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Home My WebLink About073-120-046� v 73-12-46 o e DOUG &.DIANE BROWN .430 Powell Ridge Rd.,'Orovil Permit #1586-88B,P,E(add/SF) bl'bI 03-2807 ()731,2()-046 pgpV ILLS BRO w' ELL RIDGE AJG PD' ` 430 PO GE ROOFING Cont: GEOR PROOF r cm M N .COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7 1P RMIT NO. (Rev. 12/96) APPLICATION AND PERMIT -a '�. ASSESSOR PARCEL NUMBER �1J ZONING BUILDING PERMIT . OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION SOD . OWNER s LUNG AooR s 30 a CONE OR'S NAME TELEPHONE 33 -lob 3 CONTRACTORS UNG ADDRESS _ / CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ eu DINGAD KESS Q Energy Plan Checking Fee $ t S $ PERMIT FEE S 6/,00 LAT NO. eUBDrVtSIOWS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF $,,, Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ n ^ 1 Describe Work: Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 500VOR LE Main Service zo.A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.POWGERLE License Class C.—Z2 Lic. No. otos � OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self-insure.for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. workers' compensan suranc�carrier and policy number are: Carrier Lln2� Policy Number � ~/� —� — D (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall with comply with thoserovisions. X e Date �_ 9 _ 03 _ Signa ure of Applicant - ❑ Owner Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Main Service TO 46. 00 CCU000A NEW CONST. DWELLING OCCUP. SO W:L so OR ADDNS. ( 8 ACC. BLD S. 3.50F. T. NON -ID. MULTI.OUTLET @7,50 APPARATUS a SIN OUTLET CIR.zo@,.00 Ex. Occup. OUTLET ORFIXTURES BAL @ .50 Ex. Occup. oFlx�eED�AR�ooE. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina 23.00 PERMIT FEE _ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ coNsr. TYPE TOTAL FEE $ 10/,00 Co� HAZ. D. FEES IMP I FLOOD CDF I PARCEL I PD I HD I ISSU This permit is hereby issued under the applicable provisions of. the Butte County Code and/or Resolutions to do work indi ate bove for which fees have been paid. % /\ �. I / v V5 By Datle !f PERMIT E PIR S ON / ate ReceiptNo. WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOL ENROD-APPLICANT i � t i j PERMIT NO. 1586-88B, P, E //'� PERMIT EXPIRES l0 " OWNER DOUG t `DIANE BROWN CONTR. OWNER ASSESSOR PARCEL 73-12-46 LOCATION 430 Powell Ridge Rd., Oroville Al. * I r S• l Temp. Power Pole s Called PG&E r Temp.'Elec. Service Called PG&E Temp. Gas Service f Called PG&E JOB FINALED (Date) + Signature 1' = OK 0 = Not OK ' MOBILE HOMES MISCELLANEOUS = Not Readyble Date MOBILE HOME UTILITIES (Plans) OK except #'s Date DECKS,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Sewer; Location -Test -Fall -C/O -Concrete 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Water; Location -Test -Easement Needed (Sketch) 4. Wood Awn.; Posts- Bea ms-Rftrs.-Connec.- Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 6. Gas; Location -Test -Wrap: / P'l-It. 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors / /"Nat. or/ P'L"ft./ P'LPG 7. Utility Clearance 7. Elec. 8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh Card -B1 Date Card -B1 Date 10. Roof; Shthg-Roofing Card -B1 Date Card -B1 Date 11. Ext.; Steps -Doors -Landings Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Card -B1 Date Card -B1 Date 2. Footings; Size -Spacing -Marriage Line Card -B1 Date Card -B1 Date 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances Date POOLS (Plans) OK except #'s 5. Drain; MH Test -Fall -Flex Connector '+ 1. Setbacks -Easements 6. Water; MH Test -Regulator -Connector 2. Soils; Compaction -Structure Stability 7. Water and Sewer Connected -C/O to Grade -HD Approval 3. Pool Structure; Steel -Connections -Thickness - 8. Gas and Electricity Tagged Dead Men -Lining 9. Exits; Insp.-Sketch 4. Elec.; Receptacles and Lighting, Distances-GFI 10. Cert. of Occupancy 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater Card -B1 Date Card -81 Date 8. Elec.;Grounding; Equip. w/5' -circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit Card -B1 Date Card -B1 Date 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Card -B1 Date Card -B1 Date Card -B1 Date Card -B1 Date N = OK o = NoRESIDENTIAL (Single and Duplex) Applicable - =Nott Applicable = Not Ready Date UND FLOOR (Plans) OK except #'s Date FRAMJNG (Continued) o ' g -Setbacks; -Easements -Flood -Slope. a ers-Post Caps -Anchors -Connectors tg., Main; Soils-Steel-Elec. . /.2.. ' Ftg. Depth N. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. '3. Ftg., Garage; Soils -Steel-/ /" Ftg. Depth - Fire lace Ties or Type A Flue -Fireplace Throat Clearance _ 4. Ftg., Porches & Decks; Soils -Steel-/ /"Ftg. Depth . A Access; Size & Romex Protection -Draft Stop -Ins. Baffles 5. Stemwalls, Main; Steel -Bloc kouts-Wrapped AeBdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 6. Stemwalls, Garage; Steel- Bloc kouts-Wrapped Fire Protection Framing 7. Slab; Steel -Wrapped 4trPWerty Line Firewall & Openings 8. Piers -Fireplace Ftg.-Steel Cetxt. Doors -One 3' -Check Garage -3rd story, 2 exits 9. D.W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test t ; Width -Headroom -Rise -Run -Landing -Fire Protection 10. Gas Pipe; Size -Anchors I od on Roof Overhang -Attic Vents -Rafter Outriggers 11. Water Pipe; Test -Anchors -Regulator -Service Test idin -Nailing Veneer 12. Electric; Underground . St co Mesh -Drip Screed -Fd. Vents-Underflr. Access 13. Plenums & Ducts; Clearance-Material-Supprt-Ins. Glazing Area -Glass Protection -Skylights -Plastic 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples <51T . -Shear Walls; Nailing -Bolts 15. Insulation 59, Insulation-Walls-Clg. 60. Infiltration -Wal Is-Wndws Card -B1 Card -131 Date Card -B1 Date Date Card -131 Date Card -B1 Date Card -B1 Date Card -B1 Date Card -131 Date Date PLUMBING (Permit) OK except #'s 16. er Ht. Vent -Access -Combustion Air- Baffle Date FJNAL (Plans) OK except #'s W r Pipe; Test &Anchors -Nail Protection 1 xt. Steps -Door & Sidelight Protection -Landings 10 W.V.; Test-Fttngs & Anchors -Nail Protection X2. Smoke Detector Shower Pan; Test, First Floor -Tub Access X4-Fermaee; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor -Ducts -Meth. Protection 20. Test Tub & Shower, 2nd Floor -Tub Access 21. Gas Pipe; Size & Anchors 4 edroom Exiting G.F.I. & Bath Fixtures & Tub Access -Spa 4Z 15 66. ec. Trim & Subpanel; Breaker Sizes -Labels Card-1310!72Dat! 7-,Card-131 Date 7.�Stairs &Rails Card -Biome Card -B1 Date 8 Fireplace or Stove; Clearances -Hearth at Wood Panel; Int. & Ext. Date ELECTRICAL (Permit) OK except #'stle_ft 22. FI re & Transformer Clearance -Ins. Protection Appliance; Grnd. -Air Gap -Cooking Clearance Uetlec. Receptacles Spacing -Lights & h at Doors 74--&ec�'O�tl2ts & Receptacles at Kit. Counter ;wit 24. Size Boxes & No. of Conductor Sta I it Door; Swing -Landing -Closer UT Ro .ex Installed Close to Edge of & C.J. 7 i aral e -Damper quip. Ground made up w/Mech. Fasteners -Bond Gas & Water Clearance -Comb. Air-Connector-P.R.V.- 74-tn Garage; In Garage; Above Floor-Mech. Protection Above `12772 -Appliance Circuts in Kitchen & Conductor Size/G.F.I. 5. Plb., Elec. & Mech. Equip. Listed for Location IB-Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga. Cu or Al 7 . . eceptacles in Garage; (G.F.I.)-Romex Protec. .20- +enge Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral Yes No Insulation -Foam -Looked in Attic ❑Yes uard Rails & Deck Construction -Post Caps !7ftt! rvice-Riser Conductors & Ground -Main Disconnect aTldn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor r� . Equip. Clearances. Panels-Motors-Mech. Equip. -2�2--e�ethes Closet Light -Shower Light -Spa Light 80. Following instld.; Drives es ❑ No; Walks ❑ Yes 040 Planters ❑ Yes D-fao ♦smoke Detector - inish Card -B1 Date Card -131 Date nnect, Electrical, Plumbing Card -81 Date Card -B1 Date 3. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Openings. Date MECHANICAL (Permit) OK except #'s 8 isconnect, Electrical, Plumbing 4. A.C. Ducts Insulation & Support ; G.F.I. Receptacle -Underground 35. Vent Fan; Exhaust above insulation VC6. Ventilation throughout House 36. Condensate Drain & Overflow; Size & Grade 8LS 37. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet . Corrections from Previous Inpections J 38. Attic Access & Platform if Furnace in Attics -Meters agged; Gas -Electric Wa & Sewer Connected -C/O to Grade -HD Approval Compliance Certificate -Other Certificates Card -131 Date Card -131 Dateergy . Roofing Certificate Card -81 Date Card -81 Date Card -81 04CDDate Card -B1 Date Card -B1 Date Card -131 Date Date FRAM G (Plans) OK except #'s ills roper Material & Anchors Card -131 Date Card -131 Date muds -Nailing, Spacing & Bracing -Plates -Sound Comments at Final: g Walls over Girders & Floor Nailing �ft Stop in Walls (rat proof) it Stops; Furred Ceilings -Stairs -Chases -Tub WT -leader & Beam -Size & Bearing (NOTE: An entry must be made each time you visit job site) 44 COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico— Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872.-6307 CORRECTION NOTICE z1 - 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. ij InspectorT V/Date— / ^�_ �/ 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 R PERMIT A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. Inspector_ "/ Date JCOUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 " APPLICATION AND PERMIT PERMIT N i ASSESSOR PARCEL NUMBER ZONING (k BUILDING PERMIT _ OWN ne_ rx TELEPHONE -r13 b SQ. FT. OCC. BUILDI�NG VALUATIONOWN ' AI NG D (P 1 9!�,-4(010 CO ACTOR'S E I I TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ + Filing Fee ,$' 10.00 LENDER'S MAILING ADDRESS Permit Fee U $ ARCHITECT OR ENGINEER - LICENSE No. Plan Checking Fee $ ,moo Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS �`l 1 W A Permit fee ;S $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 9,(U I� Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME - PARCEL MAP Water piping 5.00 SFO Each qas water heater or vent 5.00 ,may USE OF STRUCTURE SF IXl' Duplex❑ Mobilehome❑ Other 7� SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer _7 .00 -r L 5.100-r- Mobile Home S G W 0-00 ea TYPE OF WORK New ❑ Addition Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: i (.-p Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 00V R Main service 100 AMP ORSLESS 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 iEA.) ❑ as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) 1, as the owner, am exclusively contracting with licensed contract- ors.(Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.eI OR ADDNS. ( ACC. SLOGS. , f �ZCSgft r TLET NEW RES'D, NCH CIRCUITS) NON -R ESID .BRA CH CIRC ITS 2.50 ea POWER APPARATUS &) SINGLE OUTLET CIR. Ex. Occup OUTLETS OR FIXTURES .220 9 09030 FIXED APPLNS Ex. Occup. OUTLETS(RESID ) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ �y WORKMEN'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement,should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 10.00 -Heating Cooling g Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue agains aid County in conse encs of the granting of this permit. G X DateyT a3-�o 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 PFERMIT FE % 4 , $ o e . cows .TYPE ISCHoo R9oo PARC PID ND ISSU U This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC _ PE EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date (21 Zj.'y Receipt No. 1 7 3 /713 gBy WHITE-D.P.W.. YELLOW-A3eC3S0K. PINK -INSPECTOR. LD N • r/ /./FAvP9rd 0InAjrk,v!L, Ir COUNTY OF BUTTE - DEPARTMENT.OFwPUBLIC WORKS - BUILDING DIVISION r- 7COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET 1 Permit No. OWNER A. P. No. 73-Ia-q�o Proposed Building Use Rd�1`h� SIf' Building Inspector Date 51�31Sg 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. n. 5. Plans with Energy Design Compliance Statement. . . . . . _ 6. Qf^G6I(1.e,- School District "Fees Paid" Stamp on Floor Plan. 7 Statement of Intent for Non -Heated and AC Buildings, 8. Fees of $ 0 ,zzz-y -t ,s. (S Z � //- A,1 . C, CVz*.f 9. Letter of signature authorizea,tion.. _ 710. Sanitation approval from V�yl t �_ Health Dept.. 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . . x/1.3. Contractor's License Information (no., name style, classif.) 57 14. Owner -Builder Verification (Given to owner Mail to owner[] _15. Improvements may be required. 16. Mobilehome Installation Data. . . . . . . . . . Pre -Ins ec. request to 17. Pre -Inspection for Required. Building Inspector (Datej` 18. Recorded copy of Agricultural Acknowledgment Statement. 19. Driveway Permit. 20. Plot plan approval from city of -- 2 1 f21. Engineered trusses'in duplicate (required prior to plan check). When ou issue the permit, process as follows: Mail to owner, Mail to contractor. Telephone G39-9390 and hold for pickup atmoffice, Deliver w/inspector. Other Applicant� �`°uf ante S -d 3- &'k Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitted 1. Index permit for above items No. - 2. o._2. Additional items required -.- t issuance: (Circle new item not checked above). Contractor, designer, owner, was advised of above required 'data by_phone_mail—counter by date Contractor, designer, owner, was advised of above required data by—phone —mal Icounter by date ` Plans checked by -211Z� Date a S Plans approved by Z=ouDate 2- Sets of plans on hold in File cabinet i/ AP folder Copy—DPW .$4- i TO Buildinv Department FROM: Environmental Health SUBJECT: Sanitation Clearance �- Owner O Location AP# Plan Approved for: Sewage Disposal Water Supply Hold final for: Water Supply Final clearance O.K. for: Water Supply Clearance for _ Other � y NOTE * * * Sanitarian Date i BUTTE COUNTY,SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM (One Form per Building) } A.P. Number �%3-%,- Building Department No. School DistrictdhiA, P��rn City Q County �® Jurisdiction Property Owner Project Location/Address g(o %a Subdivision Lot Number Residential Development: Sq. Footage +.57 /# of.Living MHI Addition (Group R) / Units I Commercial/Industrial: a Sq. Footage New Addition (Including Exterior T Roofed Areas) Building Department Representative Date District Id No. (o o& a School District certifies that (A ,plicant Name) (Phone Number) 9 40g, rte, (Street Address) (City) (State) (Zip Code) has complied with the requirements of Resolution No.. 60 by the pay ent of $ representing 4176 square feet. s-, x School Dist r' Representative Date PAID BY CHECK NO. BANK NO PAID BY CASH REMARKS: white -applicant, yellow -building department, pink -school district i SCHOOL . FEE (5/88) COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 OWNER -BUILDER VERIFICATION t� 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) /10 2. -I (have/have not) IIIAt 2- 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 46rid_4 &.(-(4 Address PO X $(p City wjlrrnp Phone 53a-94`1�i Contractors License No.�9L9 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 !see- # 3 adbo- — 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: �� /1 Property .Owner ./�WY) Social Security Number� Date S'a3-Fly 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. I I FORM 7 ADDITIONS TO RESIDENTIAL BUILDINGS ENERGY SHEET 'PACKAGE "A" (Additions) Owner ,,�Y�I�J/'% Climate Zone Permit # /s�4 -�i Floor Area ,S 0 The following data showing mandatory and required features of Package "A" shall be installed for additions to dwellings. Additi-ans"•to dwellings include room additions, converting garages and patios to living areas, house moves that add footage and attic conversions,.and any space that is existing non -conditioned. space that is converted to conditioned space. Remodeling of existing conditioned space is not included. , ZONE 11 ZONE 6 APPLIES TO NEW'AREA O CEILING R-30 R - WALL R-11 R- 0 FLOOR R-11 R 19 SLAB R-7 -7 GLAZING U-.65 (Dual) -.65 (Dual) Q SHADING SOUTH - OPTIMUM OVERHANG or .36 Shading Coefficient WEST .36 Shading Coefficient LOOSE FILL INSULATION (Density) O INFILTRATION CONTROL (Weatherstrip doors, certified windows, caulking) VAPOR BARRIER (Zone 16) - DUCTS PER UNIFORM MECHANICAL CODE - Ch. 10 0 LIGHTING KITCHEN & BATH•NOT LESS THAN 25 LUMENS/WATT Q MAXIMUM .GLAZING 16% OF - AREA PLUS REMOVED GLAZING v. f /�� //b •l� 0 NEW HEATING, VENTILATING, AIR CONDITIONING AND HOT WATER SYSTEMS IN CONJUNCTION WITH AN ADDITION SHALL BE INSTALLED AS SHOWN ON BACK OF THIS SHEET. OTHER 12/85 *1 HEATING, VENTILATING, AIR CONDITIONING SYSTEM (A) Heating ❑ 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 ❑ Other (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 capacity at 95°F) ❑ Other (describe) DOMESTIC WATER SYSTEM ❑ • (A) Gas Only Gallons (brand and model number) (tank size) ❑ Heat Pump w/Electric Backup (brand and model number) Gallons 2 (tank size) [3* Active Solar (collector brand and model number) (rated y -intercept) (rated slope) (solar fraction) ft (backup heater type, brand and model number) (collector area) (collector orientation) (collector tilt) ❑ Location of Solar Panels ❑ Other (Describe) *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 °, elevation ', heating load BTU elevation factor x heating load maximum outlet capacity gas furnace BTU Cooling: Summer design temperature ", cooling load BTU *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. SIGNATURE OF BUILDING DESIGNER OR APPLICANT d Spee�fic0{ ,unlawful { / s an and - wi{IiOat t Ot Pko k 11 {imes On some �{ p�b1�G o {hL�an9cs YeTcnissi°n { SU08• 0. WOTVS. COU NOTE:—AO Materials &Workmanship SFia(f�e�i�r--� - Accordance with Recognized Good Practices aid of a quality prescribed for the Specified use in the kkJorm Building, Pluming & Maahani ''� Electrical Code. j a setba � • � �-S� � A.8 i3tiq lies a ea 4� \ 8& §1 ishall be S& §1 r °� ?%?Ov`lr�� us of e4 efi-f5 _s k 1 t 1} •_� �. j 1. 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