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Home My WebLink About078-050-002 -- r, 0 RESIDENTIAL 36-292-24 _ --- 4009-90B,E LOMBARDI, Tony 2166 Kusel Rd, Oroville �• Contr: Don Schribner (garage) r llcolq JOB FINALE Signature V=OK O = Not OK =No Applicable MOBILE HOMES , Date MOBILE HOME UTILITIES (Plans) OK except #'a 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fell -C/O Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap: / /"L"ft. / /"Net. or/ /"L"ft./ /"LPG 7. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except ti's 1. Zoning Requirements -Setbacks Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test-Demand-Valve—Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fell -Flex Connector 6. Water; MH Teat -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval S. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 10. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 DateCard B-1:' ; Date d B - Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'a 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure;.Steel-Connections-Thlckness Dead Men -Lining 4. Elec.; Receptacles`a'nd Lighting, Dletances-GFI 5. Elec.; Pool Lighting;,15 volts-GFI S. Elec.;Enclosure4;,,C.onduit Entries -Terminals -Listed 7. iW8',,°,Bgnd1ng;`Metal w/5' -Circulating Equip. -Heater B..Elec: GrouridYrig: Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main In Conduit 9. Health, Departrrient Approval 10. Plumb.; Cir. test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 'J OK O = Not OK - = Not Applicable RESIDENTIAL (; = Not Ready Date UNDERFLOOR (Plans) OK except #'s r' 1. Zoning-S4acks-Easements-Flood-Slope 2. Ftg,, Win; Soils -Elea Grnd.-/ /" Ftg. Depth 3. Fig., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Fig., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel- Bloc kouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. Gas Pipe; Size -Anchors 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Pienums & Ducts: Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 16. Water Htr.; Vent -Access -Combustion Air -Baffle 17. Water Pipe; Test & Anchor -Nail Protection 18. D.W.V.; Test -Fittings & Anchor -Nail Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors Date Card B71 Date Card B-1 Date Card B-1 Date Card B-1 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. Fastners-Bond Gas & Water 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 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 33. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 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. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet 38. Attic Access & Platform if Furnance in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except #'s 39. Sils, 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. Headers & Beam -Size & Bearing tingle & Duplex) Date FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties -Pu rlin -roof Brac-Truss-Shthng.-Rfng. 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 -Ceilings 60. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 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 Protection 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 O Yes 0 No; Walks ❑ Yes 0 No; Planters 0 Yes ❑ No 81. Stucco; Brown -Finish 82. A.C. Unit; Disconnect, Electrical, Plumbing 83. Vents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to Openings 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 Inspections 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: (NOTE: An entry must be made each time you visit job site) OWNER COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 538-7541 f 747 Elliott Road, Paradise— Phone: 872-6307' CORRECTION NOTICE 3 T NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. Date/ Inspectov COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Orovi Ile — Phone: 538-7541* 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE OWNER PERMIT NO. A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. I Date) Inspector 1 -4 I n My COUNTY OF BUTTE - OEP4TMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT. PERMIT NO. 4J009_9© ASSESSOR PARCEL NUMBER 36-292-24 ZONIN Ml BUILDING PERMIT OWNER TONY LOMBARDI TELEPHONE S0. FT. OCC.1 BUILDING VAL ON 672 M 9408.00 OWNER'S MAILING ADDRESS 2166 KUSEL RD, ORO CA 95965 CONTRACTOR'S NAME DON SCHRIBNER TELEPHONE CONTRACTOR'S MAILING ADDRESS N ST, LIVE OAK, CA 95953 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 1000 LENDER'S MAILING ADDRESS Permit Fee $ 80.25 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 40.00 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 2166 KUSEL RD, ORO CA Permit fee $ 130.25 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 ❑ Duplex❑ Mobilehome❑ Other GARAGE SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.006 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other ❑ Describe work: 94' X 98' _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6001 OR LESS 100 AMP OR LESS 10.00 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. 2 Classification License No.%� ❑ 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 Main service EA. ADD'L 100 AMP 2.50 NEW CONST.( OR ACDNS. DWELLING OCCUPACC. BLOGS. .tk 2 4sgIt NEW CONSTR. MULTI -OUTLET NON-RESID BRANCH CIRC ITS 3 2.50 ea 7,50 POWER APPARATUS h (SINGLE OUTLET CIR. ) Ex. Occup(ourLETs OR FIXTURES e20060e AL@30 FIXED APLNS Ex. Occup. OUTLETS P(RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ 17.50 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. 71/ 1 shall not employ any person in any manner so as to become subject LW 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 Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County i consequence of the granting of this permit. Signature of Applicant — Owner ❑ Contractor � Agent El 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 $ 147.75 HAz `— c A PARK SCHL FLD PAR PD ✓ HD IssuE/ (/ This permit is nereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC BY PER EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date �z �— Receipt No. 84478 — 147.75 WNITE-O.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT .OF- PUBLIC WORKS - BUILDING DIVISION r 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/516-7541 } r PERMIT APPEICkriON DATA SHEET Z OWNER /n,) Permit No. s A. P..No.- w.Z 9'.2 'Z Proposed Bui Id ing Use Building Inspector J6:4; Date.- At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED -APPROVED 1. All items have been submitted . ............................ ... 2. Plot plans in duplicate/triplicate,,signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans . . 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ............... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation instructions....................................................... 10. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13 School District fees paid .............. �4. Sanitation approval from Health Department 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: .... 18. Improvements may be required. Contact Land Development Section DPW-' Ok4o—ol*' 19. Driveway permit (construction approval required prior to occupancy) ZZ /a'" a 20. Pre -Inspection for required . Pre-Inspec.request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization 26. /3 Co 27. When youissue the permit, process follows: Mail to owner. Mail to contractor. �� Telephone and hold for pickup a office. Deliver w. /inspector. Other 5,c etvJtee`� s Applicant Date Copy of Hai -Mat form sent Health Dept. ZFre De it Pollution Date Copy of plans sent _Health Dept. Fire Dep Other Date By I The following data must be submitted rio to permit issuan e: (Circle new item not checked. above): 1. Index permit for above items No.A w 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone--naiI—counter by ..date Contractor, designer, owner, was advised of above required data'by—phone —ma II—counter by date Plans checked by Date Plans approved by _Date Sets of plans on hold in File cabinet -AP folder Copy—D,PW TO Buiidinna Department FROM: Envtxonm--ental Health SUBJECT: Sanitation Clearance Owner Location AP# Plan Approved for: Sewaqe Disposal 011- Water Supply Hold final for: Final clearance O.R. for: Clearance for ' bedroom mobile home. NOTE * * * Sanitarian Water Supply Water Supply Other Date COUNTY OF BUTTE DEPARTMENT -OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 2 v ZONING ,r✓i / BUILDING PERMIT. - OWNER a M i�i/tl ��J I TELEPHONE SO. FT. OCC. BUILDING VALUATION %✓( a d MAILING OWNER �ADDP.E� I jjj_fff��Lvvv CONTRACTOR'S NA O � TELEPHONE CONTRACTOR'S MAILING ADDRESS g`-- Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ 0AE ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee p CD Energy Plan Checking Fee E$.. $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS - Permit fee $ 30 , PLUMBING PERMIT Filing Fee 10.00 Z-/' zo C �7-2Each Trap 2,00 Solar or heat pump water heater 20.00 LOT NO. SUBOI VISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE }� SF [JDuplex❑ Mobilehome❑ Other(— SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home 1SFG IN O.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ -Other ❑ Describe work: _ 2 Y X Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 6001 OR LESS I00 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW 1 declare under penalty of perjury (Check One): - .-F-1-1•am- Ii-censed under provisions of Chapt. 9, Div. 3 of the Business _ �_and-Professions Code and my license is in full force and effect. License No. Classification ❑ =< I,- as the ownef; 'or my employees with wages as their sole compen- sation, -will do the -work, and the structure is not intended or offered -• - :. for.sale. (Sec: 7044), ' . ❑ 1, as the owner, 'am.exclusively contracting with licensed contract- _ --ors. (Sec. 7044) "- ❑ '. 1 am exempt under Sec. , Business and Professions Code for this reason OCCUP.a, NEW CONST. DWELLING OR ADDNS. ACC. BLDGS. ( , h2sgft NEW CONSTR. ULTI-OUTLET NON-RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS e (SINGLE OUTLET CIR. Ex. OCCUp(OUTLETS OR FIXTURES .200606 eAL030 Ex. Occup. oEA.) ur OUTLETS PIRESID )R 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 9 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 9 Hood 3.00 Ventilation permit Fee $ Contractor I certify that 1 have read this application and staterthat the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property -for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, -and expenses which may in any way accrue against said County in.consequence.,ofthe granting of this permit. '�� X71, ` Date Signature of Applicant— G,«.Owner.❑ ~Contractor ❑ Agent ❑ ., An OSHA permit -is - Ire quired:forexcovations -over 5'0" deep and demolition or construct- ion of structures overe�3Csttories in height.. •• Mobile Home Installation Fee $ Energy Inspection Fee $ OCC I CONSTTYPE c/ TOTAL FEE $ 7 /, HAZ CUA [;A�.FLDAL I PAR PD Ho - ISSUE This permit is nereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date Receipt No= -7 •7•=7. =lS�.- • WMIYE-O.P.W., YELLOW-AseE3sOR; PINK -INSPECTOR. GOLDENROD -APPLICANT c PEWMIT NO. 1444-77B PERMIT EXPIRES i OWNER T. Warren CONTR. Parish Const. Co., Orov il7P LOCATION (A.P. 36-292-24 2160 Kusel Rd., Oroville Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E Temp. Gas Serv. Cal l ed. PG& E B a O i FINAL JOED j (Date i �c (Sig a ure) �.UULIV rinai COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD BUILDING BUILDING (Cont'd),PLUMBING Mesh MkCAANICAL Grd. Fault Prot. Setback Firewall Soil Piping Forms Parapet 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor StemwalI Siding To out Slab Roof Sheathing Water Pi in Piers 7y Roofing Sewer Garage Fdn. Vents Fixtures Footings Stemwa I I Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for physically handicapped Conformance of ex. structure Appliances Gas Piping &Test Temp. -Gas Slab Final Sanitation Patio FIREPLACE Final Footings 'Footina ELECTR L Masonry Walls Throat Rough Relnf. Steel Final Fixtures Bond Beam ( , n, / FIAE SPRINKLERS Motors �.UULIV rinai bubpanels Mesh MkCAANICAL Grd. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent t/ Door Closer Final Final MOBILEHOME UTILIT ES ------------------ Elec. Service ` Elec. Pedestal Water Piping Sewer Gas Piping OB16EH014E INSTALLI%TION - - - - - - - - - - - - - - Support Elec. Continuity 1 Water Piping Drainage Gas Piping DATE REMARKS OR CORRECTIONS L (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE — DEPARTCIENT OF PUBLIC WO - S 7 County Center Drive — Oroville, California 95965 ! Telephone: 534-4541 �•�/( `/Y'%` APPLICATION AND PERMIT ,.. CC a ( yo,.. Date Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Building permit expires Date BUILDING Owner SQ. FT. OCC. BUILDING VALUATION b vii` K C"r" ' -50700— o7U "Mai Mai I i ng Address Telephone No. Fireplace Contractor �• /Z f•S ty' C On S eo Total Valuation Mailing Address t 7 � d itA✓) to 'Ou -• Permit Fee Plan Checking Fee &/or Penalty P1 Q O t L CE` lephon_ef o UL Permit Fee � _ 3 Building Address LA C L PLUMBING No. @ I FEE PERMIT FILING FEE $3.00 jQ 0 Q f L C Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1.50 Each gas water heater or vent 1.50 / A. P. No. 6 QZ'— .Z Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F -W.C. 1 4814014et+ Fire Dept. FireZone Use Permit Building sewer 5.00 EGA Parking Plans Parcel Declaration P rcel Ma P 60' R/W ImprovementsLawn sprinkler system 2.00 Bldg. IWans Rec'd arcel Approval Plan •Approval Permit Fee $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 iA &LICAQ- Main service 100 AMPAMP ORSLV OR L ESS 5.00 Main service EA. ADD'L too AMP 2.50 Single Family Duplex ❑ Mobil Home ❑ Others ❑ ER 600V 0 0 AMP OR LESS 25.00 Main service 1 Main service EA. ADD'L too AMP 1.00 NEW DWELING OR ADDNS. ( ACCLBLDGSCCUP. &) 22sgft NEW CONSTR. MULTI.OUTLET NON.RESID. ( BRANCH CIRCUITS) 2.50ea NEW CONSTPOWER APPARATUS &) R. RESID, (SINGLE OUTLET.CIR. NON. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under under the name styl off:p ] C _ ,,, �!"1^ 1 ✓� N Si &U cT�Q /"„((1JJ � Ex. Occup(OUTLETS OR FIXTURES) 50 BA@� Ex. Occup.FIXED APP LNS. OR2.00 OUTLETS (RESID,) EA Temporary service 10.00 0.00 Mobile Home Facilities 15.00 as7�rg License No. Classification Misc. Wiring 6.25 ❑ I am exempt from the Contractors License Laws of the State of California. Permit Fee $ $ WORKMEN'S COMPENSATION INSURANCE' 1 am aware of the provisions of Section 3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. Date 9- - —%7 TOTAL PERMIT FEE s 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. ///^/'r /JJ��'IRE T OF P IC WORKS ,.. CC a ( yo,.. Date Receipt No. White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant Building permit expires Date BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS / 7 y �r-77 .f SPECIAL INSPECTION REPORT Owner:.,_I • 04✓1-t2�`� Address: Tenant: A.P.# 36_-7P.2^2Y Date of Inspection /j Inspector 9?1.111-r-�� Building Location: Type of Inspection requested: / /1. Housing /./ 2. Financing 3. Change of Occupancy to 4. Other (specify) Present use of building: A. Sanitation (Housing) 1. Water closet: 2. Lavatory: 3. Bathtub or shower: 4. Kitchen sink: 5. Hot and cold water to fixtures: 6. Heating facilities: 7. Natural light and. ventilation: 8. Room and space requirements: 9. Bedroom window or door for second exit: 10. Infestation of insects, vermin, or rodents: 11. Connection to sewage disposal: 12. Connection to water supply: 13. Rubbish and garbage facilities: 14. Con ments• B. Structural _ 1. Piers and footings: Off_ 2. Floor construction: 3. Wall construction: 4. Ceiling and roof construction: . 5. Fireplaces: 6. Comments: • C. Electrical 1. Service and ground: 2. Receptacles: 3. Fusing: 4. Comments: --- D. Plumbing 1. Fixtures 2. Gas water connected and vented: heater: 3. Gas heating vents: 4. Comments: (continued on back) E. Other 1. Maintenance and repair: 2. Fire hazards: 3. Safety hazards: 4. Weather protection: 5. Underfloor and attic ventilation: 6. Comments• F. Commercial Buildings 1. Roof covering: 2. Distance to property lines: 3. Physically handicapped: 4. Restroom floors and walls: 5. Exits: - 6. Improvements: 7. Zoning: 8. Comments• G. Field Problems or Violations 1. Problem or violation (give complete description): 2. What action taken (give complete description): 3. What action recommended: A. Information only - file. B. Hold for ten (10) days, then write letter. C. Write letter. D. Other: COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 4T00 9 " Q D APPLICATION AND PERMIT ASS 5 R PARCEL NUMBER ZONING n7.7- R PAR BUILDING-PERMI-T--....:,_.._-_.,_�_....,__ .-.:_-- ,6-292-24 -..-.,. _. _ _._._ ,.._. F'ONY LOMBARDI OWNER'S MAILING ADDI 2166 KUSEL RD, CONTRACTOR'S NAME DON SCHRIBNER CONTRACTOR'S MAILIN N ST, LIVE OAK CONSTRUCTION LENDE ORO CA 95965 LENDER'S MAILING AODR ADDRESS CA 95953 ITECT OR ENGINEER ARCHITECT OR ENGINEER'S MAIL BUILDING ADDRESS 2166 KUSEL RD, ORO CA LOT NO. I SUBDIVISION NAME DRESS TELEPHONE S0. FT. I OCC.1 BUILDING VALUATION 672 Im 1 9408.00 ELEPHON UNKNOWN PARCEL MAP USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other GARAGE SPECIFY TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Describe work: 94' X 9R, CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt urder Sec. , Business and Professions Code for this reason . WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature of Applicant - Owner ❑ Contractor ❑ Agent ❑ An OSHA permit .is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Fireplace $ Contractor Total Valuation $ Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Filing Fee $ NEW CONST.( DWELLING OCCUP.al OR ADONS. ACC. BLDGS. 10.00 Permit Fee $ 80.25 Plan Checking Fee $ 40.00 Energy Plan Checking Fee $ Penalty $ Permit fee $ 130.25 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 Water piping 5.00 Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W I 10.00e Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADO'L 100 AMP 2.50 NEW CONST.( DWELLING OCCUP.al OR ADONS. ACC. BLDGS. 'hQSQft NEW CONSTR ULTI.OUTLET .� n a2v.S co ecru rioriutc 3 2.SOea 7.5 (POWER APPARATUS h\ (POWER OUTLET CIR. I Ex. Occuzo a s0ap(ouTLETs OR FIXTURES eALQ 30 FIXED ALNS. Ex. Occup. OUTLETS P(RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ 17.50 Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor Mobile Home Installation Fee $ Energy Inspection Fee $ OCC I CONST TYPE TOTAL FEE $ 147.75 HAZ I CUA I PARK I SCHL I FLO I PAR I PD I HO I ISSUE Th's permit is nereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS Receipt No. 84478 - 147.75 By Date PERMIT EXPIRES Date .. .,'e <C. t t�ty�t•�� c�.,cawt�: ..,��_�`�er�� - j�^'a.�' /'7;5"":?a.c-� - ry!...r.��s� -v� - czG� OFFICE COPY Address GAS Cq''ll Meter BY—Z\-k--- E y EL CTRIC Mee By Date V COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroviller California 9 59 65 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 4 Z0J01NG BUILDING PERMIT OWNER an. TELEPHONE G SQ. FT. OCC. BUILDING VALUATION OWNEW'S MAIL DRESS - 1 0 1 9 C ONTRACTOR'SNE TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING p ADDRESS 2160 A 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 0 Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 5.00 Building sewer 5.00 Mobile Home I S I G W 10.00e TYPE OF WORK$ '` ., New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other K] Describe work: Gas Pipe Test _ Min charge 25.00 10. 10.00 Permit Fee $ 25.00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 00V OR L Main Service 100 AMP ORSLESS 10.00 Main service.EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification 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 OCCUR.E OR ADDNS. ( ACC. BLDGS. , 2/20sgft NEW CONSTR. MULTI -OUTLETS) NON-RESID BRANCH CIRC ITS ea POWER APPARATUS e� SINGLE OUTLET CIR. Ex. Occup( OR FIXTURES 200600 eAL030 FIXED APLNS. EX. Occup. OUTLETS IPRESID )REAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. �Virin 9 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 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. 1 (^ X! i :, ..air-. rrif� X(rZ/.r rii Date 7� - % >l/ Signature of Applicant•=m Owner Contractor ❑ Agent 1:1 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 AL TOTAL FEE $ 25.00 HAz CUA PARK FLD PAR PD HD Issu This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which fees / j OF P/�IVORKS % DlR;ZAf,0Zate (/ B1/ PERMIT EXPIRES Date the appiicalt provi-' resolutions to do have been aid. p . br / Receipt No. 70569 WN,TE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT 140. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER . 36-299-24 ZONING 1 Nh BUILDING PERMIT OWNER T. TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNE 'S MAIL DRESS Rji� oroviiie 9s966 CONTRACTOR'S N AM TELEPHONE C N CTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 1000 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee ,$ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT FiIingFee 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[E Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 5.00 Building sewer 5.00 Mobile Home I S I G JW I 10.002 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other] Describe work: Gas Pipe Test Min charge 25.00 10. 10.00 Permit Fee $ 25.00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP ORV OR LESS10.00 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason Main service EA. ADD'L 100 AMP 2.50 OR ADDNSCONSTDDWEACCLLIN GOCCS. UPM 21/4sgft NEW CONSTR ULT' -OUTLET NON•RESID BRANCH CIRCITS 2.50 ea POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. OCcup(OUTLETS OR FIXTURES 2005 30 8AL@30 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. �f I shall not employ any person in any manner so as to become subject G� 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 Coolin g Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, a expenses which may in any way accrue agains id County in cc s;equenc f th granting of this permit. X %Q 7 �'/� r Date LLi� Signature of Applica — Owned Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ gs nn HAZ CUA PARK SCHL FLD PAR PD HD Issu This permit is nereby issued under Bions of the Butte County Code and/or work i ' ated above for which fees SIR OF PUB C B PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. ORKS Date MT J ;Zi I _J Receipt No. 70569 WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF. BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - yovi,lle, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER OWNER ZOWING BUILDING PERMIT TELEP ONE d S3� 6 OWNER'S MAI LIWG ADDRESS ^ "CONT FrIllCT 'S NAME �r\J SO. FT. OCC.1 BUILDING VALUATION i ; TELEPHONE CONTRACT 'R S M LING AODRESS F i rep I ace CONSTRUCTION LENDER UNKNOWN Total valuation $ LENOER'S MAILING ADDRESS ARCHITECT OR ENGINEER LICENSE No. Filing Fee $ 10.00 Permit Fee. Plan Checking Fee $ J $ ARCHITECT OR ENGINEER'S MAILING ADDRESS BUILDING ADDRESS Energy Plan Checking Fee $ Penalty Permit fee $ . $ PLUMBING PERMIT Filing Fee 10.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each Trap 2.00 Solar or heat pump water heater Water piping 20.00 5,00 Each qas water heater or vent 5,00 S4SfiUSE OF STRUCTURE .Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 5--� Building sewer 5.00 Mobile Home I S I G I W 10.00e TYPE OF WORK New ❑ Addition ❑ Rem Utilities ❑ Ins allat' ❑ Other Describe work: �� /4W, R� `�i E )0— /U Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service ;00°V OR o AMP ORSLESS 10.00 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): EJ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect, License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract - ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason Main service EA. ADD'L too AMP 2.50 NEW CONST. DWELLING OCCUP.& OR ADONS. ( ACC. BLDGS. '/20sgft NEWCONSTR ULT' -OUTLET NON.RESID BRANCH CIRC ITS 2.50 ea /POWER APPARATUS e) SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 200500 BALI? 30 FIXED APPLES. OR Ex. OCCU P• ouTLETs'REsID., EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee s 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 tc 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: It 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 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 or Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and.expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature of Applicant – Owner .Contractor ❑ ' Agent ❑ 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 $ HAZ CUA PARK SCHL FLO PD HD IS This permit is Hereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIPFS nate the applicable provi- resolutions to do have been paid. WORKS Date Receipt No. WHITE-O.P.W.. YELLOW-ASSESS0 . PINK -INSPECTOR. GOLDENROD-APPLI CANT COUNTY 01-' BU'TTE'- 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 pormi.t has been applied for :gin your. name and bearing your signature. Please complete and return th�.s 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 i provement (yes or no) � 2. I (have/have no signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name Address _ _ City _ Phone Contractors License No. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: Name _ Address _ City Phone Contractors License No. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Address . Phone Type of Work Signed: Property Owner Social Security Number Date s '% e(Q 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. ' Of -P Line -On Soar' C�_ O P4I P BUTTE COUNTY AREA DEPARTMENT OF DEVELOPMENT SERVICES 1 INSPECTION CARD MUST BE ON JOB SITE 24 Hour Inspection Line: (530) 538-7636 (Oroville) (530) 891-2834 (Chico) Office: (530) 538-7541 Fax: (530) 538-2140 Website: www.buttecounty.net/dds Permit No: B07-0928 Issued: 05/01/2007 Address: 2160 KUSEL RD Area: OROVILLE Owner: LOMBARDI, ANTHONY APN: 078-050-002 Applicant: CONNELLY'S PROFESS1Map Page: Permit Type: Re -Roof Description: REROOF W/COMP 18 SQ Flood Zone: None SRA Area: No SETBACKS Front Setback: Side Setback: Rear Setback: Other Setback: Minimum Setback From Centerline of Street: ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING Inspection Type IVR INSP DATE Setbacks 132 Foundations / Footings 111 Pier/Column Footings 122 Grade Beams 114 Eufer Ground 216 Forms/Steel/Holdowns 122 Do Not Pour Concrete Until Above are Signed Pre -Slab 124 Gas Test House 404 Gas Test Yard 404 Masonry Grout 120 Masonry Bond Beam 119 Underfloor Framing 149 Underfloor Ducts 319 Shear Transfer 136 Under Floor Plumbing 412 Under Slab Plumbing 411 Gas Piping 403 Do Not Install Floor Sheathing or Slab Until Above Signed Holdowns/Straps 122 Shearwall/B.W.P.-Interior 135 Shearwall/B.W.P.-Exterior 135 Roof Nail/Drag Trusses 129 Do Not Install Siding/Stucco or Roofing Until Above Signed Rough Framing 128 Rough Plumbing 406 Rough Mechanical 316 Rough Electrical 208 Gas Piping 403 Shower Pan/Tub Test 408 Fire Sprinkler Test 702 Fire Sprinkler Final 702 Building Final 802 Electrical Final 303 Mechanical Final 309 Plumbing Final 813 Pool Final 1 802 Mobile Home Final 1 802 Inspection Type 1 IVR I INSP I DATE Do Not Insulate Until Above Signed Wall Insulation 117 Ceiling Insulation 118 Do Not Cover Until Above Signed T -Bar Ceiling / RC 145 Stucco Lath 142 Stucco Scratch 143 Stucco Brown 144 Swimming Pools Setbacks 132 Pool Plumbing Test 504 Gas Test 404 Pre-Gunute 506 Pool ElecBonding/Light Nitch 502 Pool Fencing/Alarms/Barriers 503 Pre -Plaster 507 Manufactured Homes Setbacks 132 Blocking/Underpining 612 Tiedown/Foundation System 611 Site Utilities/Trench Insp. 137 Gas Test Yard 404 Manometer Test 605 Continuity Test 602 Skirting/Steps/Landings 610 Coach Info Manufactures Name: Date of Manufacture: Model Name/Number: Serial Numbers: Length x Width: Insignia: Public Works Fina 538-7681 Fire Department/CDF 538-7111 Env. Health Final 538-7281 Sewer District Final "PROJECT FINAL 801 t b < < m -rrolect anal is a cernucate ol Uccupancy for (Residential Only) PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE. IF WORK HAS COMMENCED, YOU MAY PAY FOR A 1 YEAR RENEWAL 30 DAYS PRIOR TO EXPIRATION Inspector Copy 1 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds FEE INFORMATION DBMSC Re -Roofing ; $110.00 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires CONNELLY'S PROFESSIONAL 601524 / B C39 / 08/31/2008 I HEREBY AFF y ER PENA OF RJURY that I am licensed under provisions of Chapter (commenci w action 7000 f Div' n 3 of the Business and Professions Code, and my license is in full f X _ 05/01/2007 Signature Date WORKERS' COMPENSATION DECLARATION I I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: ❑1 HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. AVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; Carrier: State Fund Policy Number: 1729016 Exp. Date:01/01/2008 (This section need not be completed if the permit is oror end llars ($100) or less.) ❑I CERTIFY THAT IN THE PERFO OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall a toy an arson i ny manner so as to become subject to the Workers' Compensati a of Califo ia, and, ee that if I should become subject to the workers' compen rovisions action 00 of the Labor Code, I shall forthwith comply with those X y_✓V__.. 05/01/2007 Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lender's Address City State Zip $110.00 Balance Due: $0.00 Receipt No: OWNER / BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: ❑I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). ❑I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). I AM EXEMPT under Section B. 8 P.C. for this reason: 1X 05/01/2007 Owner's Signature Date hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any an nditions of permit. I agree to defend, indemnify, and hold harmless Butte County ' 1cers, a nt nd employees from any and all claims and liability for personal injury, incl in eath, a pr arty damage caused by, arising out of, or in any way connected with the issu this per i ereby acknowledge that issuance of this permit does not authorize the use or pancy of sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte Co ove mentioned property for inspection purposes. I hereby certify that I am the —rty owns uthonzed to grt-on property owner's half. Q,�f5/01/2007 Owner ❑ Contractor OR ElAgent for Owner gent for FILE COPY PROJECT INFORMATION Site Address: 2160 KUSELRD Owner: Permit NO: B07-0928 APN: 078-050-002 LOMBARDI, ANTHONY W Permit type: MISCELLANEOUS 2160 KUSEL RD Issued Date: 05/01/2007 By KEJ Subtype: Re -Roof OROVILLE, CA 95966 Expiration Date: 04/30/2008 Description: REROOF W/COMP 18 SQ Occupancy: Zoning: MI Contractor i Applicant: Square Footage: CONNELLY'S PROFESSIONAL SERVI CONNELLY'S PROFESSIONA Building Garage RemdUAddn 5490 DEBBIE AVENUE 5490 DEBBIE AVENUE OROVILLE, CA 95966 OROVILLE, CA 95966 Other Porch/Patio Total (530) 533-1516 (530) 533-1516 FEE INFORMATION DBMSC Re -Roofing ; $110.00 LICENSED CONTRACTOR'S DECLARATION Contractor (Name) State Contractors License No. / Class / Expires CONNELLY'S PROFESSIONAL 601524 / B C39 / 08/31/2008 I HEREBY AFF y ER PENA OF RJURY that I am licensed under provisions of Chapter (commenci w action 7000 f Div' n 3 of the Business and Professions Code, and my license is in full f X _ 05/01/2007 Signature Date WORKERS' COMPENSATION DECLARATION I I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: ❑1 HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. AVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; Carrier: State Fund Policy Number: 1729016 Exp. Date:01/01/2008 (This section need not be completed if the permit is oror end llars ($100) or less.) ❑I CERTIFY THAT IN THE PERFO OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall a toy an arson i ny manner so as to become subject to the Workers' Compensati a of Califo ia, and, ee that if I should become subject to the workers' compen rovisions action 00 of the Labor Code, I shall forthwith comply with those X y_✓V__.. 05/01/2007 Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S FEES. CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for the performance of the work for which this permit is issued. (3097 civ. code) Lender's Address City State Zip $110.00 Balance Due: $0.00 Receipt No: OWNER / BUILDER DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: ❑I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner -builder will have the burden of proof that he or she did not build or improve for the purpose of sale.). ❑I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: The Contractor's License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). I AM EXEMPT under Section B. 8 P.C. for this reason: 1X 05/01/2007 Owner's Signature Date hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building construction, and with any an nditions of permit. I agree to defend, indemnify, and hold harmless Butte County ' 1cers, a nt nd employees from any and all claims and liability for personal injury, incl in eath, a pr arty damage caused by, arising out of, or in any way connected with the issu this per i ereby acknowledge that issuance of this permit does not authorize the use or pancy of sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte Co ove mentioned property for inspection purposes. I hereby certify that I am the —rty owns uthonzed to grt-on property owner's half. Q,�f5/01/2007 Owner ❑ Contractor OR ElAgent for Owner gent for FILE COPY BUTTE COUNTY PERMIT DEPARTMENT OF DEVELOPMENT SERVICES NO. BUILDING PERMIT APPLICATION C OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICATION Website: www.buttecounty.net/dds. BIN # **PLEASE PRINT CLEARLY** APPLICANT INFORMATION OWNER INFORMATION Last Name / Firse Mailin ddre s City Cityonof t State Stale _ Zip Phone Fax Fax E-mail Lic. # 66 APPLICANT INFORMATION CONTRACTOR Name Citywv` Address Zip City :�7 State Zi Phone 16 Fax E-mail Lic. # 66 Clas APPLICANT INFORMATION ARCHITECT/ENGINEER Name Citywv` "'Address Zip City :�7 State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name rh �_ Address .Z`�— Citywv` te Zip Phe U ZEFa :�7 E-mail APP (CANT TURE J- i\ PROJECT LOCATION AP# b Propert A r ss City WORKER'S COMPENSATION Policy Number Carder If hiring anyone other than license contractors, a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address DESCRIPTION OR SCOPE OF WORK: a--�2�-- ` o/ M Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupan V16 (Note previous use): For office use only: Zoning Flood Zone SRA I Yes No Occ. Type Const. BUTTE COUNTY AREA DEPARTMENT OF DEVELOPMENT SERVICES 1 INSPECTION CARD MUST BE ON JOB SITE 24 Hour Inspection Line: (530) 538-7636 (Oroville) (530) 891-2834 (Chico) Office: (530) 538-7541 Fax: (530) 538-2140 Website: www.buttecounty.net/dds Permit No: B07-0072 Issued: 01/11/2007 Address: 2160 KUSEL RD Area: OROVILLE Owner: LOMBARDI, ANTHONY APN: 078-050-002 Applicant: AIR CARE AND REPAIRMap Page: Permit Type: HVAC Change Out Description: INSTALL HVAC PACKAGE UNIT Flood Zone: None SRA Area: No Set Backs Front Setback: Side Setback: Rear Setback: Other Setback: Minimum Setback From Centerline of Street: ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING i' i f Ins ection Type 7_7ack Building IVR INSP DATE Set s 132 Foundations / Footings 111 Pier/Column Footings 122 Grade Beams 114 Eufer Ground 216 Forms/Steel/Holdowns 122 Do Not Pour Concrete Until Above are Signed Pre -Slab 124 Gas Test House 404 Gas Test Yard 404 Masonry Grout 120 Masonry Bond Beam 119 Underfloor Framing 149 Underfloor Ducts 319 Shear Transfer 136 Under Floor Plumbing 412 Under Slab Plumbing 411 Gas Piping 403 Do Not Install Floor Sheathing or Slab Until Above Signed Holdowns/Straps 122 ShearwalUB.W.P.-Interior 135 Shearwall/B.W.P.-Exterior 135 Roof Nail/Drag Trusses 129 Do Not Install Siding/Stucco or Roofing Until Above Signed Rough Framing 128 Rough Plumbing 406 Rough Mechanical 316 Rough Electrical 208 Gas Piping 403 Shower Pan/Tub Test 408 Fire Sprinkler Test 702 Fire Sprinkler Final 70T-- 02 Bui ing Fina 802 Electrical Final 803 Mechanical Final 809 Plumbing Final 813 Pool Final 802 Mobile Home Final 802 N M Inspection Type IVR INSP DATE Do Not Insulate Until Above S gned Wall Insulation 117 Ceiling Insulation 118 Do Not Cover Until Above Signed T -Bar Ceiling / RC 145 Stucco Lath 142 Stucco Scratch 143 Stucco Brown 144 Swimming Pools Setbacks 132 Pool Plumbing Test 504 Gas Test 404 Pre-Gunute 506 Pool ElecBonding/Light Nitch 502 Pool Fencing/Alarms/Barriers 503 Pre -Plaster 507 Manufactured Homes Setbacks 132 Blocking/Underpining 612 Tiedown/Foundation System 611 Site Utilities/Trench Insp. 137 Gas Test Yard 404 Manometer Test 605 Continuity Test 602 Skirting/Steps/Landings 610 Coach Info Manufactures Name: Date of Manufacture: Model Name/Number: Serial Numbers: Length x Width: Insignia: Public Works Fina 538-7681 Fire Deparhnent/CDF 538-7111 Env. Health Final 538-7281 **PROJECT FINAL 801 *rroject Finai is a Uertiticate of Occupancy for (Residential Only) PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE. IF WORK HAS COMMENCED, YOU MAY PAY FOR A 1 YEAR RENEWAL 30 DAYS PRIOR TO EXPIRATION r% INSTALLATION CERTIFICATE (Page 3 of 12) CF-fiR Site Address Permit Number 21.60_Kusel.Rd Om�ille_CA.95966 B0.7-0072 An installation certificate is required to be posted at the building site or made available for all appropriate inspections. (The information provided on this form is required) After completion of final inspection, a copy must be provided to the building department (upon request) and the building owner at occupancy, per Section 10-103(a). HVAC SYSTEMS: Healing Equipment Equip Type W9. heat CSC Certified Mfr. Name and Model Number # of Identical system Efficiencyt (AFIJE, etc.) ?CF -IR value Duct Location atti etc. Duct or Piping R -value Heating Load BtAr Hating Capacity Btu&r Package -AC ± Ga 7 Tran -el - -- 01 8C 0.0 /W AtticC8 C8 6075000 75 Cooling Equipment Equip T q tP ype k .heat u CEC Certified Mfr. . Name and Model Number # of Identical Sysmw(2-CF-IR Efficiency t (SEER or EER) value Duct Location attic etc. Dud R -value Cooling Load Btuft Cooling Capacity Btuthr Package-WC-7--d—as lTit 3 Ar c C8 60 75 1. > symbol reads greater than or equal to what is indicated on the CF -IR value. Include both SEER and EER if compliance credit for high EER air conditioner is claimed. Pl I, the undersigned, verify that equipment listed above is: l) is the actual equipment installed, 2) equivalent to or more efficient than that specified in the certificate of compliance (Form CF -1R) submitted for compliance with the Energy Efficiency Standards for residential buildings, and 3) equipment that meets or exceeds the appropriate requirements for manufactured devices (from the Appliance Efficiency Regulations or Part 6), where applicable. Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner AC Signature:r� ;: Date: 02127107 (Eltactronlcally signed) Copies to: BUILDING DEPARTMENT, HRRS RATER (IF APPLICABLE) BUILDING OWNER AT OCCUPANCY Residential Compliance Forms April 2005 INSTALLATION CERTIFICATE I (Page 4 of 12) CF -6R Site Address Permit Number 21.80-KuseI�Rd-0m ille_CA_95966 80.7 072 INSTALLER COMPLIANCE STATEMENT FOR DUCT LEAKAGE INSTALLER COMPLIANCE STATEMENT The building was: ✓ Tested at Final ✓ Tested at Rough -in INSTALLER VISUAL INSPECTION AT FINAL CONSTRUCTION STAGE: ❑ Remove at least one supply and one return register, and verify that the spaces between the register boot and the interior finishing wall are properly sealed. X] If the house rough -in duct leakage test was conducted without an air handler installed, inspect the connection points between the air handler and the supply and return plenums to verify that the connection points are properly sealed. ]Inspect all joints to -ensure that no cloth backed rubber adhesive duct tape is used x,New Distribution system is fully ducted (i.e., does not use building cavities as plenums or platforms returns in lieu of ✓ 13DUCT LEAKAGE REDUCTION Procedures for field veri/icafron and dMena:sfic fesfino ofair dis&ib&Won swiems are availahk in RACM_ Anmmdir RrM NEW CONSTRUCTION: MC—PRI Duct Pressurization Test Results (CFM @ 25 Pa) MeasuredValues 1 Enter Tested Leakage Flow in CFM: Fan Flow: Calculated (Nominal: ✓ IX -,Cooling ✓ ❑ Heating) or ✓ ❑ Measured 2 If Fan Flow is Calculated as 400 cfm/ton x number of tons or as 21.7 cfin/(kBtu/hr) x Heating 628 Capacity in Thousands ofBtu/hr output,enter total calculated or measured fan flow in CFM h ✓ 3 Pass if Leakage Percentages 6% for Final or 5 4% at Rough -in: ❑ Pass ❑ Fail 100 x ine # 1 / ine # 2)11 ALTERATIONS: Duct System and/or HVAC Equipment Change -Out Enter Tested Leakage Flow in CFM from Pre -Test of Existing Duct System Prior to Duct 4 System Alteration and/or Equipment Change -Out. Enter Tested Leakage Flow in CFM from Final Test of New Duct System or Altered Duct 5 S stem for Duct System Alteration and/or Equipment Chan -Out.74 Enter Reduction in Leakage for Altered Duct System 6 ine # 4 Minus 4(Line # 5 -(Only if Applicable) 7 Enter Tested Leakage Flow in CFM to Outside (Only if Applicable) ✓ �/ Entire New Duct System - Pass if Leakage Percentage <_ 6% for Final 8 100 x ine # 5 /p Line # 2 r [^-Pass ❑ Fail X� TEST OR VERIFICATION STANDARDS: For Altered Duct System and/or HVAC Equipment Change- ✓ Out Use one of the following four Test or Verification Standards for compliance: 9 Pass if Leakage Percentage 515% [100 x [ (Line # 5) / (Line # 2)1] ❑ Pass ❑ Fail 10 Pass if Leakage to Outside Percentage 5 10% [ 100 x [_(Line # 7) / (Line # 2)]] ❑ Pass ❑ Fail Pass if Leakage Reduction Percentage >t 60% [ 100 x f _ (Line # 6) / (Lane # 4 )l] 11 and Verification b Smoke Test and Visual Inspection 13 Pass [3 Fail 12 1 Pass if Sealing of all Accessible Leaks and Verification by Smoke Test and Visual I ection ❑ Pass ❑ Fail Pass if One of Lines # 9 throe # 12 Pass FyPass ❑ Fail the undersigned, verify that the above diagnostic test results were performed in conformance with the requirements for compliance credit. I, the undersigned, also certify that the newly installed or retrofit Air -Distribution System Ducts, Plenums and Fans comply with Mandatory requirements specified in Section 150 (m) of the 2005 Building Energy Efficiency standards. Installing Subcontractor (Co. Name) OR General Contractor (Co. Name) OR Owner MC—PRI Signature: o Date: 02/2j Etectronicasl ned Copies to: BUILD G-DEPA�YI MENT, HERS RATER (IF APPLICABLE) BUII.DING OWNER AT OCCUPANCY Residential Compliance Forms September 2005 INSTALLATION CERTIFICATE (Page 5 of 12) CF -6R Site Address Permit Number 21.60_KuseI_Rd_0roviIIe_CA_9 9966 BO7-00 2727 ✓ 0 THERMOSTATIC EXPANSION VALVE (TXV) Procedures for field vertfrcation of thermostatic expansion valves are available in RACM Appendix RI. ✓ ✓ ✓ 13REFRIGERANT CHARGE MEASUREMENT Verification for Required Refrigerant Charge and Adequate Airflow for Split System Space Cooling Systems without Thermostatic Exnansion Valves Outdoor Unit Serial # OF Locationgooftool -- Access is provided for inspection. The procedure shall Tr^ e Outdoor Unit Model 2Y_=036A1.0.T_5AA Cooling Capacity L7 -51 Btu/hr Date of Verification 0-1—/,10-/-0-71 consist of visual verification that the TXV is installed on 1y/061 (must be checked monthly) Date of Thermocouple Calibration 12/13/06 (must be checked monthly) ✓ 0 Yes O No the system and installation of the specific equipment ❑ ❑ shall be verified. Yes is a pass I Pass I Fail ✓ 13REFRIGERANT CHARGE MEASUREMENT Verification for Required Refrigerant Charge and Adequate Airflow for Split System Space Cooling Systems without Thermostatic Exnansion Valves Outdoor Unit Serial # OF Locationgooftool -- Outdoor Unit Make Tr^ e Outdoor Unit Model 2Y_=036A1.0.T_5AA Cooling Capacity L7 -51 Btu/hr Date of Verification 0-1—/,10-/-0-71 Dale of Refrigerant Gauge Calibration 1y/061 (must be checked monthly) Date of Thermocouple Calibration 12/13/06 (must be checked monthly) Standard Chame Measurement Procedure (outdoor air dry-bulb 55*F and above): Procedures for Determining Refrigerant Charge using the Standard Method are available in RA CM, Appendix RD2, Note: The system should be installed and charged in accordance with the manufacturer's specifications before starting this procedure. Measured Temperatures Supply (evaporator leaving) air dry-bulb temperature (Tsupply, db) OF Return (evaporator entering) air dry-bulb temperature (Treturn, db) OF Return (evaporator entering) air wet -bulb temperature (Treturn, wb) OF Evaporator saturation temperature (Tevaporator, sat) OF Suction line temperature (Tsuction, db) OF Condenser (entering) air dry-bulb temperature (Tcondenser, db) °F �u heat Charee Method Calculations for Refrigerant ChaMe Actual Superheat = Tsuction, db - Tevaporator, sat OF Target Superheat (from Table RD -2) OF Actual Superheat -Target Superheat (System passes if between -5 and +5°F) T Temperature Split Method Calculations for Adequate Airflow Split Method Calculation is not necessary ifAdeauate Airflow credit is taken Actual Temperature Split = T return, db Tsupply, db °F Target Temperature Split (from Table RD3) OF Actual Temperature Split Target Temperature Split (System passes if between - 3°F and +3°F or, upon remeasurement, if between -3°F and -100° OF Residential Compliance Forms April 2005 INSTALLAT(O(11' CLRT(R[CATL (Pae 6 of 12) CF -6R 3iteAddresa Permit Number 21-60_Kusel.Rd_Oroville_CA_95966 807_0072] StandardCliarge Measurement Summary: System shall pass both refrigerant cha rge a nd adequate a it flow calculation cr ileria from (re sa me measurements. If eorrectiveactiona weretalmn, both criteria must be remeasured and recalculated. 1 1)( Yes ❑ No I System Pasaes- Alternate Charge Measurement Procedure (outdoor ei r dfpbulb below 55T) Note; The system should be i natal led and charged. in accordance w ith the ma n ufecturer's speci fieations and i nate I ler verification shall bedocumentedon CP -6R before go rtingthiaprocedure, if outdoor sir dry-bulb ia55 "Porabove, installer anal I use the Siondard,Charge Measure P rocedure: P,aw&,,es jo, Defe Autirrg Ref,igei" C rge using Me Ahe„eare Mefikaad &-e avaskbie i,e RA C2d Appepedix RD3. Weigh to Ch arAi nA Method for Ref riAerant Charge Actual liquid line length: ti Man ufacturer'irStandard liquid line lengfu ft Di fference (Actual'— Sia ndard) ft I Man ufacturer'ecorrection (ounces per foot) x.diffuenr„e in length = ounces I 0 =add) (- = remove) 2easurelAirflow Method for Adequate Airflow Verification auaffabh A RACX Appe edit RD2.6 Calculated A it flow: Cool ing Capacity (BtuAr r) X 0.033 (cfm(Btu-h r) = cm Measured Airflow is CFF (Measured ai r flow muelbegremer (ran the calculated airflow). Alter nate Cha rge Measurement 3 umma ry: System shal I pose both refr igera nt cbs rge and adequate a it flaw calculation cr iteria from the so we measurements. If correctiveadions wereldl)en, both criteria muslbe rertmuredand recalculated. Inmal I ing 3 ubcontramor (Co. Name) OR General Contractor (Co. Name) OR Owner SignatureI Da1e: 02L2Ztyi Copies W: BUELDENO DEPARTMMNT,HMRS RATICR JI'APPUCABLIC)BUiLDWGOWNMItATOCCUPANCV Readentki Qvap"nce Fares° A p,i! 2W5 f: BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #:(530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #:(530) 538-7541 FAX#: (530) 538-2140 WEBSITE: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 2160 KUSEL RD Owner: Permit No:' B07-0072 APN: 078-050-002 LOMBARDI, ANTHONY W Issued Date: 01/11/2007 By KCG Permit type: MISCELLANEOUS 2160 KUSEL RD Subtype: HVAC Change Out OROVILLE, CA 95966 Expiration Date: 01/11/2008 Description: INSTALL HVAC PACKAGE UNIT (530) 532-1634 Occupancy: Zoning: M1 Contractor Applicant: Square Footage: AIR CARE AND REPAIR SERVICE AIR CARE AND REPAIR SER' Building Garage RemdUAddn P.O. BOX 804 / P.O. BOX 804 UKIAH, CA 95482 UKIAH, CA 95482 (530) 533-3701 i' (530) 533-3701 Other Porch/Patio Total FEE INFORMATION Heat Pump (Package Unit) $55.00 Total Charged: $55.00 Fees Paid: $55.00 Balance Due: $0.00 Receipt No: B1487 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) I State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License AIR CARE AND REPAIR SERVII 471898 / C 20 / 08/31/2008 Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 (commenci with Section 7000) of Division 3 of the Business and Professions Code, and my license pursuant to the provisions of the Contractors License Law [Chapter 9 (commencing with Section 7000) is in full or and effect. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects X 01/11/2007 the applicant to a civil penalty of not more than five hundred dollars ($500]; Please check one of the following: Contractorsig ature VDate ❑ I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of the property, who builds or improves thereon, and who does WORKERS' COMPENSATION DECLARATION I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: HAVE AND the work himself or herself or through his or her own employees, provided that such improvements ❑I WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). D ,yY..AYE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: lJ Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractors License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Carrier: VIRGINIA SURETY Cpolicy Number:WVS001626101 Exp. Date:01/01/2007 Contractors License Law.). (This section need not be competed if the permit is or one hundre ollars ($100) or ess. ❑ I AM EXEMPT under Section B. & P.C. for this reason: I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation laws of California, and agree that if I should become subject to the workers'X 01/11/2007 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owner's Signature Date provisio X :::2a,�X,01/11/2007 I hereby certify that I have read this application and slate that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, injury, including death, and property damage caused by, arising out of, or in any way connected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND ATTORNEY'S use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte FEES. Cou ty to enter the above mentioned property for inspection purposes. I hereby certify that I am the pr prty owner ram authorized t ct on t e property owners behalf. 01/11/2007 CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name el Permi ee [SIG Print Date the performance of the work for which this permit is issued. (3097 civ. code) ❑ Owner ontractor OR. 11Agent for Owner DAgent for Contractor FILE COPY Lender's Address City State Zip BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 OFFICE #: (530) 538-7541 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.net/dds "PLEASE PRINT CLEARLY" OWNER INFORMATION Last Name/ ..Q P J4 t First Na"'To Address ;2/(0o -SeC Ekj. City OV -0 l/ 1 ( I L Staten,,1 � Zipq, �6 Phone Z _ go By Fax E-mail CONTRACTOR Name .rt tc e- cS-e Address City Ofo V (1'�_ StateC� Zip �oS Phone 533-37o/ Fax 533 _ , r E-mail Lic. # ?F- Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City Address Zip City Fax State Zip Phone Map Book Fax E-mail Planner State License Number APPLICANT INFORMATION Name Address City State Zip Phone Fax E-mail APPLICANT SIGNATURE X —)/j/M g� For office use only: Zoning Property Address �/( �o leussPL pa Flood Zone Cross Street SRA I Yes I No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc PERMIT NO. BP BIN N PROJECTLOCATION AP# 0 w -0 50 - Property Address �/( �o leussPL pa City ' pe-owlte Cross Street WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than license contractors, a certificate of worker's compensation must he shown at the time of permit issuance. LENDING AGENCY Name Address J Description or Scone of Work: l'�1 STCc lf' w �ccC C �1e4 ' edd/i.k Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be required. REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: Amount: �S��D Bldg SRA Receipt #IN Sheriff &WV I�24 SMIP I Date:) C —0 Other II S5 Total Page 1 of 2 REV 8-12-05 . t " SUBMITTAL & PERMIT REQUIREMENTS The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) Installation manual, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Building Permit Application Without Required Clearances Form ❑ 12. Hazardous Material Form (for Commercial Buildings only). , Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Legal description from current recorded grant deed, ❑ Copy of M.H. Title, Title transfer, or MCO. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530) 538-7541. EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 8-12-05 eel�