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069-320-034
Pi✓' � � w ., _- .y_ '..- __ - ..;may-aM;,yw•'.;,G �:a• - -. • '69-3 ' GEORGE`Robert 340 Kelly Ridge Rd, roville G (new'_sffli :7 ) `. 4: Permit#3990-90B ? (window ;deck/sf) B07 1818 + r;.E. *i069 320-034* MISCEL'L'ANEOUS ; Siding/Stucco • •REPLACE SIDING ON�ONE,WALL�,,�, , 340 KELL�R YKRIDGEDr,{,,FTha u r r . '. GEORGE; BARBARA J REVOCABLE f. w �y • 1 1 i 1 11 1 i 11 C.fl � N BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 340 KELLY RIDGE RD APN: 069-320-034 Owner: GEORGE, BARBARA J REVOC Pennit NO: B07-1818 Issued Date: 8/24/2007 By' GLB Expiration Date: 8/23/2008 Permit type: MISCELLANEOUS Subtype: Siding/Stucco 340 KELLY RIDGE RD OROVILLE, CA 95966 Description: REPLACE SIDING ON ONE WALL (530) 589-4767 Occupancy: Zoning: SPARKS BEN CONST SPARKS BEN CONST Building Garage Remdl/Addn 241 RIM CANYON PKWY 241 RIM CANYON PKWY OROVILLE, CA 95966 OROVILLE, CA 95966 Other Porch/Patio Total (530)589-0784 (530)589-0784 FEE INFORMATION DBMSC Stucco/Siding-Stone/Bric $116.00 LICENSED CONTRACTOR'S DECLARAT_ ION Contractor (Name) State Contractors License No. / Class / Expires SPARKS BEN CONST 702995 / B / 2/28/2009 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full fors4d effect. X 8/24/2007 Signature Date I WORKERS' COMPENSATION DECLARATION I 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. ❑I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; Cartier: State Fund Policy Number: 229,001158 Exp. Date:1/1/2008 (This section nee not a competed if the permit is or on'-7un reddoIIars ($100) or ess. ❑I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those X !//f.7r� 8/24/2007 WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lenders Address City State Zip 1 Balance Due: $0.00 Receipt No: OWNER / BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: ❑I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). ❑I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). ❑ I AM EXEMPT under Section B. & P.C. for this reason: Owners 8/24/2007 Date I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any and all conditions of permit. I agree to defend, indemnity, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte County to "r the above mentioned props for inspection purposes. I hereby certify that I am the prop%� ovpr' e t o e property per's behalf. 8/24/2007 ❑ Owner ❑ Contractor OR.Agent for Owner ElAgent for Contractor FILE COPY �QT BUTTE COUNTY ° o o DEPARTMENT OF DEVELOPMENT SERVICES ° ° BUILDING PERMIT APPLICATION. °. ° OFFICE #: (530) 533-7541 FAX #: (530) 533-2140 c c A FEE WILL BE REQUIRED AT TIME OF APPLICATION .� Website: w.7 w.buttecounty.net/dds *PLEASE PRINT CLEARLY** . OWNER INFORMATION Last Name ; ,,. First Name Mailing Address City n, 0010 G� State_ J� . f Zip y Phone �. 7P Fax E-mail CONTRACTOR Name �� ✓c/"/�i�—�.S .�/ Address City40 StatP�., Zb, Phone .� X78- Fax Email ,T— D r34flV/ z Zip Class • APPLICANT S/ NATUR X PERMIT NO. BIN # PROJECT LOCATION ARCHITECT/ENGINEER Name 7� Address Yes City Occ. State Zip Phone Fax E-mail State License Number APPLICANT S/ NATUR X PERMIT NO. BIN # PROJECT LOCATION APPLICANT INFORMATION Name 7� Address Yes City Occ. State Zip Phone Fax E-mail APPLICANT S/ NATUR X PERMIT NO. BIN # PROJECT LOCATION AP# - ', O Property Address City WORKER'S COMPENSATION Policy Number Carrier 2,707 If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time ofpennit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: �i L Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy / (Note previous use): r„ For office use only: Zoning Flood Zone SRA Yes No Occ. Type Const. lot • ;,RESIDENTIAL 69-32-28 !2765-90B,P,E,M ; GEORGE, Robert , 340 Kelly Ridge -,Rd, Oro.ville t (new sf) e o 1< OFFICE COPY Address t • }M A Date • _ ELECTRIC Meter By Date J tJOB FINALED (Date)' 3 , Signature ,J OK O = Not OK Not =NotReadyable 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 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Date 1. Zoning Requirements -Setbacks Easements Date 2. Footings; Size -Spacing -Marriage Line Date 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 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-PaneIboa rds-Ins. to Main in Conduit Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK eictzept #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Coonectors Shthg: Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; L ght ng, 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-PaneIboa rds-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK O = Not OK - = Not Applicable = Not Ready RESIDENTIAL (C. ' Date UNDERFLOOR (Plans) OK except #'s l!,,Z�oning-Setbacks-Easements-,F Slope tg , Main; Soils-Elec. Gr d.-/ 2P g. Depth tg., Garage; Soils-Steel-Elec. Grnd.-/ZV"Ftg. Depth 4. Ft %, Porches & Decks; Soils -Steel-/ /Ftg. Depth to walls, Main; Steel -BI ockouts-Wrapped Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. She Steel -Wrapped Piers -Fireplace Ftg.-Steel t,9-I5'W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. Gas Pipe; Size -Anchors (y1: -Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 3. Pienums & Ducts; Clearance -Material -Support -Ins. VA: -Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Insulation Date6 Card B-1 Date Card B-1 Date j cy/9, Card B-1 �Jd' A Date Card B-1 Dates LU NG Permit OK except #'s 1p"Water Htr.; Vent -Access -Combustion Air -Baffle Water Pipe; Test & Anchor -Nail Protection Ue6W.V.; Test -Fittings & Anchor -Nail Protection Shower Pan; Test, First Floor -Tub Access Nest Tub & Shower, Second Floor -Tub Access _ as Pipe; Size & Anchors Date t 41744 Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL Permit OK except #'s Fixture & Transformer Clearance -Ins. Protection ec. Receptacles Spacing -Lights & Switches at Doors ize Boxes & No. of Conductors -Stapled . R me x Installed Close to Edge of Studs & C.J. 60tcluip. Ground made p w/Mech. Fastner -Bond Gas & Water 2 Appliance Circuts in Kitchen & Conductor Size/GFI 2& Subfee ire Size / / ga. Cu or AI-A.C. Wire Size / / ga. C r AI ange Circ.!K/ ga. Cu or Oven Circ. / / ga. Cu or AI. Insulated eutral ❑ Yes ❑ No L8 -Service -Riser Conductors & Ground -Main Disconnect - t3 uip. Clearances Panels-Motors-Mech. Equip. 1;1-2. Clothes Closet Light -Shower Light -Spa Light Aiiemoke Detector Date ll(/if/ Card B-1 �� , Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s A.C. Ducts Insulation & Support Vent Fan; Exhaust above insulation 3 Condensate Drain & Overflow; Size & Grade 3 Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet 3B--At4ic Access & Platform if Furnance in Attic Datef%j G/ Card B-1 � Date Card B-1 Dat— Card B-1 Date Card B-1 Date FRAMING (Plans) OK except #'s e.217 Sils, Proper Material & Anchors Walls Studs -Nailing, Spacing & Bracing -Plates -Sound Baring Walls over Girders & Floor Nailing Draft Stop in Walls (rat proof) Fire Stops; Furred Ceilings -Stairs -Chases -Tub 4 Ingle & Duplex) ' Date FRAMING (Continued) t�angers-post Caps -Anchors -Connectors 6. C!gg. Joist-Rftr. ties-Purlin—roof Brac4trusshthng.-Rfng. place Ties Type A Flue -Fireplace Throat clearance ttic Access; Size & Romex Pro ection-Draft Stop -Ins. Baffles 4(.49.-46rm. Windows or Exiting Doors -Sill Hgt. & Dimensions arage Fire Protection Framing 51efyoWi`fy-L ne Firewall & Openings - xt. Doors -One 3' -Check Garage -3rd Story, 2 Exits 41k53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection plywood on Roof Overhang -Attic Vents -Rafter Outriggers iding-Nailing Veneer fifi a eo-totesh-Drip Screed -Fd. Vents-Underflr. Access azing Area -Glass Protection -Skylights -Plastic 58. Shear Walls; Nailing -Bolts • 59., Insulation-Walls-Ceilings4� Infiltration -Walls -Windows - Date -//4/,/.y t nfiltration-Walls-Windows Date6y R/ Card B-1 Date Card B-1 Date Y 446U Card B-1 Date Card B-1 Date FINAL(,Plans) OK exce t #'s 6 xt. Steps -Door & Sidelight Protection -Landings /62w-5—moke Detector 6 rnace; Vents -Clearance -Comb. Air-Connector- In.Gamw; Above Floor-Ducts-Mech. Protection Bedroom Exiting F.I. & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & Subpanel; Breaker Sizes & Labels AW�Stairs & Rails re lace or Stove; Clearances -Hearth 69"E—Iec. Outlets at Wood Panel; Int. & Ext. 7 F !2iL & Appliance; Grnd.-Air Gap -Cooking Clearance ec. Outlets & Receptacles at Kit. Counter ge Fire Door; Swing -Landing -Closer J3. —Garage -Damper Wtr. Htr.; Vents -Clearance -Comb. Air -Connector -P. .V. Above Floor-Mech. Protection Elec._& Mech. Equip. Listed for Location Receptacles in Garage; (G.F.I.)-Romex Protection ion -Foam -Looked in Attic 0 Yes US-ITu-ard Rails & Deck Construction -Post Caps Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 80. Following instld.; Drive D -Y< 0 No; Walks es ❑ No; Planters ❑ Yes 11 No uc n -finish A.C. Unit; Disconnect, Electrical, Plumbing Loe-Vents Above Roof; PIbg.-Appliance-Fireplace. -Clearance to Openings 8 . nnect, Electrical, Plumbing erior lec. Trim; G.F.I. Receptacle -Underground entilation Throughout House 87. rotection . Corrections from Previous Inspections 89.-19vT sf-Meters Tagged; Gas -Electric X90. Wap r-& Sewer Connected -C/O to Grade -HD Approval f 91 nergy Compliance Certificate -Other Certificates Date 4 j Card B-1 / Date Card B-1 Date Card B-1 p 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) 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 OWKER PERMI NIO. 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 corre on of work is completed. If you have any question pertaining to this matter r need additional explanation, please contact this office immediately. y Yrfa f (�C�'r � /n /� �Gl:`� 01�011L /y'4i �G bCy17�( � GA✓4S< c I ern �,s.cl�%�G w�o�cv ��bo r 2Lc�• /'T"d 4) '5 /�s�aw+- GOl�cK ,aG�,jnln ✓v,.ia�- to�dD�. Date��/��/ Inspector= _ 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 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 �o h �. � - .yo bra_-�,� 4 • Daie ///D / Inspector y/��^— Owner: Permit No. ENERGY CERTIFICATION 340 Kelly Ridge Road Oroville LOCATION A.P. No. ROOF material Thickness(inches) DESCRIPTION OF INSULATION Brand Name Thermal Resistance (R Va1Y0,.. EXTERIOR WALL Brand Name OWENS-COR Material FIBERGLASS BATTS 19 Thickness (inches) 64" Thermal Reeistance(R V6140) CEILING Batt or Blanket Type FIBERGLASS BATTS Brand Name OWENS-CORNING Thickness(inches) 1/" Thermal Resistance(R Value) R38 Loose Fill Type FIBERGLASS Brand Name - Minimum Thicknesj(Inches) lL" Number of Bagel_ Wtv per bag .,.Z -lb. � Area covered(ft. ) nn Thermal Resistance(K Value) U5_. FLOOR, ELEVATED Material FIBERGLASS BATTS Thickness(inches) 64" FLOOR, SLAB Material Thickness(inches) Width(inches) FOUNDATION WALL Material Thickness(inches) Brand Name OWENS-CORNING Thermal Resistance(R Value),,,__,__.^., Brand Name �- Thermal Resistance(R'Valve)�„�,._.,,,,.,4, Brand Name wjw Thermal Resietana0(R Vs µ0) I hereby certify that the above insulation Was installed in the ab9V9 building in Conformance With the State of California Bneray RegyiramOatl• LOERKE INSULATION CO INC. 499150 FIRM NAME/OWn/NER STATE CONTRACTORIB I.ICE001' NO• 1 0 `• �,. March 21, 1991 SIGNA URE OF INSTALLATION APPi.ICATOR DAT)3 I hereby certify the above insulation and all required items a0 sho n on the Building Department approved plans and attachments have been inetglled ae required by the State of California Energy Requirements. All equipment, devicesander aterials are of the quality prescribed ox are s e ly approved by Clue State of California. FIRM NAME/OWNER (Please prinO STATE 'CONTRACTOg S I.ICr;N84 No• SIGNATURE OF GENERAL CONTRACTOR OWNER DATE THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIO$;.TO FIN" INSPECTION APPROVAL AND A% COPY SHALL BE POSTED WITHIN THE BUILAIN(,�; January 1984 s; COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Or�le,,6alifornia 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. 09 ASSESSOR PARCEL NUMBER 69-32-28 ZONING AR -1 - BUILDING PERMIT OWNER ROBERMAGEORGAILING TELEPHONE 589-4767 SQ. FT. OCC. BUILDING VALUATION 31 R 1240 OWNER'S ADDRESS 35 COHO CT, OROVILLE 280 Open 1400 CONTRACTOR'S NAME UNKNOWN TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER NONE UNKNOWN Total Valuation I $ 2640 Filing Fee g $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 38.50 ARCHITECT OR ENGINEER NONE LICENSE NO. Plan Checking Fee $ 19.25 Energy Plan Checking Fee $ 15.00 ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING340 ADDRESS RIDGE RD. , OROVILLE KELLY Permit tee 82.75 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2,00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑x Duplex❑ Mobilehome❑ Other 1 SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home I S I G JW I 110.00ea TYPE OF WORK New ❑ Addition ® Remodel ❑ Utilities ❑ Installation[] Other ❑ Describe work: Pop–Out Windows & Open Deck (Re: 2765-910) Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP OR1 OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): F -1I 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 or sale. (Sec. 7044) I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP OR ACDNS. ( ACC. BLDGS. .� , 2/z2sgft NEW CONSTR. ULTI.OUTLET NON.RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS tr (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 000.AL@ 230 0 3 Ex. Occup. our P ETS (RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. byirin 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 Department a Certificate of Workmen's Compensation Insurance or a Certificate 01, Consent to Self -Insure. ER/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 Cooling g 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. I also agree t save, Inde and eep harmless the County of Butte against all Ii les, dgme cost d expenses which may in any way accrue ag st said C my i copse of the granting of this permit. �/ ! f —7y Date 7 Signature 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 $ � CVOST VPE TOTAL FEE $ $2.75 HAZ CUA PARK SCHL FLD AR PD HD I This permit is hereby issued under sions or the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By. 9 PERMI EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date %J �zb _ �•= 7/Af Receipt No. 44NX 84458 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive95965 - Telephone: 916.538-7541 APPLICATION AND PERMIT PERMIT NO. AS ESSOR PA CEL BER L{J ZONING BUILDING PERMIT ._ R ©� E EPHO E 9 SQ. FT. OCC. BUILDING VALUATION ROWN ER'Sr�Ai,LIN A,ADORJc 7i -p•'(�)_ V 9 S,1� © TRACTOR'S NAM,^ v `. TELEPHONE CON RACTOR'S MAILING ADDRESS Fireplace CO S RUCTION LENDER — UNKNOWN Total Valuation Is 1 Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 1391s-0 ARCJIIrECT OR ENGINEER LICENSE NO. Plan Checking Fee r— $ J Energy Plan Checking Fee �a O ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS V / Permit fee $ - PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 tie v _ Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or ve 5.00 USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - outlets 5.00 Building sew 5.00 Mobile FAdme S G W O.00e TYPE OF WORK New❑ Addition Re odel❑ Utilities) Inst Ilation❑ Other ❑ Describe work: - �/ 1 h el 4 W 5 c -- e C Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Q 10J ` ! Main service eoov OR LESS 100 AMP OR LESS 10.00 Main service ADD'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 N_o. ClassificationFIxEO 'Ex. ❑ 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). -. . ."ors. as7044)r am exclusively contracting with licensed contract- ❑ I am exempt under Sec. , Business and Professions Code for this reason /EA. oR ADONS. ( DWEACCLLIN GOCCUP h 'h¢sgft NEW CONSTR ULTI.OUTL NO N.R ESBRANCH C ITS 2.50 ea (POWER ARATUS s� SING OUTLET CIR. Ex. Occup(O ETS OR FIXTURES 2AL SOC eALO 30 OCC OUT ETS PRESIAPLNS.D IRE A.) 2.00 Te rary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 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 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 Cooling g Hood 3.00 VentiIat pe 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 —. •Owner ❑ ?Contractor ❑ Agent ❑ _. I An OSHA permit-is'required for excavations over 5'0" deep and demolition or construct- ion of structures-ovev3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ ��— occ CONST TYPE Q J� FEE AL E TOTAL $ O�, HAz CUA PARK PAR PD Ho ISSUE This permit is nereby 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-D.P.W:, YELLOW-ASSE350R.-PI14K--INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPAR,-WENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE -- LLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET .� Permit No. OWNER QkL Yn Ge- O ► , a C. A. , ..No _ Proposed Building Use 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. Hazardo.us 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 ....... . f . ................. .. 12. Park fees paid5...jQiO`p.C.n�l...................... 13.�� SchonDistrict 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. Whe you issue the t,o�e s as follows: Mai owner. Mail to contractor. Telephone and hold for pickupalt -office.Deliver w./inspector. Other G Applicant Date Copy of Haz-Mat form sent Health Dept. Fire Dept. 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_—nall—counter by ..date Contractor, designer, owner, was advised of above required data by—phone —ma ll—counter by date 9 Plans checked by Date Plans approved by�Date Sets of plans on hold in File cabinet AP folder,O �/ C� COPY—DPW ZZ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County,_Q.ento Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. v �-7 ASSESSOR PARCEL NUMBER 69-32-28 ZONING ARI BUILDING PERMIT OWNER RobertGeor e TELEPHONE 589-4767 SO. FT. OCC.1 BUILDING VALUATION 177R R 71 190 OWNER'S MAILING ADDRESS 35 Coho Ct. Oroville 95966 CONTRACTOR'S NAME owner TELEPHONE 78 Coy 780 CONTRACTOR'S MAILING ADDRESS Fireplace IA 1,000 CONSTRUCTION LENDER VNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 340 Kelly Ridge Rd. Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 7 2.00 14.00 Solar or heat pump water het&. E. 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP n Water piping 5.00 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF MK Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 5.00 Mobile Home S G W 10.00e TYPE OF WORK Newpg Addition❑ Remodel❑ Utilities❑ Installation❑ Other ❑ Describe work: 3BR Permit Fee $ 34.00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP OR1 OR LESS10.00 10.00 Main service EA. ADD'L 100 AMP20 2.50 2.50 CONTRACTORS LICENSE LAW 1 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 e f fect. 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. DWELLING OCCUPM A OR DONS. ACC. BLDGS. Zlh2sgft 55.05 NEW CONSTR ULTI.OUTLET NON-RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS & SINGLE OUTLET CIR. ) Ex. Occu o Occup(OUTLETS OR FIXTURES 20050a eALO 30 FIXED APPLNS Ex. OCCup. OUTLETS RESID IREA.) 1 •2.00 Temporary service 10.00 Mobile Home Facilities 15.00-- Misc. Wiring 9 15.00 Permit Fee $ 77.55 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. 1 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 FiIingFee 10.00 Heating heat pump rnn Cooling 9 Hood 3.00 3.00 VentilatioA 1--3-0013.00 permit Fee $ 49.00 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 Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree save, indemnify and keep harmless the County of Butte against all iiab'. les, udgments, , an expenses which may in any way accrue agai said Co my i sequ nc f the granting of this mit. X Date Signature o14Applicant — Owner anrractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demoliti n or construct- ion of structures over 3 store in height. Mobile Home Installation Fee $ Energy Inspection Fee $ CONS T PE Y IV TOTAL FEE $,,177,-X55 HA2 CLIA �— PARK scH FL PA PD HD IssuE� This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOOF PUBLIC C By EXPIRES Date the applicable pro vi - resolutions to do have been paid. WORKS Date Jm, Receipt No. — 19 V/ 3 WHITE-O.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT PC_PERNKT ,•j�.-�r••�r w J"�• ll/ft�r .rp •• nArApR •:.3 �„� f .1 f / r '/1�`j ` � COUNTY OF BI".�' a9EPARTMENT OF PUBLIC WORKS - BUILDING DIVISION ' 7 COUNTY CENTER DRIVE OR'OVILLeE, CALIFORNIA 95965;-' TELEPHONE: 916/538-7541 i A PERMIT APPLICATION DATA SHEET Permit No. 26b �%-32-- Z8 OWNER A. P. No. 1`�YJ Proposed Building 10 Use SF � Building Inspector its Date e -9 - 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 10. instructions Fees of $ �. J ................................. As 11. Chico Urban Area fees paid ....................................... 12. 13. 14. Park fees paid .................................................... OQ0 _51el l ' Sc of District fees paid .............. /0 -2� v Qra Sanitation approval from- o•A PUt? Health Department !6 -2t -9'40 15. City of Chico plumbing permit ..................................... i 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. 24. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... Recorded copy of Agricultural Acknowledgment Statement ......... /O -2� 25. Letter of signature authorization ................................... 26. 27. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone 5$9.4_7 (0-7 and hold for pickug,at- office. ZZ777Deliver w/inspector. Other . / \ / Al Appl Dat Copy of Haz-Mat form sent Health Dept. Fire Dept. _Air Pollution Date Copy of plans sent _Health Dept. Fire Dept. Other Date By. The following data must be submitted prior to permit issuance: ( irc new 'tem of ch&ckgd above). 1. Index permit for above items N . 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone___rnail-counter by ..date Contractor, designer, owner, was advised of above required data by -phone _mall -counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP 161d,6rO Copy -DPW TO: Building tepa=ment FROM: Encroachment Permit Section RE: Driveway Clearance 60Le�eOr AP #owner lora ion Driveway permit l �y 6 S has been issued for the above property. D date si ature ASSESSOR PA CEL NUM ��-3-7 OWNER OWNER'S MAILING OF S5 Co Jin CONTRACTOR'S MAI LINE CONSTRUCTION LENDEF L ENOER•S MAILING AOD ARCHITECT OR ENGINE, ARCHITECT OR ENGINE, BUILDING ADDRESS COUNTY OF' BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT LOT NO. I SUBDIVISION NAME PARCEL MAP PERMIT NO. BUILDING PERMIT SO. FT. I OCC. I BUILDING VALUATION Fireplace �U.ZF / � VLA Filing Fee 12M. TELEPHON d S Plan Checking Fee C� Dna 959(0 Energy Plan Checking Fee $ Penalty $ TELEPHON ADDRESS PLUMBING PERMIT Filing Fee Each Trap 1 UNKNOWN ESS 20.00 R 500 Each qas water heater or vent 500 LICENSE Nf R S MAILING AOORES3 LOT NO. I SUBDIVISION NAME PARCEL MAP PERMIT NO. BUILDING PERMIT SO. FT. I OCC. I BUILDING VALUATION Fireplace �U.ZF Total Valuation J Filing Fee $ Permit Fee. S Plan Checking Fee S Energy Plan Checking Fee $ Penalty $ Permit fee $ PLUMBING PERMIT Filing Fee Each Trap 1 200 Solar or heat pump water heat r s, I_ 20.00 Water piping 500 Each qas water heater or vent 500 MI USE OF STRUCTURE SF N .Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 0.00e TYPE OF WORK New Addition ❑ Remodel ❑ Utilities ❑ . Installation❑ Other ❑ Permit Fee Describe work: i) (yl��f (J�fyy) $ C Contractor ELECTRICAL PERMIT Filing Fee 16.00 Main service 10OVAMP OR ORSLESS 10.00 lD•GO CONTRACTORS LICENSE LAW Main service EA', ADO -L. 100 AMP 2. 50 Zc� I declare under penalty of perjury (check one): NEW CONST- ( OWEL LING OCC UP.� OR AOONS, \ �l ACC. BLDGS. I IZQS ft q �jJr',65 ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license NEW C0N5TR ULTI-OUTLET NON-RES10 BRANCH CIRC ITS 2.50 ea APPARATUS is in full force and effect. License No. (POWER SINGLE OUTLET -IR. a) Classification I, Ex. OCCUp�OUTLETS OR FIXTURES 203301 eAL030p as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is FIXED APP LNS. OR Ex. Occup. F' EO As IRES10.1 EA.) 2.00 not intended or offered for sale. (Sec. 7044) I, as the Temporary service 10.00 Mobile owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) Home Facilities 15.00 El am exempt under Sec. --._, Business and Professions Cade Misc. Wiring 15.00 for this reason Permit Fee WORKMEN'S COMPENSATION INSURANCE Contractor I declare under penalty of perjury (check one): ❑ The is MECHANICAL PERMIT Filing Fee 10.00 permit for 5100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department Heating a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. 14( I Cooling shall not employ any person in any manner so as to become subject �V to the W. C. laws of California. Hood Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith Ventilation r �� Permit Fee comply with such provisions or this permit shall be deemed revoked. $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Mobile Home Installation Fee S Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte Energy Inspection Fee $ to enter upon the above-mentioned property for inspection purposes. I also agree to indemnify occ CONST save, and keep harmless the County of Butte against all Iia ilities, judgments, Costs, and expenses which may in TOTAL FEES any way accrue against said C unty in consequence of the granting of this permit. HAz CUA PARK scHL FLD PAR PO ISSUE X Date This permit is nereby issued under the applicable provi- Signature of Applicant — Owner Agent ❑ Contractor ❑ ❑ si ons of the Butte County Code and/or resolutions to do work indicated above for An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. which fees have been paid. DIRECTOR OF PUBLIC WORKS Receipt No. 7014—g!g4 2,34, Awl By WNIT£-O.P.W., T£LLOW ASSE330K, PINK-INSPC TOR.'GOLOCNROO-APPLICANT Date PERMIT EXPIRES Date 32 X 2S _ 78 ►-»® f BUTTE COUNTx SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM (One Form per Building),, A.P. Number Building Department No. School District Q120 £(Q/M City D County Q Jurisdiction Property Owner 'LG A p Project. Location/Address ICO fJl%j 12.,d6y ,Dld C 0 Subdivision ' Lot Number Residential Development: Sq. Footage -7-76 # of Living MHI Addition (Group R) Units Commercial/Industrial: DSq. Footage - New Addition (Including Exterior Roofed Areas) Building,.Pepartment Representative • s Date ; (Floor Plans reviewed by School District Personnel) v District Id No. (Q/(� School District certifies that (Applicant Name) (Phone Number) (Street Adofe§SY 6 (City) (State) (Zip Code) has complied with the requirements of Resolution No. U -9Q -Q .2�1 by "the pa ment of$09 representing.? 7Z square feet. v School DirOct Representative_ Date PAID BY CHECK NO. REMARKS: BANK NO—// -SPO 7 ' PAID BY CASH t white -applicant, yellow -building department, pink -school district r SCHOOL.FEE (8/88) 5/89 RESIDENTIAL PLAN CHECKING GUIDE (S.F., DUPLEX & MISC. ONLY) Bldg. Permit # .2 70 S"' QO OWNER ,e f e- A.P. # La_ .3.Z •fid' GENERAL Zoning requirements: (sideyards and number of permitted living units). Valuation. .Elans signed by designer. nergy Design and Compliance. �FExisting violations on property. Items on data sheet. PLOT PLAN Complete parcel size and dimensions. Setbacks, sideyards, easements, etc. Other buildings or structures. .rading, fills, drainage. lood hazard. Special conditions on.creation map or compliance document. Complete & FAS road setback. FLOOR PLAN - Complete to scale plan with dimensions. . Required windows for light and ventilation (Sec. 1205). Required windows for second exit (Sec. 1204). Skylights (Chapter 34 & Sec. 5207), Human impact glass (Sec. 5406). .equired room sizes, ceiling heights (Sec. 1207). GFCIs in baths, garage, and exterior outlets (Article 210-8). Light fixtures, switches, receptacles, and exterior receptacles for maintenance of mechanical equipment. Locations of water heater, heating and cooling equipment, other electrical or gas equipment, and plumbing fixtures. arage firewall, door size, and closer (Sec. 503(d)(3)). 1 - 3'0" exterior exit door (Sec. 3304(e)). Fireplace and wood stove location, alcoves, and clearance. J - . Smoke detectors (Sec. 1210). STRUCTURAL DETAILS Foundation plan complete enough to construct building. Floor construction details complete enough to construct building. Roof levations and wall construction details complete enough to construct building. construction details complete enough to construct building. Fireplace construction details and calcs if necessary. MISCELLANEOUS ITEMS TO LOOK OUT FOR tairway details: landings, rise and run, head clearance, handrails (Sec. 3306). Guardrail details (Sec. 1711 & 3306(j)). Brick or stone veneer (Chapter 30). 5/89 RESIDENTIAL PLAN CHECKING GUIDE MISCELLANEOUS ITEMS TO LOOK OUT FOR (CONY D) jExterior plaster - weep screeds (Sec. 4706). roper roof pitch for roof covering (Chapter 32). /Roof covering type - (fire hazard). Rafter ties or bearing ridge beam. Garage door or porch header sizes. Adequate bracing. Living area over garage - complete 1 -hour separation required on garage side including supporting walls and posts, etc. wo exits on three-story dwellings (Sec. 3303 & see Mezannines - 1716). is access and ventilation (Sec. 3205). erfloor access and ventilation (Sec. 2516). . Combustion air for fuel burning appliances. 5- Noise requirements on duplexes. Ldobe soils - special foundation design. etaining walls requiring design. nusual shape, size, or split level house requiring lateral design. lashing at all exterior openings. ENCROACHMENT PERMIT J G COUNTY OF BUTTE. ,�._.�=e--��-6-� DEPARTMENT OF PUBLIC WORKS �'(? It=Y `C%-•NTS County Center Drive - OroviIIe, California 95965 : I-j(."A i 1S Phone': (91.6) 538-7681 - yr I ♦ �J Y Ti;~;EA P P L I CATION Permit No: I, WE, the undersigned, hereby apply to the County of Butte for an encroachme rmit to he followin rk under or over the county roads an ghways, all in accordance with county ordinances an eral laws. cct�_ NAME ...-----....�.c�•-,?.•-�._ �._._...SIGNAT E -- - � --i_ >-- '-- - L MAILING ADDRESS ... 7 �.. =.:c �.. _---L-----------_. Phone ------ •eel. �_..r....<-=:.�..._ _�.-... Date ..--- r Location of work to be done _............: > -------Z-..._...._. ..-..................... .-.............. ----------- .w......... ...... .:... .:.:............... ---- ----:::_:_ .:: __........_.._ -__._.._........- .................. --- -< �._..- - .. ..--�- _- . t:-...... TYPE OF.WORK..TO BE DONE:- ,= ,:, . ::.:...• : ;,,.,,�• 1. Curb .. Gutter ...._.__.._..._ •• Sidewalk.-.-... .... "Please check" - _ _ - _...._. �_ --_......._--- ,5`- 3 2. Driveway (List type) .__...---- - �.�- -- _ •�:.•..:.;.. .:. . :. ................. .......... ................. 3. Underground Conduit .... .............:. ._........... 4. Other .......... _....._-•- - - - - - - - _ _ _-•----............._..............._.........................._...... _.... _.......... _..... PERMIT GRANTED In compliance with your above request, and subject to all terms, conditions,or special.conditions written below or printed on the back of this form, permission is hereby granted. ; SPECIAL CONDITIONS. ,.. , ..... ...... .................. ........... ............... Y r�N OF,16 ................ T oltr Jili�iis% '= .........................................�........................p•. .m n •,7vr.., .. � .......•.......... Vit;LL•:.... 0 P:fsi�.•. JATH CONT, 'l Alts H'B OV: P;7 IR ;T: __..:.. . DIRECTOR:OF PUBLIC-.WORKS Date Issued..... .............. .( Surety. ..... ..........::.....:.............. i. .. . PERMIT EXPIRES.. G ..'..� . By- '"-----•-- -............ -.................. _... GENERAL CONDITIONS','- - 1 ;f It is understood and agreed that the County has prior right to the use of its rights of way. It is further underetood and agreed by the Permittee that the doing of any work under this permit shall constitute an accept- ance of all the provisions contained herein and failure on the Permittee's part to comply with any provision will he cause for revocation of this permit. Except as otherwise provided for public agencies and franchise holders,.,, this permit is revocable at any time. This permit is to be on job at all times while the work is being done. - 2. All work shall be done sub'ect to the anpervision of and to the satisfaction of the Public Works Department . =_i r of the County of Butte. The Vermittee shall, at all times, during the progress of the work, keep the County ; Highway in as neat and clean a condition as is possible and upon completion of the work granted herein, shall.-. leave the,County Highway in a thoroughly neat, clean, and usable condition. - ' '3. ' The, Permittee agrees by the acceptance of this permit to properly maintain any encroachment placed by the,. Permittee on an art of the Count Highway and to immediately. repair an in u `to 'an portion of the highway;-- which i hwa Y P Y gh Y Y P Y 1 rY Y P 8 Y+', . which occurs as a result of the encroachment, until such time as the Permittee may be relieved of the responsi- bility of such encroachment by the County Department of Public Works. 4.. It is further agreed by the Permittee that whenever construction, reconstruction, or maintenance -work upon the highway may require, .1e installation provided for herein shall, upon request of .the, County Department of --q, Public Works; be immediately moved by and at the sole expense of•the•Permittee._-' 5. - -No material used for fill or backfill`in the construction of the encroachment shall beborrowed or taken from - within the county right of -way, r _ 6. �At least, one lane of any public road, under the jurisdiction of the Board of Supervisors of Butte County; and other public roads •junctioning or -intersecting, therewith, shell be kept open for travel by the general public at all times. No _public road under the jurisdiction of the Board shall be close_ d ' to travel by the general public without special•permission, in writing, of -the Board of Supervisors.`:. ' . _ •. '`� - - - t�'t 7. The Permittee, by the acceptance of this permit, shall assume full responsibility for all liability for personal M injury or damage to property'w'hich •may,' arise_ out of the ;work herein permitted'or. which may arise out of the ; failure on -the part of the Permittee to do the work provided for under this permit. In the event any claim of such liability is made against the County of. Butte or any department, official, or employee thereof, the Permittee shall defend, indemnify; and hold themfand' each of them harmless for such claim. 8. All excavations shall be backfilled and compacted immediately after work therein has been completed. Trenches shall not be left open farther than 300 feet in advance of pipe laying operations or 200 feet to the " rear thereof, unless otherwise permitted by the Engineer. Unless otherwise permitted under the Special Conditions, backfill shall be placed and mechanically com . - pacted in such a manner that the relative compaction throughout the entire fill within the County road right of way shall conform to the percentage of compaction as stated below. Permittee shall notify foreman 24 hours before backfilling and/or paving.- a. aving.a. The relative compaction from the bottom of exca`vati-on to.a-.plane five feet (51 .below finish surface grades shall be no less than ninety percent (90%) as determined liy Test Method No. -Calif. 216-0 of the Materials • .., w and Research Department, State of California, Transportation Department, Division of Highways, or other approv- ed test method. b. The relative compaction from a plane five feet (59 below the finish surface grade to said finish. surface grade shall be no less than ninety-five percent (95%) as determined by the above testing method. Permit= tee shall bear all costs and responsibility for compaction tests. C. Material for use as trench backfill in any existing or proposed roadway section shall be sand, shall ' be placed in 8" lifts, and be compacted to a relative compaction of not less than 95%. : Material for use as backfill in roadside gutter excavations shall be the native material and be compacted. to 'a relative compaction of not less than 90% _ Any pavement cutting shall be scored, or saw cut before trenching. '•�, - Minimum -depth of cover over all underground facilities shall be 30 inches, except drainage culverts.. All installations, parallel with roadway, shall be placed as close to the right-of-way line as possible.. No portion of the backfill(s) shall be compacted by ponding or jetting. ' All 1plyements, curbs, gutters, sidewalks, borrow ditches, pipes, headwalls, road signs', trees, shrubbery," and/or other permanent, road facilities impaired by or as a result of construction operations at the construction :. site(s), or at other ground(s): occupied by materials and/or equipment, shall be restored immediately upon back-`_''-,' , filling of the excavation to the original grades and cross sections,, and to a condition as good as, or better than, . existed prior to the construction.. -- r, All surfacing materials"of roadways and driveway approaches cut or damaged. by.or,as'a resdlE of construe tion operations, shall be replaced within ONE WEEK following the backfilling of excavation, weather permitting,,,< with compacted layers of surfacing materials.at least as thick as the existing, and no less than two inches (2") of asphalt concrete over eight inches (8") of aggregate base, according to current California State Specifi- cations. 9... Whenever necessary to secure permission from abutting property owners, such authority must'be secured by- r the Permittee prior to starting work. 10. The future safety and convenience of the traveling` public shall be given every' consideration• in the location 'and type of construction. Permittee shall cause to be placed, erected, and maintained all warning signals, lights, i �'_-: •i barricades, signs, and other devices or measures essential to safeguard travel by the general public over and at • ,' the site of work authorized herein. '4 r- 11. If the construction work covered by this permit is to be done by a private contractor hired by the applicant, _ } g-- -•�; applicant 8hall notify contractor as to the special conditions and requirements contained herein. COUNTY OF BUTTE" Department of Public Works 7 County Center Drive Oroville, CA 95965 SPECIAL CONDITIONS FOR ENCROACHMENT PERMITS No ponding and Jetting under any roadway. All pavement removed shall be replaced with a minimum of eight inches of aggregate base and two Inches of asphalt concrete surfacing; or conform to existing structural section; or conform to special trench detail, whichever Is greater. All road crossings of pipelines shall be Jacked or otherwise forced underneath pavement without disturbing same, unless specifically approved by the Department of Public Works. Minimum depth of cover. over all facilities shall be 30 inches. Material for use as backfill in any existing or proposed roadway section shall be sand, placed in eight -inch lifts and compacted to a relative compaction of not less than 95%. All drainage ditches and roadside gutters which are disturbed in the course of construction shall be reconstructed to the satisfaction of the Department of Public Works. Material for use as backfill in roadside gutter excavations shall be the native material, compacted to a relative compaction of not less than 90%. All installations will be placed as close as possible to the right-of-way line. Any pavement cutting shall.be scored or saw cut before trenching. If the construction work covered under this permit is to be done by a private contractor hired by the applicant, applicant shall notify contractor as to the special conditions and requirements contained herein. A private contractor shall obtain his own permit and have insurance on file with Butte County Department of Public Worsts. When cable is to be buried in an existing roadside ditch, said ditch shall be paved whenever the road grade exceeds 6% and this paving shall extend. down grade to the nearest cross culvert of drainage swale. Asphalt Concrete (AC) shall be Type B, 1/2" maximum, medium grading. Aggregate base (AB) shall be Class 2, 3/4" maximum, grading. FEDGE OF EXISTING PAVEMENT FLAW LINE DITCH 12' MIN. '20'MAX. NOTES: 1. PIPE TO BE C.S.P. OR EQUAL Q2"DIA. MIN.) 2.PAVING SHALL CONSIST OF 4OF AGGREGATE BASE, MIN., AND 2" OF ASPHALT CONCRETE, MIN. �m PIPE IF REQUIRED, SIZE AND LENGTH TO BE DETERMINED IN THE FIELD BY ROAD FOREMAN. > AREA TO BE PAVED 10'M IN. PROPERTY LINE BUTTE COUNTY PUBLIC WORKS DEPT. PRIVATE DRIVEWAY DETAILS ow Y R. JONES cKo. By SCALE I��= 10' . STAN.No. S -3I �.. PERMIT NO: 133-90 Lake Oroville Area Public Utility District IM E3& Stre" J." -.-OROVILLE, CALIFORNIA 95966 533-2000 == DISTRICT APPROVAL AND r' 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 Lake Oroville Area Public Utility District, must be submitted to Butte County. Date:.: Octnhar ?c;, 19an Applicant: Robert George Applicant Address: 35 Coho Court. Oroville. CA 95966 Applicant Phone No.: 589-4767 Property Location(s): 340 Kelly Ridge Road George Annexation A. P. No. (s): 69-32-28 Fees due: $900.00 SC -OR Facility Charge and $300.00 Connection F due. r / Application for service approved: LAKE OROVILLE AREA PUBLIC UTILITY DISTRICT Inspection(s) made and successful test(s) observed: Location: Date: Lake Oroville Area Public Utility District release to close permit: Date: By: CONNWrION PE[2MIT APPLICATION FOR Ssim CONNDmON AND SERVICE FROM LAKE OROVILLE AREA PUBLIC UTILITY DISTRICT hereinafter referred to as "App scant", being the property owner or owner's agent desiring sewer service, hereby requests Lake Oroville Area Public Utility District, herein- after referred to as "District", to connect Applicant's sewage disposal.line to District's sanitary sewer system and to provide sewerage service. Location of property: A• P: ]k :1 - 3 .? - �Zk *Subdivision: e_C Brio �,. Lot.([: Block #: [ 4 Property Annexed No. of E.D.U.'s this permit: l [ ] Property Not Annexed [ ] Property Annexation in Progress Multiplication Factor: 1 Kind of Service: **Monthly Charges: 730 b�J Residential blj Residence of Owner Connection Fee: OU [) Rental (single family) [ ] Rental (duplex) [ J Apartment SC -OR Facility Charge: 9,00,06- Industrial 00,0cIndustrial ( ] Commercial Total Amount Payable This Permit!4200,/)V_ Remarks: _-2�� The service applied for hereby shall be in accordance with'the conditions here- inafter set forth and the ordinances, rules, regulations and policies adopted, or to be adopted, by the Board of. Directors of District, all of which Applicant agree to abide by and fully perform. Applicant agrees to pay for such service at r es and charges as are established by District frau time to time. Signature of Appl Name of owner if not Applicant A. Mailing Add ess of Applicant Mailing Address of owner Phone # of Applicant: .s�rj— Z-1 -7 7 Phone ]k of Owner: CONDITIONS OF ACCEPTANCE OF S34ERAGE SERVICE 1. In accepting this application, District does not hold itself liable to Applicant for failure to perform any of the obligations imposed upon it or as- sumed by it under this application if such failure be caused by accident, Act of God, fire, strikes, riots, war, lack of capacity in SC -OR treatment/disposal plant or District's lines to handle the sewage or any other cause beyond rea- sonable control of District. 2. Installation of the sewer service line pertinent to this application shall conform in all respects to District's specifications. 3. Applicant shall secure permit(s) as necessary from the County of Butte prior to doing any work, including.encroachment permits when work.is.within ' county right of way. 4. Installation of the subject: sewer service line shall be at the sole:* cost and expense of Applicant:. -.:. 5. Actual connection of the subject sewer service line to District's. sewer mainlineaccomplished by District`'staff:... ': ,. �.,6. All work'shall be inspected and approved by District. �. ".•'.7. if This permit is valid for one year. If work is not canpleted within ,said—year—;.,permit renewal, will be .required, together with 'payment: of aciy:,in- crease-in:connection fee and/or SC -OR Facility Charge.-. : L.S.District,verification.form must be..issued with this permit.. Payment .of Lees/Charges required. :.LAKE OROV E ARTA P.U.D. prior to final inspection. Payment received by*[ ]cash [) checkBy: $ Date Date: /0 S cz. Permit ** Payable in the amount current at time payment•is made. Return tq DPW'-. ,' AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT 9 0 ` 4 S 9 4 4 ` :,FOR RESIDENTIAL DEVELOPMENT "Section 26-8.1 of the Butte County_ Code requires this acknowledgement be recorded prior to issuance of a building permit. 90=045944 'R e c Fee The property described herein is adjacent Check 9.00 to land or included within an area zoned Recorded ' for agricultural purposes, and residents Official Records of this property may be subject to incon- County of i , veniences or discomfort arising from the Butte ! use of agricultural chemicals, including, f Candace J,. Grubbs but not limited to herbicides, pesticides, Recorder and fertilizers; and from the pursuit t 10:08am 25 -Oct -90 X 3 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: State c_ SS. County of-Rt�� OFFICIAL SEAL o ANGELA U. MASTELOTTO NOTARY PUtLIC-CALIFORNIA 0 ® Principal Office In BUTTE County • . My CommI Ion Expires SEPT.14,i • ® ® o PROPERTY OWNERS: i �Ea,e<5:257 the undersigned Notary 'Public, personally appeared ® ® 00 0 m ®. 0 0 © . • ® ® .Personally known to me. ® Proved to me on the basis ieMR OFFICIAL SEAL �;,P3 EIIA D. MASTELOTM o of satisfactory evidence. rmTA-W PUSLIC-CALIFORNIA ® to be the person(s) whose name(s) PrindpalOfIceInBUTTECounty ® subscribed to the within instrument and acknowledged that y CammisMon Expires SEPT. 14.1M 0 executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. before me, IF Present A.P. NoU Notary'Public . I ti. 90-459+4 C,;L A M f: 1� ORDER NO. BU -113257-3 DESCRIPTION ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE STATE OF CALIFORNIA, COUNTY OF BUTTE, DESCRIBED AS FOLLOWS: LOT 18, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "GLENDALE RIDGE TRACT, UNIT NO. 111, WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON DECEMBER 6, 1927, IN BOOK 11 OF MAPS, AT PAGE(S) 25 AND 26. EXCEPTING THEREFROM THAT PORTION THEREOF CONVEYED IN THE DEED FROM THE FREYR LAND CO. TO THE COUNTY OF BUTTE, DATED JULY 25, 1940 AND RECORDED IN BOOK 86, PAGE 457, OFFICIAL RECORDS. ALSO EXCEPTING THEREFROM THAT PORTION DESCRIBED AS FOLLOWS: ALL THAT PORTION LYING EASTERLY OF THE FOLLOWING DESCRIBED LINE: BEGINNING AT A POINT IN THE SOUTHWEST QUARTER OF SECTION 7, TOWNSHIP 19 NORTH, RANGE 5 EAST, M.D.B. & M., FROM WHICH POINT THE WEST QUARTER CORNER OF SAID SECTION BEARS NORTH 29 DEG. 23' 01" WEST, 1,094.26 FEET; THENCE FROM SAID POINT OF BEGINNING SOUTH 04 DEG. 05' 03"WEST, 844.15 FEET; THENCE SOUTH 18 DEG. 00' 46" WEST, 183.95 FEET TO A POINT FROM WHICH THE SOUTHWEST CORNER OF SAID SECTION 7 BEARS SOUTH 29 DEG. 12' 22" WEST, 765.08 FEET, SAID POINT BEING THE END OF THE HEREIN DESCRIBED LINE. ALSO EXCEPTING THEREFROM THAT PORTION DESCRIBED AS FOLLOWS: A PORTION OF THE SOUTHWEST QUARTER OF SECTION 7, TOWNSHIP 19 NORTH, RANGE 5 EAST, M.D.B. & M., AND A PORTION OF LOT 18, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "GLENDALE RIDGE TRACT UNIT NO. 1", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON DECEMBER 6, 1927, IN BOOK 11 OF MAPS, AT PAGE(S) 25 AND 26, MORE PARTICULARLY DESCRIBED AS FOLLOWS: BEGINNING AT THE NORTHWEST CORNER OF LOT 18 OF SAID GLENDALE RIDGE TRACT UNIT NO. 1; THENCE NORTH 6 DEG. 08' WEST, 125.0 FEET ALONG THE EASTERLY BOUNDARY OF HILLCREST AVENUE TO A POINT; THENCE LEAVING SAID EASTERLY BOUNDARY OF SAID AVENUE SOUTH 79 DEG. 23' EAST, 110.71 FEET; THENCE SOUTH 79 DEG. 53' EAST TO A POINT IN THE WESTERLY LINE OF THAT CERTAIN PARCEL OF LAND CONVEYED BY JOHN WARNKE, ET UX, TO THE STATE OF CALIFORNIA, BY DEED RECORDED SEPTEMBER 24, 1963, IN BOOK 1271, PAGE 583, OFFICIAL RECORDS; THENCE SOUTH 04 DEG. 05' 03" WEST ALONG SAID WESTERLY LINE OF SAID STATE OF CALIFORNIA PARCEL, A DISTANCE OF 250.0 FEET TO A POINT IN LOT 18 AFOREMENTIONED; THENCE WEST, A DISTANCE OF 245.0 FEET, MORE OR LESS, TO A POINT IN THE EASTERLY CONTINUED DESCRIPTION - CONTINUED 90--45944 3 ORDER NO. BU -113257-3 LINE OF HILLCREST AVENUE; THENCE NORTHERLY ALONG SAID EASTERLY LINE OF HILLCREST AVENUE AND THE WESTERLY LINE OF SAID LOT 18 TO THE POINT OF BEGINNING. ALSO EXCEPTING THEREFROM THAT PORTION CONVEYED TO THE COUNTY OF BUTTE, BY DEED RECORDED DECEMBER.9, 1970, IN BOOK 1649, PAGE 29, OFFICIAL RECORDS,.DESCRIBED AS FOLLOWS: A PORTION OF LOT 18, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "GLENDALE RIDGE TRACT, UNIT NO. 1", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON DECEMBER 6, 1927, IN BOOK 11 OF MAPS, AT PAGE(S) 25 AND 26, MORE PARTICULARLY DESCRIBED AS FOLLOWS: BEGINNING AT. THE SOUTHWEST CORNER OF SAID LOT 18; THENCE NORTH 4 DEG. 08' 38" EAST, ALONG THE WEST LINE OF SAID LOT, 355.72 FEET; THENCE NORTHERLY ALONG THE ARC OF A TANGENT 1030.00 FOOT RADIUS CURVE, CONCAVE TO THE WEST, THROUGH A CENTRAL ANGLE OF 1 DEG. 35' 2111, A DISTANCE OF 28.57 FEET TO THE SOUTH LINE OF THAT CERTAIN PARCEL OF LAND CONVEYED.TO GERTRUDE E. PASSMORE, BY DEED RECORDED AUGUST 18, 1966, IN BOOK 1440, PAGE 39, OFFICIAL RECORDS; THENCE SOUTH 87 DEG. 51' 22" EAST ALONG SAID SOUTH LINE, 22.44 FEET; THENCE SOUTHERLY ALONG THE ARC OF A NON -TANGENT 1040.00 FOOT RADIUS CURVE, CONCAVE TO THE WEST (RADIAL LINE TO SAID CURVE AT. THIS POINT BEARS SOUTH 88 DEG. 35' 10" EAST) THROUGH A CENTRAL ANGLE OF 2 DEG. 40' 47" FOR 48.64 FEET; THENCE SOUTH 4 DEG. 05' 37" WEST, 336.53 FEET TO THE SOUTH LINE OF AFORESAID LOT 18; THENCE NORTH 85 DEG. 38' 22" WEST ALONG SAID SOUTH LINE, 23.51 FEET TO THE POINT OF BEGINNING. END Of DOCUMENT I. -Ceiling Insulation S. Infiltration (Air Leakage) Specification Points ShvK4 rd 0 6. Glass Heat boss Total 2. Wall Insulation Number of stories 2 R -value One Two ,_I Three ; R-0 -103 -49 32 R-19 -8 -4 -2 R30 -2 -1 -1 R38. 0 0 0 U -value 2 2 1 40 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 S. Infiltration (Air Leakage) Specification Points ShvK4 rd 0 6. Glass Heat boss Total 2. Wall Insulation 4 2 5 Single- Single ' Percent 12 Family Family Multi - Al to R -value Detached Attached Family Double R-0 -68 -51 34 less R-11 0 0 0 -39 R-13 2 2 1 40 R-19 8.., 6 ....4 ... -14 U -value 8 35 -75 :. 0.80 -153........ -114.. -76 • 0.50 -91 -68 -46 e : 0.30 -47 36 -24 12 .-0.10 0 0 0 z • 0.08 4 3 2 28 0.06 9' 7 5 " s ; 0.04. 14 11 7 .� -52 0.02 19 14 10 ' 0.00 '.24 18 12 -15 3. Raised Floor Insulation .1 7 14 Insulation In Floor 46 • ' -7 Number of stories 7 { R -value One Two Three S. Infiltration (Air Leakage) Specification Points ShvK4 rd 0 6. Glass Heat boss Total 14 4 2 5 U -value ' Percent 12 3 .51 to Al 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 .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 it -6 7 10 13 16 19 10 i 3 9 11 14 17 19 9 -1 10 11r 15 : 17 20 _8 _ 2 12 . 14'' 16,; _ 18 20 7. Shading (Shade Open) --Elrectlre Percent Glass (percent Plus x SC) R-0 -17 -8 -5 Effective 7: R-11 3 2 i %Glass North East South :West Skylight R-19 0 0 0 18 5 1 4 1 na R-30 3 1 1 16 4 2 5 1 na U -value 0.60 - 1 0.50 0.40 0.30 0.20 0.10 0.08 0.06 0.04 0.02 0.00 -144 -120 -95 -69 -13 -17 -11 -6 -1 4 10 -70 -58 -46 -34 -21 -8 -6 -3 0 2 5 Controlled Ventilation Crawlspace 14 4 2 5 1 na Two 12 3 3 5 2 na`-- -46 11 3 3 5 2 na 38 10 2 3 5 2 1 -33 9 2 3 5 2 2 -22- 8 2 3 5 .2 2 -14 7 1 3 4 2 2 -5 6 1 3 4 2 3 -4 5 1 2 4 2 3 -2 4 0 2 3 1 3 0 3 0 1 2 1 3 1 2 0 0 1 0 3 3 1 -1 -1 -1 -1 2 2 0 -1 -2 -4 -2 0 Controlled Ventilation Crawlspace -14 -48 Number of stories -64 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 -1. Slab Edge Insulation -26 - - -33 Number of Stories 10 R -value One Two Three R-0 0 0 0 R-5 8 5 2 R-7 8 6 3 F2 factor 7 -4 -14 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 na = not allowed IB. Shading (Shade Closed) Efrective Pei cmt Class (p4rcmt Qlassr x SQ GW& North East South we6t %yfight 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 -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 9. Interior Thermal Mass Interior Single- ..: Slab Floor Raised Floor Mass Wall Stories Family Multi Stories Mass ICFA One Two Three One Two Three 0.0 -8 3 -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 2.5 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 i 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 Exterior Single- ..: Single - . a. North b. East Wall Family Family Multi -4 Mass Detached Attached Family 0.00. 0 0 0 -25 or 0.20 3 2 1 lesi 0.40 : 5 4 3 -14 0.60 8 6 4 -9 0.80 10 8 5 -5 1.00 13 10 7 -4 1.20 13 12 8 - 0' 1.40 12 13 9 4 7 1.60 10 13 It...,. , 1.80 *10 12 12 15 2.00 _- 10 11 _ 13 i 11. Heating System 9 6I HP -HWR ' SE or RSPF 5 4 .. 3 (assumes ducts In attic) ... WSB 5 Sum of 1-6 3 2 Effective -25 or -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 10.0 EfTective SE or HSPF 19 16 13 (SE or HSPF x duct efficiency) 7 ` Effective -25 or -24 to -14 to -4 to +610 16 or SE HSPF less -15 -5 +5 +15 more 120 0.30 275 -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 1.1 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 I Sysum h SC . a. North b. East X- G. x- SEER One -5 -4 (4ssumel ducts In attic) 3 -2 -2 Stin of 7-10 " 3 3 2 -25 or -24 lo !14 to -410 +6 to 16 or SEER lesi .15 I -6 +5 +15 more 8.0 -14 .12 -10 -8 -b -4 j 8.5 -9 .7 -6 -5 ' , -4 -3 ; 18.9 -5 -4 -4 3 -2 -2 9.0 -4 3 -3 -2 •2 -1 9.5 - 0' 0 0 0 0 0' 10.0 10.5 4 7 3 3 2 6 5 4 2 3 1 2' 11.0 10 9 7 6 4 3! --120 15 13 it 9 7 5 '• 13,0 20 17 14 12 9 6I HP -HWR ' EPfedlve SEER 5 4 .. 3 (SEER xduct efficiency) 35% WSB 5 Sim of 7-10 3 2 Effective -25 or -24 to •1410 -410 +6 Io 16 or SEER less -15 -5 +5 +15 more 5.0 -30 -25 -21 -17 -13 -9 6.0 -12 -11. -9 -7 3 • -4 6.6 -5 -4 -4 3 ... -2 -2 7.0 0 0' 0 0 0 0 8.0 9 8 6 5 4 3 9.0 16 14 12 9 7 5 , 10.0 22 19 16 13 10 7 ` 11.0 26 23 19 15 12 8 120 30 26 22 18 14 9 13.0. 33 29 24 20 15 10 Zonal Control Adjustment 10 8 7 6 4 3 No.Cooling System Installed - _Stories % Glass SC Eff. % Glass a. North b. East X- G. x- _ One -5 -4 -4 3 -2 -2 Two + 3 3 2 2 2 1 .' %.T'B[ 2 KASS .1r1 r - Interior Nass/CFA COND. FLOOR AREA Single -Family Detached and Attached TYPE 2 MASS AREA = 9 G Size (sQ Exterior Wall Mass ND. L OR Water ., 1139 120Unit 10' A 700 2200 2700 Heater lfedit or • to to to: or - . of Type. Type fess 1699 2199 2699 Duct Efficiency 10.741 SG None 0 10 0.. 0 0 or Solar 12 ' 8 6 5 4 HP -HWR ' 8 5 4 .. 3 3 35% WSB 5 3 3 2 2 70% POU 8 5 4 3 3 - SE None -37 -24 -18 -15 -12 1.1 Solar -1 -1 -1 0 0 25 HWR -18 -12 -9 -7 -6 4 WSB. -25 -16 -12 -10 -8 0.2 POU -18 --12 -9 -7 -6 IG None -5 -3 -2 .2 -2 3.1 Solar 7 : 5 4 3 2 4.6 POU 3_ 2 1 1 1 IE None -28 -19 -14 -11 -9 2 Solar 8 5 4 3 3 15 POU -10 -6 -5 -4 -3 . 5 Multi -Family (individual units) 5.4 56 30% 0.5 Unit Size (SO 0.9 1.1 Water 1.6 699 700 1200 1700 2200 Heater Credit or b to to or Type Type less 4.9 1699 2199 more SG None 0 _1199 0 0 0 0; or Solar 14 7 5 4 3 HP HWR 9 5 3 2 2 4.7 WSB 9 4 3 2' 2 .50% POU 9 5 3 2 2 SE None -45 -23 -15 -it -9 3.5 Solar 2 1 1 0 0 5.1 HWR -23 -12 -8 3 '-5 0.9 WSB -25 -13 -8 -6 -5 Z4 _ PQU.. _23 -12 8 6 -5 IG None -8 -4 -3 -2 "2 - Solar. 6. 3 2 1 1 1.2 POU:, -.1.---0 1.9 0 0 '..o IE None 30 .715 -10 -8 4 4.2 Solar ' 18 9 6 4 - 4 5.6 POU -8 -4 .3 :2 -2 Point System Summary: Climate Zone 11 SCORE CARD 1. Ceiling Insulation 2.. Wall Insulation 3. Raised Floor Insulation 4. Slab Edge Insulation 5. Infiltration 6. Glass Heat Loss 7. Shading (Shade Open) a. North b. East c. South d. West e. Skylight 8. Shading (Shade Closed) Measures _'3 3! or R- a (381 t or R -value (q 1) R lor R-value(191 L 1.r2 Or R -value (0) F2factor (0.77) ype (dou le) U -value (0.65] Point Scores 0 96 Total Glass (16 Sum 1.6 % Glass SC'7 Eff. % Glass X G X = X = D % Glass SC Eff. % Glass a. North b. East X- G. x- _ / •j .. c. South O X . = D d. West In MasslCFA =� e:, ,,Skylight D x = _� 9.. Interior Thermal'Mass .' %.T'B[ 2 KASS .1r1 r - Interior Nass/CFA COND. FLOOR AREA c,10. Exterior Wall MASS TYPE 2 MASS AREA = 9 Exterior Wall Mass ND. L OR AREA ., 11. Heating System X Zona] Control? (Y / N)SE or RSPF_. `.-' Duct Efficiency [0.781 Effective SE or [0.72/6.6] : _ ' 1t. 7-utKC-4.21 Jc r •t.d .i b) HSPF 10.5615.151 12. Cooling System :: x _ • % �� Zonal Control? ( Y / N) SEER (9.5] Duct Efficiency 10.741 4 TYPE I MASS (UIMC 4.2. to: e: sed �� slab) �- : Type IsGI _77, Credit [none] - 0% 5% 10% 15% 20% 25% 30% 35% 40% 45Y. 50% 55% 60% 657. 70% 75% 80% 85% 90% 95% 1W% 105% 110% 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 32 14 3.6 3.8 4 4.2 4.4''4.6. 4.8 5 5.3 10Y. 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.9 21 23 Z5 27 2.9 3.1 13 3.5 17 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 2.7 Z9 3.1 3.3 15 11 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 1.6 2 2.2 24 Z6 28 3 3.2 3.5 17 19 4.1 4.3 4.5 4.7 4.9 5.1 5.3 5.6 5 8 -.40% 0.7 0.9 1.1 1.3 1.5 1.7 1.9 Z2 24 Z6 2.8 3 3.2 3.4 3.6 18 4 4.3 4.5 4.7 4.9 5.1 5.3 53 5.7 5.9 .50% 0.9 1.1 1.3 15 1.7 1.9 21 23 2.5 27 9 32 3.4 3.5 18 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 Z4 2.6 28 3 12 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 Z5 2.7 2.9 11 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 Z4 Z6 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 6.4 70% 1.2 1.4 1.6 1.8 2 Z2 Z$ 2.7 2.9 3.1 3.3 3.5 3.7 3.9 4.1 4.3 4.6 4.0 5 5.2 5.4 5.6 5 8 6 6.2 6 4 75% 1.3 15 1.7 .1.0 21 23 25 Z7 3 12 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 63 MY. 1.4 1.6 1.8 2 22 2.4 26 2.8 3 3.3 3.5 3.7 3.0 4.1 4.3 4.5 4.7 4.9 5.1 5.4 5.6 5.8 6 6.2 64 66 857. 1.4 1.7 1.9 2.1 2.3 25 2.7 Z9 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 6S 67 1.5 1.7 2 2.2 24 Z6 2,8 3 3.2 , 3.4 3.6 3.8 4.1 4.3 4.5 4.7 4.9 5.1 53 5.5 5.7 5.9 6.2 6.4 66 68; 95% 1.6 1.8 2 2.2 25 27 2.9 11 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 6.4 6.7 6.9 100Y. 1.7 1.9 21 2.3 25 28 3 12 3.4 3.8 18 4 4.2 4.4 4.6 4.9 5.1 5.3 55 5.7 5.9 6.1 6.3 6.5 6.7 7 105%- 1.82 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 110y. 1.9 21 2.3 2.5 27 29 11 13 3.6 3.8 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 2.2 24 2.6 2.8 3 3.2 14 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 16.6 6.8 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 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 55 5.7 5.9 6.1 6.3 6.5 6.7 7 7.2 1.4• Point System Summary: Climate Zone 11 SCORE CARD 1. Ceiling Insulation 2.. Wall Insulation 3. Raised Floor Insulation 4. Slab Edge Insulation 5. Infiltration 6. Glass Heat Loss 7. Shading (Shade Open) a. North b. East c. South d. West e. Skylight 8. Shading (Shade Closed) Measures _'3 3! or R- a (381 t or R -value (q 1) R lor R-value(191 L 1.r2 Or R -value (0) F2factor (0.77) ype (dou le) U -value (0.65] Point Scores 0 96 Total Glass (16 Sum 1.6 % Glass SC'7 Eff. % Glass X G X = X = D C 0- Point Total: '>r % Glass SC Eff. % Glass a. North b. East X- G. x- _ / •j .. c. South O X . = D d. West r . 9 x =� e:, ,,Skylight D x = _� 9.. Interior Thermal'Mass .' TYPE 1 MASS AREA _ a .1r1 r - Interior Nass/CFA COND. FLOOR AREA c,10. Exterior Wall MASS TYPE 2 MASS AREA = 9 Exterior Wall Mass ND. L OR AREA 11. Heating System X Zona] Control? (Y / N)SE or RSPF_. `.-' Duct Efficiency [0.781 Effective SE or [0.72/6.6] : _ ' . HSPF 10.5615.151 12. Cooling System :: x _ • % �� Zonal Control? ( Y / N) SEER (9.5] Duct Efficiency 10.741 .Effective SEER [7.031 13. Water Heating L) : Type IsGI _77, Credit [none] C 0- Point Total: '>r %,CA eta CftMate Gone 11 ��X& umentation Author —. 765 -po Butldin��it M Checked By / Date Faforcienent ARencv Use Only ` BUILDING DATA Glass Area % Glass �i North Condition ea r 77a Number of Stories East r :Slab sed Fl �_ _ Number of -Units �_ South Single Family Detached (SFD) [ ] Addition.Alone West I • [ ]Single Family Attached (SFA) Existing BuildingSkylight [ ] Multi -Family (MIS (] Existing -Plus -Addition Total 16.3 BUILDING SHELL INSULATION-' • - Component Insulation LocatiioniComments Type R -Value (attic, to Gamge, ripiarl, etc.) Wall .............. -i9 - - Wall .............. ,::. • . Roof ................. Roof ............. Floor.. ......... Floor .............. �. Slab Edge ..... - GLAZING ... -. Shading Devices Glazing ' --'°"- = -; Area Glass Type Interior Exterior Orientation ''' "`' (sf) - (single, double) (roller blind. etc.) khsdr=tire,-" err I Overhang Framing Type North ( ) East ( ) East ( ) k ia South ( ) 0_ _ Sou th ( ) West ( ) _3-4 West ( ) Skylight....... 0_ THERMAL MASS Type/Covering Area Thickness (slab/exposed, tile, etc.) (sf) (inches) Location/Description (kitchen, bath etc.) Mandatory Measures Checklist: Residential MF -IR NGTI: Lowrix residential buildings subject to the Standards must contain these measures mgardkm of the compliance approach used. Items marked with an asterisk (•) may be superseded by more stringent compliance requirementsfsttid _ on the Certificate of Compliance- When this checklist is incorporated into the permit docurrscrits, Ute features notashalt be considered by all parties as binding minimum component performance specifications for the mandatory measures whether they arc shown elsewhere in the documents or on this checklist only. DESCR1PnON DESIGNER ENFORCE34ENT Building Envelope Measures • §2.5352(a): Minimum ceiling insulation R-19 weighted avenge. §2.5352(by. Loose rill insulation manufacturer's labeled R -Valva • §2.5352(e): Minimum wall insulation in framed walls R-11 weighted average (does not apply to exterior mass walls). ' 12.5352ft Slab edge insulation - water absorption rate no ptua than 03%, water vapor � _. . tnrnsmission ease to greater than 2.0 perm(unch. 52.5311: Insulation specified or installed meets California Energy commission (CEC) quality standards. Indicate type and form. 12.5352(rx Vapor barriers mandatory in Climate lanes 14 and 16 only. §2.5317: Inrilaation/Exfrltntion Controls a. Doors and windows between conditioned and unconditioned spaces designed to Emit air leakage, b. Doors and windows courted. c. Doors and windows wtathersaipped: all joints and penetrations caulked and scaled §2.5352(e): Special infUuation barrier installed to comply with §2-5351 mew CEC quality _ standards _ •_ _..: _ 12-5352(d): Installation of Fireplaces I. Masonry and factory -built fucplaces have: L Tight fitting• closeable metal or glass door b. Outside air intake with damper and conal t Flue damper and coned -- 2. No continuous burning gas pilots allowed - ... . HVAC and Plumbing System Measures §2-5352(g) and 2-5303: Space conditioning equipment sizing: attach cakulations 12.5352(h) and 2-5315: Setback themtostat on all applicable heating systems. • §2.5316(a): Ducts constructed, installed and insulated per Chapter 10. 1976 UMC- 12.5316(bj: Exhaust systema have dampercontrols_ §2.5314(c): Gas-fired space heating equipment has intermittent ignition devices §2-5314: HVAC equipment, water heaters, showerheads and faucets certified by the CEC- 12-5352(i): EC §2.5352(1): Water heater insulation blanket (R-12 or greater) or combined interior/exterior insulation (R-16 or greater): fust 5 fees of pipes closest to tank insulated (R-3 «greater). 12.5312(Exeeption 1): Pipe insulation on steam and steam condensate return recirculating piping. §2.5318(4): Swimming Pool Heating 1. system has: 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 inleL Lighting and Applianct Measures §2-53520): Li htin 25 lumens/watt or greater for general lighting m kitchens and bathrooms. §2-5314(c): Gas fired appliances equipped with intermittent ignition devices. §2.5314(x): Refrigerates• refrigerator -freezers• freezers and fluorescent lamp ballasts certified by the CEC. Indicate make and model number. COMPLIANCE STATEMENT This certificate of compliance lists the building featureand performance specifications needed to comply with Title 24. Chapter 2-53 and Title 20, Chapttr2, Subcttapter4. Article I of the California Administrative code. This I certificate has been signed by the individual with overall design responsibility and the building owner, who shall HVAC SYSTEMS Minimum Duct > j retain a copy of it and transmit the certificate to any subsequent purdiaser of the building. Type (furnace, air Efficiency Location Duct Output Manufacturer / Model # conditioner, heat um) (SE, SEER,HSPF) (attic, etc.) R -Value tuh or approved equal) D�gner Building Owner 5r 7 I Nttrrx: Name 1 Address: Addmss: Te rte Maximum Furnace Heating Output: Btuh J) tx� Te HOT WATER SYSTEMS Tank Manufacturer/Model # Qjv sS stem T (storage as, etc.) Capacity ora roved equal) S i (da(e) �— Documentadon Author Enforcement Agency" I ' SPECIAL FEATURES/REMARKS (Add extra sheets if necessary) Nar><. _ - Name: Addrea. Tg ..