 33 $ d� , 34 , t When u issue the permit, process as follows: Mail to owner. Mai to contractor. Telephone — and hold for pickup at 1 Affibe. Deliver with inspector. - Other Parcel Creation4 --. i Acreage Appli ac and Date . Copy of Haz-Mat form sent Health Dept. Fire Dept.'-&' Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date The following data must be submitted prior to 1. Index permit for above items No. 2. Additional items re iced: ircle new checked above). Contractor,,designer, owner, was advised of above required data by _ phone`_ mail Contractor, designer, owne ,was advised of 'above required data by _ phone _ mail Plans checked by �� Date'_ -/6 Plans approved by Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works Counter by _ Date Counter by _ Date Date TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance E.H. USE ONLY _ Plot PI= Amched Fkm Phm Attached Sect to B.D.�� � �^ cam' /. �A2-1a?,cw Owner LocationAP# Plan' Approved for: Sewage Disposal Water Supply: Public Private Well Clearance for bedroom ho e. Other 17cu 4—: -t -c- f, Av C. Hold final for: Final clearance O.K. for: NOTE: G? Environmental Q/011 _/ —"'91" - Date "' .Date COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541ERMIT NO. APPLICATION AND PERMIT �s-� ASSESSOR PARCEL NUMBER 068-36-136 ZONING BUILDING PERMIT OWNER JAY CARTER TELEPHONE 533-9199 SQ. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS P0 BOX 884 DROVILLE, 95965 CONTRACTORS NAME PCARTER TELEPHONE CONTRACTORS MAILING ADDRESS SAME Fireplace CONSTRUCTION LENDER NONE UNKNOWN Total Valuation is Fling Fee $ 20.00 LENDERS MAIUNG ADDRESS NONE Permit Fee $ ARCHITECT OR ENGINEER JAY CARTER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ — ARCHITECT OR ENGINEERS M, IUNG ADDRESS Penalty $ BUILDING ADDRESS PERMITFEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP Solar or heat pump water heater 23.00 USE OF STRUCTURE SF C� Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New IN Addition ❑ Remodel ❑ Utilites ❑ Installation ❑ Other ❑ Describe Work: 60/640 Mobile Home I S I GI W @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filina Fee 20:00 Main Service OOOV OR LESS \ ( 200A OR LESS J 23.00 Main Service ( 200A TO t000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class "I[� Lic. No. 3 `9 k-, �.3 r OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law fpr -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 NEW CONST. DWELLING OCCUR OR ADDNS. ( 8 ACC. BLOS. ) SO. 3.5¢ FT. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 ( POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup. (OUTLET OR FUTURES ) 20 BAL so Ex. Occup. (OUTLETS(RES D.) EA ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE g Contractor WORKERS' COMPENSATION DECLARATION 1 here ffirm under penalty of perjury one of the following declarations: Er I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' co nsation laws of California, and agree that if I should become subject to the ork s' compensa ' provisions of section 3700 of the Labor Code, I shall fort ith comply it t se provisions. /� — X �/L.._G _ Date Sign ure of Appfi nt- �d' Owner ❑ ontractor ❑ Agent An SHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ HA2. I D. FEES I IMP I FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the of the Butte County Code and/or indicated above for which fees have By PERMITEXPIRESON applicable provisions Resolutions to do work been paid. Date (Date) Receipt No. 180761 — 848.40// WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT - ,.. .., .. , :rA.�.x, ^wwM'^��..tn-viY� 7.Y'*r:'`^►^-Tr,7. gyp..• r {.. .. ._r,. Y..ji'-•-••ry •.�-...,,;p'�2 �:/. ., ... y COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION., . ' 7 County Center Drive - Oroville,, California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT 9S -fig ASSESSOR PARCEL NUMBER 068-36-136 . 'f ZONINGA BUILDING PERMIT OWNER -' JAY CARTER TELEPHONE = .531 9199 SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS P , CONTRACTOR'S NAME JAY CARTER TELEPHONE ' CONTRACTORS MAIUNG ADDRESS SAME Fireplace CONSTRUCTION LENDER NONE UNMOWN Total'Valuation Is ' Filiri`g Fee $ 20.00 LENDER'S MAILING ADDRESS 'N Permit Fee $ ARCHITECT OR ENGINEER TF LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS ( - ' Penalty $ BUILDING ADDRESS PERMITFEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. ' % d SUBDNISIONS NAME PARCEL' MAF y. ,' � � Solar or heat pump water heater 23.00' USEOFSTRUCTURE SF ICK Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each.+gas water, heater.,�or.vent, _ 15.00 Gas'piping system 1 - 5 outlets 15.00 Building sewer - 15.00 TYPE OF WORK New . %�. Addition ❑ Remodel ❑ Utilities ❑ Installation Other ❑ Describe Work: - 60 '6 _ Mobile Home S I G W @20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filina Fee 20:00 Main ServiceOOOV OR LESS ( zooA OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code,( and my.license is in full force and effect. License.Class /� Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law fpr—the following reason: 751,1, 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 t�onstruct the project. ❑ f 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: 6007 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 woik for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier NEW OR ADCDNSST. ( D & LLINACCOCCUR •BLDS. ) so. 3.52 . NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 ti POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup. (OUTLET OR FIXTURES) zo p 1.00 BAL so P FIXED OR Ex. Occup. (OUTLETS RESID.) E0.) (REST 5.00E Temporary Service 23.00 Mobile Home Facilities' 20.00 Misc. Wiririg•. , 23.00 PERMITFEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' co - nsation laws of California, and agree that if I should become subject to the ork is' compensaa provisions of section 3700 of the Labor Code, I shall fort ith comply With th se provisions. X __ ___ Date Sig ure of Applicant - Owner ❑ Xontractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy InspectionrFee Is occ t ; CONST.' PE TOTAL FEE $ HAZ. D. FEES IMP FLOOo Y COF" PARC_E, PD HD ISSUE This permit is hereby issued under the of the Butte County Code and/or indicated above for which fees have By PERMITEXPIRESON applicable provisions Resolutions to do work been paid. Date (Date) Receipt No. 180761 — 848.40// WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT -OF. DEVELOPMENT SERVICES - ; 7 County Center Drive - OroviI6, .California 95965= Telephone APPLICATION AND PERMIT BUILDING DIVISION (916) 538-7541 t,-), c�PERMIT NO. Jr ASSESSOR PARCEL- NUMBER 068-36-136 ZONING BUILDING PERMIT OWNER JAY CARTER TELEPHONE 533-9199 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS Pa BOX 884 OROVILIE,95965 CONTRACTOR'S NAME JAY CARM TELEPHONE CONTRACTORS MAILING ADDRESS RAME Fireplace CONSTRUCTION LENDER Now UNKNOWN Total Valuation Is Filing Fee $ 20.00 LENDER'S MAILING ADDRESS NONNE Permit Fee $ ARCHITECT OR ENGINEER JAY CARTER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDING ADDRESS PERMITFEE $ PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDIVISION'S NAME PARE' MAP '�". Solar or heat pump water heater 23.00 USEOFSTRUCTURE SF J Duplex ❑ Mobilehome ❑ Other SPECIFY Water I in piping p 15.00 Each1 gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New VAddition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: 60/640" w Mobile Home IS I GI W I@20.00 PERMITFEE $ Contractor ELECTRICAL PERMIT Filina Fee 20.'00 Main Service000V OR LESS ( 200A OR LESS / 23.00 Main Service ( 200A TO 1000A ) 46.00 H° LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my. license is in full force and effect. --7 License Class � e? Lic. No. 3`9 I� W J ! ' OWNER -BUILDER DECLARATION ) I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law fo..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 t�construct the project. ❑ I am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUR OR ADDNS. ( a ACC. BLDS. ) SO. 3.S¢ FT. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 'rt ( POWER APPARATUS ) 8 SINGLE OUTLET CIR. Ex. Occup.OUTLET OR FIXTURES ( ) 20 Q 1.00 aAL 'O Ex. OCCU FIXED P(RESI OR p• (OUTLETS (RESID.) EA) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ Contractor WORKERS' COMPENSATION DECLARATION 1 hereby -affirm under penalty of perjury one of the following declarations: 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 woik for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the /workerscompensationgprovisions of section 3700 of the' Labor Code, I shall �fort ith comply with those provi� X �✓?i+ ��_ _ Date Sig/ ure of Applicant - Owner ❑ Xontractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee Is Energy Inspection Fee Is ;occ coNsr. rrvE TOTAL FEE $ I HAZ. D. FEES SMP F ,LOOD CDF PApCEL,, _ , PD HD ISSUE This permit is hereby issued under the of the Butte County Code and/or indicated above for which fees have By PERMITEXPIRESON applicable provisions Resolutions to do work been paid. Date (Date) Receipt No. 180761 — 848.40// WHITE-D.D.S.-B.D. CANARY -ASSESSOR • PINK -INSPECTOR GOLDENROD -APPLICANT ''}�',... I. _ COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 (::: PERMIT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 068——13Ci ZONING I �; r . BUILDING PERMIT OWNER JAY MIER TELEPHONE 535✓ -91 SO. FT. OCC. BUILDING VALUATION OWNERS MAILING ADDRESS MO LE �596" M BOX 884 CONTRACTOR'S NAME JAY CARTER TELEPHONE ,,CONTRACTORS MAILING ADDRESS qAt-w-, Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is LENDER'S MAILING ADDRESS NOW Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER ' Y GARTFP UCENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDINGADDRESS PERMITFEE $ PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 LOT NO. SUBDNIS ION'S NAME PARCEL MAP ' i + Solar or heat pump water heater 23.00 - USEOFSTRUCTURE SF O Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 TYPE OF WORK New Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ u Describe Work: 60/640 Mobile Home I S I GI W 1 920.00 PERMITFEE S Contractor ELECTRICAL PERMIT - Filinq Fee 20.'00 Main Service a00V OR LESS ( 200A GR LESS ) 23.00 Main Service ( 200A TO ,000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. w , License Class / Lic. No. '; ,. F ' OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for, the following reason: `I 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 tofConstruct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUP. OR ADDNS. ( a ACC. BLDS. ) so. 3.50 FT. NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) 97.50 ( POWER APPARATUS ) a SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 00 B20 @ I.50 Ex. Occup. OUTLETS (AES D.OEA ( ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring . 23.00 PERMITFEE $ Contractor WORKERS' COMPENSATION DECLARATION 1 hereby. affirm under penalty of perjury one of the following declarations: [7 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMITFEE $ Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shallTOTAL not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the ,workers' compensation`; provisions of section 3700 of the Labor Code, I shall forthwith comply,.with those provisions. X--•_.=/- ���.`..__ _ Date Sig 5afure of Applicant - Q Owner ❑ ,retracto_r ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE FEE $ HAwZ. D. FEES IMP FLOOD' CDF PARCEL . PD HD ISSUE This permit is hereby issued under the of the Butte County Code and/or indicated above for which fees have By PERMITEXPIRESON applicable provisions Resolutions to do work been paid. Date (Date) - ReceiptNo. 180761 " $48.40/l/ WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD•APPLICANT COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES BUILDING DIVISION NOTICE Post this job card in a safe conspicuous place. Do not remove until all required inspections are made and building is approved for'occupancy. Plans must be available on the job site. 068-360-136 PERMIT#95-1822-- ,T .. CARTER, Jay 24'F6 Ridge Rd., Oroville New 60/640 Dwelling _ ,4 PERMITTEE MUST CALL FOR INSPECTIONS Footings Piers Underground Conduit Pre-Gunite Underfloor Electrical Underfloor Mechanical Underfloor Framing Slab DoNot Install Floor or Slab. Uhtil:;Above . Signed ..... .. ....... Rough Plumbing Rough Electrical Rough Mechanical Framing Shower Pan Do NotJnsulate Until;Ab..... Xgn.4 . ":<:>': .. . ......... Insulation <:...:..........:...v..e...........i.i..;.o:::::::::> .. ::.............»:>.D ::::::::: . ........:...:.....:.............. Fireplace Footing Fireplace Throat ;Do Not Continue Fireplace:aJnti. Above S;tgned' Stucco Lath Scratch and Brown Sewer Service Water Service Pool Final Plumbing Final Electrical Final Mechanical Final Buildina or M.H. Final DO NOT OCCUPY UNTIL ALL THE ABOVE IS SIGNED AND THE BUILDING OR MOBILE HOME IS APPROVED FOR OCCUPANCY _ .. Addresses:;::'::;:::;:::::::Informatt ow..24=;Hr Ins Oroville 7 County Center Dr. 538-7541 538-7636 Chico 1469 Humboldt Rd. 891-2751 891-2834 Paradise 747 Elliott Rd. 872-6307 872-6307 Revised 7194 e U.S.MAIL Important Because we know your time and money are valuable, we suggest you call your local Post Office before you install a Mnilhnr Ask to speak to the Carrier Supervisor, who will tell you the proper location for your box and explain current requirements for mail box installation. The location and , other requirements must be approved by the Carrier Supervisor, before your carrier will begin delivery. Thanking you_ for your cooperation %lse %ured States Paata� Sa�ueee aFra' ?/� .PoeaC boat OPe 068-360-436 PERMIT#95-1822 CARTER,- Jay 24 Fox Ridge Rd., Oroville, New ,60/640 -Dwelling Dear Property Owner: We have issued a permit to construct a new.building, an addition, or to do remodeling on your property. This letter is -to inform you we have approved the building plans submitted for conformance with code requirements. We will only inspect the.construction for conformance with code requirements. It is your responsibility to see that the building conforms to your plans and expectations. Should you have any questions concerning this letter or any other matter pertaining to the construction, please do not hesitate to contact this office. Yours very truly, Michael C. Vieira, C.B.O. MCV:ahb Manager, Building Inspection 9 ' ;.r L A N D O F N A T U R A L W E A L T H A N D BEAUTY BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES v� 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965-3397 - --- TELEPHONE: (916) 538-7541 FAX: (916) 538-2140 Dear Property Owner: We have issued a permit to construct a new.building, an addition, or to do remodeling on your property. This letter is -to inform you we have approved the building plans submitted for conformance with code requirements. We will only inspect the.construction for conformance with code requirements. It is your responsibility to see that the building conforms to your plans and expectations. Should you have any questions concerning this letter or any other matter pertaining to the construction, please do not hesitate to contact this office. Yours very truly, Michael C. Vieira, C.B.O. MCV:ahb Manager, Building Inspection / punt •..: _ . - _ �� _ - - _ _ • Jam" ���_ . - : - -:' -.: - ... _ _ -. - -- . - •- . Vic • _ _ _ _ - .. = BUILDING DIVISION - _ - DEPARTMENT OF DEVELOPMENT SERVICES - - - _ 7 COUNTY CENTER ORIVE - OROVILLE. CALIFORNIA 95985-3.197 - - - - - - TELEPHONE: 191815367541 • RE: Attached Building Permit FAx 191815362"° Dear Permittee: Attached is your building permit along with the approved set of plans and a job card. Please post the job card on the job site in a conspicuous location for the inspector to sign during the various phases of construction, and also have the approved set of plans on the site at all times. Inspections will not be made if the job card and approved plans are not on the job at the time of inspection. Please review the approved set of plans before construction and make .note of any corrections made in red. If any of- these notes or corrections are not clear to you, please contact this office - do not proceed with the work without making the correction. The job card must be signed by the inspector before proceeding with each item listed. Should he not sign the card, a white correction notice will list the corrections to be made and a call back inspection must be made before going any further. Please allow 24 hours for inspection service. As a reminder to you, it is illegal to occupy this building or portion of building for which this. permit is issued without approval from this office. On certain occasions a temporary occupancy will be permitted. Please do not confuse gas or electrical service to the building as an occupancy clearance. Before occupancy, all of the "final items" listed on the job card must be signed by the inspector or special permission given. Your permit expires one year from date of issuance. If the work has started, but is not completed and finaled by the expiration. date, a renewal permit is required. If the renewal application has not been made within 30 days of the original permit expiration date, or if the work has not commenced, a new permit application and fees will be required. _ =gn completion of the work covered by this permit please contact this c�ffic a for-fin I ins2gtip . Should-you have any questions. concerning this letter or any other matter pertaining to building construction, .please.do not hesitate to contact this. office. Michael C. Vieira, C.B.O. MCV•ahb Manager, Building Inspection . C RESIDENTIAL R24068-360-136 PERMIT#95-1822 CARTER, Jay Fox Ridge Rd., Oroville New 60/640 Dwelling J=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: / P1 ft. / /"Nat. or/ /" L" ft./ P'LPG 7. Well Clearance & Disconnect 8. Utility Clearance Date _ Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks Easements 2. Footings; 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 Occ Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 t f 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- Beam s-Rftrs.-Connectors 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-Panelboards-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 - r , �1 V OK O = Not OK = Not Applicable Not Ready RESIDENTIAL (Single & Duplex) = Date UNDERFLOOR (Plans) OK'excepI #'s I 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ P' Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel -Bloc kouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit),OK except #'s 16. Water Htr.; Vent -Access -Combustion Air -Baffle -------------------- ------------------------------- 17. Water Pipe; Test & Anchor -Nail Protection --------- ------------------------------------- 18. D.W.V.: Test -Fittings & Anchor -Nail Protection ------- ------ ---- - ----------------- 19. Shower Pan; Test. First Floor -Tub Access 20. Test Tub & Shower. Second Floor -Tub Access - - - - - - - --------------------------------- 21. Gas Pipe: Size & Anchors ---------------------------------------------------------------------------- Date _ _Card B-1 --- Date - -- Card BB=1 - - -- Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s -- -- - 22. Fixture & Transformer Clearance --Ins. -Protection --------------- 23. Elec. Receptacles Spacing -Lights & Switches at Doors --------- ---------------------------------------------------------- -- - 24. Size Boxes & No. of Conductors -Stapled --------------------------------------- ------------ 25. Romex Installed Close to Edge of Studs & C.J. --------------------------------------------------------------- 26. Equip. Ground made up w!Mech. Fastners-Bond Gas & Water ---------------------- ------------------------------- 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI -------- -------------------------------------------------------- 28. Subfeed Wire Size ga. Cu or AI-A.C. Wire Size r / ga. Cu or AI- ---------------- -------------------------------------------------------- 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No -------------------------------------------------- -------------------------------- 30. Service -Riser Conductors & Ground -Main Disconnect ------------------------------------------- 31. Equip Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light -------------- --------------- --------- --- 33..Smoke Detector ---------------------------------------------------------------------------------- Date Card B-1 Date Card B-1 -------------- ------------------------------------------------------------------- Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 34. -.A. -C.- Ducts Insulation & Support 35. Vent Fan Exhaust above insulation --------------------------- --------- --- 36. _Condensate Drain & Overflow: Size & Grade 37. Furnance-Vent: Access -Comb. Air -Return Air Vent -115 outlet ------------ ------------------------------------------------------------- 38. Attic Access & Platform if Furnance in Attic ---------------------------------------------------------------------------------- ------------------------------------------- ------------------------------------- Date Card B-1 Date Card B-1 - ------------------------------------------------------------------------------------ Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except #'s 39. Sils. Proper Material & Anchors ------- ------- -------------------------------------------------------- --------- ------------ 40. Walls Studs -Nailing. Spacing & Bracing -Plates -Sound ------------------------------------------------------ 41. Bearing Walls over Girders & Floor Nailing -- --------------------------- ----------------------- 42. Draft Stop in Walls (rat proof) -------------------------------------------------------------------------------- 43. Fire Stops Furred Ceilings -Stairs -Chases -Tub ------------- ---- --- ----- ------------------------------------------------ 44. Headers & Beam -Size & Bearing Date FRAMING (Continued) _ 45. Hangers -Post Caps -Anchors -Connectors -- -46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Ring. 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles ------49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions -- -- 50. Garage Fire Protection Framing 51. Property Line Firewall & Openings --------------------- - --- 52. Ext_Doors_One 3' -Check Garage -3rd Story, 2 Exits - - - 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection - 54. plywood on Roof Overhang -Attic Vents -Rafter Outriggers ------------ 55.- Siding -Nailing Veneer --------- -- __------- __ 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access ----------- 57. - Glazing Area -Glass Protection -Skylights -Plastic --- ---- _ _ 58. Shear Walls; Nailing -Bolts 59. - Insulation -Walls -Ceilings -------------------------- - 60. Infiltration -Walls -Windows --------------------------- Date Card B-1 Date Card B-1 -------------- Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s - 61. Ext_Steps=Door & Sidelight Protection -Landings 62. Smoke Detector 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage: Above Floor -Ducts -Meeh. Protection ------------------- 64. Bedroom Exiting 65. G F.I & Bath Fixtures & Tub Access -Spa ------ - ____ 66._ Elec. Trim & Subpanel; Breaker Sizes & Labels --------------- ------------ 67. Stairs -&-Rails---- 68. Rails68. Fireplace or Stove Clearances -Hearth - - -- - ------------------------ 69. Elec_ Outlets at Wood Panel: Int. & Ext. 70. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance -- -... ------------------------ - 71. Elec. Outlets & Receptacles at Kit. Counter ---------------------------=--- 72. Garage Fire Door: Swing -Landing -Closer 73.-.A.C. Duct in Garage -Damper -------------------------------------- ----- 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage: Above Floor -Meth. Protection ------------ - 75. Plb.. Elec. & Mech. Equip. Listed for Location 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protection ------------------ -------------------------------- ---- 7;. - Insulation -Foam -Looked in--- Attic ❑ Yes ------------------------- - -28.-Guard-Rails & Deck -Const ruct ion -Post Caps 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No: Planters ❑ Yes ❑ No ----------------------- - ----------- - - - - - 81. Stucco: Brown -Finish - 82. A.C. Unit; Disconnect, Electrical. Plumbing --------------------------------- --- -- 83. Vents Above Roof: Plb9 ' APP fiance -Fire p lace. -Clearance to Openings ------ ---------------------------- 84. Water Well: Disconnect, Electrical, Plumbing ---------- --------------- 85. ------- ------85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 86. Ventilation Throughout House -- -- --- -------------- ------------------------ 87. Glass Protection ----------------------------------- 88. --------------88. Corrections from Previous Inspections - - - -- - --------------- ----- 89. Gas Test -Meters Tagged; Gas -Electric -------- ---------------------- ---- ------------ 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy -Compliance -Certificate. -Other Certificates ------------------------------------------------- --- Date Card -B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: t Certificate of Compliances Residential _. Climate Zone Mandatory Measures Checklist: Residential .. ... - MF -1R NOTE Lowrise residential buildings subject to the Standards must contain these measures regardless of the eompl6r+ee Project Title f �5� �D approach used. Items marked with an asterisk (•) may be superseded by more stringent compliance requusmcnts listed Building Permit M on the Cenificae of -Compliance. Wben this chocklis is incorporated into the permit documents, the features noted shall 8 be considered by all parties as binding minimum component perforrnarre specrGcatians fol the mandatory measures ProjectAddres7 whether they arc shown elsewhere in the documents or on this checklist only. 4 . Checked By / Date DFSCIUPTIDN DESIGNERDocumentation Author Telephone Enfoncernent Altency, Use Only r ENrORCEMENi BUILDING DATA. Conditi Floor Area 2a_fo Slawggid Floor (] Single Family Detached (SFD) [ ] Single Family Attached (SFA) [ ] Multi -Family (MF) BUILDING SHELL INSULATION' Glass Area % Glass Component Insulation Locafion/Commerxts North _51 a. Duct Number of Stories East a_ Wall..............--�-�-t-- '• Roof ............. Number of .Units _ South— 1 [ ] Addition Alone West— Floor ............. [ ] Existing Building Skylight [ ] Existing -Plus -Addition Total Glazing Area : Glass TAx Interior Exterior Overhang BUILDING SHELL INSULATION' r Component Insulation Locafion/Commerxts Type R -Value (attic, to garages, t pice3, etc-) Duct Output Manufacturer / Model # Wall..............--�-�-t-- '• Roof ............. R -Value Roof ............. (or approved equal) . .Floor ............. Floor ............. : Slab Edge..... GLAZING Shading Devices Glazing Area : Glass TAx Interior Exterior Overhang Framing Type Orientation s (single, double) caller blind, etc. (shadescreen, etc.) esmo) (metal/wood) North - North ( ) Btuh ' East East ( ) equal) South 5la - Sou th30 West ( )- West ( ) Skylight....... r) THERMAL MASS Type/Covering Area Thickness (slab/exposed tile, etc.) Of) (inches) Location/Description (kitchen, bath, etc.) HVAU SYSTEMS Minimum Duct Type (furnace, air Efficiency Location Duct Output Manufacturer / Model # conditioner, heat pump) (SE, SEER,HSPF) (attic, etc.) R -Value (Btu/h) (or approved equal) Maximum Furnace Heating Output: _ Btuh HOT WATER SYSTEMS Tank Manufacturer/Model# System T y ype (storage gas, etc.) -Capacity (or approved equal) Speci;al,Featurlb�s��." 5la _ xs - SPECIAL FEATURES/REMARKS (Add extra sheets if necessary) Building Envelope Measures §2.5352(x): Minimum ceiling insulation R-19 weighted avenge. §2.5352(bL Loose fill insulation manufacturer's labcicd R-Valuc- §2.5352(c): Minimum wall insulation in framed walls R-11 weighted average (does not apply to eats for mass wails). 62.5352(k}: Slab edge insulation - water absorption rate no greater than 0396, water vapor transmission rate no greater than 2.0 pertn/u+ch- §2.5311: Insulation specified or installed meets California Energy Commission (CEC) quality standards Indicate type and form. §2.5352(x): Vapor barriers mandatory in Climate Icarus 14 and 16 only. §2-5317: Infiltration/Esfdtration Controls a. Doors and windows between conditioned and unconditioned spaces designed to limit air Icakage- b. Doors and windows certified. c. Doors and windows weathcrstripped: all joints and penetration caulked and sealed §2-5352(c): Special inf.1 ration barrier instilled to comply with 62-5351 mocu CEC quality standards. §2.5352(d): Installation of Fucplaces 1. Masonry and factory -built fueplaces have a. Tight fitting, closeable metal or glass door b. Outside air intake with damper and control c Flue damper and control 2. No continuous buming gas pilots allowed. HVAC and Plumbing System Measures §2-5352(g) and 2-5303: Space conditioning equipment sizing: attach calculation. §2-5352(h) and 2.5315: Setback dwmcasm, on all applicable heating systems. • §2-5316(a): Ducts constructed. installed and insulated per Chapter 10, 1976 UMC. §2-5316 ft Exhaust systems have damper controls. 62-5314(c): Gas -furl space heating equipment has intermittent ignition devices - §2.5314: HVAC equipment, water heaters, showerbeads and fauens certified by.the CEC. §2.5352(i): Water hcatcr insulation blanket(R-12 or greater) or combined interior/exterior insulation (R-16 or greater): fust 5 feet of pipes closes to tank insulated (R-3 or greater). §2.5312(Exception 1): Pipe insulation on steam and steam condensate return k recirculating piping. §2-5318(d): Swimming Pool Heating 1. System has. a. On/off switch on heater. b. Weatherproof instruction plate on Anter: e. Plumbed to allow for solar. 2 75 percent thermal efficiency. 3. Pool cover. 4. Time clock. 5. Directional water inlet. Lighting and Appliance Measures 12.53520): Lighting - 25 lumens/wau or greater for general lighting in kitchens and bathrooms. §2.5314(c): Gas fired appliances equipped with intermioent ignition devices. 12-5314(a): Refrigerators. refrigerator -freezers, freezers and fluorescent lamp ballasts certified by the CEC. Indicate make and model number. i t COMPLIANCE STATEMENT This certificate of compliance lists dr, building features and performance specifications needed to comply with Title 24. Chapter 2-53 and Title 20, Chapter 2. Subchapter4. Article 1 of the California Administrative code- This certificate has been signed by the individual with overall design responsibility and the building owner, who shall retain a copy of it and transmit the certificate to my subsequent pur fuser of the building. Designer Name: TukJFum: Addteu: Tek hone hc. 0: Building Owner Name: rtklFistn: Address: (si6rranue) (date) tgnatttre) t i Documentation Author EnfoZ Name: Name: TitklFum ACHY _ . Address: Telephone: Agency (da(c) 1. Ceiling Insulation One Two Three Number of stories -17 R=value One Two Three R-0 -103 -49 32 R-19 -8 -4 -2 R-30 -2 -1 -1 R38 0 0 0 U -value -5 + 0.08 -11 . 0.50 -176 -84 -54 0.30 -102 -49 32 0.10 -26 -13 -8 0.08 -18 -9 -6. O.C6 -11 -5 -4 0.04 -4 -2 -1 0.02 4 2 1 0.00 11 5 3 2. Wall Insulation -4 I R-11 Single- Single - -2 R-19 Family Family Multi - R -value Detached Attached Family R-0 -68 -51 -34 R-11 0 0 0 R-13 2 2 1 R-19 8 6 4 U -value 2 R-7 8 0.80 -153 -114 -76 0.50 -91 -68 -46 0.30 -47 -36 -24 0.10 0 0 0 0.08 4 3 2 0.06 9 7 5 0.04 14 11 7 0.02 19 14 10 0.00 24 18 12 3. Raised Floor Insulation -1 3 8 Insulation In Floor 16 -20 Number of stories 4 R -value One Two Three R-0 -17 -8 5 R-11 -3 -2 1 R-19 0 0 0 ' R-30 3 1 1 ' U -value -14 -48 -69 - ---.0.60 . -144 -70 -46 0.50 120 SA 38 0.40 -95 -46 30 0.30 -69 -34 -22 0.20 -13 -21 -14 " 0.10 -17 -8 -5 + 0.08 -11 . 3 -4 0.06 -6 -3 -2 0.04 -1 0 0 0.02 4 2 1 0.00 10 5 3 Controlled Ventilation Crawlspace -58 -20 Number of stories -3 R -value One Two Three R-0 -11 -7 -5 R-5 4 -4 3 R-11 -2 -2 -2 R-19 -1 -2 -2 i 4. Slab Edge Insulation 7 14 25 -46 -14 --'-` - 0 Numt of glories 14 : R -value One Two Three • R-0 0 0 0 R-5 8 5 2 R-7 8 6 3 F2 factor 3 3 9 0.90 -4 3 -1 0.80 -1 -1 0 0.70 2 2 1 0.60 6 4 2 0.50 9 6 3 0.40 12 8 4 5. Inriltration (Air Leakage) Specification Points StandarQ 0 6. Glass Heat Loss Total -14 -48 -69 V U -value 16 Percent -42 -59 .51 to .41 to .31 to 0.30 or Glass Single Double .60 .50 .40 less 50 -121 -53 -39 -24 -10 4 40 -90 37 -26 -14 3 8 35 -75 -29 -19 -9 1 10 30 31 -21 -13 -4 4 12 29 -58 -20 -12 -3 5 12 28 -55 -18 -10 -2 5 13 27 -52 -17 -9 -2 6 13 26 -49 -15 _8 -1 7 14 25 -46 -14 -7 0 7 14 24 -43 -12 -5 1 8 14 23 -40 -11 -4 2 8 15 22 -37 -9 3 3 9 15 21 -34 -7 -2 4 10 15 20 31 -6 0 5 10 16 19 -29 -4 1 6 11 16 18 -26 •3 2 7 12 16 17 -23 -1 3 8 12 17 16 -20 0 4 9 13 17 15 -17 1 6 10 14 17 14 -14 3 7 10 14 18 13 -12 4 8 11 15 18 12 -9 6 9 12 15 19 11 -6 7 10 13 16 19 10 3 9 11 14 17 19 9 -1 10 13 15 ' 17 20 8 2 12 14 16. 18 20 7..Shading (Shade Open) -14 -48 -69 V Effectlre Percent Glut 16 -12 -42 -59 (percent glass x SC) na Effective -10 -35 -50 -46 %Glass North East South West Skylight 18 5 1 . 4 1 na 16 4 2 5 1 na 14 4 2 5 1 na_ 12 3 3 5 2 na - 11 3 3 5 2 na 10 2 3 5 2 1 9 2 3 5 2 2 8 2 3 5 2 2 " 7 1 3 4 2 2 6 1 3 4 2 3 5 1 2 4 2 3 4 0 2 3 1 '3 3 0 1 2 1 .3 2 0 0 1 0 3 1 -1 -1 -1 -1 2 0 -1 -2 -4 -2 0 na = not allowed 10 12 13 14 15 a3. Shading (Shade Closed) Erfective Percent Glass (percent Stas x SC) Effective %Glass Nom Eat South West S4igitt 18 -14 -48 -69 •64 na 16 -12 -42 -59 -55 na 14 -10 -35 -50 -46 na 12 -8 -29 40 -37 na 11 -7 -26 -36 -33 na 10 -6 -23 31 -29 -74 ' 9 -5 -20 -27 -25 -65 8 -5 -17 -23 -21. -56 7 -4 -14 -19 -18 -47 6 3 -11 -15 -14 38 5 -2 -9 -11 -10 -30 4 -t -6 -8 -7 -23 3 0 -4 -5 -4 -16 2 1 -1 -2 -1 -9 1 1 .1 1 1 -4 0.-' 2. 3 -- 4 _ 3 _... 0 ria . not allowed 9. Interior Thermal Mass Inmriorlv'iss/CFA COND. FLOOR AREA Interior Slab Floor Raised Floor Mass Sbries Sbries !CFA One Two Three one Two Three 0.0 -8 -5 -4 -2 -1 -1 0.1 -8 -5 3 -1 0 0 0.3 -7 -4 -2 0 1 1 0.5 -6 3 -1 1 1 2 0.7 -5 -2 -1 1 2 2 0.9 -5 -1 0 2 3 3 1.1 -4 -1 1 3 4 4 1.3 -3 0 2 3 4 5 1.5 -3 1 2 4 5 5 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 11 12 12 5.5 5 8 9 11 12 12 6.0 5 8 10 12 13 13 6.5 6 9 10 12 13 13 7.0 6 9 11 13 13 14 7.5 6 10 11 13 14 14 8.0 7 10 it 13 14 14 8.5 7 10 12 13 14 15 10. Exterior Wall Thermal Mass +6 b Exterior SiNle- Single - less -15 -5 Wall Family Family Multi Mass Detached Attached Family 0.00 0 0 0 6.0 0.20 3 2 1 -6 0.40 5 4 3 -4 -4 0.60 8 6 4 7.0 0.80 10 8 5 0 1.00 13 10 7 8 6 1.20 13 12 8 : 1.40 12 13 9 7 1.60 10 13 : 11..... 19 16 1.80 10 12 12 11.0 2-00 10 11 13 12 8 ' 120 30 26 22 11. Heating System 14 9 13.0 SE or RSPF 29 24 20 (assumes ducts In attic) 10 4.5 Sum oft 4.9 5.1 -25 or -24 to -14 to -4 to +6 to 16 or SE HSPF less -15 -5 +S +15 more 0.72 6.60 0 0 0 0 0 0 0.75 .6.88 3 3 3 2 2 1 0.80 7.33 8- 7 6 5 4 3 0.85 7.79 13 11 10 8 7 5 0.90 8.25 17 15 13 11 9 7 0.95 8.71 20 18 '-15 13 11 8 0.9 Effective SE or HSPF 1.3 15 (SE or HSPF x duct efficiency) 21 Effective -25 or -24 to -14 b -4 to +61o, 16 or SE HSPF less -15 -5 +5 +15 more 32 0.30 2.75 -73 -64 -56 -47 -38 -30 na 3.41 -45 -39 -34 -29 -24 -18 0.40 3.67 -34 -30 -26 -22 •18 -14 0.50 4.58 -10 -9 -8 -7 -5 .4 0.56 5.13 0 0 0 0 0 0 0.60 5.50 5 5 4 3 3 2! 0.70 6.42 17 15 13 11 9 7 0.80 7.33 25 22 19 16 13 10 0.90 8.25 32 28 24 20 17 13 1.00 9.17 37 32 28 24 19 15 Zonal Control Adjustment 3 2 System Type 1.4 POU 8 5 Resistance 10 9 7 6 4 3' Other 6 5 4 3 2 2 12. Cooling Systam Inmriorlv'iss/CFA COND. FLOOR AREA 10, Exteeior.Wall Mass SEER AREA 9 • 'h 1, •• fix rior Wall Mass ND. FLOOR (Lmmel duets In aide) 1.1. Heating System X_ Sten of 7-10 Zonal Control? ( Y / N) SE or HSPF Duct Efficiency [0.78] -25 or -24 to I -td b -4 b +6 to 16 or SEER less -15 -6 +5 +15 more 8.0 -14 -12 -10 -8 3 -4 . 8.5 -9 -7 -6 -5 -4 3 8.9 -5 -4 -4 -3 -2 -2 9.0 -4 3 -3 -2 -2 ' -1 9.5 0 0 0 0 0 0 10.0 4 3 3 2 2 1 10.5 7 6 5 4 3 2 11.0 10 9 7 6 4 3 120 15 13 11 9 7 5 13.0 20 17 .• 14 12 9 6 . 3.8 3.8 Effective SEER 4.2 4.4 4.6 (SEER zduct efficiency) 5 5.3 10% Sun of 7-10 0.4 0.6 Effecfne-25 or -24 to -14 b -4 b +6 b 16 or SEER less -15 -5 +5 +15 more 5.0 -30 -25 •21 -17 -13 .9 . 6.0 -12 -11. -9 -7 -6 4 ; 6.6 -5 -4 -4 3 -2-2 ; 7.0 0 0 0 0 0 0 I 8.0 9 8 6 5 4 3 !I 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 4.5 Zonal Control Adjustment 4.9 5.1 5.3 ! 10 8 7 6 4 3 1.3 No Cooling System Installed 1.7 -= Stories 2.2 24 26 2.8 3 One -5 -4 -4 3 -2 -2 Two + 3 3. 2 2 2 1 5:7 5.9 50% 0.9 1.1 1.3 15 1.7 t_ 21 23 25 Single -Family Detached and Attached 3 32 o Unit Size (sq 3.5 Water 4 '109 ' 12M A 700 2200 2700 Heater Credit or - b to to or 55% Type less 16W 2199 2699 more _Type SG None 0 0 0 0 0 or Solar 12 ' 8 6 5 4 - HP HWR 8 5 4 3 3 5.8 WSB 5 3 3 2 2 1.4 POU 8 5 21 3 3 SE None -37 -24 _4 18 -15 .12 4 Solar -1 -1 --1 0 0 5.2 HWR -18 -12 -9 -7 -6 65% WSB.. -25 -16 -12 -10, -8 2.2 POU -18 _ -12 '-9 -7. -6 IG None -5 -3 •2 -2 -2 4.7 Solar 7 5 4 3 2 5.9 POU 3 _ 2 1 1 1' E None -28 -19 14 -11 -9 2.9 Solar 8 5 4 3 3 4.1 POU -10 -6 -5 _4 -3 5.4 Muld-Famll7 (Individual units) 58 6 6.2 t W Size (s 75% 1.3 Water 1.7 699 700 1200 9 700 2200 Heater 0OC61 or b to b or, Type Type less__ ;1169_1699 4.6 2199 mors SG None 0 0 0 0 0 or Solar 14 7 5 4 3 HP HWR 9 5 3 2 2 3.5 WSB 9 4 3 2- 2 4.7 POU 9 5 3 2 2 SE None -45 23 -15 -11 -9 1.7 Solar 2 1 1 0 0 2.9 HWR -23' -12 -8 -6 '•5. 4.2 WS8 -25 -13 -8 -g -5 54 P-QU__23 -12 -8 -6 _5 ' IG None -8 2 2.2 24 Solar .' 6 .. ! 3 2 3.2 3.4 3.6 POU _ 1 0 0 0 0.. E None : 30 -15 10 _, 8 3 ;T:.Solar 64 :`18.=:. 9 _6 -:. 4 4 " - POU_ b _ • -4 '. -3 A .2 Interior MasslCFA % TITS I PASS Inmriorlv'iss/CFA COND. FLOOR AREA 10, Exteeior.Wall Mass TYPE 2 MASS AREA 9 • 'h 1, •• fix rior Wall Mass ND. FLOOR AREA 1.1. Heating System X_ Zonal Control? ( Y / N) SE or HSPF Duct Efficiency [0.78] _ Effective SE or 12. Cooling System 10..772/6.61 p - 9 X _ HSPF [0.5615. 151 Zonal Control? ( Y / N) It.7.01"C.tt Ie.eoet.d a.et Duct Efficiency [0.74] Effective SEER [7.03) 13. Water Heating _ T1'Pe ISG) a TYPE 1 MASS (UIMC & `4.2, ie- exposed slab) 0% 5% 10% 15% 20% 2S% 30% 35% 40%.45% 50% 56% 60% 69t 70% 75% 80% 85% 90% 95% 100% 105% 110Y. 115% 120% 125` 0% 0 0.2 0.4 0.6 0.8 1.1 1.3 1.5 1.7 1.9 21 23 25 2.7 2.9 3.2 3.4 3.8 3.8 4 4.2 4.4 4.6 4.8 5 5.3 10% 02 0.4 0.6 0.8 1 1.2 1.4 1.6 1.9 21 . 23 25 2.7 2.9 3.1 3.3 3.5 3.7 4 '4.2 ' 4.4 4.6 4.8 5 5.2 5.4 20% 0.3 0.6 0.6 1 1.2 1.4 1.6 1.8 2 2.2 24 21 29 3.1 3.3 3.5 17 3.9 4.1 4.3' 4.5 4.8 5 5.2 5.4 56 30% 0.5 0.7 0.9 1.1 1.4 1.6 1.8 2 22 24 26 28 3 3.2 3.5 3.7 3.9 4.1 43 4.5 4.7 4.9 5.1 5.3 5.6 58 40% 0.7 03 1.1 1.3 1.5 1.7 1.9 2.2 24 26 2.8 3 3.2 3.4 3.5 3.8 4 4.3 4.5 4.7 4.9 5.1 5.3 5.5 5:7 5.9 50% 0.9 1.1 1.3 15 1.7 1.9 21 23 25 27 3 32 3.4 3.5 3.8 4 42 4.4 4.6 4.8 5.1 5.3 5.5 5.7 5.9 6.1 55% 0.9 1.1 1.4 1.6 1.6 2 2.2 24 2.6 28 3 32 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 53 5.6 5.8 6. 62' 60% 112 1.4 1.7 1.9 21 2.3 2.5 2.7 29 3.1 3.3 3.5 3.8 4 4.2 4.4 4.6 4.8 ' 5 5.2 5.4 5.6 5.9 6.1 63 65% 1.1 1.3 1.5 1.7 1.9 2.2 24 2.6 2.8 3 3.2 3.4 35 3.8 4 4.3 4.5 4.7 4.9 5.1 53 55 5.7 5.9 6.1 64 70% 1.2 1.4 1.6 1.0 2 Z2 25 21 2.9 3.1 3.3 3.5 3.7 3.9 4.1 4.3 4.6 4.8 5 52 5.4 5.6 58 6 6.2 64 75% 1.3 15 1.7 1.9 21 23 25 27 3 3.2 14 16 3.8 4 4.2 4.4 4.6 4.8 5.1 5.3 5.5 5.7 5.9 6.1 6.3 6.5 WY. 1.4 1.6 1.8 2 22 2.4 26 2.8 3 3.3 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 54 56 5.8 6 6.2 64 66 85% 1.4 1.7 1.9 2.1 2.3 25 2.7 2.9 3.1 3.3 3.5 3.8 4 4.2 4.4 4.6 4.8 5 52 54 S6 5.9 6.1 63 65 67 90%' 1.51.7 2 2.2 24 28 2.8 3 3.2 3.4 3.6 3.1 4.1 4.3 4.5 4.7 4.9 5.1 53 55 5.7 5.9 6.2 64 66 68 95% 1.6 1.8 2 2.2 2.5 27 2.9 3.1 33 3.5 17 3.9 4.1 4.3 4.6 4.8 5 5.2 5.4 5.6 5.8 6 6.2 6.4 6.7 69 1007:1.7 1.9 21 2.3 25 28 3 3.2 3.4 3.0 18 4 4.2 4.4 4.6 4.9 5.1 5.3 53 5.7 5.9 6.1 6.3 6.5 6.7 7 105% 1.8 2 22 2.4 2.6 28 3 3.3 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.4 56 5.8 6 6.2 6.4 6.6 68 7 110% 1.9 21 2.3 2.5 27 29 3.1 3.3 36 38 4 4.2 4.4 4.6 4.8 5 5.2 5.4 5.7 5.9 6.1 6.3 6.5 6.7 69 7.1 115% 2 22 24 2.6 2.8 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 6.2 6.4 6.8 6.8 7 72 120% 2 23 2.5 2.7 2.9 3.1 3.3 3.5 3.7 3.9 4.1 4.4 4.6 4.8 5 5.2 5.4 5.6 58 6 6.2 6.5 6.7 6.9 7.1 73 125% 2t 23 25 2.8 3 3.2 3.4 3.6 3.8 4 4.2 4.4 4.6 4.9 5.1 5.3 5.5 5.7 5.9 6.1 6.3 6.5 6.7 7 7.2 7.4 roint system summary: Climate Zone 11 SCORE CARD Measures 1. Ceiling Insulation AO AO or ' R -v ue 38) U -value [0.030] 2. Wall Insulation 1,q or R -value (11) U -value (0.098] 3. Raised Floor Insulation 4. Slab Edge Insulation S. Infiltration 6. Glass Heat Loss 7. Shading (Shade Open) a. North b. East c. South d. West e. Skylight 8. Shading (Shade Closed) a. North b. East c. South d. West e. Skylight 9. Interior Thermal Mass or R -value [ 191 U -value [0.037] Point Scores or R -value [0] F2 factor 10.77] Standard p Type [double] U -value 10.65] % Total Glass (16) Sum 1-6 % Glass SC ..Eff. % Glass X Z7 X = 3.5 X = oZ 7a e� X = B % Glass SC Eff. % Glass X = f X = 2. 3 X = TYPE 1 H1ASS AREA � i-_ Inmriorlv'iss/CFA COND. FLOOR AREA 10, Exteeior.Wall Mass TYPE 2 MASS AREA 9 • 'h 1, •• fix rior Wall Mass ND. FLOOR AREA 1.1. Heating System X_ Zonal Control? ( Y / N) SE or HSPF Duct Efficiency [0.78] _ Effective SE or 12. Cooling System 10..772/6.61 p - 9 X _ HSPF [0.5615. 151 Zonal Control? ( Y / N) SEER 19.5] Duct Efficiency [0.74] Effective SEER [7.03) 13. Water Heating _ T1'Pe ISG) Credit InmeJ _ . .. -- Point Total: Sum 7.10 1. Ceiling insulauoa Insulation In.Fioor 3 -1 Number of stories Number of stories One R -value One Two Three R-0 -103 -49 -02 R-19 -8 -4 .2 R-30 .2 -1 .1 R38. 0 0 0 U -value _ 6 4 0.50 -176 -84 -54 0.30 -102 -49 " 0.10 -26 -13 .-32 -8 0.08 -18 -9 - -6 .. 0.06 -11 -5 -4 0.04 -4 -2 .1 0.02 4 2 1 0.00 11 - 5 3 2. wall Insulation Insulation In.Fioor 3 -1 Number of stories Single- Single - One R -value' Family Family Multi - R -value Detached Attached Family R-0 -68 -51 34 R-11 0 0 0 R-13 2 2 1 " R-19 8 6 4 . U -value -144 _ .. . -46 0.80 -153 -114 -76 0.50 -91- - ., . 38 .:.-46 0.30 -47 -36 -24 0.10 0 0 0 0.08 4 3 2 O.C6 9 7 5 0.04.. 14 11 7 0.02 19 .14 10 0.00 24 18 12 0.00 10 5 3 3. Raised Floor.1mulation Controlled Ventilation Crawlspace Insulation In.Fioor 3 -1 Number of stories -1 Number of stories One R -value' One Two Three R-0 -17 -8 -5 R-11 -3 .2 -1 RA9. 00 R-19 0 R-30 ' .. 3 •t. Slab Edge Insulation Loss U -value 2 5 Number of Stories Total --.._ O.EO . -144 =70 -46 0.50 -120 =58 38. 0.40 ._95 •46 30 0.30 69 -34 14 0.20 -d3 -21.-14 50 0.10 -17' -6 -5 0.08 -11 -6 ._4 -90 0.06 -6 -3 -2 0.04 =1 0 -29 0.02 4 2 1 0.00 10 5 3 Controlled Ventilation Crawlspace -4 3 -1 Number of stories -1 R -value One Two Three R-0 --11 -7 .5 R-5 -4 .4. 3 R-11 :_2 2 2 R-19 1 -2 2 •t. Slab Edge Insulation Loss 4 2 5 Number of Stories Total R -value One Two Three ' R-0 0 0 0 R-5 8 5 2 R-7 8 6 3 F2 factor 0.90 -4 3 -1 0.80 -1 .1 0 0.70 2 2 1 0.60 6 4 2 0.50 9 6 3 0.40 12 8 4 5. Infiltration (Air Leakage) 7.•Shading (Shade Open) Specification Slab Floor FJfecdve Percent Class Points Percent Class (percent Qlats x SCS standard Effective ' o-�- . _ Effective Two %Glass North Etat %Glass North East South :West Skylight 18 5 1 4 1 - 6. Glass Heat Loss 4 2 5 1 Total _ 4 2 •5 1 U -value 12 Percent 3 5 .51 to .41 to .31 to 0.30 or Glass Single Double .60 .50 ,40 less 50 -121 -53 -39 .24 -10 4 40 -90 37 -26 -14 3 8 35 -75 -29 -19 .9 1 10 30 51 -21 -13 -4 4 12 29 -58 -20 -12 3 5. 12 28 -55 _-18 -10 0 5 13 27 -52 -17 -9 .•.2 .2 6 13 26 -49 -is _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 1s 18 12 -9 6 9 12 15 19 `11 5 7 10 13 16 19 10 3 9 11 14 17 19 9 : -1 10 1315 2 17 20 8 2 12 . 14-;'. 16• 18 20 7.•Shading (Shade Open) Single. Single - Slab Floor FJfecdve Percent Class ^Elfectlre Percent Class (percent Qlats x SCS Detached Attached Effective ' (percent &tris x sC) /CFA Effective Two %Glass North Etat %Glass North East South :West Skylight 18 5 1 4 1 na 16 4 2 5 1 na 14 4 2 •5 1 na 12 3 3 5 2 na 11 3 3 5 2 na 10 2 3. 5 2 1• 9 2 3 5 2 2- 8 2 3 5 2 2 7 1 3 4 2 2 61 -56 3 4 2 3 5 1_ 2 .. 4 2 3 4 .0 2. 3 1 3 3 0 1 2 1 3 2 0 0 1 0 3 1 -1 .1 -1 .1 2 0 -1 .2 -4 -2 0 na = not allowed -1 -9 1 �!. Shading (Shade Closed) Single. Single - Slab Floor FJfecdve Percent Class Mass Mute (percent Qlats x SCS Detached Attached Effective ' 0 0 /CFA One Two %Glass North Etat South West Slryfipht 18 14 -48 -69 64 na 16 -12 -42 -59 -55 na 14 -10 -35 -50 -46 na 12 -8 .29 -40 -37 na 11 -7. -26 -36 -33 na 10 -6 -23 -31 .29 -74 9 -5 -20 -27 -25 -65 8 -5 -17 .23 -21.. -56 7 -4 -14 -19 -18 -47. 6 3 -11 -15 -14 38 5 .2 .9 -11 -10 .30 4 -1 3 -8 -7 -23 3 0 -4 -5 -4 -16 2 1 .1 -2 -1 -9 1 1 1 1 1 -4 0 2 -3 4 3 0 na • not allowed 7 8 10 11 9. Interior Thermal Mass Interior Single. Single - Slab Floor Raised Fbor Mass Mute Stories Detached Attached Family Stories 0 0 /CFA One Two Three One Two Three 0.0 - -8 -5 -4 -2 -1 -1 0.1 -8 -5 3 -1 0 0 0.3 -7 -4 -2 0 1 1 0.5 "_6 3 -1 1 1 2 0.7 -5 -2 -1 1 2 2 0.9 -5 -1 0 2 " 3 3 1.1 -4 .1 1 3 4 4 1.3 -3 0 2 ""3 _ 4 5 1.5 -3 1 2 4 5 5 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 11 12 12 5.5 5 8 9 11 12 12 1 6.0 5 8 10 12 13 13 6.5 6 9 10 12 .. 13 13 i 7.0 6 9 11 13 13 14 7.5 6 10 11 13. 14 14 .• 8.0 7 10 11 13 14 14 8.5 7 10 12 13. • 14 15 10. Exterior Wall Thermal Mass Exterior Single. Single - Measures Wall Family . Family Mute Mass Detached Attached Family 0.00 0 0 .0 0.20 3 2 1 0.40 5 4 3 0.60 8 6 4 0.80 10 8 5 1.00 13 10 7 1.20 13 12 8 1.40 12 13 9 1.60 10 13 11.. . 1.80 10 12 12 j 200. - 10 11 13 I 3 8.9 11. Heating System -4 .4 3 SE or HSPF -2 : 9.0 (assumes ducts In attic) , -2 _ Sum of 1-6 -1 9.5 -25 or -24 to -14 to �4 to +6 to 16 or SE HSPF less -15 .. -5 +5 ' +15 more, 0.72 6.60 0 0 0 0 0 0 0.75.6.88 3 3 3 2 2. 1 0.80 '7.33 8 7 6 5 4 3 0.85 7.79 13 11 10 8 7 5 0.90 8.25 17 15 13 11 9 7 0.95 8.71 20 18 ' 15 13 11 8 . 120 Effective SE or HSPF (SE or HSPF x duct etrlciency) Effective -25 or -24 to -14 In 4 to +6 to 16 or SE HSPF less -15 -5 .+5 +15 more 0.30 2.75 -73 -64 .56 -47 -38 -30 na 3.41 -45 -39 -34 .29 -24 -18 0.40 3.67 -34 30 .26 -22 .18 .14 0.50 4.58 -10 -9 -8 .7 -5 • -4 0.56 5.13 0 0 0 0 0 0 0.60 5.50 5 5 4 3 3. 2 0.70 6.42 17 15 13 11 9 7 0.80 7.33 25 22 ' 19 16 13 10 0.90 8.25 32 28 24 20 17 13 1.00 9.17 37 32 28 24 19 15 Zonal Control Adjustment - - System Type Resistance 10 9 7 6 4 3 Other 6 5 4 3 2 2 12. Cooling System i Measures r. ._.. . 10 8 7 SEER 4 3 R -v ue [38 No (assumetducts i In attic) or - . Sim of 7-10 R- ue(1 ] . 3. -25 or -24 to a14 to -410 +6 to 16 or SEER less -15 1 5 +5 +15 more 8.0 -14 -12 1 -10 -8' -6 -4 1 r..8.5 -9 -7 -6 -5. -4 3 8.9 -5 -4 .4 3 -2- -2 : 9.0 -4 3 -3 -2 -2 -1 9.5 0 0 0 0 0 0` 10.0 4 3 3 2 2 1 10.5 7 6 5 4 3 2' 11.0 10' 9 7 6 4 3 . 120 15 13 11 9 7 5 X13.0 - 20 17 ( 14 12 9 6 POU Effective SEER 5 4 3 (SEEP: xduct eMclenc7) SE None .37 Sim of 7-10 .18 .15 .12 Effective -25 or -24 'a 14 Io .4 to +6 to 16 or SEER less -1:: 5 +5 +15 more 5.0 -30 -25 .21 .17 -13 -9 6.0 -12 .1', -9 -7 -6 -4 j 6.6 -5 4 -4 3 .. -2 2 7.0 0 0 0 0 0 0 8.0 9 8 6 5 4 3 I 9.0 16 14 12 9 7 5 10.0 ' 22 19 16 13 10 7 11.0 26 23 19 15 12 8 12.0 30' 26 22 18 14 . 9 13.0 33 29 24 20 15 10 Interior MasslCFA Zonal Control Adjustment Measures r. ._.. . 10 8 7 6 4 3 R -v ue [38 No Cooling System Installed or - -Stories - - R- ue(1 ] U -value [0.098] 3. One -5 -4t -4 -3 -2 -2 Two+ 3 31 :.. 2 2 2 1. Single-Famll;r • Detached and Attached •- 6. Glass Heat Loss li L Unit Size (sQ Water '10'1 •12CO 1700 2200 2700 Heater Credit Type. Type or 1ess•,16N ,� to to to :or. . 2199 2699 more SG None 0 ' I` 0 A. 0 0. or Solar 12 ' 1 8 6 5 4 HP -HWR 8 5 4 3 3 WSB S. 3 3 2 2 POU 8_• 5 4 3 3 SE None .37 -24 .18 .15 .12 Solar -1 -1 .1 0 0 40% HWR -18 -12 -9 -7 -6 75X, WSB.. -25 -16 -12 -10' .8 POU. 48 _ -12 -9 -7_ -6 IG None -5 -3 .2 -2 -2 Solar 7' s 4 3 2 POU 3 2_ 1 1 1 IE None -28 -Ti9 -14 .11 .9 1.1 1.2 Solar 8 5 4 3 3 25 POU -10 3 -5 -4 -3 4 Multi-Famlh (Individual 4.6 - units) 5 5.3 20% 0.3 Una Size (SO 1 1.2 W Water Heater credit 699 700 1200 1700 2200 -Type Type or fess' to 1199 to 1699 to 2199 or more SG None 0-. 0 0 0 0 or Solar 14 7 5 4 3 HP HWR 9 5 3 2 2 3.1 3.2 WS8 9 4 3 2 2 4.5 POU 9 4 5 3 2 2 SE None -45, -23 -15 .11 1.9 2.2 Solar 2 1 1 0 0 3.6 HWR -23' -12 ..8 5 .5 4.9 WSB .25 -13 .8 ::--6- ' . -5 -PQU. . _23 _12_8- 1.9 6 . " .5 IG None -8 -4 --. -3 -2 i -2 4 Solar 6 3 2 1, 1 _ POU 1._.__0 _5.9 5.1 0 0 0 E. None 30 -15 -10 -8 __6 Solar 18 9 _ 6 4 4: POU •. -8 -4 .3 -2 -2 Interior MasslCFA A V111L O.YbMill Sulitwary: Climate GOIIe 11 SCORE CARD . Measures r. ._.. . 1. Ceiling Insulation 3d or R -v ue [38 U -value 10.030] 2. Wall Insulation or - - R- ue(1 ] U -value [0.098] 3. Raised Floor Insulation or _ R -value ( 19] _ .. U -value [0.037] 4. Slab Edge Insulation or R -value (01 F2 factor (0.77] S. Infiltration Standard 6. Glass Heat Loss Type [double] U -value 10.651 l TYPE 1 MSS JUW i 4.2. Le: exposed slab) 0% S% 10% 1S% 20% 2S%,..30% 35% 40% 45% 50% 55% 60% 6tf. 70% 75X, 8o% MX. 90% 95% 100% COSY. 110% 115Y. 120X 125` 1 % 107. 0 0.2 0.2 0.1 0.4 0.6 0.8 0.8 0.8 1 1.1 1.2 1.3 1.4 1.5 1.1 1.9 21 23 25 2.7 29 . 32 3.! _ 3.6 3.8 4 4.2 4.4 4.6 - 4.8 5 5.3 20% 0.3 0.6 0.8 1 1.2 1.4 1.6 1.6 1.8 1.9 2 21 2.2 23 24 2-S 27 27 29 2.9 3.1 3.3 3.5 3.1 4 4.2 4.4 4.6 4.8 5 5.2 5./ 30% 0.5 0.7 0.9 1.1 1.4 1.6 1.8 2 22 24 26 28 3 3.1 3.2 3.3 3.5 3.5 3.7 3.7 3.9 3.9 4.1 4.3 4.5 4.8 5 S.2 5.4 56 107. 0.7 09 1.1 1.3 1.5 1.7 1.9 2.2 2! 26 2.8 3 3.2' 3.4 3.6 3.8 4 4.1 4.3 4.51.7 4.9 5.1 5.3 5.6 So .50% 0.9 1.1 1.3 1.5 1.7 1.9 21 23 25 27 3 32 3.! 3.6 3.8 4 42 4.3 4.5 4.7 1.9 5.1 5.3 5.S 5.7 _5.9 5.1 1,! 4.8 !.8 S.1 S.3 S.S 5.7 S.9 55% . 60% 0.9 1 1.1 1.1 1.4 1.1 1.8 1.1 1.8 1.9 2 21 2.2 23 24 25 2.5 2.7 28 3 32 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.3 5.6 5.8 6 6 2 65% 1.1 1.3 1.5 1.7 1.9 22 24 2.6 2.8 2.9 3 31 3.2 3.3 3.4 3.5 3.6 3.8 3.8 4 4 4.2 4.4 4.6 4.8 ' 5 5.2 5.4 5.6 5.9 6.1 63 70% 1.2 1.4 1.6 1.8 2 22 2.5 27 2.9 3.1 3.3 3.5 3.7 3.9 4.1 4.3 4.3 4.5 4.6 4.7 4.8 4.9 5 5.1 5.3 55 5.7 5.9 6.1 6.4 75% 1.3 13 1.7 1.9 21 23 25 21 3 3.2 3.4 3.5 3.8 4 . -4.2. 4.4 4.6 4.8 5.1 5.2 5.4 5.6 58 6 6.2 64 _ 5.3 5.5 5.1 5.9 6.1 6.3 65 80 f. 85Y. 1.4 1.4 1.6 1.7 1.8~ 1.9 2 2.1 22 2.3 2.4 25 26 2.7 2.8 3 3.3 3.S 37 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.! 5.6 S.8 6 62 61 66 90%" 1.5 1.7 2 2.2 24 28 2.8 2.9 3 3.1 3.2 3.3 3.4 3:S 3.6 3.8 3.8 4 4.1 4.2 4.3 4.4 4.6 4.6 5 52 54 5.6 5.9 6,1 63 65 67 95% 1.6 1.8 2 22 25 27 2.9 3.1 33 3.5 3.7 3.9 4.1 4.3 4.S 4.6 4.7 4.8 4.9 5 5.1 5.2 53 5.4 5.5 5.6 5.7 5.9 6.2 6.4 66 68 100% 1.7 1.9 21 2.3 2.5 28 3 3.2 3.4 3.6 3.8 4 4.2 4.4 4.6 4.9 5.1 5.3 5.8 6 6.2 6.4 6.7 69 5.5 5.7 5.9 61 6.3 6.5 6.7 7 105%' 110% 1.8 1.9 2 21 22 2.3 2.4 2.5 2.6 27 28 29 3 3.3 3.5 3.1 't'3.9 4.1 4:3 4.S 4.7 4.9 ' 5.1 5.4 5.6 5.8 6 6.2 6.4 6.6 68 7 115% 2 2.2 2.4 2.6 2.8 3 3.1 "3.2 3.3 3.4 •' 3.6 3.6 3.8 3.8 4 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 5 5.2 5.4 5.7 5.9 6.1 6.3 6.5 6.7 69 7.1 120% 2 2.3 2.5 2.7 29 3.1 3.3 3.5 3.7 3.9 1.1 4.4 4.8 4.8 4.9 5 5.1 5.2 5.3 5.4 5.5 5.6 5.7 58 5.9 6.2 6.4 6.6 6.8 7 7.2 125% 21 23 25 2.8 3 3.2 3.4 3.6 3.8 ! 4.2 4.4 4.8 4.9 5.1 5.3 5.5 5.7 5.9 6 6.1 6.2 6.3 6.5 6.5 - 6.7 6.9 7.1 73 ' 6.7 7 72 7'4' Tl_ C- n A V111L O.YbMill Sulitwary: Climate GOIIe 11 SCORE CARD p %Total Glass 16] Sum'1-6 7: Shading (Shade Open) ' %Glass . SC Eff. % Glass/ Ll X b. East X �. el. PS 5r C. South X = d. West . C X e. Skylight X = 8. Shading (Shade Closed) % GlassGlass SC Eff. % Glass a. b. Earth � 3 if X a _ a - ----. C. South 977- d. West = X - 5 e. . Skylight d x = �� 9. Interior Thermal Mass TYPE 1 MASS AREA _ 9 Yt-eriofllf•141/CFA COND. FLOOR AREA 10. Exterior Wall Mass TYPE -2 MASS AREA = B E ieriorWallMass ND. FLOOR AREA 11. Heating System X = 72 Zonal Control? ( Y / N) SE or HSPF . Duo Efficiency [0.781 Effective SE or (0.72/6.61 HSPF (0.56/5.151 12 Cooling System `XQi x Zonal Control? ( Y / N) SEER [9.51 Duct Efficiency[0.741 Effective SEER 17.031 13.Water Heating - ,.. Type (SGI Credit (none] -..:� - 3 . Measures r. ._.. . 1. Ceiling Insulation 3d or R -v ue [38 U -value 10.030] 2. Wall Insulation or - - R- ue(1 ] U -value [0.098] 3. Raised Floor Insulation or _ R -value ( 19] _ .. U -value [0.037] 4. Slab Edge Insulation or R -value (01 F2 factor (0.77] S. Infiltration Standard 6. Glass Heat Loss Type [double] U -value 10.651 p %Total Glass 16] Sum'1-6 7: Shading (Shade Open) ' %Glass . SC Eff. % Glass/ Ll X b. East X �. el. PS 5r C. South X = d. West . C X e. Skylight X = 8. Shading (Shade Closed) % GlassGlass SC Eff. % Glass a. b. Earth � 3 if X a _ a - ----. C. South 977- d. West = X - 5 e. . Skylight d x = �� 9. Interior Thermal Mass TYPE 1 MASS AREA _ 9 Yt-eriofllf•141/CFA COND. FLOOR AREA 10. Exterior Wall Mass TYPE -2 MASS AREA = B E ieriorWallMass ND. FLOOR AREA 11. Heating System X = 72 Zonal Control? ( Y / N) SE or HSPF . Duo Efficiency [0.781 Effective SE or (0.72/6.61 HSPF (0.56/5.151 12 Cooling System `XQi x Zonal Control? ( Y / N) SEER [9.51 Duct Efficiency[0.741 Effective SEER 17.031 13.Water Heating - ,.. Type (SGI Credit (none] -..:� - 3 . -3 Serum 7/.10 Point Total: Certificate of Compliance: Residential K Climate Zone 11 Nuns Roof ............. rermit# Project Title Tckphone: Floor ............. Floor ............. BuddingP ProjectAddrev (daft) s anae) (dart) Documentation Author /-J` /0 - A Z Name: Name: Titk/Firm aedted By/ Date Documentation Author Telephone Fdotoernent Agency Use Only BUILDING DATA Glass Area 95 Gla •Condition 'f � North Area-�G--'-� Number Stories East S /Raised Floor Number of .Units 1 South �_ (fe-2= iiy Detached (SFD) [.1 Addition Alone West (] Single Family Attached (SFA) [ ] Existing Building Skylight O [ ] Multi -Family (MF) [ ] Existing -Plus -Addition Total ' BUELDING SHELL INSULATION.' Component Insulation LocannnlComments TvDe R -Value (attic .to garage, typicel, Wall..... .... K Wall... Nuns Roof ............. Tt1eJfntt Address: TekpSone Tckphone: Floor ............. Floor ............. Slab Edge..... GLAZING Glazing Area Glass Type Shading Devices Interior Exterior Overhang Framing Type North North ( ) East East ( ) South Sou th ( ) West West ( ) Skylight....... THERMAL MASS Type/Covering Area Thickness (slab/exposed, tile, etc.) (sf) (inches) Locationi"Description (kitchen, bath, etc.) IN n HVAC SYSTEMS Minimum Duct Type (furnace, air Efficiency Location conditioner, heat um) (SE, SEER,HSPF) (attic, etc.) G�tl �7 - mento Duct Output Manufacturer / Model # R -Value (Btuh) (or approved equal) I Maximum Furnace Heating Output: Btuh HOT WATER SYSTEMS Tank Manufacturer/Model # System Type (storage gas, etc.) Capacity (or approved equal) Special Feature(s) 5� SPECIAL FEATURES/REMARKS (Add extra sheets if necessary) Mandatory Measures Checklist: Residential MF -1R NOTE Lowrise residential buildings subject to the Standards must contain thcra measures regardless of the axnoianee approach used Ivens marked with an asterisk (•) may be superseded by more stringent compliance requirements fisted on the Cettifncate of Compliance. When this checklist is incorporated into the permit documents, the features noted shag be considered by all parties as binding minimum component performance specifications for the mandatary measures whether they arc shown elsewhere in the documents or on this cAocklist only. DESCRIPTfON DESIGNER I ENEORCEMENr Building Envelope Measures §2.5352(a): Minimum ceiling insulation R-19 weighted avenge. §2.5352(b} Loose fill insulation rnanufaaureu's labeled R-Valut • 12.5352(c): Minimum wall insulation in famed walls R-11 weighted average (does not apply to exterior mass walls). §2.5352 ft Slab edge insulation - water absorption rue no greater than 0.3%, water vapor transmission rate no greater than 2.0 pcmVirich. 62-5311: Insulation specified or installed meets California ErKW Commission (CEC) quality standards. Indicate type and form. 1 2.5352(1): Vapor barriers mandatory in Climate Zones 14 and 16 only. §2.5317: Infiltration/Exfiltration Controls a. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. b. Doors and windows certified. e. Doors and windows weatherstripped; all joints and pet>uruions caulked and sealed 12.5352(0): Special infdtration barrier installed to comply with 12.5351 meets CEC quality standards. §2.5352(d): Installation of Ftrephees 1. Masonry and factory -built fireplaces have a. Tight fitting, closeable metal or glass door b. Outside air intake with damper and control c. Flue damper and control 2. No continuous burning gas pilots allowed. HVAC and Plumbing System Measures 62.5352(8) and 2.5303: Space conditioning equipment sizing: attach calculations... ' §2.5352(h) and 2-5315: Sethaek thermostat on all appliablc heating systems. • §2.5316(a): Ducts constructed, installed and insulated per Chapter 10, 1976 UMC. §2.5316(b): Exhaust systems have damper controls. §2.5314(c): Gas -rued space heating equipment has intermittent ignition devices. §2.5314: HVAC equipment water heaters, showerheads and faucets certified by the CEC. §2.5352(1): Water heater insulation blanket (R-12 or greater) or combined interior/exte for insulation (R-16 or greatcry fust 5 feet of pipes closest to tank insulated (R-3 or greater). §2.5312(Exccpdon I): Pipe insulation on steam and steam condensate return & recirculating piping. §2.5318(d): Swimming Pool Heating 1. System hay. a. On/off switch on heater. b. Weatherproof instruction plate on heater: e. Plumbed to allow for solar. 2. 75 percent thermal efficiency. 3. Pool cover. 4. Time clock. 5. Directional water inlet Lighting and Appliance Measures r §2-53526): Lighting - 25 lumens/watt or greater for general lighting in kitchens and bathrooms. §2.5314(c): Gas rued appliances equipped with intermittent ignition devices. §2.5314(a): Refrigerators, refrigerator -freezers• freezers and fluorescent lamp ballasts certified by the CEC. Indicate make and model number. COMPLIANCE STATEMENT This certificate of compliance lists tin building features and performance specifications needed to comply with Mile 24, Chapter 2-53 and Title 20, Cl3aptrr 2, Subcbapter 4. Article 1 of the California Administrative code. This mrdficate has been signed by the individual with overall design responsibility and the building owner. who shall retain a copy of it and transmit the certificate to any subsequent purdtaser of the building. Designer Building Owner Name: Nuns T-ttk/Fum: Addre=: Tt1eJfntt Address: TekpSone Tckphone: t.ic. N: . 1 (sigtamre) (daft) s anae) (dart) Documentation Author Enforcement Agency Name: Name: Titk/Firm " Arceney: Addrsa: Tck*nc .Certificate of Compliance: Residential t Wall .............. Climate Zone 11 ' Project Title Roof ............. J Floor ............. ' Type (furnace, air Buil it #+ 1,5 5—�z Project Address Slab Edge..... Manufacturer / Model # - Checked By / Date Documentation Author " Telephone Framing Type Enforcement Enforcement Agency Use Only (metallwood) v Glass Area % Glass BUILDING DATA East ( )_ North East ( ) Cod • • ned Floor Area l03 � Number of Stories �_ East South ( ) ' Slab/�Ratsed Floor Number of .Units South O a ['Single Family Detached (SFD) [ ] Addition -Alone West (01 a• 5 a. [ ] Single Family Attached (SFA) [ ] Existing Building Skylight C7 [ ] Multi -Family (MF) (] Existing -Plus -Addition Total QNcialF,s BUILDING SHELL INSULATION Component Insulation Locatlnr/Comments ' Type R -Value (atdc, to garage, r-miaal. etc.) Wall .............. t Wall .............. Roof .............� Roof ............. Minimum Floor ............. ' Type (furnace, air Floor ............. Location. Slab Edge..... Manufacturer / Model # GLAZING.— . _ Shad ng Devices (SE, SEER,HSPF) S ' Glazing Area Glass Type Interior Exterior Overhang Framing Type Orientation(SO (single. double) (roller blind. etc.) (Shadmram etc.) (yesfio) (metallwood) North North ( ) East ( )_ East ( ) ySouth South ( ) West ' I Maximum Furnace Heating Output: HOT WATER SYSTEMS = I West Btuh Skylight....... THERMAL MASS Tank Manufacturer/Model # Type/Covering Area Thickness (slab/exposed, tile, etc.) (Sf) (inches) Location/Description (kitcheru bath. etc.) gas, etc.) Capacity HVAC SYSTEMS Duct Minimum ' Type (furnace, air Efficiency Location. Duct Output Manufacturer / Model # -J conditioner, heat um) (SE, SEER,HSPF) (attic, etc.) ` R -Value tuh or approved al ' I Maximum Furnace Heating Output: HOT WATER SYSTEMS = 422d!2,Q. Btuh , Tank Manufacturer/Model # t System T (storage gas, etc.) Capacity or approved equal) QNcialF,s i Mandatory Measures Checklist: Residential MF -IR NOTE: Lowrise residential buildings subject to the Standards must contain these measures mprdIL- of the compliance approach used Items marked with an asterisk (-) may be superseded by more stringent compliance roquuements listed on the Certificate of Compliance. When this checklist is incorporated into the permit documents. the features noted shall be considered by all parties as binding minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. DESCRIP11ON DESIGNER ENFORCEMENT Building Envelope Measures - §2.5352(a): Minimum ceiling insulation R-19 weighted avenge. §2.5352(b): Loose fill insulation manufacturer's labeled R -Value. §2.5352(c): Minimum wall insulation in framed walls R-1 I weighted average (does not apply to exterior mass waits). §2.5352(k): Slab edge insulation - water absorption rate no greater than 03%. water vapor transmission rate no greatu than 2.0 pmn/i nch. §2-5311: Insulation specified or installed mats California Energy Commission (CEC) quality standards- Indicate type and form. §2.5352((): Vapor barriers mandatory in Climate Zones 14 and 16 only. §2.5317: Infeltration/Exfiltration Controls a Doors and windows between conditioned and unconditioned spacesdesigned esigned to limit air leakage. b. Doors and windows certified. c. Doors and windows wealherstripped: all joints and penetrations caulked and sealed 12-5352(e): Special infiltration barrier installed to comply with 12-5351 meets CEC quality standards. §2-5352(d): Installation of Fireplaces 1. Masonry and factory -built fireplaces have: a. Tight fitting• closeable metal or glass door b. Outside air intake with damper and control c. Flue damper and eontrd 2. No continuous burning gas pilots allowed. HVAC and Plumbing System Measures §2-5352(8) and 2-5303: Space conditioning equipment siring: attach calculations. §2-5352(h) and 2-5315: Setback thermostat on all applicable heating systems. " 62-5316(a): Ducts consuuctcd, installed and insulated par Chapter 10, 1976 UMC. §2.5316(b): Exhaust systems have damper controls. §2-5314(c): Gas -rued space heating equipment has intermittent ignition devices. §2.5314: HVAC equipment, water heaters• showerhcads and faucets certified by the CEC. §2-5352(i): Water heater insulation blanket (R-12 or greater) 6r combined interior/emcrior insulation (R-16 or greater): fust 5 feet of pipes closest to tank insulated (R-3 or greater). §2.5312(Exception 1): Pipe insulation on steam and steam condensate return & recirculating piping. .. .: c - - §2.5318(d): Swimming Pool Heating - 1. System has- a. asa. On/off switch on heater. b. Weatherproof instruction plate on heater: e. Plumbed to allow for solar. 2. 75 percent thermal efficiency. 3. Pool cover. 4. Time clock. 5. Directional water inlet. Lighting and Appliance Measures t §2.53520): Lighting - 25 Iumcns/watt or greater for general lighting in kitchens and bathrooms. 62-5314(c): Gas fired appliances equipped with intermittent ignition devices. §2-5314(a): Refrigerators, refrigerator -freezers, freezers and fluorescent lamp ballasts certified by the CEC. Indicate make and model number - I .. i COMPLIANCE STATEMENT This certificate of compliance lists the building feattttes and performance specifications needed to comply with Title 24. Chapter 2-53 and Title 20, Chapttr2. Subtdiapter4. Article 1 of the California Administrative code. This certificate has been signed by the individual with overall design responsibility and the building owner. who shall retain a copy of it and transmit the certificate to sny subsequent purclu ser of the building. Designer Building Owner `SPECIAL FEATURES/REMARKS (Add extra sheets if necessary) Name None TttleJFirm TitkJF um - Address: Address: Tekpho= Tekphon Lic. M: (si6rtatwe)_ (dare) ' _ (si azure) _ (date) Documentation Author Enforcement Agency Name:' eNtlma TitWFimL Agencr F �, .Address: Telephone 0 I •'4 j I 1. Ceiling Insulation U -value COND. FLOOR AREA Flfeetive Pteretot Glass Number of stories • 1_-____--0.60. R -value One Two Three R-0 -103 -49 32 R-19 -8 4 -2 R-30 -2 -1 -1 R38 0 0 0 U -value -43 -21 -14 0.50 -176 -84 .54 0.30 -102 49 .92 0.10 -26 -13 -8 0.08 -18 -9 -6. 0.06 Al -5 -4 0.04 -4 -2 -1 0.02 4 2 1 0.00 11 5 3 2. Wall Insulation -17 -9 Number of stories Single- Single - R -value One Family Family Multi - R -value Detached Attached Family R-0 -68 -51 34 R-11 0 0 0 R-13 2 2 1 R-19 8 6 4 U -value 8 -t 22 0.80 -153 -114 -76 0.50 -91 -68 -46 0.30 -47 36 -24 0.10 0 0 0 0.08 4 3 2 0.06 9 7 5 0.04 14 11 7 0.02 19 .14 10 0.00 24 18 12 3 .1 8 0.80 3. Raised Floor Insulation -1 - - - Insulation in Floor 0.70 2 Number of stories 1 R -value One Two Three ` R-0 -17 -8 -5 R-11 -3 -2 -1 R-19 0 0 0 i R-30 3 1 1 I U -value COND. FLOOR AREA Flfeetive Pteretot Glass Slab Floor Raised Floor • 1_-____--0.60. (P4rc4mt 91140 x so 444 -70 -46 .51 to 0.50 -120 -58 -38 .60 0.40 -95 -46 -30 t 0.30 -69 -34 -22 4 0.20 -43 -21 -14 e 0.10 -17 =8 -5 i 0.08 -11 3 -4 30 -0.06 -6 .3 -2 4 0.04 -1 0 0 -12 0.02 4 2 1 • 0.00 10 5 3 13 Controlled Ventilation Crawispace -52 -17 -9 Number of stories 6 13 R -value One Two Three 71 R-0 -11 .7 -5 -14 R-5 -4 -4 3 24 R-11 ti -2 -2 .2 i R-19 -1 -2 .2 j 4. Slab Edge Insulation 8 -t 22 37 -9 3 3 9 15 Number of Sto_ries 34 -7 R -value One Two Three 20 •: R-0 00 0 0 10 R-5 8 5 2 - 1 R-7 8 6 3 -26 F2 factor 2 7 12 16 90.90 -4 3 .1 8 0.80 -1 -1 0 0 0.70 2 2 1 15 0.60 6 4 2 14 0.50 9 6 3 7 0.40 12 8 4 5.Inriltration (Air Leakage) Specification Points Standard l 0 6. Glass Heat loss Total SCORE CARD COND. FLOOR AREA Flfeetive Pteretot Glass Slab Floor Raised Floor U -value (P4rc4mt 91140 x so Percent EffeedvePei ces t Glass Two Three One .51 to .41 to .31 to 0.30 or Glass Single Double .60 .50 .40 less 50 -121 -53 -39' -24 -10 4 40 -90 37 -26 -14 3 8 35 -75 -29 -19 -9 1 10 30 -61 -21 -13 -4 4 12 29 -58 -20 -12 3 5 12 28 -55 -18 -10 -2 5 13 27 -52 -17 -9 -2 6 13 26 -49 -15 -8 71 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 3 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 i 14 -14 3 7 10 14 18 13 -12- 4 8 11 15 18 ' 12 -9 6 9 12 15 19 11 -6 7 10 13 16 19 10 3 9 11 14 17 19 9 -1 10 13 15 ' 17 20 8 2 12 14 16 18 20 7. Shading (Shade Open) SCORE CARD COND. FLOOR AREA Flfeetive Pteretot Glass Slab Floor Raised Floor ` (P4rc4mt 91140 x so � EffeedvePei ces t Glass Two Three One , Two Three J (percent Sias x SC) -1 Effective ' East South %Glass North East South ' West Skylight 18 5 1 4 1 na 16 4 2 5 1 na 14 4 2 5 1 na 12 3 3 5 2 na-`' 11 3 3 5 2 na 10 2 3 5 2 1 9 2 3 5 2 2 8 2 3 5 2 2 7 1 3 4 2 2 6 1 3 4 2 3 5 1 2 4 2 3 i 4 0 2 3 1 3 3 0 1 2 1 3 2 0 0 1 0 3 1 -1 -1 -1 -1 2 - 0 -1 .2 -4 -2 0 na = not allowed .1 -6 IB. Shading (Shade Closed) . SCORE CARD COND. FLOOR AREA Flfeetive Pteretot Glass Slab Floor Raised Floor Mass (P4rc4mt 91140 x so AREA = /CFA One Two Three One , Two Three J -5 -4 -2 -1 %Gcive lee North East South Weat Skylight 18 -14 -48 39 -64 na 16 -12 -42 39 -55 na 14 -10 35 -50 -46 na 12 -8 -29 -40 37 na 11. -7, -26 36 33 na 10 -6 23 31 -29 . -74 9 -5 .20 -27 -25 -65 8 -5 -17 -23 -21. -56 7 -4 -14 -19 -18 -47 6 3 -11 -15 -14 38 5 .2 .9. -11 -10 -30 4 .1 -6 -8 -7 -23 3 0 -4 .5. -4 -16 2 1 -1 2 -1 -9 1 1 1. .___.1 M: 1 d: 0' 2 s 3 4 3 0 na . not allowed 0 .a 0.20 3 2 9. Interior Thermal Mass SCORE CARD COND. FLOOR AREA Interior Slab Floor Raised Floor Mass Stories Stories AREA = /CFA One Two Three One , Two Three 0.0 -8 -5 -4 -2 -1 -1 0.1 -8 -5 3 -1 0 0 0.3 -7 -4 -2 0 1 1 0.5 -6 3 -1 1 1 2 0.7 -5 -2 -1 1 2 2 0.9 -5 -1 0 2 3 3 1.1 -4 -1 1 3 4 4 1.3 -3 0 2 3 4 5 1.5 -3 1 2 4 5 5 2.0 -1 2 4 5 6 7 25 0 3 5 7 7 8 3.0 1 4 6 8 8 9 3.5 2 5 7 9 9 10 4.0 3 6 8 9 10 10 4.5 3 7 8 10 11 11 5.0 4 7 9 11 12 12 5.5 5 8 9 11 12 12 6.0 5 8 10 12 13 13 ; 6.5 6 9 10 12 13 13 ; 7.0 6 9 11 13 13 14 , 7.5 6 10 11 13 14 14 8.0 7 10 11 13 14 14 8.5 7 10 12 13 14 15 10. Exterior Wall Thermal Mass 23 Exterior Single- Single - +6 Io 16 or Wall Family Family Multi Mass Detached Attached Fam)r 0.00 0 0 0 1 0.20 3 2 1 -12 0.40 5 4 3 4 j 0.60 8 6 4 3 0.80 10 8 5 0 1.00 13 10 7 0 1.20 13 12 8 5 1.40 12 13 9 16 1.60 10 13 11•...2 i 1.80 10 12 12 13 200 10 11 13 1 11. Heating System ' 15 12 8 SE or HSPF 30 26 22 (assumes ducts In attic) 14 9 13.0 Sum of 1.6 29 24 20 _ -25 or -24 to -14 to -4 to +6 to _ 16 or SE HSPF less -15 -5 +5 +15 more f 0.72 6.60 0 0 0 0 0 0 0.75 .6.88 3 3 3 2 2 1 0.80 7.33 8' 7 6 5 4 3 0.85 7.79 13 11 10 8 -.7 5 0.90 8.25 17 15 13 11 - 9 7 0.95 8.71 __20 18 15 13 11 8 2 Effective SE or HSPF 1.9 (SE or HSPF x duct efficiency) t Effective -25 or -24 to -1410 -4 to +610 16 or SE HSPF less -15 -5 +5 +15 more 0.30 2.75 .73 -64 -56 -47 i38 -30 na 3.41 -45 -39 -34 -29 -24 -18 0.40 3.67 -34 -30 -26 -22 -18 -14 0.50 4.58 -10 -9 -8 -7 -5 -4 0.56 5.13 0 0 0 0 0 0 j 0.60 5.50 5 5 4 3 3 2 j 0.70 6.42 17 15 13 11 9 7 0.80 7.33 25 22 19 16 13 10 0.90 8.25 32 28 24 20 17 13 1.00 9.17 37 32 28 24 19 15 Zonal Control Adjustment Solar System Type _ 5 4 Resistance 10 9 7 6 4 3 Other 6 5 4 3 2 2 12. Cooling System SCORE CARD COND. FLOOR AREA 10. Exterior Wall Mass SEER AREA = 1. Ceiling Insulation or ND. L OR (assume: ducts In attic) R -value 138] U -value [0.030] 2. St m of 7-10 Ri3 or SE or HSPF Duct Efficiency [0.78] Effective SE or -2S or 24 io 44 to -4 to +6 to 16 or SEER less -15 •6 +5 +15 more 8.0 -14 -12 -10 -8 -6 -4 . 8.5 -9 -7 -6 -5 -4 3 8.9 -5 -4 -4 -3 -2 -2 9.0 -4 -3 -3 -2 .2 -1 9.5 0 0 0 0 0 0 10.0 4 3 3 2 2 1 10.5 7 6 5 4 3 2 11.0 10 9 7 6 4 3 - 120 15 13 11 9 7 5 13.0 20_ 17 ., 14 -1-2- 9 6 ) 100% 105% 1toy. its% 12M 125• 07'. Effective SEER 0.2 0.4 0.6 (SEER xduct efficiency) 1.1 1.3 1.5 SIM of 7-10 1.9 21 23 Effective•25 or -24 to -1410 -410 +6 Io 16 or SEER lest -15 -5 +5 +15 more 5.0 30 .25 -21 -17 -13 -9 , 6.0 -12 -11. -9 -7 -6 4 j 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 ' I Zonal Control Adjustment 1.1 1.4 1.6 j 10 8 7 6 4 3 3 No Cooling System Installed 1 - Stories 3.9 4.1 4.3 4.5 4.7 One -5 4 -4 -3 -2 -2 Two +. 3 3 :1 2 2 2 1 1.9 22 t 26 2.8 3 3.2 3.4 3.6 3.8 4 4.3 Single -Family Detached and Attached 4.7 4.9 d 5.3 5.5 5:7 5.9 50% Unit Size (sQ 1.1 Water 1.5 1199 1200 -1700 2200 2700 Heater l:redit or •1 to to to or . Type Type less 1699 2199 2699 more SG None 0 t 0 0.. 0 0 or Solar 12 ' 18 .. ' 6 5 4 r HP - -HWR 8 5 4 3 3 32 WSB 5 3 3 2 2 4.5 POU 8 5 4 3 3 SE None 37 -24 -18 -15 -12 1.4 Solar -1 -1 -1 0 0 2.7 HWR -18 -12 -9 -7 -6 4 WSB . -25 -16 -12 -10' -8 - POU -18 _-12. -9 -7 -6 IG None ­- 5 -3 -2 -2 -2 22 Solar 7 5 4 3 2 3.4 POU 3 2 1 1 1 E None -21f__19-4 : - -11 -9 5.9 Solar 8 1 5 4 3 3 1.6 POU -10 `. 3 -5 4 , 2.9 Multi -Family (Individual units) _-3 3.5 3.7 t Unit Size (s 4.1 4.3 Water 4.8 699 • 700 1200 1700 2200 Heater Crept or to to to or Type Type 'None less '1199 1698 2199 more SG 3 0 0 0 0 0 or Solar 14 7 5 4 3 HP HWR 9 5 3 2 2 6.5 WSB 9 4 3 2- 2 2.2 POU 9 5 3 2 2 SE None -45 !-23 -15 •11 -9' 4.7 Solar .2 .• 1 1 0 0 6 HWR -23' -12 -8 " -6 -5 1.7 WSB -25 -13 -8 -6 -5 _ _eQU. 3.1 _-23 -12 -8 6 5. IG None V 4 --3 .2 -2 '. 54 Solar _-8 6 .• 3 2 63 65 POU_'1 0 _'_.0 1.5 0..- 0 .. E . None :--30 -15 _ -10 -8 !7 3 . " � '-Solar 3.6 3.8 4.1 4.3 4.5 _� 4.9 ;r-8 = -4 3 :2 -2 5.9 6.2 6.4 6 6 6 8 95% Point System Summary: Climate Zone 11 . SCORE CARD COND. FLOOR AREA 10. Exterior Wall Mass Measures AREA = 1. Ceiling Insulation or ND. L OR AREA Interior Mass/CFA R -value 138] U -value [0.030] 2. Wall Insulation Ri3 or SE or HSPF Duct Efficiency [0.78] Effective SE or 'T". -PASS 1.1 -value [0.098] 3. Raised Floor Insulation or x _ = 7 a R -value [ 191 ✓ , 4. Slab Edge Insulation or R -value [01 F2 factor [0.77] S. Infiltration Standard 6. Glass Heat Loss t1. 7•u111C•..xi ic�t .t.a .1.61 Type U -value [0.65] 3TYPE 1 :ASS - - WIMC • 4.2, to- ex sed slab) 0% 5% 10% 15% 20% 25% 30%_ 35% 40% 4S% 50% 55% 60% 65x 70% 751E 60% 85% 90% 95% 100% 105% 1toy. its% 12M 125• 07'. 0 0.2 0.4 0.6 0.8 1.1 1.3 1.5 1.7 1.9 21 23 25 27 2.9 3.2 3.4 3.6 3.8 4 4.2 4.4. 4.6 4.8 5 53 1 10Y. 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 3.5 3.7 4 4.2 4.4 4.6 4.8 5 5.2 5.4 20% 0.3 0.6 0.8 1 1.2 1.4 1.6 1.8 2 2.2 24 27 29 3.1 3.3 3.5 37 3.9 4.1 4.3' 4.5 4.8 5 52 5.4 56 30% 0.5 0.7 0.9 1.1 1.4 1.6 1.8 2 22 24 26 28 3 32 3.5 3.1 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.3 5.6 58 401/. 0.7 0.9 1.1 1.3 1.5 1.7 1.9 22 24 26 2.8 3 3.2 3.4 3.6 3.8 4 4.3 4.5 4.7 4.9 5.1 5.3 5.5 5:7 5.9 50% 0.9 1.1 1.3 1.5 1.7 1.9 21 23 25 27 3 32 3.4 3.6 3.8 4 42 4.4 4.6 4.8 5.1 5.3 5.5 5.7 5.9 6.1 ' 55% 0.9 1.1 1.4 1.6 1.8 2 2.2 24 2.6 28 3 32 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.3 5.6 5.8 6 6.2 60% 1 1.2 1.4 1.7 1.9 21 2.3 2.5 2.7 29 3.1 3.3 3.S 3.8 4 4.2 4.4 4.6 4.8 ' 5 5.2 5.4 5.6 5.9 6.1 63 r 65% 1.1 1.3 1.5 1.7 1.9 22 2.4 2.6 2.8 3 3.2 3.4 3.6 3.8 4 4.3 4.5 4.7 4.9 5.1 5.3 55 5.7 5.9 6.1 64 70Y. 1.2 1.4 1.6 1.8 2 22 25 27 2.9 3.1 3.3 3.5 3.7 3.9 4.1 4.3 4.6 4.8 5 5.2 5.4 5.6 58 6 6.2 64 75% 1.3 1S 1.7 1.9 21 23 25 27 3 3.2 9.4 9.6 3.8 4 4.2 4.4 4.6 4.8 5.1 5.3 5.5 5.7 5.96.1 6.3 6.5 801/. 1.4 1.6 1.8 2 2.2 2.4 26 2.8 3 3.3 3.S 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.4 5.6 5.8 6 6.2 64 66 85% 1.4 1.7 1.9 2.1 2.3 25 2.7 2.9 3.1 3.3 3.5 3.8 4 4.2 4.4 4.6 4.8 5 52 54 5.6 5.9 6.1 63 65 67 90% ' 1.5 1.7 2 2.2 24 26 2.8 3 3.2 3.4 3.6 3.8 4.1 4.3 4.5 4.7 4.9 S.1 53 5.5 5.7 5.9 6.2 6.4 6 6 6 8 95% 1.6 1.8 2 2.2 25 27 2.9 3.1 33 3.5 3.7 3.9 4.1 4.3 4.6 4.8 5 5.2 5.4 5.6 5.8 6 6.2 6.1 6.7 6.9 100% 1.7 1.9 21 2.3 25 28 3 3.2 3.4 3.6 3.8 4 4.2 4.4 4.6 4.9 S.1 5.3 5.5 5.7 5.9 6.1 6.3 6.5 6.7 7 t0S% 1.8 2 22 2.4 2.6 28 3 3.3 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.4 5.6 5.8 6 6.2 6.4 6.6 68 7 110% 1.9 2.12 .3 2,5 27 29' 3.1 3.3 3.6 3.8 4 4.2 4.4 4.6 4.6 5 5.2 5.4 5.7 5.9 6.1 6.3 6.5 6.7 69 7.1 115% 2 2.2 2.4 2.62.8 3 3.2 3.4 3.6 3.8 4.1 4.3 4.5 4.7 4.9 S.1 5.3 5.S 5.7 5.9 6.2 6.4 6.6 6.6 7 7.2 120% 2 2.3 2.5 2.7 29 3.1 3.3 3.5 3.7 3.9 4.1 4.4 4.6 4.8 5 5.2 5.4 5.6 58 6 6.2 6.5 6.7 6.9 7.1 7.3 125% 21 2.3 2S 2.8 3 3.2 8.4 3.8 3.8 4 4.2 4.4 4.8 4.9 5.1 5.3 5.5 5.7 5.9 6.1 6.3 6.5 6.7 7 7.2 7.4 Point System Summary: Climate Zone 11 . SCORE CARD COND. FLOOR AREA 10. Exterior Wall Mass Measures AREA = 1. Ceiling Insulation or ND. L OR AREA R -value 138] U -value [0.030] 2. Wall Insulation Ri3 or SE or HSPF Duct Efficiency [0.78] Effective SE or R -value [1. 1 ] 1.1 -value [0.098] 3. Raised Floor Insulation or x _ = 7 a R -value [ 191 U -value [0.037] 4. Slab Edge Insulation or R -value [01 F2 factor [0.77] S. Infiltration Standard 6. Glass Heat Loss Type U -value [0.65] 7. Shading (Shade Open) a. North b. East c. South d. West e. Skylight 8. Shading (Shade Closed) a. North b. East c. South d. West e. Skylight 9. Interior Thermal Mass X3...5 % Total Glass [ 161 % Glass SC Eff. % Glass X = f 15 S x = f. 4?3 d x %Glass SC /- Eff. % Glass 'Soo x ��P = X = �• J� D x = lJ a?. 5 x x TYPE 1 MASS AREA $ Point Scores -a f � 0 _(3 Sum 16 O Sum 7-10 Point Total: ¢ Y InteriorMlas/CFA COND. FLOOR AREA 10. Exterior Wall Mass TYPE 2 MASS AREA = Exterior Wall Mass ND. L OR AREA 11. Heating System • ? x 93 = . t59 Zonal Control? ( Y / N) SE or HSPF Duct Efficiency [0.78] Effective SE or 10.716.61 HSPF J0.5615. 151 12. Cooling System x •'%' = 7 a Zonal Control? ( Y / N) SEER 19.51 Duct Efficiency [0.74] Effective SEER [7.031 -13. Water Heating Type [SGI Credit [none] 3 Point Scores -a f � 0 _(3 Sum 16 O Sum 7-10 Point Total: ¢ Y