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Home My WebLink About072-270-038LYLE &JULIA HOLM 72-27-38 64a� 1335 Forbestown Rd, Oroville Permit#3136-86B,P,E,M(new single fa ily) 72-27-38�j' Permit#89-87B(add open deck/SF4/, 7 '1308-0726 - 072-270-038 MISCELLANEOUS Room Addn'-F1rsf Stry • AS-BUILT:GAR CONV(484) BATA AD :335 FORBESTOWN RD TITENSOR, LARRY & JANICE , LOWNRD 072-270-038 OUS Private Garage/Shop T SHOP/GAR(960), W/ C RRY & JANICE f i i I { i LYLE &JULIA HOLM 72-27-38 64a� 1335 Forbestown Rd, Oroville Permit#3136-86B,P,E,M(new single fa ily) 72-27-38�j' Permit#89-87B(add open deck/SF4/, 7 '1308-0726 - 072-270-038 MISCELLANEOUS Room Addn'-F1rsf Stry • AS-BUILT:GAR CONV(484) BATA AD :335 FORBESTOWN RD TITENSOR, LARRY & JANICE , LOWNRD 072-270-038 OUS Private Garage/Shop T SHOP/GAR(960), W/ C RRY & JANICE roe% Related Records and Activities for APN: 072-270-038 Address: 1335 FORBESTOWN RD ii ..... ....... I.- ................. . ...... . No Sub-GeoRecords Found No Permit Records Found R Projects F-4 ..RF108-0496 Type= R.FI BUILDING Status= Completed Description= phone call received Applied= 2129/2008 R--...RF108-0492 Type= RFI BUILDING Status= Staff Review Description= INFO RE SHOP & GAR CONV W/O PERMITS Applied= 2/28/2008 i_ ..HOC 01-04 Type= ADMINISTRATIVE PERMI Status= Finished Description= See Description Applied= 10/19/2000 No Code Enforcement Records Found No Business Licenses Found No CRM Records Found Go to Top Parent Move Selected to Top Select Cancel BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION (IVR): (530) 538-4365 OFFICE: (530) 538-7541 FAX#: (530) 538-2140 ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 1335 FORBESTOWN RD Owner: Permit NO: B08-0728 APl`l: 072-270-038 TITENSOR, LARRY & JANICE Issued Date: 07/21/2008 By KCG Permit type: MISCELLANEOUS 1335 FORBESTOWN DR Subtype: Private Garage/Shop OROVILLE, CA 95966 Expiration Date: 07/21/2009 Description: AS -BUILT: DET SHOP/GAR(960), M (530) 589-4178 Occupancy: Zoning: U SH Contractor Applicant: Square Footage: TITENSOR, LARRY & JANIC: Building Garage Remdl/Addn 1335 FORBESTOWN DR 960 OROVILLE, CA 95966 (530) 589-4178 Other Porch/Patio Total 324 1,284 FEE INFORMATION DBEH Building Review Fee $78.90 DBF Garage -Wood Frame Plan Che $241.16 DBFIRE Fire Inspection (SRA) $107.00 DBFIRE Fire Inspection (SRA) $107.00 DBFIRE SRA Fire Plan Review (S $107.00 DBMSC Garage/Shop/Strge Wood F $361.74 DBOMSC Fire Safe Standards Rev $118.98 DBSMIP Residential $2,82 Total Charged: $1,124.60 Fees Paid: $1,124.60 Balance Due: $0.00 Receipt No: B7925 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, I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 also requires the applicant for such permit to file a signed statement that he or she is licensed (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 X basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to 07/21/2008 a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: Contractors Signature Date 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 License WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements ❑ I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are notintended 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.). I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑❑ Section 3700 of the Labor Code, for I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code: the performance of the work for which this permit is issued. My Workers' Compansation insurance carrier and policy number are; The Contractors License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Carrier: Policy Number: Exp. Date: Contractor's License Law.). (This section need not be competed if the perilis or ons a hundred dollars ($100) oress. F-1 IAM EXEMPT under Section B. 8 P.C. for this reason: �j I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS Lo} ISSUED, 1 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' ��i 07/21/2008 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those O n s Signature Date provisions. �- a X 07/21/2008 ereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County Signa tU Date WARNI G AILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, ANDS ordinances, rules, regulations, and State laws relating to building 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 L SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, personal injury, including death, and property damage caused by, arising out of, or in any way connected with DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the wner or am out or d to act on the operty o s behalf. CONSTRUCTION LENDING AGENCY 007/21/2008 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for ermitte [SIG PrintDate the perforance of the work for which this permit is issued. (3097 civ. code)er teo Contractor OR: 1:1Agent for Owner Agent for Contractor FILE COPY Lenders Address City State Zip BUTTE COUNTY PERMIT DEPARTMENT OF DEVELOPMENT SERVICES NO. BUILDING PERMIT APPLICATION" OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 I ,,,_ _- _r, o�Ckoilli,§K A FEE WILL BE REQUIRED AT TIME OFAPPLICATION Website: www.buttecounty.net/dds PLEASE PRINT CLEARLY i "When filed, this application and all supporting material becomes subject to the California Public Records Act. All pub related to this application is subject to public inspection and will be posted on the County's website for electronic access. CONTRACTOR OWNER INFORMATION Last Name city(91b U i States First Name Mailing Address Fax yn E-mailewewe-i.�r L City Class Statee_p Z' Phone 5-g _ l -7$ Fax SCI e E-mail 6 o r to enc net cOh" CONTRACTOR Name Address • city(91b U i States ZiP 6 Phone / �' Fax yn E-mailewewe-i.�r L Lic. # Class ARCHITECT/ENG/NEER Name Address Address �y City J 1� StatZ' 1 Phone Fax E-mail State ' JJ2,0 COri'1 Q APPLICANT INFORMATION Name Q r Address City Stattw ZiP7676 Phone ,�5- Fax E-mail r a c APPLICANT SIGNATURE X q, — 611 1 PROJECT LOCATION AP# 171;t-111-0-0 Property Address City l q, e 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: Cu de1 Sq FT -Living Garage 05FOpen Cov &9A S Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning Flood Zone I. V I SRA ves I No Occ. Type Const. Al BUTTE COUNTY FEE SUMMARY Permit Number: B08-0728 7 County Center Drive Oroville, CA 95965 Department of Development Services Phone (530) 538-7541 Fax (530) 538-2140 Job Address: 1335 FORBESTOWN RD Contractor: Fee Description Printed: 04/21/2008 11:11 am Account Number Fee Amount Paid Date Pmt Amt DBEH Building Review Fee 0021-540013-4614901-1010 $78.90 04/21/2008 $78.90 DBFIRE Fire Inspection (SRA) 0100-450001-4617240-1010 $107.00 0100-450001-4617240-1010 $107.00 04/21/2008 $107.00 DBOMSC Fire Safe Standards Rev 0010-440001-4210500-1010 $118.98 DBFIRE SRA Fire Plan Review (S 0100-450001-4617240-1010 $107.00 04/21/2008 $107.00 DBMSC Garage/Shop/Strge Wood F 0010-440001-4210500-1010 $361.74 DBF Garage -Wood Frame Plan Che 0010-440001-4210500-1010 $241.16 04/21/2008 $241.16 DBSMIP Residential 1001-0-280-1011298 $2.82 Printed By: Kourtni Graham 19124.60 $534.06 Balance Due: $590.54 At the time of permit application, I was advised the above fees are required prior to issuance of the permit. These fees may change during the plan checking process. Signature: Date: 04/21/2008 Pursuant to Gove ent code Section 66020, you are hereby notified those items listed above may have been imposed on your project. You have 90 days from the date of approval of the project or from the impostion of the above referenced items during which you may request a protest. The requirments for a protest are specified in Government Code Section 66020(x). California Department of Forestry and Fire Protection Butte County Fire Department Fire Prevention Bureau 176 Nelson Avenue, Oroville CA 95965 (530) 538-7888 Office, (530) 538-2105 Fax Reference Number: B08-0728 Date: 04/21/2008 Location: 1335 FORBESTOWN RD By: KCG Parcel Number: 072-270-038 Sub Type: Private Garage/Shop Owner Name: TITENSOR, LARRY & JANICE Phone: (530) 589-4178 Description: AS -BUILT: GARAGE(960), ATT CARPORT(324) To meet the requirements of Government Code section 51182 and Public Resource Code 4291, Butte County requires a pre -construction inspection to pro -actively provide the below building and site requirements to the property owner. Your property is located within the State Responsibility Area (SRA) of Butte County. All development within the SRA is required to meet the below requirements: ✓ Public Resources Code 4290 ✓ Public Resources Code 4291 ✓ California Building Code, Chapter 7A ✓ Butte County Improvement Standards Requirements prior to scheduling the pre -inspection: ✓ Full plan submittal to Butte County Development Services -Building Division ✓ Driveway and building pad must be identified on site ✓ Structure location must be staked out on the building site Requests for inspections shall be made a minimum of 72 hours in advance by calling the Fire Prevention Bureau's 24 hour inspection line at (530) 538-6226, (When the recording comes on, enter the extension number). For the pre -inspections, the property owner or authorized agent is required to meet the inspector at the construction site with two hard copies of the site plan. I have read and understand the above pre -inspection requirements. 04/21/2008 Date Rev'd 5/7/07 Qa/n,o��w& -. Si ature All of the Fire Safe Requirements are posted on the Butte County Fire Department website at http://buttefire.org/FireDrevention/proti)lan/protDIan.html FILE Butte County Department of Public Works J. MICHAEL CRUMP, DIRECTOR LAND DEVELOPMENT DIVISION Storm Water Managment Program 7 County Center Drive Oroville, CA 95965 (530) 538-7266 Telephone (530)538-7171 Fax www.buttecounty.net/dds National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgment [LESS THAN 1 ACRE 1 Reference Number: B08-0728 Date: 04/21/2008 Location: 1335 FORBESTOWN RD By: KCG Parcel Number: 072-270-038 Sub Type: Private Garage/Shop Owner Name: TITENSOR, LARRY & JANICE Phone: (530) 589-4178 Description: AS -BUILT: GARAGE(960), ATT CARPORT(324) By signing below, I the project owner/owners' agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site buildouts of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the state of California Regional Water Quality Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for this project that disturbes one acre or more of land may result in revocation of grading and/or other permits or other santions provided by law. Signed: Title: FILE Date: 04/21/2008 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) 538-2140 Fax www.buttecounty.net/dds NOTICE TO BUILDERS" Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental Health, and the California Department of Forestry for their clearances and approvals. There are some things you can do to expedite your permit: 0 Make sure your application is complete. 0 Be responsive to requests from County departments for any additional materials or requirements. The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes without a complete application adds to processing time. Every permit issued by the Building Official shall expire and become null and void if the work authorized by such permit is not started or completed within one year from the date of issuance of such permit. A permit may be renewed (for a fee) prior to expiration an indefinite number of times, provided construction progress has been documented by the Building Division during each year during scheduled inspections. No changes may be made in the original plans and specifications for such work. In order to reinstate action on a permit after expiration, the permittee shall pay a new full permit fee and additional plan checking and documentation may be required. Upon completion of work covered by this permit, please contact this office for final inspection. As a reminder to you, it is illegal to occupy this building or any portion of the building for which this permit is issued without a final inspection. EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY" Application for which a permit has not been issued will expire one year after date of application. Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications, if the permit has not issued, but not after 180 days from the date of fee payment. Fees paid at the time of application are for Plan Check and administration. The Plan Check portion of fees is refundable only if the permit is cancelled or withdrawn before any plan checking is done. Building Division costs will be deducted prior to authorizing a refund and a charge to process the refund application will be assessed. Refunds on permits (issued) may be requested prior to the expiration of the permit, provided no work has been done pursuant to the permit. An Inspection may be required (and deducted from any refund amount) to determine no work was done. Fee/refund information can be read on-line at http://municipalcodes.lexisnexis.com/codesibutteco/ "When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. Reference Number: B08-0728 Date: 04/21/2008 Location: 1335 FORBESTOWN RD Parcel Number: 072-270-038 Owner Name: TITENSOR, LARRY & JANICE Phone: (530) 589-4178 Description: AS -BUILT: GARAGE(960), ATT CARPORT(324) Signature of Applicant:Tt�&�S�Date: 04/21/2008 FILE 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) 538-2140 Fax www.buttecounty.net/dds 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. ° 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. 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 PERSONALLYPL TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEMENT OR NO) 2. IQIA�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: ADDRESS CITY PHONE CONTRACTORS 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: ADDRESS CITY PHONE CONTRACTORS 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 Description: AS -BUILT: GARAGE(960), ATT CARPORT(324) Reference Number: B08-0728 Applicant Name: TITENSOR, LARRY & JANICE Owner's Name: TITENSOR LARRY & JANICE AP # : 072--270-038 Signature of Property Owner: 5 C Date: l--2// � $ Conterminous 48 States 2003 NEHRP Seisrpic Design Provisions Spectral Response Accelerations Ss and S1 Latitude = 39.498000 Longitude = -121.395000 Ss and S1 = Mapped Spectral Acceleration Values SiteClass B - Fa 1.00, Fv = 1.00 Data are based ori a 0.01 deg grid spacing. Period Sa ' (sec) (g) 0.2 0.532 Ss, SiteClass B 1.0 0.2" S1, SiteClass B Conterminous 48 States 2003 NEHRP Seismic Design Provisions Spectral Response Accelerations SMs and SM1 Latitude = 39.498000 Longitude = -121.395000 SMs = FaSs and SM1 = FvS1 Site Class D - Fa = 1.37, Fv = 1.99 Data are based on a 0.01 deg grid spacing. Period Sa (sec) (g) 0.2 0.732 SMs, Site Class D 1.0 0.407 SM1, Site Class D Conterminous 48 States 2003 NEHRP Seismic Design Provisions Spectral Response Accelerations SDs and SD1 Latitude = 39:498000 Longitude = -121.395000 SDs = 2/3 x SMs and SD1 = 2/3 x SM1 Site Class D - Fa = 1.37, Fv = 1.99 Data are based on a 0.01 deg grid spacing. Period Sal (sec) (g) 0.2 0.4$R SDs, Site Class D 1.0 0.27'1 SD1, Site Class D 0 PERMIT NO. / 3136-86B, P,E,M_ PERMIT EXPIRES OWNER LYLE & JULIArxHOLM CONTR. owner ASSESSOR PARCEL 72-27-38 LOCATION 1335 Forbestown Rd, Oroville yt ` ' e • \ O )V -o" 1 s OFFICE COPY Address 1 � t GAS jl Meter By Date ELECTRIC f Meter By Da k� fr' OFFICE COPY Address 1r ;r I GAS Temp. Power Meter By Date ELECTRIC Meter By Date Called PI Temp. Elec. Service Called PG&E j Temp. Gas Service M Called PG&E !� JOB FINALED (Date) ._ Signature 4 S r J = OK _ 0 = Not OK = Not Applicable MOBILEHOMES = Not Ready MISCELLANEOUS 41. -'• Date MOBILEHOME UTILITIES (Plans) OK except b's 1. Zoning Requirements—Setbacks—Easements Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's 1. Zoning Requirements—Setbacks—Easements 2. Soils; Special MH Support—Sketch 2, Footings; Size—Depth—Spacing—Connectors 3. Sewer; Location—Test—Fall-C/0—Concrete _ 3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails 4.. Water; Location—Test—Easement Needed (Sketch) 4, Wood Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.—Rfg.—Bracing 5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete _ 5.Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures 6. Gas; Locatior-Test—Wrap:/ /"L"ft./ /"Nat.or/ /"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 Date Card -BI Date MOBILEHOME INSTALLATION (Plans) OK except ti's 1. Zoning Requirements—Setbacks—Easements Card -BI Date Date Card -BI Date POOLS (Plans) OK except N's 1, Setbacks—Easements 2. Footings; Size—Spacing—Marriage Line 2. Soils; Compaction—Structure Stability 3. Gas; MH Test—Demand—Valve—Connector 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining 4. Electricity; MH Test—Crossovers—Breakers—Clearances 4. Elec.; Receptacles and Lighting; Distances—GFI 5. Drain; MH Test—Fall—Flex Connector 6. Water; MH Test—Regulator—Connector 5. Elec.; Pool Lighting; 15 volts—GFI 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed 7. Water and Sewer Connected—C/O to Grade—HD Approval 7, Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip.w/5'-Circulating Equip.—Pool Lghtg, Boxes—Enclosures—Panel boards—Ins. to Main in Conduit 9. Exits; Insp.—Sketch 10. Cert. of Occupancy 9. .Health Department Approval 10. Plumb; Cir. Test—Water Supply Test Card B -I Date Card -BI Date Card BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date 1 S' V 0K ' 9 0 - Not OK ="Not'yable Read = Not Ready RESIDENTIAL'(Single and Duplex) Date UND FLOOR (Plans) OK except#'s Date F MING Continued ing requirements -Setbacks -Ease 8. Property Line Firewall & Openings ain; Soils-Steel-Elec.' - - tg. Depth 3. Garage; Soils -Steel- / ' Ftg. Depth 9. 5� Ext. Doors -One 3' -Check Garage -3rd story, 2 exits �tai...� rte[" o:; -Headroom -Rise -Run -Landing -Fire Protection i-L7� _ F�t ..�-Porches & Decks; Soils -Steel- / /" Ftg. Depth _ Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 6/SStt °walls, M ' teel-Blockouts-Wrapped-Slab e2' Siding -Nailing -Veneer 6!__S_te walls rage; Steel-Blockouts-Wrapped-Slab 53 -Dri Screed-Fdn. Vents-Underflr. Access r tk` ie _fireplace Ftg.-Steel W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test LT4. _ Glazing Area -Glass Protection -Skylights -Plastic Shear Wall ailing -Bolts 9. _gA s Pipe; Size -Anchors 1f0' Water Pipe Test -Anchors -Regulator -Service Test - 11. Electric; Underground 12. lenum_s & Ducts; Clearance -Material -Support -In . girders -9 -- . . -Si Anc1�r Bolts -Jot -Veg -Cr' es Card -BI Date i Card -BI Date _ Card -BI Date-- Card -BI DateZ -147.67 Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Date FI L (Plans) OK except #'s Date PLUMBING (Permit) OK except #'s %4 --eft: Steps -Door & Sidelight Protection -Landings j/- C0/ Smoke Detector 4.ester Ht.: Vent -Access -Combustion Air �Y Yat Pipe Test & Anchors -Nail Protection *1 -'Furnace; Vents -Clearance -Comb. Air -Connector - 16 Garage; Above Floor -Ducts -Meth. Protection •-16. W.V.: Test Fttngs & Anchors -Nail Protection 17r &anwar Pan: Test, First Floor -Tub Access 18. --TShower, 2nd Floor -Tub Access 1Size & Anchors Card -BI Dat Card -BI _ Date Card -BI Dat . Card -BI Date edroom Exiting F.I. & Bath Fixtures & Tub Access Elec. _Trim & Subpanel; Breaker Sizes -Labels /Stairs &Rails ,Fireplace or Stove; Clearances -Hearth 4. lec. Outlets at Wood Panel; Int. & Ext. it. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance '- Elec. Outlets &Receptacles at Kit. Counter -� Date '14LECTRICAL Permit OK except #'s 7. Garage Fire Door; Swing -Landing -Closer „bE-_ .C. Duct in Garage -Damper 20 Fixture & Transformer Clearance - Ins. Protection 1. Elec. Receptacles Spacing -Lights & S_witches at Doors Size Boxes & No. of Conductors -Stapled 23. Romex Installed Close to Edge of Studs & C.J. " �� lEquip. Ground made up w/Mech. Fasteners -Bond Gas & Water e - - r-25."2 25. 2 Appliance Circuits in Kitchen-&- Conductor Size e / Cu orAI-A.C. Wire Size / / ga. Cu or AILooked 51715?2ed-YVire?r/ 27. Range Circ. / gaAI-Oven Circ. IS1 ga. u' AI,75. A_-_; Insula[ed Neutral No OO -- Service -Riser Conductors &-G-round-:Mai - n Disconnect _- �r29. Equip. Clearances: Panels-Motors-Mech. Equip. ---- -- -36. Clothes Closet Light -Shower Light ---- ----- Card Date - - --- B I� b /,ry7/�Card-BI Date _ _- -I - Gard B Date Card -BI Date I I"la Wtr. Htr.; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Mech. Protection jPlb., Elec. &Mech. Equip. Listed for Location 4�Pec. Receptacles in Garage; (G.F.I.)-Romex Protec. �tsulation- Foam- Looked in Attic El Yes g 3.- TGuard Rails & Deck Construction -Post Caps . Fdn. Vents & Crawl !-tole Door -Drainage & Wood -Earth Clearance . under Floor ❑Yes Following instld.: Drive ❑ Yes No: Walks , Yes ❑YNo` Planters ❑Yes ❑No v713hr-Stucco; Brown -Finish C. Unit; Disconnect-Clrnces-Brkr. & Condo Size -115V Outlet Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. c". ater Well; Disconnect, Electrical, Plumbing ��g xterior Elec. Trim; G.F.I. Receptacle -Underground Ventilation throughout House 2. Glass Protection Date MECHANICAL (Permit) OK except #'s 83. _ Corrections from Previous Inspections 84. -- Gas `est -Meters Tagged; Gas -Electric 31 .C. Ducts. Insulation & Support - Vent Fan: Exhaust above Insulation - 33• Condensate Drain & Overflow: Size & Grade 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-B Ca,d-BI Date Card -BI Date 85. Water & Sewer Connected -C/O to Grade -HD Approval -- Energy Compliance Certificate -Other Certificates -" -001- Date' - Card -BI Date Card -BI Date /�-�j Card -BI Date Card -BI Date Card -BI Date Date FRAMING(Plans) OK except #'s Com tents at Final: �6�Sil,S: Prover Material &Anchors 37. Walls: Studs -Nailing, Spacing & Bracing -Plates -Sound 31r Bearing Walls over Girders &Floor Nailing 39. Draft Stop in Walls (rat proof) - %� Fire Stops_ Furred Ceilings-Stairs_-Chases-T_ub d 41 Header & Beam -Size & Bearing H ngers-Post Caps -Anchors -Connectors s thnp.-Rfng. O Ing. Joist-Rftr�s-P..,jj�Rool BracTh�r. Fireplace Ties or Type A Flue -Fireplace 45. Attic Access. Size & Romex Protection -Draft Stop -Ins. Baffles 11"4'6. 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 196 Memorial Way, Chico - Phone: 891-2751 7 County Center Drive, Oroville - Phone: 538-7541 747 Elliott Road, Paradise - Phone: 872-6307 CORRECTION NOTICE /-�6 e):� PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office Immediately. 0 Inspector �i�/ Date//—/ -3 - COUNTY OF BUTTE uEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, OroviIle — Phone: 538-7541 747 Elliott Road„Paradise— Phone: 872.-6307 CORRECTION NOTICE )4” 1 iWN E R FIERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office Inspector Date COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751, 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise -- Phone: 872-2961, Ext. 57 CORRECTION NOTICE 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 off 'y�e immediately. ely. I A t►. / 4 •� d� f i S COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 , 7 County Center Drive, Oroville — Phone: 534-4541 Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext. 57 CORRECTION NOTICE Z- Yr-, 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. 7 Inspector-, Aw Date /aZ�j Owner: Nile. 4e)vy,-.-__ _ Permit No. LOCATION ViE N E R G Y C ERT IF ICAT ION DESCRIPTION OF INSULATION ROOF Material Thickness(inches) 0 EXTERIOR WA Material LL Thicknes (inch CEILING Batt or Blanket Type Thickness(inches) Loose Fill Type..,,d Minimum Thickn s$(Incl s) Area covered(ft.1) FLOOR, ELEVATED L_� Material � Thickness che' s)' -7 FLOOR, SLAB Material Thickness(inches) Width(inches) FOUNDATION WALL Material Thickness(inches)� A. P. No. Brand Name_ ' Thermal Resistance (R Value) Brand Name Thermal Resistance(R Value) Brand Name 'Thermal Resis ance(R Value) Brand Name /J��, Number of Bags c10 Wt. per bag .2S— lb. Thermal Resistance(R Value)_ Brand Nameli� Thermal Resistance(R Value) Brand Name Thermal Resistance(R.Value) Brand Name Thermal Resistance(R Value) I hereby certify that the above insulation was installed in the above building in conformance with the State of California Energy Requirements. FIRM NAME/OWNER STATE COBTRACTOR'S LICENSE NO. \\ �GlNaATUREOF INSTALLATION APPLICATOR DATE I hereby certify the above insulation and all required items as shown on the Building Department approved plans and attachments have been installed as required by the State of California Energy Requirements. All equipment, devices and materials are of the quality prescribed or are specifically approved by the State of California. FIRM A!E-./.OWNER_-_(Please .print) z �J SIGNATU E OF GENERAL CONTRACTOR OWNER .STATE . CONTR-ACTOR.` S—LIC.L',NSE...NO..— DATE THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPAR'TI`IENT PRIOR TO FINAL INSPECTION APPROVAL AND A COPY SHALL BE POSTED WITHIN THE BUILDING. January 1984 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION APD PERMIT PERMIT NO. 1 ASS9S.9 PAR E NUMB Fes' off/ ZONING BUILDING PERMIT o E � T P ONE SQ. FT. 0 C- BUILDING VALUATI ON OWN R'11 -IN DRE S I76- CO TRACT R'S NAME TELEPHONE /1, C: CON ACTOR'S MAILING ADDRESS Fireplace CO !qTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10 00 LENDIER'S MAILING ADDRESS Permit Fee $3-34109 AR H TECT OR ENGINEER LICENSE NO. Plan Checking Fee $ l '00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS — S �r Permit fee $ PLUMBING PERMIT Filing Fee 1 10.00 Each Trap 2.00 r Solar or heat pump water heater 20.00 LOT NO.SIPMES-3 USDI VISION NAME MAP , Water piping 5,00 Each qas water heater or vent C_ . 5.00 USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 1 5.00 Mobile Home S G W 0.00 ea TYPE OF WORK NewiK Addition ❑ Remood�el y�J)tilities [IInstallation[- Other ❑ Desceeribe work: Permit Fee $ 52- da Contractor ELECTRICAL PERMIT Filing Fee 1,10.00 00V OR 00 AMP ORLESS10.00 Main service 111 Q-citi, Main service EA. ADO'L 100 AMP 2.50 Q .10 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): FTI am licensed under provisions of Chapt. 9, Div. 3 of the BuslnesS and Professions Code and my license IS In full force and effect. License No. Classification /IXF`'I 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- ontract- ors. ors.(Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING OCCUP.ad OR ADONS. C ACC. BLDGS. , /20Sgft 47, NEW CONSTR. MULTI -OUTLET NON•RESID BRANCH CIRCUITS) 2.50 ea POWER APPARATUS &) SINGLE OUTLET CIR. EX. OCCUp(OUTLETS OR FIXTURES 200501 eAL930 FIXED APPLNS. OR Ex, Occup. OUTLETS (RESID.) EA.7 2.00 Temporary service 10.00 Q, 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. ❑ 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. 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 FiIirig Fee 10.00 Heating p Coolin✓lam 9 da , Hood 3.00 Ventilation Perm it Fee $ . d� Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all li fes, judgments, costs and expenses which may in any way accrue agai st i County in seque ce f the granting of this permit. 10 1 %� Date 10 '- Signature f Applicant — OwnerP ] Contractor ElAgent ❑ An OSHA permit is required for excov tions over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ ,-43 TOTAL PERMIT FEE%DO. Occup. e3 CVS, ST.T PE �_� aLoo ARC L 212 IS9UE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRE T " OF PUBLIC By PE IT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date - - o Receipt No. IF / WHITE-D.P.W., YELLOW-ASSC3OOR, PINK -INSPECTOR, GOLDENROD -APPLICANT Ir COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-534-4541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. 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 at rials for construction of the proposed property i provement (yes or no) . 2. I (have/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 City Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name Address City Phone Contractors 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: Property Owner _9 Date 11% — &7 -A ZR l._ NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are per- mitted to issue the permit. . 77 TO: Building Department FROM: Encroachment Permit Section , RE: Driveway Clearance Z- y /e �, /335" owner location AP 't Driveway permit 993 9 - L has been issued for the above property. 14974 ZjAl //471//�� -,20- 62" signat a date To: auilding Department t� `'7 From: ,-,nvironmental Hct:lth Subject: Sanitation Clearanc: . Oiuner L��Oocation AP// Plan Approved for:euage disposal .rater supply Hold final for: r;_:tcr supply Final clearance O.K. for: eater supply Clearance for bedroc.r. n.obilehome Other NOT; Tanitarian Date �— COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION .7 COUNTY CENTER DRIVE - OROVILLI,.CALIFQRNIA 95965 - TELEPHONE: 916/534-4541 PERMIT APPLICATION DATA SHEET Permit No. OWNER /LC /7IC22-A �2 A. P. No.:2,2 a 3� Proposed Building Use / AoV.) Building Inspector. Date 1� a0 At time of permit application, I was advised the following data must be submitted prior to permit processing andJor issuance: DATE RECEIVED APPROVED 1. 2. All items have been submitted. Plot plans in duplicate./triplicate, signed by preparer of plans. . 3. Complete plans in _duplicate. /triplicate, signed by preparer of plans. 4. Complete engineered plans and calcs, with wet signature on plans. .5. Plans with Energy Design Compliance Statement. . . . . . 6. CUSD "Fee's Paid" Stamp on Floor Plan . . . . . . . . 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ , . . , , , , 9. Letter of signature authorization. 10. Sanitation approval from Health Dept. 1.1. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner0, Mail to ownerEJ _15. Improvements may be required. . . . . . . . . . . . X16. Mobilehome Installation Data. . . . . . . . . . 17. Pre -Inspection for RequirePre-Inspec. request to (Date) Require( Building Inspect 2108. Recorded Recorded copy of Agricultural Acknowledgment Statement. 9. Driveway Permit. w�- 20. Plot plan approval from city of 21. 22. i When you issue the permit, process as follows: Mail to owner, Mail to contractor. -!2f_6_7eIephone and hold for pickup a j '' Tice, Deliver w/inspector. Applicant Date 'Zo Copy of plans sent Health Dept., Fire Dept.., Other Date The following data must be submi rior 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_�na co nter by date Contractor, designer, owner, was advised of above required data by_phone_n II unter by date Plans checked by Date 1( 1 lans approved by Date ?Vla � Sets of plans on hold in Copy—DPW File cabinet AP folder — Flours: 10:00 a.m. - 3:00 p.m. NOT COMPARED WITH RECORDED.IN OFFICIAL RECORDS 1 ORIGINAL DOCUMENT OF BUTTE COUNTY, CALIFORNIAReturn-to DPW AGRICULTURAL STATEJTENT QF ACKNOWLEDGEMENT AT THE REQUEST Or FOR RESIDENTIAL DEVELOPMENT Section 26-8.1.of the Butte County Code requires this acknowledgement 1986 OCT 20 AN 9: 59 be recorded prior to issuance of a building permit. 86-36980 ELEANOR M. BECKER The property described herein is adjacent to land or included fttk RECORDER FEE within an area zoned for agricultural purposes, and residents of this. property may be subject to inconveniences or discomfort arising from the use of agricultural chemicals, including, but not limited to herbicides, pesticides, and fertilizers; and from the pursuit of agricultural operations including, but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural zones which have as a ; priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience or disconform from normal., necessary farm operations. , All that real property situate in the County of Butte, State of California, described as follows: y Parcel.3 as shown on that Parcel Yap filed June 14, 1973, in Book 46 of—Parcel Ida s at Page age 339 Official Records of the County of Butte;, r State of California. Grantees are husband and wife and the. described property is granted thereto as joint te:'Iants. Date: �Z�� State of SS County of ®ea®®al a+.eed;�e®:®aasaaa®®®ami®d®�� w KELLY J. REESOd+I NOTARY PUBLIC GAUFORNIA Butte 0 ' 6 My ComrMsslon Expires March 5,181x0 1s 2��ad®�oH11or■®e®aaaQ�l�®�aoaolo®� Present No.. 7Q�, PROP-511TY OWNERS: + On this the ill day of (~Cinl it , 19 � L, before me, the undersigned Notary Public, personally appeared N Personally known to me. I( Proved to me on the basis of satisfactory evidence. to be the person(s) whose name(s) nP no, subscribed to the within instrument and acknowledged that W-1 executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. NcWkZy Public TOTAL POINTS = D -able 3-1. Slab Floor Points Table 3-2. Re ! In:uls- I R -Value of Insulation ( I R -Value of I thin I I I Insulation I Depth, I tnches 10-2 1 3-4 1 5-6 1' 7+ 1 T-- 1 0-111-5 I-5 (-5 i-5 1 j 12 - 15 I -5 I -3 I -2 I -1 I ! 16-191-5 1-2 I-1 1 0 1 I 20 + I -5 1 -1 t 0 1 +1' 1 -7/7/83 i Points Points below 3 I ZONE 1 -8 OWNER / POINTS PERMIT NO. -3 a, ASSIGNED ACTUAL 1. SLAB - INSULATION +3 10-3.1 I 3 I I I I 2. RAISED FLOOR - R-19 1 .20-.36 I 3. -30 CEILING - R-30- ! R -Value of Insulation I Points I 4. 4. WALL - R-191- I South ! 5. NORTH GLAZING - 2.413.6% -O:T _ - 6. EAST GLAZING - 2.5-3.6% • 03 :ti 7. SOUTH GLAZING - 1.6-3.6% � .I 1 0 1 -2 1 -4 I -4 I -6 S. WEST GLAZING - 2.9-3.6% - 0 0 9. SKYLIGHT - 0-1.3% N/A _ 10. SHADING (Exclude Overhang) ! 0.65) 1 0.41)1 EAST - ..�L ! -2 I SOUTH - .19-9- .42 I Eoints I vointsl WEST - .13-.36 -• (1(p I 0 I o .SKYLIGHT - .37-.57 A VA +3 11. HORIZONTAL SOUTH OVERHANG 2' _ b 12. MOVABLE INSULATION - NONE I +2 13. INFILTRATION (Standard=0)(Tight=+12) 49 D- 14. THERMAL MASS SF I 0 15. GAS FURNACE (SE) 71-76% I 16. HEAT PUMP (EER) 7.5-7.9% I -2 17. DUAL PACK(SE, SEER) 8.0-8.3/71-76% -25 I -18 WOOD STOVE �nr�j�,�' _- �FS_ 1 -4 ! -3 ! WORL WATER -HEATER �+��13 Am* 0 -21 ATTIC [00-% ! -9 ! -6 I =5 I OTHER . ,_ . -32 I TOTAL POINTS = D -able 3-1. Slab Floor Points Table 3-2. Re ! In:uls- I R -Value of Insulation ( I R -Value of I thin I I I Insulation I Depth, I tnches 10-2 1 3-4 1 5-6 1' 7+ 1 T-- 1 0-111-5 I-5 (-5 i-5 1 j 12 - 15 I -5 I -3 I -2 I -1 I ! 16-191-5 1-2 I-1 1 0 1 I 20 + I -5 1 -1 t 0 1 +1' 1 -7/7/83 i Points Points below 3 I -12 3-4 1 -8 5-7 I -6 8 - 12 I -C 13 - 18 I r2 a9+ I 0 Table 3-3a. Ceiling Insulation Table 3-7. South -Facing Glazing Pte I '- Floor Area Points I 0 I I East I I 3.2 ! r4 to6.4 tip +3 10-3.1 I 3 I I I I o -.19 I 0 I +1 I +2 1 .20-.36 I I Glazing Type I ! R -Value of Insulation I Points I I Total I I South ! ! I to I to I' to I to 1 up ! I I 1 of ! Sngl, I Dbl, Trpl, I .43-.66 1 0 1 -1 1 -2 1 e2 -3 1 .67 up ' .I 1 0 1 -2 1 -4 I -4 I -6 I Floor I (U - I (U - I (U - I ! 19 i -4 ' I I Area 11.10) ! 0.65) 1 0.41)1 ! 22 ! -2 I I I oints I Eoints I vointsl ! 30 I 0 I o +s +9 +3 ! 38 I +2 I I up to 1.5 1 +2 I +2 I +2 1 ! 49 ! +4 I I 1.6- 3.6 1 -1 I 0 I 0 1 I i 9.8-11.2 I I I I 3.7- 5.2 I -4 I -2 I -2 I -17 I 111.3-12.7 I -25 I -18 ! 5.3- 6.5 1 -6 1 -4 ! -3 ! -19 I 1 12.8-14.0 I -23 I -21 I 6.6- 7.7 ! -9 ! -6 I =5 I -21 I 1 14.1-15.3 -32 I -24 I 7.8- 8.9 I -11 i -8 ! -7 I -22 I 11I i 9.0-10.0 ! -13 I -10 .I -9 rable 3-4a. Wall Insulation Pointe 1 10.1-11.5 1 -17 I -13 I -11 I 111.6-13.0 I -21 I =16 I -14 I R -Value of Insulation I Pointe I ! 13.1-14.5 I -25 1 -19 I -16 I I 114.6-16.0 I i -28 I I -21 1 -'.9 ! I 11 I -7 I I I I 1 19 I o I Table 3-8. West-FacingGlazingPts. I 30 ! +3 I I 1 Glazing Type I I 1 ! I Total I ! I 1 of I Sngl, IDbl. Trpl, ! Floor I (U - I (U - I (U - I rable 3-5. North-Facin Glazing Pte ( Area 11.10) 1 0.65) 1 0.41)1 T I i I Points I oints I oincsl I Glazing Type I O i •i +i I Total 1 I I up to 1.3 1 +5 1 +6 ! +6 1 I 1 of ST, Dbl, Trpl, I 1.4- 2.2 1 +3 ! +.4 ! +5 I I Floor I U- l U- I U- I I 2.1- 2.8 I 0 1 +2I +3 I I Ares 10.66 10.42- 10.41 1 ! 2.9- 3.6 1 -3 I 0 1 +1 1 I 1 1.10 10.65 I down 1 I 3.7- 4.2 1 -5 1 -2 1 0 1 o + 1 1 4 4 1 +4 ! 4.3- 5.0 I -8 I -4 I -2 0.1- 1.2 1 +4 ! +4 ! +4 ! ! 5.1- 5.6 1 -10 ! -6 I -4 1.3- 2.3 I +1 ( +2 I +1 1 ! 5.7- 6.2 1 -13 I -8 1 -6 ! 2.4- 3.6 I -2 I 0 ! +1 I ! 6.3- 6.9 I -15 1 -10 ! -7 ! 3.7- 4.8 1 -4 ! -2 I -1 1 !. 7.0- 7.6 I -18 I -12-9 I 4.9= 6.1 1 -7 ! -4 f -3 I ! 7.7- 8.2 I -20 I -14 I -11 I 6.2- 7.3 I -9 I -6 1 -5 I I 8.3- 8.8 I -22 I -16 ( -13 ! 7.4- 8.2 ! -12 1 -8 I -7 I ! 8.9- 9.5 i -25 I -18 I -15 ! 8.3- 9.7 1 -14 ! -10 1 -8 ! ! 9.6-10.1 ( -27 1 -20 I -16 I 9.8-10.8 1 -17 ! -12 I -10 i 110.2-11.0 1 ! -23 1 -17 I 10.9-12.0 ! -19 I -14 I -12 1 ! 11.1-11.8 1 .-29 -35 I -26 1 -21 I 12.1-13.2 I -22 I -16 1 -13 I 111.9-12.7 1 -38 I -29 1 -24' i 13.3-14.5 I -24 I -18 I -15 I ! 12.8-13.5 I -42 i -32 1 -27 1 14.6-15.3 I -27 I -20 I -17 1 i 13.6-14.3 1 -46 ( -35 I -29 I I I I I ( 14.4-15.2 I -50 I -38 1 -32 ! Table 3-10. Shading Coefficient Points I SC by I I Orien- I '- Floor Area tatlon I 0 I I East I I 3.2 ! r4 to6.4 tip +3 10-3.1 I 3 I I I I o -.19 I 0 I +1 I +2 1 .20-.36 I 0 I 0 ! it ( .37-.66 i 0 ( 0 I 0 1 .67-.82 1 0 I 0 I -1 .83 up i 0 i -1 i -2 I South 1 0 1 3.2 1 6.4 18:0 19.6 I I to I to I' to I to 1 up -2 13.1 16.3 17.9 19.5 I I 0 -.18 1 0 1 +1 I +2 I +2 I +3 I .19-.42 1 0 1 0 1 0 1 0 1 0 I .43-.66 1 0 1 -1 1 -2 1 e2 -3 1 .67 up ' .I 1 0 1 -2 1 -4 I -4 I -6 West I .1 11.6 13.2 16.4 18.0 I -11 I to I to i to 1 to i up -6 1.5 i 3.1 i 6.3 i 7.9 0-.12 1 0 1 +1 1 +3 I +6 1 +7 .13-.36 I 0 1 0 1 0 1 0 1 0 .37-.57 I 0 1 -1 I -3 1 -6 1 -1 .58-.82 1 -1 1 -3 1 -6 I -12 I -15 .83 up I -2 I -4 1 -8 1 -16 1 -IO I 1 I I I Skylight I .1 1 .8 11.6 13.2 14.4 -16 I to I to I to 1. to I to -10 I I1_5 1 3.1 15.9 1 5.2 0-.12 1 0 1 +1 I +3 1 +6 I +7 .13-.36 1 0( 0 1 0 1 0 1 0 37-.57 1 0 1 -1 ! -3 1 -6 I -' :58-.82'.1 -1 1 -3 1 -6 1 -12 1 -� 83 up i -2 i -4 i -8 j -16 i -20 I 1 I 1 1 Table 3-11. Horizontal South Overhane Pointe Table 3-9. Skvlioht Points I I South Clam Table 3-6. E29 t -Facing Glazing Pts. 1 1. 1 1 Length Out I Glazing Type I 1 from Wall I Glazing Type I I Total I 1 I it T 1 1 I I z f TS 1 Dbl T 1 1 ota I 1 of I Sngl, I Dbl, Trpl, I Floor I (U - 1 (U - I (U - 1 Area 1 1.10) 1 0.65).1 0.41)1 I I oints ! oi.4nts I ointel o I Floor I I Area 1 ng I U- 10.66- 1 1.10 I U - I 1 0.42- 10.41 1 0.65 1 rp , U- I I down I 1 up to 1.3 I -1 I 0 I 0 I T o 1�+ +1 r4 I up to 1.3 1 +3 I +4 I +4 I I 1.4- 2.2 I -3 I -2 I -1 I I 1.4- 2.4 I +1. I +2 I +2 I I 2.3- 2.6 1 -6 I -4 I -3 I I 2.5- 3.6 I -2 I 0 1 O I I 2.9- 3.6 I -9 I -6 I -5 I 1 3.7- 4.6 ( -5 I -2 1 -1 I I 3.7- 4.2 I -11 I -8 I -6 ! 4.7- 5.5 I -8 1 -4 ( -3 I I 4.3- 5.0 I -14 I -10 I -8 I 3.7- 6.7 I -10 I -6 1 -5 I I 5.1- 5.6 I -16 I -12 I -10 I I 6.8- 7.7 I -13 I -8 1 -7 I I 5.7- 6.2 I -19 1 -14 I -12 i I 7.8- 8.7 ( -15 1 -10 1 -8 ( 1 6.3- 6.9 I -21 I -16 1 -13 I I 8.8- 9.1 1 -1.7 ! -12 I -10 1 I 7.0- 7.6 I -24 I -18 I -15 I i 9.8-11.2 I -21 I .-15 I -13 I 7.7- 8.2 I -26 I -20 I -17 I 111.3-12.7 I -25 I -18 1 -15 I I 8.3- 8.8 I -28 1 -22 I -19 I 1 12.8-14.0 I -23 I -21 I -18 ( I 8.9- 9.5 I -31 I -24 1 -21 I 1 14.1-15.3 -32 I -24 I -20 I 1' 9.6-10.1 I -33 I -26 I -22 I 11I Area, 1 of Floor I I 0-6.3 I 6.4 up 1 I u- u.3 1 -t I -4 1 10.6 - 1.0 I -2 I -3 1 11.1 - 1.9 I -1 I _4 I 1 2.0 up 1 0 I 1) I' I I I 1 Table 3-12. Movable Insulation Points Moveable Insulation] I I Area, 1 of Floor I points 0 - 5.3 I 0 I 5.6 - 11.S I +2 I 11.6 - 17.5 1 +4 I 17.6 - 23.5 I +6 I X23.6+ 1 +6 ! Table 3-13- Lnf!lttatiae Control Features Points �- I Control Features I Points 1 T- I I I Standard I 0 I I I I 19.9 air changes per hr ( I I I I T- Tight i +12 j 0.6 air changes per hr (' 1 I I I Table 3-15. Cas Furnace Without Refrigeration Coal-nq Points IFSeasonal Efficiency 1 Points I I (SE), L I 1 1 I I I 71 - 76 I 0 1 1 77 - 82 I +2 i I 83 - 88 I +4 I I 89 - 94 I +6 I I 95 up ( +8 I 1 I I Table 3-16. Heat Puma Points I Energy Efficleney I Points I I Ratio (EER) I I I 7.5 - 7.9 I +3 I I 3.0 - 8.3 I +6 1 I 8.4 - 3.7 I +9 I 1 8.8 - 9.1 I +12 I I 9.2 - 9.6 I +15 I I 9.7 - 10.2 I +18 I I •10.3 - 10.8 I +21 I i 10.9 - 11.5 I _+24 i 11.6 - 12.3 I +27 1 12.4 - 13.2 i +30 Table 3-17. Cas Furnace Vith Refrlueration Cooline Points IRefrigerseLonl Gas Furnace I i Cooling I SE : I I171 -177-i 83- 59-79-57T I 1 761 821 881 941 up I 1 8.0.- 8.3 1 01 +21 +41 +61 +8 1 1 8.4 - 8.7 1 +21 +41 +61 +41+10 1 1 8.8 - 9.2 1 +41 +61 +81+101+12 I 1 9.3 - 9.7 1 +61 +81+101+121+14 1 j 9.8 - 10.3 1 +31+101+121+141+16 1 10.4 - 10.9 j+1G1+L21+I!1+I6i+L8 I 1 11.0 - 11.5 1+121+141+161+181+20 1 I I I I I I 7/7/83 ZONE T1 TABLE 3-14 (AAA/TES) INTERIOR THERMAL MASS POINTS �. SASS DWELLING AREA SQUARE FOOT - AREA 1,000 1,500 2,000I 2.500 I 3,000 I 3,500 4,000 I 4,500 S_,000 j SQ. FT. 1 A B C D A 8 C D A B C D A 8 C D 1 A B C 0 A 9 C 0 A 6 C D I A i C d A 8 C 50 2 2 2 2 2 2 2 0 1 2 2 2 0 0 0 0 0 0 0 0 0 0 0• 0' 0 0 0 00 l 0 0 0 0 0. 0 0 D J1 100. 4 4 4 2 2 2 2 2 2 2 2 2 2 2 2 0 2 2 2 0 2 2 0 0 2 2 0 0 2 i 0 0! 0 0 0 0 150 6 6 6 4 4 4 4 2 2 '2 2 2 2 2 2 2 2 2 21 2 2 2 2 2 2 2 2 0 2 > 2 0 2 2 2 0 I 200 e e 6 1 6 6 4 2 4 4 4 2 4 4 2 2 2 2 .2 2 2 .2 • 2 2 2 2 2 2 2 2 2 2 2 . 2 ^, 253 10 10 8 6 6 6 6 4 6 6 4 2 4 4 4 2 4 4 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 2 300 12 12 To 6 8 6 7 4 6 6 6 4 6 6 4 2 4 4 -4 2 4 4 2 2 2 2 2 2 2 2 2 1 2. 2 I I 350 14 14 12 8 10 1G 8 6 6 6 6 4 6 6 6 2 6 4 4 2 4 4 4 2 4 4 2 2 4 4 2 T 2 2 2 2 400 14 14 12 8 10 10 8 6 8 8 6 4 6 6 4 4 6 - 6 / 2 4 4 4 2 4 4 4 2 4 4 2 2 4 4 2 2 500 18 T8 16 10 12 12 10 6 10 10 6 6 N 8 6 4 6 6 6- 4 6 6 6 2 6 6 4 2 4 4 4 2 4 a 4 ' j 600 22 20 18 12 14 14 12 8 12 12 10 6 10 10 8 6 8 8 6, 4 8 C 61 -4 6 6 6 4 6 6, a 2 6 6 4 2 j 1 703 ' 24 21 20 14 18 16 lt< 10 It 14 12 8 10 10 10 6 10 10 6 =6' 8 6 -'i' '4 8 R 6. 6 4 6 6 41 6 6 6 7. , Z30 26 24 22 16 TO 16 16 10 14 14 12 8 12 10 10 6 10 10 B 6 to R 8 4 I ? 6 6 4 8 6 6 4I 6 6 0 900 28 28 T4 16 21 20 18 12 16 16 14 10 14 14 12 8 12 12 10 6 10 10 3 6 3 8 '8 4 8 8 6 4i C 8 6 r i 1,000 30 30 16 18 ?2 20 20 14 18 16 16 10 14 14 12 8 12 12 10 6 12 to`10 '6 I10 To 8 6 8 8 6 11 B E i i 1,.00 32 32 28 20 24 24 22 14 20 20 18 10 16 16 14 8 (14 14 12 -8 12 12 10 6 10 10 10 6 10 10 6 tlf !a e E 1.200 34 32 30 22 26 26 22 16 22 20 18 li 18 18 14 10 14 1/ It i 8 1< 12 12 8 1Z 12 10 6 10 10 8 6}j 1n in 8 6 I 1.300 34 34 32 22 28 26 24 16 22 22 20 12 18 19 It 10 1 14 14 8 14 12 12 6 12 12 10 6 12 TO 10 CI 10 10 F. n I 1,400 34 34 32 24 28 28 26 18 24 24 20 11 20 20 18 12 18 16 14 10 to 14 '12`.• 8 14 11 12 8 1Z 1? :G C. 10 t0 17 b I.500 136 34 34 24 30 30 26 18 24 24 22 11 22 20 18 12 18 16 16 '10 16 16 14 8 14 14 12 ti 17 1: 10 (.I .1 11 1.: o i 2,000 I 34 34 32 22 30 30 26 18 26 26 22 16 22 22 20 14 20 20 18 12 18 18 16 10 16 16 ii GI 14 la 12 3 i 2,500 34 34 30 22 30 30 26 18 26 26 24 16 24 24 22. 14 12 22 19 !2 20 20 18 I.' 15 1n It U 3,000 34 32 30 22 30 30 26, 18 28 .26 24 10 I24 24 22 14 22 27 20 114 :2 .3 1. li i 3,500 32 32 30 •20 30 30 26 ld 24 28 24 16 26 24 21 T< i !4 -.4 TO •14 ' -4,930 - �� - � 32 12 ]0 20 � 30 10 26 18' T8 of I4 IE � 26 2S 2: if ' 1,500 32 32 28 20 30 ]0 26 1t'j is 1 r. v .t 5_000 72 lT V 20; 13 3 6 76 1= A) 1. 3y' Concrete Slab: HC -8.93; R-.29; Factor.7.3 2. 3 3/4• Thick Common Brick: 1IC-7.125; R-.13; factor -7.3 8) 1. 54' Concrete Slab: HC -14.106; P. - .4i8; F'attor•7.1 C 1. 8" sotto Filled Block: HC•20.63; R-1.93; Factor•6.t wood stove 033 pointsfno back up) 2. 8' S011d Filled Block With Both Sides Exposed To Conditioned Air. ca.sablanca fan + l.point NOTE: Use all square footage directly exposed to conditioned air for Thereal'Hass Area: HC -10.164; R-.960; Factor -6.1 + `' D) 1^ Thick Concrete/Tile: KC -2.55; R-.083; Factor -3.7 } Table 3-19. Zonally Controlled Electric Resistance S Space Heatlnq Points ' 1 Points fat thla eKasurc v!11 ? Table 3-2n. Solar Vater Heating With Cee Backup Points I be completed after the CEC i I has approved an Alternative I Component Package for Resistance 'I I neat. Table 3-19. Active Solar Space Heatlne cairn Can Fainrs Net Solar Fraction 1 Points (NSF), 2 I I 0-6 1 0 l I 7 - 14 1 +2 I I 15 - 23 I +4 1 I 24 - 30 I +6 I I 31 - 39 I +8 I 1 40 - 47 1 ; +10 I I 48 - 55 ( +12 1 ( 56 - 63 i +14 I I 64 - 71 1 +18 . I 1 72 up i I +20 I I: I • Multlfamil (per unitpoints) Floor Area Net Solar Fraction (NSF), ; per, un1t, ft2. 0.9 IC -19 20-29 30-39 40-49 50-59 60-69 70-79 600-799 0 +3 +7 +10 +14 +17 +21 +24 800-999 0 +3 +5 +8 +11 +14 +16 +19 1,000-1,499 0 +2 +4 +6 +8' +10 +12 +14 1,500-1,999 0 +1 +3 +4 +6 +7 +8 +10 2X00 and up 0' +1 +2 +4 +5 1 +6 1 +7 +9 All others (pe building points) 800-8.99 0 +5 +10 +14 +19 +24 +29 � +34 900-999 0 +4 +9 +13 +17 +il +26 +30 1,000••1,199 0 +4 •+7 +ll +15 4.19 +22 +26 1,201,-1,499 0 +3 +6 +9 +12 +15 +18 +21 1,500-1,999 0 +2 +5 +7 1 t9 +f2 +14 +lc 2,0(10-:,'199 +2 1 +3 +5 +7 +8 +10 +11 3,060 .v.d uo -0 0 +1 +3 +S +5 47 +8 +10 Table 3-21. Other Wati System Type I Point I I I i 1 1 I Cas Only I 0 I I I I I Beat Pomp I 0 I i I I ( Solar with Electric I I ( Resistance Backup I I t I Meeting the Require- I I I seat• sa Part 2 I 0 I I I I I Electric Resistance I I Only -40 co M FORM I -=:►+7'" RESIDENTIAL ENERGY PLAN CHECK/INSPECTION SUMMARY Owner Climate Zone �� Permit No.. Floor Area 143 a11k Compliance path: Pack ge ❑ A ❑ B ❑ C 11 int System ❑ Budget ❑ Other MIN R -VALUE DESCRIPTION REQ'D INSTALLED ITEMS (1) INSULATION: Roof/Ceiling Wall - l1Y Slab Floor Perimeter ❑ Raised Floor (2) INFILTRATION: ❑ (A) A vapor barrier is required in climate zones, 1, 14 & 16. p' (B) All manufactured windows and sliding glass doors shall meet the 1972 ANSI Air Infiltration Standards and shall be certified and — labeled. Ips (C) All swinging doors and windows leading to unconditioned areas shall be fully weatherstripped. Tight - the above standard features plus: . ❑ (D) Continuous infiltration barrier ❑ (E) Electrical outlet plate gasket 13 (F) Air-to-air heat exchanger (3) GLAZING: (A) Location Area Glaz,�F�9 %Floor Area Single Double Triple (� Total Bldg � IT_ IZ•�`� (� North 20 V East 2 81 V South G —� West ❑ Skylights (B) Shading Shading010, - Description L�Coefficient East South West • U(o ❑ Skylights ❑ (C) South Overhang Length of projection ft. Description ❑ (D) Moveable insulation: Area ft2 Description (E) Thermal mass ot Type - Area .2 HC= MG-' Location T =. ❑ Type -Area Ft. HC= R= MC= Location ❑ Type - Area Ft.2 HC= R= MC= Location ❑ Type - Area Ft. HC= R= MC= Location ❑ Type - Area Ft.2 HC= R= MC= Location ❑ Type - Area Ft. HC= R= MC= Location 7/83 ... r -w �A ❑ (4) MASONRY AND FACTORY -BUILT FIREPLACES shall be equipped with tight fitting closeable metal or glass doors covering the entire opening of the firebox; a combusion air intake equipped with a readily accessible, openab le, and tight fitting damper to draw air from the outside of the building; and a tight fitting flue damper with a readily accessible control. *1(5) HEATING, VENTILATING; AIR'CONDITIONING SYSTEM (A).:Heat ing ❑ Central Gas Furnace (brand and model number) SE Btu/hr (heating capacity) ❑ Heat Pump. (brand and model number) ACOP Btu/hr (heating capacity at 47°F) ❑ Active Solar type (liquid or air) Collector brand and ft2 model number solar fraction collector area collector orientation collector tilt rated y -intercept rated slope othern0 TTa.� �• (describe) *1 (B) Cooling ❑ Electric Air Conditioner (brand and model number) (seasonal EER) Btu/hr (cooling capacity at 95°F) ❑ Electric Heat Pump EER Btu/hr (cooling capac ty at 95°F) l� Other a" ASU NT (describe) ❑ (C) A TWO-STAGE THERMOSTAT, which controls the supplementary heat on its second stage, shall be required for heat pumps. ❑ (D) AN AUTOMATIC SETBACK shall be provided for all thermostats, except those controlling heat pumps. ❑ (E) AN INTERMITTENT IGNITION DEVICE shall be provided for all gas-fired fan type central furnaces, gas-fired fan type wall furnaces and gas cooking appliances. ❑ (F) BACKDRAFT DAMPERS shall be provided for all fan systems exhausting air to the outside. ❑ (G) DUCT CONSTRUCTION & INSULATION. All transverse duct, plenum, and fitting joints shall be sealed with"pressure sensitive tape or mastic to prevent air loss and shall be insulated to conform to the provisions of Section 1005 of the UMC, 1976 Edition. 7/83 2 *1 Submit documentation of sizing heating and cooling equipment by Manual J, sizing charts (form #4) or other approved methods, section 2-5352(g), and fill out the following: Heating: Winter design temperature 16 °, elevation S� ', heating load �TU elev do factor x heating load = maximum outlet capacity gas furnace. BTU Cooling: Summer design temperature 101L. °, cooling load bG BTU (USE ONLY AS A SIZING GUIDE, COOLING MAY BE INADEQUATE) *2 Submit T.I.P.S.E. chart or other approved system (form #5) to document sizing of solar panels. ® DESIGN COMPLIANCE STATEMENT: The above building design meets the requirements of Title 24, Part 2, Chapter 2-53 of the California Administration Code. 7/83 SIGNATURE OF BUILDING DESIGNER OR APPLICANT FORK 1 (6) DOMESTIC WATER SYSTEM 13 " -(A),- Gas Only Gallons (brand and model number) (tank size): Q Heat Pump w/Electric Backup (brand and model number) Gallons (tank size)" Q *2 Active Solar (collector brand and model number) (rated y -intercept) (rated slope) (solar fraction) - ft 2 :(backup heater type, brand and model number) (collector area) (collector orientation) (collector tilt) ❑ Location of Solar Panels ®� Other L=Z '/i{A RU 99K (Describe) :(B) TANK INSULATION. Storage type water -heaters and storage and backup tanks for solar systems shall be externally wrapped with R-12 insulation or greater. (C) PIPE INSULATION. The five feet of pipe closest to the water heater and outside conditioned space shall be insulated with a minimum of R-3. Steam.and steam conditioned space shall be insulated with a minimum of R-3. Steam and steam condensation return piping and recirculating hot water piping outside the building envelope shall be insulated in accordance, with T20 -1408(d). (D) FLOW RESTRICTORS shall be provided for showerheads and faucets as outlined in the new appliance efficiency standards and shall be certified to the Energy Commission. (7) LIGHTING (A) Lamps used in luminaries for general lighting in kitchens and bathrooms shall have an efficacy of not less than*25 lumens per watt (usually florescent). *1 Submit documentation of sizing heating and cooling equipment by Manual J, sizing charts (form #4) or other approved methods, section 2-5352(g), and fill out the following: Heating: Winter design temperature 16 °, elevation S� ', heating load �TU elev do factor x heating load = maximum outlet capacity gas furnace. BTU Cooling: Summer design temperature 101L. °, cooling load bG BTU (USE ONLY AS A SIZING GUIDE, COOLING MAY BE INADEQUATE) *2 Submit T.I.P.S.E. chart or other approved system (form #5) to document sizing of solar panels. ® DESIGN COMPLIANCE STATEMENT: The above building design meets the requirements of Title 24, Part 2, Chapter 2-53 of the California Administration Code. 7/83 SIGNATURE OF BUILDING DESIGNER OR APPLICANT RCSIDFNT IAL PLAN CUECKING GUIDE 7/85 (S.F., DUPLEX 6 MISC. ONLY) Bldg. Per=it 6 3134P I%F OWNER GENERA L 1. Zoning requirements: (:;ideyards and number of permitted living units). 2. Valuation. 3. Plans signed by designer. b� 4. Energy Design and Compliance. 5. Existing violations on property. PLOT PLAN 1. Complete parcel size and dimensions. 2. Setbacks, sideyards, casements, etc. 3. Other buildings or structures. 4. Grading, fills, drainage. 5. Flood hazard. 6. Special conditions on creation map or compliance document. FLOOR PLAN 1. Complete to scale plan with dimensions. 2. Required windows for light and ventilation (Sec. 1205). 3. Required windows for second exit (Sec. 1204). 4. Skylights (Chapter 34 6 Sec. 5207). 5. Human impact glass (Sec. 5406). 6. Required room sizes, ceiling heights (Sec. 1207). _--7. G.F.C.I.'a in baths, garage and exterior outlets (Article 210-8). S. Light fixtures, switches, receptacles, and exterior receptacles for maintenance of mechanical equipment. 9. Locations of water heater, heating and cooling equipment, other electrical or gas equipment, and plumbing; fixtures. _.40. Garage firewall, door size, and closer (Sec. 503(d)(3)). 11. 1 -•3'0" exterior exit door (Sec: 3304(c)). _...E2. Fireplace and wood stove location. 13. Smoke detectors (Sec. 1210). STRUCTURAL DETAILS 1. Foundation plan complete enough to construct building. 2. Floor construction details complete enough to construct building. 3. Elevations and wall constructioi: details complete enough to construct building. 4. Roof construction derails complete enough to construct building. v 5. Fireplace construction details and cages if necessary. 6. Sufficient data and details to satisfy energy requirements (State Law) (Form 1). KISCELLANE:OUS ITEMS TO LOOK. OUT FOR 1. Exposure I plywood on exposed location, and overhangs. 2. Stairway details: landings, rise and run, head clearance, handrails (Sec. 3306). 3. Guardrail details (Sec. 1711 6 3.306(j)). 4. Brick or stone veneer (Chapter 30). 5. Exterior plaster - weep screeds (Sec. 4706). 6. Proper roof pitch for roof covering (Chapter 32). 7. Rafter ties or bearing ridge beam. 8. Garage door or porch header sizes. 9. Adequate bracing. 10. Living area over garage - complete 1 -hour separation required on garage side including supporting walls and posts, etc. 11. Two exits on three-story dwellings (Sec. 3303 6 see Mezannines 1716). ----42. Attic access and ventilation (Sec..'3205). Underfloor access and ventilation (Sec. 2516). 14. Wood stoves, clearances, alcoves b 1 -hour shafts. 15. Combustion air for fuel burning appliances. 16. Noise requirements on duplexes. 17. Adobe soils - special foundation desi;;n. 18. Retaining walls requiring design. 19. Unusual shape, size fir split level house requiring lateral design. RE C§ O86— RDED39410 F6980 ICIAL RECORDS Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT OF BUTTE COUNTY, CALIFORNIA FOR RESIDENTIAL DEVELOPMENT AT THE REQUEST OF Section 26-8.1 of the Butte County Code requires this acknowledgement PARre SHOWN, be recorded prior to issuance of a building permit. 86-36980 1966 OCT 20 AN 9: 59 The property described herein is adjacent to land or included ELEANOR M.BECKER � within an area zoned for agricultural purposes, and residents of this CLERK -RECORDER FEE-. property may be subject to inconveniences or discomfort arising from the use of agricultural chemicals, including, but not limited to herbicides, pesticides and fertilizers; and from the pursuit of agricultural operations including, but not limited IZI to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, Pages smoke, noise, and odor. Butte County has established agricultural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience or disconform from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: Parcel 3 as shown on that Parcel Map filed June 14, 1973, in Book 46 of Parcel leaps at Page 33, Official Records of the County of Butte, State of California. Grantees are husband and wife and the described property is granted thereto as joint te:iants. Date: (oi '°` PRPR5RTY OWNERS 9� State of _&I bYIII IFI ) On this theyl day of (^ftjQQ AC , 1986, before SS. me, the undersigned Notary Public, personally appeared County of l,u IQ , cTe � > t1-o�v►�, T {(El -LY J. REESAId r p NOTARY PUBLIC-CAUFORNIA M Bufte Cas @ NyComrrrs*IreMarch 6,100 M 19606"1301111111aNMma;ls13®c aa®®DWN Personally known to me. / ( Proved to me on the basis of satisfactory evidence. to be the person(s) whose iiame(s) 100 subscribed to the within instrument and acknowledged that W e executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. Present A.P. No. 7c�?'-,?7-38' N r Public ,SND gZ _ROCUMEN1. LQ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville,^California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PE MIT NO. it ASSESSOR PARCEL NUMBER 72-27_38 ZONING BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS CONTRACTOR'S NA E OWNER TELEPHONE 1st renewal permit CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER NONE UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 1000 Permit Fee 1 FFF $ 16 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee -on $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 1339 FORRETOWN RD_ Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 OROVILLE Solar or heat pump water heater 20.00 LOT NO.SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SFU Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G TWT 0.00 ea. TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other ❑ Describe work: 1st renewal of permit #3136-86 Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMPOR_00V OR 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Bushes$ 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 NEW CONST. ACC. BLDGS. DWELLING OCCUP.N , !z¢sgIt OR ADDNS. NEW RESIU OUTLET 2,50 ea D, NON •R ESID BRANCH CIRCUITS) POWER APPARATUS e SINGLE OUTLET CIR. 209306 Ex. OCcup�OUTLETS OR FIXTURES DAL@ 30 FIXED Ex. Occup. OUTLETS PRESID ILNS REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 9 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement,should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FilingFea 10.00 Heating Coolin g Hood 3.00 Ventilation Permlt 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. 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 said County in consequence of the granting of this permit. %� 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 $ Energy Inspection Fee $ TOTAL PERMIT FEE $ 177.00 OCCUP. CONST.TYPE ISCHOOLIFLOODIPARcel PD I ND I Issue This permit is hereby Issued under sions of the Butte County Code and/or work Indicated above for which DIRECTOR OF PUBLIC By PERMIT EXPIRES Date 11-3—A$ the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. WHITE-D.P.W.. T[LLOW-ASSE330". PINK -INSPECTOR. GOLDENROD -APPLICANT 3136-86 PERMIT NO. 89-87B PERMIT EXPIRES ZZ 2� OWNER LYLE HOLM CONTR. — _ owner ASSESSOR PARCEL 72,-27-38 LOCATION - 1335 Forbestown Rd,"Orovill Temp. Power Pole Called,PG&E Temp. Elec. Service_ Called PG&E Temp. Gas Service Called PG&E JOb FINALE (Date) _ Signature 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 1. Zoning Requirements—Setbacks—Easements 2. Soils; Special MH Support—Sketch _Zoniy6 Requirements—Setbacks—Easements _ Vf. F otings; Si—De00r-Spa —Connectors 3. Sewer; Location—Test—Fall-C/0—Concrete VDecks; Girders and/or Joists—Decking—Bracing—Stairs—Rails 4. Water; Location—Test—Easement Needed (Sketch) 4. Wood Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.—Rig.—Bracing 5. Electricity; Location—Clearances—Grnd.—/ / Amp—Concrete 5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures 6. Gas; Locatiort—Test—Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG 6. Carports; Windows—Doors 7. Utility Clearance 7. Elec. Card -BI Date Card -BI Date Card -BI to Card -BI Date Card -BI Date Card -BI Date Card -B1 a--• and -BI Date Date MOBILEHOME INSTALLATION (Plans) OK except N's 1. Zoning Requirements—Setbacks—Easements Date ti POOLS (Plans) OK except N's 1. Setbacks—Easements 2. Footings; Size—Spacing—Marriage Line 3. Gas; MH Test-Demand—Valve—Connector 4. Electricity; MH Test—Crossovers—Breakers—Clearances 2. Soils; Compaction—Structure Stability 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining 4, Elec.; Receptacles and Lighting; Distances—GFI 5. Drain; MH Test—Fall—Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI 6. Water; MH Test—Regulator—Connector 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed 7. Water and Sewer Connected—C/0 to Grade—HD Approval 7. Elec.; Bonding; Metal w/5'—Circulating Equipment—Heater 8. Gas and Electricity Tagged 8. Elec.; Grounding; Equip.w/5'—Circulating Equip.—Pool Lghtg. Boxes—Enclosures—Panel boards—Ins. to Main in Conduit 9. Exits; Insp.—Sketch 10. Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test—Water Supply Test and B -I Date Card -BI Date Card -B( Date Card -BI Date and B-1 Date Card -BI Date Card -BI Date Card -BI Date = OK = Not OK = Not Applicable = Not Ready RESIDENTIAL (Single and Duplex) Date UNDERFLOOR (Plans) OK except N's Date FRAMING (Continued) Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /" Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits _ 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks: Soils -Steel- / /" Ftg. Depth 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 D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 55. Shear Walls; Nailing -Bolts 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 -B1 Date Card -BI Date Card -BI Date Date FINAL (Plans) OK except N's Card -BI Date Card -BI Date 56. Ext. Steps -Door & Sidelight Protection -Landings Date PLUMBING (Permit) OK except q's 57. Smoke Detector 14. Water Ht.: Vent -Access -Combustion Air 58. Furnace; Vents -Clearance -Comb. Air -Connector - 15. Water Pipe: Test & Anchors -Nail Protection In Garage; Above Floor-Ducts-Mech. Protection 59. Bedroom Exiting 16. D.W.V.: Test-Fttngs & Anchors -Nail Protection 60. G.F.I. & Bath Fixtures & Tub Access 17. Shower Pan: Test, First Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels 18. Test Tub & Shower, 2nd Floor -Tub Access 19. Gas Pipe: Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. } Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance 66. Elec. Outlets & Receptacles at Kit. Counter Card -BI Date Card -BI Date 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper Date ELECTRICAL Permit OK except p's 20. 21. 22. 23. 24. 25. 26, Fixture &Transformer Clearance -Ins. Protection Elec. Receptacles Spacing -Lights & Switches at Doors Size Boxes & No. of Conductors -Stapled Romex Installed Close to Edge of Studs & C.J. Equip. Ground made up w/Mech. Fasteners -Bond Gas &Water 2 Appliance Circuits in Kitchen & Conductor Size Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or At 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 70. 71. Plb., Elec. & Mech. Equip. Listed for Location Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 72. 73. Insulation -Foam -Looked in Attic E) Yes Guard Rails & Deck Construction -Post Caps 74. Fdn. Vents & Crawl !-Tole Door -Drainage & Wood -Earth Clearanr Looked under Floor ❑ Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral .Yes -,No _-_----_ 75. Following instld.: Drive ❑ Yes ❑ No: Walks ❑ Ye Planters ❑Yes 0 N 28. 29. 30. Service -Riser Conductors`& Ground -Main Disconnect_ - ---_ Equip. Clearances: Panels-Motors-Mech. Equip. -- w Clothes Closet Light-Shoer Light - 76. 77, 78. Stucco; Brown -Finish A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to ----_ - _-_-_-- 79. Water Well; Disconnect, Electrical, Plumbing Card B -I ---.-- Date Card -BI Date - - _- 80. 81. Exterior Elec. Trim; G.F.I. Receptacle -Underground Ventilation throughout House Card B -I _ - Date Card -BI Date 82. Glass Protection 83. Corrections from Previous Inspections Date MECHANICAL (Permit) OK except s's 84. 85. _ Gas Test -Meters Tagged; Gas -Electric Water & Sewer Connected -C/O to Grade -HD Approval 31. A.C. Ducts. Insulation & Support _ _ - _ 32. Vent Fan: Exhaust above Insulation _ 86, Energy Compliance Certificate -Other Certificates 33. Condensate Drain & Overflow: Size_& Grade 34. _ Furnace -Vent: Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace to Attic _ Card -BI Date Card -BI Date Card -BI Date Card -BI Date - Card -BI Orate Card -BI Date Card -Bt Date Card -BI Date Card -BI Date Card -BI Date Date FRAMING(Plans) OK except q's w Com tents at Final: 36. Sills. Proper Material & Anchors 37. Walls: Studs -Nailing, Spacing & Bracing -Plates -Sound - 38. Bearing Walls over Girders & Floor Nailing 39. Draft Stop in Walls (rat proof) 40. Fire Stops: Furred CeilinSt gs-air_s_-Cha_se_s-T_ub 41 Header & Beam -Size & Bearing 42. Hangers -Post Caps -Anchors -Connectors 43. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthnq.-Rfng. 44. 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 - _ (NOT E An entry must be made each time you visit job sile) V/ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATI ON AND PERMIT _P,E9MIT71-1� ASSESSOR PARCEL NUMBER _a —38 ZONI a N $f4 BUILDING PERMIT OWNER Z_TEL 04M PHONE 1011— SO. FT. OCC. BUILDING VALUATION D Z/ o OWNER'S M AI`L,ING ADDRESSS 05R IRX 9 (9 OV I LLie- II CONTRACTOR'S NAME pw�vER., TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ ® Nl Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ,Sii 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 IO.Do MISIO- Each Trap 2.00 Solar or heat pump water eater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP 9 '3-3 Water piping 5.00 Each qas water heater or vknt 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other i0PEN n6Ct- SPECIFY Gas piping system 1 - 5 outl is 00 Building sewer 5.00 Mobile Home S G W 15. .00ea TYPE OF WORK New)?"'Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: C.c aP =- 3t3& Permit Fee $ Contractor ELECTRICAL PERMIT Filin Fee 10.OD 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): ❑ 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 a5 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.& ,/zQsgft OR ACDNS. \ ACC, a DGS. NEW RESID ULT1. UTLET NON.R ESIBRANC CIRC ITS 2.50 ea POWER A PARATUS a SINGLE O LET CIR. EX. OCcup(OUTLETS OR FIXTURES 20®50Q BALI 30 FIXED OR EX. Occup. OUTLETTSS I RE ID.) EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ i have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. to the W. C. laws of California. NotiI shall not employ any person in any manner so as to become subject ce o Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation penult 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 Iia ties, judgments, cos s, and expenses which may in any way accrue X ain t sub County it1 Fonse u nce of the granting of this permit. (Y)�� Date Signature of Applicant — Owner A Contractor ❑ Agent ❑ An OSHA permit is required for excava ions over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ �- OCCUP, CO' PE FLOOD P CEL PD ND s=uE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC BY PE IT EXPIRES DateL__�'� the applicable pro%i- resolutions to do fees have been paid. WORKS Date Receipt No. 72S7( WHITE-D.P.W., YELLOW-ASSE330R, PINK -INSPECTOR, GOLDENROD -APPLICANT c. .-•. tett r t=x COUNTY OF BUTTE - DEPARTMENT OF�PIJ'Bl2IC WORKS - B _= 4 UILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 9161534:�54IX 538-7�541 PERMIT APPLICATION DATA SHEET Permit No. OWNER i`--fo-r-r^�'- , " SA . P. No IV �� 14Q Proposed Building Use Building Inspector—14eDate / /(4^t7 At time of permit application, I was advised the following data must be submitted prior to permit processing and:/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted. . . . . . . . . . . . 2. Plot plans in duplicate./triplicate, signed by preparer of plans. . 3. Complete plans in duplicate. /triplicate, signed by preparer of plans. 4. Complete engineered plans and calcs, with wet signature on plans. 5. Plans with Energy Design Compliance Statement. . . . . . 6. CUSD "Fees Paid" Stamp on Floor Plan . . . . . . . . 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ . . . , . . , tter of signature authorizati . . '. . . . . a rom . Health Dept. 1. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner0, Mail to ownerEl). _15. Improvements may be required. . . . . . . , . , 16. Mobi lehome Installation Data. . . . . . . . . . Pre-Inspec. request to (Dote) 17. Pre -Inspection for Required. Building Inspector 18. Recorded copy of Agricultural Acknowledgment Statement. 19. Driveway Permit. s,- 20. Plot plan approval from city of 21. 22. When you issue the permit, process as follows: >igail to owner, Mail to contractor. Telephone and hold for pickup at—off ice, Deliver w/inspector. Other Date Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. f- 2. Additional items required: xxxxxxx 538-7541 xxxxxxx 538-7281 Contractor, designer, owner, was advised of above required data by_phone--nail—counter by date Contractor, designer, owner, was advised of above required data by—phone _mall—counter by date Plans checked by Date Plans approved by Date 4t Copy—DPW Sets of plans on hold in File cabinet AP folder xxxxxxx 538-7601 — Flours: 10:00 a.m. - 3:00 p.m. To: Building Departcient, From;: E-,nvironmental He::1th Subject: Sanitation C ea anc.e ke Owner Location AP// Plan Approved for: Hold final for: Sewage di sponal crater supply r;_ er supply Final clearance O.K. for: ,rater supply Clearance for bedroor:n:obile home. Other N0 *** Tanitarian LL Z Date COUNTY OF BUTTE - Depaftmene'of Public Works 7 County Center Drive,•Oroville, CA 95965 Phone: 916-534-4541 OWNER -BUILDER VERIFICATION Attention Property Owner: An 'owner -builder" building permit has been applied for in your name and bearing your signature. 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 materials for construction of the proposed property improvement (yes or no) 2. I (have signed an application for a building permit for the proposed work. 3. I have contracted construction: Name Address Phone th the following person (firm) to provide the proposed Contractors License No. City 4. I plan to provide portions of this work, but I have hired the following person to coordinate, u ervi a and provide the major work: Name M Address City Phone Contractors 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: Property Owner _ Social Security N Date I -% I !r NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before,we are per- mitted to issue the permit. BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION (IVR): (530) 538-4365 OFFICE: (530) 538-7541 FAX#: (530) 538-2140 ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 1335 FORBESTOWN RD Owner: Permit No: B08-0726 APN: 072-270-038 TITENSOR, LARRY & JANICE Issued Date: 07/09/2008 By KCG Permit type: MISCELLANEOUS 1335 FORBESTOWN DR Subtype: Room Addn-First Stry OROVILLE, CA 95966 Expiration Date: 07/09/2009 Description: AS-BUILT:GAR CONV(484) BATH (530) 589-4178 Occupancy: Zoning: U SH Contractor Applicant: Square Footage: TITENSOR, LARRY & JANIC: Building Garage Remdl/Addn 1335 FORBESTOWN DR 81 484 OROVILLE, CA 95966 Other Porch/Patio Total (530)589-4178 224 789 FEE INFORMATION DBEH Building Review Fee $78.90 DBSM1T Residential $0.89 DBF Room Addition - First Stor $192.77 DBFIRE Fire Inspection (SRA) $107.00 DBFIRE Fire Inspection (SRA) $107.00 DBFIRE SRA Fire Plan Review (S $107.00 DBMSC Remodel -Residential $784.87 DBMSC Room Add -1st Story 250sf $289.15 Total Charged: $1,786.56 Fees Paid: $1,786.56 DBOMSC Fire Safe Standards Rev $118.98 Balance Due: $0.00 Receipt No: B7924 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires 1 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 X basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil of not more than five hundred dollars 07/09/2008 penalty [$500]; Please check one of the following: Contractor's Signature Date 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.). I 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 Professions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and The Contractor's License Law dows not apply to an owner of the property who builds or improves 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 competed if the permit is oris or one ehundred dollars ($100) or less. ❑IAM EXEMPT under Section B. & P.C. for this reason: K71 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' 07/09/2008 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those ers Signature Date provisions. X 07/09/2008 sem— 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 Signr Date =G: WAVFAILURE 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 AN HALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE 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 ATTORNEY'S FEES. use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte Count to enter the above mentioned property for inspection purposes. I hereby certify that I am the Pro a owner or am out o act on the pr perry owners behalf CONSTRUCTION LENDING AGENCY ` W*7/09/2008 I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for' O ermittee SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) caner 1:1 Contractor OR. Agent for Owner DAgent for Contractor FILE COPY Lenders Address City State Zip BUTTE COUNTY ' DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION" OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.nettdds PLEASE PRINT CLEARLY PERMIT NO. _ BIN N "When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. OWNER INFORMATIOust N Last Nam SSC- �-J a ! C Mailing Addr( 3 ��Rd City i° Stat , Zp Phone _ c� I r7 8 Fax 15re11Ve_ E-mail -- SD I' eno of ey cow k_ APPLICANT INFORMATION CONTRACTOR Name gac` Pil— Address �l/ City 56- 8 th Stat zl��6 Phone Fax E-mail _ $'o r �Cp Lic. # X Structure Built without Permits 0 Proposed Change of Occupancy (Note previous use): Class k_ APPLICANT INFORMATION ARCHITECT/ENGINEER Name E Statt, • �l/ Address 56- 8 th City Type Const State Zip ch t�o Open Cov X Structure Built without Permits 0 Proposed Change of Occupancy (Note previous use): Phone �g Fax E-mail State License Number k_ APPLICANT INFORMATION Name Address 3 � f�� P"One Statt, • Zjpq�12�O Fax Email c,60v____ APPLICANT SIGNATURE XS�� 51 PROJECT LOCATION API 0'7a -a70 038 Property Address city 0 WORKER'S COMPENSATION Policy Number Carrier Nhiring anyone other than licensed contractors, a certfNcate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name A/ Address /v DESCRIPTION OR SCOPE OF WORK. Zoning ve �de- o Vr'r�f`vt C SRA I Yes Car 2c)(4 2247 Occ. Type Const Sq FT- Living Garage Open Cov X Structure Built without Permits 0 Proposed Change of Occupancy (Note previous use): For office use only: Zoning J Flood Zone SRA I Yes No Occ. Type Const _TRA 31 -000 oro(Oe Elem enlar� YT 1'JU3 3TTUf ' G��IS-8�2 (OEL} .1tX.A7 1�ZGEf� (Or~2.) :r 3J1�iO V�C�TTk�i1"i�.h �O �1(it� TSA. Q3AlU�3il3ii 11�V� 33'� i; zi�LL*�r.YiflMY4311od.wityr :Aad9011 YJ-.HA3,1D TM51gl PAadq r6ilcm-uAt-1 aildliq IIA .i_A LI1vm3l :)Ilduq 1;irnolila7 5dt d ;5.,(tlur t?lo.}>71{ hOwlirm gq*hogqut IIP, bra t[oitL�I1ggr. 71td? t:lfrii ag1N!« k -MO)C A11D -191-3'104 o3i'adf3w r'cinuoD Al r:o bstzoq ed III,•r bnr roifsygani aildnq o: iagiout z+ noftratilggc tial at beide-: �, _ 2zsiiZb,1 Etti�o19 'AUNA2+A'aRMOJ 2`AWWROW iadrrul4 ploq r' is =m-dn03 bomj:A! mh iotuo ono Vitra gnnldll .9:11sca21 tim:agta OMM 9 d is nwoda ed lzura no11s2: sgmfla thgA.Io ►r .� Y 31r�3O A a'J11CY131 1 - zzs7hh.'t •hRQV�J 3Q 39OQ2 �U t1 1 gWO2 � _�-.. vol fizoo SFstE� ;;.r:yi 4; T P? N � LIirrns! luodiati 1Cu91ntdooli2 Q/' Yzrequo0o10 ognsdo bazogo19 , 0 Isar 2uo;1e1q 91100; 1 ~� Yip orOn 931ft0101 In icI3 sgyT , G 111Ol� A?�1A0��1t �3YiVY O� ' e;rsa!1 tastbA . xsg � snori? xEq 9rte,19 1-.-_,._..- - � ___,_ ti `' .�:�,• assn 3 S�33V1lc7><13\TO311t�'�SiA ' e;rsa!1 tastbA . xsg � snori? S�33V1lc7><13\TO311t�'�SiA - tastbA �--� VtO',�Ah'tAO3Vtl'tVtA�Li9gA '�� 3RU'IA..VIat� TV1AO1J9gi'� �� . 1 I '�� 3RU'IA..VIat� TV1AO1J9gi'� �� . 1 I 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) 538-2140 Fax www.buttecounty.net/dds **PERMIT APPLICATION DATA SHEET** Reference Number: B08-0726 Location: 1335 FORBESTOWN RD Parcel Number: 072-270-038 Date: 04/21/2008 By: KCG Sub Type: Room Addn-First St r Owner Name: TITENSOR, LARRY & JANICE Phone: (530) 589-4178 Description: AS-BUILT:GAR CONV(484) BATH ADD(81) ATT CARPORT(224) The above permit application has the following Clearances required prior to permit issuance. Please contact each department indicated below regarding specific requirements pertaining to your permit application. Yes No SEWER DISTRICTS Thermalito Irrigation District, 410 Grand Avenue, Oroville CA 95965 - (530) 533-0740 LOAPUD, 1960 Elgin Street, Oroville CA 95966 - (530) 533-2000 City of Chico, PO Box 3420, 411 Main Street, Chico CA 95927 - (530) 879-6700 PARKS & RECREATION DISTRICTS ❑ ❑ Chico Area Recreation District, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711 1:1 Durham Park & Recreation District, 9447 Midway, Durham CA 95938 - (530) 345-1921 1 Feather River Recreaction & Park District, 1200 Myers Street, Oroville CA 95966 - (530) 533-2011 ❑ ❑ Paradise Parks & Recreation, 6626 Skyway, Paradise CA 95969 - (530) 872-6393 Recorded copy of Agricultural Acknowledgment Statement- See Attached Instructions City of Biggs Planning Department, 3016 Sixth Street Biggs CA 95917 - (530) 868-5447 ❑ ❑ Other: ❑ n Other: "When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. t Signature of Applicant: az— Date: 04/21/2008 FILE SCHOOL DISTRICTS Biggs Unified School District, 300 B Street, Biggs CA 95917 - (530) 868-1281 Chico Unified School District, 1163 East 7th Street, Chico CA 95926 - (530) 891-3006 Durham Unified School District, 4920 Putney Drive, Durham CA 95938 - (530) 895-4675 ❑ ❑ Gridley School District, 429 Magnolia, Gridley CA 95948 - (530) 846-4723 El ❑ Marysville School District, 1919 B Street, Marysville CA 95901 - (530) 741-6000 ❑ Oroville Elementary School District, 2795 Yard Street, Oroville CA 95966 - (530) 532-3000 Oroville Union High, 2211 Washington Ave, Oroville CA 95966 - (530) 538-2300 Ext:105 Paradise Unified School District, 6696 Clark Road, Paradise CA 95969 - (530) 872-6400 OTHER Recorded copy of Agricultural Acknowledgment Statement- See Attached Instructions City of Biggs Planning Department, 3016 Sixth Street Biggs CA 95917 - (530) 868-5447 ❑ ❑ Other: ❑ n Other: "When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. t Signature of Applicant: az— Date: 04/21/2008 FILE BUTTE COUNTY FEE SUMMARY 7 County Center Drive Oroville, CA 95965 Permit Number: B08-0726 Department of Development Services Phone (530) 538-7541 Fax (530) 538-2140 Job Address: 1335 FORBESTOWN RD Contractor: Printed: 04/21/2008 10:51 am Fee Description Account Number Fee Amount Paid Date Pmt Amt DBEH Building Review Fee 0021-540013-4614901-1010 $78.90 04/21/2008 $78.90 DBFIRE Fire Inspection (SRA) 0100-450001-4617240-1010 $107.00 04/21/2008 $107.00 0100-450001-4617240-1010 $107.00 DBOMSC Fire Safe Standards Rev 0010-440001-4210500-1010 $118.98 DBFIRE SRA Fire Plan Review (S 0100-450001-4617240-1010 $107.00 04/21/2008 $107.00 DBMSC Remodel -Residential 0010-440001-4210500-1010 $784.87 04/21/2008 $784.87 DBMSC Room Add -1st Story 250sf 0010-440001-4210500-1010 $289.15 DBF Room Addition - First Stor 0010-440001-4210500-1010 $192.77 04/21/2008 $192.77 DBSMIP Residential Printed By: Kourtni Graham 1001-0-280-1011298 $0.89 11,786.56 $19270.54 Balance Due: $516.02 At the time of permit application, I was advised the above fees are required prior to issuance of the permit. These fees may change during the plan checking process. Signature• Date: 04/21/2008 Pursuant to Government code Section 66020, you are hereby notified those items listed above may have been imposed on your project. You have 90 days from the date of approval of the project or from the impostion of the above referenced items during which you may request a protest. The requirments for a protest are specified in Government Code Section 66020(a). 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) 538-2140 Fax www.buttecounty.net/dds NOTICE TO BUILDERS" Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental Health, and the California Department of Forestry for their clearances and approvals. There are some things you can do to expedite your permit: 0 Make sure your application is complete. 0 Be responsive to requests from County departments for any additional materials or requirements. The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes without a complete application adds to processing time. Every permit issued by the Building Official shall expire and become null and void if the work authorized by such permit is not started or completed within one year from the date of issuance of such permit. A permit may be renewed (for a fee) prior to expiration an indefinite number of times, provided construction progress has been documented by the Building Division during each year during scheduled inspections. No changes may be made in the original plans and specifications for such work. In order to reinstate action on a permit after expiration, the permittee shall pay a new full permit fee and additional plan checking and documentation may be required. Upon completion of work covered by this permit, please contact this office for final inspection. As a reminder to you, it is illegal to occupy this building or any portion of the building for which this permit is issued without a final inspection. EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY" Application for which a permit has not been issued will expire one year after date of application. Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications, if the permit has not issued, but not after 180 days from the date of fee payment. Fees paid at the time of application are for Plan Check and administration. The Plan Check portion of fees is refundable only if the permit is cancelled or withdrawn before any plan checking is done. Building Division costs will be deducted prior to authorizing a refund and a charge to process the refund application will be assessed. Refunds on permits (issued) may be requested prior to the expiration of the permit, provided no work has been done pursuant to the permit. An Inspection may be required (and deducted from any refund amount) to determine no work was done. Fee/refund information can be read on-line at http://municii)alcodes.lexisnexis.com/codes/butteco/ "When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. Reference Number: B08-0726 Location: 1335 FORBESTOWN RD Parcel Number: 072-270-038 Date: 04/21/2008 Owner Name: TITENSOR, LARRY & JANICE Phone: (530) 589-4178 Description: AS-BUILT:GAR CONV(484) BATH ADD(81) ATT CARPORT(224) Signature of Applicant: 00 U� Date: 04/21/2008 FILE Butte County Department of Public Works •J: MICHAEL CRUMP, DIRECTOR LAND DEVELOPMENT DIVISION Storm Water Managment Program 7 County Center Drive Oroville, CA 95965 (530) 538-7266 Telephone (530) 538-7171 Fax www.buttecounty.net/dds National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgment [LESS THAN 1 ACRE 1 Reference Number: B08-0726 Location: 1335 FORBESTOWN RD Parcel Number: 072-270-038 Date: 04/21/2008 By: KCG Sub Type: Room Addn-First Str Owner Name: TITENSOR, LARRY & JANICE Phone: (530) 589-4178 Description: AS-BUILT:GAR CONV(484) BATH ADD(81) ATT CARPORT(224) By signing below, I the project owner/owners' agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I therefore, do not need to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site buildouts of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the state of California Regional Water Quality Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for this project that disturber one acre or more of land may result in revocation of grading and/or other permits or other santions provided by law. Signed: ��SCJL— Title: D FILE Date: 04/21/2008 California Department of Forestry and Fire Protection Butte County Fire Department Fire Prevention Bureau 176 Nelson Avenue, Oroville CA 95965 (530) 538-7888 Office, (530) 538-2105 Fax Reference Number: B08-0726 Date: 04/21/2008 Location: 1335 FORBESTOWN RD By: KCG Parcel Number: 072-270-038 Sub Type: Room Addn-First Str, Owner Name: TITENSOR, LARRY & JANICE Phone: (530) 589-4178 Description: AS-BUILT:GAR CONV(484) BATH ADD(81) ATT CARPORT(224) To meet the requirements of Government Code section 51182 and Public Resource Code 4291, Butte County requires a pre -construction inspection to pro -actively provide the below building and site requirements to the property owner. Your property is located within the State Responsibility Area (SRA) of Butte County SRA is required to meet the below requirements: ✓ Public Resources Code 4290 ✓ Public Resources Code 4291 ✓ California Building Code, Chapter 7A ✓ Butte County Improvement Standards Requirements prior to scheduling the pre -inspection: ✓ Full plan submittal to Butte County Development Services -Building Division ✓ Driveway and building pad must be identified on site ✓ Structure location must be staked out on the building site All development within the Requests for inspections shall be made a minimum of 72 hours in advance by calling the Fire Prevention Bureau's 24 hour inspection line at (530) 538-6226, (When the recording comes on, enter the extension number). For the pre -inspections, the property owner or authorized agent is required to meet the inspector at the construction site with two hard copies of the site plan. I have read and understand the above pre -inspection requirements. 04/21/2008 Date Rev'd 5/7/07 9a - Sig ure All of the Fire Safe Requirements are. posted on the Butte County Fire Department website at http://buttefire.org/Fireprevention/protplan/proti)lan.html FILE 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) 538-2140 Fax www.buttecounty.net/dds 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. ° 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. 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 Pj*N TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEMENT/( OR NO) 2. I JHAV /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: ADDRESS CITY PHONE CONTRACTORS 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 CITY PHONE CONTRACTORS LICENSE 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 Description: AS-BUILT:GAR CONV(484) BATH ADD(81) ATT CARPORT(224) Reference Number: B08-0726 Applicant Name: TITENSOR, LARRY & JANICE Owner's Name: TITENSOR, A & JANICE AP # : 072-270-038 Signature of Property Owner: Date: ��o�{ 0 F J �-� J i +,.:.{ a- (i!t f l•C}(:tf,ltjr (Jri19$ .rtr,t.(..#s r:"ut,r+# X117''( r)t "rr).r«+.::Yl#"5.�31,1(� li1rC�+:'isi(1' 1#:. 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