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Home My WebLink About078-220-014J BERT . WA.R-D TP ... _ 21 Las Plumas Way, Oroville _ Permit #2909-L2 edrooms & add cov area/SF { � 7-9 v wAI�RYp, Beit H. $6-6gB3: 233,-66B _ 716--69B#* ... PERIJIT#95-2321 ANGLIN, D. Burke 21 Las Plumas Way, Or\�11 1 Las lu s��W�ay, Ville Cont; Monte„J. Pratt, c�l 1 . � � ` I � � add �iatio cover) Conv Shop to� Bedroom &-Ba,th/SF E convert part of patio o hobby shop) p)(**RENEWAL) �. .y CD 0 a RESIDENTIAL 036-550-014 PERMIT#95-2321 ANGLIN, D. Burke .21 Las Plumas Way, Oroville Cont; Monte J. Pratt Conv Shop to Bedroom & Bath/SF JOB FINALED (Date) 91— Signature —Signature + �. Pa a RESIDENTIAL 036-550-014 PERMIT#95-2321 ANGLIN, D. Burke .21 Las Plumas Way, Oroville Cont; Monte J. Pratt Conv Shop to Bedroom & Bath/SF JOB FINALED (Date) 91— Signature —Signature Owner: i � I'crmLt No. ENERGY CE`R"T I'FICATION LOCATION DE'SCRIP'TION OF INSULATION ROOF Material Thickness(inches) EXTERIOR WALL Material FIBERGLASS BATTS Thickness(inches) CEILING Batt or Blanket Type FIBERGLASS BATTS Thickness(inches)_]" Loose Fill Type Minimum 'ThicknesWnches) Area covered(ft. ) FLOOR, ELEVATED Material Thickness(inches) FLOOR, SLAB Material Thickness(inches) Width(inches) FOUNDATION WALL Material Thickness(inches) Mal 111 "AN, 11 Brand Name Thermal Resistance (R Value) Brand Name SCI-MLER INT. Thermal Resistance(R Value) Brand Name SCHULLER INT. Thermal Resistance(R Value) Brand Name Number of Bags Wt. per bag _ lb. Thermal Resistance(R Value) Brand Name Thermal Resistance(R Value) Brand Name Thermal Resistance(R Value) }grand Name Thermal Resistance(R Value) I hereby certify that the above insulation was installed in the above building in conformance with the State of California Energy Requirements. • Loerke Insulation Co., Inc. 499150 �> ,,FIRM NAME/OWNER STATE CONTRACTORS LICENSE NO.. �(lA Q Q fn &9A kLe SIGNATURE OF INSTALLATION APPLICATOR DATE I hereby certify the above insulation and all required items as shown on'the Building Department approved plans and att'acl.unents have been installed as required by the State of California Energy Requirements. All equipment, devices and materials are of the quality prescribed or are specifically approved by the State of California. FIRM NAME/WNER (Ple print) STATE CONTRACTOR'S LICENSE NO. a SIGNATURE OF QENERAI, CONTRA'TO OWNER AT' THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION APPROVAL AND A COPY SHALL BE POSTED WIT11IN THE BUILDING. January 1984 J=OK O = Not OK = Not Applicable MOBILE HOMES ! =Not Ready ' Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer: Location -Test -Fall -C/O Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap: / /" L" ft. / /"Nat. or/ /" L"ft./ /"LPG 7. Well Clearance & Disconnect 8. 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 #'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 -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. 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 .r MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Bea ms- Rftrs.-Connectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card _B- 1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 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. _ Bo xes- Enclosu res-Panelboa rds- Ins. to Main in Conduit 9. Health Department 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 m = Not Applicable d RESIDENTIAL (Single & Duplex) - - - tea Rea y Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 60Wt'g., Main; Soils-Elec. Grnd.-�O" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg.,.Porches & Decks; Soils -Steel-/ /Ftg. Depth temwalls, Main; Steel-Blockouts-Wrapped --96. Stemwalls, Garage: Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped I 8. Piers -Fireplace Ftg.-Steel 9. O.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test 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. Access & Ventilation 16. Insulation Date 7- 7/ and B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit),OK except #'s T ater ess-Combustion Air -Baffle -AAAA-- ---AAAA-- ------------------------- 17 ater Pipe; Test & Anchor -Nail Protection -AAAA-- ----AAAA-- --------------------------AAAA-- 18. D.W.V.: Test -Fittings & Anchor -Nail Protection AAAA- -----AAAA AAAA - ------------AAAA-• - -- 19. Shower Pan; Test. First Floor -Tub Access ---- 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe: Size & Anchors ----------------AAAA-- - --- - -------------- ----------------- - .Date -5-1, Card B -t Date Card B-1 ---� - - • JtA ------------------------ ------------- Date Card B-1 Date Card B -i Date ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection -AAAA-- - --- ---------------------- - - - -- ------------------ - - - AAAA --AAAA-- ---AAAA-- - -- -- - AAAA- -- AAAA- ---- Ele .Receptacles Spacing -Lights & Switches at Doors AAAA -AAAA - --------------------------•------------------------------- ize Boxes & No. of Conductors -Stapled ------------- - ------ ------------------------------ . ---------------------------- .Rome cInstalled Close to Edge of Studs & C.J. ----------------•- ------------------------------------------•--------------- . quip. Ground made up w Me d� Bond Gas & Water AAAA-- - --5---------- -- - - - - 27-2-A�Iferaee Circuts in Kitchen & Conductor SizerGFI ---AAAA -------------- ---------------------------------------- �u ee -m re Size ga. Cu or AI-A.C. Wire Sizer r ga. Cu or Al -----------AAAA-- -------------------- -------------------------------------------- 2k.$a_ ge ('ir r r ga. Cu or AI -Oven Circ. r r ga. Cu or Al. Insulated Neutral ❑ Yes ❑-No ---------------- ---------------------- 3 onductors &'around -Main Disconnect -31-.- Equip. Clearances Panels -Motors -Meeh. Equip AAAA �------------------------------------------ -- - y�r lothes Closet Light -Shower Light -Spa Light VdA1-0- ---------- -- -- - -- ------�- ----AAAA-- -AAAA--AAAA-- --- -- -- ---AAAA-- -------- 3. Smoke Detector --- -- - - -------------- ------------------------------------- Date Card B -t Date Card B -t Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except a's 34. A C. Ducts Insulation & Support ------------------------ 35 Vent Fan Exhaust above insulation _ - 36 Condensate Dram & Overflow Sze & Grade - -- --------- -- ---------- .._ _.. 37 Furnance-Vent: Access -Comb.- Air -Return Air Vent. 115 outlet -- - - AAAA- ---•---.... --- --AAAA --- AAAA--- -- ---�----._.... -- 38 Attic Access & Platform if Furnance in Attic ------ ------- ------- ----- -. -•- -------------- Date -----------Date Card B-1 Date Card B-1 --••---AAAA--- -• AAAA --- -- - - -- - -.._ _...... _ ._ Date Card B-1 Date Card B-1 Date G (Plans) OK except u s __5�y it per Material &Anchors WaIIS Studs -Nailing. Spacing & Bracing -Plates -Sound - J .,i i Girders & Fluor Nailing 42 Draft Stop In Walls (rat proof) - - 43 Fi Stops. Furred Ceilings -Stairs -Chases -Tub � Headers & Beam -Size & Bear nq Date FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors y}� 46. Cing. Joist-Rftr. ties -Pu rlin-roof Brac-Truss-Shthng.-Ring. 49-Flirepflme TierarType A Flue -Fireplace Throat clearance 48. At ' Access; Size & Romex Protection -Draft Stop -Ins. Baffles 4 . Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing ---- 51. P.Coperty Line Firewall & Openings _ Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits 53. Stairs; Wi eadroom i e -Run -Landing -Fire Protection fXlSktjk- 54_OpYwood on Roof Overhang -Attic Vents -Rafter Outriggers ___ 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 57. Glazing Area -Glass Protection -Skylights -Plastic 58. She alls: Nailing-Bolls�j nsulation-Walls-Ceilings 49. Infiltration -Walls -Windows --------- Date Card Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s Ext. Steps -Door & Sidelight Protection -Landings -------------------- moke Detector ---AAAA-AAAA-- --AAAA-AAAA-- - 63_Fvrnace.-Vents=Clearance-Comb. Air -Connector - In Garage: Above Floor -Ducts -Meth. Protection .-------------------- AAAA -AAAA- - -edroom Exiting G.F.I. & Bath Fixtures & Tub Access -Spa ----------- ------ ---------------- 66_E1ec_-T-Am_&-Subpanel_Breaker Sizes & Labels ------------------ - - --- •ft�Stairs & Rails -- Clearances -Hearth -------------- ------------- ------------ -- - -69:-ElecrOutlets at Wood Panel: Int. & Ext. - 70-KitrRxt-&-Appliance:'Grnd.-Air Gap -Cooking Clearance +-7n- tlets & R ueceptacles at Kit. Counter ---------- AAAA--------AAAA--AAAA---- arage Fire Door_ Swing_ Landing -Closer rDudt'in arage-Damper �agqe: 74.s-Clearance-Comb. Air-Connector-P.R.V. Iove Floor -Meth. Protection -----------AAAA-- ove--Meth.Pech._Equip. Listed for Location AAAA -AAAA--- Elec. -Receptacles in Garage: (G.F.I.)-Romex Protection ------------------------------------ Iced in Attic ❑ Yes ------------ ---------------------- Construction -Post Caps ---------- -AAAA- ----- --- ---AAAA- - AAAA-- - n. Vents &Crawl Hole Door -Drainage &Wood -Earth Clearance Looked under Floor- ❑ Yes - __0 Fnn A ^.. ra n..,P ❑ Yes ❑ No: Walks ❑ Yes ❑ No: Planters ❑ Yes ❑ No •-------------------------------------- ---- -----AAAA----------- -- --------------------------- -2_ _ eet-Electrical_ Plumbing ---- Vents Above Roof: Plbg.-Appliance-Fireplace.-Clearance to Openings-- -- If : D sconnect, Electrical, Plumbing - --- E no lec Trim: G.F.I. Receptacle -Underground ------ ---- -- - --- - ---AAAA-- AAAA- AAAA ' ntilation Throughout House - -----------------------------------AAAA-- ---- d7. Glass Protection . - ----------------------------------------AAAA-- 88 Corrections from Previous Inspections - - -... . _ . ..--- -------------------------------- - - -------------- rs Tagged_ Gas -Electric ............ .. . -- --- ---------------AAAA--AAAAAAAA-- 90. W r & Sewer Connected-C,O to Grade -HD Approval -- -------- - ----------------------------------------- nergy Compl ante Certificate -Other Certificates AAAA•- .. - - -- -- - ---AAAA-- DCard Dale Car1 --- Dat Card B-1 _ Date -----Card B-1 _^ Cat g B -t d B- _ -- �9._Y�AAAA- AAAA - ---- -----------AAAA-- - - Date Card B-1 Date Card B-1 Comments at Final COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE - Z�3 PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any questions pertaining to this matter, or need additional explanation, PIease,,,,,,ea,6ntact this office immediately. Date Az—'Inspector ' / 14– REV 1 COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 i CORRECTION NOTICE 2-3Z� OWNER / IPERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work is completeq,# completed,,you have any questions pertaining to this matter, or need additional explanation, please c9nfact this office immediately. Gl Date REV 1 Inspector ,;L: COUNTY OF BUTTE BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 1469 Humboldt Road, Chico, CA - (916) 891-2751 7 County Center Drive, Oroville, CA - (916) 538-7541 747 Elliott Road, Paradise, CA - (916) 872-6307 CORRECTION NOTICE PERMIT NO. A routine inspection indicates that the following violations of Butte County Ordinances exist at the above address and should be corrected. Please notify this office when correction of work 11 is completed. If you have any questions pertaining to this matter, or need additional explanation, please contact this'office immediately. Date — Inspector REV 10/92 AiIJ17, �a.rPn rtf'7��I�" , COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 -County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541PERMIT NO. APPLICATION AND PERMIT 9S-o��h�� ASSESSOR PARCEL NUMBER ZONING IR I BUILDING PERMIT OWNER D. B RKT ANGLIN4-13 TELEPHONE 1 SO. FT. OCC. BUILDING VALUATION 261 @ 60 5,220.00 OWNERS MAILING ADDRESS 21 TAS PTJJMA.; 14AY OROVIT.T.F. 95966 80 R 4,320.00 CONTRACTOR'S NAME MONTE J. PRATT TELEPHONE _ 4 87 C , 0o CONTRACTOR'S MAILING ADDRESS t T, Fireplace CONSTRUCTION LENDER UN OWN Total Valuation Is 6 LENDER'S MAILING ADDRESS Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ 23.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUILDINGADDRESS 21 LAS PLUMAS WAY PERMITFEE $ PLUMBINGPERMIT Filing Fee 20.00 Each Trap 7,00 49.00 LOT NO. SUBDNISION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 USE OF STRUCTURE SF R Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 15.00 Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Ublibes ❑ Installation ❑ Other ❑X Describe Work: CONVERT SHOP TO BEDROOM AND HATH AND ADD BATH. Mobile Home S GI W1 920.00 PERMITFEE g 99.00 Contractor ELECTRICAL PERMIT Filing Fee 20.'00 Main ServiceEOOV OR LESS ( 200A OR LESS ) 23.00 Main Service ( 200A TO 1000A ) 46.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, AO do the work, and the structure is not intended or offered for sale. U-011, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason NEW CONST. DWELLING OCCUR so. OR ( 8 ACC. BLDS. ) 3.5¢ FT. CNS. NEW CONST./ MULTI -OUTLET NON-RESID. \ BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) 'SI SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 Q 1.00 BAL .30 Ex. Occup. ourLEE'DrsPaEWSIo.�eA ( ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ 21.90 Contractor WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 Heating T X Cooling - Hood 6.50 Ventilation PERMITFEE $ ' Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation ;€-one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, 1 shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the wo com sation provisions of section 3700 of the Labor Code, I shall f wl co ply ith those provisions. X �� __ Date _ 1� Signatur AD � ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep emol`'Von or construction of structures over 3 stories in height. ii( Mobile Home Installation Fee $ Energy Inspection Fee Is 46. OCC CONST. TYPE TOTAL FEE $d/� HAZ. O. FEES IMP FLOOD CDF PARCEL PD HD SUE -� 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 AA PERM ITEXPIRESON %U (Date) Receipt No. 1855T7 7 , S WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK SPECTOR GOLDENROD -APPLICANT 701 �: < t �eTfi�R ' bfii a ^Y•... lx d+�S s' 9 t' r' b,er • -'ti"- +'Y +': •- v"h,- i:N'• :itl•r r�n,,.:r++ i.!'1"<hl` .1a .. ,.. COUNTYOF BUTTE -DEPARTMENT OF DE -V LOPMENTSERVICES-BUILDINGDIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541 / `' V PER I�'APPLICATION DATA SHEET d OWNER A. P o. Proposed Building Use Building Inspector Date 9 oZ !7 At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED BY 1. 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). .... Wmpact obilehome data and manufacturer's installation instructions, 2 sets. ...........ees of $ 7�/ . ?_5. ............... ....................... fees as shown on attached schedule.- G�TZI�?(;f. ................. . 12. California Department of Forestry plan approval/fees. ....................... . 13 Flood elevation letter (100 year flood) byl f is Engineer . ................. . 14. Sanitation and plot plan approval LO ealth 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)... ... . Fre-Inspection request 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 . ............... Existing violations/expired permits. .Cad• . .......................... Plan check list . ..................................................... 33. 34. ' Whe ou issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at 0 j ce. Deliver with inspector. Other Parcel Creation Acreage Applicant Date ?/_Z0 Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to 1. Index permit for above items No. 2. Additional items required: ance: (Circle new item not checked above). Contractor, des igne owner was advised of above required data by _K phone _ mail Counter by j�_Z Date rac esigner, owner, was advised of above required data by phone _mail Counter by Date 10-14-95 Plans checked by G -I 66 a,1-5 Date l�.ZB °�S Plans approved by G i B t3o,4 S Date 10-124S Z Sets of plans on hold in a File cabinet AP folder Copy - Department of Public Works '�'"""''.x..-•�..�.-..'..,-...G-.-,.-.v'»+'r•-.ot.+*-^YYtr�l�.-err � ,_.—.... r•�;�„ r..-. "r•g1.�f_....v"d'�5�i>M• —,'tom'^-iv.MN.n.-......•w�..l"r-r '�"-►' y r•ati.v....�-_r...r ..... ., BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One Form Per Building) School District OA -0 i%vc. W Building Department No. A.P. Number6 3G _5-S"0"u/4/ Jurisdiction: City County Property Owner v 1 6 N Property Location/Address / Ai / S �G- �^19 5 Subdivison Lot No. Residential Development 0 No. of Living MHI Units Sq. Footage 3 4 Addition (Group R) Commercial/Industrial 0 .r- . n (Floor Plans reviewed by School District Personnel) District Identification No. a 0 3 -t Sq, Footage (Including Exterior 7oled Ar s) Date _Oy,o j School District certifies that r-li I< ENV C -A X , r (Applicant) a 1 (Street Address) (State) 34- 1361 (Phone Number) S (Zip Code) has complied with the requirements of Resolution No. t co by payment of $ C, representing 341 square feet. AB 2926 $ FULL MITIGATION $ Paid by Check # Bank Number Paid by Cash Remarks: �—�—qS Date If, subsequent to the School District Representative signing this Butte County Schools Impact Fee - Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.wkt (11/94)dmm PERMIT NO. 2909-87B 4 h PERMIT EXPIRES d BERT WARDRIP OWNER CONTR. Owner ASSESSOR PARCEL 36'55714 LOCATION 21 :as Plumas Way Oroville `l Wj OFFICE COPY ' Temp. Pow. Address Called GA Temp. Elea Meter By RIC Called I M Date Temp. Gap...,,o -- - - Called PG&E JOB FINALED (Date) Signature = OK 0=Not OK =otReaable NdyMOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1..Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch 1 Sewer; Location -Test -Fall -C/O -Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 6. Gas; Location -Test -Wrap: / PV ft. / /"Nat. or/ PV ft./ /"LPG 7. Utility Clearance Card -B1 Date Card -B1 Date Card -B1 Date Card -131 Date Date MOBILEHOME INSTALLATION (Plans) OK except #'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 -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 10. Cert. of Occupancy Card -131 Date Card -B1 Date Card -B1 Date Card -B1 Date MISCELLANEOUS . , : =10. Date DECKS,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.- Shthg.-Rfg.-Bracing - 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Elec. 8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Card -131 Date Card -81 Date Card -B1 Date Card -81 Date Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness - Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 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-Panelboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Card -B1 Date Card -B1 Date Card -B1 Date Card -131 Date = OK 0 = NotOK RESIDENTIAL (Single and Duplex) - =Not Applicable 4 Na:,Ready Date UNDE OOR (Plans) OK except s . Date FRyMiNG (Continued) on' requirements -S cks-Ease s W. Ha gars -Post Caps -Anchors -Connectors tg., Main; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth Ing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. 3. Ftg., Garage; Soils -Steel-/ /" Ftg. Depth ies or ype AFlue-Fireplace Throat 4. FtgyPorches & Decks; Soils -Steel-/ /"Ftg. Depth �7. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles . temwalls, Main; Steel-Blockouts-Wrapped drm. Windows or Exiting Doors -Sill Hgt. & Dimensions 6. Stemwalls, Garage; Steel- Blockouts-Wrapped c ion Framing 7. Slab; Steel-WrappedL-5TProperty Line Firewall &Openings 8. Piers -Fireplace Ftg.-Steel '-Check Garage -3rd story, 2 exits ngs-Test-2 way C/O -Sewer Test 5 - droom -Rise- Run- Land ing-Fire Protection 10. Gas Pipe; Size -Anchors ,_P+ywood on Roof Overhang -Attic Vents -Rafter Outriggers 11. Water Pipe; Test -Anchors -Regulator -Service Test c,44. Siding -Nailing Veneer 12. Electric; Underground 55. _ - creed -Fd. Vents-Underflr. Access 13. Plenums & Ducts; Clearance-Material-Supprt-Ins. . Glazing Area -Glass Protection -Skylights -Plastic 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples ; ailing -Bolts 15. Insulation 58. Insulation-Walls-Clg. 59. Infiltration-Walls-Wndws Card -131 DateQom/ .Qand-81 Date Card -131 Date Card -131 Date Card -B1 Datel&,/gg-�10ard-131 Date Card -B1 Date Card -B1 Date Date PLUMBING (Permit) OK except #'s 16. Water Ht. Vent -Access -Combustion Air Date FINAL- Ians) OK except #'s 17. Water Pipe; Test & Anchors -Nail Protection . Ext. Steps -Door & Sidelight Protection -Landings 18. D.W.V.; Test-Fttngs & Anchors -Nail Protection moke Detector 19. Shower Pan; Test, First Floor -Tub Access 9P-Fvwaace_l(gIIls-Clearance-Comb. Air -Connector - In Gar e; Above Floor -Ducts -Meth. Protection droom Exiting 20. Test Tub & Shower, 2nd Floor -Tub Access 2 Gas Pipe; Size & Anchors .F.I. & Bath Fixtures & Tub Access -Spa Subpanel; Breaker Sizes -Labels Card -131 Date Card -B1 Date 66'-6tatrs_&Aeils Card -B1 Date Card -131 Date 6.7. Firepleewor Stove; Clearances -Hearth Date ELECTRICAL (Permit) OK except #'s 6e.-EIHC"10Uttets at Wood Panel; Int. & Ext. 2?,, -Fixture & Transformer Clearance -Ins. Protection 4Q_KU_&*4-4-Appliance; Grnd. -Air Gap -Cooking Clearance 23. Elec. Receptacles Spacing -Lights & Switches at Doors 712 -Elea -Cutlets & Receptacles at Kit. Counter G2�ySize Boxes & No. of Conductors -Stapled Gera_gx*I f{7'3bor; Swing -Landing -Closer 25. Romex Installed Close to Edge of Studs & C.J. �2!1�. Duct in Garage -Damper Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water -Clearance-Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 27. ircui s in Kitchen &Conductor Size {{�-g� Mech. Equip. Listed for Location 28. ze / / ga. Cu or AI-A.C. Wire Size / /ga. � Cu or AI 75erReeerytecles in Garage; (G.F.I.)-Romex Protec. 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral Yes No 7a.,¢uLatin cm m -Looked in Attic O Yes 7,7-- i s eck Construction -Post Caps 0. Service -Riser Conduct;rs4 Ground ain Disconnect I8!f`dn. Vqnts & Crawl Hole Door -Drainage & Wood -Earth Clegatlince Looked under Floor ❑ Yes `'T1-Equip-T1Panels-Motors-Mech. Equip. 32. efottreg-Ctaset Light -Shower Light -Spa Light 7 . ollowing instid.; Drive 0 Yes O No; Walks D Yes O No; Planters ❑ Yes o No co; Brown -Finish Card -B1 Date Or ,, Card -B1 Date 84. A.G. Wo+i; Disconnect, Electrical, Plumbing Card -B1 Date Card -131 Date Ei 'VeAtc-Abaue-Roof; Plbg.-Appliance-Firepl.-Clearance to Openings. Date MECHANICAL (Permit) OK except #'s isconnect, Electrical, Plumbing 33. A.C. Ducts Insulation & Support or Elec. Trim; G.F.I. Receptacle -Underground 34. Vent Fan; Exhaust above insulation en ' n throughout House 35. Condensate Drain & Overflow; Size & Grade lass taction 36. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet 87. Cections from Previous Inpections 37. Attic Access & Platform if Furnace in Attic Test=Meters Tagged; Gas -Electric Water & Sewer Connected -C/O to Grade -HD Approval 90. Energy Compliance Certificate -Other Certificates Card -61 Date Card -B1 Date Card -B1 i Date Card-BDate Card -B1 Date Card -81 Date Date FRAMING (Plans) OK except #'s Card -131 Date Card -131 Date 38,AKIls, Proper Material & Anchors Card -B1 Date Card -B1 Date 39. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound Commen t Incl: . Bearing Walls over Girders & Floor Nailing 44�Dr t Stop in Walls (rat proof) ops; urred Ceilings -Stairs -Chases -Tub 3. Header & Beam -Size & Bearing (NOTE: An entry must be made each time you visit job site) COUNTY OF BUTTE r, 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 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. Inspectory�% Date,// "'� / COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE 112 7 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. Inspector Wt Date_ / o— l 7 O rl COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE OWNER 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. *- COUNTY OF BUTTE - DEPARTMENT OF IIUBLIC WORKS ' t 7 County Center DrFve - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO./ ASSES • SOR PARCEL NUMBER ZON144G ` BUILDING PERMI OWNS TELEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ,i� DRESS CONTRACTOR'5 N/rA/ME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER VNKNOWN Total Valuation $ Filing Fee $ 10,00 LENDILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee _ S Energy Plan Checking Fee A$ y �-/10 ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS IL�Q/J 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 SFJ Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 110.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Insta lation❑ Other Describe work: 0 " Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00' Main service ;Doo AMP OV OR R LESS 10.00 Main service EA. ADO'L 100 AMP 2.50 Z1� CONTRACTORS LICENSE LAW I declare under penalty of p I y (check.one): perjury ❑ 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 OCC'411 OR ADDNS. ( ACC. BLDGS. /20sgft NEW CONSTR. ULTI.OUTLET 2,50 ea NON-RESID BRANCH CIRC ITS POWER APPARATUS &- (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 500506 r e AL030 FIXED APPLNS. OR I_ EX. Occup. OUTLETS (RESID.) EAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ ..� Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against I liabilities, judgments, costs, and expenses which may in any way accrue ai st said County in con equenc of the granting of this permit. %� Date 1_ Signature of Applicant — Owner ElContractE]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 PEW -IT FEE aqua. /l�J2i co rPE F PARCEL P ND ISSOE This it is hereby issued under sio of the Butte County Code and/or wo k inJicated� abope for which y ECTOR OF PUBLIC �L�- PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS D 0 3 / Receipt No. J WHITE-D.P.W.. YELLOW-A3SE330R. PINE -INSPECTOR, OLDENROD-APPLICANT ,COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLIQATION DATA SHEET _ { 11 Permit No. OWNER ? A. P. No. Proposed Building Use 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 havLdup�_IICJ��- e -su Itted. . . . . . . . . . . — 2. Plot plans ini i licate, signed by preparer of plans. U 3. Complete plans i duplicate triplicate, signed by preparer of plans. qA 0 4. Complete engineered plans and calcs, with wet signature on plans. 5. Plans with Energy Design Compliance Statement. . . . . . 6. School District "Fees Paid" Stamp o,'n Floor Plan. 7 Statement of In nt for Non -Heated and AC Buildings. 8. ees of $ (ID Letter of signature authorization. - _... 10. Sanitation approval from _ Health Dept. 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 ❑) Improvements may be required. . . . . . . . . . . . 16. Mobilehome Installation Data. . . . . . . . . . Pre-Inspec. request to (Date) 17. Pre -Inspection for__ -.- _.. _- _ Required. Building Inspector 18. Recorded copy of Agricultural Acknowledgment Statement. 19. Driveway Permit, — 20. Plot plan approval from city of _ 21. 22. _ — -- When ou issue the er IIt, ocess as follows: Mail to owny;, Mail to contractor- - Telephone37� and hold for pickup �� o,ice, Deliver w/inspector. Other Applicant',. )--Psi_, 2 -Date Copy of plans sent Health Dept.; Fire Dept., Other Date The following data must be submitted rior to 1. Index permit for above items o 2. Additional items required: it issuance: (Circle new item not checked above). Contractor, designer, own , was advised of above required data by wphone_maiI—counter by Contractor, designer, owner, was advised ct above required data by —phone _maiI—counter bA Plans checked Sets of plans on hold in Copy—DPW Date Plans approved by File cabinet AP folder 00, date__LL� ? �� date Date It/L2 r' COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, Oroville, CA 95965 OWNER -BUILDER VERIFICATION Phone: 916-538-7541 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) E: 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 if A S 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. G - PACIFIC GAS AND ELECTRIC COMPANY pUB,WT + 2226 VEATCH STREET • OROVI LLE, CALIFORNIA 95965 (916) 532-4135 PHILLIP J. EARLEWINE SERVICE PLANNING SUPERVISOR Butte County Building Department 7 County Center Drive Oroville, CA 95965 Attention: Mr. Mike Vierra Dear Mr. Vierra: November 3, 1987 RE: Meter Set/No Inspection 21 East Plumas Wy., Oroville This is regarding your request that we determine if the meter set at the above location was performed by our personnel. We have investigated this matter and found that the meter set and transfer to new facilities was not performed by any representative of.our Company. We did discover, and it was confirmed by the owner of the property, that Mr. Jim Pye transferred the overhead service and the meter from the old periscope to the new periscope. This was done without PG&E's knowledge. A letter will be sent to Mr. Pye advising him that tampering, removal and or installation of utility property/equipment by persons other than authorized utility employees is a misdemeanor and any further action of this nature will result in legal action. If you have any questions regarding this matter or if I may be of any further assistance, please contact me at the Oroville office, 532-4142. Sincerely, PHJ. EARLEWINE Service Planning Supervisor PJE:jms FORM 7 -ADDITIONS TO RESIDENTIAL BUILDINGS ENERGY SHEET PACKAGE "A" (Additions) Owner ��/o Climate Zone Permit # Floor Area The following data showing mandatory and required features of Package "A" shall be installed for additions to dwellings. Additions to dwellings include room additions, converting garages and patios to living areas, house moves that add footage and attic conversions, and any space that is existing non -conditioned space that is converted to conditioned space. Remodeling of existing conditioned space is not included. ZONE 11 ONE 16 APPLIES TO NEW AREA CEILING R-30 R 38 �. WALL R-11 R- 9 FLOOR R-11 R- 9 SLAB R-7 R-7 GLAZING U-.65 (Dual) U-.6 (Dual) SHADING SOUTH - OPTIMUM OVERHANG or .36 Shading Coefficient WEST - .36 Shading Coefficient LOOSE FILL INSULATION (Density) It INFILTRATION CONTROL (Weatherstrip doors, certified windows, caulking) VAPOR BARRIER (Zone 16) DUCTS PER UNIFORM MECHANICAL CODE .- Ch. 10 LIGHTING KITCHEN & BATH NOT LESS THAN 25 LUM02Sr-iWATT MAXIMUM GLAZING 16% OF" AREA PLUS REMOVED e"LIA?7JPNI COUNTY NEW HEATING, VENTILATING, AIR CONDITIONING�'AI�,,D..�,� OT W.��T��ER SYSTEMS IN CONJUNCTION WITH AN ADDITION SHALL BE INS'�'ALI�EASSSb_ ON. BACK OF THIS SHEET. OTHER 12/85 0 *l HEATING, VENTILATING, AIR CONDITIONING SYSTEM (A) Heating , ❑ Central_Gas Furnace % (brand any model number) SE Btu/hr (heating capacity) , ❑ Heat Pump (brand and model number) ACOP Btu/hr (heating capacity at 47°F) ❑ Active Solar type (liquid or air) Collector brand and ft2 model number solar fraction collector area collector orientation collector tilt rated y -intercept rated slope ❑ Other (describe) *1' (B) Cooling ❑ Electric Air Conditioner (brand and model number) (seasonal EER) Btu/hr (cooling capacity at 95°F) ❑ Electric Heat Pump EER Btu/hr (cooling capacity at 95°F) ❑ Other (describe) DOMESTIC WATER SYSTEM ❑ (A) Gas Only Gallons (brand and model number) (tank size) C3 Heat Pump w/Electric Backup (brand and model number) Gallons 2 (tank size) j3 * Active Solar (collector brand and model number) (rated y -intercept) (rated slope) (solar fraction) ft (backup heater type, brand and model number) (collector area) (collector orientation) (collector tilt) ❑ Location of Solar Panels ❑ Other (Describe) N *l Submit documentation of sizing heating and cooling equipment by Manual J, sizing charts (form #4) or other approved methods, section 2-5352(g), and fill out the following: Heating: Winter design temperature °, elevation ', heating load BTU elevation factor x heating load maximum outlet capacity gas furnace BTU Cooling: Summer design temperature ", cooling load BTU *2 Submit T.I.P..S.E. chart or other approved system (form #5) to document sizing of solar panels. ® DESIGN COMPLIANCE -STATEMENT: The above building design meets the requirements of Title 24, Part 2, Chapter 2-53 of the a ifornia Administration Code. SIG TURE OF BUILD N�DE GNER OR APPLICA