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HomeMy WebLinkAbout071-400-021OPEN DECK AND 2 STORY STURCTURE W/O C,a PERMITS { 8/29/90 NK Ce TRZECIAK 5Simmons Rd, app 1i ;mi E of Or incy Hwy, Orovi lle rmit##3200-80E (temp powr pole fo r future� of dev 71-08-113 �ermit #2512-81P,E titil.,MH) ELEC. _ f� GAS fog SUPPOR STRUCT1R);Q `C COMPACTIO TEST REO _ , contrcols VillagemV Oro. Permi:12513-81i`4HI sued, 77 71-40-21 i 476- EM -TRZECIAK, Hank & Sue' 121 Mayberry Rd O'.- i 1 U (new sf - 62/1 0.-21 CIAS ue `'- 1 yber R/d, Oroville O ew o en eck sf -0-021 TRZECIAK, Hank 93-181B 121 Mayberry Rd, Sue deck/mh Or 00, 071-400-021 06-1540 TRZECIAK 121 MAY -BERRY RD; BERRI j CREEK Cont: OWNER Q � ' CZ ^ ELEC RECONNEC �% A07 -?340 071=400-021 MISCELLANEOUS ale tricl ELECTRICAL RECONNEC ;' dd 121 MAYBERRY RD , ���1 G TRZECIAK, HANK X10-0?1?b t4 071-400-021 + ADMINISTRATIVE PERMIT NO'. 93-26 to allow 62/1,200 in U Zone Hank & susan Trzeciak 7/23/93 121 Mayberry Rd. , Oroville r _ i t4 071-400-021 + ADMINISTRATIVE PERMIT NO'. 93-26 to allow 62/1,200 in U Zone Hank & susan Trzeciak 7/23/93 121 Mayberry Rd. , Oroville r _ 07;�-i "M R October 10, 1990 flank & Sue Trezciak 2006 47th. Avenue San Francisco, CA 94116 RE: Permit Requirements A.P. #: 71-40-21 - 121 Mayberry Rd, Oroville Dear Mr. & Mrs. Trezciak This is a warning letter to notify you that you are in violation of the Butte County,Code at the above referenced location as follows: Failure to obtain permits, inspections and approval for a two story structure and an approximate 1500 sq. ft. open deck at the above ref- erenced location. Since permits and inspections are required for the above work, .please contact this office within ten days of the date of this letter, submit two complete sets of plans, apply for the required permits, and pay the appropriate fees. All work must stop until these permits are issued and you are authorized by our field inspector to proceed. This field authorization cannot be made until the existing work is inspected and approved. Please be aware that Butte County has entered into a Code Enforcement Program thatseeks voluntary compliance with the Butte County Code but provides an effective means of enforcement if such compliance is not obtained. If voluntary compliance is not obtained, enforcement will be pursued through the issuance of citations, fines, and the recording of a Notice of Violation. Your cooperation in resolving, this matter would be appreciated. Should you have any questions concerning this matter,, please contact Rod Taylor or Jim Glander of this office. RT: ds cc: Assessor Building Inspector Yours very truly, William Cheff Director of Public Works Rod Taylor Building Standards Training Officer use 3a COMPLAINANT Da ADDRESS: SS �S O iS PHONE NUMBER: OTHER COMMENTS: A. NG�hb O� A.P. # OSI -610-o-ori Address /al Owner f/o�,., l< d S� S0.r.r -t're zc %ca. c Owner's Address 3aa'a az Sr' C 4 �iy/tg • r 6 a Supervisoral District. TeTrarrt"' s Name VIOLATION CHECK LIST Phone No. 5'8 4 -39 57 Type of A.P. # OSI -610-o-ori Address /al Owner f/o�,., l< d S� S0.r.r -t're zc %ca. c Owner's Address 3aa'a 0.c. lvrl, Sr' C 4 �iy/tg Owner's Phone No. 6115 -1j 9 Supervisoral District. TeTrarrt"' s Name c.&- Phone No. 5'8 4 -39 57 Type of Violation in etail with Code Section Priority No.. (I) Owe- �P G k re- oho , I L i o Pe r.� i 4-S 00 NC?v r Specific Plot Plan with C/V Noted _yes ✓no Penalties Required ✓ 1st. Notice Sent /o -lo- 90 2nd. Notice Sent ate Date Comments and/or Determination -1z00 Tri=d ON�4C� %V (]�p e lNo 4.vSw� n,qr, PM +1t -12 14-4L 1 Y. TV pc , v 3� —4z4, Q & �/I ,-,ice /,C- /t, ce-& Ilk +,u,i -,�,rt QQ ,vim. �-.�-w��-�:-✓ / .� --/tom - C&& 3 D� Disposition For Citation Citation Date (Date) Department Recommendation to Court Court Action Notice of Violation Recorded I (Date C � ��-- ��l' � 7 Hank and Susan Trezciak 3222 Geary Blvd. San Francisco, CA 94118 RE: Building Code Violations 121 Mayberry Road, Oroville Dear Mr. and Mrs. Trezciak: November 30, 1992 A.P. #071-40-0-021 We sent you a warning letter dated October 10, 1990 notifying you that you are in violation of the Butte County Code at the above referenced location. As of this date, the following violations still exist. Failure to obtain the required permits, inspections and approvals from this office for construction of a two story structure and an approximate 1500 sq. ft. open deck in violation of the 1988 Uniform Building Code as adopted by Section 26-1 of the Butte County Code as follows: (a) Section 301(a) Permits Required (b) Section 305(a) Inspections Required (c) Section 305(d) Inspection Approval Required before Use or Occupancy The above violation(s) shall be corrected or abated by you by submitting three (3) complete sets of plans, applying for the required permits, and paying the appropriate fees, including penalties, within thirty (30) days of the date of this letter. After permit issuance and field authorization to proceed, the work must be completed and approved by this office within the permit specified time. Unless the violation(s) is (are) so corrected or abated, a citation shall be issued to you to appear in court for said violation(s) and for failing to comply with this notice.. Upon conviction of said violation(s) or for failing to comply with this notice, penalties shall be imposed and a Notice of Violation recorded in accordance with Section 41-7 of the Butte County Code. Should you have any questions concerning this matter, please contact David Purvis of this office at (916)538-7541. JFG:dms cc: Building Inspector Yours very truly, J.F. Glander Manager, Building Inspection PROOF OF SM'/?CE BY t-LkM I am over the ase of 12 and noc a party to this causes.. I a ---a resident of and employe_ in. the c::=c,7 where the mail occurred. My business address is Building Division Department f Development Services zr/ Councp.�a ter Drive California. 'Oroville, CA 95965 I served the foregoing 30—Day Violation Letter by enclosing a true copy is a sealed envelope and deposit -;n; said enve?ore in the United States mail with postage fully prepaid ca 30th. of November 19 92, and addressed as follows: Hank and Susan Treciak 3222 Geary Blvd. San Francisco, CA 94118 decIare under pena? t7 of Per-Jur,r under t .e laws of the State of Cali=ornia chat the zore_viing is true and corract and that c.'1is declarac-ion was executed on 11/30/92 at Qrov;iio California. Hank & Sue Trzeciak 131 Sterling Avenue Buffalo, New York 14216 70*240 J4* 4 Wp;C �,� 30 /q9� cvaa�, COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA 95965 PHONE: 916-538-7541 Hank ; --Sue- Trzeciak 440 Monterey Brisbane, CA 94005 Dear Mr. & Mrs. Trzeciak: With reference to the above subject: DATE February 3. 1993 RE: Building Permit #93-181 (Open Deck) A. P. # 071-400-021 L� Attached. is : Application for permit Mobilehome Utilities Installation Sheet Building Plans Mobilehome Installation Information Sheet Engr. Calcs Typical Plan Sheet Owner -Builder Verification Form List of Codes Enforced OTHER XXX We need the following information: Permit application signed and completed where indicated with all copies returned. • Fees of $ payable to Butte County Treasurer. Certificate of Workmen's Compensation Insurance or check exemption statement. Contractor's License Law information or check exemption statement. .Complete plans in including plot plans. Plot plans in Structural.details in Complete..plans and calcs in. by registered engineer or architect. Energy design including Street -and drainage improvement plan approval from Land Development Section (DPW). sets -of -plans in accordance with the changes marked in red. XXXX Sanitation approval from Butte County Health Department at: 1469 Humboldt Road, Chico XXX 7 County Center Dr., Oroville Skyway '& Elliott Rd.; Paradise Planning approval from Butte County Planning Department, 7 County Center Drive, Oroville, for Completed Owner -Builder Verification form. Recorded copy of deed showing .Recorded copy of agricultural acknowledgement statement... XXX/.OTHER Get Building_ Permit -#93-180 (62/1200'with Garage) issued. Should you have any questions concerning the above, please contact Tom May of this office., between 3:00 and 5:00 pm weekdays. Yours very truly, William Cheff Director of Public Works '.J.F. Glander JFG/aj COUNTY OF BUTTE 7 County Center Hank & Sue Trzeciak 440 Monterey Brisbane, CA 94005 Dear Mr. & Mrs. Trzeciak: With reference to the above subject: DEPARTMENT OF PUBLIC WORKS Drive, Oroville, CA 95965 PHONE: 916-538-7541 DATE February 3, 1993 RE: Building Permit # 93-180 (62/1200 with Garage) A.P. # 071-400-021 Attached is: Application for permit Mobilehome Utilities Installation Sheet Building Plans Mobilehome Installation Information Sheet Engr. Calcs Typical Plan Sheet Owner -Builder Verification Form List of Codes Enforced OTHER XX/ We need the following information: Permit application signed and completed where indicated with all copies returned. Fees of $ payable to Butte County Treasurer. Certificate of Workmen's Compensation Insurance or check exemption statement. Contractor's License Law information or check exemption statement. -XXX Complete plans in triplicate including plot plans. XXX Plot plans in triplicate Structural details in Complete plans and calcs in by registered engineer or architect. Energy design including Street and drainage improvement plan approval from Land Development Section (DPW). sets of'plans in accordance with the changes -marked in red. XXX Sanitation approval from Butte County Health Department at: 1469 Humboldt Road, Chico XXXX 7 County Center Dr., Oroville Skyway & Elliott Rd., Paradise XXX Planning approval from Butte County Planning Department, 7 County Center Drive, Oroville, for 2nd dwelling Completed Owner -Builder Verification form. Recorded copy of deed showing Recorded copy of agricultural acknowledgement statement. 7 OTHER 1. Take care of violations. Should you have any questions concerning the above, please contact Tom May of this office, between 3:00 and 5:00 pm weekdays. Yours very truly, William Cheff Director of Public Works .%..J.F. Glander JFG/aj I Hank Trzeciak 121 Mayberry Rd. Oroville, CA 95966 �--, I - �- 1, 1- -t-. �CAq�S 014-4, 4 { July 23, 1993 0 -1'r - P Department of Development Services PLANNING DEPARTMENT 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965-3397 TELEPHONE: (916) 538-7601 { cu op Ha- k=and Susan�Trzeciak� �` r 440 -Monterey 1$0 Brisbane, CA 94005 Re: Administrative Permit, AQP 071-400-02� Dear Mr. and Mrs. Trzeciak: Enclosed is your validated Administrative Permit No. 93-26 to allow a senior citizen dwelling no larger than 1200 square feet for 1 or 2 persons 62 years or older on property zoned "U" located at 121 Mayberry Road, 4roville. Every Administrative Permit expires and is automatically null and void without further action by the County if the Activity or use for which the Administrative Permit was granted has not been actively and substantially commenced within one year of the date of its final approval. Should you have any questions regarding this matter, please contact this office. Sincerely, n William Farrel Director of Development Services WF:lr Enc. cc: Land Development D' ision Building Division Environmental Health Department of Forestry ADMINISTRATIVE PERMIT BUTTE COUNTY PLANNING DEPARTMENT July 23, 1993 93-26 PERMIT NO. AP 071-400-021 ASSESSOR'S PARCEL NO. Pursuant to the provisions of the Zoning Ordinance of the County of Butte and the special conditions set forth below: Hank and Susan Trzeciak is hereby granted an Administrative Permit in accordance with application filed: 5/24/93 to allow a senior citizen dwelling no larger than 1200 square feet for 1 or 2 persons 62 years or older on property zoned "U" located at 121 Mayberry Road, Oroville. 1. Failure to comply with the conditions specified herein as the basis for approval of application and issuance of Permit, constitutes cause for the revocation of said permit in accordance with the procedures set forth in the Butte County Zoning Ordinance, including Butte County Code Section 24-62. 2. Unless otherwise provided for in a condition to an Administrative Permit, all conditions must be completed by the permittee within 12 months of the delivery of the countersigned permit to the permittee. 3. If any use for which an Administrative Permit has been granted is not established within one year of the date of receipt of the countersigned permit by the permittee, the permit shall be come null and void and reapplication shall be required to establish the use. 4. The terms and conditions of this permit shall run with the land and shall be binding upon and be to the benefit of the heirs, legal representatives, successors, and assigns of the Permittee. SPECIAL CONDITIONS: 1. The "living area", meaning the interior habitable floor space area of a dwelling unit including habitable basements and attics, but not including a garage or any accessory structure, shall not exceed 1,200 square feet. 2. The senior citizen dwelling unit shall be for the sole occupancy of one (1) adult 62 years of age or over or two (2) adult persons, one of whom is 62 years of age or over. An affidavit of compliance with the age requirements of this section shall be recorded in the office of the Recorder prior to issuance of building permits. Said affidavit shall include the legal description of the lot or parcel and shall constitute a covenant running with the land, binding upon the original owners and their heirs, successors and assigns, limiting fV the occupancy of the senior citizen dwelling unit to the conditions described in this section. 3. The senior citizen dwelling unit shall not be sold as a separate unit unless a parcel containing the unit is created in compliance with the existing zoning and subdivision ordinances and the resulting density is in conformance with the General Plan. 4. Two off-street parking spaces shall be provided for the senior citizen dwelling unit in addition to the parking spaces required for the primary dwelling unit. 5. Adequate sewer and water facilities shall be provided subject to the approval of the Environmental Health Department. 6.- All site development standards as required by the zoning district in which the unit is located shall be met. 7. The Senior Citizen Dwelling unit shall be a conventionally constructed building or a mobile home that complies with the National Manufactured Housing Construction and Safety Standards Act of 1974, except that in the "A", "FR", and "TM" series of zones a mobile home, as defined in Section 24-21.28, may be used. Travel trailers and recreational vehicles shall not be allowed as a Senior Citizen Dwelling Unit. 8. Dwelling must meet the fire safe regulations of PRC 4290. 9. The approval of this permit constitutes approval only to the extent that the project complies with the Butte County Code and all other applicable regulations. 10. The requirements of all concerned governmental agencies having jurisdiction by law, including, but not limited to the issuance of appropriate permits, shall be met. 11. Minor changes may be approved administratively by the Director of Development Services upon receipt of a substantiated written request by the applicant. Prior to such approval, verification shall be made by each Department or Division that the modification is consistent with the application, fees paid and environmental determination as conditionally approved. Changes deemed to be major or significant in nature shall require a formal application for amendment. NOTE: Issuance of this Administrative Permit does not waive requirement of obtaining Building and Health Department permits before starting construction and their approvals prior to use or occupancy, nor does it waive any oth9r requirements. CC: Butte County Planning Director Land Development Division Building Division Health Department Department of Forestry 00 ,.6Ypa,c!:n�+ai.c �'�'.'•�;r..._-....nv!..wt'ic0.}w .aGr�+nv.N p RRas n r r s 't O 4`Pcok;�0y �� APKOX f Nero U �xOq Wit 1./ a w J i r 6b Planning Dt�oarfn# 3� MAY 2 4 tQQA Orov:� PL OT M N9 - AP ;' 071 -Hoo -bi.� P P R 0 V ED DEVELOPMENT PLAN USE'PERMITVARIANCE BY 2� w THE METHOD OF DIVISION OF PROPERTY IN THIS AREA IS BEING REFERRED TO THE BOARD OF SUPERVISORS FOR POSSIBLE SUBMISSION TO THE DISTRICT ATTORNEY AND STATE REAL ESTATE COMNQ SSION FOR REVIEW AND APPROPRIATE ACTION. i���'� f l M r �� � G�� 3 t I �c 6W dau'. 6� A4zv�,; i. tAe- � fjt,�, L�rk.. ao G Ci� V��O�NG �pH 8&ow.. %Dills '41 4exoaoilot 4040400;r 404-, aj+ gov-NL t4o%�� +A4. *4A�� cfya 1►2� C/oa S CLAIMANT: ADDRESS: CITY & STATE: DATE OF CLAIM: e",d*. q Butte OROVILLE, CALIFORNIA GENERAL CLAIM IMPORTANT: SEE INSTRUCTIONS ON REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) AMOUNT TOTAL I, the undersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivereq, and that this claim is true and correct as stated. WAD q �� Q� �� Q�� Dated this ......................... day ofA.td`�Y::.)............ 19;�✓, et..,..�Z�/�!`!�CJCalif. ..::. .. . cG�.YM:.`:..... ....... ...+,�.............. Signature of C1 ant I. the undersigned, hereby certify W to the best of my knowledge, the services or articles specified above have been performed or de. livered and that there is a Budget Appropriation❑ or Specific Board Approval❑ (Checkone) for the some. .Dated this .................................... day of ............................. 19....... at .............................. . Calif.......................................................... ........................... Department Head or Authorized Deputy Dept. Exp. Code............................................ Code ................................................PAYABLE FROM............................................................................................ FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSS AMT. INSTRUCTIONS to CLAIMANTS All claims against the county must be itemized, giving dates and character of service rendered or work performed, quantities, de- scription and unit prices of articles furnished or delivered. Claims must be certified by the claimant and submitted to the De- partment head for approval. Upon approval the Department head will forward claim to County Auditor for payment procedure. Do not file with the County Auditor first. Claims should be presented to officials for approval immediately upon completion of services requested or material ordered. Claims are paid every Tuesday; however, same must be approved by officials and in Auditor's office before preceeding Wednesday noon. Compliance with above will expedite payment of claim, failure to do so may delay payment considerably. GOUNT'Y OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovllle, California 95965 - Telephone: 916/536-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER � , 71 —40-21 ZONING 11 BUILDING PERMIT OWNER TELEPHONE S0. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS s BriSbane. CA 94005 , CONTRACTOR'S NA TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ 74.50 ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ 7.25 Energy Plan Checking Fee ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ 149.00 BUILDING ADDRESS 191 MaVhprrV Rd-, Groville Permit fee $ 270*75 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. 12 SUBDIVISION NAME PARCEL MAP 63-7 Water piping , 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other Open —deck SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W O_00ea 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 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect.SINGLE License No. Classification. 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 CONST. DWELLING OCCUP.SI� OR ADONS. ACC, BLDGS. '/zQsgft NEW CONSTR. U TI -OUTLET NON-RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS &) OUTLET CIR. Ex. OCCUp�OUT LETS OR FIXTURES 20 ® 505 eALO 30 FIXED APPLNS. OR EX. OCCUp. OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County -of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ' I shall not employ any person in any manner so as to become subject � to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 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 aid County in consequence of the granting of this permit. If"Date / Signature of Applicant — Owner,9 Contractor ❑ Agent An 'OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 270.75 HAL I CUA PARK scHL FLD OF PA PD ) HD. ISSUE. This permit is hereby issued unser the applicable provi- sions of the Butte County. Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date Receipt No. 88250 WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT I COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Orovllle, Callfornla 95965 - Te ephone: 916/538-7541 . APPLICATION AND PERMIT As ESoR i ft&L yjl"'p R ZONING BUILDING PERMIT TEL'I"31EOf OWN R SC_ FT. OCC. BUILDING VALUATION ►^2C�e <Sui' l l I Ci _ O NERC MAI[` o togs ri ^�OD� I . NAM TELEPHONE I`ONTRACTOR'S PCOACTOR'S MAILING ADDRESSFire=laceON RUCTION LENDER UNKNOWN Tota:: Valuation g D Cl Filing Fee 5 '0.00 LENDER'S MAILING AODRESS On .. �,� s � •5 O AR H 'ECT OR L. ;Ir1EE? LICE.`.SE —NO• PIa.:Che::;:ing Fee $ 1 aS Ene-y Plan Checking Fee S ARCHITECT OR ENGINEER'S MAILING ADDRESS Peralty $ - BUILDING AOD</(� gVa Q I Per-tit fee $ M. Y C PLUMBING PERMITn9 Fili Fee 10.00 Each Trap 1 2.00 Soi:r or heat pump water heater 20.00 LOT NO. SUaOIVISION NAME PARCEL M Wa:er piping 5.00 1 Eacn oas water heater or vent 5.00 Ga piping system 1 - 5 outlets 5.00 USE OF STRUCTURE 5.00 • f Iv SF ❑ Duplex❑ Mobilehome❑ Other4 Building sewer 0.00ea q- SPECIFY Mccile Home S G W TYPE OF WORK 1 1 New Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Pe,-mit Fee S irractor • -Describe work: ELECTRICAL PERMIT Filing Fee 10.00 a!n service 10ov OR LESS 100 AMP OR LESS r..= 10.00 an service EA. ADO-L 100 AMP 2.50 CONTRACTORS LICENSE LAW M CONST. ( DWELLING oCCUP.N\Sgit AOONS. ACC. aLOGS. !! I declare under penalty of pefjury (check one): NGM coNSTR uLTI.OUTLET .NCV:RESIO "RANCH CIRC ITS 2.50 ea ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business (POWER APPARATUS a� SINGLE OUTLET CIR- . and Professions Code and my license is in full force and effect. Ez. OCcup(OUTLETS OR FIXTURES 209SOt eAL930r License No. Classification. �1 XED APPLN5. OR E^ Occup. OUTLETS IRESID.1 EA.) 00 2.0 ❑ I, as the owner, or my employees with wages as their sole compen- 10.00 sation, will do the work, and the structure 1s not intended or offered T rlporary service for sale. (Sec. 7044) M-bile Home Facilities 15.00 ❑ I. as the owner, am exclusively contracting with licensed contract- Masc. Wiring 15.00 ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code Permit Fee $ for this reason G.;ntractor j WORKMEN'S COMPENSATION INSURANCE MECHANICAL PERMIT Filing Fee 10.00 I declare under penalty of perjury (check one): 1 ❑ The permit is for $100.00 (valuation) or less. t-eating ❑I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate Coling of Consent to Self-Insure. 3.00 1 shall not employ any person in any manner so as to become subject rood to the W. C. laws of California. Ventilation Notice to Applicant: If atter making this statement, should you become subject P+rmlt Fee $ - to the W. C. provisions of the Labor Code, you must forthwith comply with such I' ' provisions or this permit shall be deemed revoked. Contractor 4abile Home Installation Fee $ I certify that I have read this application and state that the above information _ $ is correct. I agree to comply to all County Ordinances and State Laws relating =1ergy Inspection Fee _ to building construction, and hereby authorize representatives of the County of o--w CONST TYPE Butte to enter upon the above-mentioned property for inspection purposes. TOTAL FEES c) /Dr I also agree to save, indemnify and keep harmless the County of Butte against MAL C:JA I PAAKc 1 SCHL FLO C.'.F 1 PAR I PO n0•I >Suc all liabilities, judgments, costs. and expenses which may in any way accrue I I 1K against said County in consequence of the granting of this permit. .-is permit is hereby issued under the applicable prow- X Date sons of the Butte County Code and/or resolutions to do ❑ Contractor ❑ Agent ❑ -ark indicated above for which fees have been paid. Signature of Applicant — OWner • l An OSHA permit is required for excavations over 5'0" deep and demolition or construct. DIRECTOR OF PUBLIC WORKS ion of structures over 3 stories in height. -y Date Receipt No. PERMIT EXPIRES Date � + r , r •�Yj�q+��b a(�' ' .I�d • , ti'y� i}'• ' , �".'�-�f'^r ;,,C'r �� s�'�is ti r '. �����,�•� �'* '�'t� M� . "Y� < : . COUNTY OF BUTTE - DEPARTMENT.OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DAIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA tHEET Permit No. OWNER hk �- ( Tr 2— C- C I ex 1<1 Proposed Building Use 0Building Inspector—� Date 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 licate tr' ate, signed by preparer of plans ........ 3. Complete plans In plic iplicate, siwgned by Drepare� r of plans. 4. Complete engineere -plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ................ 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's. installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13. School Disjrict fees paid .............. 14. Sanitation approval from In 46 ✓ I l E- Health Department 15. City of Chico plumbing permit........... ....................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 20. Pre -Inspection for required Pre-inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization ................................... 26. 27. When you issue the permit, irocess as follows: Mai o owner. Mail to contractor. Telephone $��"�Ja3 and hold for pickup atroffice. Deliver w./inspector. Other ^� Applica v 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 t410 rmit issuance: (Circle new item not checked above). 1. Index permit for above items No, a . 2. Additional items required: Contractor, designer, o r, was advised of above required data by_phone__naiI—counter by ® ..date yIf/— 57/ Contractor, designer, owner, was advised of above required data by —phone _maII—counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW/J/s` Lr•�/�G C 12£ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA 95965 PHONE: 916-538-7541 DATE �L2nja� HANK AND SUSAN TREZCIAK 3222 Geary Blvd RE: Permit applications 93-180 & 93-181 San Francisco, CA 94118 A.P. #071-40-0-021 With reference to the above subject: / / Attached is: Application for permit Mobilehome Utilities Installation Sheet Building Plans Mobilehome Installation Information Sheet Engr. Calcs Typical Plan Sheet Owner -Builder Verification Form List of Codes Enforced OTHER /--17)4e )Te need the following information: Permit application signed and completed where indicated with all copies returned. Fees of $ payable to Butte County Treasurer. Certificate of Workmen's Compensation Insurance or check exemption statement. Contractor's License Law information or check exemption statement. XXX Complete plans in triplicate , including plot plans. Plot plans in Structural details in Complete plans and calcs in by registered engineer or architect. Energy design including Street and drainage improvement plan approval from Land Development Section (DPW). sets of plans in•accordance with the changes marked in red. - Sanitation.approval from Butte County Health Department at: 1469 Humboldt Road,.Chico XXX 7 County Center.Dr., Oroville Skyway & Elliott Rd., Paradise XXX Planning -approval - from Butte County' Planning Department, 7 -County -Center Drive, Oroville, for Use Permit for 62-1200 Completed Owner -Builder Verification form. Recorded copy of deed showing Recorded copy of agricultural acknowledgement statement. �xX Ger Building permit 93-181 issued L_.tXOTHER Unless the above mentioned items are submitted within Q0 days of thO date nf' this letter, a citation shall'be issued.to you to snn a- in. court for said violations and for failing to comply with this notice. Should you have any questions concerning the above, please contact SCOTT RUTHERFORD of this office." (916-538-7541) Yours - - Yours very truly, William Cheff Director of Public Works ,•..J.F. Glander JFG/aj 4 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMtV PERMIT NO. 93-181 ASSESSOR PARCEL NUMBER ZONING 071-40-0-021 U BUILDING PERMIT OWNER - Hank & Sue Trzeciak 415 TELEPHONE 467-2198 SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1800 o en 12,600 440 Montere Brisbane CA 94005 CONTRACTOR'S NAME TELEPHONE Owner CONTRACTOR'S MAILING ADDRESS Fir lac CONSTRUCTION LENDER UNKNOWN T I aluation $ LENDER'S MAILING ADDRESS ing Fee $ 15.00 IN ` Permit Fee $ 120.00 ARCHITECT OR ENGINEER LICENSE Plan Checking Fee $ 60.00 ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ 240.00 BUILDING ADDRESS Permit fee $ 435.00 PLUMBING PERMIT Filing Fee 15.00 Each Trap 1 5.00 Solar or heat pump water heater 1 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE Gas piping system 1 - 5 outlets 5.00 SF ❑ Duplex❑ MobilehomeK] Other Building sewer 15.00 Mobile Home S I G I W @ 15.00 SPECIFY TYPE OF WORK New ❑ Addition[E Remodel ❑ Utilities ❑ Installation[] Other ❑ Permit Fee $ Describe work: nDen deck built who permits Contractor renl arae #91-864 ELECTRICAL PERMIT Filing Fee 15.00 Main service 200V OR LESS 00AOR LESS 18.50 Main service 200ATO1000A) 37.50 CONTRACTORS LICENSE LAW NEW CONST. / DWELLING OCCUP.ad) 3.64 sq.ft. I declare under penalty of p y perjury y (check one): OR ADDNS, l ACC. BLDGS. II ❑I am licensed under p provisions Of Cha t. 9, Div. 3 of the Business/POWER NEW CONSTR. MULTI -OUTLET NON-RESID BRANCH CIRC ITS @ 5.00 and Professions Code and my license is in full force and effect. APPARATUS Q) SINGLE OUTLET CIR. License No. Classification Ex. 20 Ted p OUTLETS OR FIXTURES I, as the owner, or my employees with wages as their sole compen- Al ARA FIXED ALNS Ex. OCCup. OUTLETS P(RESID )REA.) 3.00 sation, will do the work,and the structure is not intended or offered Temporary service 15.00 for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract - Mobile Home Facilities 15.00 ors. (Sec. 7044) Misc. Wiring -15.00 ❑ I am exempt under Sec. , Business and Professions Code for this reason Permit Fee $ WORKMEN'S COMPENSATION INSURANCE Contractor I declare under penalty of perjury (check one): MECHANICAL PERMIT Filing Fee 15.00 ❑ The permit is for $100.00 (valuation) or less. Heating ❑ 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. Cooling I shall not employ any person in any manner so as to become subject Hood 6.50 L--- to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject Ventilation -- - to the W. C. provisions of the Labor Code, you must forthwith comply with such Permit Fee $ provisions or this permit shall be deemed revoked. Contractor I certify that I have read this application and state that the above information Mobile Home Installation Fee S is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Energy Inspection Fee $ Butte to enter upon the above-mentioned property for inspection purposes. occ CONST TYPE I also agree to save, indemnify and keep harmless the County of Butte against TOTAL FEE $ 435.00 all liabilities, judgments, costs, and expenses which may in any way accrue HA2 DFEES IMP FLOOD cDF PARc,_*_tltg HD ISSUE against said County in onsequence of the granting of this permit. I X Date JAL This permit is hereby issued under the applicable provi- signature of Applicant — AwnerjgContractor ❑ Agent F1 sions of the Butte County Code and/or resolutions to do An OSHA permit is required for excavations over 5'0" deep and demolition or construct- Work indicated above for which fees have been paid. ion of structures over 3 stories in height. DIRECTOR OF PUBLIC WORKS Receipt No. 135159--75.00 p/c// By Date PERMIT EXPIRES Date WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT • J s AiCOUNTYOF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROWL&E, CALIFORKIA 95965 - ~TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET Proposed Building Use .DQnS DSC. Building Inspector P. No. 6) 7/ - IYO 6 Z Date S3 At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1. 2. 3. .4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 31. 32. All items have been submitted . ....................................... . Plot plans, 3/4 sets, signed by preparer of plans . ......................... . Complete plans, 3/4 sets, signed by preparer of plans . ..................... . Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. Hazardous Material Form. ......................................... . Energy Design Compliance and supporting documentation . ................. . Statement of Intent for Non -Heated and A/C Buildings . ...................... Engineered truss details and layout in duplicate (required prior to plan check). ... . Mobilehome data and manufacturer's installation instructions, 2 sets. ........... Feesof $......................................... Impact fees as shown on attached schedule. ............................. . California Department of Forestry plan approval/fees. ....................... Flood elevation letter (100 year flood) by California Engineer..... . Sanitation and plot plan approval Obi) l"' Health Department. City of Chico plumbing permit. ........................................ . Plot plan and business license approval from City of Biggs/Gridley. ............. Planning approval for (A) Use: (B) Parking: . ........ Contact Land Development about (A) Improvements (B) Drainage. .. 0 ........ Driveway permit (construction approval required prior to occupancy). .. . . Pre -ins ection for PB�"�egt1ns actor p required. . to Building Inspector (Date) Contractor's license information. (No., Name Style, Classification) . .............. Certificate of Workmans Compensation Insurance . .......................... Owner -Builder Verification (Given to owner , Mail to owner )........... . Recorded copy of Agricultural Acknowledgement Statement . .................. Letter of signature authorization. ....................................... . Copy of recorded deed of parcel creation and 60 right of way to a public road. ..... Letter of intent on building use . ............................ 0 ............ Mobilehome utility clearance . ......................................... . Documentation of legal access . ..................... :.......... ....... . Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . .............. . Existing violations/expired permits . ..................................... . Plan check list. ... vvnen y9m Issue the perm) rocess as follows: Mail to owner. Mail to contractor. / [Telephonef/5' l-2198and hold for pickup at o20j•1«- office. Deliver with inspector. Other Parcel Creation Acreage 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 1. Index permit for above items No. 2. Additional items required: issuanLe: jCircle new item not checked above). Contractor, designer, oar, was advised of above required data by _ phone _ � mail V" Counter byDate5- Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works ' 0 / COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916:'538-7541 �� / / j APPLICATION AND PERMIT - ASSESSOR PARCEL NUMBER ZONING ' Q 2 IIJI BUILDING PERMIT OWNER Z& Sve �Z �eGia K Y/5 TELEPHONE - r 98 SSS. FT. OCC. BUILDING VALUATION OWNERLI Ir p ADORE SS CA- z G o c:>'S A^V//J e� I sh'Ne CONTR A_C TOR'S NAM TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN u Total Valuation LENDER'S MAILING ADDRESS - _ Filing Fee $ 15.00 Permit Fee $ 120 , pp ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ —65.0-0 ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty X $ (/ ✓L6 �'1 ,OG> BUILDING ADDRESS (,e�� Permit fee $ 121 U I� PLUMBING PERMIT Filing Fee 15.00 Each Trap5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE Gas piping system 1 - 5 outlets 5.00 SF ❑ Duplex❑ MobilehomepK Other -_ Building sewer 15.00 _.-cCI FY Mobile Home S I G I W @ 15.00 TYPE OF WORK New❑ Addition Remodel[] Utilities❑ Installation❑ other ❑ Permit Fee $ Describe work: CDOfV 011- Contractor -c> QecmocS ELECTRICAL PERMIT Filing Fee 15.00 �--- i !ems ! 8�D Main service 6200VORLESS 00V OR LESS 18.50 Main service 20CATO 1000A) 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): NEW CONST./ DWELLING OCCUP.�\ OR ADONS, l ACC. BLDGS. // 3.6Q sq.ft. ❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business NEW CONSTR.ULTI-OUTLET NON -R ESID BRANCH CIRC ITS @ 5.00 and Professions Code and my license is in full force and effect. (POWER APPARATUS e \SINGLE OUTLET CIR. License No.' Classification EX. OCcup(OUTLETS OR FIXTURES 20 @ 76d 1, as the Owner, or my employees with wages as their sole compen^ FIXED APPLNS. OR EX. OCCUp. OUTLETS (RESID.) EA.) A 4 3.001 sation, will do the work,and the structure is not intended or offered Temporary service 15.00 for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract - Mobile Home Facilities 15.00 ors. (Sec. 7044) Misc. Wiring 15.00 ❑ 1 am exempt under Sec. , Business and Professions Code for this reason Permit Fee $ WORKMEN'S COMPENSATION INSURANCE Contractor I declare under penalty of perjury (check one): MECHANICAL PERMIT FiIingFee I 15.00 ❑ The permit is for $100.00 (valuation) or less. Heating ❑ 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. Cooling ❑ I shall not employ any person in any manner so as to become subject Hood 6.50 to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject Ventilation to the W. C. provisions of the Labor Code, you must forthwith comply with such Permit Fee $ provisions or this permit shall be deemed revoked. Contractor 1 certify that I have read this application and state that the above information Mobile Home Installation Fee $ is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Energy Inspection Fee $ Butte to enter upon the above-mentioned property for inspection purposes. OCC COr,STTYPE = I also agree to save, indemnify and keep harmless the County of Butte against TOTAL FEE $ f- all liabilities, judgments, costs, and expenses which may in any way accrue HAz 11 FEES IMP FLOOD CDF PARr•.t ISSUE against said County in consequence of the granting of this permit. iPD7H0 II X Date This permit is hereby issued under the applicable provi- Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ sions of the Butte County Code and/or resolutions to do An OSHA permit is required For excavations over S'0" deep and demolition or construct- work indicated above for which fees have been paid. ion of structures over 3 stories in height. DIRECTOR OF PUBLIC WORKS Receipt No. / 35153 -� PC F,- 7-5 �. By Date WNITC-D.P.W.. YELLOW-A9eE990R, PINK•INSPECTOR, GOLDENROD•APPLICANT PERMIT EXPIRES Date BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION. OFFICE #: (530) 538-7541 FAX#: (530) 538-2140 A FEE WILL BE'REOUIRED AT TIME OF.APPLICATION Website: W. ?w.huttecounty.net/dds ..*PLEASE PRINT CLEARLY** APPLICANT SIGNATURE PROJECT LOCATION AP# Property Address m r city PERMIT NO. BIN # WORKER'S COMPENSATION . Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: OWNER INFORMATION Last Nam . I Flood First Name Mailing Address Grove, City J �\� State Zip p.s„ Phone �1 _ I Q�b Fax L��p E-mail • Lic. # APPLICANT SIGNATURE PROJECT LOCATION AP# Property Address m r city PERMIT NO. BIN # WORKER'S COMPENSATION . Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: CONTRACTOR Name I Flood -•--- Address ------ J �; City. Ciiy. w � S�.Zlp Zip Phone .� L Fax . E-mail . Lic. # Class APPLICANT SIGNATURE PROJECT LOCATION AP# Property Address m r city PERMIT NO. BIN # WORKER'S COMPENSATION . Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: ARCHITECT/ENGINEER Name I Flood Address J �; city w � State Zip Phone .� L Fax E-mail - State License Number APPLICANT SIGNATURE PROJECT LOCATION AP# Property Address m r city PERMIT NO. BIN # WORKER'S COMPENSATION . Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: APPLICANT INFORMATION Name' I Flood Address LAp J �; City � w � State L Zip o0 Phone L\ .� L Fax -E-mail APPLICANT SIGNATURE PROJECT LOCATION AP# Property Address m r city PERMIT NO. BIN # WORKER'S COMPENSATION . Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning I Flood I SRA -T No Occ. _Yes Type Const. 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 BUTTE COUNTY NOV 21 2001 DEVELOPMENT SERVICES PROJECT INFORMATION Site Address: 121 MAYBERRY RD Owner: Permit No: B07-2340 APN: 071-400-021 TRZECIAK, HANK Issued Date: 11/16/2007 By KEJ Permit type: MISCELLANEOUS 37 GROVE ST. Subtype: Electrical BUFFALO, NY 14207 Expiration Date: 11/15/2008 Description: ELECTRICAL RECONNECT (716) 876-0601 Occupancy: Zoning: U Contractor Applicant: Square Footage: TIM TRZECIAH Building Garage Remdl/Addn 440 MONTEREY ST BRISBANE, CA 94005 Other Porch/Patio Total (415) 350-9410 FEE INFORMATION DBE Misc Residential Wiring $58.00 Total Charged: $58.00 Fees Paid: $58.00 Balance Due: $0.00 Receipt No: B5328 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires 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 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 pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. 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 X 11/16/2007 the applicant to a civil penalty of not more than five hundred dollars ($500]; Please check one of the following: Contractor's Signature Date n 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 WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: HAVE AND the work himself or herself or through his or her own employees, provided that such improvements ❑I WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). !HAVE AND WILL' MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by`—` I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractor's License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). Carrier: Policy Number: Exp. Date: (This section need not be completed if the permit is oror on�dr� Ilars ($100) or less. ElI AM EXEMPT under Section B. & P.C. for this reason: 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' J~ Compensation laws of California, and agree that if I should become subject to the workers' 11/16/2007 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those w prosi s. 10wners Signature Date 11/16/2007 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 Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, 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 DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the -prope owner or am authorized to act on he property owner's behalf. " N11/16/2007 CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Permi [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) Owner 1:1 Contractor OR E]Agent for Owner Agent for Contractor �l FILE COPY Lenders Address City State Zip Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, BUTTE COUNTY CA 95965. (530) 538-7601 Telephone NOV 2 7 100 % (530) 538-2140 Fax www.buttecounty.net/dds DEVELOPMENT SERVICES OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. n If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal C income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. '1�?, I PERSONALLY P O PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY \i IMPROVEMENT 1 "�2. I VE NOT) GNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. 3'I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: ADDRESS PHONE CONTRACTORS LICENSE CITY 4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: ADDRESS CITY PHONE CONTRACTORS LICENSE NO 5. 1 WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED: NAME ADDRESS PHONE TYPE OF WORK Description: ELECTRICAL RECONNECT Reference Number: B07-2340 Applicant Name: TIM TRZECIAH Owner's Name: TRZECIAK, HANK pp AP # : 071-400-021 CSignature of-PropertSFOwne 1 -- �I,.�a.�• _Date: ?O ,0 ' Butte County Department of Development Services NOTES ; 7 County Center Drive, Oroville, CA 95965 (530) 538-7601—.buttecounty.n@Vdds •COUIIty 'i RESIDENTIAL i� 071-400-021 • , 06-154 r APN: TRZECIAK ' } 121 MAYBERRY RD, BERRY CREEK )Owner. Cont: OWNER -- Site Addrei ELEC RECONNECT I 7 Contractor. t t Type of Permit 4 - , CHECKED BY SRA FLOOD CERTIFICATE EQUIRED FIRE SPRINKLERS REQUIRED SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUBSTANDARD HOUSING.LETTER ENCROACHMENT PERMIT REINSPECTION FEE PAID ENV HLTH CLEARANCE 5r r ' A DATE JOB FINALED: SIGNATURE: 0 = Not OK --- —RESIDENTIAL (Single & Dup-lex) , DATE JUNDERFLOOR, DATE IPLUMBING : 1 Zoning -Setbacks -Easements -Flood -Slope 2 Ftg Main; Soils-Elec Grnd• Ftg Opp 3 Ftg Garage; Soils-Elec Grnd Ftg Dpth 4 Ftg Porches/Decks; Soils -Steel Ftg Dpth 5 Stemwalls Main; Steel-Blockouts Wrapped 6 Stemwalls Garage; Steel-Blockouts Wrapped 6a Hold Downs and Special Anchrs - 7 Slab, Steel Wrapped 8 Piers-Frplc Ftg-Steel 9 DWV; Fall -Fitting -Test -2 -way CIO -Sewer Test 10 UF, Gas Pipe; Sz Anchrs-Sz Test 11 Wtr Pipe; Test-Anchrs-RgltrService Test 12_ Elec Undrgrnd 13 Plenums & Ducts; Cirnc-MaterialSupportansultn 14 GirdersSills-Anchr Bolts-Joists-Vnts-Cripples 15 Acc & Vntitn 16 Insulation DATE JFRAMING 17 Sills Proper Materials & Anchrs 18 Walls Studs -Nailing Spacirig & Braces -Plates -Sound 19 Bearing Walls over Girders 8 fir Nailing 20 Draft Stop in Walls (rat proof) • 21 Fire Stops; Flirted CeilingsStairs-Chasers Tubs 22 Headers 8S BeamsSi &'Bearing' 23 Hangers-PosfCaps-Anchrs-Cnnctns - 24 Ceiling Joist-Rftr Ties-Purlin-Roof Brac TrussShthg 25 Frplc Ties or Type A Flue=Frplc Throat Clmc 26 Attic Acc; Si &•Rmz Prtctn-Draft Stop -Ins Baffles 27 Bdrm Wndws or Exiting Doors -Sill Ht & Dimensions 28 Garage Fire Prtctri Framing -RC Chanel 29 Prprty Line Firewall 8< Opngs' 30 Ext Doors -One 3' -Check Garage 3rd Story, 2 Exits 31 Stairs; Width-Hdrm-Rise-Run-Landing-Fire Prtctn 32 Plywd on Roof Ovrhng-Attic Vnts-Rftr Outrgrs 33 Siding -Nailing Veneer 34 Stucco Lath Weep Screed-Fndtn Vnts-Undriir Acc 35 Glazing Area -Glass PrtctnSkyLts-Plastic . 36 Shear Walls; Nailing -Bolts 37 Brace Int/Ext Wall pnis 38 Insultn-Walls-Cell ings 39 Infiltration Walls-Wndws s DATE JELECTRICAL 40 Fxtr & Trnsfrmr Cirnc4ns Prtctn 41 Elec Rcptcls Spacing-Lts & Switches at Doors 42 Sz Boxes & No Of Cndctrs Stapled 43 Romex Installed Close to Edge of Studs & CJ 44 Eqp Grnd made up w/Mech Fstnrs 45 Gmdng Electrode Bond Gas & Wtr 46 2 Appinc Cires in Ktchn & Cndctr Sz GFI 47 Subfeed Wire Sz ❑ CU'or ❑AL AC Wire Sz , ❑ CU or ❑ AL 48 Range Clic w Q CU or ❑ AL Oven Circ ga QCU or F-1 AL Insulated Neutral QYes 0 N 49 Service -Riser Cndctrs & Grnd Main Dscnnct 50 Eqp CImcs pnls-Motors-Mech Eqp 51 Clothes Closet Lt-Shwr Lt -Spa Lt 52 Smoke Detector 53 Wtr Htr; Vent-Acc-Cmbstn Air Baffle 54 Wtr Pipe; Test & Anchr-Nail Prtctn 55 DWV; Test Fittings & Anchr. Nail-Prfctn 56 Shwr Pan; Test, First fir -Tub Acc 57 Test Tub '& Shwr, 2nd fir - Tub Acc 58 Gas Pipe; Sz & Anchrs 59 Fire Sprinkler; Test 60 Yard Gas.Piping o,a LIAM IMECHANICAL 61 AC Ducts Insulin & Support " 62 Vent Fan, Exhaust abv Insultn 63 Condensate Drain & Ovrflw, Sz & Grade 64 Furnace -Vent Acc-Comb Air Rtrn/Vent 115 Outlet 65 Attic Acc & Pltfrm if Furnace In attic FINAL 66 Ext Steps -Door & SideLt Prtctn-Landings 67 Smoke Detector 68 Furnace Vnts-Cimc-Comb, Air-Cnnctr In Garage; abv-flr-Ducts-Meth Prtctn 69 Bedroom Exiting 70 GFI A Bath Fxtrs & Tub Acc-Spa 71 GFI Arc Fault 72 Elec Trim & Subpnl, Breaker Szs & Labels 73 Stairs, Guard/Handrails 74 Frplc or Stove, Clrnc-Hearth 75 Elec Outlets at Wood Pnl, Int & Ext 76 Ktchn, Fxtr & Appinc; Gmd Air -Gap -Cooking Clmc 77 Elec Outlets & Rcptcls at Ktchn Counter 78 Garage Fire Door, Swing -Landing -Closure 79 AC Duct In Garage -Damper. 80 Wtr Htr; Vnts-Clmc-Com Air Cnnctr-PRV; abv fir Mech Prtctn; LPG Appince Undr House 3" drain 81 Plmb; Elec & Mech Eqp Listed for Lactn 82 Elec Rcptcls in Garage (GFI) Romex Prtctn 83 Insultn-Foam-Looked in Attic 84 Guard Rails & Deck Cnstrctn-Post Caps 85 Fndn Vnts & Crawl Hole Door Drnge & Wood -Earth 86 Clmc Dmge Planters Q Yes ❑ No 87 Stucco Brown -Finish 88 AC Unit Dscnnct, Elec-PImb 89 Vnts abv Roof, PImb-Appinc-Frplc-Clmc to Opngs 90 Wtr Well, Dscnnct, Elec, PImb .91 Ext Elec Trim, GFI Rcptcl-Undrgrnd 92 Vntltn thru House 93 Glass Prtctn .94 Corrections from previous 16spctns 95 Gas Test -Meters Tagged, Gas-Elec _ 96 Wtr & Sewer Cnnctd-CIO to grade -HD Apprvl .97 Energy Cmpinc Cert -Other Certs 98 Address Posted -99 Fire Sprinkler +=OK MANUFACTURED HOMES DATE (J PERMANENT FOUNDATION LJ SOFT -SET 1 Zoning -Setbacks -Easements 2 Soils; Special MH Support Sketch 3 Sewer; Loctn-Test; FaIUC/O-Concrete 4 Wtr; Loctn-Test-Easement Needed -Regulator 5 Elec Loctn-Clmcs-Grad 'Amp -Concrete 6 Yard Gas; Loctn Test Wrap Nat ❑ or LP❑ Inch Sz Ft Lngth 7 Bickng; SzSpacing-Marriage Ltne 8 Gas; MH Test-Demand-Vatve-Cnnctr 9 Elec MH Cntnty Test-Crossovers-Breakers-Clmcs 10 Drain; MH Test -Fail -Flex Cnnctr 11 Wtr & Sewer Connected -CIO to Grade 12 Gas and Electricity Tagged 13 Tie Downs ❑ Foundation ❑ 14 Exits 15 Cert of Occupancy 16 HUD Label/Insignia Numbers Serial Numbers o'r d� o'A vim MISCELLANEOUS- DECKS'COVERS•CARPORTS'GARAGES 1 ZoningSetbacks-Easements 2 Figs; SoilsSz-DpthSpacing-CnnctrsSteel 3 Decks, Girders/Joists-Dcking-Brcing Stairs-Guard/Handrails 4 Wood Awn; Posts-Beams-Rtirs-CnnctrsShthg. Frmg-Brcng 5 Alum Awn; Columns-DnnctnsSplice-Decal-Enclsrs 6 Carports; Wndws-Doors 7 Electric 8 Frmg; Sills-AnchrsStuds-Rftrs Tnuses 9 Siding; Nailing -Veneer -Stucco -Lath 10 Roof; Shthg-Roofing 11 Ext; Steps -Doors -Landings 12 Braced Wall pnls 1 Setbacks -Easements 2 Soils; 'CompactionStructure Stability 3 Pool Structure; Steel-Cnnctns-Thickness Dead Men -Lining 4 Elec Rcptcls/Lting; Distance-GFl 5 Elec Pool Lting; 15 volts-GFI 6 Elec.Enclsrs; Conduit Entries Terminals -Listed 7 Elec Bonding; Metal w1W-CrcItng Egp-Htr 8 Elec Gmdng; Eqp w/5' Crcltng Eqp-Pool Ightg Boxes-Enclsrs-pnlboirds-lnsultn to Main Conduit 9 Health Dept Apprvl 10 Pimb; Cir Test-Wtr Supply Test 11 Lt Niche , 12 Enclsr, Fencing -Alarms 13 Bonding, Diving board or Slide ?........ !. - COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 County Center Drive • Oroville, CA • (530) 538-7541 CORRECTION NOTICE C� �i0 '£ OW, IR PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please call for re -inspection when correction of s. work is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact the Building Inspector as indicated below.1) " n � f Date r `' Inspector REV 4/05 Phone # =. FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 'r as" x Date r `' Inspector REV 4/05 Phone # =. FOR RE -INSPECTION CALL: 538-7636 OR 891-2834 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (630) 638-7636 (OROVILLE) (630) 891-2834 (CHICO) OFFICE #: (630) 638-7541 LICENSED CONTRACTORS 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 : License Number: Dale: Contractor. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a 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 State 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 penally of not more than rive hundred dollars ($500).): I, as owner of the properly, or my employees with wages as their sole compensation, will do the work, and the structure is not Intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' Stale License Law does not apply to an owner of property who builds or Improves thereon, and who does such 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 improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or Improve for the purpose of sale.). ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' Slate License Law does not apply to an owner of property who builds or Improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ 1 am Exempt under Article 3 of the Business and Professions Code Date: Owner: iw f�a WORKERS' COP ____.....,.+�. I hereby affirm under penally 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 the Labor Code, for the performance of the work for which this permit is Issued. My workers' compensation Insurance carrier and policy number are: Carrier: Policy #: 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 provisions. Date: Applicant: / I: Rf1Mrs- `�- WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees. and/or This eirtiiris iie eby is ed and CONSTRUCTION LENDING AGENCY p I hereby affirm that there Is a construction lending agency for the Resolutions to Indicated p ��j performance of the work for which this permit Is Issued (Sec 3097 Civ.) By Date:'"- C�/v Name: Ci PERMIT EXPIRES 0 Address: Date ❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code; which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19627.5 of California Health & Safety Code Is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. I hereby certify that I have- read this application, that the above information Is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it Is unlawful to alter the substance of any official form or document of Butte County. I hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. Print Name: �LxC- j Signature:Gy✓�-zit-��''��-L„' Date: G ❑ Agent for Owner ❑ Agent for Contractor Owner ❑ Contractor 9 PERMIT NO. BP061540 Issued Date: 06/26/2006 APN: 071-400-021-000 Site Address: 121 MAYBERRY RD BCK Map index: Description: RECONNECT ELECTRIC Owner: TRZECIAK, HANK AND SUSAN 37 GROVE ST BUFFALO,NY 14207 716-876-0601 Applicant: TRZECIAK, HANK AND SUSAN 37 GROVE ST BUFFALO,NY 14207 716-876-0601 Contractor: License #: Architect: Engineer: Total Square Ft: Valuation: Census Code: 0 S. F. $0.00 erlhe-applicable provisions of the outlz,County Code a above for which fees have been paid. a r. a,dldina Permil0l•16-04 pg 1 9 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (630) 538-7636 (OROVILLE) (630) 891-2834 (CHICO) OFFICE #: (630) 638-7641 LICENSED CONTRACTORS DECLARATION I hereby affirm under penally 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 : License Number: Date: Contractor: OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a 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 State 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 penally of not more than five hundred dollars ($500).): I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who builds or Improves thereon, and who does such 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 improvements are sold within one year of completion, the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). ❑ I am Exempt under Article 3 of the Business and (Professions Code Date: Owner: WORKERS' COP ____�....... 1 hereby affirm under penalty of perjury one of the following declarations: O 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 the Labor Code, for the performance of the work for which this permit is Issued. My workers' compensation Insurance carrier and policy number are: PERMIT NO. BP061540 Issued Date: 06/26/2006 APN: 071-400-021-000 Site Address: 121 MAYBERRY RD BCK Map Index: Description: RECONNECT ELECTRIC Owner: TRZECIAK, HANK AND SUSAN 37 GROVE ST BUFFALO,NY 14207 716-876-0601 Applicant: TRZECIAK, HANK AND SUSAN 37 GROVE ST BUFFALO,NY 14207 716-876-0601 Contractor: License #: Architect: Engineer: Carrier: -I Total Square Ft: 0 S. F. Valuation: $0.00 Policy #: Census Code: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith com//ply/with those provisions. Date: Lr F 1.1 /n �►' Applicant: _ r WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest, and attorney's fees.�l�j, r CONSTRUCTION LENDING AGENCY® is lending agency for the This permit is he eby is Resolutions to ed under the applicable provisions of the Butte County Code and/or _ indicated above for which fees have been paid. I hereby affirm that there a construction Is Issued (Sec 3097 Civ.) ��/(/� performance of the work for which this permit By: Date ' Name: PERMIT EXPIRES 0 Address: (Date) K Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530)538-7785 Facsimile ADMINISTRATION * BUILDING * PLANNING Hank and Susan Trzeciak 37 Grove St. Buffalo, NY 14276 ,June 13; 2006 Dear Mr. and Mrs. Trzeciak, BUTTE COUNTY JUN 2 6 2006 DEVELOPMENT SERVICES Your son came in today on your behalf to apply for an electrical reconnection permit. Unfortunately we were not able to issue the permit to him without your written authorization. Therefore I am enclosing the paper work for you to complete so we can issue this permit for you. Please complete the Owner Builder Verification enclosed as well as the Building Permit. I have highlighted on the permit the areas you need to mark and sign. Please read the statements and mark the appropriate box. Do not forget to date and sign the bottom of the building permit. Please enclose a check or money order for $55.00 made out to Butte County for the cost of the permit, enclose all the documents I have sent you and return to us. I understand'that your son lives in the Bay Area and would like us to mail him the permit when we get these items back from you. Please send us instructions on where and who to mail the permit to. If you have any questions please don't hesitate to contact us. Sinc ely Kare E. Jone Permit Technics 0,V,J-rC-4C1 g r' 60e JS 6A AJ6 c -A 9 a�� BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636• CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name irst Name Address d,;,Ve City v� State \\\\ Zip Phone �y ` Y Fax E-mail 3'1 M 044-6 AOL, 66 APPLICANT INF RMATION CONTRAC R Name City Address Zip City Fax State Zip Phone Lot # Fax E-mail Lic. # Class APPLICANT INF RMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Lot # Fax E-mail State License Number APPLICANT INF RMATION Name �W Address City State Zip Phone Fax E-mail 1 /l APPLICAAW SIGNATURE I X For office use only: Zoning Flood Zone SRA I Yes No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS 11 K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc Page 1 of 3 PERMIT cl�q. 1.540 BP BIN # PROJECT LOCATION AP# Property AddressCit12, y r uxy Cross Street IIC WORKS COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address Description or S pe of Work: Cali Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: Amount: —� Bldg SRA Receipt�%,C� q5s I✓) Sheriff SMTP Date:4 J'—.'&['j'B (((___ `� Other Total REV 8-12-05 'r. SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) 'OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate - ❑ 7. Metal bidgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet-siqned by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Building Permit Application Without Required Clearances Form ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carder and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538.7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees -for work plan checked avid other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 3 REV 8-12-05 OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and -bearing your. signature. i : . Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and -issuing your building permit. No building permit*will be issued`until this verification is received. , 1.? I personally plan to provide the major labor and material for construction of this proposed property improvement: YES [>(l NO [ ]. 2: A HAVE [,\<I HAVE NOT [ ] signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide -the proposed construction: NAME: _ ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: i PROPERTY OWNER: r DATE: NOTE:' This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. Rev'd 11/4/2004 Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-7785 Facsimile www.buttecounty.net/dds OWNER -BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers' compensation insurance, disability insurance costs, and unemployment compensation contributions. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "own er-builder" =building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321-CSLB (2752) or by accessing their website at www.CSLB.ca.gov. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. Sincerely, — A-1 h Rliit � , �i Scott Rutherford Manager, Building Divi ion NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. 4 1 . 2512-81P E PERMIT NO. , 1 + PERMIT EXPIRES } OWNER Hank Trzeciak CONTR. Owner ASSESSOR PARCEL 71-08-113 } LOCATION SIS Simmons Rd., app.12 mi.E.of Oro Quincy Hwy, Oroville M }r 9a { J kIR a y 6Aa f Y t Temp. Power Pole a a Called PG&E Y. Temp. Elec. Service Called PG&E Temp. Gas Service Called PG&E -Z •ji JOB FINA D (Date) I . Q i Signature ti •fit J OK 0••- Not OK = Not Applicable * = Not Ready MOBILEHOMES MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except N's Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's Zoning Requirements—Setbacks—Easements 1. Zoning Requirements—Setbacks—Easements e2.�.S ils; Special MH Support—Sketch 2. Footings; Size—Depth—Spacing—Connectors Sewer; Loc#ron—TV4-- Fatf�6/ Concretg.: 3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails a!'tNater; Location.. r Easement Needed (Sketch) c:Jr 4, Wood Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.—Rfg.—Bracing 5!Electricity; Location—Clearances—Grnd.-62010/ Amp—Concrete 5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures 6. Gas; L ion— —W / /"L"ft./ /"ICor/3 "L"ft./ "LPG 6. Carports; Windows—Doors 7. Utility Clearance 7. Elec. Card -BI Date Card -BI Date " Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI _ Date i Card -BI Date. Date MOBI OME INSTALLATION (Plans) OK except N's Date POOLS (Plans) OK except #'s ing Requirements—Setbacks—Easements 1. Setbacks—Easements F rugs; Size—Spacing—Marriage Line 2. Soils; Compaction—Structure Stability Ga MH Test—Demand—Valve—Connector 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining le ity; MH Test—Crossovers—Breakers—Clearances i 4, Elec.; Receptacles and Lighting; Distances—GFI rat • H Test—Fall—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI at H Test—Regulator—Connector 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed A­WS�9 and Sewer Connected—C/0 to Grade—HD Approval 7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater Gas a d Electricity Tagged B. Elec.; Grounding; Equip. w/5'—Circulating Equip.—Pool Lghtg. Boxes— Enc losures— Pane lboards— Ins. to Main in Conduit xi Insp.—Sketch ert. of Occupancy - 9. Health Department Approval 10. Plumb; Cir. Test—Water Supply Test Card 13 ate— Card -BI Date I Card -BI Date Card -BI Date Card B -I Date Card -BI Date A Card -BI Date Card -BI Date I T V = OK O = Not OK - = Not Applicable RESIDENTIAL (Single and Duplex) = Not Ready Date UNDERFLOOR Plans OK exce t#'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /'' Ftg. Depth 48. 49. Property Line Firewall & Openings 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 51. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 52. Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. Glazing Area -Glass Protection -Skylights -Plastic 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 9. Gas Pipe; Size -Anchors 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 Card -BI Date Date FINAL (Plans) OK except k's 56. Ext. Steps -Door & Sidelight Protection -Landings Card -BI Date Date Card -BI Date PLUMBING (Permit) OK except q's 57. Smoke Detector 14. Water Ht.; Vent -Access -Combustion Air 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 15. Water Pipe; Test & Anchors -Nail 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. 63. Stairs & Rails 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 k's 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. 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 AI 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 (:1 No 75. Following instld.: Drive EJ Yes E] No: Walks El Yes [3 No; Planters []Yes ❑No 28. 29. Service -Riser Conductors & Ground -Main Disconnect Equip. Clearances; Panels-Motors-Mech. Equip. 76. Stucco; Brown -Finish 77, A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B I Date Card BI Date 81. Ventilation throughout House Card B -I Date Card -BI Date 82. 83. Glass Protection Corrections from Previous Inspections Date MECHANICAL (Permit) OK except H's 84. Gas Test -Meters Tagged; Gas -Electric 31. A.C. Ducts; Insulation & Support 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 Date FRAMING(Plans) OK except q's Comments at Final: 36. Sills; Proper Material & Anchors _ 37. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound 38. Bearing Walls over Girders & Floor Nailing 39. _40. Draft Stop in Walls (rat proof) Fire Stops; Furred Ceilings -Stairs -Chases -Tub 41. Header & Beam -Size & Bearing 42. 43. 44. Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. Fireplace Ties or Type A Flue -Fireplace Throat 45. Attic Access: Size & Romex Protection -Draft Stop -Ins. Baffles 46. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. Garage Fire Protection Framing (NOTE: Anentry must be made each time you visit job site) ' COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drivp - O�ovjlle, California 95965 - Telephone 916/534-454 / APPLICATION AND PERMIT ASSESSOR PARCEL NUMBE".. / C3L� , // .N, N# BUILDING PERMIT OWNER d Jp' T , \ / J� LEQIA1- TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS C t•Jr/'f NAME�� I�� �411"g` TELEPHONE AD i� Rax /— t N1 I1.0 l wD R E� //V (l J /L /^2®_tJ 1 �. G � ��--T1 rep I ace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee A4 7 ,$ Z)foo Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS ^.'9� - �' . •� •— r'' ,.�.*� �L PLUMBING PERMIT Filing Fee 10.00 A "L s Each Trap 2.00 Repair drainage or vent piping 5.00 /� LilluMON.s 1eD- App A4, OF -0) QU/NCP y Water piping LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome®,-ST/Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installationether ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 1OR OR LESS 100 AMP R LESS 5.00 L P s a_ Main service EA. ADD'L 100 AMP 2,50 NEW CONST. DWELLING OCCUP.51) OR ADDNS. ACC. BLDGS. / 20 sq CONTRACTORS LICENSE LAW I declare under penalty of perjury (check One): am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions C de and y license is in full _ e 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 NI-CON5TR NON.R ESID BRAI.OUTRC TSLET 2.50 ea NCH CI NEW CONSTR. POWER APPARATUS D NON-RESID. SINGLE OUTLET CIR. 50®2s¢ Ex. OCCUp OUTLETS OR FIXTURES BAL@tOt FIXED Ex. Occup.�OUT LETS P(RESID ) EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. I placed on file with the County of Butte Building 'Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating ' Cooling Hood 3.00 Ventilation permit Fee S Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any ay pccrue taga st sa County in consequ a of the granting of this permit. X Date ature Of App icant — Owner ❑ Contractor gent 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 $ Q7 TOTAL PERMIT FEE $ 5D,,0Z) occUP. GROUP I TYPE OF CONST. PARCEL PD I NO I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR ELIC By PERMIT EXPIRES Date the applicable provi - resolutions to do fees have been paid. WORKS Date v�/ cp Receipt No. 537 92� WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET t 1. owner's name: INA 2. Installer's name: Z I /U &/,N �1 ffi4lz 3. Is the site currently under permit? Yet, No (If yes, furnish permit number ) OR Is the site an existing site? Yes / / No (If yes, furnish two (2) plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes No (If no, clarify ( ) 5. What is the mobilehome electrical rating? ----------------------- /.�� Amps .6. •What is the mobilehome site service rating? --------------------- c2 -CFD Amps 7.. What is the mobilehome site circuit breaker rating? ------------- �� �� _ Amps 8. Is there any other electric load to be served by the mobilehome siteservice? --------------------------------------------------- Yes No (If yes, identify the load and size: Zu I (Load) a © (Amps) 9. What is the mobilehome site gas pipe size? ---------------------- (in.) 10. What is the type of gas service? ----------------------------- Natural /% LPG / .11. What is the gas pipe length from meter ortankto the mobilehome? �(ft.) 12. What is the mobilehome gas demand? = Q L�- -- "t�sTO (This information not required if pipe length less than 6 ft. on natural gas . or less than 50 ft. on LPG.) BUTTE COUNTYr BUILDING DEPARTMEN1 APPROVED 91 MOBILEHOME SUPPORT DATA (f .)(in:) Cente support loc tions* t.)(in.) ' (ft.)(iln•) (ftj)(in.) (f#.)j (in.) *If center piers are other than drawn above, draw in locations, spacing, and dimensions. pressure treated or foundation grade. Other (specify) Supports,.(check one) .-Concrete..block.' Other (specify) agalong or Expando,' how support-detiails. pport ze _. Spacing .ang f If Mobilehome W furnish other than Setup s'ingle'wide, Model No. „ : , hear Mfr. r -ST Width(ft.) Box Length (o (ft.) Tagalong or Expando Size -"-ft. x ft. (SHOW SUPPORT DETAILS BELOW) On all mobilehomes manufactured after October 7, 1973; furnish manufacturer's instillation manual and structural setup sheets (if not on file with the County of Butte). All center supports measured from front of « mobilehome unless otherwise specified. Footings (check one) Single i w�„.� at frhar (f .)(in:) Cente support loc tions* t.)(in.) ' (ft.)(iln•) (ftj)(in.) (f#.)j (in.) *If center piers are other than drawn above, draw in locations, spacing, and dimensions. pressure treated or foundation grade. Other (specify) Supports,.(check one) .-Concrete..block.' Other (specify) agalong or Expando,' how support-detiails. pport ze _. Spacing .ang COUNTY OF BUTTE - DEPARTMENT 0F 7 County Center Drive - Oroville, California 95965 - ' APPLICATION AND PER PUBLIC WORKS PERMIT N0. Telephone 916/534-45 MIT ASS.VSSOR P•4RCEL NUMBER ZONIN "7/—l%� �v BUILDING PERMIT OWNER ELER ANE N X C 114 -ii ty^j/ SQ. FT. OCC. BUILDING VALUATION ` Ii/��� OWN S IgIG ADD �$,� p�!/ L � /Y �N1T !'//IIO ��1/ I �4 CONTRACTOR''SS NAME,/,f�/,J� TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEE LICENSE NO. Plan Checking Fee ' ` $ l0tC90 Penalty $ ARCHITECT OR ENGI EER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 S// 4M,9/Vs PD• �Z �(i1/ �• Ot ©,QQ– VIA; /// Water piping LOT NO. SUBDI V , ION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets .00 USE OF STRUCTURE SF ❑ Duplex❑ MobilehomeK Other // SPECIFY Building sewer 0—v6 Lawn sprinkler system 5.00 L_ TYPE OF WORK New ❑ Addition ❑ Remodel ❑/ Utilities ' Installation ❑ Other ❑ Describe work: ���`L CZJom— �— Permit Fee $ tQ(� Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service OR LESS 100 100 AMP OR LESS 5•00 5(f)o AM Main service EA. ADD'L 100 AMP 2.50 NEW CONST. ( DWELLING OCCUP.py` OR ADONS. ACC. BLDGS. / 20 sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check one): ❑ i am licensed under provisions of Chapt. 9, Div. 3 of the Business �an�dPofessions Code and my license is in full force and effect. No. Classification 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 le. (Sec. 7044) e owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR -OU LET 2,50 ea NON-RESID BRANCH CIRC TS NEW CONSTR (/POWER APPARATUS 6\ NON -NON (SINGLE OUTLET CIR. Jr eo @ �e Ex. OCCup OUTLETS OR FIXTURES BAL01e Ex. Occup. I,OUTLETS FIXED PIRESID ILNS REA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 �QD Misc. Wiring 7.50 Permit Fee $ Contractor MECHANICAL PERMIT FiIingFee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. F1-J_J–eh,J l 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 shal I be deemed revoked. Heating Cooling Hood 3.00 Ventilation Permit Fee S Contractor 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said ounty ionseqqence ofthe ranting of this permit./�� X Date Signature of Applicant Cdn.,X Contractor ❑ Agent ❑ An OSHA permit is required for xcavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ Z. JPO OCcUP, GROUP I TYPE OF CONST, PARC PD ND ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRE O OF PUBLIC By PE T EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date C P Receipt No. g/ WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, OroviIle— Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE BUILDING OR PROPERTY ADDRESS 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. COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 CERTIFICATE OF,OCCUPANCY_ This mobilehome has been installed in accordance with the requirements of the Calif ornia,Administrative Code, Title 25, Chapter 5, under permit number=2-d7W�V- for the following location: r en- - ✓ /'2�� ofi k 'OF OLO 4D//n nG V- O Ca r Owner's Address c/7 "14a4 ,S f' �'/I. �S►�//�. Mobilehome Mfg. /-dxW,,, CT Model Year�� Insignia NoPA I -J / -� �/J`� Serial No. It is hereby certified for occupancy at the above described location and may be occupied. Director of Public Works Date %-/'/- %t/ By THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED COUNTY OF BUTTE , DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 534-4541 Skyway and Elliott Road, Paradise = Phone: 872-2961, Ext. 57 CORRECTION NOTICE 1 T7� Ziz�C i�/C. BUILDING OR PROPERTY ADDRESS g ?i A routine inspection indicates that the following violations of County Ordinance 4 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 rz a* Z-5 . Date ,��� i Ila r< )MO, 71 69, i+ A permit will be required "for t4i� installation of the mobilehome. , Q– A, v L� Nfk-4C4 Utility connections shall e within 4 ft. of the mobileho e, ,ee�j/� directly behind or wit half of the roadside (left) mobilehome. A setback of 5 ft. fr the property lines an a setback of 50ft. from t road centerline sh be clear of • structures equipment except anship Shall Be i" for a 2 f eave ovarhang. a{ecials & d Practices and NONE—'. M RQcodnized • ,ed use in the Accordance with for the Spe Coded dnd, Of quality _prescr,b.A & Machanic a Build, ;1""bing U-ni ,form Electrical Code. the N �. BUTTE COUNTY ations MUST be ��,. BUILDING DE?ARTMEN1 This set of. plans and specifici} is unlawf y! to APPROVED the job at all times and wi}V�out ' kept on es or plterationsaortsclMe me� of Public make any chonq written permission from the Dep Works, County . of Butte. ,;, t ,.�• eta � - •� 0 0 1 R COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. ASS �SSO ;PARCEL N=M6�' � ZOjJIN� n/, f r BUILDING PERMIT OWTELEPHONE A h r -C I SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING DD`RESS D 4 . (1 t 1 CONTRACTOR'S NAME TE EPHONE CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER V N UNKNOWN Fireplace Total Valuation $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEERLICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESSt .S%s' -S,/ rn tM �n c, � �I �� lh/ PLUMBING PERMIT Filing Fee 3.00 / . IM 1 n r0 Each Trap 2.00 Repair drainage or vent piping 2.00 (S/ 0 J 6h r 0;; �1 t Water piping LOT NO:%;4 2 I SUBDIVISION NAME .01PARCEL MAP Each qas water heater or vent 2.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex ❑ Mobi lehome ❑ Other SPECIFY Building sewer Lawn sprinkler system 2.00 TYPE OF WORK New ❑ Addition Remodel ❑ Utilities ❑ Installation OtherEl, Describe work: A r ') A 04 11 rP_ `'l�• d �� ItA R K�IA ���t�1AM LO (� Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 3.00 Main service 10ov OR LESS 00 AMP OR LESS 5.00 r 1 J, QD r Main service EA. ADO'L 100 AMP 2.50NE W OR ADDNS. CONST (DACCLBLDGLING OCCUP.&) 20sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NON•RESID R BRANCH CI1LE 1CTITS 2.50 ea NEW CONSTR POWER APPARATUS & NON-RESID. (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 50 BAL@101 FIXED APP LNS, OR Ex. Occup.(0UTLETS (RESID•) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 3.00 Heating Cooling Hood 2.00 Ventilation permit Fee $ Contractor 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this perrmit. �} -� /'/r+.✓t 1�.��!�.�,,C Date w /pts r � Signature of Applicant — I O04ner K 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 $ Land Development Fee $ TOTAL PERMIT FEE $ 0. <o OCCUP. GROUP I TYPE OF CONST. PARCEL PD I HD I ISSUE This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOfYOF PUBLIC WORKS A Bye � ��// .�c. �.._�Date �- �.� . •s� � PERMIt EXPIRES Date '? O s� Receipt No..+[ WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD-APPLI CANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 C ` APPLICATION AND PERMIT • "llrl/�mm ASS,JSOR PARC NUMBER • --r ZOjJING /na�j BUILDING PERMI OW TELEPHONE SQ. FT. OCC. BUILDING U OWNER'S MAILING DIRESS �® I CONTRACTOR'S NA 41 e�fne TE E HONE CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER UNKNOWN Fireplace Total Valuation $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING AD RESS� Permit fee $ S ,n BUI D N GAJ�St<R ESS ' 1 PLUMBING PERMIT Filing Fee 3.00 1-0Each Trap 2.00 Repair drainage or vent piping 2.00 Water piping LOT O. SUBDIVISION NAMEPARCEL MAP Each qas water heater or vent 2.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 2.00 TYPE OF WORK New F1 AdditioE Remodel❑ Utilities❑ Installation[ Other Describe work: - �C ti �-� P,� �.1t1/,1� pM J Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 3.00 Main service 10ov OR LESS 100 AMP OR LESS 5.00 r Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADDNS. ( ACC. BLDGS. 20sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure Is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason R BRANCH CTTITS 2.50 ea NON -RESIT RC NEWCONSTR. ( POWER APPARATUS a1 NON .RESID. SINGLE OUTLET CIR. / Ex. Occ Up(OUTLETS OR FIXTURES 50@250 BAL@1Ds FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 6.25 Permit Fee $ MAI _105 Contractor WORKMEN'S COMPENSATION INSURANCE 1 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 3.00 Heating Cooling Hood 2.00 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 to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against d Co ty in co equence of the granting of this permit. Date O Signature of Applicant — ner% 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 $ Land Development Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP I TYPE OF CONST. PARCEL PO HD I ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOOF UBLIC By — PE T EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date -- '? Receipt No. 'S 9� ?� T— WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT II COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS `' 695 Oleander Avenue, Chico — Phone 343-4211, Ext. 70 7 County Center Drive, Oroville — Phone 534-4541 Skyway and Elliott Road, Paradife — y''hone 877-3435 CORRECTION NOTICE izGf14 A- SWmOK-e BUILDING OR PROPERTY ADDRESS A routine inspection indicates that the following violations of County Ordinance exist at the above address anld 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. /1E 000 Or— /NF o GO�)JNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. A,a SOR FARCE NUMBER --,) 1� zoAll �� BUILDING PERMIT OWN Y C � '� T�EtLEPHONE SQ. FT. I OCC. BUILDING VALUATION _ G OaJ E`5,5 (/�/ 1, OWNER'SMAI{LIINyI, C1 Q41 D(DG CONTRACTOR'S NA - 41 TE EP1iONE CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER J / UNKN017N Fireplace Total Valuation is LENDER'S MAILING ADDRESS- Permit Fee $ ARCHITECT OR ENGINEER LICENS I_ NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS ' 1 { _ Permit fee $ BUILD NG RESS 1 PLUMBING PERMIT Filing Fee 3.00 Q I VA C4 i Each Trap 2.00 Repair drainage or vent piping 2.00 (SIO d O _114 Water piping LOT NO. SUBDIVISION NAME PARC Et_ MAP Each qac water heater or vent 2.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE ,•, SF ❑ Duplex[] Mobilehome❑ Other %- 1 7 SPECIFY Building sewer Lawn sprinkler system 2.00 TYPE OF WORK t New F-1 Addition Remodel❑ Utilities❑ Installation[, Other Describe work: ���102 b 1 101 AI�!-n piv,� �_ � C' f Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 3.00 Main service 60CV OR LESS 100 AMP OR LESS 5.00 t -` 1 Main service EA. ADD -L 100 AMP 2.50 NEW CONS.- OP. ADDNST ` ACC. DWE-BLOGS.LING CCUF.&� 20sgft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check One): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Businesseo@zs_ and Professions Code and m license is in full force and effect. y License No, Classification 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended o, 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 CONSTP. ( MULTI -OUTLET NON.RESID. `BRANCH CIRC ITS 2.50 ea NEW CONST // POWER APPARATUS & NON-RESID. SSINGLE OUTLET CIR. Ex. Occup( OR FIXTURES gAL@ICC FIXED APPLNS. OR Ex. Occup.(OUTLETS (RESID.) EA.) 2.00 Temporary service 10.00 Mobile Horne Facilities 15.00 Misc. Wiring 6.25 Permit Fee $ , Contractor MECHANICAL PERMIT FiIingFee 3.00 WORKMEN'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the Countf of Butte Building Ddpartment a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. 0I shall not employ any person in any manner so as to becomf, subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you becorri.� 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 Flood 2.00 Ventilation___ Permit peFee Fee Contractor $ I certify that I have read this application and state that the above in'ormation 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 Butt: against all liabilities, judgments, costs, and expenses which may in any wiry accrue against `id Co my in co equence of the granting of this permit. �j�iD Date a Signature of Applicant — ner Contract., ❑ 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 5 Land Development Fee $ TOTAL PERMIT FEE $ UC CU P, GROUP TYPE OF CONST. PAPCEL PD NO ISSUE This permit is hereby issued Lander cions of the butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. ��Z WHITE-D.P.W.. YELLOW-ASSP.SSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT CLAIMANT: ADDRESS: 90% of,- VJ� OROVILLE, CALIFORNIA GENERAL CLAIM. JESSEE HEATING & A/C 3025 SOUTHGATE LANE CHICO CA 95928 CITY & STATE: IMPORTANT: 7/15/93 SEE INSTRUCTIONS DATE OF CLAIM: ON REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) i AMOUNT OWNER HAS DECIDED NOT TO DO WORK. (BLDG PERMIT APPLN. #93-2136, RECEIPT #14139, DATED 7/2/93, A.P. #071-400-021,. OWNER: HANK AND SUE TRZECIAK). TOTAL FEES PAID --------------------------------------$60:50 RETAIN PLUMBING PERMIT FILING FEE ------ $15.00 RETAIN ELECTRICAL PERMIT FILING FEE ----$15.00 AMUUNT RETAINED ------------------------------------ $30.00 TOTAL REFUND DUE ---------------=---------------------$30.50 $30. 50 TOTAL $30. 50 I, the undersigned, declare under penalty of perjury that the services.or articles claimed have been performed or delivered, and that this claim is true and correct as stated. Dated this 1.<5 ..... day of „�, 191?3 at ,,,,5.%`!), Q ., Calif. „t` .� .�...� .��� � Stgnature of Claimant I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specifi above have n performed or de- livered and that there is a Budget Appropriation Q or Specific Board Approval E] (Check one) for the. 5TH JULY ........... 19.. 93 . at ... OROV.ILLE ........ .Cell[. Dated this ........... 1. .............. day of ........ ........................ ................... ... ............................................................ Department Head or Authorized Deputy Dept. 440-002 Exp. 4210500CONST. PERMITS FUND Code............................................ Code ................................................PAYABLE FROM ....... DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSS AMT. i i rVM7"l r 'wt,i OROVILLE, CALIFORNIA GENERAL CLAIM CLAIMANT: ADDRESS: CITY & STATE: DATE OF CLAIM: IMPORTANT: SEE INSTRUCTIONS ON REVERSE SIDE SUBMIT CLAIM TO DEPARTMENT RECEIVING GOODS OR SERVICES DATE DESCRIPTION OF CLAIM (DESCRIBE FULLY TO AVOID DELAY) WAMOUNT 7T 14 Il t P d -' � d Pf 2,116 2 , 7 (3 43 TOTAL I, theundersigned, declare under penalty of perjury that the services or articles claimed have been performed or delivered, and that this claim is true and correct as stated. Dated this ....../....� 1...... day of .....J..�.. ....... 19� et...f..r✓4./..C,�....• Calif. .... ......... ... Si ature of Claiman� i I, the undersigned, hereby certify that, to the best of my knowledge, the services or articles specified above have been performed or de- livered and that there is a Budget Appropriation ❑ or Specific Board Approval^iJ (Check one) for the same. Datedthis .................................... day of ............................. 19....... at .............................. , Calif. .................................................................................... Department Head or Authorized Deputy Dept. Exp. Code............................................ Code ................................................PAYABLE FROM............................................................................................ FUND DO NOT WRITE BELOW THIS LINE - AUDITOR'S USE ONLY DEPT. & SUB. PROJ. SUB. OBJ. CLAIM NO. INV. NO. INV. DATE ENCUMB. GROSS AMT. INSTRUCTIONS to CLAIMANTS All claims against the county must be itemized, giving dates and character of service rendered or: work performed, quantities, de- scription and unit prices of articles furnished or delivered. . Claims must be certified by the claimant and submitted to the De- partment head for approval. Upon approval the Department head will forward claim to County Auditor for payment procedure. Do not file with the County Auditor first. Claims should be presented to officials for approval immediately upon completion of services requested or material ordered. Claims are paid every Tuesday; however, same must be approved by officials and in Auditor's office before preceeding Wednesday noon. Compliance with above will expedite payment of claim, failure to do so way delay payment considerably. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916.538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 071-400-021 ZONING U BUILDING PERMIT OWNER Hank & Sue Trzeciak (415) TELEPHONE 467-2198 SQ. FT. OCC.1 BUILDING VALUATION OWNER'S MAILING ADDRESS 440 Monterey, Brisbane, Ca 94005 CONTRACTOR'S NAMETELEPHONE Jessee Heating & AC 891-4926 CONTRACTOR'S MAILING ADDRESS 3025 Southgate Lane, Chico 95928 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation is Filing Fee $ 15.00 LENDER's MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER's MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 15.00 - 6189 Or Bangor,__ Qroville' Each Trap 5.00 . Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF L3 Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 1 5.001 5-00 Building sewer15.00 Mobile Home S G W @ 15.00 TYPE OF WORK New a Addition _] Remodel ❑ Utilities ❑ Installation[! Other ED Describe work: HVAC & GaG Line _ RE: B.P 93-0181_ FI Permit Fee $ 20.00 Contractor ELECTRICAL PERMIT Filing Fee 15.00 �1 Main service 20000AAORLESS 2OR LESS 18.50 Main service 200ATO1000A, 37.50 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 Profess IO s Code and my license is in full force andel effect. License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason Nw CONST. DWELLING OCCUP.& OR ADDNS. (ACC. BLDGs. 3.6Q sq.ft. NEW CONSTR R NCH TLET CIRCUITS) NON•RESIO BRANCH CRC ITS @ 5•QD POWER APPARATUS 9 (SINGLE OUTLET CIR. / Ex. OCCup(OUTLETS OR FIXTURES 20 760 FIXED APLNS. Ex. OCCUp. OUTLETS P(RESID,)REA.� I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Iyirin 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 of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject t� 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 15.00 Heating 119.00 9,00 Cooling 9 1 16.5 16.50 Hood 6.50 Ventilation Permit Fee $ 40.50 Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this per t. X Date Signature o A licant — Owner g pp Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep an de Inion or Construct. ion of structures over 3 stories in height. Mobile Home Installation Fee S Energy Inspection Fee $ OCC CONST TYPE I TOTAL FEE $ 60.50 HAz 1 DFEES I IMP I FLOOD I CDF PARCEL PD HD ISSUE This permit is hereby issued under the Bions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date Receipt No. V J /5y WHITE-D.P.W., YELLOW-ASSESS0 . PINK -INSPECTOR, GOLDENROD -APPLICANT ;w gOUNTYOF BUTTE - DEPARTMENT OF DEV�LOPMENT,SERVICES - BUILDING DIVISION- - 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER 2•,�K �. Iz C7 %SLY A. P. No. Proposed Building Use 5/0 /fid - Building Inspector / Date At time of per it application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1. All items have been submitted. .......! 4,.......i ....................... 2. Plot plans, 3/4 sets, signed by preparer of plans. .. �....................... 3_ Complete plans, 3/4 sets, signed by preparer of plans . ...................... .4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form . ............................................. . 6. Energy Design Compliance and supporting documentation . .................. 7. Statement of Intent for Non -Heated and A/C Buildings. ........• .............. 8. Engineered truss details and layout in duplicate (required prior toplancheck). .... 9. Mobilehome data and manufacturer's installation instructions,.2 sets. ........... 10. Fees of $......................................... 11. Impact fees as shown on attached schedule. ............................. . 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) by California Engineer . ................. . 14. Sanitation and plot plan approval Health Department . ............ 15. City of Chico plumbing permit . .......................................... 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: . ........ 18. Contact Land Development.a bout (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). .. . uest 20. Pre -inspection for required. . tos�ild g Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner............ -• 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . ........................................ 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. ..... 27. Letter of intent on building use . ........................................ . 28. Mobilehome utility clearance . ........................................... 29. Documentation of legal access . ..................... :.................. 30. Documentation of .50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements.' ..............' 31. Existing violations/expired permits . ...................................... 32. Plan check list . ..................................................... 33. .34. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver with inspector. Other Parcel Creation Acreage 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 _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, Cal.for�nia 95965 - Telephone 916 538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER Z NI G BUILDING PERMIT OWNER 111,4 (�� T / 'J TELEPHONE �L7-Z/yam SO. FT. OCC. BUILDING VALUATION R•s MA ING ADDRESS OBio o Dom R CONTRA O's NAME , ess Z /z TELEPHONE 1315/- vyi� CONTRACTOR'S MAILING ADDRE / 3 c>Ir rSo,,q-� Iac_ 1ly Fireplace CONSTRUCTION LENDER - UNKNOWN Total Valuation $ Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee _ $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee - $ " PLUMBING PERMIT Filing Fee 15.00 O�� ��� ��'Each Trap 1 5.00 41�ILaJ/ �f� Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION -NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New Addition.77 Remodel LUtilities ❑ Installation E:,, Other Describe work: L y S'/fs %, J Q_ _ q3- Teo c3 . /e/- Permit Fee $ Z U - Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 200A OR LESS 18.50 Main service 20CATO1000AI 37.50 CONTRACTORS LICENSE LAW I declare under penaltyof perjury p I y (Check One): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business/POWER and Professions Code and my license is in full force and effect. License No. Classification j_J I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as. the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.tr) OR ACDNS. ACC. BLDGS. 3.64 sq.ft. NEW CONST R. MULTI -OUTLET NON-RESID BRANCH CIRC ITS @ 5.00 APPARATUS &) (SINGLE OUTLET CIR. ) Ex. OCcup(OUTLETS OR FIXTURES 20 76d FIXED EX. Occup. OUTLETS IIRESID IREA.) I .3.00 Temporary service 1 15.00 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 15.00 Heating �j- Cooling jLS� Hood 6.50 Ventilation permit Fee $ ,>.>�a 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 accrueHAz against said County in consequence of the granting of this permit. X Date Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee S Energy Inspection Fee $ OCC CONST TYPE TOTAL FEES ,, fJ OFEES IMP FLooO coF PARCEL Po Ho ssuE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date /By Receipt No. / �✓ / WHITE-O.P.W.. YELLOW-ASSES30R. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS ` 7 County C.n ter Drive - Oroville, California 95965 - Telephone: 916;'538-7541 " � ' APPLICATION AND PERMIT Z -7q PERMIT O. ASSESSOR PARCEL NUMBER O - Z/O0. O2 ZONING �J ��'Zo BUILDING PERMIT OWNER �SUC ("Fe'n'A K yes TELEPHONE W SO, FT. OCC. BUILDING VALUATION OWNER'S MAILI�NJG ADDRESS I/o 04 ?-IDO S- CONTRACTOa-S NAME TELEPHONE 8 $ 2_ (/ 6 7 00 CONTRACTOR'S MAILING ADDRESS Fireplace L CONSTRUCTION LENDER UNKNOWN Total Valuation $SS 1 70?1 LENDER'S MAILING ADDRESS ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ Y 15.00 Permit Fee $ 39 Plan ecking Fee $ ,JO 5 ARCHITECT OR ENGINEER'S MAILING ADDRESS BUILDING ADDRESSPenalty /�C� J rgy Plan Checking Fee $,� g - Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap S.00L20,oro Solar or heat pump water heater 20.00 LOT NO. v _ SUBDIVISION NAME PARCEL MAP (!�✓� Water piping 7.00 .,60 Each qas water heater or vent 7.00 , DCS USE OF STRUCTURE SFN_ Duplex❑ Mob ilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.005. O0 Building sewer 15.00 oo Mobile Home S I G I W @ 15.00 TYPE OF WORK Newer Addition[] Remodeli Utilities❑ Installation[] -Other Describe work: S F ZOo W ►-µl G A JltCr I✓ Alit �`f" AI sq -bo O Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 e to g� Main service LESS 200AOR ORLESS 18.50 CONTRACTORS LICENSE LAW I declare under penalty. of perjury (check one): ❑ i am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is .in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compe n- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason Main service 200ATO1000A1 37.50 NEW CONST. /DWELLING OCCUP &� OR ADDNS, l ACC. SLOGS. 3.SQ sq.ft. 1�(, 1) 1) NEW CONSTR. ULTI.OUTL T NO N.R ESID BRANCH CIRCUITS) @ 5.00 ( POWER APPARATUS 8, SINGLE OUTLET CIR. / Ex. Occup( OR FIXTURES 20 750 A L. Ex. Occup. OUTLETS PIRESIDIR EA.) I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 en► itil % 6 ' . ,BQ Permit Fee $5„ 0 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. F—]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 15.00 Heating_00 rnt Cooling Hood 6.50 62-50 tf 150 Permit Fee $ Contractor IZP g 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. Mobile Home Installation Fee $ Energy Inspection Fee $ 0 occ CONST TYPE TOTAL FEE $ 3� y r,Az DFEES IMP FLOOD CDF PARCEL I PD I HO SSUE ^ Date l "`r — 1 Signature of Applicant — Owner ElContractor FIAgent❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over stories in height./ Receipt No.] 3SI67 & re -CS 277 WHITE-O.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT 1 111s permit is nereoy fssuea unaer the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date COUNTY OF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION 7 COUNTYCENTER DRIVE - OROVILLE, CALIFORNIA 95§365 - TELEPHONE (916) 538-7541 PERMIT APPLICATION DATA SHEET OWNER���� Proposed Building Use - Z rAI, wilding Inspector 9,f P. No. 6 7 / - Y66 -0Z �� Date / .21- 19 3 At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY mm 1. 3_ .4. 5. 6. 7. 8. 9. 10. 11. 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. 22. 23. 24. 25. 26. 27. 28. 29. 30. 32. 33. 34. All items have been submitted . ........................................ Plot plans,W/4 sets, signed by preparer of plans . ............... ........... Complete plans,04 sets, signed by preparer of plans . ...................... .5 Z 1 3 2 e Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. Hazardous Material Form ............ .................................. . Energy Design Compliance and supporting documentation . .................. Statement of Intent for Non -Heated and A/C Buildings . ...................... Engineered truss details and layout in duplicate (required prior to plan check). ... . Mobilehome data and manufacturer's installation instructions, 2 sets. ........... Fees of $/ to -5' a- 70 ......................................... Impact fees as shown on attached schedule. ............................. . California Department of Forestry plan approval/fees. ....................... . Flood elevation letter (100 year flood) sb� .Ca ifornia Engineer . ........... . Sanitation and plot plan approval OZI / Health Department . ............ Z °l3 eo City of Chico plumbing permit . ......................................... Plot plan and business license al from City of Biggs/Gridley. ............. pprova Planning approval for (A) Use: ✓ (B) Parking: ........ Contact Land Development about (A) Improvements (B)• Drainage. .......... . Driveway permit (construction approval required prior to occupancy) . ............ Pre -inspection forrequired. .. to Building �nspeato. (Date) Contractor's license information. (No., Name Style, Classification) . .............. Certificate of Workmans Compensation Insurance . .......................... Owner -Builder Verification (Given to owner , Mail to owner _)............ Recorded copy of Agricultural Acknowledgement Statement . .................. Letter of signature authorization . ........................................ Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . Letter of intent on building use . ......................................... Mobilehome utility clearance . .......................................... Documentation of legal access . ..................... :.................. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements. Existing violations/expired permits.�s�r�...W./.i�1 . �3 ... �i:�/..... . Plan check list . ..................................................... When you issue the permit, process as follows: Mail to owner Telephone #6- %drid hold for pickup at _ &042 Other Parcel Creation Acreage Applicant Mail to contractor. _ office. Deliver with inspector. Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date The following data must be submitted prigr to 1. Index permit for above items No. 2. Additional items required: new4e,m not ked above). Date By_ Contractor, designer, owner, was advised of above required data by _ phone -mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by 42(e� Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works I{.H, IISI: U ' 1'Ld I'I:m AuaehcJ Floor Plan Awichcd _ . Jcnl 1')IS.U ,. � TO: Building Department �L FROM: Environmental Health 7Ft SUBJECT: Sanitation Clearance -1 7/-17, 1-uA Owner Location AP// Plan Approved for: Sewage Disposal v Water Supply: I'ublic. Private Well Clearance for c) I e u Other Hold final for: Final clearaTr5 NOTA, 8/92 f COUNTY OF BUTTE - DEPARTMENT. OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541, APPLICATION AMPERMIT x I. PERMIT NO. ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 15.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 1 5.00 Solar or heat pump water heater 1 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 1 7.00 Each qas water heater or vent 1 7.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5_outlets 1 5.00 Building sewer 1 15.00 Mobile Home I S I G W 615.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A OR LESS 18.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑NON.RESID I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification 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 Main service 200A TO 1Oo0A) 37.50 NEW CONST. ( DWELLING OCCUP.�\ OR ADDNS. 1 ACC. BLDGS. / 3.64 sq.ft. NEW CONSTR. U TI.OUT LET BRANCH CIRC ITS 5.00 /POWER APPARATUS e\ (POWOUTLET CIR. EX. OCcup(OUTLETS OR FIXTURES 20 @ 76 FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EA.) 3.00 Temporary service 15.00 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. No ce 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 15.00 Heating Cooling Hood 6.50 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 to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against s d Cou ty in cor>�equence of the granting of this permit. X LJ Date 4G Signature of Applicant — wner� Contractor ❑ Agent En 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 S Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ HA z DFEES IMP FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date Receipt No. WHITE -D. P.W„ YELLOW-A98E990R, PINK -INSPECTOR, GOLDENROD -APPLICANT Return to DPW AGRICULTURAL STATFrtiIENT OF ACiC!IOGTLEDGEMENT X91-12239 FOR RESIDENTIAL DEVELOPMENT Section 26-8.1 of the Butte County Code requires this acknowledgement be recorded - - prior to issuance of a building permit. ' All that real :property.' situate in the County of Butte, State of California, described as follows: eaX at 12 � ow 44tw-' . Y, ePl-a.t� pa'a-CeL VA 0 .,84 q Pb.;Joz... Aut";, �. I r0611- e� ,�,�,�� ,dt.�'e_ 1 ��-�, �►. �o�u�nc1^e-� off /� 9 � �, /_-3.o-a0 ! 3 ��.a-e. 00 Date: �� PROPERTY OWNERS: State of C� ��'f ) On this the _7'�A day of Vrt�rC� 19 q1, before me, the SS. undersigned Notary Public, personally appeared County of H ��' �� Tr k e c /` 0L__ k OFFICIAL SEAL L. LANCASTER Personally known to me. � Proved to me on the basis LNWARYPUSUC-CALIFORNIAof satisfactory evidence. COUNTYes�,,,ary,e,1W to be the person(s) whose name(s) is subscribed to the within instrument and acknowledged that t executed the same for. the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Present A.P. No. 6 � � Y. Notary Public END OF DOCUMENT 1 91-012239 ; Rec Fee 5.00 The property described herein is adjacent ; Cash 5.00 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 ; veniences or discomfort arising from the i Butte ; use of: agricultural chemicals, including, ! Candace J. Grubbs ; but not limited to herbicides, pesticides, Recorder ; and fertilizers; and from the pursuit 10:16am 1 -Apr -91 ; XX 1 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 discomfort from normal, necessary farm operations. All that real :property.' situate in the County of Butte, State of California, described as follows: eaX at 12 � ow 44tw-' . Y, ePl-a.t� pa'a-CeL VA 0 .,84 q Pb.;Joz... Aut";, �. I r0611- e� ,�,�,�� ,dt.�'e_ 1 ��-�, �►. �o�u�nc1^e-� off /� 9 � �, /_-3.o-a0 ! 3 ��.a-e. 00 Date: �� PROPERTY OWNERS: State of C� ��'f ) On this the _7'�A day of Vrt�rC� 19 q1, before me, the SS. undersigned Notary Public, personally appeared County of H ��' �� Tr k e c /` 0L__ k OFFICIAL SEAL L. LANCASTER Personally known to me. � Proved to me on the basis LNWARYPUSUC-CALIFORNIAof satisfactory evidence. COUNTYes�,,,ary,e,1W to be the person(s) whose name(s) is subscribed to the within instrument and acknowledged that t executed the same for. the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Present A.P. No. 6 � � Y. Notary Public END OF DOCUMENT p^r TF7' :ra-- ,.W.." W .. t .,5,�„y„� .,, ,,,�., .. ..�y.. ._--,...y,w„ ,, .,,,,.n�Fr;�?h"�gr'@k;�tf+'iy �fTFy'M M6"r,"°TC:di-'� *Fri rig` ^'� Ave V1.�4r / 45b; Pty Tj BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM � V ... Q � � (One Form per Buiiding) A.P. Number Building Department No. School .District(oro Uh l ph Hi City= County � Jurisdiction Property Owner lYQ AIS , �1n 2C..-% Gt k Project Location/Address 6 � / A/0 r o Ile Subdivision Lot Number Residential Development: a a Sq. Footage- # of Living MHI Addition (Group R) e y> Units Commercial/Industrial: Sq. Footage ' New Addition (Including Exterior Roofed Areas) 1 Building Department Representative Date. (Floor Plans reviewed by School District Personnel) rictId No. 9 018 5 s: .. t fA i School District certifies that ti (Applida t Name) (Phone Number) (S e t Ad ress) L (City) ,("State) I ( Zip Code).,,' has complied with t4are rements o RWsolu ionno. ESC•. �t by the payment of $ prese•ting square 'f.eet. IZZ �=4� 1&e School District AepresentativeVDate . . PAID BY CHECK NO. RVWKS: BANK NO PAID BY CASH white -applicant, yellow-buildi SCHOOL.FEE (8/88) artment,aink-school d.is rict 0 1 8/91 RESIDENTIAL-- PLAN.GHECKIANG .,GUIDE (S.F., DUPLEX & MISC. ONLY) Bldg. Permit # . 7-/"-%r O :'OWNER A.P. # W-4/0 a / Plan Checker L c, "GENERAL Toning requirements: (sideyards and number of permitted living units). L2-.----'Valuation.� CV2C_��' Plans signed by designer. �4-' Proper description of work on application. 9D5. Existing violations on property. 6. Items on data sheet. (W.C., fees, Health, Developer Fees, License law, ec Recorded 7 � Recorded notice of violation. r PLOT PLAN'` ik-*"Complete parcel size and dimensions. 2Setbacks, sideyards, easements, 3Other buildings or structures. r�a.,,-'Grading,Grading, fills, drainage. S. -'*"Flood hazard. 16 -:-'Special conditions on creation Iustible, and.foundations). 11� a7 <FAU &-FAS road setback. 'qZZ-1tA Building or utilities across lot lines (Record form). Lo-1dOR PLAN � � �1�,ya� •�.a� ',.,�, 1 Complete to scale--plan-with dimensions. Required -window's for light',;andaventiAt;ion.,(Sec:r1,205)7� � Required windows" for'second-exit�(Sec. 4r Skylights (Chapter 34 &' Sec.% 5207.).1)P�k J\jj�-(ir'J 'a�•a�Catc�� i. �5 Human impact glass"(�Sec._5406). 1 i( Required room 'sizes, ceili g heigHts-(Sec 1207) . GFCIs in+,baths,'garage, kitchen, and exterior outletsa(Article210,,8) �1,_ .8 - Light fixtures; switches,treceptacles, and exterior receptacles for main- tenance of mechanical equipment.A �` , �►%`- - )YK; E9,. Locations of,,water heater,_heatingand cooling equipment, other electrical or gas equipment. M—Garage firewall, door size, and closer (Sec.C.503(d)(3)).� �, \ 1111 - 3'0" exterior exit dobr (sec. 3304 (f) �,i A _�_\A -.% t- -12!`Fireplace and wood stove location, alcoves, ands clearance. +-'3- Smoke detectors '(Sec. 1210) - .S "Plumbing fixtures, water closet clearances Snd shower size. STRUCTURAL: DETAILS etc. map, (noise, CDF, fire sprinklers, non -comb A.'00 Standard bracing or engineered design (Table 25V) -23.'' Unusual shape, size, or split level house requiring lateral design. --3-:- erestory requiring balloon framing and/or engineering. s4: Three story building requiring engineered calculations and plans. . - undation plan complete enough to construct building. Floor construction details complete enough to construct building. Elev,4tions and wall construction details complete !Ro construction details complete enough to -9 r F'replace construction details and calcs if �l•:" after ties or bearing ridge beam. c .. Garage door or porch header sizes.., E1 -E- Stud heights. 4 33?"Adobe soils - special foundation design. a'p4': Retaining walls requiring design. .IZ- Special Inspection required. V�� enough to construct building construct building. necessary. Z F- C' he 8,91 RESIDENTIAL PLAN CHECKING GUIDE MISCE.LL'ANEOUS�T= M .l0JK G abao o ri "OUT FOR • Stairway details: landings, rise and run, head clearance, handrails Sec. 3306). \� • • Guardrail details (Sec. 1711 & 3306(j). . Brick or stone veneer (Chapter 30). Exterior plaster - weep screeds (Sec. 4706). . Proper roof pitch for roof convering (Chapter 32). L . hoof covering type - (fire hazard). oam insulation - protection. 36" halls and stairways. Living area over garage - complete 1 -hour separation required on garage side including supporting walls and posts, etc. . Two exits on three-story dwellings (sec. 3303 & see Mezannines - 1716). ttic access and ventilation (Sec. 3205). nderfloor access and ventilation (Sec. 2516). _, mbustion air for fuel burning appliances - L.P.G. requirements. oise requirements on duplexes. ergy design. , . Flashing at all exterior openings. . OF responsible area requirements. G abao o ri ,t T, XJ2�C770AJ o� ��l/CO � �xw/v �� Tg kgv/",/ (�-iwd Q -F-T T7 9) D 0) Mo IV6 21. F1 F-. L-1- I Wt . 7 -,!Q'y US Q �N� 2 AI/Z- EArH S/aE2 Row - p /6 0r @ /2'�o c. ��2 JoiSTS �E)6X�28A4. _x �E X (0 P©S T 30 o�sd. k /8�'L� . %14 ENG/A)C-Erz/A/G R �./ �51;9ti6-V �5/a9/ql i r ar Ti COUNTY -OF -BUTTE - DEPARTMENT OF P.�UBLIC WORKS 7 County Center Drive - OrovIIIe, CaIItorn Ia 959.P,E#- ToIopnone:'916/538-7541 APPLICATION AND PERMIT ,r PERMIT NO. A88t8SOR PARCUL NUM13M 71-40-21 ZONING U BUILDING PERMIT �WHank and Sue Trzeciak (415 467-2198 S0. FT. OCC. BUILDING VALUATION OWN 'S MAILING AOORUSS 440 Monterey, Brisbane, CA 94005 CON R C O 'S N M TELEP ON Owner -- y� V CONTRACTOR'S MAIL G ADDRE S _T Fireplace "All CONSTRUCTION LENDER fv one NKNOWN Total Valuation $ Filing Fee $ 10 0� LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER None LICENSE NO. Plan Checking Fee $ 128 00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ �-�" $ BUILDING ADDRESS 121 Mayberry Rd., Oroville Penalt $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 41 2.00 8.00 Solar or heat pump water heater 120.00 LOT NO. SUBDIVISION NAME PA CEL MAP �J f Water piping 5.00 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF a Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 �f-, D0 Building sewer 5.00 5.00 Mobile Home S I G I W 10.00ea TYPE OF WORK New yk Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other ❑ Describe work: (62/1200) Permit Fee $ .24� Contractor .33LOO ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP OR ORSLESS 10.00 10,00 Main service EA. ADD'L 100 AMP 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 effect. License No. Classification. ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.N OR ADDNS. ( ACC. BLDGS. , /20sq ft 39.20 NEW D U TI.OUTLET RESIR NON•R ESIBRANCH CIRC ITS 2.50ea POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20050Q BALOeo Ex. OCCUp. OUTLETS P(RESID.)FIXED APLNS REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ 59.20 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. r - - 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 aS d I -ups 6.00 Cooling g Hood 3.00 Ventilation permit Fee $ Contractor 0 1 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 again t'said County in consequence of the granting of this permit. X Date .Z Z Signature of Applicant — Ownerg Contractor ❑ Agent ❑ An OSHA permit is required for excavation ��eep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ DO— c co TTYPE V TOTAL FEE $ 10 20 HAz. cuA PARK scH I FL CDF PAR PD I ) HD. ISSUE, This permit is hereby issued under the applicable provi- sions of the Butte County. Code and/or resolutions to do work indicated above for- which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date Receipt No. 83853 —/d5/.ap //.Ago WNITC-D.P.W., YELLOW -ASSESSOR, PINK- , GOLDENROD -APPLICANT - NSP EC TO R ,r s=� ��i iS ���,�� ` TO ,FROM: SUBJECT: Buildinv Department Environmental Health .. Sanitation Clearance Z -P ZC-C,4 MAW - Ev Owner ^^Location AP# Plan Approved for: Sewage Disposal Water Supply C/ Hold final for: l< Final clearance O.K. for: Clearance for bedroom mobile /� Uc C'IW,4-G F Water Supply Water Supply IV -.r 0 NOTE **� I hl,15-8 Sa .tariain Date •r ,1��''°iF,«r�� {�7. �'� � !�Rl'�. ��i���i'tr�'`.,i.q ��..p,... i, rfe �4��'s..c 4�``. . , �y.:.ti r r itJR:.. �._..:._,,:. ' � •.► LTi .. `r COUNTY OF BUTTE - DEPARTMENT OF PUAL•IC11VORKS -'BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -.TELEPHONE: 916/538-7541 '= PERMIT APPLICATION DATA"SHEET Permit No. fl OWNER f ! Cc V1 k f (\a2 a I Q '` A. P. No. Proposed Building Uses je (A Building Inspector m. 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 V/ 17 18. 19. 20. 21. 22. 23. 124. 25. O 2. t 27 7. All items have been submitted . ................................... ' Plot plans in duplica triplicate, signed pre a,� rgr of Dlans ....... Complete plans in plica /triplicate, signed by Dlans .. Complete engineered plans and calcs, with wet signature on plans .. Hazardous Material Form .......................................... Energy Design Compliance and supporting documentation ......... Statement of Intent for Non -Heated and AC Buildings ............... Engineered truss details and layout in duplicate (required prior to plan check) sill Mobilehome installation data including manufacturer's installation instructions.....j........................................ l 0 Fees Of $ ........ Chico'Urban Area fees paid ....................................... Park fees paid ........................................ rc� �nt cin School Dis rd'ct fees paid ............. . Sanitation approval from ('�t"c7 v �(� Health Department City of Chico plumbing permit ........................... .......... Plot plan and business license approval from City of v (see City for other requirements) Ne -U,) Planning approval for (A) Use:/AV arking: = g �•{ " �� ' ', Improvements may be required. Contact Land Development Section DPW Driveway permit (construction approval required prior to occupancy) Pre -Inspection for required . Pre-inspec. request to ' Building Inspector (Dated,. Contractor's license information (No., Name Style, Classifications ... Certificate of Workmans Compensation Insurance .................. =. Owner -Builder Verification (Given to owner ❑, Mail to owner0) ..... Recorded copy of Agricultural Acknowledgment Statement ......... I When you issue the permit, process as follows: Mail o owner. _ Telephone .559'/. and hold for pickup atoffice. Other Applican Mail to contractor. —Deliver w/inspector. 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 submittedprior to permit iss an e: Circle ne tem of checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, o er, was advised of above required data by phone_rnall_counter by--Odate- L� Contractor, designer, owner, was advised of above Plans checked by Copy—DPW uired data by—phone —ma II—counter by date Plans approved by of plans on hold in --File cabinet AP folder Date 1 Q COUNTY—OF. BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Orovllle, California 95965 - Tplephbnei 919/539.7541 APPLICATION AND PERMIT ASS sa CUL NUMOUR" BUILDING PERMIT Wf i 1 S (te r Z es;` S f �� )�j /rIJJ TCLUP� "o" 9 pi SO. FT. OCC. BUILDING VALUATION �S / / (O O ER0M I INA©ADDe Y� ^` e �L'C n n -L(( �O 11 U l �/ l/ � �D�O Q CO TRAC OR'3 NAM �W&IC, Y TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace ' ( Q Q CONS RU T ION LENDER � - O v1 UNKNOWN c Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ S O ARCHITECT OR ENGINEER Vic'Ener LICENSE NO. Plan Checking Fee $ . P-I-af,Checkin Fee $ Y g � \ ARC ITECT OR ENGINEER'S MAILING ADDRESS -Penalty $ BUILDING AODR a Ae rr �✓'o v ' e Permit fee 00 $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 d Q 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 STRUCTUR 11 SF;K Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 5 (90 Mobile Home S G W 0.00 ea TYPE OF WORK New ( ] Addition❑, Ree odel Utilities Installation❑ Other ❑ Describe work: ( a� a �d Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee - 10.00 Main service 10OV OR 00 AMP ORSLESS 10.00 /0r06 Main service EA. ADD -L 100 AMP 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 BuslneSS and Professions Code and my license IS In full force and effect. No. Classification. ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively -contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason OR CONST' ( DDWEACCLLIN GOCCBS. s& ADONS'/22sgft ,3 Q NEW CONSTR. MULTI -OUTLET NON.RESID BRANCH CIRC ITS 2.SOea ..--""' POWER APPARATUS e (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 200301 eALO 30 FIXED APPLNSLicense Ex. OCCUp. OUTLETS I-RESID )REA.) 2.00 Temporary 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. IContractor Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating [om qiavcl Cooling g Hood ( 3.00 3 Ventilation Permit Fee $ 00 I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. Signature of Applicant — Owner ❑ Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ so 06 occ CONST TYPE TOTAL FEE $ �� �,� HAL CUA PARK SCHL FLD coF PAR PD I Ho. ILO SSUE This permit is hereby issued unser the applicable provi- sions of the Butte County. Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date P Receipt No. n ok WNITE-D..W.. TELLOW-AS.ESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTNIENT OF DEVELOPMENT SERVICES, BUILDING DIVISION 7 County Center Drive, OrDVllle CA 95965 Phone: 916-538-7541 HANK AND SUE TRZECIAK 440 MONTEREY BRISBANE CA 94005 RE:- Building Permit 'ARpins 93-180 & 93-181 DATE: A.P. # 071-4&-O-wW1 With reference.to the above subject: Attached is: Application for permit -Mobilehome Utilities Installation Sheet Building Plans Mobilehome Installation Information Sheet Engineered Calculations Typical Plan Sheet Owner -Builder Verification Fm List of Codes Enforced We need the following.information prior to permit processing and/or issuance: Permit application signed and completed where indicated with all copies returned. Plot plans, 3/4 sets, signed by preparer of plans. Complete plans, 3/4 sets, signed by preparer of plans. Engineered plans and calcs, 3/4 sets, with wet signature on plans. Hazardous Material Form Energy Design Compliance and supporting documentation. Statement of Intent for Non -Heated and A/C Buildings. Engineered truss details and layout in duplicate. Mobilehome data and manufacturer's installation instructions, 2 sets. XXX Fees of $ 1 ,699.7nl , payable to Butte County Treasurer Impact fees paid. California Department of Forestry plan approval/fees. Flood elevation letter (100 year flood) by California Engineer. Sanitation and plot plan approval Health Department. City of Chico plumbing permit. Plot plan and business license approval from City of Biggs/Gridley. Planning approval for Land Development (a) Improvements (b) Drainage. Driveway permit (approval of construction required prior to occupancy). Contractor's license information (No. Name Style, Class) or exemption statement. Certificate of Workmans Compensation Insurance. Owner -Builder Verification Form. Recorded copy of Agricultural Acknowledgement Statement. Letter of signature authorization. Copy of recorded deed of parcel creation and 60' right of way to a public road. Letter of intent on building use. Mobilehome utility clearance. Documentation of legal access. Documentation of 501k subdivision developed or (a) Road improvements completed and (b) Parcel meets zoning area and frontage requirements. Existing violations/expired permits resolved. Plan check list data and revisions. sets of plans in accordance with changes marked in red. Other: Since this was built without permits, please obtain the above item as soon as possible to avoid Code Enforcement. Thpsp applications Pxp ire 1/96/94, and rannot ha i cctlPrl after that date Should you have any questions concerning the above, please contact Scott Rutherford of this office. MCV:ahb Yours very tr ly, L&c L"twwl,- Mic ael C. ieira, C.B.O.. Man ger, Building Inspection 1. Ceiling insulation 2. Wall Insulation Single- Number of stones 0.80 R -value One Two Three R-0 -103 -49 32 R-19 -8 -4 -2 R-30 .2 -1 .1 R-38 0 0 0 U -value 8 6 4 0.50 -176 -84 -54 0.30 -102 -49 32 0.10 -26 -13 -8 0.08 -18 .9 .. -6 0.06 -11 -5 -4 O.C4 -4 .2 .1 O.C2 4 2 1 0,00 11 5 3 2. Wall Insulation 3. Raised Floor Insulation Insulation in Floor Single- Single - 0.80 R -value Family Family Mullk R -value Detached Attached Family R-0 -68 -51 -34 R-11 0 0 0 R-13 2 2 1 R-19 8 6 4 U -value -144 .70 -46 0.80 -153 -114 •76 0.50 -91 -68 -46 0.30 -47 -36 -24 0.10 0 0 0 0.08 4 3 2 0.06 9 7 5 0.04 14 11 7 0.02 19 14 10 0.00 24 18 12 3. Raised Floor Insulation Insulation in Floor Controlled Ventilation Crawispace -4 Number of stories 0.80 R -value One Two Three R-0 -17 4 -5 R-11 -3 -2 -1 R-19 0 0 0 R-30 3 1 1 U -value One Two Three ' R-0 -0.60 -144 .70 -46 0.50 -120 -58 38 0.40 .95 -46 30 0.30 -69 -34 -22. 0.20 -43 -21 -14 0.10 -17 -8 -5 0.08 -11 -6 -4 0.06 -6 -3 .2 0.04 -1 0 0 0.02 4 2 1 0.00 10 5 3 Controlled Ventilation Crawispace -4 Number of stories 0.80 Fl -value One. Two Three R-0 -11 -7 -5 R-5 -4 -4 3 1 - R-11 -2 .2 -2 R-19 .1 .2 -2 4. Slab Edge Insulation less 50 - Number of Stories -53 R -value One Two Three ' R-0 0 0 0 R-5 8 5 •2 R-7 8 6 .3 F2 factor 0.90 -4 3 -1 0.80 .1 .1 0 0.70 2 2 1 0.60 6 4 2 0.50 9 6 3 0.40 12 8 4 S. Inriltration (Air Leakage) Specificetion Points Standard 0 6. Glass Heat Loss Total -14 -12 .48 .42 -69 -59 -64 -55 Ll -value East Percent West Skylight .51 to .41 to .31 to 0.30 or Glass Single Double .60 .50 .40 less 50 -121 -53 -39 -24 -10 4 40 -90 37 -26 -14 .3 8 35 -75 -29 -19 -9 1 10 30 -61 -21 -13 .4 4 12 29 -58 -20 -12 -3 5 12 28 -55 -18 -10 -2 5 13 27 -52 -17 -9 -2 6 13 26 -49 -15 -8 .1 7 14 25 -46 -14 -7 0 7 14 24 -43 -12 -5 1 8 14 23 -40 -11 -4 2 8 15 22 -37 -9 .3 3 9 15 21 34 -7 .2 4 10 15 20 -31 -6 0 5 10 16 19 -29 -4 1 6 11 16 18 -26 3 2 7 12 16 17 -23 -1 3 8 12 17 16 -20 0 4 9 13 17 15 -17 1 6 10 14 17 14 -14 3 7 10 14 18 13 -12 4 8 11 15 18 12 -9 6 9 12 15 19 11 -6 7 10 .13 16 19 10 3 • 9 11 14 17 19 9 .1 10 13 15 17 20 8 2 12 14 16 18 20 7. Shading (Shade Open) Effective Percent Glass (pereent=Ws x SC) Effective -14 -12 .48 .42 -69 -59 -64 -55 %Glass North East South West Skylight 18 5 1 4 1 na 16 4 2 5 1 na 14 4 2 5 1 na .12 3 3 5 2 _. na 11 3 3 5 2 na 10 2 3 5 2 1 9 2 3 5 2 2 8 2 3 5 2 2 7 1 3 4 2 2 6 1 3 '2 2 3 5 Gil/' 2' 4 2 3 4 0 2 3 1 3 3 0 1 2 1.- `0 3 2 0 "0 1 4 3 1 -1 -1 -1 -1 2 0 -1 .2 7 -2 0 na = not allowed 5 7 7 8 IB. Shading (Shade Closed) Effective Peremt class (pessmt stats x SC) . Ellecdo %Glen Nw* East Sot10t West Sigripltt 18 16 -14 -12 .48 .42 -69 -59 -64 -55 ne na 14 12 -10 -8 .35 -29 -50 -40 -46 -37 na na 11 10 -7 -6 -26 .23 .36 -31 -33 -29 na -74 9 8 -5 -5 -20 -17 -27 .23 -25 -21. -65 -56 7 6 -4 3 -14 -11 -19 -15 -18 -14 -47 -38 5 a ',2 1� `0 -9 s `ii>/ e -10 a •30 -23 3 2 1 -455 9 56 � , 1 1 -16 -9 1 0 1 2 1 - 3 1 4 3 -4• 0 9. Interior Thermal Mass Intent Single. Sbvle- Family Slab Floor +6 to Raised Floor Mass less Stories Deteched Attached Family Stories 0 0 /CFA One Two Three One Two Three 0.0 -8 -5 .4 0.60 �1 1 0.1 -8 -5 -3 .1 0 0 0.3 -7 -4 -2 0 1 1 0.5 -6 -3 -1 1 1 2 0.7 -5 .2 -1 1 2 2 0.9 -5 .1 0 '2 3 3 1.1 -4 .1 1 3 4 4 1.3 -3 0 2 3 4 5 1.5 -3 1 2 4 5 5 20 -1 2 4 5 6 7 25 0 3 5 7 7 8 3.0 1 4 6 8 8 9 3.5 2 5 7 9 9 10 4.0 3 6 8 9 10 10 4.5 3 7 8 10 11 11 5.0 4 7 9 11 12 12 5.5 5 8 9 11 12 12 6.0 5 8 10 12 13 13 6.5 6 9 10 12 13 13 7.0 6 9 11 13 13 14 7.5 6 10 11 13 14 14 8.0 7 10 11 13 14 14 8.5 7 10 12 13 14 15 10. Exterior Wall Thermal Mass Exterior Wall Single. Sbvle- Family IkIi +6 to Family SEER less Mass Deteched Attached Family 0.00 0 0 0 -12 .10 0.20 3 2 1 8.5 0.40 5 4 3 -4 0.60 8 6 4 .4 -4 0.80 10 8 5 9.0 1.00 13 10 7 .2 1.20 13 12 8 0 0 1.40 12 13 9 10.0 1.60 10 13 11 2 1.80 10 12 12 6 5 200 10 11 _ 13 11.0 11. Heating System 9 7 6 4 SE or HSPF 120 15 13 11 (assumes duels In able) 7 5 13.0 Sum of 146 17 14 12 9 _25 or -24 to -1410 -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-A5_._ 13 11 8 . more Effective SE or HSPF .30 (SE or HSPF x duct eMciency) -17 Effective .25.or 24 to 4 b -4 to +610 16 or SE HSPF less' -15 -6 +5' +15 more -12 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 11 9 7 0.80 7.33 25 22 19 16 13 . 10 0.90 8.25 32 28 24 20 17 '13 1.00 9.17 37 32 28 24 19 15 Zonal Control Adjustment System Type Resistance 10 ' 9 7 6 4 3 Other 6 5 4 3 2 2 12. Cooling Syst.-ln SEER (amine; ducts In aisle) Stan of 7-10 Zonal Control Adjustment 10 8 7 6 4 3 No Cooling System Installed :--Stories -25 or 24 b x1410 -4 b +6 to 16 or SEER less .15 .6 +5 +15 mom 8.0 -14 -12 .10 -8 -6 -4 8.5 -9 .7 -6 -5 -4 -3 8.9 -5 .4 -4 -3 -2 -2 9.0 -4 -3 -3 -2 .2 -1 9.5 0 0 0 0 0 0 10.0 4 3 3 2 2 1 10.5 7 6 5 4 3 2 11.0 10 9 7 6 4 3 120 15 13 11 9 7 5 13.0 20 17 14 12 9 6 3 .3 SE None 37 -24 -18 -15 -12 Effative SEER Solar -1 .1 .1 (SEER xefuet efficiency) 0 _ HWR. astir of 7-10 -9. -7 Effective -25 or 24 to -14 to . -4 to +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 -6 -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 6 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 North_ b. East c. South One -5 -4 3 .2 -2 Two + 3 (0- 3 i.. "2 2 2 1 Single -Family lietaehed and Attached aTrrctR"S t Unit Size (sq Water :199 120A '1700 2200 2700 Heater Uredlt . or ., io to to -or Type Type less. 11699 2199 2699 more SG None 0 t. 0 0. 0 0 1 or Solar 12 '' . 8. 6 5 4 HP -HWR 8 5 4 3 3 � exposed WSB 5 3 3 2 2 POU _ . 8. 5 4 3 .3 SE None 37 -24 -18 -15 -12 Solar -1 .1 .1 0 0 _ HWR. -18 1 -12 -9. -7 -6 WSB:. -25 ' -16 -12 -10- -8 1 5% 10% .9 _-7 -6 ' IG None �5 -3 =2 _ .2 -2 j Solar " 7_ ;: 5. - •4 3 2 4 POU : 3 2 1 1 .1 IE None 28_._ -19 -14 .11 -9 1.7 Solar ' 8 5 4• 3 3 2.9 POU .10 ' .6 .5 -4 -3 4.2 Mum-Famf7 (individual units) 4.8 5 10% U* size (8 0.4 0.6 Water 1 699 ; 700 1200 1700 2200 Heater Creo or l it, . to 10 or Type Type less 1 1199 1699 2199 more SG None 0 +. 0 0 0 0 or Solar 14 7 5 4 3 HP HWR .9 5 3 2' 2 3.1 WSB 9 4 3 2 2 4.3 POU 9 r 5 3 2 2 SE None .45 -23 -15 •11 -9 1.6 Solar 2 1 1 0 0,-1', 28 HWR ' 23 -12 .8 -6 -5 • WSB -25 i -13 .8 4 -5 ' -1 2_-8.. -6 -5 IG None �-8 -4 6 -3 2-2 1.7 1.9 Solar; ;1 3 2 1' 1 _ POU >!' 0 _ 0 0 0 IE None : 30 1 -15 _ .10 -8 -6 5 7 SOW 18 9 6 4 4 1.7 POU -8 .4 .3 -2 -2 Point System Summary: Climate Zone 11 SCORE CARD 1. Ceiling Insulation 2. Wall Insulation 1 3. Raised Floor Insulation 4. Slab Edge Insulation S. Infiltration 6. Glass Heat Loss 7. Shading (Shade Open) a. North_ b. East c. South d. West e. Skylight S. Shading (Shade Closed) a. North Interior MassICFA - East c. South d. West e. Skylight aTrrctR"S �'•�•u11e•'•21 4 TYPE 1 MASS 1UiMC + 4.2. Se: � exposed slab) _ 0% 5% 10% 15% 20% 2S% 30% 35% 40% 45Y. 50% 55% 60% 69X 70% 75% 60% AMY. 00% 05% 100% 105% 110% 115% tx-. 0% 0 0.2 04 0.6 0.8 1.1 1.3 1.5 1.7 1.9 2.1 23 2.S 2.7 2.9 3.2 3.4 3.6 3.8 4 4.2 44 4.6 4.8 5 10% 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.9 21 23 25 2.7 2.9 3.1 3.3 3.5 3.7 4 4.2 4.4 4.6 4.8 5 5,' 20% 0.3 0.6 0.8 1 1.2 1.4 1.6 1.8 2 2.2 24 27 29 3.1 3.3 3.5 3.1 3.9 4.1 4.3 4.5 4.8 5 5.2 54 30% 0.5 0.7 0.9 1.1 1.4 1.6 1.8 2 22 24 26 28 3 32 3.5 3.7 3A 4.1 4.3 4.5 4.7 4.9 5.1 5.3 5s 40% 0.7 0.9 1.1 1.3 1.5 1.7 1.9 22 2.4 26 28 3 3.2 3.4 3.6 3.8 4 4.3 4.5 4.7 4.9 5.1 5.3 ' 5.5 5 7 .50% 0.9 1.1 1.3 1-5 1.7 1.9 21 23 2.5 27 3 32 3.4 3.6 3.0 4 42 4.4 4.6 4.8 5.1 5.3 5.5 5.7 5.9 55% 0.9 1.1 1.4 1.6 1'.8 2 2.2 2.4 2.6 26 3 32 3.5 3.7 3.0 4.1 4.3 4.S 4.7 4.9 5.1 5.3 5.6 5.8 E 60% 1 1.2 1.4 1.7 1.9 21 23 2.5 2.7 2.9 3.1 3.3 3.5 3.8 4 4.2 4.4 4.6 4.8 S 5.2 5.4 5.6 5.9 E 1 65% 1.1 1.3 1.5 1.7 1.9 22 2.4 2.6 2.8 3 3.2 3.4 36 3.8 4 4.3 4.5 4.7 4.9 5.1 5.3 5.5 5.7 5.9 6 1 70% 1.2 ' 1.4 1.6 1.8 2 22 25 27 2.9 3.1 3.3 3.5 3.7 3.9 4.1 4.3 4.6 4.8 5 5.2 5.4 5.6 58 6 6 2 75% 1.3 1.5 1.7 1.9 21 23 25 2.7 3 3.2 3.4 3.6 3.8 4 4.2 4.4 4.6 4.8 5.1 5.3 5.5 5.7 5.9 6.1 61 E 80% 1.4 1.6 " 1.8 2 22 2.4 26 2.8 3 3.3 3.S 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 54 5.6 5.8 6 6.2 64 E 85%1.4 1.7 1.9 2.1 2.3 25 2.7 2.9 3.1 3.3 3.5 3.8 4 4.2 4.4 4.6 4.8 S 5.2 54 5.6 5.9 6.1 63 6 S E 90% . 1.5 1.7 2 2.2 24 26 2.8 3 3.2 3.4 3.6 3.8 4.1 4.3 4.5 4.7 4.9 5.1 53 5.5 5.7 5.9 6.2 64 66 E 95% 1.6 1.8 2 2.2 25 27 29 3.1 33 3.5 3.7 3.9 4.1 . 4.3 4.6 4.8 S 5.2 5.4 5.6 6.8 6 6.2 6.4- 6 7 E 100Y. 1.7 1.9 21 2.3 2S 28 3 3.2 3A 3.6 3.8 4 4.2 4.4 4.6 4.9 5.1 5.3 SS 5.7 5.9 6.1 6.3 6.5 6.7 ; 105% 1.8 2 2.2 2.4 2.6 28 3 3.3 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.4 56 5.8 6 6.2 6.4 6.6 68 . 110% 1.9 2.1 2.3 2.5 27 29 9.1 3.3 3.6 3.8 4 4.2 4.4 4.6 4.8 S 5.2 5.4 5.7 5.9 6.1 6.3 6.5 6.7 E 9 7 115% 2 2.2 2.4 2.6 2.8 3 3.2 3.4 3.6 3.8 4.1 4.3 4.5 4.7 4.9 5.1 5.3 5.S 5.7 5.9 62 6.4 '6.6 6.8 7 120% 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 S 5.2 SA 6.6 SO 6 6.2 6.S 6.7 6.9 71 - 125% 21 2.3 2S 2.8 3 32 3.4 9.6 3.8 4 4.2 4A 4.6 4.9 5.1 S.3 5.5 5.7 5.9 6.1 6.3 6.5 6.7 7 7.2 Point System Summary: Climate Zone 11 SCORE CARD 1. Ceiling Insulation 2. Wall Insulation 1 3. Raised Floor Insulation 4. Slab Edge Insulation S. Infiltration 6. Glass Heat Loss 7. Shading (Shade Open) a. North_ b. East c. South d. West e. Skylight S. Shading (Shade Closed) a. North b. - East c. South d. West e. Skylight 9. Interior Thermal Mass 10. Exterior Wall Mass 11. Heating System Zonal Control? ( Y / N } -12. Cooling System Zonal Control? ( Y / N ) 13. Water Heating Measures T _ or R -value 1381 U -value [0.030] IQ or R -value 11] U -value [0.098] Or R-Qui[191 U -value [0.037] Point Scores 0 P T J) Or R -value [0] F2 factor [0.77] Standard •0 } Type [double] U -value 10.65] % Total Glass 1161 Sum 1-� % Glass SC Eff.• % Glass �C( x R`7`-7 _ At"7 r1 X X iiia X X'•"" % Glass. SC/ Eff..•,,%�qGlass r [O f X I X X TYPE 1 MASS AREA s • l3 a ,� COND. FLOOR AREA 9t rio7Nus/CFA TYPE 2 MASS AREA Exterior Wall Mass COND. L R AREA Sum - SE or HSPF Duct Efficiency [0.78] Effective SE or 10.7?J6.61 HSPF [0.56/5.15] SEER [9S] Duct Efficiency [0.74] Effective SEER [7.03] Type [SG) Credit (nene] �G � Point Total: Certificate of Compliance: Residential Climate Zone 11 Project Title Building Pertgit M &/ . z� Project Addrew ( Cbedced By / Data DocutoentaLion Author Telephone Enforcement Are cy Use Only BUILDING DATA Glass Area % lass North Con ' ' ea %� Number of Stories r East SlaNumber of Units / South Single Family Detached (SFD) (] Addition Alone West ` [ ] Single Family Attached (SFA) [ ] Existing Building Skylight [ J Multi -Family (MF) [ ] Existing -Plus -Addition Total --�r J dD • Y BLM,DING SHELL INSULATION Component Insulation LocatiiorvComme..-U Type R -Value it (Attire, .to gwaseh Mica, eta.) Wall .............. Wall .............. Roof ............. Roof ............. Floor ............. Floor ............. Slab Edge..... GLAZING Shading Devices Glazing Area Glass Type Interior Exterior Overhang Framing Type Orientation sf) (sinde, double) oller blind. etc.) (audescreen, etc.) (yewho) (mewWood) North ( ) _� / ZFoV North ( ) East ( ) East South ( ) �- South ( ) 5 West ( ) West ( ) Skylight....... THERMAL MASS Type/Covering Area Thickness (slab/exposed, tile, etc.) (SO (inches) Location/Description (kitchen. bath. etc.) HVAC SYSTEMS Minimum Type (furnace, air Efficiency conditioner. heat vurnD) (SE. SEERMS Duct Location Duct (atae, etc.) R -Vali Maximum Furnace Heating Output: _ HOT WATER SYSTEMS Tank Btuh Manufacturer / Model # t IN�" M Manufacturer/odel # lit -- ----- - n\J SPECIAL FEATURESlREMARKS (Add extra sheets if necessary) Mandatory Measures Checklist: Residential MF -1R NOTE: Lowrm residential buildings subjoct to the Stsndards must co Wn those coram= regardless of the eomplim= approach used. Items marked with an asterisk (')-MY be superseded by more sn12119—complsanoa reiltu ements listed on the Certificate of Compkancc. When this Checklist is incorporated into the permit documents. the features rested shall 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 eheckfist only. DESCRIPTION DESIGNER ENFORCEMENT Building Envelope Measures • §2.5352(1): Minimum ceiling insulation R-19 weighted average. 62.5352(b): Loose fill insulation manufacturer's labeled R -Value. 62.5352(c): Minimum wall insulation in framed walls R-11 weighted average (does not apply n exterior mass walls). §2-5352(kr Slab edge insulation - water absorption rate no greater than 0.3%. water vapor transmission rate no greater than 2.0 permltoch. 62-5311: Insulation specified or installed meets California Energy Commission (CEC) quality standards. Indicate type and forth. §2.5352((): Vapor barriers mandatory in Climate Zones 14 turd 16 only. §2.5317: lnfiltration/Exftltration Controls a. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. b. Doors and windows certified. c. Doors and windows weatherstripped: all joints and penetrations caulked and sealed 12.5352(e): Special infiltration barrier installed tocomply with 12.5351 mats CEC quality standards 12-5352(d): Installation of Fireplaces 1. Masonry and factory -built fueplaees have a. Tight fitting, closeable metal or glass door b. Outside air intake with damper and control c. Flue damper and control 2. No continuous burning ger pilots allowed. HVAC and Plumbing System Measures §2-5352(g) and 2-5303: Space conditioning equipment siring: attach calculation. 12-5352(h) and 2-5315: Setback thermostat on all applicable heating systems. • 12-5316(a): Ducts constructed. installed and insulated per Chapter 10. 1976 UMC. §2-5316(br Exhaust systems have damper controls. §2-5314(c): Gas-fired space heating equipment has intermittent ignition devices. 62-5314: HVAC equipment. water heaters. showerheads and fatteut certified by the CFC. §2-5352(1): Water heater insulation blanket (R.12 or greater) or combined interiorkaterior insulation (R-16 or greater): fust 5 feet of pipes closest to tank insulated (R-3 or greater). 12.5312(Emception 1): Pipe insulation on steam and steam condensate return do recirculating piping. §2.531R(d): Swimming Pool Heating 1. System herr. a. On/off switch on heater. b. Weatherproof instruction plate on heater. - c. Plumbed to allow for solar. 2. 75 percent thermal efficiency. 3. Pool cover. 4. Time clock. 5. Directional water inlet. Lighting and Appliance Measures ` 12.5352(1): Lighting - 25 lumens/watt or greater for general Lighting in kitchens and bathrooms. §2-5314(c): Gas ftrcd appliances equipped with intermittent ignition devices. §2-5314(1): Refrigemers. refrigerator -freezers, freezers and fluorescent lamp ballasts certified by the CEC. Indicate make and model number. COMPLIANCE STATEMENT This certificate of compliance lists the Wding features and perfotmance specifications needed to comply with Title 24. Chapter 2-53 and Title 20. C3%a*.r 2, Subchapter4. Article 1 of the California Administrative code. This certificate has been signed by the individual with overall design responsibility and the building owner, who shall -. retain a copy of it and transmit lite certificate to any subsequent purchaser of the building. Designer Narne: Ti cJFi= Address: Teleplume: 1-ic. #: (signature) (date) Documentation Author Namc: Tidc/Fum: Addn=: Building Owner Name -.. ._..... __ -. TitkJFum: Address: Tetcphone: (signature) Enforcement Agency Name: Agetcr. Telephone (date)