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RESIDENTIAL ,
�`U3(i=46=-0-040���� � 92-2957 BPEM
AZEVEDO, Larry
2710 Oak Knoll Way, Oroville
new sf
- - — ----- ----
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OFFICE COPY
FAd.
dress
GAS
7
L- DateRIC Date !
Hadress
GAS
I
Meter ByDates
ELECTRIC
Meter By Date
JOB FINALED (Date w _
Signature
J=OK
O=Not OK
Npt
- Not Readyable MOBILE HOMES
Date MOBILE HOME UTILITIES (Plans) OK except ff's
1. Zoning Requirements-Setbacks-Easements
2. Soils; Special MH Support Sketch
3. Sewer; Location-Test-Fall-C/O Concrete
4. Water; Location-Test-Easement Needed (Sketch)
5. Electricity; Location-Clearences-Grnd-/ /Amp-Concrete
6. Gas; Location-Test-Wrap: / /" L"ft
/ /"Nat. or/ /" L"ft./ /"LPG
7. Well Clearance & Disconnect
8. Utility Clearance ;
Date _ Card B-1 Date Card B-1
Date Card B-1 Date Card B-1 e
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 R' ".. \ N
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 i
10. Cert. of Occupancy
-4
Date -Card B-1 Date Card,13-1
f
Date Card B-1 Date Card B-1,
t
L
r S
t
MISCELLANEOUS
Date .DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK except If'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-Beams-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 8=1
Date POOLS (Plans) OK except #'s
1. Setbacks -Easements 1
2. Soils; Compaction -Structure Stability f
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 Lgfitg.
_ 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
J=OK
O=Not OK
= Not Applicable
Not Ready RESIDENTIAL (E
=
Date UNDEBPL1OOR (Plans) OK except N's
o fig -Setbacks -Easements -Flood -Slope
F ., Main; Soils-Elec. Grnd.-j1t-' Ftg. Depth
Garage; Soils-Steel-Elec. Grnd.-/ " Ftg. Depth
Ftg., Porches & Decks; Soils-Steel-/,42�tg. Depth
5. Stemwalls, Main; Steel -Bloc kouts-Wrapped
6. Stemwalls, Garage; Steel-Blockouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab; Steel -Wrapped
6. Pie -Fireplace Ftg.-Steel
.W.V.; fall -Fitting -Test -2 Way C/O -Sewer Test
10. OF as Pipe; Size -Anchors - yard gas piping: size -test
1 ater Pipe; Test -Anchor -Regulator -Service Test
12. EI cfhc; Underground
. Pi nums & Ducts; Clearance -Material -Support -Ins.
1 ers-Sills-Anchor Bolts -Joists -Vents -Cripples
Access & Ventilation
16. Insulation
DatetkZ, rd B-1 Date Card B-1
Date and B-1 Date Card B-1
Date PLUMBING (Permit).OK except a's
Water Htr.: Vent-Access-Combustio6 Air -Baffle
-------- ------ -- -----------------------
1n7!Water Pipe; Test & Anchor -Nail Protection
----------
1------- ----------------------
e3. . ".V.: Test -Fittings & Anchor -Nail Protection
---- ------
---- ----
19�SFiower-- Pan; Test. First Floor -Tub Access
--- --------------------
.2Q-Test Tub & Shower, Second Floor -Tub Access
A, Gas Pipe; Size & Anchors
- - -- -- - -- - - -
Date i Card B� -- Date - Card B-1
Date Card B-1 Date Card B-1
Date ELECTRICAL (Permit) OK except ft's
— 22. Fixture & Transformer Clearance—Ins.—Protection
-- 23.--Erec. Receptacles Spacing Lights & Switches at Doors - ---
24Size Boxes & No of Conductors Stapled
--- - -- ----- ---------- -----------------a--- --- - ---- - ---- ---
2-s.Romex Installed Close to Edge of Studs & C.J.
---ZT�ip. Ground made up w!Mech. Fastners-Bond Gas & Water ---
2 Appliance Circuts in Kitchen & Conductor Size!GFI
-. -- -ir ------_
2Size i ga Cu or AI-A.C. Wire Size i ! ga
Cu or Al
24. Ram@@ q rc ! / ga Cu or AI -Oven Circ. / / ga. Cu or Al.
Insulated Neutral ❑ Yes ❑ No
----------------------------------------------------- - ----- -
38!Srvice-Riser Conductors & Ground -Main Disconnect
------------
--------------------------------------
qui .Clearances Panels-Motors-Mech. Equip.
Clothes Closet Light -Shower Light -Spa Light
moke Detector
------------ _Detect-----------------------------------
----- - - - - - ----- ------------------
----------------- --- - -
- - --------------
-------------------------
------------
and B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date MECHANICAL (Permit) OK except 4's
A.C. Ducts Insulation & Support
--------------------------------------------------------------------------------------
- 3& --Vent Fan: Exhaust above insulation
Vl�'Condensate Drain & Overflow: Size & Grade -
-- d;r
-Fur nce-Vent: Access -Comb Air -Return Air Vent -115 outlet
-- ---- ----------------------------------------------------------
d. Attic Access &Platform it Furnance in Attic
Dated r �� 1Card B-1 Date Card B-1
------------------------------------------------------------------------------
Date Card B-1 Date Card B-1
Date FRAMING (Plans) OK except #'s
'�Sils. Proper Material & Anchors
-------------- ---------------------------------------------
A9.-Walls Studs -Nailing. Spacing & Bracing -Plates -Sound
--------------------------------------------------
Bear ng Walls over Girders & Floor Nailing
-------------------------------- -----------------------
fi@.Draft Stop in Walls (rat proof)
- - - ---------------------------------------------------------------------
-43 �Fire Stops: Furred Ceilings -Stairs -Chases -Tub
-4. Headers & Beam -Size & Bearing
►ingle & Duplex)
Date • FRAMING (Continued)
Han ers-Post Caps -Anchors -Connectors
Ing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-Rfng.
4d-Ptrepfaee�ies or,Type A Flue -Fireplace Throat clearance
tic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
drm. Windows or Exiting Doors -Sill Hgt. & Dimensions
-- ---ara a Fire Protection Framing
Property Line firewall & Openings
xt. Doors -One 3' -Check Garage -3rd Story, 2 Exits
4;;;irs: Width -Headroom -Rise -Run -Landing -Fire Protection
wood on Roof Overhang -Attic Vents -Rafter Outriggers
m-lidinij-Naiiing Veneer
-5&9�sh-Drip Screed -Fd. Vents-Underflr. Access
------------------ --
az.ing Area -Glass Protection -Skylights -Plastic
hear Walls: Nailing -Bolts
59. Insulation -Walls -Ceilings
60. Infiltration -Walls -Windows
----
-- f--- -- -- —
Dat�' • Card B Date Card B-1
Date Card Date Card B-1
Date FINA IanS) OK except N's
1 Ex eps-Door & Sidelight Protection -Landings
Smoke Detector
-------------------- -
urnace; Vents -Clearance -Comb. Air -Connector -
In G ge: Above Floor -Ducts -Meth. Protection
------------------------------
eid xiting
5 . &Bath Fixtures & Tub Access -Spa
---- ---- - lec. Trim -& Subpanel: Breaker Size e'
fairs & Rails
---------- ----------- ---------- —
o e: Clearances -Hearth
let. Outlets at Wood Panel; Int & Ext.
LzD_+trt.Fixt &-Applian , _Air Gap -Cooking Clearance
c Outlets ecep a t Krt. Counter
Garage Fire Door: Swing -Landing -Closer
- - ---
Damper
Wtr. Htr Vents -Clearance -Comb. Air-Connector-P.R.V. .
In G rage: Above Floor-Mech. Protection
Ib.. Ee &Mech. Equip. Listed for Location
7 c. Recept
-acles in Garage: (G.F.I.)-Rom rotection
- -- - -
------------- ---- ------ --
c ,. In - n- Foam -Looked in Attic ❑ Yes--------------
_
- - and Rails & Deck Construction -Post Caps
Fin. Vents & Crawl Hole Door -Drainage & Wood -Earth
--- -- - - - - -
--------------- Clearance Looked-under
Floor ❑ Yes
80. Following instld.: Drive ;ties ❑ No; Walks ❑ Yes o:
Planters ❑ _�'q0_
- -- -eco:-Brown-Finish
------------
-_
A.C. Unit Disconnect, Electrical, Plumbing
-------- ------------
- -------- —t-
ents Above Roof:.Plbg.-Appliance-Fireplace.-Clearance to
Openings
- ------ - -- -------- ----------------
_secuiect. Electrical, Plumbing
is terror Elec. Trim: G F.I. Receptacle -Underground
- —
Ventilation Throughout House
"is -- las
-s Protection
----------- ---- --------------------------
88.Co ctions fcom`Previous Inspections
._-------- - - ---------------------------------------
Gas Meters Tagged; Gas -Electric
ate,. & Sewer Connected -C/O to Grade -HD Approval
9),/Energy Compliance Certificate. Other Certificates
Date Card B-1 / Date Card B-1
Date '.0 2Card B-1 _Date Card B-1 —
Dat / Card B- Date Card D-1
Comments at Final
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
ASSESSOR PARCEL NUMBER
036-460-040
OWNER
LARRY AZEVEDO
ZONING
AR
TE�33H 4�3�6
BUILDING PERMIT
SQ. FT. OCC. BUILDING VAL ATIO
OWNER'S MAILING ADDRESS
1668 ORO DAM BLVD W. OROVILLE 95965
CONTRACTOR'S NAME TELEPHONE
OWNER
1350 R 72,900
855 M 15,390
65 COV 845
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LEN R
FEATHER RIM STATE BANK
UNKNOWN
Total Valuation $ 8 ,
LENDER'S MAILING ADDRESS
ARCHITECT OR ENGINEER LICENSE No.
NONE
Filing Fee $ 15.00
Permit Fee $ 52
5,50
)
Plan Checking Fee $ `276.25
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Energy Plan Checking Fee $ 20.00
Penalty $
BUILDING ADDRESS
2710 OAK KNOLL WAY OROVILLE
Permit fee $ 863.75
PLUMBING PERMIT Filing Fee 15.00
Each Trap 5.00 40.00
Solar or heat pump water heater 20.00
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Water piping 7.001 7,00
Each qas water heater or vent 7-001 7.00
USE OF STRUCTURE
SFba Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets 5.001 5.00
Building sewer 15.00 15.00
Mobile Home S I IS I W @ 15.00
TYPE OF WORK
New [RX Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work: 3BR _
Permit Fee $ 89.00
Contractor
ELECTRICAL PERMIT Filing Fee 15.00
Main service 200A OR LESS 18.50 18.50
CONTRACTORS LICENSE LAW
declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and my license Is in full force and effect.
LI nse 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
Main service 200A TO 1000A) 37.50
NEW CONST. DWELLING OCCUPM
3.64sq.ft.I
OR ADONS. ACC.BLOGS. 77.15
NEW CONSTR. U LOUT LET
NON-RESID BRANCH CIRC ITS @ 5.00
(POWER APPARATUS f)1
SINGLE OUTLET CIR. /
EX. OCCU 20 76
Occup(OUTLETS OR FIXTURES
FIXED APPLNS. OR
EX. Occup. OUTLETS IRESID.) EAJ 3.00
Temporary service 15.00
Mobile Home Facilities 15.00
Misc. Wiring -15.00
Permit Fee $ 110.
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ 1 have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
0 resent to Self -Insure.
shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT Filing Fee 15.00
Heating 9.00
DUAL PAK
Cooling 9,00
Hood 6.50 6,50
Ventilation 4.50
Permit Fee $ 44.00
Contractor
I certify that I have read this application and state that the above information
is correct. I agree to comply to all .County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to sa e, indemnify and keep harmless the County of Butte against
all liabilities, gments, costs, and expenses which may in any way accrue
against unty in consequence of the ting of this permit.
Date //�'��
Signature of Ap ,cant -er Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee S
Energy Inspection Fee $ 40,00
OCC
CONST TYPE
TOTAL FEE $ 1.147.40
HAz
DFEES
IMP
000
CDF
PARCEL
Po
HD
IssuE
This permit is hereby issued under the applicable provi-
sions of the B tte County Code and/or resolutions to do
work Ind' to for which fees have been paid.
R OF PUBLIC WORKS
By Date
E PIKES Date - -
Receipt No. , ��c
122589 3-%A M 11129$32 791 15
WNITC-D.P.W.• YELLOW-AS8F5SoR_ PINK -INSPECTOR. GOLDENROD -APPLICANT
i }«` :1FI �, F r� .' l ��� ► ,' '"'` � j` ' " ' '�R7 y +� ' " "tYi� y.�9r ° . ,�_ 'j + ,.j...
COUNTY OF BUTTE -DEPARTMENT OF PUBLIC WOI - BUILDING DIVISION
7 COUNTY CENTER DRIVE-,OROVILLE, CALIFORNIA 95965 - TELEPHONE (916) 538-7541
PERMIT APPLICATION DATA SHEET
OWNER TvIve, AocK A. P. Ro3:6 (60 -C o
Proposed Building Use -547 `90K. Building Inspector Date &OVY 2 -
At
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� 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 XWc 444 .......... '7 -
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. Mobileho manufacturer's installation instructions, 2 sets. ......... .
Fees of $-� %9.1 %..................................... � 1,`�-
�` 0.
Impact fees as shown on attached schedule .............................. //-Z- 92 2
12. California Department of Forestry plan approval/fees. ........................ .
Flood elevation letter (100 year flo d b Calif rnia Engineer ...................
1 Sanitation and plot plan approval Health Department. ........ . ..
15. City of Chico plumbing permit. ........................................ .
16. Plot plan and business license approval from City of Biggs/Gridley. .............
17. Planning approval for (A) Use: (B) Parking: . ........
18. Contact Land Development about (A) Improvements (B) Drainage. .......... .
qjV 19. Driveway permit (construction approval required prior to occupancy). .. ... ....�
20. Pre -inspection for required. ..
Ire-Inspectionilpector (Date)
21. Contractor's license information. (No., Name Style, Classification) . ..............
Certificate of Workmans Compensation Insurance . ..........................
23. Owner -Builder Verification (Given to owner Mail to owner ). . .
24. Recorded copy of Agricultural Acknowledgement Statement . ..................
25. Letter of signature authorization. ....................................... .
26. Copy of recorded deed of parcel creation and 60 right of way to a public road. .... .
27. Letter of intent on building use . .........................................
24 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/expired permits . ......................................
32. Plan check list . .....................................................
33.
34.
When issue the��ppermit, rocess as follows: Mail to owner. Mail to contractor.
Telep..-..- 3'I $(o and hold for pickup at office. Deliver with inspector.
Other /
Parcel Creation
Acreage Applicant
Date 6--/
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
1. Index permit for above items No.
2. Additional items required:
nce: (Circle new item not checked above).
Contractor, designer, owner, was advised of above required data by _ phone _.mail Counter by _ Date
Contractor, designer, owner, was advised;of above required data by _ phone _ mail Co nter by _ Date
Plans &ticked by Date Plans approved by _ Date
Sets of plans on hold in File cabinet AP folder
Copy - Department of Public Works
TO: Building Department
FROM: Encroachment Permit Section
RE: D-kiveway Clearance
-7 /0
AP #
owner location
Driveway permit �?2 0 has been issued for the above . p-�operty.
n b
date
sign>6re
f
COUNTY OF BUTTE
BUILDING DIVISION
"�D V-ARTMENT OF DEVELOPMENT SERVICES
1469 Humboldt Road, Chico, CA - (916) 891-2751
- (916) 538-7541
7 County Center Drive, Oroville, CA
747 Elliott Road, Paradise, CA - (916) 872-6307
CORRECTION NOTICE
WvNER 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 comp�ta�d.ou have any questions pertaining to this matter, or need additional explanation,
_0 ct
t 1� offi
/Please c C 1h ice immediately,
_7
dp—'� 20 ebo" Inc 14,;
-r- r
Inspector
Datez�2�&.2
REV 10/92
COUNTY OF BUTTE
BPILDING 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
7-5 7
dWJN E R PERMIT No.
A routine inspection indicates that the following violations of Butte County Ordinances exist at -411
the above address and should be corrected. Please notify this office when correction of work
is completed. If you have any questions pertaining to this matter, or need additional explanation,
please contact this office immediately.
d2-c:ce� 5 -4 --S 6 &1
Date Inspector
REV 10/92/
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENVOF 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
92
PERMIT NO.
-
A routim btspection indicates that the following violations of Butte County Ordinances exist at
the abave address and should be'corrected. Please notify this office when
correction of work
is C01ff4Ae--- ' �,'-u nave any questions pertaining to this matter, or need additional explanation,
1111— t this office immediately.
42e-
-61
4C.
A
,4r
4/4 2 IF - rl— 42:�� - /� -rTle - 'A-< c �=a r-
RBf 10W
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTM`ENT 00 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) 872-6367
44/' 1 --
CORRECTION NOTICE
9 9 5:5� 7
bwl�!Ek PERMIT NO.
A routine inspection indicates that the following violations of Butte County Ordinances exist at
the above address and should be corrected. Please notify this office when correction of work
is completed. If you have any questions pertaining to this fer, or need additional explanation,
,please contact this office immediately.
A"
Ali 14
94),
ILI
M MW j W - - - - 0 -
J
Date Inspector 0-/4dt—'
REV 10/92
CALIFORNIA-
Insulation
ALIFORNIAInsulation Certificate
1 2 /0 0ll I J,4f I V,
Number and Strcet Ctt
a-elo
County Subdivision Lot Number
Description of Installation
ROOF f
Material Brand Name \
Thickness (inches) Thermal Resistance (R -Value)
EXTERIOR WALL
Material Brand Name V ,
Thickness (inches) Thermal Resistance (R -Value) –
CEILING
v
Batt or Blanket Type Brand Name
Thickness (inches)fin t Thermal Resistance (R -Value)
Loose Fill Type Brand Name
Contractor's minimum installed weight/ft lb. Minimum thickness lG r inches
Manufacturer's installed weight per square foot to acheive Thermal Resistance (R -Value)
,—� RAISED FLOOR
Material Brand Name rY1r�/)
Thickness (inche Thermal Resistance (R -Value)
SLAB FLOOR
Material Brand Name
Thickness (inches) Thermal Resistance (R -Value)
Width (inches)
FOUNDATION WALL
Material
Thickness (inches)
Brand Name
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 Buildi Energy Efficiency Standards for new residential buildings contained in Title 24 of the
Cal ifomi&Admi irative Code,/" _-_7
C/ actor If&[) License Number
Sr'" --
i ands" a Date
F Sub-Contractor(InsulatiOnlnstaller) A, ber
/l
Signature and Title ate
�*• EwS +,cg c'ka!��}
�•�ti� 1' _aR '. '•.- 'i ,t ..? . t� FJµ. 1 1{
1tSC�F'•_�sY.'. �
'
'?COUN'1�V BUTT - 0 PARTMENT OFIPUBLIC WORKS „
�J
PERMIT P1o.
cFounty'ceenNu v
teOrlvle -Y0 vIIF�FI CalIfomla9S883Telephc 918'539
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OR PARCKL. NY M 0 IL ORLro',"q;4e. '1�^9 ?'j'CF i 'i' �4q
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aNtw cy �.,` ' }SO: FT :OCC. =`+ 'BUILDING VALUATION
'
,V AlSING qp�
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INTRA OF!,�3, NAM ¢''�' .- _- .rf L - MONt ys *.` ^: s 1Y 49�,7
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ONTRACTOR•S, MAILING AODR633y`tj'j•a+•iEp,K, �•7-4^1'�.h{ +•'y��y (-''f* 1 �t �r w... -
�i, =t^= i�.�t"�?���r.�-�53.. ' p:�ne��R�t�r � ° Fireplace's �•� i..- . .:r�, � .''rte �:..:' .I��-,.. `,,� :�� ."'+.
.�'l. �Ffi.:�'.' _� nHr�t3".�
ONfRUCTION.L n �r v.�v`.S "•v. ••.0 - •v.". YNKNOYrN :,r.k•r.�v,"°' rnn., ^$ '°t
e• r "�°,r � � Notal Valuation F -
". % rr y Fri a
•'t ;%
u '' ei zK rr
!iF�.iQLb:1i�4z'G&rtyij
� x s {
Y FIIIng�Fee h 7"" �"4'. t i
$^F, .i�yr- �%?i:1S OO
KNOER.'s MAtLIN6 AOORRSSS - t^• •"'+ rr-w-csrr w �M •+y ,f -y �••�y y' .w•� ��: .} +
�W�w lrY��G 3 +� „i..+. -R' 1..
N •1 -~ )�,.
P.ermit•Fee-
-F�S)F �`�"4A•;t�#�iYr?'w�.•�.y,..3„..i.. :..�-.�
-`• �_$
RCM17fiCT�OR-f RNGINfiER k�d F,y `+� � ,-^=lv t Ll C. N .;Plan-:Checking_Fee `�`.�- _.4 -�.•� - .6
! ,;
�'Erie�gy_PIan.Checking-Fees
'$ _`
CT -OR ENGINER S MAILING VAOOR833 � #�
RCMITEE
'1 !'r I" '111 i bi 4
$ ,.
. • .�
tee ri _ - , �. =.
. _
$.
z,,a;
� ;PLUMBING PERMIT -� -� �
Fili Fee -::15.00
n9
•
_
<"'� tL' t: ""
, .�
5.00 00
,EachaTrap
"`•, �;,
43,XVLt
uj .,
arorheat Pum
00f
20.
OT NO. -.++f SUBOAV ISION NAME. zar "w�iy' } + .Nip PARCEL MAP.Water.plping
Eys
.'-. : -°`.• . r t,`...µ
''7.00 -T •'^•. 0�
gas water: heater or Vent
7.00
1 �- w'£ �. :� `t Each
fi. . .n.:a�Za' -.x.. .t'�n .?"-.. +�-tiv.�iC�i.�•. 'e4:CK ..
OFt'`{` .<s `. *x .irF *G
,. 'STRUCTURE
as piping system 1' - 5. outlets
' 5:00 .
V0
15.00
3x qtr.-� :Building
iF� Duplex `MobilehomWEJ-,. ther
.. ._Y�:^�'"t1iEs.,y.�,:;�`"S+ .t,.:rD,u.°a'h:a7; SPECIFY
sewer- ♦
..
Mobile Home S G W
@ 15.00 ,
Ar V=�TYPE-OF WORK
Penttit-Fee. --_ __ _ —_ __
_ $ o p
` `�
Vew AddiUoh � ..Rem Utilities ❑ Installaiion[J Other ❑ =
Contractor-
describe work: ,mss s f!?725i9��
__ E.l:ECTRICAL PERMIT
J`
Filing Fee ., ;15.00
,,��. _:• _ �-
BOOV OR LESS '
Main ServlCe' 200A OR LESS-
18.50
SS �'
Main service- 20GA.TOI000As..r -1
-1 37.50.. -
CONTRACTORS' LICENSE LAW'': NEW CONST. OWELLING OCCUPM I3.60sq.ft.1
-- .- _ OR AODNS. ACC. BLDGS.
declare under penalty o_f perjury` (check one):.
I am Iicensed'under �provisioris of-Chapt'. 9; 0IV. 3--of-the Business -
and Professions -Code and'my''license is:Tin-full- force -and - effect:-
�.' r -
_ - License No. Classification
Classification
❑: I. as the owner; or my employees with wages as their sole compen-
satlon, will" do-tbe-work,-and the structure -is not intended or offered
for. sale. (Sec: 7044)x,;,.;;, ;;. -
❑=-1, as the owner, -am>exclusively contracting_ with,licensed contract-:-
- ors. (Sec. 7044) - .
❑ �;: am exempt under Sec Business and Professions Code•
forr this• reason'
WORKMEN'S. COMPENSATION INSURANCE
declare under penalty of -perjury.. (check one):. -
Th e
ne):•_The permit .i s. 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 riot employ, any person in any manner so as to become subject
to the W. C. Iaws of- CalIfomia.
Notice to Applicant: If after making this statement, should you became subject
to the W. C. provisions of the Labor Code, you must forthwith comply -with such
provisions or this permit shall be deemed revoked.
I certify that I have read this application and state that the above- information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the Countyot
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree• to save, indemnify. and keep harmless the. County of Butte against -
all liabilities, jueoments„costs, and expenses -which may in:any way, accrue-
ag said Coun_;r in consequence of the granting of this. permit.
X Date
Signature of Applicant- Owner❑ Contractor G Agent ❑
An OSHA permit is required for excavations over 5'0” deep and demolition at construct.
len of structures over l stones -.n height.
Receipt NoJ18G
L1x-o --. rtl.l.oW.Aaataaoa'. PINx-INePxxroN. c0LoeNw0o-A0euCArr
SINGLE OUTLETTCIR..
EX. OCCUp(OUTLETS OR FIXTURES
111E1 APPLNS. OR
Ex. Occup. OUTLETS IRESIO.1 EA.
Temporary service
Mobile Home Facilities
Misc.:Wiring- - -
Permit Fee
Contractor
MECHANICAL PERMIT
Heating
Cooling
Hood
Venti Iat.ion
Permit Fee
Contractor
Mobile Home Installation Fee
Energy Inspection Fee 7,40`
Occ CONST Tri TOTAL FEE
^ i
I I' F, I 111V 11-11I I-
This permit is hereby issued. under the applicable provi-
sions of the Butte County Code and/or `resolutions to do
work indicted above for which fees have been paid.
DIRECTOR, OF PUBLIC WORKS
By Date
PERMIT EXPIRE& Date
Return to DPW AGRICULTURAL STATE TM OF ACKNOWLEDGEIM
FOR RESIDENTIAL DEVELOPMENT
Section. 26-8.1 of the Butte County Code
requires this acknowledgement be recorded
prior to issuance of a building permit. 92-0381651'
The property described herein is adjacent I
to land or included within an area zoned Recorded I
for agricultural purposes, and residents Official Records I
of this property may be subject to incon- County of I
veniences or discomfort arising from the Butte I
use of agricultural chemicals, including, Candace J. Grubbs 1
but not limited to herbicides, pesticides, Recorder I
and fertilizers; and from the pursuit 12:09pm 25 -Aug -92 I
U f agricultural operations including,
but not limited to cultivation, plowing,
spraying, pruning, and harvesting which
occasionally generate dust, smoke, noise, and odor.
tural zones which have as a priority use for productive
within said zones and on adjacent property should be
or discomfort from normal, necessary farm operations.
92-36165
Rec Fee
Cash
PUBL XX
5.00
5.00
Butte County has established agricul-
agricultural purposes, and residents
prepared to accept such inconvenience
All Ehat real property situate in the County of Butte, State of California, described as
follows:
Cep tt �3cv —4t�o -e4o
Z__7�0
Date: i2Lk
State
County
PROPERTY
of ) On this the eq( day of r9�� before me,
SS.
of
the
Personally known to me. roved to me on the basis
OFFICIALSr-ALof satisfactory evidence.
PAULITA A. HOPPER o be the person(s) whose name(s)
-a NOTARY PUBLIC -CALIFORNIA s scribed to the within instrument and acknowledged that
LAKE COUNTY egcuted the same for the purposes therein contained. IN ITNES
y�„re
MY COMM SStON EXPIRES FEB. 8, 1993
" REOF, I hereunto set my hand and o ficial seal.
Present A.P. No. ,iU44,4eva,22�L - votary Public
END OF DOCUMENT
1
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916)5387541
01WNER L Apie % A 2-97I/61
A. P. N0. 36 -1f 60 - 0�-ta
PROPOSED BUILDING USE eJ DATE
School Distric Fees 0 -go
(paid at District Office) _
2. Sheriff Fees
(paid at Building Department)
o� o�
Residential ......... X 360 =$ �•
unit amt.
Commercial(per sq.f t.) % =$
sq.ft. amt.
3. 'Urban Area Fees
(paid at Building Department
Residential (per unit) % _$
# units amt.
Commerical(per sq.ft.) x =$
sq.ft. amt.
4. Recreation District Fees
(paid at District Office)
5. Drainage District Fees
(Contact Land Development)
6. Other
REC. # DATE REC
/ Z Cy -S -3z //-Z- 9'L --
7.
Z
7. Other
At time of permit application, I was advised the above fees are required to be paid pr--;o----
1---o
rio-10 issuance of the permit.
APPLICANT DATE
COUNTY OF BUTTE - Department of'Public Works j
7 County Center Drive;'Oroville, CA 95965 Phone: 916-538-7541
OWNER -BUILDER VERIFICATION
Attention Property Owner.:..
An---"owner-builder" building permit has been applied for in your name and bearing
your signature.
...Please complete. and.return this information at your. earliest --opportunity to avoid
unnecessary delay in processing and issuing your building permit-.- No building permit
will be issued until -this verification is received.
1. T personally plan to provide the majo labor and materials for construction.of-
the proposed property improvement es or no)
2. I (have/have not) signed an application for a building permit
for the proposed work.
3. I have contracted'with.the.following person (firm) to provide the, proposed
construction:
Name
Address City
Phone Contractors License No.
4.` I plan to provide portions of this work, but I have hired the following person
to coordinate, supervise, and provide the major work:
Name
Address ".City
_ . Phone -- _ Cont'ractors' License= No.
5. I will provide some of the work but I have contracted (hired) the following
persons -to provide the work indicated _ -
Name -Address Phone- Type of Work
Signed:
Property Owner
Social Se rit Nua
Date
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 and
19832 of the California Health and Safety Code.
This verification must be completed and returned to our office before we are per-
mitted to issue the permit.
(�/rj.
to lr
y
��
BUTTE COUNTY SCHOOLS IMPACT FE E•CERTIFICATION FORM 3 3�
(One Form Per Building)
OfV
School District NICO �LC��/��0� Y
Building Department No
A.P. Number � urisdiction' ''t'((.Veity
3b -�6o - 6�ro . ggrisd � .
N°
r�ounty
Property Owner Z.0 V GL/
Property Location/Address a; K , K/V („ L (A)A
q
CT)ZQ .
Subdivison �_
Lot No.
Residential Development
Sq. Footage
` No. df Living MHI
Addition
(Group R)
Units
;;•
• F
Commercial/Industrial 0
0
Sq. footage
New
Addition
(Including Exterior
Roofed Areas)
r
- 2.0
Building Departmen resentativ.
Date ).
(Floor Plans reviewed by School District Personnel)
it G
r
District Identification No.
n>
School District certifies that
(Ap icant)
(Street Address) '
(Phone Number)
(City)` ` .-or ' (State) (Zip Code) _ s
has complied;with the requirements of Resolution No. a2 —/ by payment of $ X3310
representing -�7 �� square feet.
j
72V.
School District Representative Date
Paid by Check Number// %_.
Bank Number 2 1 ? 74
Paid by Cash
Remarks:
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-bCalifornia Environmental Quality Act (CEQA), this project may be subject to
additional school fees to i66 -mitigate its impact on the school district's schools.
White (applicant), Yellow (building department), Pink (school district) feeformmkl (4/92)
rig'
RESIDENTIAL"+PLAN'CHECKI NG' .GUIDE 8/91
(S.F., DUPLEX & MISC. ONLY) p
Bldg. Permit #
OWNER _ A A. P. # 9./='.- lv -
Plan Checker_
GENER
AL
requirements: (sideyards and number of permitted living units).
24___�V cation. G�2tZEL-T-E'�j
3'>1 ans signed by designer.
1_�/�Proo er description of work on application.
15 Existing violations on property.
�tems on data sheet. (W.C., fees, Health, Developer Fees, License law, etc).
cor d notice of violation.
PLOT PLAN
l� plete parcel size and dimensions.
?!./Setbacks, sideyards, easements, etc.
�ti er.buildings or structures.
,4-.---G- ding, fills, drainage.
54—"flood hazard.
6. Special conditions on creation map, (noise, CDF, fire sprinklers, non-comb-
ustible, and foundations).
FAU & FAS road setback.
Building or utilities across lot lines (Record form).
FLOOR PLAN
,�plete to scale plan with dimensions.
ed windows for light and ventilation Sec. 1205
3! Required windows for second exit (Sec. 1204). > -`
zg is (Chapter 34 & Sec. 5207)-. _
nimpact glass (Sec. 5406).
red room sizes, ceiling heights (Sec. 1207).
7!/GFChs, garage, kitchen, and exterior outlets (Article 210-8).
8 ight fixtures, switches, receptacles, and exterior receptacles for main -
ten a of mechanical equipment.
9. cations of water heater, heating and cooling equipment, other electrical
o gas equipment.
1Pd!Ga,rage firewall, door size, and closer (Sec. 503(d)(3)).
1- exterior exit door (sec. 3304 M.
and wood stove location, alcoves, and clearance.
1 moke detectors (Sec. 1210). `
1 Plumbing fixtures, water closet clearances and shower size.
STRUCTURAL DETAILS
1. Standard bracing or engineered design (Table 25V)
4:--Iinusual shape, size; or split level house requiring lateral design.
-3---el-e—restory requiring balloon framing and/or engineering.
e story building requiring engineered calculations and plans.
Y. -'Foundation plan complete enough to construct building.
E�Floor construction details complete enough to construct building.
7. Elevations and wall construction details complete
woof construction details complete enough to
9. l @ construction details and talcs if
1rara
e ie r bearingrid e
r� porct�e�d r�
12 ---Stud eights.
�3—Ad �e soils - special foundation design.
14-.-1etaining walls requiring design.
1-5-.-S-p'ecial Inspection required.
enough'to construct building
construct building.
necessary.
�\D(=> 8/91
RESIDENTIAL PLAN CHECKING GUIDE
MISCELLANEOUS ITEMS TO LOOK OUT FOR
2:-- aldetails: landings, rise and run, head clearance, handrails
(Sec. 3306).
GuaT4 'il details (Sec. 1711 & 3306(j).
3,- ri or stone veneer (Chapter 30).
or plaster - weep screeds (Sec. 4706).
5 Proper roof pitch for roof convering (Chapter 32).
--6--Raof-covering type - (fire hazard).
7.�o6am insulation - protection.
8e 36" halls and stairways.
ging area over garage - complete 1 -hour separation required on garage side
inc diag�supporting walls and posts, etc.
—exits on three-story dwellings (sec. 3303 & see Mezannines - 1716).
lA! Attic ccess and ventilation (Sec. 3205).
1 U rfloor access and ventilation (Sec. 2516).
1:!P.- Combustion air for fuel burning appliances - L.P.G. requirements.
requirements on duplexes.
. En y design.
1 . dashing at all exterior openings.
?T. -DF responsible area requirements.
/Ps -o
Z,S
s3R D I>- Ca-
& -04- o!z
o x /4 o P-
��e �'��fl�
(_ T_
P�2 2tL w ) L
L-
/47
�4� 0 c�F -r Cp Ffz M - Twd� w.�C7 �
��� AP
Return to DPW AGRICULTURAL STAM= OF AC@TOWLEDGE=
FOR RESIDENTIAL DEVELOPIMFKNT
Section 26-8.1 of the Butte County Code
requires this acknowledgement be recorded
prior to issuance of a building permit. 92-0381651'
The property described herein is adjacent I
to land or included within an area zoned Recorded I
for agricultural purposes, and residents Official Records I
of this property may be subject to incon- County of I
veniences or discomfort arising from the Butte I
use of agricultural chemicals, including, Candace J. Grubbs I
but not limited to herbicides, pesticides, Recorder I
and fertilizers; and from the pursuit 12:09pm 25 -Aug -92 1
of agricultural operations including,
but not limited to cultivation, plowing,
spraying, pruning, and harvesting which
occasionally generate dust, smoke, noise, and odor.
tural zones which have as a priority use for productive
within said zones and on adjacent property should be
or discomfort from normal, necessary farm operations.
Rec Fee
Cash
PUBL
5.00
5.00
XX 1
Butte County has established agricul-
agricultural purposes, and residents
prepared to accept such inconvenience
All tlTat real property. -situate in the County of Butte, State of California, described as
follows:
Date:
State
County
cep 4�- 03(s -4 (, 0 -eUo
b -t- 33
COUNTY OF BUTTE
BUILDING DEPT
AUG 2 6 1992
of ) On this the
}�, � . _) SS. undersigned Notary
of �Sd�)--
PROPERTY
1-1
day of az4� (�� r9� before me, the
Public. Ders;6nally annparari
Personally known to me.roved to meron'the basis
Pof satisfactory evidence.
be the person(s) whose name(s)
scribed to the within instrument and acknowledged that
cuted the same for the purposes therein contained. IN WITNES
REOF, I hereunto set my hand and o ficial seal.
Present A.P. No.
Notary Public
.. 'Nit
1.�i0:1•�.:•.otl:'+�a1�0!IMT'f:ILe..T9S�?n("�'.�4R1f..4'.1
PROPERTY
1-1
day of az4� (�� r9� before me, the
Public. Ders;6nally annparari
Personally known to me.roved to meron'the basis
Pof satisfactory evidence.
be the person(s) whose name(s)
scribed to the within instrument and acknowledged that
cuted the same for the purposes therein contained. IN WITNES
REOF, I hereunto set my hand and o ficial seal.
Present A.P. No.
Notary Public
196 MEMORIAL WAY
CHICO, CALIFORNIA 95926
(9161891-2727
Owner's
BUTTE COUNTY DEPARTMENT OF PUBLIC HEALTH
DIVISION OF ENVIRONMENTAL HEALTH
7 COUNTY CENTER DRIVE 747 ELLIOTT ROAD
OROVILLE, CALIFORNIA 95965 PARADISE, CALIFORNIA 95969
(9161538-7281 19161872-6308
/ APPLICATION FOR PERMIT TO CONSTRUCT A SEWAGE DISPOSAL SYSTEM 5/
Applicant's Name
Mailing Address
sessor s arse NO.�
_Phone No.
1. Construction Site 2210 8 A 5/10 LG W"
(Street and number or direction and distance ton rest crossroad)
2. Lot Size %T feet x 3 feet. acres
3. APPLICATION FOR: New system for new building ❑ Auxiliary or secondary system ❑
Repair of or addition to old system ❑ New system to replace existing facilities ❑
4. Type of building to be served by proposed system:
Mobile Home ❑ (size ) No. Bedrooms Garbage disposal?
House No. Bedrooms Garbage disposal? IV 0
Other C7'%(specify)
5. Water supply for premises: (Must be safe, potable water) Community Oq Private well ❑ Other
Water supply for ajoining properties: Community A Private well ❑ Other
6. WORKMEN'S COMPENSATION INSURANCE
I am aware of the provisions of Section 3100 of the California Labor Code.
Which requires every employer to be Insured against liability for Workmen's
Compensation.
❑ 1 have placed on file with the County of Butte a certificate of Workmen's
Compensation Insurance.
❑ 1 certify that In the performance of the work for which this permit Is
Issued I shall not employ any person in any mannerso alto become sublectto
the Workmen's Compensation Laws of California.
7. SCALE PLOT PLAN TO BE FURNISHED
Sketch to scale on reverse side hereof, or attach scale sketch of plot plan of the premises showing:
a. Property lines.
b. Location of all proposed and existing buildings,
structures, driveways and parking areas. I .
c. Location of large trees, rocks, or other obstacles.
d. Location of any well, spring, creek or other body of
water on the parcel and within 100 feet of property line.
e. Show direction and approximate amount of slope.
f. Source of water.
g. Water lines.
h. Set back lines and easements.
i. Proposed sewage disposal system and area for
replacement.
I hereby state that the information above and on the reverse side hereof or attached hereto is correct and
true to the best of my knowledge. I understand that the permit must be obtained before any construction is
begun either on the building or on the sewage disposal system, and that a satisfactory inspection of the system
is required before the new building or dwelling may be occupied or the system backfilled, or put into use. I also
understand tha a safe potable water must be supplied to the new building or dwelling before occupancy can
take place.
Signed Owner ❑ Authorized agent Licensed contractor ❑
Date (An original letter of authorization must accompany this application in order for
an authorized agent to sign.)
FOR OFFICE USE ONLY
Legal parcel? Zoning
Access Rcpt. No.
Water plans cleared Potable water
Comment
S4 -579R
Usepermitted?
_Amount
■■■■
■■O■
NONE
soon
■SS■■
■USES
EUS■■
■■N■■
■E■■■
OAK ANoc-C-
i7'
Ph,'(AJeI�6 sz-1
P# -36-L160 -0'-(O
Certificate of Compliance: Residential .
Climate Zone 11
ProjectTiue ''
92- Z9S%
2710 t 1416 k � o L,L
Buil If-itN 9- ?r 9 Z
Protect Addl-eas
Checked By/ Date
J Documentation Author Telephone
Entotoattent Agency Use Only
Gla%41 rea % Glass
BUILDING DATA
North '00
Conditioned Floor Area 13540 Number of Stories
East _ 6
_J_
Slab/Raised Floor Molts Number of Units
W� Z,.Single
Family Detached (SFD) [ ] Addition Alone
Single Family Attached (SFA) [ ] Existing Building
Skylight !�
Total A0,
[ I Multi -Family (MF) [ ] Existing -Plus -Addition
BUU,DING SHELL INSULATION -
Component Insulation LomflonfComments
—"—
Type R -Value (astir:, .to garage, typiC4 ate-)
PO(IV,T if% AL
Wall .............. Q- l
L
Roof .............
T
Roof .............
Floor .............
Floor .............
:
Slab Edge .....
GLAZING Shading Devices
Glaring Area Glass Type Interior Exterior Overhang Framing Type
Orientation (sf) (single. double) (yoller blind. etc.) (sltedeacreen. etc.) (yea/fto) (mtstal/wood)
North
North
East
---
East ( )
South
South ( )
West ( ) O
West ( )
Skylight....... Q_
--�
THERMAL MASS
Type/Covering Area Thickness
(slab/exposed tile, etc.) (So (inches) Location/DCSCription (kitchen, bath. etc.)
HVAC SYSTEMS Minimum Duct
Type (i'ttttlace, air Efficiency Location Duct Output
Manufacturer / Model #
conditioner, hest pltmp) (SE, SEER.HSPF) (attic, etc.) R -Value (Btuh)
(or approved equal)
r'u ray► 1 7 z4 � ,
s-9 AC/L
A, • C , 7
DEPARMEW
Maximum Furnace Heating Output: S!o Btuh
HOT WATER SYSTEMS
Q ('��/
A P P„v F D
Tank Ma nufacturer/Model-#
v
SPECIAL FEATURES/REMARKS (Add extra sheets if necessary)
A
Mandatory Measures Checklist: Residential MF -1R
NOTE: Lowtise residential buildings subject to the Standards must contain these meow= regardless of the compliance
approach used. Items marked with an asterisk (•) may be superseded by more stringent compliance requirements listed
on the Certificate of Compliance. When this checklist is incorporated into the permit documents. the features rioted shall
be considered by all parties as binding minimum component performance specifications for the mandatory measures
whether they are shown elsewhere in the documents or on this checklist only.
DESCRIPTION DESIGNER ENFORCEMENT
Building Envelope Measures
§2.5352(x): Minimum ceiling insulation R-19 weighted average.
§2.5352(b). Loose rail insulation manufacturer's labeled R -Value.
' §2-5352(c): Minimum wall insulation in framed walls R. 11 weighted average (does not apply to
exterior mass walls).
1
2.5352(k): Slab edge insulation - water absorption rate no greater than 0.3%. water vapor
transmission rate no greater than 2.0 pent►/urch.
12-5311: Insulation specified or installed meets California Energy Commission (CEC) quality
standards. Indicate type and form.
§2.5352((): Vapor barriers mandatory in Climate Zones 14 and 16 only.
§2.5317: Infiltration/Exfiltration Controls l
y a Doors and windows between conditioned and unconditioned spaces designed to limit air
t leakage.
b. Doors and windows certified.
c. Doors and windows weatherstripped: all joints and penetrations caulked and sealed
§2.5352(e): Special infdtration barrier installed to comply with §2-5351 meets CEC quality
standards.
§2.5352(d): Installation of Fireplaces
1. Masonry and factory -built FMlaces have:
a Tight fitting, closeable metal or glass door,
t b. Outside air intake with damper and control
c. Flue damper and control
2. No continuous burning gas pilots allowed.
HVAC and Plumbing System Measures
62-5352(8) and 2-5303: Space conditioning equipment sizing: attach calculations.
§2-5352(h) and 2-5315: Setback thcmgstat on all applicable heating systems. .
•
62.5316(a): Ducts constructed, installed and insulated per Chapter 10, 1976 UMC.
112-5316(b): Exhaust systems have damper controls.
12-5314(c): Gas -rued space heating equipment has intermittent ignition devices.
#' §2.5314: HVAC equipment, water heaters, showerhcads and faucets certified by the CEC.
§2.5352(1): Water heater insulation blanket (R-12 or greater) or combined interiodcaterior
I insulation (R-16 or greater): fust 5 feet of pipes closest to tank insulated (R-3 or greater).
§2.5312(Exception 1): Pipe insulation on steam and steam condensate return & recirculating
piping.
§2-5318(d): Swimming Pool Heating
1. System has:
a. On/off switch on heater.
b. Weatherproof instruction plate on heater.
e. Plumbed to allow for solar.
.2. 75 percent thermal cffkciency.
3. Pool cover.
4. Time clock.
5. Directional water inlet.
Lighting and Appliance Measures
§2.5352(j): Lighting .25 lumens/watt or greater for general lighting in kitchens and bathrooms.
§2.5314(c): Gas feed appliances equipped with intermittent ignition devices.
I
12.5314(a): Refrigerators. refrigerator -freezers. freezers and fluorescent lamp ballasts certified
by the CEC. Indicate make and model number.
COMPLIANCE STATEMENT
This oerdficate of compliance lists the bolding featut+es and performance specifications needed to comply with
t Title 24. Chapter 2-53 and 79tle 20, C'liaptcr2, Subchapter4. Article 1 of the California Administrative code. This
certificate has been signed by the individual with overall design responsibility and the building owner. who shall
retain a copy of it and transmit the certificate to any subsequent purdmser of the building.
Designer Building Owner
Name: Narita
• Titk/Firrn: TitWFIrm:
Address: Addn=:
Telephone: Telephone:
Lk. N:
(sitnature) (date) (signature) (date)
z-
Documentation Author Enforcement Agency
Name: None:
Trtkl um Atm
Address: Tett phones
1. Ceiling Insulation
U -value
Single-
Number of stories
-46
R -value
One
Two
Three
R-0
-103
49
-32
R-19
-8
-4
-2
R-30
-2
-1
.1
R38
0
0
0
U -value
Single-
Single -
-46
0.50
-176
-84
-54
0.30
-102
-49
-32
0.10
-26
-13
-8
0.08
-18
-9
-6
0.06
-11
-5
-4
0.04
-4
-2
-1
0.02
4
2
1
0.00
11
5
3
2. Wall Insulation
3. Raised Floor Insulation
Single-
Single -
-46
Number of stories
Family
Family
Multi -
R -value
Detached
Attached
Family
R-0
-68
-51
-34
R-11
0
0
0
- R-13
2
2
1
R-19
8
6
4
U -value
-6
-3
.2
0.80
-153
-114
-76
0.50
-91
-68
-46
0.30
-47
-36
-24
0.10
0
0
0
0.08
4
3
2
0.06
9
7
5
0.04
14
11
7
0.02
19
14
10
0.00
24
18
12
3. Raised Floor Insulation
- . 0.60
Insulation in Floor
-70
-46
Number of stories
-120
R -value
One Two
Three
R-0
-17 -8
-5
R-11
-3 -2
-1
R-19
0 0
0
R-30
3 1
1
U -value
-8
-5
- . 0.60
-144
-70
-46
0.50
-120
-58
38
0.40
-95
-46
30
0.30
-69
-34
-22
0.20
-43
-21
14
0.10
-17
-8
-5
0.08
-11
-6
-4
0.06
-6
-3
.2
0.04
-1
0
0
0.02
4
2
1
0.00
10
5
3
Controlled Ventilation Crawlspace
-4
3 .1
Number of stories
-1
R -value
One
Two
Three
R-0
-11
-7
-5
R-5
4
4
3
R-11
-2
-2
-2
R-19
.1
-2
-2
4. Slab Edge Insulation
40
-90
-37
Number of Stories
-14
R -value
One
Two
Three
R-0
0
0
0
R-5
8
5
2
R-7
8
6
3
F2 factor
0.90
-4
3 .1
0.80
-1
-1 0
0.70
2
2 1
0.60
6
4 2
0.50
9
6 3
0.40
12
8 4
S. Inriltration (Air Leakage)
Speafiration Points
Standard 0
,6. Glass Heat Loss
1 Total
-14
-48
-69
-64
U -value
East
(Percent
West
Skylight
.51 to
.41 to
.31 to 0.30 or
Glass Single
Double
.60
.50
.40
less
50
-121
-53
-39
-24
-10
4
40
-90
-37
-26
-14
-3
8
35
-75
-29
-19
-9
1
10
30
-61
-21
-13
-4
4
12
29
-58
-20
-12
-3
5
12
28
-55
-18
-10
-2
5
13
27
-52
-17
-9
-2
6
13
26
-49
-15
-8
-1
7
14
1
24
1
0
3
1 -1
7
14
-1
-43
-12
-5
10
8
14
23
-40
-11
-4
2
8
15
22
-37
-9
3
3
9
15
21
-34
-7
-2
4
10
15
20
31
-6
0
5
10
16
19
-29
-4
1
6
11
16
18
-26
3
2
7
12
16
17
-23
-1
3
8
12
17
16
-20
0
4
9
13
17
15
-17
1
6
10
14
17
14
-14
3
7
10
14
18
13
-12
4
8
11
15
18
12
-9
6
9
12
15
19
11
-6
7
10
13
16
19
10
3
9
11
14
17
19
9
-1
10
13
15
17
20
8
2
12
14
16
18
20
7. Shading (Shade Open)
Eftextive Paeent class
(Percent =lass x SC)
Effective
-14
-48
-69
-64
%Glass North
East
South
West
Skylight
18 5
1
4
1
na
16 4
2
5
1
na
14 4
2
5
1
na
12 3
3
5
2
na
11 3
3
5
2
na
10 2
3
5
2
1
9 2
3
5
2
2
8 2
3
5
2
2
7 1
3
4
2
2
6 1
3
4
2
3
5 2
4
2
3
4 0
2
,-3
1
3
3 0
1
2
1
3
2 0
0-
1
0
3
1 -1
-1
.1
-1
2
0 -1
-2
-4
-2
0
na = not allowed
0
2
3
4
lB. Shading (Shade Closed)
Effective Pes t class
(Percent glom x SO
09*4
Glen North Eval South WWI S WIlight
18
-14
-48
-69
-64
na
16
-12
-42
-59
-55
na
14
-10
-35
-50
-46
na
12
-8
-29
-40
-37
na
11
-7
-26
-36
-33
na
10
-6
-23
-31
-29
-74
9
-5
-20
-27
-25
-65
8
-5
-17
-23
-21..
-56,
7
-4
-14
-19
-18
-47
6
3
-11
-15
-14
.38
5
-2
-9
-11
-10
-30
4
�
-6
-8
-7
-23
3
0
-4
-5
-4
-16
2
1
-1
-2
-1
-9
1
1
1
1
1
-4
0
2
3
4
, 3
0
no - not allowed
8
9 10
10
4.5
9. Interior Thermal Mass
Interior
SUV6- Savie.
Slab Floor
Raised Floor
Mass
Multi
Stories
Detached kladwd
Stories
0.00
1CFA
One
Two
Three
One Two
Three
0.0
-8
3
.4
1
-1
0.1
-8
-5
-3
0
0
0.3
-7
-4
-2
-0 1
1
0.5
-6
-3
-1
1 1
2
0.7
-5
-2
-1
1 2
2
0.9
-5
-1
0
2 3
'3
i 1.1
-4
-1
1
3 4
4
1.3
-3
0
2
3 4
5
1.5
-3
1
2
4 5
5
2.0
-1
2
4
5 6
7
2.5
0
3
5
7 7
8
3.0
1
4
6
8 8
9
3.5
2
5
7
9 9
10
4.0
3
6
8
9 10
10
4.5
3
7
8
10 11
11
5.0
4
7
9
11 12
12
5.5
5
8
9
11 12
12
6.0
5
8
10
12 13
13
6.5
6
9
10
12 13
13
7.0
6
9
11
13 13
14
7.5
6
10
11
13 14
14
8.0
7
10
11
13 14
14
8.5
7
10
12
13 14
15
10. Exterior Wall Thermal Mass
Exterior
SUV6- Savie.
(assumes ducts In attic)
Wall
Family Famiy
Multi
Mass
Detached kladwd
Family
0.00
0 0
0
0.20
3 2
1
0.40
5 4
3
0.60
8 6
4
0.80
10 8
5
1.00
13 10
7
1.20
13 12
8
1.40
12 13
9
1.60
10 13
11.
1.80
10 12
12
2.00
10 11
13
11. Heating System
-1
00
SE or HSPF
3 3
2
(assumes ducts In attic)
10
10.5
Sum of t-6
6 5
4
-25 or -24 to -14 to -4 to
+6 to 16 or
SE HSPF
less -15 -5 . +5
+15 more
0.72 6.60
0 0 0 0
0 0
0.75 6.88
3 3 3 2
2 1
0.80 7.33
8 7 6 5
4 -3
i 0.85 7.79
13 11 10 8
7 5
0.90 8.25
17 15 13 11
9 "7
0.95 8.7120
18 = 15_ 13
11 8
30%
Effective SE or HSPF
(SE or HSPF x duct efficiency)
Effective -2S or -24 to -1410 :4 to +6 In
16 or
SE HSPF
less -15 -5 +5
+15
nore
0.30 2.75
-73 x64 -56 -47
-38
-30
na 3.41
-45 -39 -34 -29
-24
-18
0.40 3.67
-34 -30 -26 -22
-18
-14
0.50 4.58
-10 -9 -8 -7
-5
-4
0.56 5.13
0 0 0 0
0
0
0.60 5.50
5 5 4 32
-6
-4
0.70 6.42
17 15 13 11
9
7
0.80 7.33 25 22 19 16 13 l 10
0.90 8.25 32 28 24 20 17 13
1.00 9.17 37 32 28 24 19 15
Zonal Control Adjustment
System Type
Resistance 10 9 7 6 4 3
Other 6 5 4 3- 2 2
12. Cooling Syst •m
SEER
Zonal Control Adjustment
10 8 7 6 4 3
No Cooling System Installed
Stories
North
(assumes ducts In attic)
East
c.
South
. Sim of 7-10
-5
-4
.4
-25 or -24 b r14 to
-4 In
+6 to
16 or
SEER
less
-15 •6
+5
+15
more
8.0
-14
-12 -10
-8
-6
-4
8.5
-9
-7 -6
-5
-4
-3
i .. 8.9
-5
.4 -4
-3
-2
-2
9.0
-4
3 .3
-2
-2
-1
00
4
3 3
2
2
10
10.5
7
6 5
4
3
2
11.0
10
9 7
6
4
3
120
15
13 11
9
7
5
_13.0
20
17 1 14
12
9
6
3
2
EKealve SEER
30%
POU
8
(SEER xduet efl7ciency)
4
3
•3.
St::n of 7-10
None
37
Effective
-25 or ,24 to -1410
-410
46 to
16 or
SEER
less
-15 -5
+5
+15
more
5.0
-30
-25 -21
-17
-13
-9
6.0
-12
-11. -9
-7
-6
-4
6.6
-5
-4 4
3
-2
-2
7.0
0
0 0
0
0
0
8.0 -
9
8 6
-2
4
3
9.0
16
14 12
9
7
5
10.0
22
19 16
13
10
7
11.0
26
23 19
15
12
8
12.0
30
26 22
18
14
9
1
13.0
i
33
29 24
20
15
10
Zonal Control Adjustment
10 8 7 6 4 3
No Cooling System Installed
Stories
North
b.
East
c.
South
One
-5
-4
.4
- -3
-2
-2
Two+
3
3
.• 2
2
2
1
Single -Family
16tached and
Attached
l
[0.72/6.6]
HSPF 10.56/5.151
Unit Size (sf)
Water
Zonal Control? ( Y / N)
; i99
120x;.
'1700
2200
2700
Heater
Credit
or
I to
to
to
or
Type
Type
less.
11699
2199
2699
more
SG
None
O t
r 0
0..
0
0
or
Solar
12
i ll
6
5
4
HP
-HWR
8
5
4
3
3
WSB
5
3
3
2
2
30%
POU
8
5
4
3
•3.
SE
None
37
-24
-18
-15
-12
"
Solar
-1
-1
.1
0
0
1.1
HWR
-18
-12
-9
-7
-6
2.5
WSB..
-25
-16
-12
-10'
-8
4
ROLL-
- -1-8
_12
-9
-7
-6
IG
None
'-5
-3
-2
.2
-2
IA
Solar
7_
: 5
.4
3
2
2.0
POU
..3_
2
1
1
1
IE
None
-28
-19
-14
-11
-9
0.3
Solar
8
5
4
3
3
1.8
POU
-10
-6
-5
-4
-3
3.3
Multi-Famliy
(Individual units)
3.9
4.1
4.3
4.5
4.6
5
5.2
Water
56
699
700
1200'81700
0.9
2200
Heater
Crept
or
to
to
to
or
Type
Type
less
1199
Im
2109
more
SG
None
0
0
0
0
0
or
Solar
14
7
5
4
3
HP
HWR
_ 9
5
3
2
2
3.2
WSB
9
4
3
2
2
4.7
POU
9
5
3
2
2
SE
None
-45
-23
-15
-11
-9
2.1
Solar
2
1
1
0
0
!
HWR
--25
42
4.4
4.6
4.8
I
WSB
S.S
13
-8
4
.5
POU
-23
-12
•8.,
-6
-5
. IG
None
; -8
-4
-3
2
.2
3.7
Solar; '°6
4.1
3
2
1
1
5.1
POU_
1
0
0
0
0
IE
None ;
-30
-15
-10
-8
-6
2.5
Solar -
18
9
6
4
4
4
POU
-8
-4
.3
-2
-2
5.4
5.6
SS
6.1
63
65%
1.1
Point System Summary: Climate Zone 11
SCORE CARD
1. Ceiling Insulation
2. Wall Insulation
3. Raised Floor Insulation
Measures
30 or
R -value [381 U -value 10.0301
Iq or
R -value [ 11] U -value [0.098]
or
R-valutr [ 191 U -value [0.037]
Point Scores
_z
4. Slab Edge Insulation or
R -value (0] F2 factor [0.77]
S. Infiltration Standard 0 / 2
6. Glass Heat Loss /D, � B
(double] U -value [0.65] To loud Glass (16] � Sum 1-6
7: Shading (Shade Open)
a. North
b. East
c. South
d. West
e. Skylight
8. Shading (Shade Closed)
a.
North
b.
East
c.
South
d.
West
e.
Skylight
t10:ExteriorWall�Mass1 1w 4
:...r+ �:.r• +
Interior MasslCFA
.,.'t�.
Exterior Mass
1 : Heatin&System
't Zonil Cona01?4( YY/'N)
.7 7i-
SE or HSPF
t n.c 2 loss
l
[0.72/6.6]
HSPF 10.56/5.151
12. Cooling System
X I
Zonal Control? ( Y / N)
-SEER (�51
Duo Efficiency [0.74] Effective SEER [7.03]
13. Water Heating
`
.
Type SG]
Credit [none]
.
41.7.uINC•4.II
Iatpt.0 a.bl
4 TYPE 1
MASS
(UIItC a 4.2. le:
exposed slab)
0%
5%
10%
15%
20%
25%
30%
35%
40%
4SY.
50%
55%
60%
65%
701E
75%
80%
85%
90%
95%
l00% toy% Ile% 11SY. 1207E 12S•
0%
0
0.2
0.4
0.6
0.8
1.1
13
1.5
1.7
1.9
2.1
23
2.5
2.7
2.9
3.2
-3.4
3.6
3.8
4
4.2
4.4
4.6
- 4.8
S
5.3
10%
0.2
0.4
0.6
0.8
1
1.2
IA
1.6
1.9
2.1
2.3
Z5
2.7
2.0
3.1
3.3
3.5
3.7
4
4.2
4.4
4.6
4.8
5
5.2
5.4
20%
0.3
0.6
0.8
1
1.2.
1.4
1.6
1.8
2
2.2
24
2.7
2.9
3.1
3.3
3.S
3.7
3.9
4.1
4.3
4.5
4.6
5
5.2
S.4
56
30%
0.5
0.7
0.9
1.1
1.4
1.6
1.8
2
22
24
2.6
28
3
32
3.5
8.7
89
4.1
43
4.5
4.7
4.9
5.1
5.3
5.6
S.8
40%
0.7
02
1.1
1.3
1.5
1.7
1.9
2.2
2.4
2.6
2.8
3
3.2
3.4
3.6
3.8
4
4.3
43
4.7
4.9
5.1
S.3
5.5
S.1
5.9
.50%
0.9
1.1
1.3
1S
1.7
1.9
2.1
2.3
2.5
27
3
32
3.4
3.6
3.8
4
42
4.4
4.6
4.8
5.1
S.3
S.S
5.7
5.9
6.1
55%
0.9
1.1
1.4
1.6
1.8
2
22
2.4
2.6
28
3
32
3.5
3.7
3.9
4.1
4.3
4.5
4.7
4.9
5.1
5.3
5.6
S.8
6
6.2
60%
1
1.2
1.4
1.7
1.9
21
2.3
2.5
2.7
2.9
3.1
3.3
3.5
3.8
4
4.2
4.4
4.6
4.8 '
5
5.2
5.4
5.6
SS
6.1
63
65%
1.1
1.3
1.5
1.7
1.9
2.2
2.4
2.6
2.8
3
3.2
3.4
3.6
3.8
4
4.3
4.5
4.7
4.9
5.1
S.3
5.5
5.7
5.9
6.1
6.4
70%
1.2
1.4
1.6
1.8
2
2.2
2.5
27
2.9
3.1
3.3
3.5
3.7
3.9
4.1
4.3
4.6
4.8
S
5.2
5.4
5.6
58
6
6.2
64
75%
1.3
iS
1.7
1.9
21
2.3
2.5
2.7
3
3.2
3.4
3.6
3.8
4
4.2
4.4
4.8
4.8
5.1
5.3
5.S
5.7
5.9
6.1
6.3
6.5
80%
1.4
1.6
1.8
2
2.2
2.4
26
2.8
3
3.3
3.5
3.7
3.0
4.1
4.3
4.5
4.7
4.9
5.1
5.4
5.6
5.8
6
6.2
64
66
05%
1.4
1.7
1.9
2.1
2.3
25
2.7
2.9
3.1
3.3
3.5
3.8
4
4.2
4.4
4.6
4.8
5
5.2
64
5.6
5.9
6.1
6.3
SS
6 7
90%'
1.5
1.7
2
2.2
24
26
2.8
3
3.2
3.4
3.6
3.8
4.1
4.3
4.5
4.7
4.0
5.1
53
.5.5
5.7
5.9
6.2
6.4
66
66
95Y.
1.6
1.8
2
22
25
27
2.9
3.1
3.3
3.5
3.7
3.9
4.1
4.3
4.6
4.8
5
5.2
5.4
5.6
5.6
6
6.2
6.4
6.7
6.9
• 100%
1.7
1.9
21
2.3
2.5
28
3
3.2
3.4
3.5
3.8
4
4.2
4.4
4.6
4.9
5.1
5.3
53
5.7
5.9
6.1
6.3
6.5
6.1
7
105%
1.8
2
2.2
2.4
2.6
28
3
3.3
3.5
3.7
3.9
4.1
4.3
4.5
4.7
4.9
5.1
5.4
5.6
5.8
6
6.2
6.4
6.6
6.8
7
110%
1.9
2.1
2.3
2.5
2.7
29
3.1
3.3
3.6
3.8
4
4.2
4.4
4.6
4.8
5
5.2
5.4
5.7
5.9
6.1
6.3
6.5
6.7
6.9
7.1
115%
2
2.2
2.4
2.6
2.8
3
3.2
3.4
3.6
3.6
4.1
4.3
4.5
4.7
4.9
5.1
5.3
5.5
5.7
5.9
6.2
6.4
'6.8
6.8
7
7.2
120%
2
2.3
2.5
2.7
29
3.1
3.3
3.5
3.7
3.9
4.1
4.4
4.6
4.6
5
5.2
5.4
5.6
58
6
6.2
6.S
6.7
8.9
Ti
7.3
125%
2.1
2.3
25
2.8
3
3.2
$.1
3.6
3.8
4
4.2
4.4
4.6
4.9
5.1
5.3
5.5
5.7
5.9
6.1
6.3
6.5
6.7
2
7.2
7.4
Point System Summary: Climate Zone 11
SCORE CARD
1. Ceiling Insulation
2. Wall Insulation
3. Raised Floor Insulation
Measures
30 or
R -value [381 U -value 10.0301
Iq or
R -value [ 11] U -value [0.098]
or
R-valutr [ 191 U -value [0.037]
Point Scores
_z
4. Slab Edge Insulation or
R -value (0] F2 factor [0.77]
S. Infiltration Standard 0 / 2
6. Glass Heat Loss /D, � B
(double] U -value [0.65] To loud Glass (16] � Sum 1-6
7: Shading (Shade Open)
a. North
b. East
c. South
d. West
e. Skylight
8. Shading (Shade Closed)
a.
North
b.
East
c.
South
d.
West
e.
Skylight
t10:ExteriorWall�Mass1 1w 4
:...r+ �:.r• +
% Glass Sc Eff. % Glass
6191_ X .27 = 4150
-4ITI- X I %7
49 X r
C x = O
% Glass SC Eff. % lass
S, �t XML = 3 t
X = zi
-'-��- X
�- X
TYPE 1 MASS AREA
9. InterioryThermatmass
I
COND. FLOOR AREA � B
Interio ass/CFA
t10:ExteriorWall�Mass1 1w 4
:...r+ �:.r• +
TYPE 2 MASS AREA $
ND. FLOOR AREA
.,.'t�.
Exterior Mass
1 : Heatin&System
't Zonil Cona01?4( YY/'N)
.7 7i-
SE or HSPF
x _
Duct Efficiency 10.78] Effective SE or
l
[0.72/6.6]
HSPF 10.56/5.151
12. Cooling System
X I
Zonal Control? ( Y / N)
-SEER (�51
Duo Efficiency [0.74] Effective SEER [7.03]
13. Water Heating
`
.
Type SG]
Credit [none]
r 7
SurQ7-10
v
Point Total: ..L�