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o� RICPERMIT#95-0091 RICHARDSONHARDSON, JAMES A. 2672 V6 RD., OROVILLE CONT: MIKE HURST; ELE POLE FOR FIRE DAMAGE/SF 936 104-903- PPER�MITN95-1725' NS, Dar 2672 �� 2672 V-6 Rd., Or. ville New Single Family(Replaces Burned SF) 93fi T0� II0T 99-0615 PARRISH, Jeff I 2672 V6 Road, Oroville Contr: Owner )1 I Add living room i 1 .eRii4f herr `, 6 -k36_194 —rn- ZELDA RICHARDSON 2672JV-6 Road, Oroy i Permi£; 2447 82E(eleser r, r NOTESRESIDENTIAL W6 -1U4-007 . 99-0615 PERMIT NO. PARRISH, Jeff 2672'V6'Road, Oroville Contr: Owner Add living room r f r ;4 SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER .r r 4 JOB FINALED (Date) Signat r SPECIAL CONDITIONS CHECKED BY SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER .r r 4 JOB FINALED (Date) Signat V= OK 0 = Not OK - = Not Applicable = Not Ready RESIDENTIAL Date rfloor (Plans) OK except #'s 9. Z22 n b -Setbacks - Easements- Flood- Slope 10. Ftg., Main; Soils-Elec. Grnd.-/CZ-fFTg_Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors (Single & Duplex) 7. Slab, Steel -Wrapped 8. Piers -Fireplace Fig. -Steel 9. D.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 -Anchors -Regulator -Service Test 12. Electric Underground 13. 6- Plenum Ducts; Clearance -Material -Support -Ins. rders-Sills-Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Z�X Card B-1 Date Card B-1 Datey Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protec 19. D.W.V.; Test Fittings & Anc ail Protection 20. Shower Pan; Test .1 Floor -Tub Access 21. Test Tub ower, Second Floor -Tub Access 22. ioe: Sixe & Anchors Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELJECTRICAL (Permit) OK except #'s („2'.T. Fixture & Transformer Clearance -Ins. Protection lec Receptacles Spacing -Lights & Switches at Doors a. Sizes & No. of Conductors Stapled Romex Installed Close to Edge of Studs & C.J. quip. Ground made up w/Mech Fastenersz4padGa6JWdor 2 tante ucuits in Kitchen & Conductor Size GFI 29. Su aa. Cu or AI-A.C. Wire Size / / as Cu or At 30 or AI -Oven Circ. / / ga Cu or Al Insulated Neutral O Yes ❑ No 31. Ground Main Disconnect 32. els-Motors-Mech. Equip. 33. ower Light -Spa Light 34_.Smeke-BET>rroTr Date ;71 rllq Card B-1 Date Card B•1 Date f Card B-1 Date Card B•1 Date MECHANICAL (Permit) OK except #'s 35. A.C. Ducts Insulation & Support 36. Fan, Exhaust above insujaliop 37. Condensa Overflow, Size & Grade 38. Fjpm1ceVent Acc -Comb. Air -Return Air Vent 115 outlet 39. Attic Access & Platform umace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s Sits_Proper Materials & Anchors Wal tuds-Nailing Spacing & Braces -Plates -Sound B g Walls over Girders & Floor Nailing Draft Stop in Walls (rat proof) ops, Furred Ceilings -Stairs -Chasers -Tubs jAe"Headers & Beams -Size & Bearing Date FRAMING (Continued) angers;Post Caps -Anchors -Connectors ing. Joist-Rftr. Ties- Purlin-Roll Brac.-Truss-Shting.-Rfng. A&-RmrftC91 s or Type A Flue -Fireplace Throat Clearance maize & Romex Protection -Draft Stop -Ins. Baffles 5 xiting Doors -Sill Ht. & Dimensions ge ire Protec i n Framing 52 penings V.5 xt. Doors -One 3' -Check Garage 3rd Story, 2 Exits Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection ywood on Roof Overhang -Attic Vents -Rafter Outriggers ding -Nailing veneer Waco Mesh -Drip Screed -Fd. Vents-Underflr. Access Glazing Area -Glass Protection -Skylights -Plastic a s; ailing -Bolts `tj" . Brat Interior/Exterior Wall Pan Is . Insulatio a s 62. Infiltration- ails -Windows Date . 09 Card B-1 - Date Card B-1 Date V r.Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 63. Ex gteps-Door & Sidelight Protection -Landings 6 . Smoke Detector 65. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection --66--Bedroom Exiting `67,- ' 4-& Bath Fixtures & Tub Access -Spa 8.- Elec. Trim & Subpanel, Breaker Sizes & Labels - 68-3ta1Ts 8 Rails '^ F'reploe-or Stove, Clearance -Hearth 7 ec. Outlets at Wood Panel, Int. & Ext. �7 t��t. & Appliance; Ground -Air Gap -Cooking Clearance ec. Outlets & Receptacles at Kit. Counter. 74. (�ArageFire Door; Swing -Landing -Closure �A 2�Duct in Garage -Damper 76.�t*. -Verits-Clearance-Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 77�-Elec..& Mech. Equip. Listed for LocationMach. Equip. Listed for Location 78. EI@__,_ _tc,. eptacles in Garage (F.F.I.)-Romex Protection nsulation-Foam-Looked in Attic -81T.-Guard Rails & Deck Construction -Post Caps Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth --elg-arance Looked under Floor C) Yes 82. Following Insild./Drive 0 Yes Q No/Walks ] Yes .l No/Planters 0 Yes ❑ No 81-_Studown-Finish 84. A.C. Unit Disconnect, Electrical -Plumbing 85. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings Well, Disconnect, Electrical, Plumbing 87. Exterior-Elec. Trim, G.F.I. Receptacle -Underground 88. Ventilation Throughout House 89...GIasWPiotec1lio n 90. Corrections from Previous Inspections as Test -Meters Tagged, Gas -Electric 92 Water & Sewer Connected -C/O to Grade -HD Approval 3. Energy Compliance Certificate -Other Certificates Address Posted J` Dateq-' -' Card B-!� _,) Date Card B-1 Date Card 11 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: V = OK 0 = Not OK . = Not Applicable = Not Ready MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s Zoning Requirements -Setbacks -Easements 1. Zoning Requirements -Setbacks -Easements Footings; Soils -Size -Depth -Spacing -Connectors -Steel 2. Soils; Special MH Support Sketch Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 3. Sewer; Location -Test -Fall -C/O -Concrete Wood Awn.; Posts-Beams-Rftrs.-Con nectors Shthg.-Frg-Bracing 4. Water; Location -Test -Easement Needed (Sketch) Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete Carports; Windows -Doors 6. Gas; Location -Test -Wrap;-/ /" L'ft. / P Nat. or / /"L"ft./ PLPG Electric 7. Well Clearance & Disconnect Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 8. Utility Clearance Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. 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 1. 4. Electricity; MH Test -Crossovers -Breakers -Clearances 2. 5. Drain; MH Test -Fall -Flex Connector 3. 6. Water; MH Test -Regulator -Connector 4. 7. Water and Sewer Connected -C/O to Grade -HD Approval 5. 8. Gas and Electricity Tagged 6. 9. Tie Downs -Type -Installation Can. 7. 10. Exits; Insp.-Sketch 8. 11. Cert. of Occupancy 9. 12. Permanent Foundation Only; License Decal Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 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; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Con nectors Shthg.-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (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, Distance-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- Pane lboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Insulation Certificate BUILDING OWNER: 'P BUILDING PERMIT A: Y- -6 BUILDING LOCATION: �. rD - y Description of Installation ROOF Material Thickness (inches) Brand Name Thermal Resistance (R -Value) CEILING riB or Blanket Type 5 Brand Name �Dl� Thickness (inches) ;% ; "' Thermal Resistance_(R-Val Loose Fill Type Brand Name Contractor's minimum installed weight/ft lb Minimum thickness inches Manufacturer's installed weight per square foot to acheive Thermal Resistance (R -Value) -k--EXTERIOR-WALL Material I� (�% s Brand Name 7/ l Thickness (inches) r % Thermal Resistance (R -V ) te - / 3 RAISED FLOO� Material l� f f s Brand Name �y%Z�7/ Thickness (inches) 17F% NKS JOUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 -Telephone (530) 538-7541 PERMIT N (Rev.12/96) APPLICATION AND PERMIT �9 'ASSESSOR PARCEL NUMBER 036-10-4-007 ZONING AR BUILDING PERMIT OWNER IEEE PARRISH TELEPHONE 534-5611— SO. FT. OCC. BUILDING VALUATION 1189 R 21,006 .OWNERS MAIUNG ADDRESS ROAD, 0 -R0111 -1 -LE CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAIUNG ADDRESS CONSTRUCTION LENDER Fireplace LENDERS MAIUNG ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Flinq Fee $ 20.00 Permit Fee $ 225.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 146-99 BUILDING ADDRESS ROAD,0ROVILLE Energy Plan Checking Fee $ 23.00 $ PERMIT FEE $ 4 4-99 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF IR Duplex ❑ Mobilehome ❑ Other SPECIFY Solar or heat pump water heater 23.00 Water piping Water 15.00 gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑XRemodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: ADD LIVING ROOM Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 800VOR LESS Main Service zo.A OR IES. 23.00 LICENSED CONTRACTOR'S DECLARATION 1 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.PSING 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: 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors - to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: O 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 Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation ws of California, and agree that if I should become subject to the workers' coVi pe ation provisions of section 3700 of the Labor Code, I shall forth ith c mpl with a proVl 'ons. e� 4 X Date 7'r�'- ! / Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Main Service TO +000A 46.00 NEW CONST. DWELLING OCCUP. SO I3 . O OR ADDNS. ( DY; Y; .5015 ACC. LS. 3.5¢Fr. NEW CONST. MULTI.O NON-RESID. UTLET 97.50 8 OUTLET OWELER APPARATUCIR.S OUTIET OR FD(TUREs Ex. Occup. eA� �'; o Ex. Occup. ounErs A6M.OEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S 33.60 MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FETE $ Mobile Home Installation Fee $ Energy Inspection Fee Is 46 on OCC CONST. TYPE TOTAL FEE $ 3 ,8/5 z. FEE. P c - FLOOD F p D U This permit is hereby issued under the of the Butte County Code and/or indicate4 above for hich fees have By PERMIT EXPIRES ONZe applicable provisions Resolutions to do work been paid. �+ ao Dale Receipt No. 264579 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISIONr t ` 7 County Center Drive Oroville, California 95965 � Telephone (530) 538-7541 PERMIT No. D(Rev.12/96) APPLICATION AND PERMIT - '�9 �l(n ASSESSOR PARCEL NU1N_ 0 lDD .7 mN"o � BUILDING PERMIT l/// OWNER 'ER,4 29 JQJS Td1sDNON° 4�3-S� SO. FT. OC . BUILDING VALUATION OWNER'S MAILING ADDRESS/ �/) f ^ _ CONTRACTOR'S NAMETE1.1341ONE CONTRACTOR'S MAILING ADORESO CONSTRUCTION LENDER LENDERS MAILING ADDA08 [Fir, lace Total Valuation S ARCHITECT OR ENGINEER LICENSE No. Flin Fee S 20.00 ARCWTECT OR ENGINEER'S MATING AODRE8S Permit Fee LAT NO. I SUe0NWION'SNAIE USEOFSTRUCTURE Y ' SF Duplex O Moblehome 0 Other sPECFY TYPE OF WORK New O Addition P,,,d�ell 13 Utilities/ ,3 Installlaatttiionp0 Other E3 Describe Work: Receipt No. WHITE-O.D.S..-B.D,. Plan Checking Fee $ Energy Plan Checking Fee S 15.00 S er or vent PERMIT FEE $ PLUMBING PERMIT Each Trap 15.00 Solar 48.00 Water Home ISIGIWI -.� @20.00 g Fsal 20.00 or hent um water hea 23.00 Each a piping : 15.00 as venter h er or vent 15.00 iing vp6m 1 - 5 outlets 15.00 sower 48.00 15.00 Home ISIGIWI -.� @20.00 1 PERMIT FEE : ELECTRICAL PERMIT -Filln Fee 20.00 Main Service 000v LESS 200AOORR LESS 23.00 Main Service L 200A To 10A 48.00 NEW CONST. DWELLING OCCUP. -.� OR ADDNS. i ACO. BlD3. 3.5C NEW GUMT. NOIFRESIO. MULTI-OUTLETMULTI-m 17.50 S 1 • POWER APPARATUS i SNOLE OUTLET C0. Ex. Occup. OUTLET OR PDLTIRIES 2001.00 SAL s0 EX. OCCUP.ovnzn rREs .)E. 5.00 Temporary Service 23.00 Mobile Home Facilities . 20.00 Misc. Wirinq 23.00 PERMIT FEE S MECHANICAL PERMIT Fling Fee 0.00 [Heatina - 8.50 Ventilation PERMIT FEt S Mobile Home Installation Fee S Energy Inspection Fee S �' occ CONST. TYPE TOTAL FEES l P KAZ- 1 0. FEES IMP I FLOOD I COf I PARCEL PO HO i ISSUE This permit is hereby Issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By Date PERMIT EXPIRES ON R GOLDENROD -APPLICANT �ro1 :� � �.., �a � COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541 i PERMIT APPLICATION DATA SHEET OWNER:LI. ASSESSOR PARCEL ER: 036 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 By ❑ 1. All iiems have been submitted .-----------------------------==-.----------------------------------------------------- ❑2. Plot plans, 3/4 sets, signed by the preparer of plans. ----=---=I— ------------------------------------------------- ❑ 3. Complete plans, 3/4 sets, signed by the preparer of plans. ----------------------------------------------------- ❑4. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. -------- ❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------ El 6. Energy Design Compliance and supporting;documentation- ---------------------------------------------------- ❑ 7. Statement of Intent for Non -Heated and A/C Buildings. --------------------------------------------------------- ❑ 8. Hazardous Material Form. ------------------------ '------------------------------------- ----------------------------- ❑9. Manufactured Home -data and installation insh ctions�inc� lauding Tie Down Specifications .------------------ ❑ 10. Fees of $ "'—" --- -------------------f------- - O N V�-/----------------------------------- Impact fees as shown on the attached sclieduleg��F`-----'------------ ------ --------------------------- —� 9 ! Kf California Department of Forestry plan approvaUfees`'� �--,---w- ---- 7-------------------- ---- ❑ Mood elevation certificate. --------------------------------- ----$---�=— �-.----------------- 14. Sanitation and plot plan approval Health Department. --------------------- ❑ 15. City of Chico plumbing permit. ------------------ .- --- -- -------------------------------------------------------------- ❑ 16. Plot plan and business license approval, from the City of Biggs.-----------------------------�= _ --------------- ,17. Planning approval for (A) Use: —(B) Parking: -------------------------- 1118, ----------------------=-- ❑18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ----------------------- 111. 9. ---------------------- ❑1.9. Encroachment Permit for driveway (construction approval prior to occupancy). --------------------- 020. Pre -inspection for . required Request to Building Inspector on ❑21. Contractor's license information. (Number, Name Style, Classification). ❑22.Workers' Compensation carrier -and policy number. ----------------------- ❑23.Owner-Builder Verification (Given to owner ❑, Mailed to owner ❑). -- 024. Letter of signature authorization. ------------------------------ ❑25. Recorded copy of Agricultural Acknowledgment Statement. ❑26. Letter of intent on building use. -------------------------------- ❑27. Manufactured Home utility clearance. ------------------------- 028. Existing violations and/or expired permits. ------------------- 0 29. 1143 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to HDD: 030. Other: r' / / ; '------- Wh ou issue the p t, roces]� follows ❑ Mai`lto owner;`❑Mail' o contractor. Telephones 3 �� ` and hold for pickup at" �� ice i e ver•with-inspector. / Applicant: Date: Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution Date: By: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By: (Date) 1. Index permit application for the above items numbered: ❑ Plan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building D' ision counter, by Z Plans reviewed by: Date: Plans approved by: Date: Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: q Yellow Copy - Department of Development Services, Building Division. OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid'unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement : YES DO NO 13= =' 2• 1 HAVE PO HAVE NOT O signed an application for a building permit for the proposed 3. I have contracted with the following person (firm) to provide the proposed construction rif. ADDRESS: PHONE: 4. I plan to provide portions of this work, supervise, and provide work: NAME: ADDRESS: PHONE: CITY: OR'S ENO. but I have ed the followin • f . _ g person to' cooi�dinatr� CITY: 'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicate NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTYOWNER: SOCIAL SECURITY NUMBER:__ DATE:—�– NOTE: This Owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. OVER I OWNER BUILDER INFORMATION Dear Property Owner: An application for a building permit has been submitted in your name listing yourself as the builder of property . improvements specified. For your protection, you should be aware that as "owner-buildee, you are the responsible party ofrecord on such a permit.. Building permits are not required to be signed by property owners unless they are personally performing their own work. if your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. I ou plan to ur own work, with the exception of various trades that you plan to subcontract, you.should . be aware f the following in o ation f r your benefit and protection: ♦ If yo ,employ or otherwise enga, y persons other than your immediate family, and the work (including materials and o er costs) is 5300 or mo or the entire project, and such persons are not licensed as contrac'tois or subco dors, then you may be employer. ♦ If you an employer, you mus register with the State and Federal Governments as an employer and you�are subject to eral obligations.' eluding state and.federal income tax. withholding, federal social security.taxeSt. ..: workers compe n ins ce, disability insurance costs, and unemployment compensation contributions. ,. :.�..� . ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under'limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contragprs may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" �n the reverse side of this form so that we can confirm that you.. are aware of these matters. The building permit will not be issued until the verification is returned. i rely, Mic el C. Vi ira, C.B.O. M ger, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. OVER M ffutte ount LAND OF NATURAL WEALTH AND BEAUTY BUILDING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE • OROVILLE, CALIFORNIA 95965-3397 TELEPHONE: (530) 538-7541 FAX: (530) 538-2140 April 8, 1999 Jeff Parrish 2672 V-6 Road, Oroville CA. 959 Building Permit Number: 99-0615 Assessors Parcel Number: 036-104-007 The above referenced building plans were reviewed by this office. Provide additional information and/or make revisions to plans, specifications and calculations as follows: 1. The bracing shown on plan does not comply with ch.23 of the Uniform Building Code. Revise to comply or provide lateral design by an architect or engineer. If you wish to discuss any requirements, you may contact me at (530) 538-7541 between the hours of 1:00 p.m. and 4:00 p.m., Monday through Friday. Sincerely, David Wasne Building Inspector III. .. .- .:r .rt. .,'M .� ,r.• 'v. ..'-.'7ra A•.. r ,.. .�`47.�.�a. ,� -t ti .:lr L�.,..•ia� ^y.,. n....R. 'riw ,r..frl.ryr '•,in,•�h �r f.ii I'r�4y✓.r ,Wf 1Fi.. ^,r BUTTE COUNTY4SGH00 S-IM'PACT�FEE CERTIFICATION FORM "�""=` "' • (One,form per Building) School District 0-40 1 L_. L E 1,— La Building Department No. A.P. NumbeC)3& —10(4 d © Jurisdiction: City �ounty Property Owner F Property Location/Address Subdivision Residential Development No of Living Mobile Home Units Installation .Commercial/Industrial t = f Lot No. .................r.........�......................................................................................, Iy I Addition/ *Supplemental to Conversion Permit # '(No foundation inspection): ..:................................................................................................................. f Sq. Footage (Including Exterior Roofed Areas) Dat Sq. Footage j 7 (Group R) V imoor runs reviewea Dy acnooi uistnct rersonneo District Identification No. �1�ffs School District certifies that (Applicant) 2� (Street Address) (Phone Number) (City) has complied with the requirements of Resolution No representing square feet. School District Representative Paid by Check # Remarks: (State) IZip �-9 by payment of $ AB 2926 _ FULL MITIGATION = Date — Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the imposition of the fees in any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified bj the applicable Local Planning Agency that, this project is being reviewed under the California Environmental Quality Act ICEQAL 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.xls 110/98)dmm �.RE.SMENTIAL - 036-104-007 PERMIT#95-1725 WATKINS, Dar 2672 V-6 Rd., Oroville New Single Family(Replaces Burned SF) f �/319b J=OK O = Not OK ' = Not Applicable ' Not Ready RESIDENTIAL (Single & Duplex) a - ' =� ' Date UNDERFLOOR (Plans) OK except'N's Date F-RA'MING (Continued) oning-Setbacks-Easements-Flood-Slope , 45. Hangers -Post Caps -Anchors -Connectors 2�tcf, L Main; Soils-Elec. Grnd.-/ , /" Ftg. Depth ----- Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Ring. 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth -- � - �48. lace Ties or Type A Flue -Fireplace Throat clearance 4. Ftg., Porches &Decks; Soils -Steel-/ /Ftg. Depth Access; Size & Romex Protection -Draft Stop -Ins. Baffles 5. Stemwalls, Main; Steel-Blockouts-Wrapped �� 8 rm. Windows or Exiting Doors -Sill Hgt. & Dimensions 6. Stemwalls, Garage; Steel-Blockouts-Wrapped - --- -- ire Protection Framing 6a. Downs and Special Anchors -------- --- ------ 54--Pro erty Line Firewall & Openings Slab; Steel -Wrapped -------- k. . Ext. Doors -One 3' -Check Garage -3rd Storv. 2 Exits 8. Piers -Fireplace Ftg.-Steel .W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF. Gas Pipe; Size -Anchors - yard gas piping: size -test i 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 ! and 13-1 Date Card B-1 Da — Card 1 Date Card B-1 Date G (Permit) 2K ex ter Htr.: V A MCoion Air- e ------- - --- - ---------------------- Wa ipe; Test & Anchor- o ec ion -%j_t _W.V ; Test -Fittings & Anchor -Nail Protection_- ------ ----------- 1-9-Shower ----- 1-9-Shower Pan: Test. First Floor -Tub Access -- -- 20.,Test Tub & Shower, Second -Floor -Tub Access-- ----- -- - , ---� Gas Pipe; Size &Anchors Date Card B-1 Date Card B-1 ! Date W, °J Card B -J/ Date Card B-1 Date AL (Permit) OK except #'s ure & Transformer Clearance -Ins. Protection - ---- - EI c. Receptacles Spacing -Lights & Switches at Doors - ---- ------------ ------ ---- --------------------------------- Size Boxes & No. of Conductors -Stapled ---- - - ------------------------------ ---------------------------- F.ex'lnstalled Close to Edge of Studs & CJ.. Ground made`up w!Mech. Fastners-Bond Gas-& Water ------------------------- ------------- -------------- liance Circuts in Kitchen & Conductor Size!GFI -------------------------------------------'------------------------- ed Wire Size ga. Cu or AI-A.C. Wire Size ! / ga. r AI ..- _.----- «YRange Circ. ! ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral ❑ Yes ❑ No -----..------------------------------------------------------------------------- � Service -Riser Conductors & Ground -Main Disconnect ------ 31. Equip Clearances Panel s- Motors- Mech.Equip.- -- - - -- - -_✓JL GI thes Closet Light -Shower Light -Spa Light ---------------- -- - - Smoke Detector --------------------------------------- --------------------------------------------- Date Card B-1 Date Card -B- 1 - ------------------------------------------------------------------------------- ' Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except 4's 34. A.C. Ducts Insulation & Support - ---------------------------- ------------------------------------------- 3�. Vent F , xhaust above insulation ----------------- - - ------------------------------------------------ ndensate Drain & Overflow: Size & Grade --------- -- - --- --- ---- ------------------------------ ------ --- -------- ..- 37. Fu ance-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 FRA G (Plans) OK except ft's Si"K -per Material & Anchors -- - --- ----------------------------------------------------------- ,1A1Is Studs -Nailing. Spacing & Bracing -Plates -Sound ---- ----------------------------------- ------------------- Bearing Walls over Girders & Floor Nailing -- - ---- - . - --- --- -------------------------------------------------- `4 D Stop in Walls- (rat proof) ------------ - -- ---- -- �i'Stops: Furred Ceilings -Stairs -Chases -Tub f Headers & Beam -Size & Bearing i Width -Headroom -Rise -Run -Landing -Fire Protection p ywood on Roof Overhang -Attic Vents -Rafter Outriggers _________ _ _g -Nailing Veneer_ 5 Mesh -Drip Screed -Fd. Vents-Underflr. Access ------- _ Glazin _Area -Glass Protection -Skylights -Plastic S r Walls: Nailing -Bolts ----- -- 9_Insulation_Walls-Ceilings 1L-6(rin-filtration-Walls-Windows Date !� �and B- _ Date and B-1 D - -- - Dat (j CaOB-1 Date Card B-1 Date FIN (Plans) OK except N's St ps-Door & Sidelight Protection -Landings ---------------- - - Soke Detector !Fur ce: Vents -Clearance -Comb. Air -Connector - Garp e; Above Floor -Ducts -Meeh. Protection Be oom ding .-..----- ElFecTrim Bath Fi es & Tub A ss -Spa & Subpanel; Breaker Sizes & Labels ---------------------------- ----------------------- - ----------- -- - - -- -------- ------------ R R is ---_-----_-_---------Bee-erg_----. ---_ _ eatth N_ O Siywa/�0 - ot7..��E ets at Wood Panel; Int. &Ext.xt. & Appliance; Grnd.-Air Gap -Cooking Clearance Outlets & Receptacles at Kit. Counter -- _- arege`Ei w_ing-Landing-Closer - -ti --- ----------------------- age-Bampe r ------------------------------- --- ------ -- - tr. Htr.: Vents-Clearance-Com"i i o r -P. ' I tion ------------------- -Mech_Equip. Listed for Location ------------- - --- ---- a ecep_a in arag _ tion Insulation -Foam -Looked in Attic ----------------------------- - 7 . r 9eck CenslcuG4e.A.Pom-Saps ----------------------- n. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes d ollowing instld.; -Dave f� S - No; Walks El Yes No; Planters 1:1 Yes allo ..-----------------------W'n---h ----- ------------------------------------------ --- — m _ isco nee ents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to OK Ope - ----- — ----------------- 8 " a ell: Disconnect, Electrical, Plumbing xt lec. Trim: G.F.I. Receptacle -Underground --- 8 dation Throughout House P--Lection --------.------ — -------- 8"-- orr ti nsfrom Previous Inspections - - G st-Meters Tagged; Gas -Electric__ _ - ter.& Sewer Connected -C/O to Grade -HD Approval I EnergyComplianceCertificate-Other Certificates — — -- -- n -- Date /[ �f� Card B-1 Date Card B-1 — - r�i-- - _-•--------- - _Dat f1,-qk Card B-1 j Date Card B-1 - - I,,-- - -- --- I`' --- ---- — Date Card B-1 Date Card B-1 Comments at Final: J=OK O = Not OK = Not Readyable MOBILE HOMES 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" tt. / /"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 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 3-1 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. _ Boxes -Enclosures -Panel boards -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 COUNTY OF BUTTE- DEPARTMENT OF DEVELOP_MENT_SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMLT APPLICATION AND PERMIT �- ASSESSOR PARCEL NUMBER 036-104-007 AR ZONING BUILDING PERMIT OWNER DAR WATKINS TELEPHONE 534-7123 SO, FT. OCC. BUILDING VALUATION gl6 R 44,064.00 OWNERS MAILING ADDRESS 630 IEHAMA p CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTORS MAILING ADDRESS Fireplace A 1,500.00 CONSTRUCTION LENDER UNKNOWN Total Valuation $ 45,564.00 Filing Fee $ 20.00 LENDER'S MAILING ADDRESS Permit Fee $ 388.50 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 252.50 Energy Plan Checking Fee $ 23.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Penalty $ BUIL.DINGADORESS 9679 RD PERMITFEE $ 684.00 -6 OROVTTLE PLUMBING PERMIT Filing Fee 1 20.00 Each Trap 81 7.00 56.00 LAT NO. SUBDIVISION'S NAME PARCEL MAP Solar or heat pump water heater 23.00 USEOFSTRUCTURE y SF E3 Duplex ❑ Mobilehome ❑ Other SPECIFY Water piping 15.00 15.00 Each gas water heater or vent 15.00 15.00 Gas piping system 1 - 5 outlets 15.00 15.00 Building sewer 15.00 15.00 TYPE OF WORK New QX Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: NEW 2 BR - Mobile Home S I G W @20.00 PERMITFEE S 136.00 Contractor ELECTRICAL PERMIT Filinq Fee 20:00 Main Service000V OR LESS ( 20oA OR LESS ) 23.00 Main Service ( 200A TO ,000A ) 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 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License L� the following reason: WI, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 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. ❑ 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 NEW CONST. DWELLING OCCUR s0. OR ADDNS. ( 8 ACC. BLAS. ) 3.50 FT. 28.55 NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS ) @7.50 (,POWER APPARATUS ) SINGLE OUTLET CIR. Ex. Occup. (OUTLET OR FIXTURES) BA2L (I•50 L .SO Ex. Occup. (OUTLETSFIXAPPLN o.OR ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMITFEE $ 419, 55 Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating WALL .15-00 Cooling Hood 6.50 6-90 Ventilation PERMITFEE $ 41 50 Contractor Policy Number (The above sections need not be completed if the permit is for work of a valuation V10one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the ' compensation provisions of section 3700 of the Labor Code, I shall comply with those provisions. �--- I ^I Dateindicated pplicant - ❑ Owner ❑ Contractor ❑ Agent JAn is required for excavations over 60" deep and demolition or construction__ PApermit of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee Is 146- nn Occ CONST. TYPE TOTAL FEE $ 956.05 HAZ. _ D. FEES IMP _ FLOOD X CDF PARCEL X PD HD ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work ve for which fees have bee paid. BY DaatQt�� PERMITEXPIRESON I (Date) Receipt No. WHITE-D.D.S.-B.D. ARY-ASSESSO PINK -INSPECTOR GOLDENROD -APPLICANT COUNTYOF BUTTE - DEPARTMENTOF DEVELGP4E TSERVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIMiMA 95965 - TELEPHONE (916) 381 541 PERMIT APPLICATION DATASHEET OWNER 14111 / 'k / IVIS'IS' 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: W DATE RECENED BY 1. All items have been submitted . ........................................ 2. Plot plans, 3/4 sets, signed by preparer of plans. ......................... . 3. Complete plans, 3/4 sets, signed by preparer of plans . ...................... 4. Engineered plans and calcs, 3/4 sets, with wet signature on plans . ............. 5. Hazardous Material Form . ............................................ 6. Energy Design Compliance and supporting documentation . .................. T 27 Statement of Intent for Non -Heated and A/C Buildings . ...................... 8. Engineered truss details and layout in duplicate (required prior to plan check). .... M bilehome data ,nd m facturer's installation instructions, 2 sets. ........... ees of $ l 1 pact fees as shown on attached schedule . .... .. . ........ ... California Department of Forestry plan -app oval/ ees . ......... ........... . 13. Flood elevation letter (100 year flo d y rn gineer................... 1-7 t4' Sanitation and plot plan approval Health Department.. ......... _15. City of Chico plumbing permit. . . . . . . . . . .I . . . . . . . . . . . . . . . . . . . . 16. Plot plan and business license approval from City of Biggs/Gridley. ............. 17. Planning approval for (A) Use: (B) Parking: . ........ qg..Driveway ontact Land Development about (A) Improvements (B) Drainage. ........... permit (construction approval required prior to occupancy). . . Preanspection reque—Ts Pre -inspection for required. .\ . to Building Inspector ell' (Date) 21. Contractor's license information. (No., Name Style, Classification). ........... Certificate of Workmans Compensation Insurance. .......... "................ Owner -Builder Verification (Given to owner , Mail to owner ............ _ 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 . ............... 31. Existing violations/expiredi,permits....................................... 64e V Plan check list. ........ . (1::2w,vE When ygd'issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at /) /2 office. Deliver with inspector. Other Parcel Creation ®�. Date Acreage Applic Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit issyance)rrcle I 1. Index permit for above items No. /f 2. Additional items required: Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Contractor, designer, owner, was advised of above required data by _ phone _ mail Counter by _ Date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works y- 95 �+. RECREATION DISTRICT FEES (paid at District Office) ......................... 5. DRAINAGE DISTRICT FEES (Contact Land Development Division)............... 4�C6. SRA FIRE INSPECTION AND PLAN CHECK = $89.00...... (paid at Building Department) 7. O'T'HER t 8. OTHER At time of permit application, I was advised the above fees are.required to be paid prior to issuance of the permit. APPLICANT DATE COUNTY OF BUTTE . - DEPARTMENT OF DEVEMPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE CA 95965 - TELEPHONE.�916) 538-7541 _ OWNER /� A.P. PROPOS -BUILDING.USE �� DATE REC. # DATE REC 1. SCHOOL DISTRICT FEES /G 2. (paid at District Office).. .................... SHERIFF FEES � D (paid at Buildii Depaitm Residential...... x =$ unit amt. Commercial (sgft) x _$ sq.ft'. amt. 3. URBAN AREA FEES (paid at Building Department) Residential (per unit) -X- # units amt. # Commercial (per sq.ft) x =$ sq.ft. amt. �+. RECREATION DISTRICT FEES (paid at District Office) ......................... 5. DRAINAGE DISTRICT FEES (Contact Land Development Division)............... 4�C6. SRA FIRE INSPECTION AND PLAN CHECK = $89.00...... (paid at Building Department) 7. O'T'HER t 8. OTHER At time of permit application, I was advised the above fees are.required to be paid prior to issuance of the permit. APPLICANT DATE Attention -.Property Owner: _ - _: An -"owner -builder" building permit has been applied for in your naive 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. personally plan to provide the major1 bor and materials for construction of the proposed property improvement: YES[► NO[ J. 2. HAVE[✓ HAVE NOT[ ]signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm)_ to provide the proposed construction: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 4. I plan to provide portions of this work, but I have hired the following person to coordinate, supervise, and provide the major work: NAME: ADDRESS: CITY: PHONE: CONTRACTOR'S LICENSE NO. 5. I will provide some of the work but I have contracted (hired) the following persons to provide *the work indicated: NAME ADDRESS PHONE TYPE OF WORK SIGNED: PROPERTY OWNER: V� , SOCIAL SECURITY NUMBER:— DATE: NOTE: This owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before - . we are permitted to: issue the permit. OVER Dear Property -Owner: - An application for a building permit has been submitted in your name "listing yourself as the builder of property improvements specified- For pecifiedFor your protection, you should be aware that as "owner -builder" you are the responsible party of record on such a. permit. Building permits are' not required to be signed by property owners unless they are personally. performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: 0 If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $300 or more for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an employer. 0 If you are an employer, you must register with the State and Federal Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions.. 0 There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. 0 For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who..are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "ownerbuilder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. !n4'Clerell ,mac« Micha4l C. Vier a, C.B.O. Manager, Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. OVER ;�r�`..+�',q'`��""-"7.T7*`.-��+.iri.-v'rw..i.r._;.»l. +KG,'....=rrLP`l r".�.r.?'�S±'F�'l..°�C '}�+.`�` iY�::.,i8y�.:�:A�'.., �-ee �s , ro-.r'k•-7���•1l� �.,._ _ `"�.•"y. '.'�. :.'W ,., 'r'r �Pt-�i�` -.�' �"�% y y.• c rJt, .ti,,.'.� ..I'sr R.--�iYr^'^ BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One Form Per Building) School District O A -a Fi Lr -EI" Building Department No. A.P. Number SOS!-UU% Jurisdiction: City County Property Owner 2, W14- Property Location/Address c; Subdivison Lot No. Residential Development j Sq. Footage No. f Living MHI Addition Group Units. Commercial/Industrial 0 NOW Arirlitir)n Sq. Footage (Including Exterior ofed Areas B ildi g Departm t Repres ntative Date (Floor. Plans reviewed by School District Personnel) District Idenytificati 1 "No, (Street Address) (City) �O /.S— School District certifies that A licant ( Pp ) (Phone Number) has complied with the requirements of Resolution No. representing F / to square feet, School District Representative trip uoue) - 3 JY /o by payment of $ /) /4 I/ Date Paid by Check # Remarks- dank Number Paid by Cash . r 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) feeformmk, („/sa)dmm And when recorded mail to: Building Division #7 County Center Drive Oroville, Ca. 95965 QUO AUG - 'a 1995 r --- 1 95-025949 AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT FOR RESIDENTIAL DEVELOPMENT Section 26-8 of the Butte County Code requires this acknowledgment to be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort from the use of agricultural chemicals. including. but not limited to herbicides. pesticides. and fertilizers: and from the pursuit of agricultural operations including, but not limited to cultivation. plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise. and odor. Butte County has established agricultural purposes and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal. necessary farm operations. All that real property situate in the County of Butte. State of California. described as follows: Date D «q State of California Countv of5A,3,--P490, m) AgC./ s�� �- 74 OWNERS: On &k,: a- l59y before me, S4a r K VV 6 -,e -S . {'�°� '�'t IQJ'S C.l C - personally appeared 44 VQ -re- p 4 .tcnnwn to me (or proved to me of c�he basis of satisfactory evidence) to be the person( hose names subscribed to the �S� within instrument and acknowledged to me that hthey executed the same in I+ikh6/their authorized capacity(ics), and that by Aixt of #4ir sign ure(s�,on the instrument, the personN-or the entity upon behalf of which the person(s�-Acted, executed the instrument WITNESS m.' hand 4/official seal.�� Signature A.P.# - o0 COWA.I1045242 Z Ndc ry Pubic — Cdifctnla Seal: SAN JOACUIN COUNTY WwMy Comm. b4tres NOV 20.1998 NOTE TO RECORDER: DO NOT RECORD THIS SIDE A.A.- 1 iunnnna- Instructions for recording Agricultural Statement of Acknowledgement: 1. Insert the legal description of the property in the space provided on the other side of this form. The legal description is the narrative description of the property - which will be on your deed. If you don't have access to the deed, the Recorders Office can provide this information. ( The description may be handwritten or typed in the space provided or attached ,on a separate sheet if :more space is required). . 2. Properly owners must sign in the presence 'of a' Notary Public and have .the form notarized. 3. Make a copy of the form and then take the original and copy to the Recorder's Office at 25 County Center Drive, Oroville (the Administration Center building). The Recorder will record both the original and copy. They will keep the original and return the copy to you. Just bring the copy back to the Building Division at 7 County Center Drive. RECORDER'S FEES: $6.00 - 1st. Page $3.00 - Each Additional Page RECORDER'S OFFICE HOURS: 9:00a.m. - 3:00p.m. (Monday - Thursday). Order No.: 53337 VL LEGAL DESCRIPTION EXHIBIT -"All All that certain real property situate in the County of Butte, State of California, being more particularly described as follows: All that portion of.Lot 3, Block 25, according to that certain Map entitled, "Map of Villa:.Verona,.,Butte County,. California", which .Map was filed in the office of the Recorder of the County of Butte, State of California, January 1.7, 1889, described as follows: Commencing at the Southeast corner of said Lot 3 and running thence along the East line of said Lot 3, North 450.0.0 feet to the true point of beginning of this description; thence. parallel to the North. line of said Lot 3, West 1.20.00 feet; thence parallel to the East line of sid Lot 3, North 210.00 feet to the North line of sid Lot 3, located on the centerline of a 60 foot public road; thence along the North line of said Lot 3, and along the centerline of said 60 foot public road, East 120.00 feet to the Northeast corner of said Lot 3; thence along the East .line of said Lot 3, South 210.00 feet to the true point of beginning. (A.P. No. 036-104-007) End of Legal PERMIT NO: 27-95 Lake Oroville Area Public Utility District 1960 Elgin Street OROVILLE, CALIFORNIA 95966 533-2000 DISTRICT APPROVAL AND VERIFICATION OF INSPECTION BUILDING SEWERS This verification form must be submitted to the.Butte County. Department of Public Works Building Department prior to issuance of a building or occupancy permit, whichever is applicable. Prior to final approval by Butte County of a Building or an Occupancy Permit, a copy of this verification form, signed off by Lake Oroville Area Public Utility District, must be submitted to Butte County. Date: Applicant: Applicant Address: Applicant Phone No.: Property Location (s): A. P. No. (s): August 2, 1995 Dar Watkins 2672 V-6 Rd, Oroville, CA 95966 2672 V-6. Rd, Oroville, CA 95966 Villa Verona a portion of lot 3 Blk 25 036-104-007-0 Fees due: No fees due. Replacing burnt home. Application for service approved: LAKE OR PUBLIC UT Inspection(s) made and successful test(s) observed: Location: Date: M XREA STRICT Lake Oroville Area Public Utility District release to close permit: Date: By: 11 OWNER WZ(fa-7ZO RESIDENTIAL PLAN CHECKING GUIDE (S.F., DUPLEX & MISC. ONLY) Bldg. Permit # 1S —/;;, -� A. P. # 7 r, - eli>�-7 Plan Checker j N, 8/91 . GENERAL ning requirements: (sideyards and number of permitted living units). Valuation. Plans signed by designer. Proper description of work on application. Existing violations on property. 6 Items on data sheet. (W. C., fees', Health, Developer Fees, License law, etc).' -�� Recorded notice of violation. -• PLOT PLAN jPomplete parcel size and dimensions. etbacks, sideyards, easements, etc. _ _ x- er buildings or structures. ding, fills, drainage. Gd hazard. Special conditions on creation map, (noise, CDF, fire sprinklers, non-comb- Bustible, and foundations.). AU & FAS road setback. ilding,or,utilities across lot lines (Record form). FLOOR PLAN Complete to scale plan with dimensions. Required windows for light and ventilation (Sec. 1205). ` Required windows for second exit (Sec. 1204). ' Skylights (Chapter 34 & Sec. 5207). Human impact glass (Sec. 5406). _ Required room sizes, ceiling heights (Sec. 1207). GFCIs in baths, garage, kitchen, and exterior outlets (Article 210-8). Light fixtures, switches, receptacles, and exterior receptacles for main- tenance of mechanical equipment. Locations of water heater, heating and cooling equipment, other electrical or gas equipment. 5>.arage firewall, door size, and closer (Sec. 503(d)(3))'. 3'0" exterior exit door (sec. 3304 (f). . Fireplace and wood stove location, alcoves, and clearance. Smoke detectors (Sec. 1210). :Plumbing fixtures, water closet clearances and shower size. STRUCTURAL DETAILS Standard bracing or engineered design (Table 25V) s Unusual shape, size, or split level house requiring lateral design. Clerestory requiring balloon framing and/or engineering. Three story building requiring engineered calculations and plans. Foundation plan complete enough to construct building. Floor construction details complete enough to construct building. "-Elevations and wall construction details complete enough to construct building -Roof construction details complete enough to construct building. Fireplace construction details and calcs if necessary. • after ties or bearing ridge beam. . Garage door"or porch header sizes. • Stud heights. Adobe soils - special foundation design. Retaining walls requiring design. �' Special Inspection required. 8/91 RESIDENTIAL PLAN CHECKING GUIDE MISCELLANEOUS ITEMS TO LOOK OUT FOR Stairway details: landings, rise and run, head clearance, handrails . (Sec. 3306). Guardrail details (Sec. 1711 & 3306(j). Brick or stone veneer (Chapter 30). Exterior plaster - weep screeds (Sec. 4706). Proper roof pitch for roof convering (Chapter 32). Roof covering type - (fire hazard). Foam insulation - protection. 36" halls and stairways. Living area over garage - complete 1 -hour separation required on garage side including supporting walls and posts, etc. Two exits on three-story dwellings (sec. -3303 & see_Mezannines - 1716). Attic access and ventilation (Sec. 3205). nderfloor access and ventilation (Sec. 2516). Combustion air for fuel burning appliances - L.P.G. requirements. _4No' requirements on duplexes. . Energy design. V5.'Cashing at all exterior openings. DLF responsible area requirements. 0 1 nv, S 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 /<I' ?s / - i � ' A tis OWNER _ ` 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:.lf you have any questions pertain ng to this matter, or need additional explanation, please contact this office immediately. •r _T �v,: ate. ��� � sOlO�PL�i dam✓ - P-9 O /l L14 AJ '7 l r �v a o_ �i �L 5�p u p- .� Ol 'F 1 4 ��� in.,✓ � �� �..�� � � ln y, �11 -r Date Inspector REV 10192 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, Poradise, CA - (916) 872-6307 CORRECTION AOTICE OWNER - 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 ou have any questions pertaining to this matter, or need additional explanation, please contahis office immediately. REV IMIZ ,j:N Insulation Certificate BUILDING OWNER: Description of Installation ROOF Material Thickness (inches) - BUILDING PERMIT #: 7L5 Brand Name '1'liermal Resistance (R -Value) CEILING. (:B rBlanket T ft=T-r /'" A�. Brand Name v5L,/,I7 o . Type ' Thickness ('orches) _ ,2.s / /?- /q f/A-f Thermal Resistance (R -Value) Loose Fill Type Brand Name �I Connector's minimum installed weight/ lb - Minimum thickness inches .d Manufacturer's installed'weight per square foot to acheive Thermal Resistance (R -Value) !: EXTERIOR WALL MaterialBrand Name �• _ J',usu/.��,®n�. Thickness (inch ) 3 • " 'z x-01 Ow. ;Thermal Resistance (R -Value) 9-/3 -7c/ RAISED FLOOR Material ?P:and Name i q .,.. Thickness (inches) Thermal Resistance (R -Value) SLAB FLOOR ' Material e e Rt *z- . Brand Name Thickness (inches) Thermal Resistance (R -Value) Width (inches) FOUNDATION WALL Material Brand Name Thickness (inches) Thermal Resistance (R -Value) Declaration I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Title 24 of the tri California Administrative Code. l Gener Co trac(Builder) license Number t' Signarare and Tide Date Sub -Contractor (lruulation Installer) License Number Signature and Title Date THIS CERTIFICATE MUST .BE PROVIDED TO THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION APPROVAL AND A COPY SHALL BE POSTED WITHIN THE BUILDING. JANUARY 1993 Installation Certificate: Residential CF -6R BUILDING OWNER: _[%) A j? � QT� � �� _9 BUILDING PERMIT #: 0(5- 1) 2,s BUILDING LOCATION: P—,,4 ci ceo W: I Ile CA. 9S96G An installation certificate is required to be posted at the building site prior to the issuance of the occupancy permiL This form may be used to meet these requirements. All appliance categories listed below are the actual equipment installed. Note that the efficiency and type of the appliance installed must be equivalent or better than the appliance specified on the Certificate of Compliance (CF -1 R). This certificate (or its equivalent) shall be prepared and signed by the person(s) assuming overall responsibility for the appliance installation. . I, the undersigned, verify that the equipment listed in the category above my signature is the actual equipment installed and that the equipment meets or exceeds the requirements of the Appliance Efficiency Standards. In addition, I have verified that the equipment is equivalent to or more efficient than the equipment specified on the Certificate of Compliance submitted to demonstrate compliance with the Energy. Efficiency Standards for residential buildings. HVAC SYSTEMS Note: Hydronic boiler information is entered here. Other hydronic or combined hydronic equipment is listed under Water Heating Systems. Heating Equip. Type (furnace, heat pump, etc.) we"I turNaec CEC Certffled Manuf. Make & Model Number l�-(lel r a -.w1 S 2.2— Actual Distribution Duct or Heating Load Heating Efficiency Type and Piping Before Over- Equipment (AFUE, etc.) Location R -Value Sizing (Bt h) Capacity (E t:EC Certifiedi + o © 0 154 Cooling Equip. Compressor Unit' Actual Distribution Type (air Gond., Manuf. Make & Efflclency Type and heat pump, etc.) Model Number (SEER) Location Duct or Plping R - Value The building design heat loss and design heat gain rate have been determined using a method specified in Section 150(h) of the Energy Efficiency Standards, and are two of the criteria used for equipment sizing and selection. Signature WATER HEATING SYSTEMS Water Heating System Type Date CEC Certified Rated' Manuf. Make & Input (kW Model Number or Btuh) 5�-,cje L04, , 0 ® a Piz(15n M g3 HVAC Subontraaor (Co. Name) or General Contractor or Owner Energy Tank Factor or Capacity Recovery Stant (oallons) Efflciencv Loss External Tank Insulation R -Value t. For small gas storage (rated input:5 75.000 Stu/hr), electric resistance and heat pump water heaters, list Energy Factor. For large gas storage water heaters (rated input >75,000 Btulhr), list Rated Input, Recovery Efficiency and Standby Loss. For Instantaneous gas water heaters, list Rated Input and Recovery Efficiency. For Instantaneous electric water heaters, list Rated Input. FAUCETS & SHOWER HEADS All faucets and showerheads installed are listed in the Commission's Directory of Certified Faucets and Showerheads, ursuant to Title 24, Part 6.(Sybchapter 2. Section 111. 7 -1? -?k _ ©CUiUP.e . re _ Date Plumbing Subcontractor (Co. Name) or General Contractor or Owner THIS CERTIFICATE MUST BE PROVIDED TO THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION APPROVAL AN -D A COPY SHALL BE POSTED WITHIN THE BUILDING. JANUARY 1993 TABLE OF CONTENTS TOC Project Title.......... Residence for Watkins Date........ 07!24/95 Project Address........ 2672 V-6 Rd. Oroville Documentation Author... Neal Kuopus Company ................ CALCTECH Telephone .............. (916) 534-5066 Compliance Method...... MICROPAS4 by Enercomp, Inc. Climate Zone........... it MICROPAS4 v4.02 File-WATKINSO Wth=CTZllS92 Program -TOC User#-MP1320 User-CALCTECH Run -Proposed Residence TABLE OF CONTENTS Report Page FORM CF -1R ................ 1 FORM MF -1R ................ 4 FORM C -2R ................. 6 FORM C -3R ................. 9 HVAC SIZING ............... 14 CERTIFICATE OF COMPLIANCE: RESIDENTIAL Page 1 CF -1R Project Title.......... Residence for Watkins Date........ 07/24/95 Project Address........ 2672 V-6 Rd. Oroville Documentation Author... Neal Kuopus Building Permit Company ................ CALCTECH Telephone .............. (916) 534-5066 Plan Check Date Compliance Method...... MICROPAS4 by Enercomp, Inc. Climate Zone........... 11 Field Check/ Date MICROPAS4 v4.02 File-WATKINSO Wth-CTZllS92 Program -FORM CF -1R User#-MP1320 User_CALCTECH Run -Proposed Residence GENERAL INFORMATION Conditioned Floor Area..... Building Type .............. Construction Type ......... Building Front Orientation. Number of Dwelling Units... Number of Stories.......... Floor Construction Type...: 816 sf Single'Family Detached New Front Facing 0 deg (N) 1 1 Slab On Grade (Package D) BUILDING SHELL INSULATION Component Insulation Assembly Type R -value U -Value Location/Comments Wall R-=13 0.083 FRONT, RIGHT, BACK, LEFT Wall �R-13 0.084 HWH CLOSET Wall R-13 0.090 TO ATTIC Roof 2-191.0.046 FLAT CEILING Roof R -25J 0.038 TILT CEILING S1abEdge R-0 0.900 SLAB EDGE S1abEdge R-0 0.720 SLAB EDGE S1abEdge R-0 0.500 SLAB EDGE FENESTRATION # of Interior Over - Area U- Pan- Shading/ Exterior hang/ Framing Orientation (sf) Value es Description Shading Fins Type Window Front (N) 39.0 0.750 2 Drapes.Std None None Metal Door Front (N) 20.0 0.550 2 Drapes.Std None None Glz.<50% Window Right (W) 3.0 0.750 2 Drapes.Std None None Metal Window Back (S) 33.0 0.750 2 Drapes.Std None None Metal Window Back (S) 30.0 0.750 2 Drapes.Std None Yes Metal Door Back (S) 20.0 0.550 2 Drapes.Std None Yes Glz<50% Window Left (E) 15.0 0.750 2 Drapes.Std None None Metal Window Left (E) 10.0 0.750 2 Drapes.Std None Yes Metal CERTIFICATE OF COMPLIANCE: RESIDENTIAL Page,2 iCF-1R Proiect Title.......... Residence for Watkins Date ......... 07�24/95 MICROPAS4 v4.02 File-WATKINSO Wth-CTZ11S92 Program-FORM.CF-1R User#-MP1320 User-CALCTECH `Run -Proposed Residence ' THERMAL MASS i Area Thickness Type Exposed (sf) (in) Location/Comments S1abOnGrade Yes 237 3.5 Exposed S1abOnGrade No 579 3,5 Covered InteriorHorz Yes 148 f 1.0' Tile Floor HVAC SYSTEMS y Minimum Duct Duct Thermostat •, Equipment Type Efficiency Location R -value Type CFurnace 0"7-3-0AFUE—None v R=4-72—Setbac=� -CSplit —10-. Of -S -EER Attic R-4°r-2—Setb-ack WATER -HEATING SYSTEMS . Number Tank External in- Energy Size Insulation Tank Type Heater Type Distribution,Type System Factor- (gal) R -value Storage 'Gas Standard 1 0.62 EF 40_ •R-12 SPECIAL FEATURES/REMARKS R-4.2 duct insulation required i Slab -on -Grade floor,construction R-13,wall insulation required per Form 3`s ` R-19.& R-25 ceiling insulation required per Form 3s Glazing U -values per.MFR'S. NFRC testing;& certification Mi.lga-r-d_a.lum.,f.rame dual -pane clear glazing required WALL_._FURN.73: CEC MIN. REQUIREMENT for Fan -Type wall heaters AC�C�r.-10.OT:CEC MIN. REQUIREMENT HWH: A:O-. SMITHFGR=40 w/ -R 12-ext—insult b'lanket_or equal -EF HWH---I 4 . i CERTIFICATE OF COMPLIANCE: RESIDENTIAL Page 3 CF -1R Project Title.......... Residence for Watkins Date........ 07;124/95 MICROPAS4 v4.02 File-WATKINSO Wth-CTZ11S92 Program -FORM CF�IR User#-MP1320 User-CALCTECH Run -Proposed Residence COMPLIANCE STATEMENT This certificate of compliance lists the building features and performance specifications needed to comply with Title -24, Parts 1 and 6 of the California Code of Regulations, and the administrative regulations to implement them. This certificate has been signed by the individual with overall design responsibility. When this certificate of compliance is submitted for a single building plan to be built in multiple orientations, any shading feature -that is varied is indicated in the Special Features/ Remarks section. DESIGNER or OWNER DOCUMENTATION AUTHOR Name.... Watkins Name.... Neal Kuopus Company. A.P. No. 036-104-007 Company. CALCTECH Address. 2672 V-6 Rd. Address. 1835 S. Villa Ave. Oroville, CA Palermo, CA 95968 Phone... ( 916 )3y_j%z3J Phone... ( 916 ) 534-5066 License. Owner Signed.. ,y -Signed.. `���' �� (date) ( ate0 ENFORCEMENT AGENCY Name.... Title... Agency.. Phone... Signed.. (date) MANDATORY MEASURES CHECKLIST: RESIDENTIAL Page 4 MF-lR Project Title.......... Residence for Watkins Date........ 07;124/95 Project Address........ 2672 V-6 Rd. Oroville Documentation Author... Neal Kuopus Company ................ CALCTECH Telephone .............. (916) 534-5066 Compliance Method...... MICROPAS4 by Enercomp, Inc. Climate Zone........... 11 Building Perm=t Plan Check Date Field Check/ Date MICROPAS4 v4.02 File-WATKINSO Wth-CTZllS92 Program -FORM MF -1R User#-MP1320 User-CALCTECH Run -Proposed Residence Lowrise residential buildings subject to the Standards must contain these measures regardless of the compliance approach used. Items marked with an asterisk (*) maybe superseded by more stringent compliance requirements listed on the Certificate of Compliance. When this checklist is incorporated into the permit documents, the features noted shall be considered by all parties as binding minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. BUILDING ENVELOPE MEASURES Design- Enforce- 150(1): Slab edge insulation - water absorption rate no greater than 0.3%, water vapor transmission rate no greater than 2.0 perm/inch. 118: Insulation specified or installed meets CEC quality standards. Indicate type and form. 116-17: Fenestration Products,.Exterior.Doors and Infiltration/ exfiltration controls a. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. b. Manufactured fenestration products have label with certified U -value, and infiltration certification. c. Exterior doors and windows weatherstripped; all joints and penetrations caulked and sealed. 150(8): Vapor barriers mandatory in Climate Zones 14 and 16 only. 150(f): Special infiltration barrier installed to comply with Sec. 151 meets CEC quality standards. 150(e): Installation of Fireplaces, Decorative Gas Appliances and gas logs 1. Masonry and factory -built fireplaces have: a. Closeable metal or glass door b. Outside air intake with damper and control c. Flue damper and control 2. No continuous burning gas pilots allowed. 10L ewent Tz %L *150(a): Minimum R-19 ceiling insulation. 150(b): Loose fill insulation manufacturers labeled R -Value. *150(c): Minimum R-13 wall insulation in framed walls (does not apply to exterior mass walls). *150(d): Minimum R-13 raised floor insulation in framed floors; minimum R-8 in concrete raised floors. Aft 150(1): Slab edge insulation - water absorption rate no greater than 0.3%, water vapor transmission rate no greater than 2.0 perm/inch. 118: Insulation specified or installed meets CEC quality standards. Indicate type and form. 116-17: Fenestration Products,.Exterior.Doors and Infiltration/ exfiltration controls a. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. b. Manufactured fenestration products have label with certified U -value, and infiltration certification. c. Exterior doors and windows weatherstripped; all joints and penetrations caulked and sealed. 150(8): Vapor barriers mandatory in Climate Zones 14 and 16 only. 150(f): Special infiltration barrier installed to comply with Sec. 151 meets CEC quality standards. 150(e): Installation of Fireplaces, Decorative Gas Appliances and gas logs 1. Masonry and factory -built fireplaces have: a. Closeable metal or glass door b. Outside air intake with damper and control c. Flue damper and control 2. No continuous burning gas pilots allowed. 10L i MANDATORY MEASURES CHECKLIST: RESIDENTIAL Page 5 rMF-1R Project Title.......... Residence for Watkins Date........ 07/24/95 MICROPAS4 v4.02 File-WATKINSO Wth-CTZ11S92 Program -FORM MF -1R User#-MP1320 User-CALCTECH Run -Proposed Residence SPACE CONDITIONING, WATER HEATING AND PLUMBING SYSTEM MEASURES Design- Enforce- er Ment 110-13: HVAC equipment, water heaters, showerheads and faucetsji� certified by the CEC. � 150(1): Setback thermostat on all applicable heating systems. 150(j): Pipe and Tank insulation 1. Indirect hot water tanks (e.g., unfired storage tanks or s backup solar hot water tanks) have insulation blanket (R-12 or greater) or combined interior/exterior insulation (R-16 or greater). 2. First 5 feet of pipes closest to water heater tank, non.- recirculating on-recirculating systems, insulated (R-4 or greater). 3. All buried or exposed piping insulated in recirculating sections of hot water system. 4u16(&Act 4. Cooling system piping below 55 degrees insulated. U. 5. Piping insulated between heating source and indirect hot water tank. *150(m): Ducts and Fans 1. Ducts constructed, installed and sealed to comply with UMC sections 1002 and 1004; ducts insulated to a minimum installed value of R-4.2 or ducts enclosed entirely within conditioned space. 2. Exhaust fan systems have backdraft or automatic dampers. 3. Gravity ventilating systems serving conditioned space have either automatic or readily accessible, manually operated dampers. 114: Pool and Spa Heating Systems and Equipment 1. System is certified with 78% thermal efficiency, on-off switch, weatherproof operating instructions, no electric resistance heating and no,pilot light. 2. System installed with: a. At least 36 inches pipe between filter and heater for future solar heating. b. Cover for outdoor pools or outdoor spa. 3. Pool system has directional inlets and a circulation pump time switch. 115: Gas-fired central furnace, pool heater, spa heater or household cooking appliance have no continuously burning pilot light (Exception: Non -electrical cooking appliance with pilot < 150 Btu/hr.). LIGHTING MEASURES 150(k): 40 lumens/watt or greater for general lighting in kitchens and rooms with water closets; and recessed ceiling fixtures IC (insulation cover) approved. Design- er / I\J Enforce- ment r COMPUTER METHOD SUMMARY Page 6 C -2R Project Title.......... Residence for Watkins Date........ 07/24/95 Project Address........ 2672 V-6 Rd. Oroville Documentation Author... Neal Kuopus Company ................ CALCTECH Telephone .............. (916) 534-5066 Compliance Method...... MICROPAS4 by Enercomp, Inc. Climate Zone........... 11 Field Check/ Date MICROPAS4 v4.02 File-WATKINSO Wth-CTZ11S92 Program -FORM C -2R User#-MP1320 User-CALCTECH- Run -Proposed Residence MICROPAS4 ENERGY USE SUMMARY Energy Use Standard Proposed Compliance (kBtu/sf-yr) Design Design Margin Space Heating.......... 23.71 22.80 0.91 Space Cooling.......... 17.57 21.42 -3.85 Water Heating.......... 22.01 18.10 3.91 Total 63.29 62.32 0.97 *** Building complies with Computer Performance *** GENERAL INFORMATION Conditioned Floor Area..... Building Type .............. Construction Type ......... Building Front Orientation. Number of Dwelling Units... Number of Building Stories. Weather Data Type.......... Floor Construction Type.... Number of Building Zones... Conditioned Volume......... Footprint Area ............. Ground Floor Area.......... Slab -On -Grade Area......... Glazing Percentage......... Average Ceiling Height..... 816 sf Single Family Detached New Front Facing 0 deg (N) 1 1 ReducedYear Slab On Grade (Package D) 1 7452 cf 816 sf 816 sf 816 sf 20.8 % of FA 9.1 ft { BUILDING ZONE INFORMATION Floor # of Area Volume Dwell Cond- Thermostat Zone Type (sf) (cf) Units itioned Type HOUSE Residence 816. 7452 1.00 Yes Setback 1 Vent Special Height Vent Area (f t ) ( s`f ) 2.0 n/a COMPUTER METHOD SUMMARY Page 7 ' C -2R Project Title.......... Residence for Watkins Date........ 07/24/95 MICROPAS4 v4.02 File-WATKINSO Wth-CTZllS92 Program -FORM C -2R User#-MP1320 User-CALCTECH Run -Proposed Residence Surface HOUSE 1 Wall 2 Wall 3 Wall 4 Wall 5 Wall 6 Wall 7 Roof 8 Roof Surface OPAQUE SURFACES Area U- Insul Act Solar Form 3 (sf) value R-val Azm Tilt Gains Reference 237 0.083 R-13 0 90 Yes 357 0.083 R-13 270 90 Yes 227 0.083 R-13 180 90 Yes 378 0.083 R-13 90 90 Yes 48 0.084 R-13 0 90 No 198 0.090 R-13 0 90 Yes 552 0.046 R-19 0 0 Yes 264 0.038 R-25 0 27 Yes EDGE PERIMETER LOSSES ,- Location/ Comments i DW.13.2X4.16 FRONT DW.13.2X4.16 RIGHT DW.13.2X4.16 BACK DW.13.2X4.16 LEFT E GW.13.2X4.16 HWH CLOSET AW.13.2X4.16 TO ATTIC R.19.2X6.24 FLAT CEILING R.25.2X12.24 TILT CEILING Length F2 Insul Solar (ft) Factor R-val Gains Location/Comments HOUSE ; 9 S1abEdge 51 0.900 R-0 No SLAB EDGE 10 S1abEdge 110 0.720 R-0 No SLAB EDGE 11 S1abEdge •6 0.500 R-0 No SLAB EDGE FENESTRATION SURFACES # of Vent SC SC Interior Area Pan- Frame Open U- Act Glass Int Shading/ Surface (sf) es Type Type value Azm Tlt Only Shade Description HOUSE 1 Window 39.0 2 Metal Slider 0.750 0 90 0.88 0.78 Drapes.Std 2 Door 20.0 2 Glz<50% Hinged 0.550 0 90 0.88 0.78 Drapes.Std 3 Window 3.0 2 Metal Slider 0.750 270 90 0.88 0.78 Drapes.Std 4 Window 33.0 2 Metal Slider 0.750 180 90 0.88 0.78 Drapes.Std 5 Window 15.0 2 Metal Slider 0.750 180 90 0.88 0.78 Drapes.Std 6 Window 15.0 2 Metal Slider 0.750 180 90 0.88 0.78 Drapes.Std 7 Door 20.0 2 Glz<50% Hinged 0.550 180 90 0.88 0.78 Drapes.Std 8 Window 15.0 2 Metal Slider 0.750 90 90 0.88 0.78 Drapes.Std 9 Window 10.0 2 Metal Slider 0.750 90 90 0.88 0.78 Drapes.Std OVERHANGS AND SIDE•FINS Window- Overhang Left Fin Right Fin - Area Left Rght Surface (sf) Hght Wdth Dpth Hght Ext Ext Ext Dpth Hght Ext Dpth Hght HOUSE 5 Window 15.0 5 3 1 4.9 n/a n/a n/a n/a n/a n/a n/a n/a 6 Window 15.0 5 3 1 4.9 n/a n/a n/a n/a n/a n/a n/a n/a 7 Door 20.0 6.7 3' 1 4.9 n/a n/a n/a n/a n/a n/a n/a n/a 9 Window 10.0 5 3 1 2.3 -n/a n/a n/a n/a n/a n/a n/a' n/a COMPUTER METHOD SUMMARY Page 8 C -2R Project Title.......... Residence for Watkins Date........ 07%24/95 MICROPAS4 v4.02 File-WATKINSO Wth-CTZ11S92 Program -FORM C -2R User#-MP1320 User-CALCTECH Run -Proposed Residence THERMAL MASS Area Thick Heat Conduct- Surface Mass Type (sf) (in) Cap ivity R -value Location/Comments HOUSE 1 S1abOnGrade 237 3.5 28.0 0.98 R-0.0 Exposed 2 S1abOnGrade 579 3.5 28.0 0.98 R-2.0 Covered 3 InteriorHorz 148 1.0 24.0 0.67 R-0.0 Tile Floor HVAC SYSTEMS Minimum Duct Duct Duct System Type Efficiency Location R -value Efficiency HOUSE Furnace 0.730 AFUE None R-4.2 1.000 ACSplit 10.00 SEER Attic R-4.2 0.810 WATER HEATING SYSTEMS ' �1 Number Tank External in Energy Size -Insulation Tank Type Heater Type Distribution Type System Factor (gal) R -value 1 Storage Gas Standard 1 0.62 40 R-12 SPECIAL FEATURES/REMARKS R-4.2 duct insulation required Slab -on -Grade floor construction i R-13 wall insulation required per Form 3s R-19 & R-25 ceiling insulation required per Form 3s Glazing U -values per MFR'S. NFRC testing & certification Milgard alum. frame dual -pane clear glazing required f WALL.FURN.73: CEC MIN. REQUIREMENT for Fan -Type wall heaters AC.10.0: CEC MIN. REQUIREMENT HWH: A.O.SMITH FGR -40 w/R-12 ext. insul.Iblanket or equal EF HWH 'i CONSTRUCTION ASSEMBLY Page 9 3R Project Title.......... Residence for Watkins Date........ 07/24/95 MICROPAS4 v4.02 File-WATKINSO Wth-CTZllS92 Program -FORM 3R User#-MP1320 User-CALCTECH Run -Proposed Residence Reference Name . DW.13.2X4.16 Description .... DF Wall R-13 2x4 16oc Type ........... Wall R -Value 13 sf-F/Btuh ' Framing Material ..... FIR.2X4 Spacing ...... 16 inches on center Fraction 0.15 4 Sketch of Construction Assembly LIST OF CONSTRUCTION COMPONENTS Material Cavity Frame Name Description R -Value R -Value 0. FILM.EX Exterior air film: winter value 0.17 0.17 1'. PLY.0.63 0.625 in plywood 0:77 0.77 2. BLDG.PAPER Building paper (felt) 0.06 0.06 3c. BATT.R13 R-13 batt insul (cavity = 3.5 in) 13.00 -- 3f. FIR.2X4 2x4 in fir framing -- 3.46 4. GYP.0.50 0.50 in gypsum or plaster board 0.45 0.45 I. FILM.IN.WLL Inside air film: heat sideways 0.68 0.68 Total Unadjusted R -Values 15.13 5.59 FRAMING ADJUSTMENT CALCULATION Cavity Framing Total U -Value:, (1 / 15.13 x 0.85) + (1 / 5.59 x 0.15) = 0.083 Btuh/sf-F Total R -Value:. 1 / 0.083 = 12.05 sf-F/Btuh CONSTRUCTION ASSEMBLY Page 10 3R Project Title.......... Residence for Watkins Date........ 07/24/95 MICROPAS4 v4.02 File-WATKINSO Wth-CTZ11S92 Program -FORM 3R User#-MP1320 User-CALCTECH Run -Proposed Residence Reference Name . GW.13.2X4.16 Description .... Wall R-13 2x4 16oc Type .......... Wall R -Value 13 sf-F/Btuh Framing Material ..... FIR.2X4 Spacing ...... 16 inches on center Fraction ..... 0.15 Sketch of Construction Assembly LIST OF CONSTRUCTION COMPONENTS Material Cavity Frame Name Description R -Value R -Value 0. FILM. EX 1. GYP. 0.63 2. BLDG.PAPER 3c. BATT.R13 3f. FIR. 2X4 4. GYP.0.50 I. FILM.IN.WLL Exterior air film: winter value 0.17 0.625 in gypsum or plaster board 0.62 Building paper (felt) 0.06 R-13 batt insul (cavity = 3.5 in) 13.00 2x4 in fir framing -- 0.50 in gypsum or plaster board 0.45 Inside air film: heat sideways 0.68 Total- Unadjusted R -Values 14.98 FRAMING ADJUSTMENT CALCULATION Cavity Framing Total U -Value: (1 / 14.98 x 0.85) + (1 / 5.44 x 0.15) 0.084 Btuh/sf-F Total R -Value: 1 / 0.084 = 11.86 sf-F/Btuh r 0.17 0.62 0.06 3.46 0.45 0.68 5.44 CONSTRUCTION ASSEMBLY Page 11 3R Project Title.......... Residence for Watkins Date........ 07/24/95 MICROPAS4 v4.02 File-WATKINSO Wth-CTZ11S92 Program -FORM 3R User#-MP1320 User-CALCTECH Run -Proposed Residence Reference Name AW.13.2X4.16 Description .... Wall R-13 2x4 16oc Type .......... Wall R -Value 13 sf-F/Btuh Framing Material ..... FIR.2X4 Spacing ...... 16 inches on center Fraction ..... 0.15 Sketch of Construction Assembly LIST OF CONSTRUCTION COMPONENTS Material Name Description O. FILM.EX Exterior air film: winter value 1. BLDG.PAPER Building paper (felt) 2c. BATT.R13 R-13 batt insul (cavity = 3.5 in) 2f. FIR.2X4. 2x4 in fir framing 3. GYP.0.50 0.50 in gypsum or plaster board I. FILM.IN.WLL Inside air film: heat sideways Total Unadjusted R -Values FRAMING ADJUSTMENT CALCULATION Cavity U -Value: (1 / 14.36 x 0.85) + (1 / Total R -Value: Cavity Frame R -Value R -Value U.1/ 0.06 13.00 0.45 0.68 14.30 Framing Total 4.82 x 0.15) = 0.090 Btuh/sf-F 1 / 0.090 = 11.08 sf-F/Btuh 0.06 3.46 0.45 0.68 4 . i31. CONSTRUCTION ASSEMBLY Page 12 3R Project Title...:...... Residence for Watkins Date........ 07/24/95 MICROPAS4 v4.02 File-WATKINSO Wth-CTZllS92 Program -FORM 3R User#-MP1320 User-CALCTECH Run -Proposed Residence Reference Name . R.19.2X6.24 Description .... Roof R-19 2x6 24oc Type ....... Roof R -Value 19 sf-F/Btuh.) Framing Material ..... FIR.2X6 Spacing ...... 24 inches on center Fraction ..... 0.07 Sketch of Construction Assembly LIST OF CONSTRUCTION COMPONENTS Material Name Description O. FILM. EX 1. SHNGL.ASPHLT 2. BLDG.PAPER 3. PLY.0.50 4. AIR.RF.3.50 5c. BATT.RII.0 5f. FIR.2X6 6. BATT.R8.0 7. GYP.0.50 I. FILM.IN.RF Exterior air film: winter value Asphault shingle roofing Building paper (felt) 0.50 in plywood 3.5 in & greater air space: heat flow up R-11 batt insul (cavity > 3.5 in) 2x6 in fir framing R-8 batt insul (cavity > 3.5 in) 0.50 in gypsum or plaster board Inside air film: heat flow straight up FRAMING ADJUSTMENT CALCULATION Cavity Total Unadjusted R -Values Framing Cavity R -Value 0.17 0.44 0.06 0.62 0,.80 11.00 8.00 0.45 0.61 22.15 Total U -Value: (1 / 22.15,x 0.93) + (1 / 16.59 x10.07) = 0.046 Btuh/sf-F Total R -Value: 1 / 0.046 = 21.64 §f-F/Btuh Frame R -Value 0.17 0.44 0.06 0.'62 0.80 5.45 8.00 0.45 0.61 16.59 N CONSTRUCTION ASSEMBLY Page 13 3R Project Title.......... Residence for Watkins Date........ 07/24/95 MICROPAS4 v4.02 File-WATKINSO Wth-CTZllS92 Program -FORM 3R . User#-MP1320. User-CALCTECH Run -Proposed Residence Reference Name . R.25.2X12.24 Description .... Roof R-25 2x12 24oc Type ........... Roof R -Value ........ 25 sf-F/Btuh Framing Material ..... FIR.2X12 Spacing ...... 24 inches on center Fraction ..... 0.07 Sketch of Construction Assembly LIST OF CONSTRUCTION COMPONENTS Frame R -Value 0.17 0.44 0.06 0.62 0.80 11.14 0.45 0.61 14.29 Material Cavity Name Description R -Value 0. FILM.EX Exterior air film: winter value 0.17 1. SHNGL.ASPHLT Asphault shingle roofing 0.44 2. BLDG.PAPER Building paper (felt) 0.06 3. PLY.0.50 0.50 in plywood 0.62 4. AIR.RF.3.50 3.5 in & greater air space: heat flow up 0.80 5c. BATT.R25.0 R-25 batt insul (cavity > 7.5 in) 25.00 5f. FIR.2X12 2x12 in fir framing -- 6. GYP.0.50 0.50 in gypsum or plaster board 0.45 I. FILM.IN.RF Inside air film: heat flow straight up 0.61 Total Unadjusted R -Values 28.15 FRAMING ADJUSTMENT CALCULATION Cavity Framing Total U -Value: (1 / 28.15 x 0.93) + (1 / 14.29 x 0.07) = 0.038 Btuh/sf-F Total R -Value: 1 / 0.038 = 26.36 sf-F/Btuh Frame R -Value 0.17 0.44 0.06 0.62 0.80 11.14 0.45 0.61 14.29 HVAC SIZING Page 14 HVAC Project Title.......... Residerice.for Watkins Date........ 07/24/95 Project Address........ 2672 V-6 Rd. Oroville Documentation Author... Neal Kuopus Building Permit Company ................ CALCTECH Telephone .............. (916) 534-5066 Plan Check Date Compliance Method...... MICROPAS4 by Enercomp, Inc. Climate Zone.......... 11 Field Check/ Date MICROPAS4 v4.02 File-WATKINSO Wth-CTZ11S92 Program -HVAC SIZING User#-MP1320 User-CALCTECH Run -Proposed Residence GENERAL INFORMATION Floor Area ................. 816 sf Volume .. ..... ............ 7452 cf Front Orientation.......... Front Facing Sizing Location............ OROVILLE RS Latitude... ... ........ 39.5 degrees Winter Outside Design...... 30 F Winter Inside Design....... 70 F Summer Outside Design...... 104 F Summer Inside Design....... 78 F Summer Range . ...... ...... 37 F Interior Shading Used...... No Exterior Shading Used...... No Overhang Shading Used...... No Latent Load Fraction....... 0.20 Description HEATING AND COOLING LOAD SUMMARY 0 deg (N) Heating Cooling (Btuh) (Btuh) Opaque.Conduction and Solar...... 11403 4551 Glazing Conduction ............... 4780 3107 Glazing Solar .................... n/a 3959 Infiltration ..................... 4239 1740 Internal Gain .................... n/a 1875 Ducts ............................ 0 1523 Sensible Load .................... LatentLoad.......... ............. 20422 n/a 16756 3351 Minimum Total Load 20422 20108 Note: The loads shown are only one of the criteria affecting the selection of HVAC equipment. Other relevant design factors such as air flow requirements, outdoor design temperatures, coil sizing, availability of equipment, oversizing safety margin, etc., must also be considered. It is the HVAC designer's responsibility to consider all factors when selecting the HVAC equipment. Fri- . �E - OWNER: er,8,0AS T". -A DATE LOCATION:. V �, A. P. # CONTRACTOR: ZONING ----------------- PRE-INSPECTION FOR: DATE TO INSPECTOR PERMIT HISTORY: NONE AS FOLLOWS: i- 0 / n 4 1 1 TYPE OF OCCUPANCY FIELD - INFORMATION BUILDING USAGE: TENNANT: [� OCCUPIED r__] HAS ELECTRIC Q HAS GAS HAS SANITATION FACILITIES [� HEATED -COOLED L PERSON CONTACTED, OTHER COMMENTS: lv 6 Q��i-u-h-��►-i i �-�--- -boar jvo-r a ©fie ACTION RECOMMENDED: ISSUE HOLD FOR OTHER: BY DATE PAGE G OF CDF / BCFD DAILY INCIDENT LOG DAY/DATE FROM 0800 QVN / - 1 DAY/DATE TO 0800 DAMAGE: SO WT DOZ CREW AA AT HC SAVED: OTHER EOUIP: MEDICS v CAUSE: / ENGINES: CDF BCFD CO# OFFICER: DAMAGE: SO WT. DOZ CREW AA AT HC SAVED: OTHER EQUIP: MEDICS 0 UYYIVtK/ I MAN 1 WKA R.P. B.I. MISC.: CAUSE: ENGINES: CDF BCFD CO# FFICER: . DAMAGE:i... DOC) 'It S WT OZ CREW AA AT HC SAVED: OTHER E UIP: MEDICS /LAND USE: ACRE/TYPE TOTAL OWNER/TENANT WRA -��® R.P. - S _ B.I. MISC.: t� SAVED: OTHER EQUIP: MEDICS V MIDI;.: I.AUJt: tNbiNtJ: I.UF bLl-u WIF Uf 1-1k tK: DAMAGE: SO WT DOZ CREW AA AT HC SAVED: OTHER EQUIP: MEDICS v MIDI..: 1 : rr..r-or •.^r-ws�ntr .rnyrs •. .f�'yC� _ `k'.:^)r't „7' a"c: ,7 ,*9�,: r .`l :F ya`=ci'ia�2i w. y. 1: _v- ` fn-,=-r. .ew•--- •� Y+.Y �(C Y •'fir FR -007_ PERMIT#95-0091i t • SON, JAMES6 RD., OROVILLEMIKE HURST ELE .POLE FOR FIRE DAMAGE/SF r • ' q l . • , , - � .fly 1 . . a r -�Q BOUNTY OF BUTTE "DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION „.. 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 036-104-W7 369 A/.W7 ZONING sRi i[ BUILDING PERMIT OWNER JA RIMARDSON t�x7 AMES TELEPHONE 133-0 3671 SQ, FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 2672 V6 RD OROVILIE, 95966 CONTRACTOR'S NAME*q���tr� MIKE IMS TELEPHONE , CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER r�. UNKNOWN Total Valuation Is LENDER'S MAILING ADDRESS Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE No. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 2672 V6 RD PERMIT FEE $ DROVILLE, 95966 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SFO Duplex O Mobilehome O Other SPECIFY Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @ 20.00 TYPE OF WORK New ❑ Addition O Remodel ❑ Utilities C3 Installation O Other ❑ DescribeWork: POWER POLE, FOR FIRE DAMAGE 1$j— PERMIT FEE Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( BOOV OR LESS ) 200A OR LESS 23.00 L j+ Main Service ( 200A TO 1000A ) 46.00 NEW CONST. DWELLING OCCUP. OR ADONS. ( & ACC. BLDS. ) S 3.50 FT.O, CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) ❑ I am a licensed underP Provisions of Chapter 9, Division 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 compensation, will do the work, and the structure is not intended or offered for sale. (Sec 7044) ID 1, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) ❑ I am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET NON -REBID. ( BRANCH CIRCUITS ) @7.50 ( POWER APPARATUS ) & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES ) 20 @ 1.00 BAL. @ .50 Ex. Occu FIXED APPWS. OR p' ( OUTLETS (RESID.) EA. ) 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00lZe 'y• WORKER'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. El 1 shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ 6• Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certify that I have read this application and state that the above information is correct. 1 agree to comply to all Butte County Ordinances and California State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above mentioned, property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which"may in any way accrue against said County in consequence of ;thee''g;anting%of this permit. / ) X ii //YYj�,� l./%irCt'�1 Date/-'� -f Signature of Applicant - ❑ Owner ❑ Contractor ' ❑ Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ OCC. CONST. TYPE TOTAL FEES 66.00 HAz• 1 o. FEES IMP I FLOOD A® COF PARCEL Po HD ISSU r 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. s.••�--1 - �✓ By ' ' ���'�' .r Date / W PERMIT EXPIRES ON f Z? - IDa rel Receipt No. 170978 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK-INSPECTOR'N GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95265 - Telephone (916) 538-7541/.,Ie-PERMIT NO APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 036-104-007 ZONING SR1 BUILDING PERMIT OWNER JAMES A RICHARDSON TELEPHONE) 533-0 3671 SQ. FT. OCC. BUILDING VALUAT ON OWNER'S MAILING ADDRESS 2672 V6 RD OROVILLE, 9596� CONTRACTOR'S NAME MIKE HURST TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 20,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 9679 V6 RD PERMIT FEE $ niRnyTT.T.F., 95966 PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 LOT NO. SUBDIVISION'S NAME PARCEL MAP Each gas water heater or vent 15.00 USE OF STRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Gas piping system 1 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describework: POWER POLE FOR FIRE DAMAGE PERMIT FEE $ Contractor ELECTRICAL PERMIT Filing Fee 20.00 Main Service ( OOOV OR LESS ) 200A OR LESS 23.002J UU Main Service ( 200A TO 1000A I 46.00 NEW CONST. DWELLING OCCUP. OR ADONS. ( & ACC. OLDS. I SO, 3.50 FT. CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one) ❑ 1 am a licensed under provisions of Chapter 9, Division 3 of the Business and P P 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 compensation, will To the work, and the structure is not intended or offered for sale. (Sec 7044) O I, as the owner, am exclusively contracting with licensed contractors. (Sec 7044) ❑ 1 am exempt under Sec. Business and Professions Code forthis reason NEW CONST. MULTI -OUTLET NON-RESID. ( BRANCH CIRCUITS I @7.50 ( POWER APPARATUS I & SINGLE OUTLET CIR. Ex. Occup. ( OUTLET OR FIXTURES I a 1.00 SAL. .so Ex. Occu FIXED APPWS. OR P• ( OUTLETS (RESID.) EA. I 5.00 Temporary Service 23.00 Mobile Home Facilities20.00 Misc. Wiring 23.00 WORKER'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ This permit is for $100.00 (valuation) or less. ❑ 1 have placed on file with the County of Butte Dept. of Development Services, Building Division a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -insure. El I shall not employ any person in any manner so as to become subject to the Worker's Compensation laws of California. Notice to Applicant: If after making this statement, should you become subject to the Worker's Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit will be revoked. PERMIT FEE $ 66.00 Contractor MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all Butte County Ordinances and California State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said Count in cons r� permit. eqLothisce ofPC14 X (.� Date / Zo Si' ature of Applicant - Q Owner ❑ Contractor O Agent An OSHA permit is required for excavations over 5"0" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ ocC CONST. TYPE TOTAL FEE $` 66.00 HAZ. D. FEES IMP FLOOD AO CDF PARCEL PO HD ISSU This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By ^ �l� PERMIT EXPIRES ON 112 the applicable provisions Resolutions to do work been paid. Date �/ r Ll� 39� (Oetel Receipt No. 170978 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT -.�sr,...v.h"�.w�r�:•..::t[!'''.--•ra-,(�rw=.. +a++. - - .-:•^,�:,...J.i+.in �^w+.�s�^-r r'-.n.�.--TMt'_.,,-..++-�z.-.,.p-.`.-..:--•""-:+"t'-'-......y...tir.-_-.�-.`.-y.-.�:�,r.�•.�, COUNTY•OF BUTTE -DEPARTMENT OF DEVELQPMENT SERVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA95965 -TELEPHONE (916) 538-7541 7RMITAIPPLICATION DATASHEET _ OWNER P' ' Proposed Building Use Building Inspector' Date At ti e , f p rmit 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). .... 9. Mobilehome data and manufacturer's installation instructions, 2 sets. ........... 10.. Fees of $:..... ...................................... . • :• �. 11. Impact fees as shown on attached schedule.` .....:..................... . 12. California Department of Forestry plan approval/fees. 13. Flood elevation letter (100 year flood) by California Engineer. .................' 14. Sanitation and plot plan approval Health Department . ............ 15. City of Chico plumbing permit . .......................................... 16. Plot plan and business license approval from City of Biggs/Gridley. . ........... . 17. Planning approval for (A) Use: (B) Parking: . ........ 18. Contact Land Development about Improvements -(B) Drainage. .......... . - riveway permit (co r c�n/appr v e i d prior to occupancy). . . IL 20. Pre -inspection for �.��^C/� �`� 11nspection reque''//ff _ required. . to Building Inspecto - (Date) 21. Contractor's license information. o., Name Style, Classification) . ............. 22. Certificate of Workmans Compe sation Insurance . .......................... 23. Owner -Builder Verification (Given to owner , Mail to owner . .......... . 24. Recorded copy of Agricultural Acknowledgement Statement.k ................ 25. Letter of signature authorization ........................ I................. 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 t and (B) Parcel meets zoning area and frontage requirements. ...........a... . 31. Existing violations/expired permits . ...................................... 32. Plan check list . ..................................................... 33. 34. ' When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver with inspector. Other ` Parcel Creation Acreage �M' y Applicant Date Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted 1. Index permit for above items No. _ 2. Additional items required: r permit issuance: (Circle new item not checked above). Contractor, designer, owner, was advised of above required data by Contractor, designer, owner, was advised of above required data by phone _ mail phone _ mail Plans checked by Date Plans.approved by Counter by _Date Counter by _ Date Sets of plans on hold in File cabinet AP folder Copy - Department of Public Works Date A A c COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER ZONING j — 7-D BUILDING PERMIT owN ) J TELEPHONE SQ. FT. OCC.1 BUILDING VALUATION OWNER'S MAILING ADDRESS' 7 V ,fid r CONTRACTOR'S NAME TELEPHONE hPr CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER ©SS LICENSE NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS ` <-\ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 Water piping LOT NO.SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5,00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF ©Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Ut,Imes ElInstal lation ❑ Other ` Describe work: It>' C C. Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 1,100V OR LESS 100 AMP OR LESS 00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. (DWELLING OCCUP.y\ OR ADONS. l ACG. BLDGS. / 22 sq ft CONTRACTORS LICENSE LAW I declare under penalty of perjury (check One): ❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification © 1, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR I_ u LET 2.50 ea NON-RESID, BRANCH CIRC ITS NEW CONSTR. I POWER APPARATUS 6\ NON-RESID. %SINGLE OUTLET CIR. 1 Ex. Occup OUTLETS OR FIXTURES a �� IXED AP LNS. OR Ex. OCCu X17UTLETS (RESID,) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring .50 – !�_ •�a Permit Fee $ 6,0D Contractor MECHANICAL PERMIT Filing Fee 10.00 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 shal I be deemed revoked. Heating Cooling Hood 3.00 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence`of the granting of this permit. X ✓ ':r• r .'l —,P. Date ' - ' - '_. Ignature of Applicant — Owner u Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct-lREC ion of structures over 3 stories in height. Mobile Home Installation Fee $ TOTAL PERMIT FEE $ occuP. CROVP I TYPE OF CONST. PARCEL PD ND ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which O F PUBLIC // By PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS �'' 0 Sf I / C 1 Receipt No.► WHITE-D.P.W.• YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT County of Butte DEPARTMENT OF PUBLIC WORKS ve., Chico - 348 4244, Exi. ?ID -- 7 County Center Dr., Orqville -,534-454f Skyway and Elliott Rd., Paradise - 8;; 3439 8 7.? - ? ow CORRECTION NOTICE .. ...................... 14 ........... Building or Property Address 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. 4 ..... ........ . ....... ez��7.e ................. ........................................................................................... 410' e4p,, ......... . .............. .......... t / .... .. .. ........ I . ....... 000 .... . . = ...... . ..... C� ........ ................. .......... Do Not Remove This Tog (400-4) �• f COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4 APPyLICATIU AND PERMIT ASSESSO PARCEL NU BER � . ZONING BUILDING PERMIT AVP OWN7eJ TELEPHONE rJ_-71 SQ. FT. OCC. BUILDING VALUATION OWNER'S MA LING V74, CONTRACTOR'S NAME >1 �r 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 " LI CENSE'NO. Plan Checking Fee $ Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Repair drainage or vent piping 5.00 1-0 Water piping LOT NO.SUBDI VISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Building sewer Lawn sprinkler system 5.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ U 'lities ❑ Installation ❑ Other Describe work: exc- C— Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service e10V OR LESS 00 100 AMP OR LESS r Main service EA. ADD'L 100 AMP 2:51] NEW CONST'( DWELLING OCCUP.el 2¢ sq ft OR ADDNS. \ ACC. BLDGS. 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 m license is in full force and effect. y 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) El 1, as the owner, am exclusively contracting with licensed contract - ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONSTR -OUTLET 2,50 ea NON-RESID BRANCH CIRC TS NEW CONSTR /POWER APPARATUS e1 NON-RESID, %SINGLE OUTLET CIR. 50 @ 25e Ex. OCCUp OUTLETS OR FIXTURES BAL@1 00 FIXED APP LNS, OR EX. Occup.(OUTLETS (RESID.) EA. 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring.50 OD ,b Permit Fee $ Contractor MECHANICAL PERMIT FiIirig Fee 10.00 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 f Consent to Self -Insure. U ' 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. Heating Cooling Hood 3.00-. Ventilation Permit Fee S Contractor 1 certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against ai C my in c se ence f the ting of this permit. X /�`7 Date D--�- ignature of Applicant — Owner Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over stories in height. 3 Mobile Home Installation Fee $ TOTAL PERMIT FEE $ OCCUP. GROUP I TYPE OF CONST. PARCEL PD HD IssuE This permit is hereby 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. IR F PUBLIC WORKS By Dat PERMIT EXPIRES Date `-- to Receipt No. � / / ! -7 I WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT