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069-240-025
69-24-25 I ON HORNER �/ � 7/-? ,t 482 Royal Oaks Dr, Oroville 7 ontr: Better Builders ermit #2757-84B,P3'E,M(new single family) 69-24-25j t �`-C„„ � Contr: Better Bldrs T-�� Permit#1620-85B(add awning/SF)��� j 069-240-025 8-1924 HORNER DON 5482 ROYAL OAKS OROVILLE `. ROYAL FLUSH PLUMBING GAS LINE & S,TOVE 8/Z(% 069-240-025 99-1399 HORNER, Don H. 5482 Royal Oaks Dr., Oroville Contr: George Roofingq Re Roof� / 121-10 6 Fq i o j o I i i s 69-24-25 I ON HORNER �/ � 7/-? ,t 482 Royal Oaks Dr, Oroville 7 ontr: Better Builders ermit #2757-84B,P3'E,M(new single family) 69-24-25j t �`-C„„ � Contr: Better Bldrs T-�� Permit#1620-85B(add awning/SF)��� j 069-240-025 8-1924 HORNER DON 5482 ROYAL OAKS OROVILLE `. ROYAL FLUSH PLUMBING GAS LINE & S,TOVE 8/Z(% 069-240-025 99-1399 HORNER, Don H. 5482 Royal Oaks Dr., Oroville Contr: George Roofingq Re Roof� / 121-10 6 Fq .�.. -.4 -r-. -> � :•�... �.}wr, -—•-��w• ��t.. _. .,�j,:�.R.� � ",�, ,�:. .. � .-y�r •7+r7rus'z:. . . ... , . �. , _ _ _. .. COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive.- .Orogille, California 95965 - Telephone (916) 538-7541 �; / PE �T o (Rev. 12/96) APPLICATION AND PERMIT ,�_ /� n /: ASSESSOR PARCEL NUMBER 0— �f �j J� —6 V a( �'rI'`/// v(!-("'�) ZONING BUILDING PERMIT OWNER Horner Don H. TELEPHONE 5E9-3287 SQ. FT. OCC. BUILDING VALUATION Co,tp 1500.00 OWNERS MAKING ADDRESS 5482 Royal Oaks Dr, Orovills, CA 9596& CONTRACTOR'S NAME George Roofing TELEPHONE 533-6393 CONTRACTOR'S MAILING ADDRESS 5810 Lincoln Blvd OrovilloCA 95966 CONSTRUCTION LENDER [Fireplace LENDER'S MAILING ADDRESS Total Valuation $1500.00 ARCHITECT OR ENGINEER LICENSE NO. Fee' $ 20.00 —Filing Permit Fee - $ 35.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 5482 Royal Oaks Dr. Oroville CA 95966 Energy Plan Checking Fee E $ PERMIT FEE _55.00 LOT NO. SUBDNISION'S NAME - PARCEL MAP 1 - PLUMBING' PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF :t 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 O Other ❑ Describe Work: Composition Shingles Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I WFF_ @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 a00V OR LESS Main Service 200A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is i full for %effect. License Class t'� y � Lic. No. 452260 OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 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 ^to 'construct the pr6ject. ❑ ' i am exempt -..under4Se" ec. Business and Professions Code for this 11 � reason v' Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. So OR ADDNS. ( 6 ACC. BUDS. 3.50FT. NO,REs11DST. MULTI -OUTLET @ 7.50 POWER APPARATUS 6 SINGLE OLITLET CIR. Ex. Occup.OUTLET OR FIXTURES BAIL @' 50 Ex. Occup. ouTTtTS AEs o.) E 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT "FEE, s WORKERS' COMPENSATION DECLARATION 1 hereby: affirm under penalty of perjury one of the following declarations: )❑: 1 -have and will maintain a certificate of consent to self -insure for workers' compensation, as -provided for by section 3700 of the Labor Code, for the •performance of the.work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My worker rYaii%sofa TsurrSpacpdr er, arj � c5il tuber are: Carrier p MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Numberliv L 0 5 J 7 0 S (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 forthw'th comply with those provisions. l+ X tXA �_ /�� _ Date —& -h g'A ' 1 licant - ❑ n01ki er` ❑ Co' rector ❑ Agent T Signature, pp g An OSHAipar it 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 FEES 55.00 HAZ. D. FEES IMP FLOOD CDF PARCEL I PD HD ISSUE This permit is hereby issued under the applicable provisions- of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. y B Al��/ i Date /a h EXPIRES ON fY X�HITE-D.D.S.-B. 8fe rReceiptNoPERMIT D. ` CANARY-ASSE SOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES- BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PF RMIT NO. (Rev. 12/96) APPLICATION AND PERMIT 4V-1. 99 ASSESSOR PARCEL NUMBER j-� / h n ZONING BUILDING PERMIT OWNER Horner Don H. TELEPHONE 589-3287 SQ. FT. OCC. BUILDING VALUATION 2500 com 500.00 P OWNER'S MAIUNG ADDRESS 5482 Royal Oaks Dr, Oroville CA 95966 CONTRACTOR'S NAME George Roofing TELEPHONE 533-6393 CONTRACTOR'S MAIUNG ADDRESS 6810 Lincoln Blvd Oroville CA 95966 CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $1500.00 ARCHITECT OR ENGINEER LICENSE NO. Fee $ 20.00 —Filing Permit Fee $ 35.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 5482 Royal Oaks Dr Oroville CA 95966 Energy Plan Checking Fee $ $ PERMIT FEE $ 55.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF $I Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation IR Other ❑ Describe Work: Composition Shingles Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( zo.A oa mss 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.PO License Class C-39, C-14 Lic. No. 452266 OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service ( 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( 8 ACC. BLOS. SO 3.50FT. N CONST NON-RFRID. MULCTI-OCU. @7,50 FR APPARATUS a SINGLE OUTLET CIR. Ex. Occup.OUTLET ORFO(TUREs 20 @ I o0 BALQ .50 Ex. Occup. OUTLEETS REwSDOEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: X0A 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' cgmpensation insurance carrier and policy number are: Carrier Vl llanova Insurance Company MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE S Policy Number WC 20537019 (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 T'th comply with those provisions. �1 X _ _ Date �� l Sipplicant - ❑ n ❑ ractor ❑ Agent An OSHA it 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 $ 5 5.0 0 HAZ. D. FEES IMP I FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. n By ate PERMIT EXPIRES ON 4®�/ ate Receipt No. 3r -07 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT CJo- iv. C�s "Ic -7 C7 (Rev. 12/96) COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER � 7 n_n� ZONING RT 1 BUILDING PERMIT OWNER 1169NER, DO °.")E287 SO. FT. OCC. BUILDING VALUATION OWNERS "AILING ADDRESS 5482 Royal Oaks Drive, Oroville 95966 CONTRACTOR'S NAME Royal Flush Plumbing WJPOZ 128 g CONTRACTORS MAILING ADDFPSo* Box 243, Palermo, CA 95968 CONSTRUCTION LENDER LENDER'S MAILING ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filin Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS 5482 Royal Oaks, Oro Energy Plan Checking Fee $ $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP I PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY i 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 TYPE OF WORK { New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ I Describe Work: Gas line and free standing stove 1 1 Gas piping sy2tern 1- 5 outlets 15.00 , Building sewer 15.00 Mobile Home I S I G W 920.00 PERMIT FEE S • ELECTRICAL PERMIT Fling Fee 20.00 Main Service 2o0A 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. L y OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 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 to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Main Service 200A TO 1000A 46.00 NEW CONST. DWa .UNG OCCUP. OR ADDNS. ( ACC. S. SO 3.5¢FT. CONS MULTI-BRANC.OUTLET N @7,50 POWER APPARATUS a SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FD(TUREs 20 @ 1.00 SAL @ .50 Ex. Occup. DFIxLITe RLL.. ) E.- 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Filing Fee 20.00 Heating - •t Cooling Hood 6.50 Ventilation PERMIT FEt S 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.) 14 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. p y X rte i•C.v�cx. n Date C.1 -��-" / Signature of Applicant - ❑ Owner WContractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FEE $ 70.00 HAZ. I D. FEES IMP I FLOOD I COF PARCEL I PD HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have f/ BY n . � -+ PERMIT EXPIRES ON'��-s the applicable provisions Resolutions to do work been paid. Date �i ,c 5� ate ReceiptNo. 2 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT R y )1 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541gg 1 41 ,4 O. (Rev. 12/96) APPLICATION AND PERMIT O ASSESSOR PARCEL NUMBER 940-095 ZONING RT 1 BUILDING PERMIT OWNER NER, DOJ °'287 SO. FT. OCC. BUILDING VALUATION .OWNERS MAILING ADDRESS 5482 Royal Oaks Drive, Oroville 95966 CONTRACTOR'S NAME Royal Flush Plumbing MMl28 CONTRACTORS MAILING ADDPFSO Box 243, Palermo, CA 95968 i CONSTRUCTION LENDER 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 5482 Royal Oaks, Oro Ener Plan Checking Fee $ Energy g $ PERMIT FEE $ LAT NO. SUBDNISIONS 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 13 Utilities ❑ Installation 13 Other ❑ Describe work: Gas line and free standing stove Gas piping stem1 - 5 outlets 15.00 Buildingsewer . 15.00 Mobile Home I S I G I W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 vILE Main Service 200AO'R SS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class �- (j Lic. No. iS % o�� OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Main Service 200A TO 1000A 46.00 NEW CONST. DWELLING OCCUP. s0 OR ADONS. a ACC. BLOB. 3.50x. NON-REOSID. MULTI -OUTLET CIRCUITS @7,50 POWER APPARATUS a SINGLE OUTLET CIR. Ex. OCCU . OUTLET OR FDRURFS 20 @''00 BAL @ .50 Ex. Occup. OFUTLEEDrsA p�ID°� 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 t_ PERMIT FEE S MECHANICAL PERMIT Fling Fee 20.00 Heating 1 15.005.O Cooling Hood 6.50 Ventilation PERMIT FEE $ 35.00 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.) j� 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 orthwith cc r nply with those provisions. 1( y X L .ark Date -d`3 e ! Signature of Applicant - ❑ Owner $'Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 70.00 HAZ. D. FEES IMP I FLOOD I CDF PARCEL 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. O By Mn A Date 21.r YA PERMIT EX IRES ON 2� Dete Receipt No. 2 C/CI %�� WHITE-D.D.S.-B.D. CAN Y -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT (Rev. 12/96) COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER ZONING D-6 ( BUILDING PERMIT OWNER TELEPHOrS 7 3NE Y2 0—e.OWNERS SO. FT. OCC. BUILDING VALUATION MAIUN QADSS /�1/d /q'' I C C� Q v V CONTF�R'S NAME TELEPHON C T 5 UNG ADDRESS 2 CONS TRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Klin Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAKING ADDRESS Plan Checking Fee $ BUILDING ADDRESS ZS !4' ` Energy Plan Checking Fee $ 0`'6 $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Tra 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ / Describe Work: \lam S C-( lis` � V—��� e�.�.t.,0 Gas piping system 1 - 5 outlets 15.00 00 Building sewer 15.00 Mobile Home S G W Q20.o0 PERMIT FEE $ a GY6 ELECTRICAL PERMIT Fling' Fee 20.00 600V OR LESS Main Service zow OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION 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. ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit Is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X Date Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service goal TO 1000A 46.00 NEW CONST. DWEWNG OCCUP. S° OR ADDNS. ( s ACC. ocs. 3.5¢x: PION p°NIp,' muLT o,"IET @7.50 POwEA APPARATua a sINGLE ourLET C, IR 00 Ex. Occup. OUTLET OR FIXTURES SAL .so 2L @ .50 APPLNS Ex. Occup. O�DO.R. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE S MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FES $ b Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ D Oo , D FEES LMP FLOOD COF PARCEL Po HDD ISSUE_ This permit is hereby issued under the applicable If the Butte County Code and/or Resolutions indicated above for which fees have been By Date PERMIT EXPIRES ON provisions to do work paid. to Receipt No. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT y. PERMIT NO. 2757-84B,P,E,M • .PERMIT EXPIRES OWNER DON HORNER' rnMTO Better Builders ASSESSOR PARCEL 69-24-•25 (Z— t: 5 IY5482 Royal Oaks Dr Oroville LOCATION S -Z' OFFICE COPY 1. . Temp. Power Address I{1 Called i GAS Date_— I Meter B Temp. Elec. , ELECTRIC" Date �3 Meter By %,\_ I Viz, Called P I ,S 1' Temp. Gas Service Cal led PG&E ,y JOB FINALED (Date) 14 Signature I l J = OK 0 = Not OK = Not,Applicable MOBILEHOMES ' * = Not Ready. - MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except q's 1. Zoning, Requirements -Setbacks -Easements- Date DECKS,'COVERS, CARPORTS, ETC. (Plans) OK except N's 1. Zoning Requirements -Setbacks -.Easements , 2. Soils; Special MH Support -Sketch 3. Sewer; Location -Test -Fall -C/0 -Concrete' 2. Footings;.Size-Depth-Spacing-Connectors 3. Decks; Girders and/or Joists-Decking=Bracing-Stairs-Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.-Shthg.-Rfg.-Bracing 5. Electricity;.Location-Clearances-Grnd.-/ / Amp -Concrete 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap:/ /"L" ft,/ /'Nat.or/ /"L" fL/ */"LPG 6. Carports; Windows -Doors 7. Utility Clearance ; i.� 7. Elec. Card -BI Date Card -BI Date r 5 Card -BI Date Card -BI Date' Card -BI Date Date Card -BI i ,Date .. MOBILEHOME INSTALLATION (Plans) OK except N's 1.• Zoning Requirements -Setbacks -Easements Card -BI Date Date Card -BI Date POOLS (Plans) OK except a's 1. Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line. '2. Soils; Compaction -Structure Stability 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining 4. Elec.; Receptacles and Lighting; Distances-GFI 5: Drain; MH Test -Fall -Flex Connector 5. Elec.; Pool Lighting; 15 volts-GFI , 6. Water; MH Test -Regulator -Connector 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Water and Sewer Connected -C/0 to Grade -HD Approval 7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater 8. Gas and Electricity Tagged B. Elec.; Grounding; Eg6ip.w/5'-Circulating Equip. -Pool Lghtg. Boxes -Enc losures- Pane lboards-Ins. to Main in Conduit 9. Exits; Insp.-Sketch 10. Cert. of Occupancy , 9. Health Department Approval 10. Plumb; Cir. Test -Water Supply Test t• .1 Card B-1 Date Card -BI Date Card -Bl. Date Card -BI Date _ Card B -I Date Card -BI Date Card -BI Date Card -BI Date i 5 = OK = Not OK = Not Applicable = Not Ready RESIDENTIAL (Single and Duplex) Date UNDERFLOOR Plans OK except #'s Date FRAMIW(Continued) 1. Zoning requirements -Setbacks -Easements 48. rty Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. . Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50 S s; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 51. PDLI-rood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. iding-Nailing-Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53 esh-grip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54., Qfazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. r Wagpi 4ailing Bolts 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. 13. Plenums & Ducts; Clearance -Material -Support -Ins. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples WCa,d-BI Dat /0 Card -BI Date ate Card -BI Date Card -BI Date Card -BI Date Date Date Card -BI Date (Plans) OK except q's Card -BI Date Card -BI Date Date PLUMBING (Permit) OK except q's 56./ xt. teps-Door & Sidelight Protection -Landings 57. PffioDetector 14. Xater Ht.; Vent -Access -Combustion Air 58 rnace; Vents -Clearance -Comb. Air-Connector- Infdarage; Above Floor-Ducts-Mech. Protection iK Pipe; Test & Anchors -Nail Protection 18"' D.W.V.; Test-Fttngs & Anchors -Nail Protection 5;i' froom Exiting 1 . Shower Pan; Test, First Floor -Tub Access 60 .R:I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 6 . E- .Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 6 rs & Rails Filapface or Stove; Clearance -Hear 64 lec. Outlets at Wood Panel; Int. & Ext. Card- I Date 0 Card -BI Date 25( Pixy &Appliance; Grnd.-Air Gap-Cookin Clearance rd -BI Date Card -BI Date 66.Ler . Outlets & Receptacles at Kit. Counter Date ELE AL Permit OK except N's 67.kdarage Fire Door; Swing -Landing -Closer n Gara a -Dam er 2 F' ture & Transformer Clearance -Ins. Protection 69.r. r.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In arage; Above Floor-Mech. Protection 21 Receptacles Spacing -Lights &Switches at Doors 7 I ler. & Mech. Equip. Listed for Location 2 S' Boxes & No. of Conductors -Stapled 71. le eceptacles in Garage; (G.F.I.)-Romex Protec. 23. gotex Installed Close to Edge of Studs & C.J. 24 ip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72, s tion-FoartFLooked in Attic-Ej'Yes 25. 2 Appliance Circuits in Kitchen & Conductor Size 73. uard Rails &Deck Construction -Post Caps Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 74. Fdn. Vents & Crawl Hole r -Drainage & Wood -Earth Cleara e Looked under Floor Yes Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral ❑Yes ❑No 75. Following instld.: Drive as C] No; Walks Yes El No; Planters ❑Yes o 28. ervice-Riser Conductors & Ground -Main Disconnect 7 rown-Finish 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77, 1f1.0 nit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet ,oe30 Clothes Closet Light -Shower Light 78. ents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. - 7 ; Disconnect, Electrical, Plumbing 80. x or Elec. Trim; G.F.I. Receptacle -Underground a Date Card -BI Date 81 a ation throughout House Card B-I� n Dae Card -BI Date 82 lass Protection Date ME ANI (Permit) OK except N's 83. Corrections from Previous Inspections e - eters Tagged; Gas -Electric JV A4C, Ducts; Insulation & Support 85 ate Sewer Connected -C/O to Grade -HD Appr I 32. Vent Fan; Exhaust above Insulation g ergy Compliance Certificate -Other Certificates 33. Condensate Drain & Overflow; Size & Grade 4. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic Card -B Date Card -BI Date rB d - Date . (i Card -BI Date Card -BI Date Card -BI Date '17 -and -BI Date Card -BI Date Card -BI Date Card -BI Date Date FRAM G(Plans) OK except q's Comments at Final: 36 s; Proper Material &Anchors 37 a Is; Studs -Nailing, Spacing & Bracing -Plates -Sound 38. ea ing Walls over Girders & Floor Nailing 3. aft Stop in Walls (rat proof) 40. re to s; Furred Ceilings -Stairs -Chases -Tub 41. ader & Beam -Size & Bearing 42." Hangers -Post Caps -Anchors- onnectors 43. 44. Clnq. Joist-Rftr. Ties- in-Roo_f_Brac. r Shthng_.-Rfn_g_.__ re�p1"ace Ties or Type Flue -Fireplace Throat 4 A tic ccess; Size &Romex Protection -Draft Stop -Ins. Baffles 46. B m. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. arage Fire Protection Framing (NOTE: Anentry must be made each time youvisit jobsite) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR P CEL NUMBER - - ZOT BUILDING PERMIT OWNER f�... TELEPHONE SO. FT. OCC. BUILDING VALUATION v OWNER'S MAILING AL)UHEb CONTRA T R' NA E /bTELEP� ( /`�j��/ 'CON RACTOR'S MAILING D RESS Fireplace 11 rt CONSTRUCTION LENDER LINKN- !/ Total Valuation 1 $ 70469 Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ _0 1221-19D ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penaltylic $ �^ Q r ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ ` BUILDING ADOREs Y' PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar Water Heater Water piping 20.00 , 5.00 LOT NO SUBDIVISION< E K/ PARCEL -MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Building sewer 5.00 Mobile Home S G W 10.00 e TYPE OF WORK New Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other Describe work: — Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NE % OC OR ADDNS. 1 G P.&\ •21/20sq ft _t / 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 fQ= and effect. License No.��3�s Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR,ULT'-OUTLET NON.RESID BRANCH CIRC ITS 2,50 ea �'� NEW CONST R. ( POWER APPARATUS &1 NON -RES,D, SINGLE OUTLET CIR. / 20@56C Ex. Occup(O OR FIXTURES BAL0PPLNS 30 FIXED A Ex. Occup. our ETS ((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 FiIingFee 10.00 Heating . Cooling o2 �> Hood 3.00 Ventilation 5d 5.00 (� 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 bove-mentioned property for inspection purposes. Butte to enter upon t'h7Vs, I also agree to s ve, emnify and keep harmless the County of Butte against all liabiliti s j dgm costs, and expenses which may in any way accrue against my n consequence of t e granting of this permit. X _ 625 14i� Or Date Signatur of Applicant Owner Contractor ❑ Agent 9 An OSHA permit is required for excav ions over 5'0" deep and demolition or construct- ion of structures 3 stories in height. Mobile Home Installation Fee $ 3Q ' TOTAL PERMI E $ OCCUP. GROUP _3 TYPE OF CONST. PAR L PD H SSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which D=IRR III BLIC P BY � ` PERMIT EXPIRES DateIr the applicable provi- resolutions to do fees have been paid. WORKS Date ..000ver Receipt No. ol��j Gn WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT ll COUNTY OF BUTTE - DEPARTMENT 01 +1tPUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CA"LIF"`ORNIA 95965 - TELEPHONE: 916/534541 t PERMIT APPLICATION DATA SHEET Permit No. OWNER` / 111'►'� A. P. No. fn_ 9 - Proposed Building Use /- Permit Fee Based Upon: Complete Contract Price / _DPW Valuation t 1 Other (Explain) 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. . . . . . . . . . . 3. Complete plans in duplicate/triplicate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. State Energy Forms No. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . , . . , , , 9. Letter of signature authorization. . . . . . . . . . 10. Sanitation approval from Health Dept. ' 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . ..; 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner[], Mail to owner ❑•) 15. Improvements may be required. . . . . . . . . . . •a 16. Mobilehome Installation Data. . . . . . . .. •Pre-Inspec. request to 17. Pre-Ins,peotion for - Required. Building Inspector (Date) i 18. Other When you issue the permit, process as Vol lows: Mai Telephone and hold for pickup at Other Applicant owner. Mail to contractor. ';office. Deliver w/inspector. Copy of plans sent Health Dept., Fire Dept., Other v Date During the plan checking process, the following data must be submitted prior to permit issuance: `(For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by y Plans checked by_ Plans approved by Other: Copy—DPW Telephone Mail Date Date Date Other Telephone 'y 583-2000 North Burbank Public Utility District 1960 Erin Street OROVILLE, CALIFORNIA 95965 s DISTRICT APPROVAL AND 42-84 VERIFICATION OF INSPECTION BUILDING SEWERS This verification form must be submitted to the Butte County Department of Public Works - Building Department prior to issuance of a building or occupancy permit, whichever is applicable. Prior to final approval by Butte County of a Building or an Occupancy Permit, a copy of this verification form, signed off by North Burbank Public- Utility District, must be submitted to Butte County. • r DON & BETSY HORNER, (Better Builders) Applicant: Applicant Address: 10801 N. 45th St., Phoenix, AZ 85028 Applicant Phone No.: Property Location (s): 5482 Royal Oaks Drive, Oroville Kelly Ridge Estates Unit 4B, Lot 133 ' A. P. No. (s): 69-24-25 Fees Paid: $XNNXNNX . ALL FEES PAID Application for service approved: North Burbank August 29, 1984 Public Utility District Inspection(s) made and successful tests) observed: Location: Date: By: • ° North Burbank Public Utility District release to close permit: Date: By: ' Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT Y FOR RESIDENTIAL DEVELOPMENT �`1cq�'� t O�-FBUTTE C0UNTY-C-A1.1'-' ICi�t�aW(?�c�uc; Section 26-8.1 of the Butte County Code requires this acknowledgement be recorded prior to issuance of a building permit: ��h Sf�i'►',r The property described herein is adjacent'to land or included SEP ZO J00 FIS 19R�! within an area zoned for agricultural purposes, and residents of this Fl_tt:►iC;; �I;; t; ::� property may be subject to inconveniences .or discomfort arising from CL. t:fiK - 11,Fcolduu( the uee of agricultural chemicals,including,. but not limited,to herbicides, peeticideif.E 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 agricultural 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: Lot 153, as shown on that certain map enti.tled,':'KELLY RIDGE ESTATES UNIT 4B", which map was filed in the office of the Recorder of the County of Butte, ,State of California, November 10, 1977 in Book 58 of Maps, at pages 73, 74, 75, 76 and 77. Subject.to all easements, rights of way and restri:ttions of record. ' Date: September 19,1 984 PROPERTY OWNERS:, ' Don H & State of ) On this the day of19� , before SS. me, the undereigie, Notary Public, personally appeared County of ) 4- Ll Personally known.to me. Proved to me on the basis of satisfactory evidence. to be the person(s) whose hame(s) n)r4 &C,5 subscribed to the within, instrument and acknowledged that executed the same for the purposes therein conte ned., IN WITNESS WHEREOF „I hereunto set my hand.and official seal. Present. A.P. No. 9 — IS— v' tary Publi My Commission b.,oires Dec. 21;1984 z;, •• COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES '1469 Humboldt Road, Chico, CA - (916) 891-2751 7 ,County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE 2t>17YKER PERMIT NO. Awcofei nVeo£on indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work 59cmageted.9fy.onhave any questions pertaining to this matter, or need additional explanation, Ipleme +curnactiNs office immediately. 7 �-A FA T%/ i SIT IDaW L6 / 7 Inspector �� r I COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 5344541 Skyway and Elliott Road, Paradise — Phone: 872-2961,• Ext. 57 t CORRECTION NOTICE' Z7,5 -7-'F 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. / \ /�- Inspector Da COUNTY -OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE 7 F5 PFRhI 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. Inspector Date /Z—,t COUNTY OF BUTT-- DEPARTMENT UTT-DEPARTMENT OF PUBLIC'WORKS 196 Memorial Way, Chico— Phone: 891-2751 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE R / — 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. Inspector A/ f Date T � r 5i'a6 -1"'Ywl 0 Permit No. 'sRc�•n C is l; 'r IF ICATInM ROOF DESCUIPTION OF INSULATION Material Thickneas(inches) EXTERIOR WALL Material Fiberglass Thickness(inches),� CEILING Batt or Blanket Type_fiberglass Thickness(inches) Loose Fill Type Fiber.alass Minimum Thicknesl(Inches) Area covered(ft. )_ FLOOR, ELEVATED Material Fiberglass Thickness(inchea) FLOOR, SLAB Material Thicknesa(inches) — Width(inches) FOUNDATION WALL Material Thickness(inches) I hereby certify that tiw abo in conformance with r.tw State A.r. No. Brand Name lherwAl Resistance (k Value)_______ Brand Name Certainteed Thermal Resietanee(R Value)— J Brand Name Certainteed Thermal Resiatance(R Value) Brand Name Certainteed Nuuiber of Balla Wt. pper ThE: rma1 Resise(R Value) F,g Brand Name Certainteed Thermal Resiotance(R Value) -4Z-- Brand Name Thermal Resistance(R Value). Brand Name Thermal Resistance(R Value) L, insult, tion ',,as installed in the above: of California Energy Requtre"nte. Hawkins Insulation Co., Inc. L2 --F1 NAME/OWNER — SIGNATURE OF INST�V.LA'1'ION APPLICNfOR building 378407 . I'VIL CONTRACTOk'S L-ICENSE777:- NO. %6—% 2 DATE �`---- I her,!by certify th,: above insulation lend all building Department required items as c,wn on the appruveJ sh plans and attaclunents have been installed as required by the State of California Energy Requirements, All equipment, device;; and materials are of the quality prescribed or are specifically approved by the Stat;! Of California. FIRM NAME/OWNER (Please print) STATE CONTRAICTOR S LICENSE No. SIG NA RE GENERAL CON'1'1uICTOR OWNER ` _ 4- NA DATE THIS CERTIFICKPE MUST BL ON FILL WITH T11C BU].LUING DEPARTMENT INSPECTION APPROVAL AND A COPY SliALL PKIUk TO FINAL BE 1'US'iGD WITHIN 'rHE BUILDING . Jalivary l�,i•=, f " - ��. � -may --;Z6 -` _ FORM. RESIDENTIAL ENERGY PLAN ,CHECK/INSPECTION SUMMARY Owner l ��,=�, �r :: Climate Zone Permit No. Floor Area _127( > . Compliance path: Package ❑ A ❑ B ❑ C 0 Point System ❑ Budget• ® Other - MIN R -VALUE DESCRIPTION REQ ' D . . INSTALLED ITEMS _(1) INSULATIO t �J Roof/Ceili g I •So Wall ❑ Slab Floor Perimeter- -Raised. Floor t , (2) INFILTRATION: ❑ (A) A vapor barrier is required"in climate zones, 1, 14 & 16. ® (B) All manufactured windows and sliding glass doors shall meet the 1972 ANSI Air Infiltration Standards and shall be certified and labeled. ® (C) All swinging doors and windows leading to unconditioned areas shall be fully weatherstripped. .Tight - the above standard features plus: ' ❑' (D) Continuous infiltration barrier ❑ (E) Electrical outlet plate gasket .❑ (F).Air-to-air heat exchanger (3) GLAZING:. (A) Location Area Glazing %,Floor Area Single Double Triple . ®. Total Bldg I/ I %. (. . ® North - --S-1 ® East _ • - South West ❑ Skylights (B) Shading Shading Coefficient Description ❑ East ' ❑ South ® West • USA t t • or . Y aellzr ❑" Skylights (C) South Overhang _ Length of projection �ft. Description ❑ (D) Moveable insulation: Area ftZ Description (E) Thermal mass. ❑ Type .. - Area Ft.2 HC= R= MC= Location _ ❑ Type - AreaFt.Z HC= R=- MC= Location ❑ Type,,. - Area Ft..2 HC= R= MC= - ;Location , - ❑ Type - Area Ft.Z HC= R=. .. MC= Location Q Type: - Area' Ft.2 HC=-- R= MC= Location ❑ TYPe-. - Area Ft.Z HC= R= - MC= Location 7/83 (brand and model 'number) (seasonal EER) MRM, I ❑ (4) MASONRY AND FACTORY -BUILT FIREPLACES shall be equipped with tight.. (cooling capacity at 95°F) , fitting closeable metal or glass doors covering the entire opening of the firebox; a combusion air intake equipped with.a readily, accessible, openable, and tight fitting damper to draw air from the EER outside of.the building; and a'tight fitting flue damper with a readily accessible control. ' *1(5) HEATING VENTILATING -AIR CONDITIONING SYSTEM (cooling capacity at•95°F) (A). -Heating ❑ • Central Gas Furnace (brand and model number) SE (describe) Btu/hr (C) (heating capacity) ® Heat Pump. its second stage, shall be required for heat pumps. (brand and model number) ACOP (D) Btu/hr (heating capacity at 47°F) Q Active Solar (E) ':type (liquid or air) Collector brand and ft2 fan type central --furnaces, gas-fired fan type wall furnaces and model number solar fraction collector area collector ' orientation collector tilt rated y -intercept rated slope,1 ? ® / Other-t/mel� (describe), 4 ® *1 (B) Cooling Q Electric Air Conditioner. . (brand and model 'number) (seasonal EER) Btu/hr (cooling capacity at 95°F) , ® Electric Heat Pump EER Btu/hr (cooling capacity at•95°F) ❑ Other (describe) ® (C) A TWO-STAGE THERMOSTAT, which controls"the supplementary heat on i its second stage, shall be required for heat pumps. ❑ (D) AN AUTOMATIC SETBACK shall be provided for all thermostats,except those controlling heat pumps. ❑ (E) AN INTERMITTENT IGNITION DEVICE shall be provided for all gas-fired fan type central --furnaces, gas-fired fan type wall furnaces and gas cooking appliances. (F) BACKDRAFT DAMPERS shall be provided for all fan systems exhausting air to the outside. 4 ® (G) DUCT CONSTRUCTION &:INSULATION. All transverse duct, plenum, and fitting joints shall be sealed with pressure sensitive tape or mastic'to prevent air.loss and shall be insulated to,conform to the provisions of .Section 1005 of the UMC, 1976 Edition. 7/83 , 2 . FOR K1 ' (6) DOMESTIC WATER SYSTEM • ❑ -(A). Gas: Only Gallons ` ' ,(brand,and.model number) , (tank size) ® Heat Pump w/Electric Backup (brand and model number) Gallons . (tank size):.. l (j *2 Active Solar -(collector brand and model number) (rated y -intercept) (rated slope,) (solar fraction) ft :(backup heater type, brand and model number) (collector area) (collector orientation) (collector tilt) ❑, Location of Solar Panels ❑ other ' T (Describe) ® '(B).TANK INSULATION..` Storage type water heaters and storage and ' backup tanks for.solar systems shall be externally wrapped with . R-12 insulation or greater.. 0 (C)`PIPE INSULATION. The five feet of pipe closest to the water • heater and outside conditioned space shall be insulated with,a minimum of R-3. Steam and steam conditioned space shall be insulated with'a minimum of R-3. Steam and steam'condensation. return piping and recirculating hot water piping outside the ' building envelope shall be insulated'in accordance with T20 -1408(d). (D) FLOW RESTRICTORS shall be provided for showerheads and faucets as outlined in the,new appliance efficiency standards and shall be certified to the Energy Commission. .' (7) LIGHTING ® (A) Lamps used in luminaries for general lighting in kitchens and bathrooms shall havean efficacy of not less than 25 lumens per watt (usually florescent). Submit documentation of sizing heating and cooling equipment by Manual J, sizing charts (form #4) or other approved methods., section 2-5352(g), and fill out the following: Heating: Winter design temperature,?—d °, elevation —/do d ', heating -load ,Q.9SBTU elevation factor x heating load =-maximum outlet capacity gas furnace BTU' Cooling: Summer design temperature toy °, cooling load ,S' BTU * Submit T.I.P.S.E.,chart or other approved'system (form #5) to document sizing of , solar panels. [I DESIGN COMPLIANCE STATEMENT:, The•above building desi meets the requirements of Title 24,,Part 2, Chapter 2-53 of the California Ami istration Code 5 7/83 SI ATURE OF UILDING D4§&GNER ORA L/I�CANT • 3 GLAZING PLAN TAKEOFF SHEET • 3=5 North Glazing QUANTITY SIZE AREA (SQ.FT.) (a) �_ x (b) / x ao .391 _ (c) �_ x 4e&a20 = (d) x w_ (e) x Total North Glazing = (SQ -FT.) (a+b+c+d+e) TOTAL NORTH TOTAL BLDG CONVERSION TOTAL % GLAZING FLOOR AREA FACTOR NORTH GLAZING .S:3 /77(, x 100 3,0 SQ.FT. SQ.FT. FORM 6 3-.6 East Glazing QUANTITY SIZE AREA (SQ.FT:) (a) 7 x 9` o3n = Co (b) x _?o is _ 3_ (c) / x r ,jya _ (d) x = (e) x Total East Glazing— -73,_ (SQ.FT.) (a+b+c+d+e) TOTAL EAST TOTAL BLDG GLAZING FLOOR AREA 33 /77, x. SQ.FT. SQ.FT. CONVERSION TOTAL % FACTOR EAST GLAZING 100 % 3-7 South Glazing 3-8 West Glazing QUANTITY SIZE AREA (SQ.FT.) QUANTITY SIZE AREA '(SQ.FT.)_ (a) _�_ x (oOAO = (a) x ov = 3C. (b) x = _�_ (b) x _ 26 (c) x = ..2. (c) _� x -a _ s0 (d) x = (d) _� x 6o6 (e) x = (e) x -.:Total South Glazing _ _ (SQ.FT.) Total West Glazing a (SQ.FT.) (a+b+c+d+e) (a+b+c4.d+e) /d TOTAL TOTAL SOUTH ..,TOTAL BLDG, CONVERSION TOTAL % WEST TOTAL BLDG CONVERSION TOTAL % GLAZINGFLOOR AREA FACTOR SOUTH GLAZING GLAZING FLOOR AREA FACTOR WEST GLAZING /7 7 L x 100 = / _/. : / 7f,, x 100 S '.FT. SQ.FT. SQ.FT. SQ.FT. 3-9 Skylights QUANTITY SIZE AREA (a)x _ (b) _ (c) x = Total Skylights (a+b+c) TOTAL SKYLIGHT TOTAL BLDG GLAZING FLOOR AREA SQ.FT. SQ.FT. OWNER PERMIT NO. 7/83 CONVERSION FACTOR x 100 = (SQ -FT-) (SQ.FT-) TOTAL SIGHT GLAZING Table 3-7. IOU th-Facing Glazing Pee T_ Glazing..Type 1 I . Total I I i I of 1_fn gl, 1 Dbl, I Trpl, I Floor I (U - I (U - I (U - I Area 11.10) 10.65) 1 0.41)1 I I ointe I oints I olntsl 0 +3 +! +3 1 up t I 1.6- 3.6 -1. 10 1 0 1 I 3.7- 5.2 1 -4 1 -2 I -2 1 1 5.3- 6.5 1 -6 1 -4 1 -3 1 I 6.6- 7.7 1 -9 1 -6 1 -5 1 I 7.8- 8.9 1 -11 1 -8 I -7 1 1 9.0-10.0 I -13 I -10 .I -9 1 1 10.1-11.5 I -17 I -13 I -11 I 1 11.6-13.0 1 -21 i =16 I -14 1 113.1-14.5 I -25 ( -19 ( -16 1 14.6-16.0 1 -28 i -22 1 -19 I I I I 1 I Table 3-8. West -Facing Glazin Pts. I i Glazing Type 1 I Total I I 1 Z of I Sngl, IDbl, Trpl, I Floor 1 (U - '! (U - I (U - I ( Area 1 1.10) ! 0.65) 1 0.41)1 I Ioints I oints I ointsl - o +e +6 +6 1 up to 1.3 I +5. I +6 I +6 I 1 1.4- 2.2 1 +3 ! +4 I +5 I 1 2.1- 2.8 I 0 1 +2I +3 I 1 2.9- 3.6 I -3 I 0 1 +1 I I 3.7- 4.2 1 -5 I -2 I 0 1 4.3- 5.0 I -8 I -4 I -2 I 5.1- 5.6.1 -10 I -6 I -4 5.7- 6.2 1 -13 I -8 I -6 6.3- 6.9 I -15 I -10 I -7 i 7.0- 7.6 1 -18 i .-12 ! -9 1 7.7- 8.2 I -20 I -14 I -11 I 8.3- 8.8 ! -22 1 -16 1 -13 I 8.9- 9.,5 1 -25 I -18 I -15 1 9.6-10.1 ! -27 -20 1 -16 1 10.2-11.0 I -29 1 -23 I -17 11.1-11.8 I -35 1 -26 I -21 I 11.9-12.1-1 -38 -1 -29 I -24' I 12.8-13.5 I -42 1 -32. I -27 'I 13.6-14.3 I -46 I -35 I -29 I 14.4-15.2 I -50 I -38 I 32 I Table 3-9. Skylight Points I I Glazing e I I Total I 1 I Z of TSngl. 1, Trpl, I Floor I U- I - I U- I I Area 1 0.66- 0.42- 10.41 ! I 1 1.1 1 0.65 1 down 1 I up to 1.3"I ZO 11 04SrLk/cv e.. its f 3 1.4- 2.2 3 OWNER -1 Table 3-3a. Ceiling Insulation Table' 3-6. East ati,- :>u z� .Points PERMIT N0. - ASSIGNED ACTUAL -9 ITEMS SHOWN - ZERO POINTS !i(>Bi✓� 37-.2 I I Glazing Type 1•A=Value of Insulation 1 Points 1. SLAB - INSULATION NONE -5' I' of 1 Floor 1 Sngl, (U - I Trpl, (U - I (U - I -19 -14 T 66.9.3 I Area 1 2. n RAISED FLOOR - R-19---C+(-II ''G I 19 I , '-4' I Points 1 Q tiun 1 I 22 I -2 1 3. CEILING - R-30 ;� 0 6 Depth, j I I ---j ( ! 4. WALL - R-19 r3 +3 ! � 38 49 I i +2 +4 5. NORTH GLAZING - 2.4-3.6% ,10' +1. I .LI +2 1 I 1 I I I 1 below 3 1 -12 I 6. EAST GLAZING - 2.5-3.6% 4 0 1 0 1 I -2 I -4 ! -8 1 -16 1 -20 I I I I I I 3- 4 1. 7. SOUTH GLAZING - 1.6-3.6% /e IC/ +-L- Table 3-4a. Hall Insulation Pointe S. WEST GLAZING - 2.9-3.6% I 5- 7 I A -value of Ineulaelon ! Points I 9. SKYLIGHT - 0-1.3% 12 - 15 ( -5 I -3 I -2 1 -1. I 1 8 - 12 I -4' ) I 5.7- 6.7 I -10 I . -6 I' -5 I 19 I -2 I -1 I 0 !. I 13 - 18 I 10. SHADING (Exclude Overhang) -13 I -8 I -7 I 1 0 ! I •19+ ( 0 I I 7.8- 8.7 1 -15 I -10 I -B 'I I I I I I EAST - 1,� .67-.82 l%C 0 1 30 -1.7 1 +3 SOUTH - /, y .19-.42 ( -21 I.-15 I -13 1 HEST ,,3 .13-.36 � Table 3-5. 7orth-FacinS Glazing Pta -�T .SKYLIGHT - .37-.57 i-18 I ! Glazing Type I 11. HORIZONTAL SOUTH OVERHANG 2' _ Z _ _ I Total I I 2 of Sngl, Trpl, ! Dbl, 12. MOVABLE INSULATION - NONE 1 Floor ! U - I Axes 10.66 ! U - 10.42- ! U - 1 0.41 ! ! 13. INFILTRATION (Standard=0)(Tight=+12) I 1 1.10 10.65 I down ! c 1 44 1 + 4' +4 14. THERMAL MASS SF I ! 0.1- 1.2 I +4 1.3- 2.3 I +1 ! +•4 I +2 I +2 I 15. GAS FURNACE (SE) 71-76% I I 2.4- 3.6 I -2 3.7- 4.8 I -4 I 0! I -2 +1 I -1 I ! 16. ?TEAT PU1IP (EER) 7.5-7.9% +3 ! I 4.9- 6.1 I -7 6.2- 7.3 I -9 I -4 I -6 ! -3 I -5 I ! I 7.4- 8.2 ! -12 ! -8 ! -7 ! 17. DUAL PACK (SE, SEER) 8,0-8.3/71-76% I 8.3- 9.7 i -14 I -10 I -8 I 13. ACTIVE SOLAR 607, MIN (NONE)I I 1 9.8-10.8 -17 0.9-12.0 I -19 1 -12 ! -14 -10 I 1 ! -12 I 112.1-13.2 1 -22 1 -16 I -13 I 19. ZONALLY CONTROLLED ELECTRIC 113.3-14.5 I -24 I -18 I -15 I 114.6-15.3 I -27 ! -20 ( -17 1 20. SOLAR 4IITH GAS BACKUP (HW) I I I 21. OTHER - NO ELECTRIC (HW) Table 3-7. IOU th-Facing Glazing Pee T_ Glazing..Type 1 I . Total I I i I of 1_fn gl, 1 Dbl, I Trpl, I Floor I (U - I (U - I (U - I Area 11.10) 10.65) 1 0.41)1 I I ointe I oints I olntsl 0 +3 +! +3 1 up t I 1.6- 3.6 -1. 10 1 0 1 I 3.7- 5.2 1 -4 1 -2 I -2 1 1 5.3- 6.5 1 -6 1 -4 1 -3 1 I 6.6- 7.7 1 -9 1 -6 1 -5 1 I 7.8- 8.9 1 -11 1 -8 I -7 1 1 9.0-10.0 I -13 I -10 .I -9 1 1 10.1-11.5 I -17 I -13 I -11 I 1 11.6-13.0 1 -21 i =16 I -14 1 113.1-14.5 I -25 ( -19 ( -16 1 14.6-16.0 1 -28 i -22 1 -19 I I I I 1 I Table 3-8. West -Facing Glazin Pts. I i Glazing Type 1 I Total I I 1 Z of I Sngl, IDbl, Trpl, I Floor 1 (U - '! (U - I (U - I ( Area 1 1.10) ! 0.65) 1 0.41)1 I Ioints I oints I ointsl - o +e +6 +6 1 up to 1.3 I +5. I +6 I +6 I 1 1.4- 2.2 1 +3 ! +4 I +5 I 1 2.1- 2.8 I 0 1 +2I +3 I 1 2.9- 3.6 I -3 I 0 1 +1 I I 3.7- 4.2 1 -5 I -2 I 0 1 4.3- 5.0 I -8 I -4 I -2 I 5.1- 5.6.1 -10 I -6 I -4 5.7- 6.2 1 -13 I -8 I -6 6.3- 6.9 I -15 I -10 I -7 i 7.0- 7.6 1 -18 i .-12 ! -9 1 7.7- 8.2 I -20 I -14 I -11 I 8.3- 8.8 ! -22 1 -16 1 -13 I 8.9- 9.,5 1 -25 I -18 I -15 1 9.6-10.1 ! -27 -20 1 -16 1 10.2-11.0 I -29 1 -23 I -17 11.1-11.8 I -35 1 -26 I -21 I 11.9-12.1-1 -38 -1 -29 I -24' I 12.8-13.5 I -42 1 -32. I -27 'I 13.6-14.3 I -46 I -35 I -29 I 14.4-15.2 I -50 I -38 I 32 I Table 3-9. Skylight Points I I Glazing e I I Total I 1 I Z of TSngl. 1, Trpl, I Floor I U- I - I U- I I Area 1 0.66- 0.42- 10.41 ! I 1 1.1 1 0.65 1 down 1 I up to 1.3"I -1 04SrLk/cv e.. its f 3 1.4- 2.2 3 -2• -1 2.3- 2. -6 Table' 3-6. East -Facing Glazing Pts. -9 ITEMS SHOWN - ZERO POINTS !i(>Bi✓� 37-.2 I I Glazing Type _ 4.3 5.0 --- - Total 1 1 Z I I Dbl, ble 3-1. Slab Floor Points (able 3-2. Raised Floor Points of 1 Floor 1 Sngl, (U - I Trpl, (U - I (U - I -19 -14 T 66.9.3 I Area 1 1.10) 1 0.65).1 0.41)1 7n�ila- I R -Value of Insulation 1 ) R -Value of I I I Il Points 1 oints I ointel tiun 1 I I Insulation. I Points I I -22 I +'4 + .4 +< -I Depth, j I I ---j ( ! 1 1 up to 1.3 1 +3 ! +4 1 +4 1 lnches 1 0-2 1 3-4 15-6 I' 7+ I I to I to I to I to I to 1 1.4- 2.4 I +1. I .LI +2 1 I 1 I I I 1 below 3 1 -12 I I 2.5- 3.6 I -2 I 0 1 0 1 I -2 I -4 ! -8 1 -16 1 -20 I I I I I I 3- 4 1. -8 1 1 3.7- 4.6 I -5 I -2 ( -1 I 0- It I -5 I -5 I -3 1 -5 I I 5- 7 I -6 I I 4.7- 5.6 I -8 I -4 ! -3 i 12 - 15 ( -5 I -3 I -2 1 -1. I 1 8 - 12 I -4' ) I 5.7- 6.7 I -10 I . -6 I' -5 I 16 - 19 I -5 I -2 I -1 I 0 !. I 13 - 18 I +2 1 I 6.8- 7.7 I -13 I -8 I -7 I 20 + I -5 i -1 10 I +1 1 I •19+ ( 0 I I 7.8- 8.7 1 -15 I -10 I -B 'I I I I I I I I I I 8.e- 9.7 1 -1.7 1 -12 1 -10 I I 9.8-11.2 I -21 I.-15 I -13 1 1.81.i2iii7/7/&3 2-40 i-18 -3 14.1-15.3 I -32. I -24 I -20 fIf Table 3-7. IOU th-Facing Glazing Pee T_ Glazing..Type 1 I . Total I I i I of 1_fn gl, 1 Dbl, I Trpl, I Floor I (U - I (U - I (U - I Area 11.10) 10.65) 1 0.41)1 I I ointe I oints I olntsl 0 +3 +! +3 1 up t I 1.6- 3.6 -1. 10 1 0 1 I 3.7- 5.2 1 -4 1 -2 I -2 1 1 5.3- 6.5 1 -6 1 -4 1 -3 1 I 6.6- 7.7 1 -9 1 -6 1 -5 1 I 7.8- 8.9 1 -11 1 -8 I -7 1 1 9.0-10.0 I -13 I -10 .I -9 1 1 10.1-11.5 I -17 I -13 I -11 I 1 11.6-13.0 1 -21 i =16 I -14 1 113.1-14.5 I -25 ( -19 ( -16 1 14.6-16.0 1 -28 i -22 1 -19 I I I I 1 I Table 3-8. West -Facing Glazin Pts. I i Glazing Type 1 I Total I I 1 Z of I Sngl, IDbl, Trpl, I Floor 1 (U - '! (U - I (U - I ( Area 1 1.10) ! 0.65) 1 0.41)1 I Ioints I oints I ointsl - o +e +6 +6 1 up to 1.3 I +5. I +6 I +6 I 1 1.4- 2.2 1 +3 ! +4 I +5 I 1 2.1- 2.8 I 0 1 +2I +3 I 1 2.9- 3.6 I -3 I 0 1 +1 I I 3.7- 4.2 1 -5 I -2 I 0 1 4.3- 5.0 I -8 I -4 I -2 I 5.1- 5.6.1 -10 I -6 I -4 5.7- 6.2 1 -13 I -8 I -6 6.3- 6.9 I -15 I -10 I -7 i 7.0- 7.6 1 -18 i .-12 ! -9 1 7.7- 8.2 I -20 I -14 I -11 I 8.3- 8.8 ! -22 1 -16 1 -13 I 8.9- 9.,5 1 -25 I -18 I -15 1 9.6-10.1 ! -27 -20 1 -16 1 10.2-11.0 I -29 1 -23 I -17 11.1-11.8 I -35 1 -26 I -21 I 11.9-12.1-1 -38 -1 -29 I -24' I 12.8-13.5 I -42 1 -32. I -27 'I 13.6-14.3 I -46 I -35 I -29 I 14.4-15.2 I -50 I -38 I 32 I Table 3-9. Skylight Points I I Glazing e I I Total I 1 I Z of TSngl. 1, Trpl, I Floor I U- I - I U- I I Area 1 0.66- 0.42- 10.41 ! I 1 1.1 1 0.65 1 down 1 I up to 1.3"I -1 I 0 I 0 1 1.4- 2.2 3 -2• -1 2.3- 2. -6 -4 -3 .-3 629 -9 -6 -5 37-.2 -11 -6 -6 4.3 5.0 -14 -10 -8 5 5.6 -16 -12 -10 .2.7- -19 -14 -12 66.9.3 -21 -16 -13 .0-7 76 . -24 -19 IIIIIIIII -15 .-8. -26 I -20 I -17 1 1 8.3- 8.8 I -28 I -22 I -19 1 1 8.9- 9.5 1 -31 i -24 I -21 I I 9.6-10.1 i -33 i -26 I -22 I I to I to I to I to I to (ice t_s I 3.1 I 3.9 I 5.2 Table 3-10. Shading Coefficient Points SC by 1 . 1 Orien- ( Z Floor Area tation I Last I I -3.2 I 1 1 0-3.1 I to 1 6.4 up I I I 6.3 I I 0 -.19 I. 0 ( +1 I +2 I .20-.36 I 0 1 0 I -1 I .37-.66 I 0 1 0 I 0 1 .67-.82-7 -01 0 I -1 .83 up i 0 i -1 i -2 K i South i 0 1 3.2 16.4 18:0 19.6 I I to I to I' to I to 1 ,up 1 3.1 1 6.3 17.9 19.5 f' I 0 -.18 1 0 1 +1 I +2 I +2 I +3 I .19-.42 1 0 1 0 1 0 1 0 1 0 1 .43-.66 1 0 1 -1 I -2 I -2 I -3 I .67 u`p__t_-U'r -2 1 -4 1 -4 1 -6 ' West I .1 11.6 13.2 16.4 19.0 I to I to I to ( to I up ± 1.5 i 3.1 i 6.3 i 7.9 0-.12 I 0 1 +1 I +3 I +6 I +7 .13-.36 I 0 1 0 1 0 1 0 1 0 .37-.57 I 0 1 -1 I -3 I -6 I -7 .58-.82 i =1 1 -3 ! .-6 1 -12 1 .83 up I -2 1 -4 I -8 I -16 I 70 Skylight I .1 I .8 1 1.6 1 3.2 1 4.0 I to I to I to I to I to (ice t_s I 3.1 I 3.9 I 5.2 0-.12 1 0 1 +1 I +3 I +6 I +7 .11-.36 I 0 1 0 1 0 1 0 1 0 .37-.57 1 0 1 -1 I -3 I -6 1 .58-.82 I -1 I -3 I -6 1 -12 1 -, .83 up I -2 I -4 ! -8 1 -16 1 -20 I I I I I Table 3-11. Horizontal South Overhane Points South Glazing I Length Out I Area, 2 of Floor I 1 from Wall I I I ft T- 1 1 0-6.3 I 614 up I I I I 1 0 - 0.5 1 -2. -4 1 0.6 - 1.0 I -2 I -3 i 1 1.1 - 1.9 1 -1 2.0 up i 0 ; 0 Table 3-12. Hovable Insulation Points 1 Moveable Insulation] I 1 Area, Z of Floor ! Younis (. I 0- 5.5 I 0 I I 5.6 - 11.5 I +2 I I 11.6 - 17.5 I +4 I 17.6 - 23.5 I +6 1 I >23.6+ +8 ! Table 7-13- Iaf!Itsation Control a- FeRtures Points I Control Features I Points I Standard I 0 1 I I 11.9 air changes per hr ( I I I i T- Tight j +12 I I I l 0.6 air changes per hr 1' I i l Table 3-15. Cas Furnace Withouc Refrigeration Cool!ng Points -- 1 I Seasonal Efficiency I Points I 1 (SE), E i I 71 - 76 I 0 1 1 77 - 82 I +2 I I 63 - 88 I +4 1 1 89 - 94 I +6 i 1 95 up 1 +8 I I I I Table 3-16. teat Pump Points I Energy Effic!eney I Points i I Ratio (EER) 1 j I 7.5 - 7.9 1 +3 1 I 3.0 - 8.3 I +6 I I 8.4 - 8.7 I +9 I I 8.8 - 9.1 1 +12 1 1 9.2 - 9.6 i +li 1 I 9.7 - 10.2 1 +f8 I 1 10,3 - 10.8 I +21 I I 10.9 - 11.5 I +24 j I 11.6 - 12.3 1 +27 1 12.4 - 13.2 i +30 Table 3-17. Cas Furnace With Refrigeration Cooling Points 1111efelgeraelod Cas Furnace 1 I Cooling I SE ; I I171 -177-183-139--r-95= 1 8.0 - 8.3 1 01 +21 4.41 +61 +8 1 1 8.4 - 8.7 1 +21 *:1 +61 +81+10 1 1 8.8 - 9.2 1 +41 +61 +EI+101+12 I I 9.2 - 9.7 1 +61 +81+101121+14 1 1 9.8 - 10.3 1 +d1+101+121+1'41+16 1 1 10.4 - 10.9 1+101+121+141+161+18 I 111.0 - 11.4 1+121+141+1614.181+20 1 I I i I I i 7/7/83 TABLE 3-14 (ADAPTED) MASS DWELL AREA 1,000 1,500 sq. FT. A 8 C 0 A. 8 C ZONE 11 INTERIOR THERMAL MASS POINTS 2.000__2.SOO 1 3,000 1 3,500 + 4 B C D A 6 C D I A 8 C 0 1 A 8 C O. A 8 4,SGO 5,000 1 BB C D 1 -i- so - B C S0 2 2 2 2 2 2 2 0 1 2 2 2 0 1 0 0 0 0 0 0 0 0 0. 0 0 01 0 0 0 0 0 0 0 01 0. 0 0 0 100' 4 4 4 2 2 2 2 2 2 2 2 2 2 2 2 0 2 2 2 0 2 2 0 0 2 2 0 0 2 2 0 0� 0 0 0 0 iSO 6 6 6 4 4 4 4 2 2 *2 2 2 I 2 2 2 2 I 2 2 2 2 2 2 2 2 2 0 2 2 2 0 Z Z 2 0 200 8 8 6 4 6 6 4 2 4 4 4 2 4 4 2. 2 2 2 .2 2 2 .2 2 2 2 2 2 2 2 2 2 253 10 10 a 6 6 6 6 4 6 6 4* 2 4 4 4 2 4 4 2 2 2 2 2 2 2 2 2 2 2 2 2 2 300 12 12 10 6 8 6 6 4 6 6 6 4 6 6 4 2 4 4 4 2 ! 4 2 2 t 2 2 2 t 2 1 2 2. 7 2 2 350 14 14 12 8 10 10 a 6 6 6 6 4 6 6 6 2 6 4 4 2 ! 4 4 2 4 4 2 2 4 / 2 7 2 t 1 2 400 14 14 12 8 10 10 8 6 8 8 6 4 6 6 4 4 6 - 6 4 2 4 4 4 2 4 4 ! 2 4 4 2 2 4 1 2 2 507 IS IS i6 10 12 12 10 6 10 10 8 6 R B 6 4 6 6 6 4 6 6 6 2 6 6 4 2 4 4 603 22 20 18 12 14 )4 12 8 12 12 10 6 10 10 8 6 8 8 6 4 8 C 6 4 6 6 6 4 6 6 2. 4 12 6 6 1 2 1 703 24 24 20 14 18 16 111 10 14 14 12 8 10 10 10 6 10 10 8 6 8 8 6 4 8 6. 6 4 h 6 6 41 6 6 f. 2 230 26 24 22 16 70 16 16 10 14 14 12 8 12 10 10 6 10 10 8 6 10 R 6 4 I P 6 6 4 8 6 6 OI 6 6 u 4 903 28 28 74 16 22 20 18 12 16 16 14 10 14 14 12 8 12 12 10 6 10 10 3 6 3 8 '8 4 a 8 6 11 B 8 6 c, 1,010 30 90 25 18 22 20 20 14 18 18 16 10 14 14 12 8 12 12 13 6 12 10 10 6 10 10 8. 6 8 8 0 41 .n. 8 C 4 i 1,:00 32 32 28 20 14 24 22 14 20 20 18 10 16 16 14 8 14 14 12 8 12 12 10 6 10 10 10 6 13 to 8 C. ?0 e e � 1,200 34 32 30 22 26 26 22 16 22 20 18 12 18 18 14 10 14 14 12 8 14 12 12 8 '12 12 10 6 10 10 8 6�` In In 8 6 1.330 34 34 32 22 28 26 24 16 22 22 20 12 18 18 lC 10 iJ 14 14 8 14 12 12 8 12 12 10 6 12 10 10 CI 10 ?o P. o 1,40o 34 -34 32 24 28 28 26 18 24 24 20 14 120 20 18 12 18 16 14 10 14 14 12 8 14 14 12 8 12 11 :G 6; 10 10 10 S 1 1.iea J6 31 14 24 30 30 26 18 24 24 22 14 22 20 18 12 18 18 16 10 16 16 14 8 14 14 11 8 17 11 10 (,j ;2 12 1- c j 2,000 34 34 32 22 30 30 26 18 26 26 22 16 22 22 20 14 120 20 18 12 18 18 16 10 16 16 i3 CI 14 )a 1! g i 2.S00 34 34 30 22 30 30 26 18 26 26 24 16 24 24 22. 14 22 22 IS :2 TO 20 IS I: I! 13 lE '3 J.:00 34 32 30 22 30 30 26 18 28 26 24" 16 �24 24 22 14 22 2? 20 1111:J 1. li 3,500 32 32 30 20 30 30 26 la 26 28 24 16 26 24 2? 141 ?4 24 20 14 4,000 32 32 30 20 30 30 16 18 'i 28 18 21 )f 25 2.5 2: if 4,500 132 32 28 20130 30 26 It is 2" ?4 :f S,Q00 l2 17 2f 23 j- IJ C, 76 I.A. A) 1. Dy Concrete Slab: NC -8.93; R-.29; Factor -7.3 2. 3 3/4• Thick Common Brick: IIC=7.125; R-.13; Factor -1.3 8) 1. Sk- Concrete Slab: HC -14.106; d -.4i8; Factor -7.1 WOOd SCOVO C 1. 8n Solid F1IIed Block: HL•20.63; R-1.91; .Faeeor•6.t #33 points'(no back up) 2. 8• Solsd Filled Block With Both Sides Exposed To Conditioned Air. - casablanca fan + 1 point NOTE: Use all square footage directly exposed to conditioned air for Thermal'Mass Area: IIC-10.164; R-.965; Factor -6.1 D) 1- Thick Concrete/Tiles NC-2.SS; R-.083; Factorr3.7 Table 3-19. Zonally Controlled Electric Reslstance Space Heating Points , I Points for this measure w!11 I Table 3-20. Solar Water Heatin With Cas Backu Points I be completed after the CSC 1 I has approved an Alternative I I Component Package for Resistance 1 I Seat. Table 3-18. Active Solar Space Heating with Cas Points Net Solar Fraction I Points (NSF), ; j I 0-6 I 0 1 I 7 - 14 j +2 j i 15 - 23 j i4 j I 24 - 30 1 +6 i I 31 - 39 j +8 I I 40 - 47 j : +10 I I 48 - 55 I +12 I 56 - 63 i +14 1 1 64 - 71 j +18 . I' I 72 up I • +20 I 600-799 800-999 1,000-1,499 1,500-1,999 2 C00 and u 0 0 0 0 0' M.ultifamil (per unitpoints) Floor Area per untc, fc2. Net Solar Fraction (NSF), Z Heating Pts. 1 System Type I I Points I i I 0.9 10-19 20-29 30-39 40-49 50-59 60-69 70-79 600-799 800-999 1,000-1,499 1,500-1,999 2 C00 and u 0 0 0 0 0' +3 +3 +2 +1+3 +1 +7 +5 +4 +2 +10 +8 +6 +4 +4 +14 +11 +8 +6 +5 +17 +14 +10 +7 +6 +21 +16 +12 +8 +7 +24 +19 +14 +10 +q All others (pe buildlnr points) 800-899 900-999 1,000--1,199 1,204-1,499 1,500-1,999 2,1)00-:,999 ] OGO nt.d uo 0 0 0 0 0 0 -0 +5 +4 +4 +3 +2 +2 +1 1 +10 +9 +7 +6 +5 +3 +j +14 +13 +11 +9 +7 +5 +4 1 +19 +17 +15 +12 +9 +7 +5 +24 +it +19 +15 +12 +8 +7 +29 r +3p +26 +30 +22 +26 +18 +21 +14 +16 +10 +11 +8 +10 I Table 3-21. Other Water Heating Pts. 1 System Type I I Points I i I jCas Only i 0 i jSeat Pump ! 0 Solar with Electric ( I I Resistance Backup I I 1 Meeting the Require- I I ments its Part 2 i 0 1 Electric Resistance I I i only -40 I 9 !f �r r l 2751+7+=84 1620-85B PERMIT NO. PERMIT EXPIRES AF6 OWNER DON HORNER F CONTR., Better Builders Const ASSESSOR PARCEL 5482 Royal Oaks Drive LOCATION 69-24-25 i4 1' Temp. Power Pole Called PG&E Temp. Elec. Service r Called PG&E t f, Temp. Gas Service i Cal led PG&E JOB FINALED (Date) Signature J = OK 0 = Not OK a = Not Applicable MOBILEHOMES * = Not Ready I , . r MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except. N's 1. Zoning Requirements–Setbacks–Easements Date " DECKS, OVERS, CARPORTS; ETC. (Plans) OK except Ws oni Requirements–Setbacks-.Easements t 2. Soils; Special MH Support–Sketch ootings; Size–Depth–Spacing–Connectors. 3. Sewer; Location–Test–Fall-C/O–Concrete 3__Pe.rlois s–Decking–Bracing–Stairs–Rails 4. Water; Location–Test–Easement Needed (Sketch) ood Awn.; P –Bgwn r— ifV. CoRtfec.–Sht*gf. Rfg -Bracing 5. Electricity;,Location-Clearances–Grnd.–/ / Amp–Concrete 5- Ahem Awn-- Columns–Connections–Splice–Decal-Enclosures 6. Gas; Location–Test–Wrap:/ /"L" ft./ /"Nat.or/ /"L"ft./ /"LPG oors 7. Utility Clearance 7.--E+ee. 'Card -B1 Date Card -BI Date Card-B Dat Card -BI Date Card -BI. Date Card -BI Date Card -BI Date Card -BI Date Date MOBILEHOME INSTALLATION (Plans) OK except k's 1. Zoning Requirements–Setbacks–Easements Date POOLS (Plans) OK except N's 1• Setbacks–Easements 2. Footings; Size–Spacing–Marriage Line 2. Soils; Compaction–Structure Stability 3. Gas; MH Test–Demand–Valve–Connector 3. Pool Structure; Steel–Connections–Thickness–Dead Men–Lining 4. Electricity; MH Test–Crossovers–Breakers–Clearances 4. Elec.; Receptacles and Lighting; Distances–GFI 5. Drain; MH Test-Fall–Flex Connector 5. Elec.; Pool Lighting; 15 volts–GFI 6. Water; MH Test–Regulator–Connector 6.' Elec.; Enclosures; Conduit Entries–Terminals–Listed 7. Water and Sewer Connected–C/O.to Grade–HD Approval 7. Elec.; Bonding; Metal w/5'–Circulating Equipment–Heater 8'. Gas and Electricity Tagged B. Elec.; Grounding; Equip.w/5'–Circulating Equip. -Pool Lghtg. Boxes–Enc losures– Pane lboards–Ins. to Main in Conduit 9. Exits; Insp.–Sketch 10. Cert. of Occupancy , 9. •Health Department Approval " 10. Plumb; Cir. Test–Water Supply Test , Card B-1 Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date t D a = OK = Not OK = Not Applicable = Not Ready RESIDENTIAL-jSingle and Duplex) Date UNDERFLOOR Plans OK except #'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 51. 52. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 9. Gas Pipe; Size -Anchors 54. 55. Glazing Area -Glass Protection -Skylights -Plastic Shear Walls; Nailing -Bolts 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date Card -BI Date FINAL (Plans) OK except H's 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date Date Card -BI Date PLUMBING (Permit) OK except N's 14. Water Ht.; Vent -Access -Combustion Air 15. Water Pipe; Test & Anchors -Nail Protection 57. 58. Smoke Detector Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 19. Gas Pipe; Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance: Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except q's 67. Garage Fire Door; Swing -Landing -Closer 68. 69. A.C. Duct in Garage -Damper Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 20. Fixture & Transformer Clearance -Ins. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 22. Size Boxes & No. of Conductors -Stapled 70. Plb., Elec. & Mech. Equip. Listed for Location 23. Romex Installed Close to Edge of Studs & C.J. 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. Insulation -Foam -Looked in Attic E] Yes 25. 2 Appliance Circuits in Kitchen &Conductor Size 73. Guard Rails & Deck Construction -Post Caps 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or At, Insulated Neutral ❑Yes E) No 75. Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑Yes 0 N 28. Service -Riser Conductors & Ground -Main Disconnect 76. 77. Stucco; Brown -Finish A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 29. Equip. Clearances; Panels-Motors-Mech. Equip. 30. Clothes Closet Light -Shower Light 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. Water Well; Disconnect, Electrical, Plumbing Card B -I Date Card -BI Date 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground 81. 82. Ventilation throughout House Glass Protection Card B -I Date Card -BI Date Date MECHANICAL (Permit) OK except N's 31. A.C. Ducts; Insulation & Support 83. 84. Corrections from Previous Inspections Gas Test -Meters Tagged; Gas -Electric 85. Water & Sewer Connected -C/O to Grade -HD Approval 32. 33. Vent Fan; Exhaust above Insulation Condensate Drain & Overflow; Size & Grade 86, Energy Compliance Certificate -Other Certificates 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Comments at Final: Date FRAMING(Plans) OK except N's 36. Sills; Proper Material & Anchors 37. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound 38. Bearing Walls over Girders & Floor Nailing 39. Draft Stop in Walls (rat proof) 40. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. 42. Header & Beam -Size & Bearing Hangers -Post Caps -Anchors -Connectors 43. 44. 45. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Sh_thng.-Rfng_. Fireplace Ties or Type A Flue -Fireplace Throat Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 46. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing (NOTE:Anentrymust be made each time youvisit jobsite) COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. / 7 County Center Drive - Orovillk Califorrtla 95965 - Telephone 916/534-4541 Alao a=k� APPLICATION ANDPERMIT ftl ASSESSOR PARCEL jIBE; 4 2_ ZONING .' - ' BUILDING PERMIT OWNER E TELEPHONE SO. FT. OCC.1 BUILDING VALUATIO OWNER'S AI(.LJJNNGG ADDRESS S • D L 1 CONT CTOR'S NAME Rt ITELEPHONE CONTRACTOR'S MA LING ADDRESS Gj(g'�j ecgwg © Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Filing Fee $ 10.00 LENDER'S MAILING ADDRESS - Permit Fee $ $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 1 / ,2,57 Penalty $ ARCHITECT OR ENGINEER'S MAILING DDRESS Permit fee $ BUILDING ADDRESS PLUMBING PERMIT FiIingFee 10.00 _ v Each Trap 2.00 Solar Water peater 20.00 Water pipin 5.00 LOT NO3 UBDIVISION PARCEL MAP Each qas wa r heater or vent 5.00 Gas piping sy LIST 1 - 5 outlets 5.00 USE OF T UCTURE 0 SF D� Duplex ❑ Mobi lehome Other Q V6 SPECIFY Building sewer 5.00 Mobile Home G W 10-00ea TYPE OF WORK New ❑ Addition CK Remodel ❑ Utilities ❑ Installation ❑ Other Describe work: 8X3!0 4wof jJ z Permit Fee $ , Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 ^�_�� Main service EA. ADD'L 100 AMP 2.50 NEW CONST.(DWELLING OCCUP OR ACDNS. .& ACC. BLDGS. t 2/20sgft CONTRACTORS LICENSE LAfV I declare der penalty of perjury (Check One): rLrJ✓ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions�nd lny license is in full fo and effect. ��� License No. Classification El 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR ULTI.OUTLET NON-RESID ANCH CIRC ITS 2,50 ea NEW CONSTP ER APPARATUS & NON-RESID,R (SIN E OUTLET CIR. z0@s0a Ex. Occup(ouTLE oR FIXTURES eALQ 300 EX. OCCUp. OUT ETFIxED P(RESILNS D )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): permit is for $100.00 (valuation) or less. RR -,Thave placed on file with the County of Butte Building Department - Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against saidC my 'n consequence of the granting of this permit. X Date a Signature of Applicant — Owner El Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE Ll $ 4(p%7 OCCUP. GROUP TYPE OF CONST, PA EL �PDHDISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC BY Pi IT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date 4-1 C7— S� ~�� A Receipt No. qv� -30 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD-APPLI CANT OWNER COUNTY OF BUTTE - DEPARTMENT ©F PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916%534-4541 Cr ....'—'`w 3 PERMIT APPLICATION DATA SHEET Permit No. 9 A. P. No.� X1-2- ev S7 •� Proposed Building Use Permit Fee Based Upon: Complete Contract rice oe ---DPW Valuation Other Explain) Building Inspector /'` -� Date 1-�' % drS At time of permit application, I was advised the following data must be submitted prior to permit processing and1or issuance: DATE RECEIVED. APPROVED 1. All items have been submitted. . . . . . . . . . . . 2.. Plot plans in duplicate./triplicate. . . . . . . . . . . 3. Complete plans in duplicate./triplicate. . . . . . . . . 4. Complete engineered plans and calcs. . . . . . . . . . 5. Plans with Energy Design Compliance Statement. . . . . . 6. State Energy Forms No. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . . . . . 9. Letter of signature authorization. . . . . . . . . . . 10. Sanitation approval from Health Dept. . . 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner[], Mail to owner ❑ ) 15. Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . •Pre-Inspec. request to 17. Pre -Inspection for Required. Building Inspector (pate) 18. Recorded copy_of-Agricultural Acknowledgment Statement. 19:-OtFier`"` — _ "�- When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w. /inspector. Other Applicant Jay,�.�!!!a.�. .� Date Copy of plans sent Health Dept., Fire.Dept., Other Date During the plan checking process, the following data must be submitted prior to permit issuance: (For required items not checked above at time of application, circle item.) 1. Index permit for above Items No. 2. Additional items required: (Contractor, Designer, Owner) was advised of above required data by Telephone Mail By Plans checked by Plans approved b,. Other: Copy—DPW Date Date Date -Ila Other s