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DUCLOS. LAIN)' K KLOCKI:R. A4YR'I'I,1-.
25 MELROSE DR.. OROVII.I.Ii
CONT: WIS'II?RN REGION IMALEp
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636 6H0 01� 03-0761
DUCLOS, LARRY
25 MELROSE, OROVILLE
Cont: LEONARDS LANDSCAPING
LAWN SPRINKLERS
r
936�66B6t9 04-
DUCLOS,LAWERENCE
3
25 MELROSE DR, OROVILL INALED
Cont: SUN POWER GrZS-d9
ROOF MNT SOLAR ELEC SY
NOTES 1!
PERMIT NO
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RESIDENTIAL
036-600-010 _ _ 04-1652_ 1
DUCL'OS,LAWERENCE'�-
25 MELROSE DR, OROVILLE
Cont: SUN POWER
ROOF MNT SOLAR ELEC SYS
SPECIAL CONDITIONS
CHECKED
BY
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY -
(
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
I'
4
ij
JOB FINALED (Date) 2'
i Signature
1
J=OK
0 = Not OK
. = NotReadyable
6.
MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
Electric
1.
Zoning Requirements -Setbacks -Easements
Frmg.; Sills-Anchors-Studs-Rftrs-Trusses
2.
Soils; Special MH Support Sketch
Siding; Nailing -Veneer -Stucco -Mesh
3.
Sewer; Location -Test -Fall -C/O -Concrete
Roof; Shthg-Roofing
4.
Water; Location -Test -Easement Needed (Sketch)
Ext.; Steps -Doors -Landings
5.
Electricity; Location-Clearances-Grnd-/ /Amp -Concrete
Braced Wall Panels
6.
Gas; Location -Test -Wrap;-/ P' L'ft.
/ P Nat. or/ P' L "ft./ P LPG
7.
Well Clearance & Disconnect
Card B-1 Date Card B-1
8.
Utility Clearance
Card B-1 Date Card B-1
Date
POOLS (Plans) OK except #'s
1.
Setbacks -Easements
Date
2.
Card B-1 Date Card B-1
Date
3.
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
Elec.; Receptacles and Lighting, Distance-GFI
1.
Zoning Requirements -Setbacks -Easements
Elec.; Pool Lighting; 15 Volts-GFI
2.
Footings; Size -Spacing -Marriage Line
Elec.; Enclosures; Conduit Entries -Terminals -Listed
3.
Gas; MH Test -Demand -Valve -Connector
Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
4.
Electricity; MH Test -Crossovers -Breakers -Clearances
Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes- Enclosures- Panelboards-Ins. to Main Conduit
5.
Drain; MH Test -Fall -Flex Connector
Health Department Approval
6.
Water; MH Test -Regulator -Connector
Plumb.; Cir. Test -Water Supply Test
7.
Water and Sewer Connected -C/O to Grade -HD Approval
Light Niche
8.
Gas and Electricity Tagged
Enclosure; Fencing -Alarms
9.
Tie Downs -Type -Installation Cert.
10.
Exits; Insp.-Sketch
Card B-1 Date Card B-1
11.
Cert. of Occupancy
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
PERMANENT END SYSTEM (ONLY)
1.
Zoning Requirements -Setbacks -Easements
2.
Footings; Size -Spacing -Marriage Line
3.
Blocking
4.
Gas; MH Test -Demand -Valve
5.
Electricity; MH Test
6.
Water; MH Test
7.
Water and Sewer Connected
8.
Gas and Electricity Tagged
9.
Exits
10.
License Decals
11.
Verify #'s with Office
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-Connectors
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
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, 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- Panelboards-Ins. to Main Conduit
9.
Health Department Approval
10.
Plumb.; Cir. Test -Water Supply Test
11.
Light Niche
12.
Enclosure; Fencing -Alarms
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
J=OK
0 = Not OK
- = Not Applicable
. = Not Ready
RESIDENTIAL (Single & Duplex)
Date
UNDERFLOOR (Plans) OK except #'s
1.
Zoning -Setbacks -Easements -Flood -Slope
2.
Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. 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
7.
Slab, Steel -Wrapped
8.
Piers -Fireplace Ftg.-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.
Plenums & Ducts; Clearance -Material -Support -Ins.
14.
Girders -Sills -Anchor Bolts-Joists-Vents-Crippies
15.
Access & Ventilation
16.
Insulation
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
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 Protection
19.
D.W.V.; Test Fittings & Anchor -Nail Protection
20.
Shower Pan; Test, First Floor -Tub Access
21.
Test Tub & Shower, Second Floor -Tub Access
22.
Gas Pipe; Sixe & Anchors
71.
23.
Fire Sprinkler; Test
72.
Elec. Outlets at Wood Panel, Int. & Ext.
Date
Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance
Card B-1 Date Card B-1
Date
Elec. Outlets & Receptacles at Kit. Counter
Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) OK except #'s
24.
Fixture & Transformer Clearance -Ins. Protection
25.
Elec. Receptacles Spacing -Lights & Switches at Doors
26.
Size Boxes & No. of Conductors Stapled
27.
Romex Installed Close to Edge of Studs & C.J.
28.
Equip. Ground made up w/Mech Fasteners -Bond Gas & Water
29.
2 Appliance Circuits in Kitchen & Conductor Size GFI
30.
Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al
31.
Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al
Insulated Neutral 0 Yes 0 No
_
32.
Service -Riser Conductors & Ground Main Disconnect
33.
Equip. Clearances Panels-Motors-Mech. Equip.
34.
Clothes Closet Light -Shower Light -Spa Light
35.
Smoke Detector
87.
Water Well, Disconnect, Electrical, Plumbing
Date
88.
Card B-1 Date Card B-1
Date
89.
Card B-1 Date Card B-1
Date
MECHANICAL (Permit) OK except #'s
Glass Protection
36.
A.C. Ducts Insulation & Support
Corrections from Previous Inspections
37.
Vent Fan, Exhaust above insulation
Gas Test -Meters Tagged, Gas -Electric
38.
Condensate Drain & Overflow, Size & Grade
Water & Sewer Connected -C/O to Grade -HD Approval
39.
Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet
Energy Compliance Certificate -Other Certificates
40.
Attic Access & Platform if Furnace in Attic
Date
Card B-1 Date Card B-1
Date
Date
Card B-1 Date Card B-1
Date
FRAMING (Permit) OK except #'s
41.
Sills Proper Materials & Anchors
42.
Walls Studs -Nailing Spacing & Braces -Plates -Sound
43.
Bearing Walls over Girders & Floor Nailing
44.
Draft Stop in Walls (rat proof)
45.
Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs
46.
Headers & Beams -Size & Bearing
Date
FRAMING (Continued)
47.
Hangers -Post Caps -Anchors -Connectors
48.
Cling. Joist-Rftr. Ties- Purl in -Roll Brac.-Truss-Shting.-Rtng.
49.
Fireplace Ties or Type A Flue -Fireplace Throat Clearance
50.
Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
51.
Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions
52.
Garage Fire Protection Framing -RC Channel
53.
Property Line Firewall & Openings
54.
Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits
55.
Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection
56.
Plywood on Roof Overhang -Attic Vents -Rafter Outriggers
57.
Siding -Nailing Veneer
58.
Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
59.
Glazing Area -Glass Protection -Skylights -Plastic
60.
Shear Walls; Nailing -Bolts
61.
Brace Interior/Exterior Wall Panels
62.
Insulation -Walls -Ceilings
63.
Infiltration -Walls -Windows
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
FINAL (Plans) OK except #'s
64.
Ext. Steps -Door & Sidelight Protection -Landings
65.
Smoke Detector
66.
Furnace Vents -clearance -Comb, Air -Connector -
In Garage; Above Floor-Ducts-Mech. Protection
67.
Bedroom Exiting
68.
G.F.I. & Bath Fixtures & Tub Access -Spa
69.
Elec. Trim & Subpanel, Breaker Sizes & Labels
70. Stairs & Rails
71.
Fireplace or Stove, Clearance -Hearth
72.
Elec. Outlets at Wood Panel, Int. & Ext.
73.
Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance
74.
Elec. Outlets & Receptacles at Kit. Counter
75.
Garage Fire Door; Swing -Landing -Closure
76.
A.C. Duct in Garage -Damper
77.
Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V.
in Garage; Above Floor-Mech. Protection
78.
Plb.; Elec. & Mech. Equip. Listed for Location
79.
Elec. Receptacles in Garage (F.F.I.)-Romex Protection
80.
Insulation -Foam -Looked in Attic
81.
Guard Rails & Deck Construction -Post Caps
82.
Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance Looked under Floor 0 Yes
_
83.
Following Instld./Drive 0 Yes 0 No/Walks 0 Yes 0 No/Planters 0 Yes 0 No
84.
Stucco Brown -Finish
85.
A.C. Unit Disconnect, Electrical -Plumbing
86.
Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings
87.
Water Well, Disconnect, Electrical, Plumbing
88.
Exterior Elec. Trim, G.F.I. Receptacle -Underground
89.
Ventilation Throughout House
90.
Glass Protection
91.
Corrections from Previous Inspections
92.
Gas Test -Meters Tagged, Gas -Electric
93.
Water & Sewer Connected -C/O to Grade -HD Approval
94.
Energy Compliance Certificate -Other Certificates
95.
Address Posted
96.
Fire Sprinkler
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Comments at Final:
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAX#: (530)538-2140
WEBSITE: www.buttecounty.net\dds
PERMIT NO.
BP041652
LICENSED CONTRACTORS 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
Issued Date'' 06/22/2004 APN: 036-600-010-000
the Business and Professions Code, and my license is in full for and
effect.�l�U
License CI ss : License.
Site Address' 25 MELROSE DR ORO
fNumber:
Date:% Contractor. �II/y iU�
Map Index:
Description: ROOF MOUNT SOLAR ELECTRIC SYSTEM
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
Owner: DUCLOS FAMILY TRUST ETAL
to its issuance, also requires the applicant for such permit to file a
KLOCKER MYRTLE ROSE LIVING TRUST
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's State License Law (Chapter 9 commencing with Section
25 MELROSE DR
7000) of Division 3 of the Business and Professions Code) or that he or
OROVILLE, CA 95966-7702
she is exempt therefrom and the basis for the alleged exemption. Any
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions
Applicant: SUN POWER &GEOTHERMAL ENERGY
Code: The Contractors' State License Law does not apply to an
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
proving that he or she did not build or improve for the purpose of
sale.).
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
Contractor: SUN POWER & GEOTHERMAL ENERGY
pursuant to the Contractors' State License Law.).
❑ 1 am Exempt under Article 3 of the Business and Professions Code
863 EAST SAN FRANCISCO BLVD
Date: Owner:
SUITE A 94901
530-533-5988
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ I have and will maintain 'a certificate of consent to self -insure for
License #: 759086
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
is issued.
>a( I have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
Architect:
the work for which this permit is issued. My workers' compensation
Engineer:
insurance carrier and policy number are:
FUND
Carrier: /n'v
I
Policy p: u%
Total Square Ft: 0 S. F.
❑ I certify that in the performance of the work for which this permit is
Valuation: $0.00
issued, I shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
Census Code:
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date:
Applicant:
WARNING: Failure to secure workers' compensation coverage is
employer to criminal and one
unlawful, and shall subject an penalties
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
,
code, interest, and attorney's fees. .
CONSTRUCTION LENDING AGENCY
This permit' her y issued under the a.pplicagle provisions of the Birtte County Coda 2nrvor
I hereby affirm that there is a construction lending agency for the
for this is issued (Sec 3097 Civ.)
Resoli to o work' dicated above for which fees have been paid. (�
f
Q
performance of the work which permit _
" _ _. _
. By:
_ Date:��
Name:
v �%t
PERMIT EXP ES N: --r �^
Address:
Date
❑ 1 hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any t icial form or documen f\Butte County. I hereby
authorize representatives off Butte County to enter upon the above mentioned property for inspection purposes.
%1
f v C l Signature:JAII/ ✓ ��
Print Name:
a
Date: Q
❑ Owner ❑ Contractor ❑ Agent for Owner ❑ Agent for Contractor
BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
BUILDING PERMIT
24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO)
OFFICE #: (530) 538-7541 FAX#: (530)538-2140
WEBSITE: www.buttecounty.nehdds
PERMIT NO.
BP041652
LICENSED CONTRACTORS 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
Issued Date: 06/22/2004 APN: 036-600-010-000
the Business and Professions Code, and my license is in full gp and
effect. (�!
License CI ss : License (Number:
Site Address: 25 MELROSE DR ORO
Date: Contractor: (J U!y TUB
Map Index:
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the
Description: ROOF MOUNT SOLAR ELECTRIC SYSTEM
Contractors' State License Law for the following reason (Sec. 7031.5
Business and Professions Code: Any city or county which requires a
permit to construct, alter, improve, demolish, or repair any structure, prior
Owner•• DUCLOS FAMILY TRUST ETAL
to its issuance, also requires the applicant for such permit to file a
KLOCKER MYRTLE ROSE LIVING TRUST
signed statement that he or she is licensed pursuant to the provisions of
the Contractor's Slate License Law (Chapter 9 commencing with Section
25 MELROSE DR
7000) of Division 3 of the Business and Professions Code) or that he or
OROVILLE, CA 95966-7702
she is exempt therefrom and the basis for the alleged exemption. Any
violation of Section 7031.5 by any applicant for a permit subjects the
applicant to a civil penalty of not more than five hundred dollars ($500).):
❑ I, as owner of the property, or my employees with wages as their
sole compensation, will do the work, and the structure is not
intended or offered for sale (Sec. 7044, Business and Professions
Code: The Contractors' State License Law does not apply to an
Applicant: SUN POWER GEOTHERMAL ENERGY
owner of property who builds or improves thereon, and who does
such work himself or herself or through his or her own employees,
provided that such improvements are not intended or offered for
sale. If however, the building or improvements are sold within one
year of completion, the owner -builder will have the burden of
proving that he or she did not build or improve for the purpose of
sale.).
❑ I, as owner of the property, am exclusively contracting with
licensed contractors to construct the project (Sec. 7044, Business
and Professions Code. The Contractors' State License Law does
not apply to an owner of property who builds or improves thereon,
and who contracts for such projects with a contractor(s) licensed
Contractor: SUN POWER 8r GEOTHERMAL ENERGY
pursuant to the Contractors' State License Law.).
❑ 1 am Exempt under Article 3 of the Business and Professions Code
863 EAST SAN FRANCISCO BLVD
Date: Owner:
SUITE A 94901
530-533-5988
WORKERS' COMPENSATION DECLARATION
1 hereby affirm under penalty of perjury one of the following declarations:
❑ 1 have and will maintain a certificate of consent to self -insure for
License #: 759086
workers' compensation, as provided for by Section 3700 of the
Labor Code, for the performance of the work for which this permit
is issued.
have and will maintain workers' compensation insurance, as
required by Section 3700 the Labor Code, for the performance of
Architect:
the work for which this permit is issued. My workers' compensation
Engineer:
9
insurance carder anndd/pJ/olliicc%y number are:
Carrier:Pl-
Policy #:
Total Square Ft: 0 S. F.
❑ I certify that in the performance of the work for which this permit is
Valuation: $0.00
issued, I shall not employ any person in any manner so as to
become subject to the workers' compensation laws of California,
Census Code:
and agree that if I should become subject to the workers'
compensation provisions of Section 3700 of the Labor Code, I shall
forthwith comply with those provisions.
Date:
Applicant:
WARNING: Failure to secure workers' compensation coverage is
unlawful, and shall subject an employer to criminal penalties and one
J
hundred thousand dollars ($100,000), in addition to the cost of
compensation, damages as provided for in Section 3706 of the Labor
code, interest, and attorney's fees.
(�j �•LP
CONSTRUCTION LENDING AGENCY
This permit 0 here y issued under the applicable provisions of the Butte County Coda and/or
'
I hereby affirm that there is a construction lending agency for the
performance of the work for which this permit is issued (Sec 3097 Civ.))
Resod b o work dicated above for which fees have been paid.
Name:
By: — Date -
Address:
PERMIT EXP®r:SN:
Date
❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage,
handling and use of hazardous materials.
❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project.
❑ Attached are copies of the required E.P.A. notification forms.
I hereby certify that I have read this application, that the above information is correct, and that I am the owner or the duly authorized agent of the owner. I agree to comply with
all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance of any fficial form or documen Butte County. I hereby
authorize representatives of Butte County to enter upon the above mentioned property for inspection purposes. r
2—
Print Name: v Signature: V
Date:
0 Owner ❑ Contractor 0 Agent for Owner 0 Agent for Contractor
o �V T TFo BUTTE COUNTY
DEPARTMENT OF DEVELOPMENT SERVICES
0 o
0 BUILDING PERMIT APPLICATION
AND SUBMITTAL REQUIREMENTS
o-`a�"�.. ' 0 24 HOUR INSPECTION#: OROVMLE: (530) 538-7636 • CHICO: (530) 891-2834
c�U 14OFFICE #: (530) 538-7541
A FEE WILL BE REQUIRED AT TIME OF APPLICATION
v
CONTRACTOR
OWNER
Name I
AW ReNCE TELOS
Address
632:R-(50
City
ILLE
I StateC�
1 Zip /
l�
Phone
U�• U
Fax
E-mail
Map Book
CONTRACTOR
Name II
6WQ7_
Address
00 0OLP _PM
632:R-(50
City O i�Dv l U'e-
State
4 G -
Phone 53 "
Fax 533-�46
/
U�• U
Lic. # �pyJ
Qb
s V
APPLICANT NAME
ARCHITECT/ENGINEER
Name
City
Address
Zip
City
Fax
State
Zip
Phone
—
Type Const.
Fax
E-mail
Map Book
State License Number
APPLICANT NAME
Name
Address
City
State
Zip
Phone
Fax
E-mail
APPLICAAfT SIGNATURE
Y26L,L-3-0
For office use only:
Zoning
Flood Zone
SRA
I Yes
INo
00c.
—
Type Const.
Subdivision Name
Map Book
Page
Lot #
Planner
Date Approved:
UVtK FUK SUBMITTAL REQUIREMENTS
PERMIT
NO.
9n4-(&
BIN #
LOCATION
AP#
a3�•6co•otd
Property Address C91�
Cross Street H uwg--mve-
WORKER'S COMPENSATION
Policy Number
Carrier S-�n I V RN -D
If hiring anyone other than license contractors, a certificate of worker's
compensation must be shown at the time of permit issuance.
LENDING AGENCY
Name
Address
Description or Scope of Work:
WOCSYSMM
Sq. Footage
❑ Structure Built vAhout Permits
❑ Proposed Change of Occupancy
(Note previous use):
EXPIRATION OF APPLICATION
Applications for which a permit has not been issued will expire one
year after the date of application. In order to renew action on an
application after expiration, a new application, plans and fee will be
REQUEST FOR REFUNDS
Refunds can only be made upon written request by the person who
paid the fee. The request must be made prior to the expiration of the
permit and no construction work has been done. Filing fees, plan
check fees for work plan checked and other department costs are not
refundable.
Received by: I Amount: 384-. '?3 Bldg
I SRA
Receipt #: 4-06346 Sheriff
SMIP
Date: (o 11164- g 4 Other
Total
K:\FORMSWILDING F0RMS\B1dgApp1SubRgmts.doc Page 1 of 2 REV 4-30-04 l
J
J I
SUBMITTAL REQUIREMENTS
The following drawings and specifications must be submitted to the Building Division in order to apply
for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE
LEGIBLE AND W INK.
Residential, New, Remodels, Additions, and Accessory Structures:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER!
❑ 2. 3 Complete sets of plans, signed by the preparer. NO GRAPHPAPER!
❑ 3. 3 Engineered plans (if required)'with wet signature on plans AND 2 sets of stamped and signed
calculations.
❑ 4. 2 Engineered truss details and layouts (if required) (NO FAXES!).
❑ 5. Letter from Engineer or Architect for truss design review.
❑ 6. 2 Energy compliance design and supporting documentation: (Note: Not required for additions to
mobile or modular homes.)
❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑ 8. Detached Accessory Building Form, filled out by the property owner (if required).
❑ 9. Sanitation and site plan approval from the Environmental Health Department.
❑ 10. Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in
triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer.
Mobile, Manufactured, or Modular Homes:
❑ 1. 3 Site Plans, signed by the preparer. NO GRAPH PAPER!
❑ 2. 2 Data sheets and installation instruction manual.
❑ 3. 2 Marriage line information.
❑ 4. 2 Floor plans.
❑ 5. 2 Engineered Tie Downs or Foundation plans.
❑ 6. Sanitation and site plan approval from the Environmental Health Department.
❑ 7. 2 Flood Elevation Certificate, wet -stamped and signed (if required).
Commercial, New, Additions and Remodels:
❑ 1.
4 Site Plans, signed by the preparer. NO GRAPHPAPER!
❑ 2.
4 Engineered plans with wet signature on plans AND 2 sets of stamped and signed calculations,
with code analysis.
❑ 3.
2 Engineered truss details and layouts (if required) (NO FABS!).
❑ 4.
Letter from Engineer or Architect for truss design review.
❑ 5.
2 Energy compliance design and supporting documentation (if required).
❑ 6.
2 Flood Elevation Certificate, wet -stamped and signed (if required).
❑ 7.
Statement of Intent for Non -heated and A/C (if required).
❑ 8.
Metal Buildings: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in
triplicate, (D) Floor plans in triplicate, All of these must be stamped and wet -signed by the engineer.
❑ 9.
Letter of intent.
❑ 10.
'Hazardous Material Form.
❑ 11.
Sanitation and site plan approval from the Environmental Health Department.
If you have questions or would like additional information regarding this process, contact a Permit
Application Assistant at (530) 538-7541.
OVER FOR BUILDING PERMIT APPLICATION
KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2
REV 4-30-04
,7,;�,...�,�.,�.:.-.F. � .r - r Jam-.• ,si Y.. 'Yrrh yl.ls'4+,5' '.'Y."
COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140
PERMIT APPLICATION DATA SHEET
OWNER:
ASSESSOR PARCEL NUMBER �� h • !m no • o ► o
Proposed Building Use: :E_�c> t_,A 2cc M�b«HJT Counter Technician: t� Date: ' 04-
Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply.
1 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. .
' 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans.
❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and.signed calculations.
❑ 4. Engineered truss details and layouts in duplicate. No faxes!
❑ 5. Letter from Engineer or Architect for truss design review.
❑ 6. Energy compliance design and supporting documentation in duplicate.
❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings.
❑ 8. Manufactured homes: (A) Data sheets and installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in
duplicate.
❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these
must be stamped and wet -signed by the engineer.
❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate
❑ 11. Site plan and business license approval from the City of Biggs
❑ 12. Letter of intent for non-residential buildings
❑ 13. Detached Accessory Building Form filled out by the owner
❑ 14. Hazardous Material Form
gk 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable.
❑ 16. Other
Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.)
❑ 17. Fire Sprinklers............................................................................................
❑ 18. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by
❑ 19. Soils Report and/or Engineered Foundation required ........................................... ........
❑ 20. Erosion Control Plan Required........................................................................ ........
❑ 21. Fees as shown on the attached Schedule of Fees Due Sheet ..............................
❑ 22. City of Chico Plumbing permit........................................................................
❑ 23. California Department of Forestry plan approval ❑ paid. Sent by: .............
❑ 24. Planning approval (A) Use: (B)Parking: (C) Parcel Check:
❑ 25. Contact Land Development about _ Improvements, _ Drainage ...:.....................
❑ 26. NPDES Form.............................................................................................
❑ 27. Encroachment Permit for driveway from the Public Works Dept ...........................
❑ 28. Pre -Inspection for required.......
❑ 29. Contractor's license information. (Number, Name Style, Classification) ...................
❑ 30. Worker's Compensation Carrier and Policy Number ..........................................
❑ 31. Owner -Builder Verification (_ Given to owner, _Mailed to owner) .....................
❑ 32. Letter of Signature authorization ...................................... :........................""'
❑ 33. Recorded copy of Agricultural Acknowledgment Statement .................................
❑ 34. Manufactured home utility clearance...............................................................
❑ 35. Existing violations and/or expired permits.........................................................
❑ 36. Deed Restriction.........................................................................................
❑ 37. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $
❑ 38. Other: '?
❑ 39. Other:
When issued Telephone 37-� • .1)d03Xq and hold for pickup.
I have been inform d the above items and requirements for obtaining a building permit.
Applicant: Date:
1. Index per ' application for the bove item ntiered: Plan Check L tter
2. Additional items required
Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date:
Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, Date:
Plans reviewed by: Date: Plans approved by: Date
Structural reviewed by: Date: Structural approved by: _ Date: fat "Itul
Note transfer by: Date:
Yellow: Building Division
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DUCLOS 2.25KW
PHOTOVOLTAIC ARRAY
25 MELROSE OROVILLE, CA 5966
FLUSH ROOF MOUNTED PHOTOVOLTAIC ARRAY
ROOF: 17 DEGREE COMPOSITION SHINGLE
• (16) KYOCERA KC167W PV MODULES
(1) SMA 250OW SUNNY BOY INVERTER
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- 41W47-7039
PROPERTY OF SUNPOWER & GEOTHERMAL ENERGY CO., INC.
DATE:
CONFIDENTIAL. THIS DRAWING AND ANY DATA, DESCRIPTION, AND OTHER 6/8/04
INFORMATION CONTAINED HEREIN ARE CONSIDERED AS PROPRIETARY AND THE
EXCLUSIVE PROPERTY OF SUNPOWER & GEOTHERMAL ENERGY CO., INC. AND
SHALL NOT BE PUBLISHED, REPRODUCED, COPIED, DISCLOSED, OR USED, IN NTS
WHOLE,OR IN PART, FOR ANY PURPOSE.WITHOUT THE EXPRESS WRITTEN SHEET:
PERMISSION OF A DULY AUTHORIZED REPRESENTATIVE OF SUNPOWER &
GEOTHERMAL ENERGY CO., INC. ALL RIGHTS RESERVED.
.
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PV ARRAY
(FLUSH MOUNTED (16) KYOCERA 167W PV
EXISTING RESIDENCE 180
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DRAWN BY;
ATOM MCCAMBRIDGE
a1SR47ao3s
PROPERTY OF SUNPOWER & GEOTHERMAL ENERGY CO., INC.
MELROSE DRIVE CONFIDENTIAL. THIS DRAWING AND ANY DATA, DESCRIPTION, AND OTHER
INFORMATION CONTAINED HEREIN ARE CONSIDERED AS PROPRIETARY AND THE
EXCLUSIVE PROPERTY OF SUNPOWER & GEOTHERMAL ENERGY CO., INC. AND
SHALL NOT BE PUBLISHED, REPRODUCED, COPIED, DISCLOSED, OR USED, IN
WHOLE OR IN PART, FOR ANY PURPOSE WITHOUT THE EXPRESS WRITTEN
PERMISSION OF A DULY AUTHORIZED REPRESENTATIVE OF SUNPOWER &
GEOTHERMAL ENERGY CO. INC. ALL RIGHTS RESERVED.
DATE:
8/8/04
SCALE.,
SHEET.,
1 61'-2"
DC DISCONNECT
PV INVERTER
DUCLOS 2.25KW PHOTOVOLTAIC ARRAY
PV ARRAY LAYOUT @ 1' SCALE
KYOCERA 167W PV MODULE
DIMENSIONS:
3'-3"
4'-211 6"
63L -666 - 6 10
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ATOM MCCAMBRIDGE
4151747-7039
PROPERTY OF SUNPOWER & GEOTHERMAL ENERGY CO., INC.
DATE:
CONFIDENTIAL. THIS DRAWING AND ANY DATA, .DESCRIPTION, AND OTHER 618/04
INFORMATION CONTAINED HEREIN ARE CONSIDERED AS PROPRIETARY AND THE SCALE;
EXCLUSIVE PROPERTY OF SUNPOWER *& GEOTHERMAL ENERGY CO., INC. AND
SHALL NOT BE PUBLISHED, REPRODUCED, COPIED, DISCLOSED, OR USED, IN
WHOLE' OR IN PART, FOR ANY PURPOSE WITHOUT THE EXPRESS WRITTEN SHEET:
PERMISSION OF A DULY AUTHORIZED REPRESENTATIVE OF SUNPOWER &
GEOTHERMAL ENERGY CO., INC. ALL RIGHTS RESERVED.
j ROOF MOUNT ER-STANTIONS
(FALL ON RAFTER- 2" X 6" @ 24" O.C.)
B22 STRUCTURAL CHANNEL (8' MAX SPAN)
UNI -CLIP (STAIN
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ATOM MCCAMBRIDGE_
415/747-7039
PROPERTY OF SUNPOWER & .GEOTHERMAL ENERGY CO., INC.
DATE
CONFIDENTIAL. THIS DRAWING. AND ANY DATA; DESCRIPTION, AND OTHER 8/8/04
INFORMATION CONTAINED HEREIN ARE CONSIDERED AS PROPRIETARY AND THE Ste:
EXCLUSIVE PROPERTY OF SUNP.OWER & GEOTHERMAL 'ENERGY CO., INC: AND 1/2•= r
SHALL NOT BE PUBLISHED, REPRODUCED, COPIED, DISCLOSED, OR USED, IN
WHOLE OR IN. PART, FOR ANY PURPOSE WITHOUT THE EXPRESS WRITTEN SHEET:
PERMISSION OF A DULY AUTHORIZED REPRESENTATIVE OF SUNPOWER &
GEOTHERMAL ENERGY CO., INC. ALL RIGHTS RESERVED.
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PROPERTY OF SUNPOWER & .GEOTHERMAL ENERGY CO., INC.
DATE
CONFIDENTIAL. THIS DRAWING. AND ANY DATA; DESCRIPTION, AND OTHER 8/8/04
INFORMATION CONTAINED HEREIN ARE CONSIDERED AS PROPRIETARY AND THE Ste:
EXCLUSIVE PROPERTY OF SUNP.OWER & GEOTHERMAL 'ENERGY CO., INC: AND 1/2•= r
SHALL NOT BE PUBLISHED, REPRODUCED, COPIED, DISCLOSED, OR USED, IN
WHOLE OR IN. PART, FOR ANY PURPOSE WITHOUT THE EXPRESS WRITTEN SHEET:
PERMISSION OF A DULY AUTHORIZED REPRESENTATIVE OF SUNPOWER &
GEOTHERMAL ENERGY CO., INC. ALL RIGHTS RESERVED.
(16) KYOCERA 167KW PV MODULES
DUCLOS 2.25 KW SINGLELINE DIAGRAM
(16) KYOCERA 167W PV MODULES IN SERIES
PER MODULE:
OPEN CIRCUIT VOLTAGE: 28.9 V
MAX POWER VOLTAGE: 23.2 V
SHORT CIRCUIT CURRENT: 8.0 AMPS
MAX POWER CURRENT: 7.2 AMPS
MAX POWER: 167 WATTS
ARRAY TOTAL:
SHORT CIRCUIT CURRENT: 8.0 A
MAX POWER CURRENT: 7.2 A
MAX POWER VOLTAGE: 371.2 V
OPEN CIRCUIT VOLTAGE: 462.4 V
(1) SUNNY BOY SMA SWR25000 SBD INVERTER
PEAK POWER TRACKING RANGE: 234-550 V DC
METER
PG&E 200 AMP SERVICE
MAIN HOUSE GROUNDING SYSTEM
DUCLOS 2.25KW PHOTOVOLTAIC ARRAY
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wk - 6o0- 6 [0
1410 THHN DC
1410 THHN
1410 GROUND PV TO FRAME BOND DISC
CUTLER HAMMER
NON-FUSABLE LOCKABLE
3R 3 -POLE 30 AMP 600VOLT
DH 361 URK
WARNING!! ELECTRICAL SHOCK HAZARD.
DO NOT TOUCH TERMINALS ON BOTH LINE AND LOAD SIDES..
MAY BE ENERGIZED.
AC DISCONNECT LOCATED W/IN10' OF PG/E METER
1-#10 THHN
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1410 THHN EXTERIOR UTILITY
BREAKER
1410 GROUND BOND
SERVICE PANEL
1410 THHN
1410 THHN
1410 GROUND BOND
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1410 THHN
CUTLER HAMMER
NON-FUSABLE LOCKABLE
3R 2 -POLE 30 AMP 240 VOLT
DG221URB
WR25000-SBD
2.5kW
SUNNY BOY
INVERTER
240 VAC
UL#E210376
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PROPERTY OF SUNPOWER & GEOTHERMAL ENERGY CO., INC.
CONFIDENTIAL. THIS DRAWING AND ANY DATA, .DESCRIP.TION, AND OTHER
INFORMATION CONTAINED HEREIN ARE CONSIDERED AS PROPRIETARY AND -THE
EXCLUSIVE PROPERTY OF SUNPOWER & GEOTHERMAL ENERGY CO.. INC. AND
SHALL NOT BE PUBLISHED, REPRODUCED, COPIED, DISCLOSED, OR USED, IN
WHOLE OR IN PART, FOR ANY PURPOSE WITHOUT THE EXPRESS WRITTEN
PERMISSION OF A DULY AUTHORIZED REPRESENTATIVE OF SUNPOWER &
GEOTHERMAL ENERGY CO., INC. ALL RIGHTS RESERVED.
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415J747.7039
6/8/04
NTS
THE NEW VALUE FRONTIER
CC KYGEERa
KC167G
HIGH EFFICIENCY
MULTICRYSTAL
PHOTOVOLTAIC
MODULE
U�0
LISTED
MODEL KC167G
HIGHLIGHTS OF KYOCERA PHOTOVOLTAIC MODULES
Kyocera's advanced cell processing technology and automated production facilities produce a highly efficient
multicrystal photovoltaic module.
The conversion efficiency of the Kyocera solar cell is 15%
These cells are encapsulated between a tempered glass cover and an EVA pottant with back sheet to provide
maximum protection from the severest environmental conditions.
The entire laminate is installed in an anodized aluminum frame to provide' structural strength and ease of
installation.
Equipped with plug-in connectors.
APPLICATIONS
KC167G is ideal for grid tie system applications.
• Residential roof top systems • Water Pumping systems
• Large commercial grid tie systems • High Voltage stand alone systems
QUALIFICATIONS
UL1703 certified.
PERFORMANCE WARRANTY
25 year"� limited warranty on power output
SPECIFICATIONS
■ Electrical Specifications
MODEL
KC167G
Maximum Power
167 Watts
Maximum Power Voltage
23.2 Volts
Maximum Power Current
7.2OAmps
Open Circuit Voltage
28.9 Volts
Short -Circuit Current
8.00Amps
Length
1290mm (50.8in.
Width
990mm (39.0in.)
Depth
36mm (1.4in.)
Weight
16.Okg (35.3lbs.)
■ Thermal parameters
Nominal Operating Cell Temperature 47°C
Isc Current temperature coefficient (A /°C) (8.60x 10-3) A/°C
Voc Voltage temperature coefficient (V/°C) (-1.12 x 10-t) V/°C
Note: The electrical specifications are under test conditions of Irradiance of
1 kw/m2, Spectrum of 1.5 air mass and cell temperature of 25°C
Kyocera reserves the right to modify these specifications without notice
■ Physical Specifications (Unit: mm)
990(39.Oin.) 36(1.41in.)
NN
(h
N O>
NN
c Q (O
6
CD
CD N N
N v (D
MN �
N Ql
XPower output of the module after 25 years will not be less than 80% of the
minimum power specified in the data sheet.
ELECTRICAL CHARACTERISTICS
Current -Voltage characteristics of Photovoltaic Module
KC167G at various cell temperatures
10 IRRADIANCE: AM1.5, 1kW/m2
8
75°C 50°C 25°C
Q 6
c
U 4
2
0
0 10 20 30
Voltage (V)
Current -Voltage characteristics of Photovoltaic Module
KC167G at various irradiance levels
10 CELL TEMP. 25°C
8 1000w/ml
800W/m,
Q 6
c 600W/m2
m
3
U 4
400W/m'
2
200W/ml
01 I
0 10 20 30
Voltage (V)
QUALITY ASSURANCE
Kyocera multicrystal photovoltaic modules exceed government specifications for the following tests.
• Thermal cycling test • Mechanical, wind and twist loading test
• Thermal shock test • Salt mist test
• Thermal/ Freezing and high humidity cycling test • Light and water -exposure test
• Electrical isolation test • Field exposure test
• Hail impact test
Please contact our office to obtain details without hesitation.
1900CERa
KYOCERA Corporation
■ KYOCERA HEAD OFFICE
SOLAR ENERGY DIVISION
6 Takeda Tobadono-cho
Fushimi-ku, Kyoto
612-8501 Japan
Phone:(81)75-604-3476 Telefax:(81)75-604-3475
http://www.kyocera.co.jp
• KYOCERA FINECERAMICS GmbH
Fritz Muller Slra/3e 107, D-73730 Esslingen, F.R.G.
Phone: (49)711-9393417 Telefax:(49)711-9393450
• KYOCERA ASIA PACIFIC PTE. LTD.
298 Tiong Bahru Road, N13-03/04/05
Central Plaza, Singapore 168730
Phone: (65)271-0500 Telefax: (65)271-0600
• KYOCERA ASIA PACIFIC LTD.
Room 803, Tower 1 South Seas Centre, 75 Mody Road,
Tsi mshatsui East, Kowloon Hong Kong
Phone: (852)2-7237183 Telefax:(852)2-7244501
• KYOCERA ASIA PACIFIC LTD., TAIPEI BRANCH
Suite 501, Asia Enterprise Center,
No.142-144, Sec. 3, Min Chuan E.Road Taipei, Taiwan
Phone: (886)2-2718-3595 Teletax:(886)2-2718-3587
• Kyocera Solar, Inc.
7812 East Acoma Drive
Scottsdale, AZ 85260
Phone: (480)948-8003 or (800)223-9580 Telefax:(480)483-6431
• Kyocera Solar Pty, Ltd.
Cnr Forbes St & Riverside Drive
West End, OLD, 4102 Australia
Phone: (61)7-3844-6686 Telefax:(61)7-3844-8569
• Kyocera Solar do Brazil Ltda.
R.Mauricio da Costa Faria, 85
Recreio dos Bandeirantes-Rio de Janeiro
Cep:22.790-280
Phone: (55)21 -2437-8525 Telefax:(55)21-2437-2338
The contents of this catalog are subject to change without prior notice for further improvement. LIE/101 LO305S4SAGS-01 (Recycled Paper)
i
Sunny'Boy
The leading grid -tied photovoltaic inverters in Europe and America
SuVy
t,�.F
Shown with optional display
mg inverter
The SMA Sunny Boy inverter, the most popular grid -tied photovoltaic inverter in Europe, is
�ign is
• • • now UL 1741 Listed and available in North America. Sunny Boy's extensive track record in
ranle to
!Uafly any some of the world's most demanding markets has made it the favorite among PV professionals
tern size everywhere. Over 200,000 Sunny Boy inverters have been installed worldwide. Having
achieved the highest reliability of any PV inverter, Sunny Boy gained immediate acceptance
in the US and Canadian markets. Superior design, rock -solid German engineering, and
exceptional real-world efficiency have made Sunny Boy the top choice for American solar
° designers. These professionals know that Sunny Boy is a grid -tied inverter that they can -
JSTEDrecommend without reservation and install with confidence.
PV+
EOUIPMENT
GROUND
J DC
PV_ DISCONNECT
SWITCH
SUNNY BOY 25000
INVERTER
PV
ARRAY
Specifications for Sunny Boy 2`5000
Inverter Technology
Real sine -wave, current source, high frequency PWM
AC Input Voltage
213-262 (240 V AC) or 183-229 (208 V AC)
AC Input Frequency
59.3-60.5 (60 Hz), 50 Hz also available
DC Input Voltage
250-600 V DC
Peak Power Tracking Voltage
234-550 V DC (at 240 V AC)
PV Start Voltage
300 V DC
Minimum DC Input Voltage
207-256 V dependent on available line voltage
Maximum Array Input Power
(DC @ STC) 3000W (240 AC), 260OW (208 V AC)
Maximum AC Power Output
2500 W (240 V AC), 2200 W (208 V AC)
Current THD
Less than 4%
Power Factor
Peak Inverter Efficiency
Cooling
Maximum AC Output Current
Maximum DC Input Current
DC Voltage Ripple
Power Consumption
Ambient Temperature Rating
Enclosure
Unity
94.1%
Convection cooling (no fan)'
12.0 A
13A
Less than 5%
0 W nighttime, < 0.25 W standby
45 °C
NEMA 4X stainless steel
Size 17.1 W x 11.6 H x 8.4 D inches
(434 W x 295 H x 214 D mm)
Weight 71 lbs (32 kg)
Compliance United States:
UL 1741, E210376, UL 1998, IEEE 519, IEEE 929
ANSI C62.41 C1 & C3, FCC part 15 A&B
International:
DIN EN50082 Part 1, 61000-32, 50081, 50014, 600055 Part 2,
55011 Group l Class B, 50178, 60146 Part 1-1
ALL SPECS MAY CHANGE WITHOUT NOTICE
DISTRIBUTED BY
BREAKER
SIZE
2p 15 Amp
AC
DISCONNECT
SWITCH
UTILITY
D I I NEUITRAL
AC
DISTRIBUTION _
PANEL EARTH GROUND
Sunny Boy's unsurpassed reliability and efficiency is the
result of SMA's manufacturing philosophy that combines
simple design with robust execution. SMA's state -of the -
art maximum power point tracking performance results
in greater real-world energy capture than any other
grid -tied PV inverter. Sunny Boy's safety and reliability
record is also exceptional due, in part, to the inverter's
redundant grid monitoring and built-in ground fault
detection and interruption protection. The inverter's
IGBT power stage generates a nearly perfect sine wave
with the lowest harmonic distortion in the industry and
meets ultra -strict FCC EMC standards. SMA's unique
String Inverter technology makes future system expan-
sion -simple. SMA advanced communication options are
available to satisfy almost any application.
'Optional external fan (Sunny Breeze) available
SMA America , Inc., 12438-C Loma Rica Drive, Grass Valley, CA 95945
Phone 530-273-4895•Fax 530-274-7271.
www.SMA-AMERICA.com • email: info@SMA-AMERICA.com
Solar Today...
Energy Tomorrow
Rev. 9/25/03
Mo
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
• 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 PERMIT NO.
(Rev. 12/96) APPLICATION AND PERMIT 01-0761
ASSESSOR PARCEL NUMBER
036-600-010
w
ZONING
BUILDING PERMIT
OWNER
LARRY DUCLOS MYRTLE MCKER
TELEPMONE
589-1615
SO, FT. OCC. BUILDING VALUATION
. OWNERS MAILING ADDRESS
11 RIDGFLINE Cr,
CONTRACTOR'S NAME
LEONARDS LANDSCAPING533-1112
TELEPHONE
CONTRACTORS MAILING ADDRESS
2611 FOOTHILL BLVD,
CONSTRUCTION LENDER
LENDER'S MAILING ADDRESS
Fireplace
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee
$ 20.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Permit Fee
$
Plan Checking Fee
$
BUILDING ADDRESS
25 MELR
Energy Plan Checking Fee
$
$
PERMIT FEE
$
LAT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT
Fling Fee 20.00
USEOFSTRUCTURE
SF ❑ Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap
7.00
Solar or heat pump water heater
23.00
Water piping
15.00 1-5,00
Each as water heater or vent
15.00
TYPE OF WORK
New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: �[,N cj?j?k���,�t 1Rc�T6A�ri�N��'T'�,"�-�—
Gas piping system 1 - 5 outlets
15.00
Building sewer
15.00
Mobile Home S G W
@20.00
PERMIT FEE
S35.
ELECTRICAL PERMIT
Fling Fee 20.00
Main Service eoov oR tEss
zoOA OR LESS
23.00
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.y�
License Class — Lic. No. C/ CD8
OWNER -BUILDER DECLARATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ I, as owner of the property, or my employees with wages as their sole compensation,
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:
❑ 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
/ of employ any person in any manner so as to become subject to workers'
compensation laws of California, and agree that f I should become subject to the
workers' compensation provisig s of section 3700 of the Labor Code, I shall
forthwith c mply wit those pr ions.
_ Date
i ria a of plicant wrier ntractor ❑ Agent
An OS permit is required for excav tions over 5'0" deep and demolition or construction
of structures over 3 stories in height.
Main .Service 200A TO 1000A 46,00NEW
CONST. DWELLING OCCUP. SO
OR ADDNS. ( 8 ACC. BLDS. 3.5¢FT.
=REOSIDT. MULTI.OUTIET 97.50
POWER APPARATUS
SINGLE OUTLET CIR.
Ex. OCCU OUTLET OR FIXTURES B20 @ 1.000
Ex. Occup. 0 Ery I'M.oe.A 5.00
Temporary Service
23.00
Mobile Home Facilities 20.00
Misc. Wiring
23.00
PERMIT FEE $
MECHANICAL PERMIT Fling Fee 20.00
Heating
Cooling
Hood 6.50
Ventilation
PERMIT FES S
Mobile Home Installation Fee $
Energy Inspection Fee $
occ
corer. TYPE
TOTAL FEE $ 35.00
HA2
D FEES IMP
FLOOD
CDF
PARCEL
Po
HD
ISSUE
This permit is hereby issued under the applicable provisions
of the Butte County Code and/or Resolutions to do work
indicated abov for which fees have been paid,
j�J
By Datt5 1 l -
PERMIT EXPIRES�N) 3' 1 0
ale
Receipt No. ��� C�� nn
WHITE B. D. A S PINK -INSPECTOR GOLDENROD -APPLICANT
GOUH i Y OF BUTTE - DEPARTMEHT OF DEVELOPMERT SERVICES - BUILD[HG DIVISION
7 County Center Drive s, Oroville, Caftfornia 95963 • Telephone (530) 53B -15A — pEPLIAT 1+0•
�►.tuss� APPL(CATION AND PERMIT
ss Psn � O� U v
=MUM BUILDING PERMIT
SQ. FT. OCC. 5UELDING VALUATION
smUum -
)
LL
.ill
!�D$a�a
�""£
F-ITho Fm
S
2D.D0
Permit Fee
gt=aster Da 0 t e URG .aDWW8
Pian Caeckinv Fee
aatmaGAmaa» tJ' i U�
Anergy Pian Che-�g Fee
S
PLAIT Fi+
S
zrm s ons Hue
res
PLI36QBmG 'PERWffT
Fibg FEel
20.DD
Each Twp
7. D D
[i5EOF5"ie UCNF�E
Solar or hest P=p water hem
23.DD
;p p D,nt= Q Wboshome O Mier
Water 00' g .
15.3D 75�
sir
mA pus water he2r or vent
1 S.DD
7Y?EOFWOM
C -es wim mmtm7-5=j%ets
1S.DD
I,hw f] Admen O rr'lea• tzdel C] Miss D
bzsh&ft
0 05sr O
WId'atg saver
1 S. D D
�i� I.bmg SG W
C�2o.DD
D�rbe 1Natt
P- =T Fi
S
•
MECMICRL Perri
I Hing PD -1
2D.1>0
Idem swim =&t
23.DD
Idem Sanirs sem► TD SM"
4LDD
KIM ° a �
�CFt.
` 'Q
C7.6D
timMur Cm
Datta oaFCMMMam
® ib
Er. F=M CR;
S.DD
*P i' FEE ?.�iD
$
Test setviae
?.3.DD
Wbfle Home F --mms
MOD
Cv�
$
WL -Min
23 DD
5K'ct�rr
$
$
PER6tHtT Fi: c
S
arm•
AF-CHAiMAL PMWT
Ting Fee
2 D. DD
$
Heafa►g
H=d
6,SD
b MECWR (h.
P-rTMIT IFEEE S
I&Ws Hams hts m- u Fee =
Energy htsAmdm Fee 5
o" . oan6t rimfit,
TLrcE$
To__��coFi✓ GVF t PD
V�7� This pernt is heresy issued under the appir_•abie PT', nn=
of be Butte C zwq Cade and/or AesoUftm b d:, worf
insrcaled mbwo for wNtah fees have been paid.
9y Ds3e
Fte=-�piNs PBRNAT EXPIRES ON
NOTES
RESIDENTIAL
036-600-010 02-1302
PERMIT NO. .DUCLOS, LARRY R. KLOCKER, MYRTLE_...,-
25 ML-'LROSE DR., OROVILLE
CONT: WESTERN REGION
NSF
11 SPECIAL. CONDITIONS 11
SRA
FLOOD CERTIFICATE REQ.
FIRE SPRINKLERS REQ.
SPECIAL INSPECTION ITEMS
VERIFY
USE PERMIT CONDITIONS
SUB -STANDARD HOUSING LETTER
I
1 OFFICE COPY
4 Address
M CCe
ELECTRIC
Meter By Date/b
JOB FINALED (Date)
Signature
CHECKED
BY
✓ = OK
0 = Not OK
= Not Applicable
Not Ready RESIDENTIAL (Single & Duplex)
=
Date linderfloor (Plans) OK except #'s Date
o ing-Setbacks- Easements- Flood- Slope ange
Ftg. ain; Soils-Elec. Grnd.-/ /" Ftg. Depth 4 Cling.
Ft Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4 rept
/ Fig., Porches & Decks; Soils -Steel-/ /" Ftg. Depth tic A
I VW�Stemwaiis, Main; Steel-Blockouts-Wrapped 5 rm.
and Special Anchors
7
f�%/zj/ �
�JyB� D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
�J `� 10. UF, Gas Pipe; Size Anchors - Yard Gas Piping; Size Test
11. Water Pipe; Test -Anchors -Regulator -Service Test
12. Electric Underground
13. Plenums & Ducts; Clearance -M ' (-S
ate upport-Ins.
14. Girder nch olts-J s ents- pp'
Access & Ventilation
16. Insulation
Date �,/ rd B-171
ate Card B-1
Date �—( Card B-1 Date Card B-1
Date PLUMBING (Permit) OK except #'s
-ter Htr.; Vent -Access -Combustion Air Baffle
meter Pipe; Test & Anchor -Nail Protection1.9�Test Fittings & Anchor -Nail Protection
ower an; Test, First Floor -Tub Access
Test Tub & Shower, Second Floor -Tub Access
fV 22. Gas Pipe; Sixe & Anchors
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date
ELECTRICAL (Permit) OK except #'s
2�xture
& Transformer Clearance -Ins. Protection
2�
lec. Receptacles Spacing -Lights & Switches at Doors
2!r—Size Boxes & No. of Conductors Stapled
2,6!Romex
Installed Close to Edge of Studs & C.J.
27�quip.
Ground made up w/Mech Fasteners -Bond Gas & Water
2
Appliance Circuits in Kitchen & Conductor Size GFI
2g.
ubfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or AI
0.
Range Circle/ / ga Cu or AI -Oven Circ. / / ga Cu or At
Insulated Neutral O Yes O No
31.
Service -Riser Conductors & Ground Main Disconnect
. Equip. Clearances Panels-Motors-Mech. Equip.
3
3
Clothes 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 #'s
3
A.C. Ducts Insulation & Support
36.
nt Fan, Exhaust above insulation
ondensate Drain & Overflow, Size & Grade
3
u ce-Vent Access -Comb. Air -Return Air Vent 115 outlet
Attic Access & Platform if Furnace in Attic
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date FRAMING (Permit) OK except #'s
40 --sits Proper Materials & Anchors
�alls Studs -Nailing Spacing & Braces -Plates -Sound
-ring Walls over Girders & Floor Nailing t
raft Stop in Walls (rat proof)
4. F' tops, Furred Ceilings -Stairs -Chasers -Tubs
Headers & Beams -Size & Bearing
Ste
Stucc
oFRAMING (Continued)
Joist-Rftr. Ties-Purlin-RoN Brac.-Truss-Shting.-Rfng.
ace Ties or Type A Flue -Fireplace Throat Clearance
ccess; Size & Romex Protection -Draft Stop -Ins. Baffles
Windows or Exiting Doors -Sill Ht. & Dimensions
e Fire Protection Framing
3y,Line Firewall & Openings
Dors-One 3' -Check Garage 3rd Story, 2 Exits
-Width-Headroom-Rise-Run-Landing-Fire Protection
id on Roof Overhang -Attic Vents -Rafter Outriggers
-Nailing Veneer
Mesh -Drip Screed -Fd. Vents-Underflr. Access
g Area -Glass Protection -Skylights -Plastic
Walls; Nailing -Bolts
62. Infiltration -Walls -Windows
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date ,,-fINAL (Plans) OK except #'s
telf Ext. Step -Door & Sidelight Protection -Landings
64. SrooKeDetector
Furnace Vents -clearance -Comb, Air -Connector -
In Gar ; Above Floor-Ducts-Mech. Protection
edrogin Exiting
I.&Bath Fixtures & Tub Access -Spa
Trim & Subpanel, Breaker Sizes & Labels
7dj,41-replace or tove, Clearance -Hearth
7e EI . utlets at Wood Panel, Int. & Ext.
i Appliance; Ground -Air Gap -Cooking Clearance
73;-tTec.__QW4ets"& Receptacles at Kit. Counter
ire Door; Swing -Landing -Closure
Duct in Garage -Damper
6..; Vents -Clearance -Comb. Air Connector-P.R.V.
arage; Above Floor-Mech. Protection
Alf PI ec. & Mech. Equip. Listed for Location
Elec-F-Wceptacles in Garage (F.F.I.)-Romer. Protection
ifa%Insu] -Foam-Looked in Attic
uard Rjile &'beck Construction -Post Caps
VBents & Crawl Hole Door Drainage & Wood -Earth
Clearance�Looked under Floor p Yes
82. Fola mg Instld./Drive F s ❑ No/Walks ^ es 0 No/Planters No
. S co Brown -Finish
4f -A. C,Disconnect, Electrical -Plumbing
ants Above Roof, Pibg-Appliance-Fireplace-Clearance to Openings
e , Disconnect, Electrical, Plumbing
7. dor Elec. Trim, G.F.I. Receptacle -Underground
6 a tion.Fhrouahout House
,SP- CgPr6ction,s from Previous Inspections
G sl -Meters Tagged, Gas -Electric
W S wer Connected -C/O to Grade -HD Approval
av Compliance Certificate -Other Certificates
Address Posted
Date " Card B-1 41 Date Card B-1
DateZ2_794, � rd B-14Date Card B-1
Date / Card B-1 Date Card B-1
Comments at Final:
✓ = OK
0 = Not OK
= = Not Applicable
=Not Ready
MOBILE HOMES
Date
MOBILE HOME UTILITIES (Plans) OK except #'s
i
1.
Zoning Requirements -Setbacks -Easements
4.
2.
Soils; Special MH Support Sketch
i
i
3.
Sewer; Location -Test -Fall -C/O -Concrete
7.
4.
Water; Location -Test -Easement Needed (Sketch)
Gas and Electricity Tagged
5.
Electricity; Location-Clearances-Grnd-/ /Amp -Concrete
10.
6.
Gas; Location -Test -Wrap;-/ /" L'ft.
/ P 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.
Tie Downs -Type -Installation Cert.
10.
Exits; Insp.-Sketch
11.
Cert. of Occupancy
12.
Permanent Foundation Onlv: 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.-Connectors
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- Panelboards-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
........... :i I i .i 1 A ,!
- COUNTY OF BUTTE:
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
411 Main Street • Chico, CA • (530) 891-2751
7 County Center Drive • Oroville, CA • (530) 538-7541
CORRECTION NOTICE
T"'), „ c 17 i-)7
OWNER PERMIT NO.
A routine inspection indicates that the following violations of butte county Ordinances exist at the "t
above address and should be corrected. Please notice 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.
Date 1, I ` - 102— Inspector
REV 10/92
COUNTY OF BUTTE
BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES
411 Main Street - Chico, CA - (530) 891-2751
7 County Center Drive * Oroville, CA - (530) 538-7541 f
CORRECTION NOTICE
.4
-y' n
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 notice this office when correction of work is
completed. It you have any questions pertaining to this matter, or need additional explanation,
please contact this office immediately.
1j,
Date Inspector
REV 10/92
COUNT,Y OF BUTTE
BUILDING DIVISION
' DEPARTMENT OF' DEVELOPMENT SERVICES
;. 411 Main Sheet - Chico, CA - (530) 891-2751
7 County Center Drive - Oroville, CA - (530) 538-7541
COR.ROCTION NOTICE
Xf C' �Oj'-
OWNER \ PERMIT NO.
s
A routine Inspection indicates tdat_the_tol.lowin`g violations of butte county Ordinances exist at the
above address and should be corrected. Please notice this office when correction of work is
completed. It you have'any questions pertaining to this matter, or need additional explanation,
please contact is.offce immediately.
f2�
14-1
L=�� i u 2 /. r��zvr
14
Z'
Date �� '—� `� Inspector
REV 10/92
t
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 ^��/ ER�vIIT P.
(Rev. 12/96) APPLICATION AND PERMIT C°� L`
ASSESSOR PARCEL NUMBER
036-500-010
ZONING
AR
BUILDING PERMIT
OWNER
DUCLOS LA2,aY & KLO '5(9q-1
TELEPHONE
615
SQ. FT. OCC. BUILDING VALUATION
1864 R
OWNEAS MAILING ADDRESS
11 RIDGELIKE CT., 0R0VTTJFF,
604 U 10;872.00
CONTRACTOR'S NAME
WESTERN REGION
TELEPHONE
1534-976-1
572 COV 7.436.00
CONTRACTORS MAILING ADDRESS
3061 O?.AANG
CONSTRUCTION LENDER
Fireplace
LENDER'S MAIUNG ADDRESS
Total Valuation $
ARCHITECT OR ENGINEER
LICENSE NO.
Filing Fee $ 20.00
Permit Fee $ 706.00
ARCHITECT OR ENGINEERS MAILING ADDRESS
Plan Checking Fee $458-90
BUILDING ADDRESS
25 MELROSE DR. OROVILLE
Energy Plan Checking Fee $ 23.00
$
PERMIT FEE $1207.9
LAT NO.
SUBDIVISIONS NAME
PARCEL MAP
PLUMBING PERMIT Filing Fee 20.00
USEOFSTRUCTURE
SF N Duplex ❑ Mobilehome ❑ Other
SPECIFY
Each Trap 9 7-0063.00
Solar or heat pump water heater 23.00
Water piping 15.0019-00
Each as water heater or vent 15.0015,00
TYPE OF WORK
New h Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe Work: NSF
Gas piping system 1 - 5 outlets 15.00 1 5 -no
Building sewer 15-0015.00
Mobile Home I S I G I W @20.00
PERMIT FEE $ 143. 00
ELECTRICAL PERMIT Filing Fee 20.00
R LESS
Main Service ?DDA OR LESS 23.00 23.00
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.POWER
License Class R3 11-1 Lic. No. % � �
OWNER -BUILDER DEC RATION
I hereby affirm under penalty of perjury that I am exempt from the Contractors License
Law for the following reason:
❑ I, as owner of the property, or my employees with wages as their sole compensation,
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:
❑ 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
Main Service 200A TO IODOA 46.00
NEW CONST. DWELLING OCCUP. SO
OR ADDNS. ( 8 ACC. BLDS. 3.5¢x,
NON-aaloT. MULTI.OUTLET @7,50
APPARATUS
1,SINGLE OUTLET CIR.
E x. OCCU OUTLET OR FD(TUREs 20 Q''DD
BAQ .SO
Ex. Occup. oFU EEEDTS . DER. 5.00
Temporary Service 23.00
Mobile Home Facilities 20.00
Misc. Wiring 23.00
PERMIT FEE s 129.35
MECHANICAL PERMIT Filing Fee 20.00
Heating L5. 00
Cooling
Hood 6.50 6,50
Ventilation
PERMIT FEE $
Policy Number
(rhe 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 laws of California and agree that if I should become subject to the
workers' compensation provis ns of section 3700 of the La or Code, I shall
forthwith , Onriply with ose pr isions. J
X - Date / /
Signature of A plican' wner Contractor ❑ Agent
A OSHA permit is required for excava ions over 50" deep and demolition or construction
of es over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $
CD TTY
TO AL FEE $ 160 .7
HAZ.
D, FEES I
CDF
PAO PD HD
ISSU
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/'� � ✓ l �Btte
PERMIT EXPIRES ON
Dafe
ReceiptNo. 353697 $561.90//
WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT
;► `1^I. 4 a �. ,r . , � , �, .- ...r..•.'+k•'f" , r ... . V`^-1 p`y�'c^i n^.';+ '�h `.;`I�..". i4 X7'4;:• ,ir . - w . �-'1.i•.. V . �i a .'r /- .
COU�TY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION
7 C unty Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140
PERMIT APPLICATION DATA SHEET h
OWNER: Cr �� �" (� CVt/� ` ASSESSOR PARCEL NUMBER
Proposed Building Use: Counter Technician: Date:
Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply.
V.. Plot plans, 3 or 4 sets, signed by the preparer of the plans.
0."'Complete plans, 3 or 4 sets, signed by the preparer of the plans.
❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations.
V4, -Engineered
truss details and layouts in duplicate. No faxes!
. Energy compliance design and supporting documentation in duplicate.
❑ 6. Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or
foundation plans, all in duplicate.
❑ 7. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate.
(D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer.
Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The permit will be
indexed and returned to the plan review line-up when required items are received.
Date Received By
❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................
❑ 9. Plot plan and business license approval from the City of Biggs ....................................
❑ 10. Letter of intent for non-residential buildings.........................................................
DAL, L, '-Detached Accessory Building Form filled out by the owner .....................................
❑ 1.2. Haz .,..
a'rdous'Material Form...............................................................................
❑ 13. Other '
Re aining items needed to issue the permit. (May require additional plan review upon receipt of the following items.)
4. es as shown on the attached Schedule of Fees Due Sheet .......................................
tatement of Intent for Non -heated and A/C Buildings..................................�"'V
Sanitation and plot plan approval from the Environmental Health De mc tin
I f Chico Plumbing permit .......................................... ............
alifornia Department of Forestry plan approval paid. Sent by ............... D
19. Planning approval for (A) Use: Go W___(B)Parking: (C) arce Check:
Contact Land Development about ❑ Improvements, ❑ Drainage ................................
Entroachment Permit for driveway from the Public Works Dept. (construction approval prior, occupancy):
22. Pre -Inspection for required ................
❑ 23. Contractor's license information. (Number, Name Style, Classification) ......................
❑ 24. Worker's Compensation Carrier and Policy Number ............................................. `
❑ 25. Owner -Builder Verification (❑ Given to owner, ❑ Mailed to owner) .....................
Wetter of Signature authorization...... w'I'e*.......ecorded copyofAgriculturalAcnowledgment Statementanufactured home utility clearance...............................................................
❑ 29. Existing violations and/or expired permits.........................................................
❑ 30. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $
❑ 31. Other:
When issued Telephone
�a I have been informed C
oar Applicant:
and hold for pickup.
and requirements for obtaining a building per it.
Date:
1. Index pe it pf lication for the above items umbered: 1 7 'L/� Plan Check L tt
2. Additiona items required /
Contractor, designer, owner, was a sed of the above'da by ate:
, , , U r/
n rac o designer, owner, was advised of the above data byhone, ❑ mail, ❑ counte , b . Date: Z
s reviewed by: Date: Plans approved by: Date:
Structural reviewed by: Date: Structural approved by: Date: u2
Note transfer by: _ Date: - l
1 Ye low: Building Division
OWNER
COUNTY OF BUTTE
DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541
FEES DUE
PROPOSED BUILDING USE r
BUILDING PERMIT FEES
Balance Due ....................... $ -
Additional Fees Due ................. $ t1
Additional Fees Due ................. $
os((paid
vised Plan Checking Fee .............$ /
HOOL DISTRICT FEES CVS te) at District Office) (Available after Plan Check) l
3. SHERIFF FEES (paid at Building Division)
Residential ...................... $
Units
Commercial (sq. ft.) ............... x $0.03 = $
Sq. ft.
4. URBAN AREA FEES (paid at Building Division)
Residential ................... -x-=$
# Units Amt.
Commercial (sq. ft.) ............ -x_=$
Sq. ft. Amt.
5. RECREATIONAL DISTRICT FEES
(paid at District Office) (Available after Plan Check)
6. THERMALITO DRAINAGE DISTRICT FEES
$510.00 (paid at Building Division)
4
7. SRA FIRE INSPECTION AND PLAN CHECK
paid at Building Division)
8. WATER TENDER FEES (Battalion # )
$200.00 (paid at Building Division)
9. CSA 87 TRAFFIC FEE
$2500.00 (paid at Building Division)
10. OTHER
A.P. # _ JUl9`
DATE
RECEIPT i DATE REC.
At time of permit application, I was advised the above fees are required to be paid prior to issuance of the building permit. These fees
may be changed during the plan checking proces
APPLICANT' r DATE
Pursuant to'Gov�ern ent"Code Section 66020, you are hereby notified that items 2, 3, 4, 5, 6, 7, 8, 9, and 10 above may have been
imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned
items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a).
Original - Buiding Div. 2nd Copy - Applicant 3rd Copy - Owner ' (Rev. 6100)
11
AND WHEN RECORDED MAIL TO:
BUTTE COUNTY BUILDING DIVISION
7 COUNTY CENTER DRIVE
OROVILLE, CA 95965
Jo
• IIII ili 111 l 1111 l 11 l 111111 11 l 1111 11
I/ 2002-0037421
Recorded
I RE.'C FEE
Official Records
I COPIES
County Of
I
BUTTE
I
CANDACE J. GRUBBS
I
Recorder
I
ROSEMARY DICKSON
I
Assistant
I Kathy
11:25AM 22 -Jul -2002
I Page 1 of i
AGRICULTURAL STATEMENT OF ACKNOWLEDGMENT
FOR RESIDENTIAL DEVELOPMENT
Section 26-8 of the Butte County Code required 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:
Lot 75, as shown on that certain Map entitled, "COPLEY ACRES SUBDIVISION", filed in
the Office of the County Recorder of Butte County, California, on August 1, 1963,
in Book:30, of Maps, at Page(s) 38,39 and 40.
Date PROPERTY OWNERS:
State of California
County of B v rz C -
On Ja,(,lU before me,
�. �UCLOJ
personally appeared MMLfle 2.1 WW"nel�er and LduylenW A- Du0.1oS personally
known to me (or proved % me on the basis of satisfactory evidence) to be the person(s) whose name(s) ' ar subscribed
to the within instrument and acknowledged to me that 06/Oe he xecuted the same in VJe authorized
capacity(ies), and that by l SA/r ei signature(s) on the instrument, the person(s) or the entity upon behalf of which
the person(s) acted, executed the instrument.
WITNESS my hand and official seal.
Signatures kY u ". 1--"TV0aA Seal:
AMIE M. HOWARD
COMM. # 1351390
NOTARY PUBLIC-CALiFORNA
BUTTE COUNTY ..
IN1y Commission Expires APR. 15, 2006 Ir
7. @@
1.00
FROM CHICO Insulation FAX NO. 630-894-2475 _*t. 08 2002 02:26PM P2
CLIMATC
PROM
FtIBER -ASS BLOWnVG Wo,,
Your home has been rofe
p ss"nally insulated to provide
a guaranteed thermal resistance.
ADDSS
rnv ��' -STAI ' � zip
RECORD OF INSTALLATION
BLOWING WOOL HAM AND Rous
%NEw (.',01.qSTRUCT m IF RETROFIT: R•VALUE THICKNESS AREA INSULATED
(]. RETRt)V11
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Veru" Or PREVIOUS
NUMRF:R OY BAt;S USED
:MINIMUM:WEIGHT"
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DOME &&MER SIGNATURE
COMPANY ADDRESS PHONE
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Johns ManV�71e
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O 1997Jotv:: M-110 C0M=YDn
Jahns Menv@le CoMaration, P.O. BOR 5108. Denver. CO 80217-5108, InternpC "ttp>m ...im.COm. for more intOrmelion on t-BOO.6WIV3.
SITE PLAN REVIEW APPLICATION
Date: S— 2Z— 0 2 AP#
Permit Number (if applicable) 02 — 19 0 r2 -
APPLICANT
APPLICANT INFORMATION
Owners Name: D V G
Owners Address
Telephone No.:
Situs Address:
Proposed Use:
Parcel Size:
`l � )t L
I I 121 n(s6 U oe C'T .
'Z t; r,•Etr. -) �s- 6, IYZ .
Residential
New Single Family Residential
❑ Single Family Addition
❑ Mobile Home
❑ Residential Accessory
❑ Permanent Second Dwelling
❑ Temporary Mobile Home (Aunt Minnie)
❑ Temporary Travel Trailer
❑ Multi -family
Non-residential
❑ New Commercial
❑ Commercial Addition
❑ New Industrial
❑ Industrial Addition
Other
❑ Septic
❑ Agricultural Exempt Building
❑ Other:
Brief Explanation (if necessary):
MS AL
❑ Single Family Remodel
❑ Commercial Remodel
❑ Industrial Remodel
❑ Well
DO NOT WRITE BELOW THIS LINE
DEVELOPMENT SERVICES INFORMATION (For Staff Use)
YY --)-1 2T L6
Approved .❑ Conditionally Approved ❑ Resolve Problems Prior to Approval
® Site Plan Stamped Approved
By �qe Date S -rL:1 Q,
Page 1 of 5
ALL ITEMS CHECKED APPLY TO THE PROPERTY
Parcel Is In:
❑ Snow Load Area:
❑ Land Conservation Act Minimum Acreage: ❑ Verify residence can be built per contract
❑ Nitrate Action Plan (See Environmental Health for standards)
❑ Watershed Protection Overlay Zone (See attached standards and requirements)
❑ Expansive Soils (Test for expansive soils and if verified proper foundation design required)
SRA - (CDF to determine specific requirements)
❑ 100 -Year Flood Plain: (See attached)
• Flood Zone: Ix I
• Flood Panel No.: 001 BS Index Date: Lt -'W--moo
❑ Sacramento River Reclamation District (Approval must be obtained from the California Reclamation Board)
❑ Feather River Reclamation District (Approval must be obtained from the California Reclamation Board)
❑ North Chico Specific Plan (See Development Fees Section and attached standards and requirements)
❑ Chapman/Mulberry (See attached standards and requirements)
❑ Cohasset Area (See attached standards and requirements)
❑ Grading Zone (See attached handout)
Use Requires:
❑ Use Permit ❑ Minor Use Permit ❑ Administrative Permit
❑ Minor Variance ❑ Variance
--------------------------------------------------------------- 7--------------------------------------------
❑ Detached Building Use Form ❑ Encroachment Permit
❑ Agricultural Worker Affidavit ❑ Agricultural Acknowledgement Statement
Zoning: A ~ 1 `
Applicable Building Setbacks:
❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
Page 2 of 5
Zoning Code
Streets & Highways
Fire Prevention
Subdivision Map
Front
L
Side
Side Street
Rear
`s
Height
Waterway
N/A
N/A
N/A
❑ Setbacks drawn on site Plan. ❑ CDF approval needed for encroachments into SRA setbacks.
Page 2 of 5
r Applicable Development Fees:
Standard Fees Amount
❑ - Fire
❑ School*
❑ Parks/Recreation
❑ Roads
❑ Sheriff
❑ Drainage
❑ NCSP/CSA 87
❑ Chico Urban Area — Road
❑ Thermalito Impact
❑ Other
Subdivision Map Special Fees
❑
Water Tender
❑
Road Improvement
❑
North Oroville Area
❑
Other (per map)
Formula
* Check with school district to verify actual fee if pre -application review. A final determination will be made at the time of
the building permit.
Parcel Created By
Q Deeds:
Date of Creation: Legal Access Provided: ❑ No ❑ Yes
,Deed of Reference: Legal Access Required ❑ No ❑ Yes
Parcel Frontage on Publicly Maintained Road: ❑ No ❑ Yes, Road Name:
Complies with County Standards for Deed Creation: ❑ No ❑ Yes
Comments:
n
❑ Parcel Deemed to be legal
❑ Verify Legal Parcel ❑ Verify Legal Access ❑Provide Deed of Creation
❑ Obtain a Certificate of Compliance
F-1Obtaina Merger ❑ Obtain a Lot Line Adjustment
❑ Comply with Old Subdivision Lot Ordinance (Maps recorded prior to Book 17 of Maps Page 23).
❑ Construct road to: ❑ Meet Parcel size required by zone
❑ Meet current Environmental Health Department requirements
Page 3 of 5
X
in Subdivision Map/Parcel Map: C� Pl_e l YAC.261s
Map Date of Recording:
Lot: -75 Book: 3 Page: C)
❑ Use Permit/Minor Use Permit
Permit Number: Date of Approval:
❑ Comply with the following Conditions of Approval:
❑ Meet the Fire Safe Regulations of Butte County and P.R.C. 4290
❑ Automatic fire suppression sprinkler systems shall be installed in accordance with the
National Fire Protection Association Standard for installation of sprinkler systems in one
and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized
community water system, with hydrants that meet the Fire Department specifications, serves
the parcel.
❑ Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission
requirements of the California Clean Air Act of 1988, as amended.
❑ Provide an erosion control plan for building and land disturbance on slopes steeper than
30%. The Erosion Control Plan must be prepared by a registered civil engineer or other
qualified professional and be submitted to and approved by the Department of Public
Works.
❑ A plan prepared by a certified arborist, botanist or landscape architect that shows the existing
on-site mature trees, located in any area proposed for buildings and vehicular access, and
provides for methods to protect the trees identified to be preserved, shall be provided to and
approved by the Planning Division prior to the issuance of building permits and/or prior to
grading or vegetation removal. The removal of mature trees shall be minimized, where
possible. A mature tree shall be defined as a tree with a trunk measuring 4 inches in
diameter, 4 feet from ground level. Mature trees removed shall be replaced on a 3 -to -1
ratio, utilizing existing oak tree stock. Each tree to be preserved shall be surrounded by a
circular zone (minimum 40 -foot radius) identified by an orange fence during construction
activities. No vegetation removal, soil disturbance, or other development activities shall
occur within the fenced area.
❑ _Measures shall be taken to control fugitive dust emissions from all driveway and other civil
construction associated with residential development. Approved dust control measures are
found in the fugitive dust control plan for the site approved by the Butte County Air Quality
Management District, a copy of which can be obtained from the Butte County Department
of Development Services, Building Division."
❑ Engineered foundations are required.
❑ Class A roofs are required.
Page 4 of 5
} QV`
0
C
0
Summary of Specific Requirements:
�jDNG—
This information provided in this summary is based on the application information and on the best available data at the time
of review.
CAMy DocumcnM3uilding Permit Site Plan Reviewl.doc
Page 5 of 5
. .....r.W4.r..«..•Y+�.,.,,.. r.ra-t4 i�.•..•n ��wr..w.- --4; �.. r %.a1' 'rZ f°ti�.7•,-�-K�C .moi ` � 3-^,,...rT,��4+,.•.-r+.�.-s,r..+3y-U^„qt +s. -.-•r -•,
BUTTE. COUNTY SCHOOLS;IMPACT FEE CERTIFICATION FORM
(One form per Building)
School District — �i�-c/`� `�'T( Building Department No.
A.P. Number 36— SQ—/0 Jurisdiction: city County
Property Owner L &czo5r— ��Goc rye
Property Location/Address
Subdivision Lot No.
.......................................................................................... ;
Residential Development
No'of Living Mobile Home Addition/ 'Supplemental to
Units Installation Conversion Permit #
i •(No foundation inspection)'
...................................................................................................................
Commercial/Industrial 0
oor rians reviewea ov scnooi uistnct
Sq. Footage 944
(Grorip R)
Sq. Footage
(Including Exterior
Roofed Areas)
Date
District Identification No.
School District certifies that
(Applicant)
(Street Address)
(City)
has complied with the requirements of Resolution No.
representing 10 square feet.
/ 1 G AL41
School District Representative
Paid by Check # Remarks:
(Phone Number)
(State) (Zip
by payment of $ 9m, 'Z6
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 660201a), 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 CertificationForm, 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) feeformAs (10/98)dmm