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073-340-008
73-34-08 ydALTER JACKSON & BETTIE :IARTIN -- 121 Kristy Crescent -Rd, Forbestown Permit#3617-88P,E(util, MH) travel trail ELEC. GAS SUPPORT STRUCTURE REQ. COMPACTION TEST REQ. 73-34-08 PErmit#3618-88B,P,E,M(newsingle family) Permit#830-90 73-34-08 Ost renewal/3618`88) '��,,,,. 73-34-08 Permit#1028-91B (2nd renewal/,3618-88)��� 73-34-0892-1387B JACKSON,;& MARTIN 121:-.Kirsty.Crescent Rd, Forbestow j 34d renewal/8873618'11 . .�..IL ��/ 073-34-0-008 93-1313 B JACKSON.& MARTIN 121 KIRSTY.CRESCENT_RD,-OROVILL COMPLETE/88=3618 073-340-008` / 94-1247 JACKSON, -Walter-&_ MARTIN, Bettie 121 KIRSTY CRESENT, FORBESTOWN 8, COMPLETE BP#3618-88.• M�a� F- 'Ife��ur Lo DPW' AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8.1 of. the BuLte County Code requires this acknowledgement be recorded pr:i.or to oi.ssuance of -,.a building permit. 88-038207 ; Rec Fee 7.00 The property described herein is adjacent ; Cash 7.00 to land or :included within an area zoned Recorded .I'or agricu.l.Lural purposes, and residents Official Records of. Lhi.s property may be subject to incon- County of ; ,4,:, -;�LA-d--r ✓l veniences or discomfort arising from the Butte use of agricultural chemicals, including, Candace J. Grubbs but not :limited to herbicides Recorder ; pesticides, ; and fertilizers; and from the pursuit. g :07am 9 -Nov -88 BG 2 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 esLabl .i shed ;i;;r i cii I Luray zones which have as a priority use for productive agricultural purposes, Mid resideu! : within said zones and on adjacent property should be prepared to accept such or disconform from normal, necessary :farm operations. All. that. real property situate in the County of Butte, St.ate'.'tif: Cali.forni;t, ;is fol.l.ows: Date: �� \ PROPW sRS : State or ��6`1mOn this the day of 19_�L, he l'orc im , SS. the undersigned Notary Public, personally appeared County cif r, ,._•_- _ .. _-,.__,��,". ❑ Personally known to me. ® Proved to me on Lhe hrisis ^ • of satisfactory evidence. PAUL E. DEAGAICH y Notary Public -CalifomA to be the persons) whose name(s) �Y'E'_P ALAMEDA COUNTY subscribed to the within instrument and acknowledged !.h;t! _ �: 261991 executed the same for the purposes therein contained. IN WITN I;tiS WHEREOF, I hereunto set my hand and official seal. Present A.P. No. "` )J_'_ Notary Public C - t. ORDER NO. BU -98752-3 DESCRIPTION ALL THAT CERTAIN REAL PROPERTY SITUATE IN THE STATE OF CALIFORNIA, COUNTY OF BUTTE, DESCRIBED AS FOLLOWS: PARCEL I• LOT 7, .AS SHOWN ON THAT CERTAIN MAP ENTITLED, "WALDENPOND ESTATES, PHASE I", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON FEBRUARY 4, 1987, IN BOOK 104 OF MAPS, AT PAGE(S) 72 AND 73. RESERVING THEREFROM A RIGHT OF WAY OVER KRISTY CRESCENT ROAD, AS SHOWN ON SAID MAP. PARCEL II: A RIGHT OF WAY FOR INGRESS AND EGRESS AND PUBLIC UTILITIES, OVER KRISTY CRESCENT ROAD, AS SHOWN ON THAT CERTAIN MAP ENTITLED, "WALDENPOND ESTATES, PHASE I", WHICH MAP WAS RECORDED IN THE OFFICE OF THE RECORDER OF THE COUNTY OF BUTTE, STATE OF CALIFORNIA, ON FEBRUARY 4, 1987, IN BOOK- f04 OF MAPS, AT PAGE(S) 72 AND 73. EXCEPTING THEREFROM ALL THAT PORTION LYING WITHIN THE BOUNDS OF PARCEL -I, DESCRIBED ABOVE. t A t t PERMIT NO. PERMIT EXPIRES OWNER WALTER JACKSON & BETTIE MARTIN I CONTR. owner ASSESSOR PARCEL 73-34-08 l LOCATION 121 Kirsty Crescent Rd, Forbestown I . Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E Temp. Gas Service Called PG&E JOB FINALED (Date) �I Signature Af ''41 = OK 0 --'Not OK = Notflea*abie MOBILE HOMES MISCELLANEOUS 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-Conrf ctors-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-Beams-Rftrs.-Connec.- Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 6. Gas; Location -Test -Wrap: / P'L"ft. / /"Nat. or/ P' ft./ P'LPG 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. 8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh Card -131 Date Card -131 Date 10. Roof; Shthg-Roofing Card -81 Date Card -131 Date - 11. Ext.; Steps -Doors -Landings Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Card -131 Date Card -81 Date 2. Footings; Size -Spacing -Marriage Line Card -131 Date Card -131 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 - Dead Men -Lining 8. Gas and Electricity Tagged 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 8. Elec.;Grounding; Equip. w/5' -circulating Equip. -Pool Lghtg. Boxes -Enclosures -Panel boards -Ins. to Main in Conduit Card -81 Date Card -B1 Date Card -131 Date Card -B1 Date 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Card -61 Date Card -131 Date Card -131 Date Card -131 Date f 0 =OK o = Not - =Not Applicable RESIDENTIAL (Single and Duplex) =, Not Ready Date —UNDERFLOOR (Plans) OK except #'s gr,:Mai n f Ele6. F -6d.=// /" Ftg. Depth ] /c/ e; Soils -Steel-/ /" Ftg. Depth Ftg., Porches & Decks; Soils -Steel-/ /"Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel- Blockouts-Wrapped 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test 10. Gas Pipe; Size -Anchors 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric; Underground 13. Plenums & Ducts; Clearance- Material-Su pprt-Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Insulation Card -B1 a and -61 Date Card- Date ' Card -131 Date Date PLUMBING (Permit) OK except #'s 1.6. Water Ht. Vent -Access -Combustion Air -Baffle 17. Water Pipe; Test & Anchors -Nail Protection .18'D.W.V.; Test-Fttngs & Anchors -Nail Protection hower Pan; Test, First Floor -Tub Access 2 es b & Shower, 2nd Floor -Tub Access Gas Pipe; Size & Anchors Card-BDate �/ - Card -B1 Date Card -131 Dat Card -81 Date Date ELECTRICAL (Permit) OK except #'s 22. F!Xturej&Transformer Clearance -Ins. Protection Elec. Receptacles Spacing -Lights & Switches at Doors . Si a Boxes & No. of Conductors -Stapled . Rqmex Installed Close to Edge of Studs & C.J. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water .27�2 Appliance Circuts in Kitchen & Conductor Size/G.F.I. . Subfeed Wire Size / / ga. Cu orXaA.C. Wire Size / /ga. Cu or Al / ga. Cu or -Oven Circ. / / ga. Cu or AI. In�ted Neu I Yes No er 'ce-Riser Conductors & Ground -Main Disconnect . Clearances Panels-Motors-Mech. Equip. CILAhes Closet Light -Shower Light -Spa Light 33 Smoke Detector Card -131 Date : Z q and -B1 Date Card -131 Dat Card -131 Date Date MECHANICAL (Permit) OK except #'s 34. A.C. Ducts Insulation & Support 35. Vent Fan; Exhaust above insulation 36. Condensate Drain & Overflow; Size & Grade . 37. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet 38. Attic Access & Platform if Furnace in Attic Card -131 Date Card -131 Date Card -131 Date Card -131 Date Date FR ING (Plans) OK except #'s S�ileProper Material & Anchors 4 W s St ds -Nailing, Spacing & Bracing—Plates-Sound 4 r' g Walls over Girders & Floor Nailing icp!totop in Walls (rat proof) e Stops; Furred Ceilings -Stairs -Chases -Tub Header & Beam -Size & Bearing Date FRA_kUN>a(Continued) 48.Hangers- Caps -Anchors -Connectors 4 n . Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. fireplace Ties or Type A Flue -Fireplace Throat Clearance 48 -Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles Windows or Exiting Doors -Sill Hgt. & Dimensions Gaffe Fire Protection Framing ro y Line Firewall & Openings ,42 -Ext. Doors -One 3' -Check Garage -3rd story, 2 exits idth-Headroom-Rise-Run-Landing-Fire Protection ywood on Roof Overhang -Attic Vents -Rafter Outriggers 5 iding-Nailing Veneer c - rip Screed -Fd. Vents-Underflr. Access aZ-atifi-ing Area -Glass Protection -Skylights -Plastic 56._Sh alts; Nailing -Bolts 59. Insulation-Walls-Clg. 60. Infiltration-Walls-Wndws Card-BDate i' Card -B1 Date Card -131 Date Card -131 Date Date FI L Plans) OK except #'s 141�1. Steps -Door & Sidelight Protection -Landings Smoke Detector wq63--m-wace; Vents -Clearance -Comb. Air-Connector- In,Garage; Above Floor-Ducts-Mech. Protection .F.I. & Bath Fixtures & Tub Access -Spa ec. Trin-1,WSubpanel; Breaker Sizes -Labels Rails Fireplace or Stove; Clearances -Hearth Outlets at Wood Panel; Int. & Ext. . ixt. & Appliance; Grnd. -Air Gap -Cooking Clearance Elec. Outlets & Receptacles at Kit. Counter e Fire Door; Swing -Landing -Closer -Z2-- "Duct in Garage -Damper tr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In-Garage; Above Floor-Mech. Protection PIb.,Elec. & Mech. Equip. Listed for Location 7 lec Receptacles in Garage; (G.F.I.)-Romex Protec. sulation- Foam- Looked in Attic ❑ Yes uard Rails & Deck Construction -Post Caps dn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 80. Following instld.; Drive ❑ Yes 0.+Z -,Walks ❑ Yes n'1Vo•, Planters ❑ Yes ❑ No cco; Brown -Finish A.C. Unit; Disconnect, Electrical, Plumbing ents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Ad%Water Well; Disconnect, Electrical, Plumbing xt •ior Elec. Trim; G.F.I. Receptacle -Underground entilation throughout House �YCiI s`Protection rections from Previous Inpections Test -Meters Tagged; Gas -Electric �(ate & Sewer Connected -C/O to Grade -HD Approval Energv Compliance Certificate -Other Certificates Card -B1 Date�- and -81 Date Card -B Dat / and -81 Date Card -B1 Date and -131 Date Comments at Final: (NOTE: An entry must be made each time you visit job site) ,;. �. � .y ... _f.:- i'•-mx;F� .,,�5irt.s`��9,;.',`,.,.""..- Y . a.. w.i �� 1 . � 073-340-008 94-1247B JACKSON, Walter & MARTIN, Bettie ' 121 KIRSTY CRESCENT, FORBESTOWN COAMPLETE BP#3618-88 f 5 --yS } { t ..� -r y - PA COUNTY OF`BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION i"CQunty Center Drive - Oroville, California. 95965 - Telephone (916) 538-7541 ,EERMIT NO. APPLICATION -.AND PERMIT 2 !�y - /;J y - ASSESSOR PARCEL NUMBER In 073-340-08 ZONING U BUILDING PERMIT OWNER ELEPHONE WALTER JACKSON/ BETTIE MARTIN 569-8461 SQ. FT. OCC. BUILDING VALUATION T 1X000.00 OWNER'S MAILING ADDRESS t - i PO BOX 274 i70RBPST0WN 959941 CONTRACTOR'S NNAryA��M�EE���� llAl�rl� TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOW Total Valuation Is Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ 15,00 ARCHITECT OR ENGINEER LICENSE NO.:, Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 121 KIRSTY CRESCENT ,t. PERMIT FEE $ 35.00 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 v Solar or heat pump water heater 23.00 Water piping 15.00 LOT NO. SUBDIVISION'S NAME PARCEL M ^. Each gas water heater or vent 15.00 USE OF STRUCTURE SF OX Duplex O Mobilehome O Other SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 TYPE OF WORK New ❑ Addition O Remodel ❑ Utilities ❑ Installation ❑ Other O Describe Work: PERMIT TO 6MV= PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service BOON OR LESS ( 200A 0R LESS ) 23.00 .: ",�• Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( 6 ACC. BLOS. ) 3.5C FSTO,. CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) w O 1 am a licensed under provisions of Chapter 9, Division 3 of the Busin end Professions Code and my license is in full force and effect. �License No. Classification f, as the owner, or my employees with wages as their sole compensation, ill do the work, and the structure is not intended or offered for safe. (Sec 704'-) O I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) ❑ lam exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET NON.RESID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) & SINGLE OUTLET CIR. X. Occup. ( OUTLET OR FIXTURES ) BAL. @ 1.50 Ex. Occu FIXED APPwS. OR Occup. ( OUTLETS IRESID.I EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23,00 WORKER'S COMPENSATION INSURANCE r' 1 declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a CW.titrcate of Consent to Self -insure. tlorsohall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all Butte County Ordinances and California State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of•this permit! X .d - Date _ Signature of Applicant - ❑ Owner ❑ Contractor O Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ ocC CONST. TYPE TOTAL FEE $ 35.00 HAZ. I D. FEES IMP I FLOOD COF PARCEL I PD HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. 7 y By ,,%.��.9�r(�-� Date PERMIT EXPIRES ON /Date/ Receipt No. 162638 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT I �•.�.:,''^'T-A. .k..: -fin _. Iw.... I.ri• ... �ti .. � . ENERGY INSTALLATION CERTIFICATE Building Owner Building Location Building Permit # DESCRIPTION OF INSULATION ROOF Material Brand Name A%yt////6y- Thickness(inches) Thermal Resistance (R Value) )EXTERIOR WALL Material I 1 4, Brand Name Thickness(inches) �— _ Thermal Resistance(R Value) CEILING Batt or Blanket Type Brand Name Thickness(inches.)_ j' Thermal Resistance(R.Value) r , Loose Fill Type Brand Name , Minimum Thickness(Inches) Area Number of Bags Wt. per bag lb. covered(ft.?) Thermal Resistance(R Value) OR, ELEVATED toterial 42 Brand Name Thickness(inches) fo Thermal Resistance(R Value) FLOOR, SLAB Material Brand Name Thickness(inches) Thermal.Resistance(R Value) Width(inches) FOUNDATION WALL - - - - Material N` Brand Name Thickness(inches) Thermal Resistance(R Value)— I hereby certify that the above insulation was installed in the above building, is consistent -with approved building -department- plans -and -attachments--and- con- forms witli requirements of Chapter 2-53 of State of California Energy Requirement FIRM NAME/OWNER STATE CONTRACTOR'S LICENSE NO. SIGNATURE OF INSTALLATION APPLICATOR DATE I hereby certify the required features, devices, and equipment, ab shown on the approved Building Department—plans—and attachments have been installed and conform to the appli- ance standards and Chapter 2-53 of the State of California Energy Lequirements. UILDING CONTRACTOR/OWNER (Please Print) STATE CONTRACTOR'S LICENSE NO. (FIRM NAiME) GNATURE OF BenING CONTRACTOR/OWNER kA --TE HVAC FIRM NAME/OWNER (Please Print) SIGNATURE OF HVAC CONTRACTOR/OWNER STATE CONTRACTOR'S LICENSE NO. DATE THIS CERTIFICATE MUST BE ON FILE WITH THE.BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION APPROVAL AND A COPY SHALL BE POSTED WITHIN THE BUILDING. SEPTEMBER 1988 •M 'J COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive- OroviRe, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 73-34-08 ZONING 1 BUILDING PERMIT OWNER WALTER JACKSON BETTIE MARTIN TELEPHONE 415-569-8461 SQ. FT. OCC.1 BUILDING VALUATION OWNER'S MAILING ADDRESS 1127 84th Ave Oakland CA 94621 CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 1000 LENDER'S MAILING ADDRESS Permit Fee 1 $ 197.00 ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 121 Kirsty Crescent Rd Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ®XXDuplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uti lities ❑ Installation ❑ Other ❑ Describe work: 1St rP>a.ewal,13618=88 _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service BOOV 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. nse No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.& OR ADDN5. ACC. BLDGS. , /zQsgft NEW RESID. RANCH TLET NON -R ESID BRANCH CIRC ITS CIRCUITS) 2,50 ea POWER APPARATUS & SINGLE OUTLET CIR. Ex. Occu po UTLETS OR FIXTURES 20050¢ eAL030 FIXED APLNS. Ex. Occup. OUTLETS PRESID )REA.) 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 Ce ficate of Workmen's Compensation Insurance or a Certificate 0 onsent to Self -Insure. 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 liabiliti s judgments, costs, and expenses which may in any way accrue against sa' ou y i consequence o the grant' of this permit. X .�" ate 2-26-9/o "26`9/o Signature of pplicant — 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. df Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE AL TOTAL FEE E HAz CUA PARK E I PAR PD Is This permit is hereby issued under sions o e Butte County. Code and/or wor Indi ated above for which fees DI OF P B PERMIT EXPIRES Date ____5/4 the applicable provi- resolutions to do have been paid. WORKS Date ,[ Receipt No. O� �/ 3 WHITE-D.P.W.. YELLOW -ASSESSOR, PIN - R, COLDEN D -APPLICANT COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 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 im rovement (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 74 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 Number /- Date 3 —,P-6 - 9Q 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. Il r COUNTY OF BUTTE;- DEPARTMENT OF PUBLIC WORKS 7 County Center Drive_- Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASS SOPARC L UMB � — — ZONI G ' BUILDING PERMIT D N �. T EP oN -s - SQ. FT. OCC. BUILDING VALUA ION OWNE MAIL ,(a IDRE 'L/( i'I h -CA 950 O RACTOR•S NAME EPHONIV N RAC OR'S MAILING ADDRESS Fireplace CO TRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ . Permit Fee $ ARCH TECTT OR ENGINEER LICENSE No. Plan Checking Fee V Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRES I RA Permit fee $ PLUMBING PERMIT FiIingFee 10.00 Each Trap 2,00 r Solar or heat pump water heater 20.00 LOT NO. SU BDI VISION NAME PARCEL MAP Water piping 5,00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehomeg Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S O.00ea TYPE OF WORK New E-1 Addition [_1 Remodel ❑ Utilities Inst llation❑ Other F1 Describe work: Tr,2 12,a ra f L ►'` Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6001 OR LESS 100 AMP OR LESS 10.00 Q Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check One): ❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is In full force and effect. License No. Classification 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.S� , OR ADDNS. ( ACC. SLOGS. /20sgft NEW CONSTR. U TI.OUT LET NO N.RESID .BRANCH CIRC ITS 2.50 ea POWER APPARATUS e) SINGLE OUTLET CIR. Ex. OCcU OUTLETS OR FIXTURES p 20A50teAL990 FIXED APP LNS. OR EX. Occup. OUTLETS (RES1O.) EA.) 2.00 Temporary service 10.00 _ Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement,should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3,00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the 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, an expenses which may in any way accrue against said Count in consequence f e r permit. 0 r).,. �'� Date Signature of Applic Own 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 oeeuP. coNST.TrPc JSCH00Lt1',1**J PARCEL PD HD Is This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTO OF PUBLIC _ BY PEWIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date `�" Receipt No. WHITE-D.P.W.. YELLOW -ASSESSOR PINK -INSPECTOR. aOLDEMROD-AP►LI CANT • '"y" •+r.� .r",x l' s-rsli.'�Y•r .`r'S' f.-``.tv�7K+[ rw�� riW r, ..^.. ' c"ua°'Sivrwy'YS�`�'. S•`j-�. '�•'Y'�r�'".+"r.v3 r-.•vtit'-:.t .� ...� .` - u COUNTY OF BUTTE - DFIPARZTMENt 00,°,,PUIIBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE,. CALIFORNIA 95965 -TELEPHONE: 916/538-7541 PERMMIPPLICATION DATA SHEET — U (�GC'��9 Permit No. /� e OWNER �La&V_ Ar#je' X:ylilln 4 A. P.KID. Proposed Building Use T Building'Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and:/or issuance: DATE RECEIVED APPROVED 1. All items. have een submi . -d,—_ - _�2. Plot plans in duplicate r igned by preparer of plans. 3. Complete plans In up icate./triplicate, signed by preparer of plans. 4. Complete engineered plans and calcs, with wet signature on plans. 5. Plans vith Energy Design Compliance Statement. . . . . 6. /IJ School District "Fees Paid" Stamp on Floor Plan. 7 Statement of Intent for Non -Heated and AC Buildings. 8. Fees of $ , . , , . , , • 9. •0. Letter of signature authorizati�] Sanitation approval from V �� V ►•�/�" Health Dept. r� 11. Planning approval for (A) Use: (B) Parking: 12. Certificate of Workmen's Compensation Insurance. . . . . .. 13. Contractor's License Information (no., name style, classif.) 14. Owner -Builder Verification (Given to owner❑, Mail to owner ❑ ) _15. Improvements may be required. . . . . . . . , , , , 16. Mobi lehome Installation Data. . 7. Pre-Inspec. Pre -Inspection for Required. Building Inspector request to l°qje) ' Recorded copy of Agricultural Acknowledgment Statement. 1'�f8 Driveway Permit. f 20. Plot plan approval from city of �: 21. Engineered trusses in duplicate (required prior to plan check). ✓22. When you issue the permit, process as follows: Mail to owner, Mail to contractor. Telephone and hold for pickup at office, Deliver w/inspector. Other Applicant``,'''' ' p Z i % rC 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. as 2. Additional items required: Contractor, designer, owner, was advised of above required data by—phone---Mail —'counter by date Contractor, designer, owner, was advised of above required data by—phone —ma ll—counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW TO Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance E, )71 00 Owner. T-ocalcigrt AP# .. . Plan Approved for: Sewage Disposal v Water Supply Hold final for: Final clearance O.K. for: Clearance for !� Water Supply NOT *** San ar an Date COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 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/have not) ligned an a plication 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 Social Security N Date 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. X, I I - Z�O� 3 Von GaIdern Engineering Company • 430 Second Street Yuba City, CA 95991 916-673-6330 NUCLEAR COMPACTION! TEST DATA LOCATION t -JIM - P,tA--) v.-, VIATERIAL 4--2e-/ 7 c , lgu Ale 61 DATE-- >�' �' TAKEN BY 40., Q TES T NL; ;SER STATION LOCATION OF TEST p�•-GI, 775wt `—'— DEPTH DENS. CNT. 3716 WET DENS. DRY DENS. alv, ._a- 17,0 o q G, LAB MOISTURE Z,sr _MOISTUREf- ' OISTURE STD. DENS. 3.� 3 i 1a 3, 3 I 1 Y,Z l o3„t OPT. MOISTURE /D. S", i0.r1l WET % COMP. 1 ~" DRY % COMP. REMARKS: • IMPACT TEST DATA INITIAL WET WEIGHT OF TEST SPECIMEN (GRAP,15): ------------------------- -------------------------- INCREMENT 1 2 3 4 ----- ---- ----- ----- - - - -- --------------------- WATER ADJUSTMENT (GRAMS) . (vP 7c, 4-Ug�� TAMPER READINGII ll ll� ___ _-_-_ -___ - - -- - - - -- WET DENSITY (13, L ► L ll�{- 2 Q" - - PERCENT RELATIVE COMPACTION- - - - - - - - - SPECIFICATIONis /PASSED k19U J Y6 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION A& PERMIT PERMIT NO. Q 2 - L:3257 ASSESSOR PARCEL NUMBER ZONING 73-34-08 ` U BUILDING PERMIT OWNER EPHONE T WALTER JACKSON/BETTIE MARTIN � ELL '1 SO. FT. OCC. BUILDING VALUATI N OWNER'S MAILING ADDRESS 7 L , 1� XENEWAL CONTRACTOR'S NAME © —7 OTrIP1ER PHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 1.55,00 Permit Fee a FEE $ 197.0 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDINGADDRESS RYIpSlY CRESCENT _.� li "' .;� "ORBESTGTr1N Permit tee $ 212.00 PLUMBING PERMIT Filing Fee 15.00 Each Trap 1 5.00 Solar or heat pump water heater 1 20.00 LOT NO. SUBDIVISION NAME 7PARCEL MAP Water piping 1 7.00 Each qas water heater or vent 1 7.00 USE OF STRUCTURE SF EX Duplex[] Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home I S I G JW @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Otherff Describe work: '?Ri3 IR7%,Tri'IAT Cp 21P 3618-3R _ —�18T/839-p0, 9DTn/1n28-9i Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 00V OR LESS Main service 200A OR LESS 18.50 Main service 200A TO 1000A) 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): _ ❑I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. Icense No. Classification el, 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) ❑ l; as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ 1 am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING OCCUP.N\ OR ACDNS. ACC. BLOGS. / 3.64 sq.ft. NEW CONSTR. MULTI -OUTLET NON•RESID BRANCH CIRC ITS @ 5.00 (POWER APPARATUS h) SINGLE OUTLET cIR. EX. OCCU o p UTLETS OR FIXTURES 20 76 Ex. Occup. OUTLETS ((RESID )REA.) I 3.00 Temporary service 15.00 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 KfsConsent to Self -Insure. hal not employ any person in any manner so as to become subject the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 15.00 Heating Cooling g Hood 6.50o Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, j d .ents, costs, and expenses which may in any way accrue f ermit. against s id y cons uence of t e �n'ate��,-2S. X Signature of Appli nt — ownerrCactor ❑ Agent ❑ Si OSHA ion of structures 39storiees-oineheer 5'0" deep and demolition or construct- Mobile Home Installation Fee S Energy Inspection Fee $ OCC CONST TYPE TOTAL FEE $ 212.00 HAz 1) FEES IMP FLOOD cDF PARCEL PD HD ISSUE I This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DRE TO F PUBLIC By PER XPIRES Date 5_3_Q3 applicable provi- resolutions to do have been paid. WORKS Date �to)veerr Receipt No. / /JSD47 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - Department of Public Works 7 County Center Dri-y6;'Oroville, CA 95965 Phone: 916-538-7541 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/have not) LAJ_Li 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 / / A Address / City Phone Pontiictors License No. 4.-1 plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and.pro-,ide the major work: Name Address City Phone C ntr &tors License No. 5. I will provide some of the work but I have contracted (hired) the following persons -to provide the work indicated: MMMn AAA -race Piinna Tena of T.Tnrl- S ig n e d : Property Owner Social Security Number / - - Date 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 t. the permi COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovlller California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. to ASSESSOR PARCEL NUMBER 73-34-08 ZONING BUILDING PERMIT OWNER Walter Jackson/Bettie Martin 415 TELEPHONE 569-8461 SO. FT, OCC, BUILDING VALUATION OWNER'S MAILING ADDRESS 1127 84th Ave. Oakland CA 94621 CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee 1FFF $ 197 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 121 Kirsty Crescent Rd. Forbestown Permit fee $ ?n7 nn PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping , 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SFK3 Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S FG J7WT7 0.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ OtheX® Describe work: 2p.d. Qf R12#361$ QQ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check One): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business d Professions Code and my license is in full force and effect.SINGLE License No. Classification, I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.p OR ADONS. ACC. BLDGS., /Z0sgft NEW CONSTR. MULTI -OUTLET NON-RESID BRANCH CIRC ITS POWER APPARATUS &) OUTLET CIR. Ex. OCcup(OUTLETS OR FIXTURES 200600 SALO so FIXED Ex. Occup. OUTLETS P(RESID )REJ1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate Cnsent to Self -Insure. I shaoll not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed.revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against :gUall liabilities, judgments, costs, and expenses which may in any way accrue agai s Co ty ' co sequen a the ran 'ng of this per it. ate _2z Signature of Applicant — Owner ontractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ E 207.00 HAz. CUA- PARK SCHL FLo PAR PD ) HD. ISSU This permit is hereby issued unaertne sions of the Butte County. Code and/or work i0kcat.2d above for which f D I RAVI OF P Rk B PERMIT EXPIRES Date 5—'1-99 applicable provi- resolutions to do s have been paid. WORKS Date Receipt No. WHITE-O.P.W., YELLOW-ASeESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT 1 c � �P7_4� COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 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 imp ovement (yes or no) 2. I (have/have not) igned an ap ication for a building permit for the proposed work. 3. I have contracted with the f711,1 construction: Name Address Phone 4. 1 111a to provide portions of/ this to coordinate, supervise, and prov Name / ER Address Phone Cntr, person (firm) to provide the proposed City s License No. rk, but I have hired the following person the major work: rs License No. City 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 Securit Number — . ,% Date 2 ' , — 9/ 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. PERMIT NO. ,M PERMIT EXPIRES NO WNER WALTER JACKSON & BETTIE MARTIN =O CONTR. owner ASSESSOR PARCEL 73-34-08 LOCATION 121 v_'fsty n_ _BEentRd L+...,.bes h_ do i; •moi,... � �,.��s:�v-�--- OFFICE COPY 'i t Address GAS i3 f l� Da Meter By I E LEC.flI C pd• Meter By i Temp. Power Pole Called PG&E emp Elec. Service A Called PG&E Temp. Gas Service Called PG&E JOB FINALED (Date) Signature i i = OK `D=Not OK ' = Not Readyable MOBILE HOMES MISCELLANEOUS 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 4 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: / /"L"ft. / /"Nat. or/ /"L"ft./ /"LPG 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. 8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh Card -61 Date Card -B1 Date 10. Roof; Shthg-Roofing Card -131 Date Card -B1 Date 11. Ext.; Steps -Doors -Landings Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Card -131 Date Card -131 Date 2. Footings; Size -Spacing -Marriage Line Card -61 Date Card -61 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 - Dead Men -Lining 8. Gas and Electricity Tagged 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 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 Card -131 Date Card -131 Date 9. Health Department Approval • 10. Plumb.; Cir. Test -Water Supply Test Card -131 Date Card -131 Date Card -81 Date Card -131 Date a 1 =OK 0 = NotOK RESIDENTIAL (Single and Duplex) - =Not Applicable =• Not Ready Date UN LOOR (Plans) OK except #'s pr Z ing-Setbacks;-E sements-Flood-Slope 3 tg ain So' to Elec. Grnd.-/ /" Ftg. Depth _ g., Garage; Steel-/ /" Ftg. Depth 4. F ., Porches & Decks; Soils -Steel-/ /"Ftg. Depth . temwalls, Main; Steel- Bloc kouts-Wrapped r t!Stemwalls, Garage; Steel- Blockouts-Wrapped 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test Gas Pipe; Size -Anchors 14 -'Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric; Underground 13. PI nums & Ducts; Clearance- Material -Su pprt-Ins. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Insulation Card -B1 Q Date rJV_<Y'!�Pard-B1 Ce Date'. Card -131 OCI Date 'i >.').vv9 Card -B1 c-tjB Date y Date PLUMBING (Permit) OK except #'s 16. Water Ht. Vent -Access -Combustion Air- Baffle 17. Water Pipe; Test & Anchors -Nail Protection 18. D.W.V.; Test-Fttngs & Anchors -Nail Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, 2nd Floor -Tub Access 21. Gas Pipe; Size & Anchors Card -B1 Date Card -B1 Date Card -81 Date Card -B1 Date Date ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection 23. Elec. Receptacles Spacing -Lights & Switches at Doors 24. Size Boxes & No. of Conductors -Stapled 25. Romex Installed Close to Edge of Studs & C.J. 26. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 27. 2 Appliance Circuts in Kitchen & Conductor Size/G.F.I. 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga. Cu or AI 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral Yes No 30. Service -Riser Conductors & Ground -Main Disconnect 31. Equip. Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light Card -81 Date Card -81 Date Card -B1 Date Card -B1 Date Date MECHANICAL (Permit) OK except #'s 34. A.C. Ducts Insulation & Support 35. Vent Fan; Exhaust above insulation 36. Condensate Drain & Overflow; Size & Grade 37. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet 38. Attic Access & Platform if Furnace in Attic Card -81 Date Card -B1 Date Card -131 Date Card -131 Date Date FRAMING (Plans) OK except #'s 39. Sills, Proper Material & Anchors 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound 41. Bearing Walls over Girders & Floor Nailing 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Header & Beam -Size & Bearing Date FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. Ging. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Ring. 47. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing 51, Property Line Firewall & Openings 52. Ext. Doors -One T -Check Garage -3rd story, 2 exits 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 54. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 55. Siding -Nailing Veneer 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 57. Glazing Area -Glass Protection -Skylights -Plastic 58. Shear Walls; Nailing -Bolts 59, Insulation-Walls-Clg. 60. Infiltration-Walls-Wndws Card -81 Date Card -81 Date Card -81 Date Card -81 Date Date FINAL (Plans) OK except #'s 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & Subpanel; Breaker Sizes -Labels 67. Stairs & Rails 68. Fireplace or Stove; 'Clearances -Hearth 69. Elec. Outlets at Wood Panel; Int. & Ext. 70. Kit. Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance 71. Elec. Outlets & Receptacles at Kit. Counter 72. Garage Fire Door; Swing -Landing -Closer 73. A.C. Duct in Garage -Damper 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 75. Plb., Elec. & Mech. Equip. Listed for Location 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 77. Insulation -Foam -Looked in Attic ❑ Yes 78. Guard Rails & Deck Construction -Post Caps 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No 8i. Stucco; Brown -Finish 82. A.C. Unit; Disconnect, Electrical, Plumbing 83. Vents Above Roof; PIbg.-Appliance-Firep I. -Clearance to 84. Water Well; Disconnect, Electrical, Plumbing 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 86. Ventilation throughout House 87. Glass Protection 88. Corrections from Previous Inpections 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval 9i. Energy Compliance Certificate -Other Certificates 92. Roofing Certificate Card -B1 Date Card -81 Date Card -B1 Date Card -81 Date Card -131 Date Card -81 Date Comments at Final: (NOTE: An entry must be made each time you visit job site) COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERM T NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER IffiXX 073-340-08 ZONING U . BUILDING PERMIT / V l OWNER ELEPHONE WALTER JACKSON / BETTIE MARTIN 4 569-8461 SO, FT, OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS PO BOX 274 FORBESTOWN 959941 EST 1,000.00 :; t CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $ 15.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 121 KIRSTY PERMIT FEE $ 35.00 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15,00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SF QX Duplex O Mobilehome EJOther SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20'(]0 TYPE OF WORK New 1:1Addition ❑ Remodel 1:1Utilities C) Installation ❑ Other El Describe Work: PERMIT TO COMPLETE 12-3-1313 PERMIT FEE $ ELECTRICAL. PERMIT Filing Fee 20.00 Main Service ( 'OVOR LESS ) 23.00 200A OR LESS Main Service ( 200A TO IOOOA ) 46.00 NEW CONST. DWELLING OCC P. OR ADDNS. I 8 ACC. BLDS. ) 3.50 FT,S0. CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) ❑ I am a licensed underrovisions of Chapter 9, Division 3 of the Business and P P Professions Code and my license is in full force and effect. LIC�nse No. Classification 6Aas the owner, 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) ❑ I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) ❑ I am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET NON-REs10. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 @ 1.00 BAL. 0 ro Ex. Occup.FIXED APPLNS. OR ( OUTLETS (RESID.) EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE 1 declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a C Cate of Consent to Self -insure. shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all Butte County Ordinances and California 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 w&�chh,in any way accrue against said in cons ence of th gran g ofjthX �/Date S'J Signature of Applicant - &&W—ner '❑ r6mractor ❑ Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE I TOTAL FEE $ 35.00 HAZ. D. FEES IMP FLOOD CDF PARCEL PDCounty This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By Date / PERMITEXPIRESON J /Date! Receipt No. 162638 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT �r+'�"►'�D+�+`-. "+'�+r--"1�� � .�'►'Si'•�'`�►frthrlw+'++►�.�14P•lt�.�,n,v�+'�t�f.,4 `r, l'�(,. ."�j•'.:`.(�; r,i%�y1..-�"""'k+Y%�'lr"-''uri"i`.) E_ w Dirt C 'U`NTYOF BUTTE - DEPARTMENTOF DEVELOPMENT SERVICES -BUILDING DIVISION ,} OWNER 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA95965 -TELEPHONE (916) 538-7541 PERMIT APPLICATION DATASHEET , ry1 Building Use Building Inspector 73_ Date At time of per t application, I was advised the following data must. be submitted prior to permit processing and9or issuance: DATE RECENED BY 1. All items have been submitted. ....... ............................. . 2. Plot plans, 3/4 sets, signed by preparer of plans . .......................... 3_ Complete plans, 3/4 sets, signed by preparer of plans . ...................... .4. Engineered plans -and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form. ........,.................................. . 6. Energy Design Compliance and supporting documentation. .................... 7. Statement of Intent for Non -Heated and A/C Buildings. .......... 8. Engineered truss details and layout in duplicate (required prior to plan check). ... . 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10. Fees of $......................................... 11. Impact fees as shown on attached schedule . .............................. 12. California Department of Forestry plan approval/fees. ....................... . 13. Flood elevation letter (100 year flood) -by California Engineer ................... 14. Sanitation and plot.plan approval Health Department . ............ 15. City of Chico plumbing permit . ........................................ . 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: 18. Contact Land Development about (A) Improvements (B) Drainage. .......... . 19. Driveway permit (construction approval required prior to occupancy). .. .. . . ' �Freanspection requ� 20. Pre -inspection for required. . . to Building Inspector (Date) 21. Contractor's license information. (No., Name Style, Classification) . .............. 22. Certificate of Workmans Compensation Insurance . .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner _). ........... 24. Recorded copy of Agricultural Acknowledgement Statement . .................. 25. Letter of signature authorization . .......................................... 26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... . 27: ,Letter of intent on building use . .................... ..................... 28. Mobilehome utility clearance . .................................. ....... 29. Documentation of legal access . ..................... :.................. 30. Documentation of 50% subdivision developed or (A) Road improvements completed and (B) Parcel meets zoning area and frontage requirements . .............r� 31. Existing violations/expired permits . ...................................... 32. Plan check list . ................. "I, ................................ 33. '34. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver with inspector. Other Parcel Creation Acreage Applicant Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works COUNTY OF BUTTE Department of Development Services Building Division Oroville: 7 County Center Dr., Oroville CA 95965 Ph: 916-538-7541 Chico: 1469 Humboldt Rd., Chico CA 95928 Ph: 916-891-2751 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/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 Contractor's 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 Contractor's License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of Work Signed: Property OwnerG�'o►'i— Social Security Number Date __5' — _75 " 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 permitted to issue the permit. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916.'538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 073-340-008 ZONING„ U " BUILDING PERMIT OWNER Walter Jackson Bettie Martin 415 TELEPHONE 569-8461 S0. FT. OCC.1 BUILDING VALUATION( 3.00 .00 OWNER'S MAILING ADDRESS P.O. Box 274 Forbestown 95941 CONTRACTOR'S NAME Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation [$3,000.00 Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ 45.00 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ 60.00 PLUMBING PERMIT Filing Fee 15.00 191 Kirsty Crescient Rd., Oroville Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ® Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S G W @ 15.00 TYPE OF WORK��I New �j Addition LJ Remodel F_!u Utilities Installation❑ Other Describe work: Permit to CompleteB. P. 92-1387 (Original B.P. #3618-88) Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 200A OR LESS 18.50 Main service 200ATO1000A) _ 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business a Professions Code and my license is in full force and effect. icense No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. (DWELLING OCCUP.&\ OR ACDNS. 1 ACC. BLDGS. I 3.64 sq.ft. NEW CONST R. MULTI -OUT LET NON•R ESID BRANCH CIRC ITS @ 5.00 /POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 760 FIXED APLNS. Ex. Occup. OUTLETS ) TS (RESICIREA.) I 3.00 Temporary service 15.00 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 K/Consent to Self -Insure. shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating Cooling Hood 6.50 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct: I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilitie , judgments, costs, and expenses which may in any way accrue against � unt in th9 ;=once granting of this permit. NLZ 'Date _..� signatur Applicant — O4er Contractor ❑ Agent ❑ An OSHA permit is required or cavations over 5'0" deep and demolition or construct- ion of structures over 3 storie height. Mobile Home Installation Fee $ Energy Inspection Fee $ DCC CONST TYPE TOTAL FEE $ 60.00 I HAz I DFEES I IMP I FLOOD I COF I PARCEL PD I HD I ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DI T R PUBLIC BY r�O ` PERMIT EXPIRES Date applicable provi resolutions to do have been paid. ORKS D e �j 141230 Receipt No. WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - Department of Public Works 7 County Center Drive,,,..Orovtille, CA 95965 OWNER -BUILDER VERIFICATION Attention Property Owner: Phone, .916-538-7541 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 mprovement (yes or no) 2. I (have/have not) signed an application for a building permit for the proposed wo k. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address City Phone Contractors License No. 4. .1 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 Social Security Number — Date 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. COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSES P=R Ely NUtYt,B�Rj (/J UUu ZONI BUILDING PERMIT OWN R 1 Ls -Y` 4 O 7 EL P ONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAIL, DR E55 lI X11 a vt CONrAC OR'S NAME TELEPHONE CONTRACTOR'S AILING ADDRESS 4 Fireplace CONSTIi CTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee S ARC I ECT OR ENGINEER LICENSE NO. Plan Checking Fee i Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING AD RESS ei rUrezee!jt RL Permit fee PLUMBING PERMIT Filing Fee 10.00 Each Trap a 2,00 y+ Solar or heat pump water heater 20.00 LO NO. SUB IVSI N NAM .}- D 1 �tg ,I S ! PARCEL MAP t� 6 ater piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SFA Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00 ea TYPE OF WORK New# Addition❑ Remodel❑ Utilit'es Installation❑ Other ❑ Describe work: o Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service R LESS 000 AMP OR 1 P 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 Business and Professions Code and my license is in full force and effect. License No. Classification 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I. as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OC 'h2sgft CC'TI New DonNisTP_ A U OUTLET NON.RESID .BRA C CIRC ITS 2.50 ea POWER APPARATUS & SINGLE OUTLET CIR. I Ex. OCCUp(OUTLETS OR FIXTURES 20®50t eAL93o FIXED APPLNS. OR Ex. OCCUp. OUTLETS (RESID.) EA.) 1 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling 9 Hood 3,00 Ventilation/ 3, 3. • . 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 accrueTii against said Co my in consequence e a ting2;J peermit. Xa l6 �� Signature of Appli Own Contractor ❑ Agent ❑ An OSHA permit is required for xcavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE , -1 Co PC ISCNOQk i♦// pw0� (; PARCCL V/ K�J 9 This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTOR OF PUBLIC BY PERM EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date _ �- Receipt No. WNITC-D.P.W., YELLOW -ASSESSOR, PINK-INSprcTOR. OOLDCNROD-APPLICANT 04 r ' 'RIPP: Wlw,*.$— ,4'tj YMl to i f•.vv`"r"""'""�,','Y`•�:s`4ri"v'i�-'t11'y,l�+'Fr'}, } wi}.,.la 1 ,.'.>�I'.� ,i •:�sl .... "^f SY.�'� ,'h�!'N � "1.i- fir •. ,. COUNTY,OF-BUTTE - DEPART, MENT'`OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 s -,-•�"'. PERMIT APPLICATION DATA SHEET Permit No. 1 �/� �J • OWNER I e t, To ck5oy) A ✓' 0.. Proposed Building Use P wc% -Building Inspector—i&V Date At time of permit application, I was advised the following data must be submitted prior to permit processing and:/or issuance: DATE RECEIVED APPROVED 1, All items. have bean -submitted. . . . . . . . . . . . Plot plansra—'!qpliCat licated/plicate, signed by preparer of plans. //- 9- � /j Complete pn iplicate, signed by preparer of plans, ��/ - g �� 3 i 4. Complete engineered plans and calcs, with wet signature on plans. a 5. Tris with nergy Design Compliance Statement.6.i^ Vi�r' School District "Fees Paid" Stamp on Floor Plan.; _11"`69-21P _0/ 10 7 'Statement of Intent for Non -Heated and AC Buildings, i.', �'-��'�' 8. Fees of $ .r 9. Letter of signature autliorizatiy�q . , , ,F •0. Sanitation approvaFfrom (/V'©*V /,* � Health Dept. �^ 11. Planning approva(I'forf,((A) Use: .rte '(B).<Parking: 12, Certificate of Workmeny'P2�plompensation Insurance. 13. Contractor's Lic.en� se nformation '(no�i�ame style, classif.j� : 14, Owner -Builder_ trification-(G, Venn to=owner❑, Mail to owner ❑) - �` _15. Improvements may be�regpir� .. , 16. Mobilehome Install:atign�Daa..�t-a;:, `. ,. %f f . v • Pre-Inspec. request to 17 . Pre -Inspection for , Re uired. (Date) r q Building Inspector T Recorded copy of Agricultural Acknowledgment Statement. *20. . Driveway Permit. f/- 5'- ie Tom, Plot plan approval from city of i 1. Engineered trusses in duplicate required prior to plan check). When you issue the permit, process as follows: Mail to owner, Mail to coeg ntractor. Telephone and hold for pickup at office, Deliver w/inspector. Copy of plans sent Health Dept., Fire Dept„ L Other Date The following data must be submitted prior r,to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. ��- 2. Ar•Irlitt,,,,�� ito..,� .o..iroa• Contract, des wnpr_ as advised of above required data by_ hone___rnail_counter by date Contract , esi owner, was advised of above required data by phone_mall_counter by109 date Plans checked by Date // —/Plans approved by U Date Z Sets of plans on hold in 'File cabinet AP folder f J-0 7r Copy—DPW TO Buildino Department FROM: Environmental Health SUBJECT: Sanitation Clearance FtLa�4on ner ocationAP# I Plan Approved -for: Sew l e Disposal �'u PlS _ � Water Supply 'I Hold final for: Water Supply Final clearance O.R. for: Water Supply j Clearance -for _bedroom mobil home Other NOTE *** Sanitarian j I at COUNTY OF BUTTE - Department of Public Works 7. County Center Drive, Oroville, CA 95965 Phone: 916-538-7541 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 aterials for construction of the proposed property imp ovement (yes or no) 2. I (have/have not) gned an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: 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: M: Property Owne,`? Social Security NuTmber Date 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. -� CERTIFICATE OF COMPLIANCE: RESIDENTIAL Page 1 CF -1R Project Title.......... NEW RESIDENCE - 1200 SF Date........ 04/24/89 Project Address........ LOT 7 WALDEN POND ---------------------- BUTTE --------------______ BUTTE COUNTY | Documentation Author... JOHN J. BIDWELL | Buil-�-------�--- | ozng rermz� � Company................ BIDWELL & ASSOCIATES | Telephone 415-447-7172 ( .............. 415-447-7172 Plan Check / Date': Compliance. Method...... MICROPAS3 by Enercomp, Inc. | Fi--------------- | Climate Zone........... 16 � MICROPAS3 v3.01 File -JACKSON Weather-CTZ16 Program -FORM CF -1R | | User#-MP0112 User-BIDWELL & ASSOCIATES Run -FINAL DESIGN | _______________________________________________________________________________ GENERAL INFORMATION Conditioned Floor Area..... 1200 sf Building Type.............. Single Family Detached Building Front Orientation. Front Facing 270 deg (W) Number of Dwelling Units... 1 Number of Stories.......... 1 Floor Construction Type.... Raised Floor Infiltration Control....... Standard BUILDING SHELL INSULATION _________________________ Component .Insul Type R -value Wall R-19 Door R-0 Floor R-19 Roof R-38 Glazing GLAZING Overhang ________ Area Orientation ___________________ Exterior Panes _____ (sf) Window Front (W) ------ 60 Window Left (N) 95 Window Back (E) 60 Window Right (S) 40 ocation/Comments WEST, NORTH, EAST, SOUTH SOLID WOOD TO CRAWLSPACE ATTIC THERMAL MASS' GLAZING Overhang ________ # of Interior Exterior Panes _____ Shading __________ Shading -------------- 2 drapes None 2 drapes None 2 drapes None 2 drapes None THERMAL MASS' Area Thickness Hard Surfaced/ Type (sf) (in) Exposed Location/Comments ____________ ______ _________ ______________ ________________________ InteriorHorz 50 4.0 Yes FIREPLACE ' InteriorVert 100 4.0 Yes FIREPLACE Framing Overhang ________ Type Yes -------- Metal Yes Metal Yes Metal Yes Metal Area Thickness Hard Surfaced/ Type (sf) (in) Exposed Location/Comments ____________ ______ _________ ______________ ________________________ InteriorHorz 50 4.0 Yes FIREPLACE ' InteriorVert 100 4.0 Yes FIREPLACE CERTIFICATE OF COMPLIANCE: RESIDENTIAL Page 2 CF -1R =============================================================================== Project Title.......... NEW RESIDENCE - 1200 SF Date........ 04/24/89 =============================================================================== | MICROPAS3 v3.01 File -JACKSON Weather-CTZ16 Program -FORM CF -1R | | User#-MP0112 User-BIDWELL & ASSOCIATES Run -FINAL DESIGN | _______________________________________________________________________________ ASSUMED HVAC SYSTEMS -------------------- Assumed Duct Duct Assumed System Efficiency Location R -value _______________ ____________ _____________ -------- Gas ______Gas 0.720 SE None R-0.0 "d Air Conditioner 8.90 SEER None R�0.0 ACTUAL HVAC SYSTEMS -------------------- Actual __________________Actual Output Manufacturer and Model # Actual System Efficiency (Btuh) (or approved equal) Heating Cooling ---- ___ -------- ________---__________------------ Cooling Coil ------------ CEC Maximum Output for Gas Central Furnaces: 52000 Btuh WATER HEATING SYSTEMS --------------------- Tank Capacity Manufacturer and Model # Energy System Type (oal) (or aooroved on/,Al) r—Ai+- Storage, Gas 50 ~`��r ~ None SPECIAL FEATURES/REMARKS ------------------------- This _______________________ This building incorporates a Zonally Controlled HVAC System. F 1/0 e-12 AZ_ 9 _V zV... ------------------------------------------------------------- CERTIFICATE OF COMPLIANCE: RESIDENTIAL Page 3 CF -1R =============================================================================== Project Title..!....... NEW REqIDENCE - 1200 SF Date........ 04/24/89 =============================================================================== | MICROPAS3 v3.01 File -JACKSON Weather-CTZ16 Program -FORM CF -1R | � User#-MP0112 User-BIDWELL & ASSOCIATES Run -FINAL DESIGN | _______________________________________________________________________________ COMPLIANCE STATEMENT ---------- _--------- This certificate of compliance lists the building features and performance specifications needed to comply with Title 24, Chapter 2-5Z and Title 20, Chapter 2, Subchapter 4, Article 1 of the California Administrative code. This certificate has been signed by the individuak with overall design responsibility and the building owner, who shall retain a copy of it and transmit the certificate to any subsequent purchaser of the building. When this certificate of compliance is submitted for a single building plan to be built in multiple orientations, all building conservation features which vary'are indicated in the Special Features/Remarks section. DESIGNER Name.... DAVE FOX Company. _________________________ Address. 581 ZIRCON WAY LIVERMORE CA 94550 Phone... 415-447-7089 License.' _________________________ � Signed _______w________`___________ (date) DOCUMENTATION AUTHOR OWNER Name.... JACKSON Company. Address. Phone... ___________�_____________ ` Signed n______ (date) ENFORCEMENT AGENCY Name.... JOHN J. BIDWELL Name.... ___ Company. BIDWELL & ASSOCIATES Title... ------------------------- Address. 789 LIDO DRIVE Agency.. ______------------------- LIVERMORE, CALIF 94550 ��----------------- Phone... 415-447-7172 Phone... ------------------------- SignedSigned (date) (date) �, », ' COMPUTER METHOD SUMMARY ` , Page 1 C -21R Project Title.......... NEW RESIDENCE - 1200 SF` Date........ 04/24/89 Project Address........ LOT 7 WALDEN POND ------------------___ BUTTE COUNTY Documentation Author. JOHN J BIDWELL | Buil-�-------�--- | .. J. ozng rermzr � Company................ BIDWELL & ASSOCIATES Telephone.............. 415-447-7172 | Plan Check / Date ------�-------- | | | Compliance Method...... MICROPAS3 by Enercomp, Inc. | -�--------------- � Climate Zone........... 16 _________________---- =============================================================================== | MICROPAS3 v3.01 File -JACKSON Weather-CTZ16 Program -FORM C -2R | � User#-MP0112 User-BIDWELL & ASSOCIATES RUn-FINAL DESIGN � _______________________________________________________________________________ ================================================================= = MICROPAS3 ENERGY USE SUMMARY = = = = Energy Use = (kBtu/sf-yr) = _______________________ = Space Heating.......... = Space Cooling.......... = Water Heating.......... = = Total Standard Proposed Compliance = Design __________ DesignMargin __________ = __________ 38.27 40.06 = -1.79 = 12.74 6.15 6.59 = 19.08 ________ 16.88 ________ 2.20 = 70.09 63.09 ________ = 7.00 = = = = *** Building complies *** = GENERAL INFORMATION Conditioned Floor Area..... 1200 sf Building Type.............. Single Family Detached Building FKont Orientation. Front Facing 270 deg (W) Number of Dwelling Units... 1 Number of Building Stories. 1 Weather Data Type.......... ReducedYear Floor Construction Type.... Raised Floor- Number loorNumber of Building Zones... 1 Conditioned Volume.....'.... 12000 cf Footprint Area............. 1200 sf Slab -On -Grade Area......... 0 sf Glazing Percentage......... 21.3 % of FA Average Ceiling Height..... 10 ft BUILDING ZONE INFORMATION Floor Cond- Area Volume # of Thermostat Zone Type itioned (sf) (cf) Units Type ______________ _______ _________ _________ _____ ____________ HOUSE Living Yes 1200 12000 1.00 NoSetback A Vent Special Height Vent Area (ft) (sf) ______ --------- 2.0 n/a COMPUTER =============================================================================== METHOD SUMMARY . Page 2 C -2R Project Title.......... =============================================================================== NEW RESIDENCE - 1200 SF Date........ 04/24/89 | MICROPAS3 v3.01 File -JACKSON Weather-CTZ16 Program -FORM C -2R | | ____________--__________________________________________________________________ User#-MP0112 User-BIDWELL & ASSOCIATES Run -FINAL DESIGN | ivity R -value OPAQUE SURFACES AreaU- Insul ---------------- ______________Area Act Solar Location/ Form 3 Surface ____________ (sf) value R-val --- ___ _____ _____ Azmth Tilt Gains Comments _____ Reference HOUSE R- ____ _____ ________________ ------------- ___________HOUSE 1 Wall 240 0.065 R-19 270 90 Yes WEST ' 2 Wall 205 0.065 R-19 360 90 No NORTH ------------ 3 Wall 260 0.065 R-19 90 90 No EAST ------------ 4 Wall 260 0.065 R-19 180 90 Yes SOUTH --------�---- 5 Door 20 0.330 R-0 270 90 No SOLID WOOD ------------ 6 Floor 1200 0.037 R-19 0 0 No TO CRAWLSPACE ------------ 7 Rpof 1.200 0.03.0 R-38 0 0 Yes ATTIC ------------ GLAZING SURFACES ---------------- Sc Interior Sc Area # of Frame Open U- Act Glass Shade Gls+ Surface ___________ (sf) Panes Type _____ _____ ____7___ Type value Azmth Tilt Only ______ Type Shade HOUSE _____ _____ ____ _____ __________ ------- ____HOUSE 1 Window 60 2 Metal Slider 0.65 270 90 0.77 drapes 0.66 2 Window 95 2 Metal Slider 0.65 360 90 0.77 drapes 0.66 3 Window 60 2 Metal Slider 0.65 90 90 0.77 drapes 0.66 4 Window 40 2 Metal Slider 0.65 180 90 0.77 drapes 0.66 OVERHANGS ---------- ________Area . AreaWindow Overhang Overhang Surfdce ___________ ______ (sf) Height Length Height ______ ________ HOUSE ________ 1 Window 60 5.0 8.0 0.5 2 Window 95 5.0 3.0 0.5 3 Window 60 5.0 3.0 0.5 4 Window 40 5.0 3.0 0.5 Location/Comments --------------------------- FIREPLACE _________________________ FIREPLACE . THERMAL ------------- MASS Area Thick Heat ___________Area Conduct- Surface Mass Type _______________ (sf) ______ (in) _____ Cap ivity R -value HOUSE _____ ________ -------- 1 InteriorHorz . 50 4.0 28.0 0.98 R- 2 InteriorVert 100 4.0 21.0 0.59 R-0 Location/Comments --------------------------- FIREPLACE _________________________ FIREPLACE . COMPUTER METHOD SUMMARY . ° Page 3 C -2R Project Title.......... NEW RESIDENCE - 1200 SF Date........ 04/24/89 =============================================================================== | MICROPAS3 v3.01 File -JACKSON Weather-CTZ16 Program -FORM C -2R | | User#-MP0112 User-BIDWELL & ASSOCIATES Run -FINAL DESIGN | _______________________________________________________________________________ HVAC SYSTEMS WATER HEATING SYSTEMS _____________________ Minimum Duct Duct Duct System Type ________________ Efficiency Location ____________ _____________ R -value Efficiency HOUSE Size _______ ---------- Gas 0.720 SE None R-0.0 1.000 Air Conditioner 8.90 SEER None R-0.0 1.000 WATER HEATING SYSTEMS _____________________ SPECIAL FEATURES/REMARKS ________________________ This building incorporates a Zonally Controlled HVAC System. � Capa- Pilot System # of city Effic- Standby Input Size Type __________ Heaters (gal) _______ ________ iency Loss ___________ Rating (Btuh) Credits o Strage ______ ____________ ________ __________ Gas 1 50 0.760 RE 2.00% 37000 Btuh n/a NONE SPECIAL FEATURES/REMARKS ________________________ This building incorporates a Zonally Controlled HVAC System. � HVAC SIZING Page 1 HVAC Project Title.......... NEW RESIDENCE - 1200 SF Date........ 04/24/89 Project Address........ LOT 7 WALDEN POND ----------------------- BUTTE ------------________BUTTE COUNTY | | Documentation Author JOHN J BIDWELL � ... JOHN J. �uz��zng Permit # | Company................ BIDWELL & ASSOCIATES It | Telephone. 415-447-7172 � } ----------------- . ...,.~....... Plan Check / Date | | | Compliance Method...... MICROPAS3 by Enercomp Inc | ----------------- , . Field Check/ Date | Climate Zone........... 16 ___________---------- =============================================================================== | MICROPAS3 v3.01 File -JACKSON Weather-CTZ16 Program -HVAC SIZING � | User#-MP0112 User-BIDWELL & ASSOCIATES Run -FINAL DESIGN ( _______________________________________________________________________________ GENERAL INFORMATION ___________________ Floor Area................. 1200 sf Volume..................... 12000 cf Sizing Location............ OROVILLE RS Latitude................... 39.5 degrees Winter Outside Design...... 30 F Winter Inside Design....... 70 F Summer Outside Design...... 104 F Summer Ingide Design....... 78 F Summer Range............... 37 F Shading Used............... No Latent Load Fraction....... 0.20 HEATING AND COOLING LOAD SUMMARY -------------------------------- Heating Cooling Description (Btuh) (Btuh) _________________________________ ___________ ___________ Opaque Conduction and Solar.�.... Glazing Conduction............... Glazinq Solar...........'''''''' Infiltration..................... Internal Gain.................... Ducts...............~............ Sensible Load.................... Latent Load...................... Total Load 5989 3009 6630 4310 n/a 8828 6826 2802 n/a 2100 0 0 19445 21049 n/a . 4210 19445 25258 Note: The loads shown are only one of the criteria affecting the selection of HVAC equipment. Other relevant design factors such as air air flow requirements, outdoor design temperatures, coil sizing, availability of equipment, oversizing safety margin, etc., must also be considered. I' - is the HVAC designer's responsibility to consider all factors when selecting the HVAC equipment. CEC Maximum for gas central furnaces only: 45000 + 100.0 x (0.72 - 0.71) x 7000 = 52000 Btuh Chapter 2• INPUT REFERENCE 2.7.3. DUCT SYSTEMS OVERVIEW The amount of energy loss through the HVAC duct system can be over 20% of the building's space conditioning energy use. The portion of energy loss through the ducts is quantified by a value called the duct efficiency. This value is multiplied by the HVAC equipment efficiency to obtain the overall efficiency of the HVAC system. The duct efficiency used by MICROPAS is an interpolated value depending on the location of the ducts, on the duct insulation level and on the number of stories in the building as shown in Table 2-9. Standard Design The Standard Design assumes ducts insulated to R-2.1 and located in the attic. The Proposed Design energy use can be lowered by increasing duct insulation, relocating the ducts or eliminating the duds. Heating Ducts MICROPAS requires inputs for the location of "heating' ducts and of •cooling" duds. versus Cooling Duds of course are normally shared between the heating and cooling systea;s. Ducts However, these separate input values allow credit where duds are not used for either of the heating or cooling systems. An example of this is a building heated with electric baseboard beaters (no ducts) and cooled with a central air conditioner. Cooling System '' U a cooling system is not installed, the duct location for the cooling system must be Not In8t8ll9d assumed to be the attic. Ducts In Multiple If the HVAC duds occur in more than one location, a length weighted average duct Locations efficiency can be calculated and entered by the user in the place of the dud location. Duct efficiencies for crawlspaces, basements and attics can be averaged Duct efficiencies for conditioned space cannot be averaged because all efficiencies assume a portion of the dud length is in conditioned space. Input Data Description XDUCT SYSTEM Name of duct system. This name is used in the Zones Section to link the characteristics NAME of the duct system to the building zone. Maximum length is 12 characters. Co "& 19M by Ene=mp; Inc. lune 7, 1988 PCanplianee Manugl 2-51 Figum 2-2Q Duct Systems Input Data DUCT SYSTEMS DUCT DUCT HEATING COOLING SYSTEM INSUL DUCT DUCT MANE R -VALUE LOCATION LOCATION .....-1•----• --- ----- ----- 1> ATTIC 2.1 Attic Attic 2> ATTIC.N.ONLY 2.1 Attic None 3> ATTIC.C.ONLY 2.1 None Attic 43o ATTIC.R4 4.0 Attic Attie. 5> CRAIILSPACE 2.1 Crowtspece Crawlspece 6), �( A I COND.SPACE NO.DUCTS 2.1 0.0 Conditioned None Conditioned None \ 8> N1XED.LOCA 2.1 0.85 0.88 93, CVCRAYL 2.1 CVCrawtspace CVCeawtspace OVERVIEW The amount of energy loss through the HVAC duct system can be over 20% of the building's space conditioning energy use. The portion of energy loss through the ducts is quantified by a value called the duct efficiency. This value is multiplied by the HVAC equipment efficiency to obtain the overall efficiency of the HVAC system. The duct efficiency used by MICROPAS is an interpolated value depending on the location of the ducts, on the duct insulation level and on the number of stories in the building as shown in Table 2-9. Standard Design The Standard Design assumes ducts insulated to R-2.1 and located in the attic. The Proposed Design energy use can be lowered by increasing duct insulation, relocating the ducts or eliminating the duds. Heating Ducts MICROPAS requires inputs for the location of "heating' ducts and of •cooling" duds. versus Cooling Duds of course are normally shared between the heating and cooling systea;s. Ducts However, these separate input values allow credit where duds are not used for either of the heating or cooling systems. An example of this is a building heated with electric baseboard beaters (no ducts) and cooled with a central air conditioner. Cooling System '' U a cooling system is not installed, the duct location for the cooling system must be Not In8t8ll9d assumed to be the attic. Ducts In Multiple If the HVAC duds occur in more than one location, a length weighted average duct Locations efficiency can be calculated and entered by the user in the place of the dud location. Duct efficiencies for crawlspaces, basements and attics can be averaged Duct efficiencies for conditioned space cannot be averaged because all efficiencies assume a portion of the dud length is in conditioned space. Input Data Description XDUCT SYSTEM Name of duct system. This name is used in the Zones Section to link the characteristics NAME of the duct system to the building zone. Maximum length is 12 characters. Co "& 19M by Ene=mp; Inc. lune 7, 1988 PCanplianee Manugl 2-51 MICROPAS3 Input Data Desalptlon DUCT R -value of dud insulation. Duct insulation with a R -value of 2.1 is the minimum INSULATION R- required by the Uniform Mechanical Code. Units: hour-sf-4g F/Btu. VALUE HEATING DUCT Keyword to describe the location of heating system duds. Legal values: 'Attid, LOCATION 'Crawispace, 'Basement', 'Conditioned', 'CVCrawlspace' or 'None. Use 'None' if the heating system does not use duds. Use 'Conditioned' if the duds are entirely contained J� within the conditioned space. The value'Basement' results in the same dud efficiencies as'Crawlspace'. A numeric value of dud efficiency can be entered if the efficiencies of two dud locations are "length -averaged". COOLING DUCT Location of cooling system duds. See HEATING DUCT LOCATION above. LOCATION Table 2-9.• Duct Efficiencies Accw ding to Location V 'Crawlspace' or 'None or 'Attic' 'Basement' 'CVCrawlspace'(2) 'Conditioned' Dud R-value(1) Heating Cooling Heating Cooling Heating Cooling Heating Cooling If input value NUMBER OF STORIES is equal to 1: 2.1 0.78 0.74 0.78 0.84 0.85 0.88 1.00. ' 1.00 4.2 •0.82 0.81 0.82 0.86 0.88 0.88 1.00 ' ` 1,00 6.3 0.84 0.83 0.84 0.87 0.89 0.89 "1.00 1.00 If input value NUMBER OF STORIES is greater than 1: 2.1 0.85 0.83 0.85 0.89 0.90 0.92- 1.00'* 1.00 42 0.88 0.87 0.88 0.91 0.92 0.92 1.00 1.00 63 : 0.90 0.89 0.90 0.91 0.930.93 1.00 -. ; 1.00 1. MICROPAS interpolates between dud R -values as necessary and reports the actual dud efficiency used on the C -2R Report. 2. 'CVCrawlspace' values may only be used with a minimum R-5 foundation wall insulation and if the crawlspace meets the Controlled Ventilation Crawlspace criteria discussed in the Glossary of the Ene V Conservation Manual. 2-56 Compliance Manual June 7,19188 CopPOW 19M by EnexWMA Itrc. 1. Ceiling Insulation Insulation in Floor Number of stories ' •' Number of stories R -value . R -value One Two Three R-0 -103 -49 -02 . R-19 -8 -4 -2 R-30 -2 -1 -1 R-38 0 0 0 U -value 8 6 j 0.50 -176 -84 -54 0.30 -102 -49 -32 0.10 -26 -13 -8 0.08 -18 -9 -6. 0.06 -11 -5 -4 0.04 -4 -2 -1 0.02 4 2 1 0.00 11 5 3 2. Wall Insulation Insulation in Floor Number of stories - Single- Single - R -value One Two Family Family Multi - R -value Detached Attached Family R-0 -68 -51 34 R-11 0 0 0 R-13 2 2' 1 R-19 8 6 4 U -value 0.06 -6 -3 0.80 -153 -114 -76 0.50 -91 -68 -46 0.30 -47 -36 -24 0.10 0 0 0 0.08 4 3 2 0.06 9 7 5 0.04. 14 11 - 7 0.02 19 •14 10 0.00 24 18 12 3. Raised Floor Insulation U -value Insulation in Floor Number of stories - Number of stories -144 R -value One Two Three R-0 -17 -8 -5 R-11 3 -2 -1 R-19 0 0 0 R-30 _ 3 1 1 U -value Slab Floor Number of stories Errective Percent Glue - ----0.60 -144 -70 -46 0.50 -120 -58 --38 0.40 -95 -46 30 0.30 -69 -34 -22 0.20 -43 -21 -14 0.10 -17 -8 -5 0.08 -11 -6 -4 0.06 -6 -3 -2 0.04 -1 0 0 0.02 4 2 1 0.00 10 5 3 .Controlled Ventilation Crawispace 5. Infiltration (Air Leakage) -Specification Points Standard 0 6. Glass Heat Loss Total Slab Floor Number of stories Errective Percent Glue R -value One Two Three R-0 -11 -7 -5 R-5 -4 -4 3 R-11 -2 -2 -2 R-19 -1 -2 -2 4. Slab Edge Insulation -10 4 40 Number of Stories -37 R -value One Two Three R-0 0 0 0 R-5 8 10 2 R-7 8 ,5 6 - 3 ' F2 factor 12 ` -58 0.90 -4 3 -1 0.80 -1 -1 0 0.70 2 2 1 0.60 6 4 2 0.50 9 6 3 0.40 12 8 4 5. Infiltration (Air Leakage) -Specification Points Standard 0 6. Glass Heat Loss Total Slab Floor Single - Errective Percent Glue " U -value (Percent sun x SC) Percent Effective Stories .51 to .41 to .31 to 0.30 or Glass Single Double .60 .50 .40 less 50 -121 -53 -39 -24 -10 4 40 -90 -37 -26 -14 3 8 35 -75 -29 -19 -9 1 10 30 -61 -21 -13 -4 4 12 29 -58 -20 -12 -3 5 12 28 -55 -18 -10 -2 5 13 27 -52 -17 -9 -2 6 13 26 -49 -15 -8 -1 7 14 25 -46 -14 -7 0 7 14 24 -43 -12 -5 1 8 14 23 -40 -11 -4 2 8 15 22 -37 -9 3 3 9 15 21 34 -7 -2 4 10 15 20 31 -6 0 5 10 16 19 -29 -4 1 6 11 16 18 -26 3 2 7 12 16 17 -23 -1 3 8 12 17 16 -20 0 4 9 13 17 15 -17 1 6 10 14 17 14 -14 3 7 10 14 18 13 -12 4 8 11 15 18 12 -9 6 9 12 15 19 11 -6 7 10 13 16 19 10 3 9 11 14 17 19 9 -1 10 13 15 17 20 8 2 12 14 16 18 20 7: Shading (Shade Open) Slab Floor Single - Errective Percent Glue " Efrecttve Percent Glass (Percent sun x SC) Multi Effective Stories (percent Mast x SC) 1CFA Effective Two Three _..._�...__ Eta %Glass North East South West Skylight 18 5 1 4 1 na 16 4 2 5 1 na 14 4 2 5 1 na .12 3 3 5 2 na 11 3 3 5 2 na 10 2 3 5 2 1 9 2 3 5 2 2 8 2 3 5 . 2 2 7 1 3 4 2 2 6 1 3 4 2 3 5 1 2 4 2 3 4 0 2 3 1 3 3 0 1 2 1 3 2 0 0 1 0 3 1 -1 -1 -1 .-1 2 0 -1 -2 d -2 0 na = not allowed -1 -9 1 16. Shading (Shade Closed) Slab Floor Single - Errective Percent Glue Mass Family (Percent sun x SC) Multi Effective Stories Attached 1CFA One Two Three %Glean Nom Eta South ' West Skylight 18 -14 -48 -69 -64 na 16 -12 -42 -59 -55 na 14 -10 -35 -50 -46 na 12 -8 -29, -40 -37 na 11 -7 -26 36 -33 na s. 10 -6 -23 31 -29 -74 9 -5 -20 -27 -25 -65 8 -5 -17 -23 -21.. -56 7 -4 -14 -19 -18 -47 6 3 -11 -15 -14 -38 5 -2 -9 -11 -10 -30 4 -1 -6 -8 -7 -23 3 0 -4 -5 -4 -16 2 1 .1 -2 -1 -9 1 1 1 1 1 -4 0 2 3 4 3 0 3"Interior Thermal Mass Interior Slab Floor Single - Raised Floor Mass Family Stories Multi Mass Stories Attached 1CFA One Two Three One Two Three 0.0 -8 -5 -4 -2 -1 -1 0.1 -8 -5 3 -1 0 0 0.3 -7 -4 • -2 0 1 1 0.5 -6 -3 -1 1 1 2 0.7 -5 -2 -1 1 2 2 0.9 -5. -1 0 2 3 3 1.1 -4 -1 1 3 4 4 1.3 -3 0 2 3 4 5 1.5 -3 1 2 4 5 5 2.0 -1 2 4 5 6 7 25 0 3 5 7 7 8 3.0 1 4 6 8 8 9 3.5 2 5 7 9 9 10. 4.0 3 6 8 9 10 10 4.5 3 7 8 10 11 11 5.0 4 7 9. 11 12 12 5.5 5 8 9 11 12 12 6.0 5 8 10 12 13 13 6.5 6 9 10 12 13 13 7.0 6 9 11 13 13 14 7.5 6 10 11 13 14 14 8.0 7 10 11 13 14 14 8.5 7 10 12 13 14 15 10. Exterior Wall Thermal Mass Exterior Single- . Single - Sum of 1.6 Wall Family Family Multi Mass Detached Attached Fam4 0.00 0 0 .0 0.20 3 2 1 0.40 5 4 3 0.60 8 6 4 0.80 10 8 5 1.00 13 10 7 1.20 13 12 8 1.40 12 13 9 I 1.60 10 13 11. 1.80 10 12 12 0.90 2-00 10 11 13 11 11. Heating System SE or HSPF 4 (assumes ducts In attic) Zonal Control Adjustment System Type Resistance 10 9 7 6 4 3 Other 6 5 4 3 2 2 Sum of 1.6 _ -25 or -24 to -14 to -4 to +6 to 16 or SE HSPF less -15 -5 +5 +15 more 0.72 6.60 0 0 0 0 0 0 0.75 6.88 3 3 3 2 2 1 0.80 7.33 8 7 6 5 4 3 0.85 7.79 13 11 10 8 7 5 0.90 8.25 17 15 13 11 9 '7 0.95 8.71 20 18 15 13 11 8 Effective SE or HSPF (SE or HSPF x duct efficiency) Effective -25 or -24 to -1410 -4 to +610 16 or SE HSPF less -15 -5 +5 +15 more 0.30 275 -73 bl -56 -47 38 -30 na 3.41 -45 -39 -34 -29 -24 -18 0.40 3.67 -34 -30 -26 -22 -18 -14 0.50 4.58 -10 -9 -8 -7 -5 -4 0.56 5.13 0 0 0 0 0 0 0.60 5.50 5 5 4 3 3 2 0.70 6.42 17 15 13 11 9 7 0.80 7.33 25 22 19 16 13 10 0.90 8.25 32 28 24 20 17 13 1.00 9.17 37 32 28 24 19 15 Zonal Control Adjustment System Type Resistance 10 9 7 6 4 3 Other 6 5 4 3 2 2 Mandatory Measures Checklist: Residential MF -1R NOTE: Lowrise residential buildings subject to the Standards must contain these measures regardless of the tarnpliarce approach used. Items marked with an asterisk (•) may be superseded by more stringent compliance requirements listed on the Certificate of Compliance. When this checklist is incorporated into the permit documents, the features rated shall be considered by all parties as binding minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. DESCRIPTION I DESIGNER I ENFORCEMENT Building Envelope Measures • §2.5352(a): Minimum ceiling insulation R-19 weighted average. §2.5352(b): Loose fill insulation manufacturer's labeled R -Value. ' §2-5352(c): Minimum wall insulation in framed walls R-1 I weighted average (does nes apply to exterior mass walls). §2.5352(k): Slab edge insulation - water absorption rate no greater than 03%, water vapor transmission rate no greater than 2.0 pemVinch. §2-5311: Insulation specified or installed meets California Energy Commission (CEC) quality standards. Indicate type and form. 12.5352((): Vapor barriers mandatory in Climate Zones 14 and 16 only. §2-5317: Infiltrabori/Exfcltration Controls a. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. b. Doors and windows certified. c. Doors and windows weathcrstripped; all joints and penetrations caulked and settled §2.5352(e): Special infiltration barrier installed to comply with 12-5351 meets CEC quality standards. 12.5352(d): Installation of Fireplaces 1. Masonry and factory -built fireplaces have: L Tight fitting, closeable metal or glass door b. Outside air intake with damper and control c. Flue damper and control 2. No continuous burning gas pilots allowed. HVAC and Plumbing System Measures §2.5352(8) and 2-5303: Space conditioning equipment sizing: attach calculations. §2-5352(h) and 2-5315: Setback thermostat on all applicable heating systema. ' §2-5316(a): Ducts const ructed, installed and insulated per Chapter 10, 1976 UMC. 12.5316(b): Exhaust systems have damper controls. §2-5314(c): Gas -rued space heating equipment has intermittent ignition devices. §2-5314: HVAC equipment, water heater, showerheadt and faucets certified by the CEC. §2.5352(1): Water heater insulation blanket (R-12 or grater) or combined interiorkxterior insulation (R-16 or greater)-. fust 5 feu of pipes closest to tank insulated (R-3 or greater). §2.5312(Exception p: Pipe insulation on steam and steam condensate mum & recirculating piping. §2-5318(d): Swimming Pool Heating 1. System has: a On/off switch on heater. b. Weatherproof instruction plate on heater: e. Plumbed to allow for solar. 2. 75 percent thermal efficiency. 3. Pool cover. 4. Time clock. 5. Directional water inlet. Lighting and Appliance Measures 62.5352(j): Lighting - 25 lumens/watt or greater for general lighting in kitchens and bathrooms. 12-5314(c): Gas fired appliances equipped with intermittent ignition devices. §2.5314(a): Refrigerators, refrigerator -freezers, freezers and fluorescent lamp ballasts certified by the CEC. Indicate make and model number. COMPLIANCE STATEMENT This mrdficate of compliance lists the building features and performance specifications needed to comply with Title 24, Chapter 2-53 and Title 20. Chapter 2. Subchapter 4. Article 1 of the Califontia Administrative code. This certificate has bast signed by the individual with overall design responsibility and the building owner, who shall retain a copy of it and transmit the certificate to any subsequent purchaser of the building. Designer Name: rawFu= Addn=: Tekphona Lic. 8: (signature) (date) Documentation Author Name: rideffib re Addntss: Building Owner Name: TitWFum: Address: Enforcement Agency Name: Agersry: Tekphom !+^st»'.....rw".a.ra^',x.,L.w�*,1pv,..�.,H�,A•v:¢'�.-rn4r�+i1""'ri`i..•r. V'i�ti;.�.:�"Y7^ 1�+s+�nt�'�„^Nt�'"t''%N`���.+ 4f'.�Y�iv;,x�spy�y,.i.•..ti%�.5 sw•,. ,.e. '...,.. a.S.>---�'A: „'y—:S..r, Jf r«. ,_ '•.x.. ^._ BUTTE COUNTY SCHOOLS'DEVELOPMENT FEE CERTIFICATION FORM (One Form per Building) A.P. Number �(►�� Building Department No. School District City Q County /�% Jurisdiction -Pro perty Owner Cs G Project Location/Address i 1� 6'cs As Subdivision 1,y�%IPh n S f�{(�S Lot Number I Residential.bevelopment: �r Sq. Footage # of Living MHI Addition (Group R) Units Comm4rci-al/Indust-rials., y.-:�f-., *'.k!.—Footage-o- -- --a� °tom New Addition (Including Exterior ti Roofed Areas) Buil i apartment Representative Date District Id No. J_�C - 71 7 3l �` s9 School District certifies that a d •p a�70�-i o6l-) (Applicant Na e) (Phone Number) 112-7 if -//74 W ti el�r U e (Street Address) C/7 (State) ' ( Zip, Code) has complied with;the requirements of Resolut1 o. by the payment of $��oZ �"'represent ng 1612 3 quare feet. School District Representative Date 41 PAID BY CHECK NO. BANK NO PAID BY CASH REMARKS: white -applicant, yellow -building department, pink -school district SCHOOL . FEE (5/88) fia Certificate of Com nce. Residential Compliance: C11II23te ZT 6 Mandatory Measures Checklist: Residential MF-1R 3 Project Title NOTE: h used tWhe*b rildings hU an nhrsY (•) May be g� of the compliance . buildings pit b the Standards must contain tlmeae trncasstres R y superseded by more stringent compliutce requi cm me, listed •+ Budding Permit 0 - hoe M Cur a all �Plianct When Nis d+acklUM is ircoryorated into the permit doeumatts, the (coma noted %hall Project Address r Whirs as banding minimum component porforrnunce speofimra mu for the mandatory measures - whether they are shown elsewhere in the documents or on this checklist only. Checked By / Date Documents Lion Author Telephotos Enforcement Ag2cy Use Only DFSCIUMON DESIGNER ENFURCEmENT { Building Envelope Memures BUILDING DATA Glass Area % Glass • §2.5352(a): Minimum ceiling insolation R-19 weighted average. r NOrih 42.5352(bk Looe fin insulation muufactruv•s It, R-value Conditioned Floor Area Number of Stories East • §2.53=cy Minimum wall insulation in framed walls R-11 weighted average (don not apply to —_ ct urior mass walls). Slab/Raised Floor Number of Units South 12.5352ft Slab edge insulation - wucr absorptim rate no greater than 0.3%. water vapor [ ] Single Family Detached (SFD) [ ] Addition Alone West transmission rate no greater than n pumlutch. [ ] Single Family Attached (SFA) [ ] Existing Building Skylight 12.5311: Insulation specified or installed mitt California Energy Commission (CEC) quality [ ] Multi-Family (MF) [ ] Existing-Plus-Addition Total standards, Wit= type and form g- §2.5352(f): Vapor barriers mandatory in Climate Zones 14 and 16 only. §2.5317: InfiltntiotUEslJtration Conoots L Door and windows between conditioned and unconditioned spaces designed to limit air BUILDING SHELL INSULATION leakage. Location/Comments ,,��oca�+,, b. Doors and windows cenifed L Component _ Insulation tion/Comments c Doors and windows weathermipped: all joints and pu+wations caulked and acak4 Type R-Value (attic, to garages typical etC.) §2.553sta�� Special inhittation barrier installed b comply with §2-5351 mccu CEC quality Wall .............. §2.5352(d)- Installation of Fireplaces , 1. Masonry factory-built fireplaces have Wall ............. and a. Tight fitting. closeable me-ml or glass door Roof ............. b. Outside air intake with damper and control c. Flue damper and control Roof ...........» g gas p- , i . - 2 No continuous trurrtin ubu albwcd. 'i F1oOr....:...:.... HVAC and Plumbing System Measures Floor ............. §2-5352(g) and 2-5303: Space conditioning equipmcnt sizing: attach calculations. Slab Edge ..... u §2-5352(h) and 2-5315: Setback thermostat on all applicable heating systems - • §2-5316(a): Ducts constructed. installed and insulated per Chapter 10. 1976 UMC. f GLAZING_ _ _... ShadingDeviees I §2-5316ft Exhaust systermhave damper toteoLs. . GlaZln §2-5314(0) Gas-fired space heating equipment has intermittent ignition devices. " $ Area Glass Type Interior • Exterior Overhang Framing Type §2-5314: HVAC equipment. water heaters. showerheads and muse,= certified by the CEC. - Orientation (sf) (single, double) (roller blinders.) (shadescreen,etc.)yes/no) (metall'wood) _i I 42-5352(1} Waterlusterinsrdationblumket(R-12«greater)orcombincdintuior/utesior ; F r j insulation (R-16 or greater): fust 5 feet of pipes closest to tank insulated (R-3 or greater). North §2-5312(Esception I): Pipe insulation on steam and steam condensate return & recirculating , NO1Z11 ) m - piping. East_ ) I 42-531g(d): Swimming Pool Hating - e _ ) 1. System has: East. \ �)_. 4 a.On/off switch onheater. s ( ) b. Weatherproof instruction plate on heater. SOUL e. Plumbed to allow for solar. r`.,. SOU Lh ) 7Pno1cover.fL 2. thermal eeieney. 3. West ( ) 4. Timc clock. ! West ( ) " .� - -,� er { 5. Directional water inlea t Lighting and Appliance Measures Skylight......: - e _ §2-5352(1):'Lighting - 25 lumcns/watt or greater for general lighting in kitchens and bathrooms. THERMAL MASS _ — - - _ i e §2-5314(e): Gas fired appliances equipped with intermittent ignition devices. Type/Covering Area Thickness It 12-5314(a): Rcfrigenors. refrigeratm-frcercrs. freezers artd fluorescent lamp ballasts certified (slab/exposed, tile. etc.) (sf) (inches) Location/Description (kitchen, bath etc) ! by the CEc. Indicate snake and model number. COMPLIANCE STATEMENT _ f This certificate of compliance lists the building features and performance sp=fi(ations needed to comply with Title 24. Chapter 2-53 and Title 20, Chapter 2, Subchapter 4. Article I of the California Administrative code. Thi certificate has been signed by etre individual with overall design responsibility and the building owner. who shall HVAC SYSTEMS Minimum Duct _ l retain a copy of it and trar=it the certificate to any subsequent purchaser of the building. Type (furnace. air Efficiency Location Duca Output _. Manufacturer / Model # Designer conditioner. heat pump) (SE, SEER HSPF) (aeric, etc.) R-Value (Btuh) (or approved equal) Building Owner t .. f Narna Natrac ` - TukJl=tnrs . _ T,tk/FimL Aedstext. Address: Tete*_ Telephone Maximum Furnace Heating Output:: Btuh t;c a: HOT WATER SYSTEMS Tank Manufacturer/Model # 1 System Type (storage gas, etc.) Capacity (or approved equal) Special Feature(s) (sitnaosre) _ (date) (sig;naru:re) (date) ' Documentation Author Enforcement Agency 4 - SPECIAL FEATURESIREMARKS (Add extra sheets if necessary) Name: Name: Titk/lri : Acc-r. ' - 2. Wall Insulation -70 -65 Number of stories j R -value One Two Three • R-0 ° -120 -59 -40 R-19 -10 -5 3 R-30 - -2 • -1 -1 R-38 0 0 0 U -value -6 -4 R-19 ' 0.50 -200 -99 -66 0.30 -118 -59 39 0.10 -02 -16 -11 0.08 -23 -11 -8 0.06 -14 -7 -5 0.04 -5 -2 -2 0.02 5 2 0.06 _ 0.00 14 7 4 ' - 2. Wall Insulation -70 -65 [ `• Interior interior Mass /CFA 0.0 j Single- Single - One 1 FamilyFamily R-0 Multi - R -value Detached Attached Family R-0 -102 -77 -51 R-11 -11 -8 -5 R-13 -8 -6 -4 R-19 0 0 0 U -value -13 10 -8 -4 I 0.80 -212 -160 -107 0.50 -132 -100 -67 0.30 -74 -56 37 0.10 -11 -8 -6 -0.08 -5 -3 -2 0.06 2 1 1 0.04 9 6 4 0.02 15 11 8 0.00 22 16 11 8 12 1.5 -3 1 3. Raised Floor Insulation 5 6 5 6 Insulation in Floor 0 0 Number of stories 20 R -value ?' One Two Three R-0 8 -12 -8 R-1 1 -5 5 -2 -1 R-19 0 0 0 R-30 4 2 1 U -value 7 17 i3.5 4.0 0.60 -218 -103 37 0.50 -180 -85 -55 0.40 -142 -67 -44 0.30 -103 -49 -32 0.20 -64 -31 -20 0.10 -24 -12 -8 i; 0.08 -17 g 14 16 0.06 -9 -4 Exterior 0.04 -1 -1 0 ' 0.02 6 3 2 0.00 14 7 5 Controlled Ventilation Crawispace -70 -65 [ `• Interior interior Mass /CFA 0.0 Number of stories Thermal Slab Floor Stones Two -6 R -value One Two Three R-0 -15 -10 -7 R-5 -4 -5 + R-11 .1. 3 -2 R-19 0 -2 -2 j 4. Slab Edge Insulation 0.3 0.5 • R -value One Number of Stories Two Three R-0 R-5 -13 10 -8 -4 R-7 0.7 -6 0 0 F2 factor 0.90 -19 -13 -6 0.80 -14 -9 .5 0.70 -9 -6 3 0.60 -a 3 -1 0.50 0 0 0 0.40 5 3 2 S. Infiltration (Air LeakAge) Specification points Standard 0 -70 -65 [ `• Interior interior Mass /CFA 0.0 One -10 Thermal Slab Floor Stones Two -6 Mass Three -4 Raised One -2 Floor Stories -1 Three -1 in attic) 6. Glass Heat Loss 1J 14 14 14 Sum of 7-10 0.1_g 10 6 12 4 9 6 11 4 -5 3 -1 0 0 Total 20 21 6.0 U -value +5 0.3 0.5 -8 -7 -4 3. -2 -1 0 1 1 2 1 2 Percent .51 to .41 to .31 to 0.30 0 0.7 -6 -2 -1 2 2 3 Glass Single Double .60 .50 .40 less 0.9 -5 -1 0 2 3 4 50 -190 -85 -63 +1 _20 1 1.1 1.3 -5 -4 -1 0 1 2 3 4 4 4 40 141 59 35 -117 -46 42 -31 25 -17 8 -2 8 12 1.5 -3 1 3 5 5 6 5 6 I 3 0 0 17 20 0 3 4 6 7 8 _ 29 -88 . -31 - 28 -84 -29 -19 -17 -7 -6 5 6 -16 17 1 3.0 1 5 7 9 10 10 27 -79 -26 -15 + 7 17 i3.5 4.0 2 3 6 7 8 9 10 11 12 26 -75 -24 -13 -3 8 18 4.5 4 8 10 11 12 13 12. Cooling System 25 24 -70 -65 SEER -11 -9 -1 1 9 10 19 19 5.0 5.5 (assumes ducts in attic) Ic 13 1J 14 14 14 Sum of 7-10 Effective SEER (SEER x duct efficiency) 10 6 12 4 9 6 11 4 23 22 SEER -25 r less +5 ++615 11 12 20 21 6.0 -15 -5 +5 14 15 more 8.0 -6 -5 -3 -2 -1 0 8.5 8.9 -2 0 -2 -1 -1 0 0 9.0 1 0 0 0 0 0 0 0 0 0 0 9.5 3 3 2 1 1 0 10.0 6 4 3 2 1 0 10.5 8 6 5 3 2 0 11.0 10 8 6 4 2 0 120 13 10 8 5 3 0 13.0 16 13 9 6 3 0 25 24 -70 -65 -22 -19 -11 -9 -1 1 9 10 19 19 5.0 5.5 5 9 6 11 Ic 13 1J 14 14 14 Skylight Effective SEER (SEER x duct efficiency) 10 6 12 4 9 6 11 4 23 22 -61 -56 -17 -7 -5 2 4 11 12 20 21 6.0 10 7 11 12 12 14 15 15 16 15 16 6 5 of 1 6 4 21 20 52 +7 12 3 1 5 7 13 22 6.5 7.0 . 7 11 8 12 13 13 15 16 16 17 16 17 Effective -25 or -24 tour 14 to + to SEER less +6 to 16 or 19 +3 7 1 8 15 16 22 23 7.5 8.0 8 12 8 12 14 16 17 17 5.0 -15 -5 +5 +15 more 18 -39 -5) 3 10 17 24 8.5 9 13 14 14 16 17 17 18 6.0 -16 -13 -10 -6 -5 + 3 0 17 -34 -2 4 11 18 24 -25 or -24 to -"to to +6 to 16 or SE HSPF less -15 5 +5 +15 SE None 39 18 18 6.6 -3 -2 0 0 -1 0 16 15 -30 -25 0 2 6 8 13 14 19 20 25 26 0.2 WSB 2 1 1 7.0 0 0 3 2 2 1 0 1 0 p 14 13 -21 17 5 7 10 12 16 17 21 22 26 27 10. Exterior Wall Thermal Mass 110% 8.0 9.0 9 7 5 4 13 11 8 5, 2 3 0 0 12 11 -12 8 9 12 14 16 19 20 23 24 28 Exterior Single- 7 Single- 4 3 10.0 11.0 17 14 10 7 20 16 12 8 3 4 0 10 9 -4 0 14 16 18 19 21 25 28 29 Wall Mass FamilyFamily Detached Fach Attached Multi Family 12.0 13.0 23 18 14 9 25 20 15 10 5 5 0 ; 8 4 18 21 23- 24 26 27 � 30 Multi -Family (individual 0 units) 0 0 l7 _ Zonal Control Adjustment 0 46 0.50• 4.58 -13 -12 -11 -10 _8 0.56 5.13 Water 5 52 699 700 1200 00.00 2200 0 0 0 0 0 0 0.60 5.50 7 6 6 5 4 q 2 1 or less to 1199 to 1699 to 2199 or 0.70 6.42 21 19 17 15 13 11 0.80 7.33 32 29 26 I SG None 0 0 0 0 040 5 or HP Solar HWR 14 10 7 5 5 3 10 8 6 4 2 0 :I 7. Shading (Shade Open) 1 No Cooling System Installed Effective Percent Glass 0.80 10 8 5 1.00 1310 Stories: (percent glass x SC) - Effective a. North --- %Glass North East South West Skylight 18 16 10 6 12 4 9 6 11 4 na 14 12 7 6 10 4 6 6 9 na na 10 4 4 5 4 na 9 8 4 4 7 4 4 8 3 4 6 4 5 6 5 2 3 4 3 6 4 1 2 3 2 1 1 2 1 6 6 2 - and Attached , 14 1 1 2 3 2 -1 + -6 -3 4 3 0 -2 -6 -11 -6 0 na = not allowed 1199 '8. Shading (Shade Closed) 1700 2200 Effective Percent Glass 11. Heating System I TYPe (percent glass x SC) ar lets Effective to 2199 to 2699 9'. Glass North East South West Skylight 18 16 -9 32 +6 -45 -8 -27 39 38 na 14 12 -6 -23 32 31 -5 -18 -25 -24 na na 11 10 -5 -16 -22 -21 + -14 -19 -18 na na -63 9 8 -4 -13 -16 -15 -3 -10 -14 -13 -54 -46 7 6 -3 -8 -11 -1138 2 -6 -8 -8 30 5 4 -1 -4 -5 -6 -23 3 -1 -2 -3 3 0 -17 2 -1 -1 -1 0 1 1 2 -11 -7 1 0 1 2 3 4 -3 6 1 4 4 6 0 na = not allowed -25 or -24 to -"to to +6 to 16 or SE HSPF less -15 5 +5 +15 4 2 0.60 7 6 4 1 No Cooling System Installed :.. 0.80 10 8 5 1.00 1310 Stories: 7. - - a. North --- _ ... b. East - 1.20 16 12 g One 0 t) 0 0 0 0 1.40 19 Two + 5 4 3 2 1 _..-_.�,_..._ 0 1.60 22 16 1�1 ' 13. Water Heating e. Skylight 9. Interior Thermal Mass 1.80 22 19 12, 2.00 22 21 Single -Family -Family - and Attached , 14 -Single I _Detached -Detached. Unit Size (sQ t,_ TYPE 2 MASS Water Heater Credit 1199 1200 1700 2200 2700 11. Heating System I TYPe TYPO ar lets to 1699 to 2199 to 2699 or more Sum 7-10 SE or HSPF [0.7216.6] None 0 0 0 0 0 SE or HSPF lSG or HP Solar HWR 12 S 8 6 6 4 5 4 (assumes ducts in attic) Ir.n.e.a .�•al WSB 17 12 9 3 7 3 Sum of 1-6 1 "Pe 1 POU 9 6 4 3 6 3 -25 or -24 to -"to to +6 to 16 or SE HSPF less -15 5 +5 +15 SE None 39 -26. -19 -15 -13 more 0.72 6.60 0 0 0 0 0 • 0 90X Solar HWR -2 -18 12 -9 -7 _g 0.75. 6.88 4 4 3 3 3 2 0.2 WSB 2 1 1 1 0.80 7.33 11 10 9 8 7 6 POU -18 -12 -9 -7 -6 0.85 7.79 16 15 13 12 10 9 Q5X 100% 105% 110% Its% 0.90 8.25 21 19 17 15 13 11 IG None -2 -1 -1 -1 -1 0.95 8.71 26 24 21 19 16 14 11 1./ Solar 10 7 5 4 3 live live E or HSPF (SE or SPF 29 POU 7 5 3 3 2 duct efficiency) -25 24 to16 or IE None Solar -28 10 -19 7 -14 5 -11 .9- HSPF lesective s tiro +55 more t POU -7 _-5 3 4 3 3 -2 0.30 275 -94 -85 76 -68 -59 -50 1 Multi -Family (individual 2.9 3.1 units) 33 na 3.41 -57 -52 -46 -41 -36 -31 0.40 3.67 -43 -39 35 - 31 -27 _23 l7 4 4.2 Unit Size (sQ 46 0.50• 4.58 -13 -12 -11 -10 _8 0.56 5.13 Water 5 52 699 700 1200 1700 2200 0 0 0 0 0 0 0.60 5.50 7 6 6 5 4 q Heater `I Type Credit Type or less to 1199 to 1699 to 2199 or 0.70 6.42 21 19 17 15 13 11 0.80 7.33 32 29 26 I SG None 0 0 0 0 more 0 23 20 17 0.90 8.25 40 37 33 29 25 22 1.00 or HP Solar HWR 14 10 7 5 5 3 3 3 9.17 47 43 38 34 30 25 1.1 WSB 29 14 10 7 6 . Zonal Control Adjustment 26 POU 10 5 3 3 2 System Type SE None +6 -23 -15 .12 -9 Resistance 10 9 7 6 5 3 5 a Solar HWR 2 -23 1 -11 1 -8 0 -6 0 -5 Other 6 5 4 4 3 2 WSB 22 11 7 5 4 16 16 POU -73 -11 -8 -8 -5 3.1 S.3 n None -2 -1 -1 0 0 L4 1.6 Solar 11 6 4 3 2 3 32 POU 8 4 3 2 2 IE None -28 -14 -g -7 -6 W% 65% 1 Solar 22 11 7 6 4 25 27 POU + -2 -1 -1 -1 Point System Summary: Climate Zone 16 SCORE CARD Measures - Point Scores 1. Ceiling Insulation 01- -- - - --- Z -value 1381 U -value (0.030] - - 2. Wall Insulationor .:._._ -value 191 U -value (0.066]--- 3. Raised Floor Insulation �l4 or R -value U -value [0.037] 4. Slab Edge Insulation S.::Infiltration� :.. 6.^;Glass Heat Loss 7. Shading (Shade Open) a. North _.._ _ ... b. East - - -Interior Mass /CFA Eff, g'o Glass d. West X e. Skylight 8. Shading Shade Closed) ---=� - .� a. North b. East X C. South X = d. West e. Skylight 9. Interior Thermal Mass Interior Nies/CFA _ GOND. FLOOR AREA - -•--- TYPE 2 MASS AREA 8 Exterior Wall Mass ND. L R AREA Sum 7-10 SE or HSPF [0.7216.6] X - Duct Efficiency (0.78] Effective SE or HSPF (0.56/5.15] ' X =_ u SE Ir.n.e.a .�•al Duct Efficiency (0.74] Effective SEER [6.59] TYPe [SG] Credit (none] 1 "Pe 1 ?USS (OLtC s 4.2• t•t Owposed stab) 0% S% 10X IS% 20% 2S% 30% 35% 40% 4S% 50% 5S% 60% 6Sk 70% 75% a0% d5% 90X ox 0 0.2 0.4 06 Q5X 100% 105% 110% Its% 120% 125`. to% a2 0./ 0.6 0.6 0.6 1 1.1 1.2 11 1./ 1.5 1.6 1.7 1.9 1.9 21 23 2S 27 29 32 14 3.6 3.6 ! 12 <! 4.6 4.8 20% 0.3 0.6 0.6 1 12 1.4 IA 1.6 2 21 22 23 24 25 27 27 29 2.9 3.1 11 33 3.5 l7 4 4.2 4.4 46 4.6 5 5 52 53 54 Jo% 10% 0-S al a1 0.9 09 1.1 "1 1.1 1.6 1.6 2 22 24 2a 26 3 3.2 13 3.S 15 17 17 39 3.9 4.1 4.1 4.3 4.S 4.8 5 52 5.4 56 SOX a9 1.1 1.3 11 13 1.5 1.7 1.7 1.9 1.9 21 22 21 26 2a 3 3.2 3.4 16 11 t /.7 4.3 <.5 4.5 1.7 4.7 1.9 t .9 5.1 5.3 5.6 5 a 23 25 27 3 32 14 16 16 4 42 4.4 4.6 4.6 S.1 3.1 S.3 53 SS 5.7 59 5S% a9 1.1 L4 1.6 1.6 2 22 24 2.6 26 3 32 33 5.5 5.7 5.9 6.1 W% 65% 1 12 1.4 1.7 1.9 21 23 25 27 2-9 11 13 35 3.7 3.a 19 1 4.1 4.3 4.5 4.7 4.9 11 53 56 5a 6 62 70% 1.1 1.2 1.3 1.4 1.5 1.6 1.7 1.6 1.9 2 22 2! 26 26 3 12 14 36 3.6 4 1.2 4.J 1.4 I.S !.6 1.7 1.6 ' S S.2 S.1 S.6 5.9 6-1 62 15X 1 ] 13 1.7 /9 21 22 23 2S 2S 27 2.9 11 13 SS 3.7 3.9 4.1 4.3 4.6 4-a a.9 S 5.1 52 S.J 5 S S S.7 5.9 6.1 61 27 3 12 14 16 16 4 4.2 4.4 4.5 4.6 5.1 5.3 .4 SS S.6 5.7 5a 6 62 64 60% 1.4 1.6 1.a 24 26 2t 3 3.J 3.S 11 3.0 1.1 . 5.9 6.1 6.3 65 6SX 90% 1.1 1.5 1.7 1.7 1.9 2 2.1 .3 2] 25 2.7 29 3.1 ]7 3.S 16 4 42 1.3 4.4 4.5 !.6 4.7 4.9 5.1 SI 5.6 sa 6 62 61 66 95% 1.6 1.a 2 22 24 2S 26 27 2.6 29 ] ].2 ].! 3.6 16 4.1 4.3 1.6 4.7 4.6 4.9 S S.1 S2 S 3 S4 S.6 S9 6.1 6] 3 6S 5 67 1007: 1.1 19 21 2.3 25 26 3 11 u 33 9A 3.5 16 17 19 4.1 4.J 4.6 4.a S 5.2 S.4 S S S.6 s.7 S.6 S.9 6 6 2 6 6 6 6 16 4 12 4.! 1.6 4.9 51 S.J S.5 S.7 S.9 61 6 2 6.] 6.! 6.7 6 9 105% 1.8 2 22 2.4 26 26 3 3.3 3.5 3.7 3.9 4.1 4.3 45 6.5 6.7 7 110% 115% 1.9 2 21 22 23 25 27 29 11 13 3.6 3.8 4 4.2 4.4 4.6 4.7 t.a 4.9 S 5.1 5.2 5.4 s.6 5.a 6 62 6.1 6.6 6a 7 120% 2 23 24 25 2.6 2.7 26 29 3 3.1 3.2 13 14 3.6 3.6 4.1 4.3 4.5 4.7 1.9 5.1 5.3 5.! 5.5 5.7 s.7 5.9 61 6-] 6S 6.7 69 1.1 125% 21 23 2S 2.3 3 32 34 15 16 3.7 18 3.9 4.1 4.4 4.6 4.6 S S.2 5.1 S.6 S a S.9 6 a.2 62 6.4 6.S 6.6 BA 7 7.2 7.2 4 4.2 !A 4.6 4.9 s.1 13 55 5.7 5.9 &1 6.3 65 6.7 6.9 7.1 a-7 7 7.2 7.4 Point System Summary: Climate Zone 16 SCORE CARD Measures - Point Scores 1. Ceiling Insulation 01- -- - - --- Z -value 1381 U -value (0.030] - - 2. Wall Insulationor .:._._ -value 191 U -value (0.066]--- 3. Raised Floor Insulation �l4 or R -value U -value [0.037] 4. Slab Edge Insulation S.::Infiltration� :.. 6.^;Glass Heat Loss 7. Shading (Shade Open) a. North _.._ _ ... b. East - - C. South Eff, g'o Glass d. West X e. Skylight 8. Shading Shade Closed) ---=� - .� a. North b. East X C. South X = d. West e. Skylight 9. Interior Thermal Mass R; value [71 or F2 factor [0.51] _ _ - - - - - - Standard ---�<g Type [double] -value- [0.651 75 Total Glass (16] - a Sum 1-6 Glass _.. ` SC _. Eff, g'o Glass �•3 X = �• X86 +� ---=� - .� X X = 0 X = Q_ 10. Exterior Wall Mass 11. Heating System Zonal Control? ( Y / N ) 12. Cooling System Zonal Control? ( Y / N ) 13. Water Heating % Glass . = SC Ef°. % Glass ---�<g X �•3 X = �• X86 +� ---=� - X - y X = 0 _ TYPE 1 MASS AREA Interior Nies/CFA _ GOND. FLOOR AREA - -•--- TYPE 2 MASS AREA 8 Exterior Wall Mass ND. L R AREA Sum 7-10 SE or HSPF [0.7216.6] X - Duct Efficiency (0.78] Effective SE or HSPF (0.56/5.15] ' X =_ u SE Duct Efficiency (0.74] Effective SEER [6.59] TYPe [SG] Credit (none] -- �- -� I I ---.---- � . �-- . � 11 7-------"---ImmmmmmwaWM�,.�—,---Ir I � I I I 11 - . 11 I �, .1 ;: �- - I I I � I I � - � � 1. I I - - - - � I 11 . 1 -�--------1`--- 1 - .1 I - . I I ----, 1-1 - I. .1 I - —, � , � .... 1-11 I -- I �. I I I I - I � , - , I I I - - I � I 11 I .. " ", I I � I . I � I � I I . � I . � i,----.--,.-,-, �-;,,,,r,11-1- - � -, �j - ,--.-."-----,, -----"r" --wre ,,,- -------.1-r1-1",-, �� -,`-', , �Iik-, -1--l- -,----T�i, 1 71--', --,� --- --,- --�-,-1V---r--t,--r-*-- - -1- - -.-:�." -----I..-.- , - -- ... I --l"-- -i,-i,,,---'--,7- � - - ,��- � ,----. " I 11 - I 11 -7�77-- ,--, -T,- I , I fe,!", � ��, �� 11 1, "I - . �,'4, 1 �, , , ,; : If. . , . I -I-711- 1 �7 -,- ,-; - �r%-I`rl- . , � I . I , I � I , , - . 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