HomeMy WebLinkAbout079-340-044ri
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HILTON ZI M-M-ON�1226 Mt. Ida Rd
, l
zo,tz�Q 1
,Orov6.0il-fl
e'Permit#6205-80B,P,E,M(new,,S/F)
070. y? -0(/V
PermjtWr3l81P(addl,P2g/6205-80).
PERMIT NO. 6205-8A,P,E,M
PERMIT EXPIRES
OWNER HILTON SIMMONS
CONTR. owner
ASSESSOR PARCEL 36-67-28
LOCATy N 1226 Mt. Ida Rd, lot 3, Oroville
1
9
Temp. Power Pole
Called PG&E
Ai,
Temp. Elec. Service 2 j
Ez
Called PG&E
Temp. Gas Service
Cal led PG&E
JOB FIN�LE (Date)
Signature
J+= OKE
O = Not OK
= Not Applicable MOBILEHOMES
* = Not Ready
MISCELLANEOUS
Date
MOBILEHOME UTILITIES (Plans) OK except N's
1. Zoning Requirements -Setbacks -Easements
Date
DECKS, COVERS, CARPORTS, ETC. (Plans) OK except N's
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support -Sketch
_
2. Footings; Size -Depth -Spacing -Connectors
3. Sewer; Location -Test -Fall -C/O -Concrete
3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails
4. Water; Location -Test -Easement Needed (Sketch)
4. Wood Awn.; Posts-Beams-Rfirs.-Connec.-Shthg.-Rig.-Bracing
5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Gas; Location -Test -Wrap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG
6. Carports; Windows -Doors
7. Utility Clearance
7. Elec.
Card -BI
Date Card -BI Date
Card -BI
Date Card -BI Date
Card -BI
Date
Date Card -BI Date
MOBILEHOME INSTALLATION (Plans) OK except N's
Card -BI
Date
Date Card -BI Date
POOLS (Plans) OK except q's
1, Zoning Requirements -Setbacks -Easements
1. Setbacks -Easements
2. Footings; Size -Spacing -Marriage Line
2. Soils; Compaction -Structure Stability
3. Gas; MH Test -Demand -Valve -Connector
3. Pool Structure; Steel -Connections -Thickness -Dead Men -Lining
4. Electricity; MH Test -Crossovers -Breakers -Clearances
5. Drain; MH Test -Fall -Flex Connector
4. Elec.; Receptacles and Lighting; Distances-GFI
5. Elec.; Pool Lighting; 15 volts-GFI
6. Water; MH Test -Regulator -Connector
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Water and Sewer Connected -C/O to Grade -HD Approval
7. Elec.; Bonding; Metal w/5' -Circulating Equipment -Heater
8, *Gas and Electricity Tagged
8. Elec.; Grounding; Equip. w/5' -Circulating Equip. -Pool Lghtg.
Boxes -Enclosures -Panel boards -Ins. to Main in Conduit
9. Exits; Insp.-Sketch
10, Cert. of Occupancy
9. Health Department Approval
10. Plumb; Cir. Test -Water Supply Test
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
Card B -I
Date Card -BI Date
Card -BI
Date Card -BI Date
fi
t
V = OK
O = Not OK
- = Not Applicable RESIDENTIAL.(Single and Duplex)
= Not Ready
Date
UNDEROOR Plans O exce try's
Date FRAMING Continued
Zo 'ng requirements -Setbacks -Ea ements i
4 roperty Line Firewall & Openings
t ,Main; Soils -St -EI rnd.- / th
4 xt. Doors -One 3' -Check Garage -3rd story, 2 exits
Ftg., Garage; Soils -Steel- 11Z_1- Ftg. Depth
5 airs; Width -Headroom -Rise -Run -Landing -Fire Protection
.4.-.Ftg., Porches & Decks; ils-Steel- / /" Ftg. Depth
Sa f::r ywood on Roof Overhang -Attic Vents -Rafter Outriggers
_
walls, Main; St -Blockouts-Wrapped-Slab
Siding -Nailing -Veneer
temwalls, Garage; Steel-Blockouts-Wrapped- la
-53'rStucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access
7. P• s-Firepla Ftg.-Steel
*- lazing Area -Glass Protection -Skylights -Plastic
D.W.V.: F -Fi gs-T way Sewer t
Shear�Walls; Nail' - Its
71
°,6r-eas Pipe; Size -Anchors
Z
44.—Nater Pipe; Test -Anchors -Regulator -Service Test
11. Electric; Underground
12. Plenums & Ducts; Clearance -Material -Support -Ins.
oc
13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples
Card -BI Date Card -BI Date
Card -BI Date Card -BI Date
Card -BI Date Card -BI Date
Card -BI
Date / 44 Card -BI Date
Date FINAL(Plans) OK except q's
Card -BI Date and -BI Date
Date
P UM G (Permit) OK except p's
. Steps -Door & Sidelight Protection -Landings
57. Smoke Detector
W ter Ht.; Vent -Access -Combustion Air /J
6Purnace; Vents -Clearance -Comb. Air -Connector -
Cr;
✓✓ In Garage; Above Floor-Ducts-Mech. Protection
Water Pipe; Test & Anchors -Nail Protection
V.; Test-Fttngs &Anchors -Nail Protection
Bedroom Exiting
1 Shower Pan; Test, First Floor -Tub Access
• G.F.I. & Bath Fixtures & Tub Access
1 est Tub & Shower, 2nd Floor -Tub Access
Ele . Trim & Subpanel; Breaker Sizes -Labels
38r.6as Pipe; Size & Anchors
tairs & Rails
fireplace or Stove; Clearances -Hearth
6 c. Outlets at Wood Panel; Int. & Ext.
Card -BI
Date t9 Card -BI Date
. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance
Card -BI
Date Card -BI Date
ec. Outlets & Receptacles at Kit. Counter
DateELEC
RICAL Permit OK except q's
garage Fire Door; Swing -Landing -Closer
amp
6 A C. Duct in Garage-Qer
2 Fixture & Transformer Clearance -Ins. Protection
Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- "
-Garage: Above Floor-Mech. Protection
2dlElec. Receptacles Spacing -Lights & Switches at Doors
W. -'Size Boxes & No. of Conductors -Stapled
_11)
0. F,4b., Elec. & Mech. Equip. Listed for Location
Ele Receptacles in Garage; F.I.)-Romex Protec.
omex Installed Close to Edge of Studs & C.J.
24e -Equip. Ground made up w/Mech. Fasteners -Bond Gas &Water
2L,,`25Appliance Circuits in Kitchen &Conductor Size
267. bfeed Wire Size / / ga. Cu or AI-A.C. Wire Size /Ir / ga. CLY or Al
7 u lat ion- Foam- Looked in Attitti c es
Gard Rails & Deck Constr tion -Post Caps
dn. Xerfs & Crawl ��e �DD or -Drain & Woo arth Clearance
ooked under Floor 'Yes
Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or AI,
Insulated Neutral ❑Yes El No
Following instid.: Drive es No; Walks as ❑ No;
Planters Dyes Ifo
8B14ervice-Riser Conductors & Ground -Main Disconnect
i6r6 tucco; Brown -Finish
2G�quip. Clearances; Panels-Motors-Mech. Equip.
A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet
39. --Clothes Closet Light -Shower Light
Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs.
. Water Well; Disconnect, Electrical, Plumbing
Exterior Elec. Trim; G.F.I. Receptacle -Underground
Card B -I
Date /O / Card -BI Date
. Ventilation throughout House
Card B-1
Date Card -BI Date
Sf'iG'fass Protection
Date
MEC ANICAL ermit) OK except q's
W -Correct ions from Previous Inspections
. Gas Test -Meters Tagged; Gas -Electric
A.C. Ducts;(PInsulation & Support
8 ;ter & Sewer Connected -C/O to Grade -HD Approval
Vent Fan; Exhaust above Insulation
BiEr Energy Compliance Certificate -Other Certificates
_
93r Condensate Drain & Overflow; Size & Grade
F_raaes-Vent; Access -Comb. Air -Return r Vent -115V outlet
Vr-Attic Access & Platform if Furnace in Attic
Card -BI Date / and -BI Date
Card -BI
_
_Date
_ /O i Card -BI Date
Card -BI Date Card -BI Date
Card -BI
Date 1 4 Card -BI Date
Card -BI Date Card -BI Date
Comments at Final:
Date FRA ING Plans) OK except q's
211s; Proper Material & Anchors
��,
;irtells; Studs -Nailing, Spacing & Bracing -Plates -Sound
_
A`-BBe_aring Walls over Girders & Floor Nailing
:its Draft Stop in Walls (rat proof)
40 --Fire Stops; Furred Ceilings -Stairs -Chases -Tub
_
4 Hader & Beam -Size & Bearing
4 gers-Post Caps -Anchors -Connectors
4 . gang. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng.
Fireplace Ties or Type A Flue -Fireplace Throat
)' `ttic Access; Size & Romex Protection -Draft Stop -Ins. Baffles
_-
Qf! Qdfm. Windows or Exiting Doors -Sill Hgt. & Dimensions
Garage Fire Protection Framing
(NOTE: Anentry must be made each time you visit job site)
RES IDEM' IAL
ENERGY CONSERVATION STANDARDS
CONSTRUCTION COMPLIANCE CERTIFICATE
THIS IS TO CERTIFY TIIAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN
INSTALLED IN CONFORMANCE WITH CURRENT ENERGY CONSERVATION REGULATIONS
AT Mt Ida Oroville
(location)_
BUILDING PERMIT NO. & 2051 X50 A. P. NO. 7� 6,
THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS:
(Check each item or write N/A if not applicable)
APPROVED WTR. H'rR.
I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED
IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREM�ENTS AND AGREE TO
THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED.
Insulation Applicator Name Hawkins Insulation Co Inc
Signature of �/ (p ease nt)
Insulation Applicato/Z%/o�
General Contractor/Owner
Signature of
General Contractor/Owner
State Cont r tors
Lic s No y/ �
Name
(please print)
Date
State Contractors
License No.
0
THIS CERTIFICATE MUST BE ON FILE WITH THE BU ILD ING DEPARTMENT PRIOR TO
REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION
WITHIN THE DWELLING.
INSULATION:
GLAZING:
Slab Edge NA
Single Glazed
NA
Fdn. Walls NA
>
Special (Insulated)/
NA
Floors —
CERT. .& LABELED WDS.
Walls .. R_31 14M pj �
& SLIDING. DRS. ���
NA
Ceiling/RoofRs� 0
WEATHERSTRIPPED DRS.
NA
Ducts
BACK DAM13ERED FANS
NA
Circulating Pipes NA
INTERMITTENT IGNITION DEVI S
APPROVED 11EATER bAAffl�
CERT. APPLTANCES
NA
APPROVED WTR. H'rR.
I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED
IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREM�ENTS AND AGREE TO
THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED.
Insulation Applicator Name Hawkins Insulation Co Inc
Signature of �/ (p ease nt)
Insulation Applicato/Z%/o�
General Contractor/Owner
Signature of
General Contractor/Owner
State Cont r tors
Lic s No y/ �
Name
(please print)
Date
State Contractors
License No.
0
THIS CERTIFICATE MUST BE ON FILE WITH THE BU ILD ING DEPARTMENT PRIOR TO
REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION
WITHIN THE DWELLING.
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO.
7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 /�/O
APPLICATION AND PERMIT co An v
ASSESSOR PARCEL NUMBE6p
36.-67-28'
ZOIN
AR
BUILDING PERMI
ow E
^
PH
Iy
-O.00
SQ. FT. OCC. BUILDING VALUATION
O ER'S MAILING ADDRESS
.O 'aV L 0 rpvi 1
30s- Cal/
1525-0
CONTRACTOR'S A E TELE HONE
-5-00Mo/OnO
-Q
V
`
CONTRACTOR'S MAILING ADDRESS%
_
Fireplace I�
0 �7
CONSTRUCTION LEND R -
UNKNOWN
Total Valuation $
-ac,
Filing Fee
$ 10.00
LENDER'S MAILING ADDRESS
Permit Fee
$ '97,00
ARCHITECT OR ENGNG NE�
LICENSE No.
Plan Checking Fee
$ 3.50
Penalty
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee
$ 2767,-5-0
BUILDING_ ADDR SS.
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00 A0,00
Repair drainage or vent piping
5.00
Water piping
.5,��
LOT NO. SUBDIVISION NAME
3 S1MMOAJS y
PARCEL MAP
-39
Each qas water heater or vent
5.00
Gas piping system 1 - 5 outlets
USE OF STRUCTURE
SF I_I Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer
Lawn sprinkler system
5.00
TYPE OF WORK
New Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑
Describe work:
Permit Fee
$ 36.00
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 100V OR
00 AMP ORSLESS
5.00 ,00
Main service EA_ ADD'L 100 AMP
2.50 O
NEW CONST. // DWELLING O
OR ADDNS. \ ACCBLDGS.
.
20S ft
q 44. Z
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check One):
E-1 I am licensed under provisions of Chapt. 9, Div. 3 of the Business
and Professions Code and m license is in full force and effect.
y
License No. Classification
❑ I, as the owner, or my employees with wages as their sole compen-
sation'will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONSTR -OUTLET 2.50 ea
NON-RESID BRANCH CIRC TS
NEW -CONSTR (POWER APPARATUS e1
NON RESID. SINGLE OUTLET CIR.
50 ® 250
Ex. OCCUp OUTLETS OR FIXTURES BAL�1
FIXED APPLNS. OR
Ex. Occup.(OUTLETS (RESID.) EA. 2.00
Temporary service
.10.00
Mobile Home Facilities 15.00
Misc. Wiring 7.50
_(�7
Permit Fee $ ,7S
Contractor
MECHANICAL PERMIT
FiIingFee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ 1 have placed on file with the County of Butte Building Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith Comply with such
provisions or this permit shall be deemed revoked.
Heating 00
00
% PUS
Cooling 3T
f�,00
Hood
3.00 3, 00
Ventilation
permit Fee
S 'Z 23'. dp
Contractor
1 certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemn; y and keep harmless the County of Butte against
all liabilities, judgm s, sts, and expenses which may in any way accrue
1.
aggi" t ai ou o quenje of the granting of this pe mit.
1051-50 - Date
Signature of Applicant - Owner ❑ Contractor ❑ Agent
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3�stories in height.
Mobile Home Installation Fee
$
TOTAL PERMIT FEE $
OCCUP GROUP
"�j.,�
^^
TYPE *F•CONST.
V•N�
VV-
PARCEL
PD .%
Y
1590
1✓
This permit is hereby issued under
sions of the Butte County Code and/or
work indicated above for which
DIRECTOR OFPUBLIC
By
PERMIT EXPIRES Date
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date �—
�— '�
Receipt No. 7si�
WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT
Telephone
583-2000
North Burbank Public Utility District
1960 Elgin Street
OROVILL'E, CALIFORNIA 95965 26680
DISTRICT APPROVAL AND
VERIFICATION OF INSPECTION
BUILDING SEWERS
This verification form must be submitted to the Butte County Department of
Public Works - Building Department prior to issuance of a building or occupancy
permit, whichever is applicable.
Prior to final approval by Butte County of a Building or an Occupancy Permit, a
copy of this verification form, signed off by North Burbank Public Utility District,
must be submitted to Butte County.
Applicant:
HILTON E. SIMMONS
Applicant Address: P. 0. BOX 2466, OROVILLE. CA 95965
Applicant Phone No.: 589-0418
Property Location (s): 1226 MT IDA ROAD
SIMMONS SUBDIVISION UNIT 2, LOT 3
A. P. No. (s): 036-67-0-028-0
Fees Paid: ALL FEES UNPAID AS OF 12124/80
M
Application for service approved:
DECEMBER 24, 1980
N16rth Burbank
Public Utility District
Inspection(s) made and successful test(s) observed:
Location:
A
Date:
North Burbank Public Utility District release to close permit:
Date: By:
' Telephone
�j•1.. C ,., ♦ ♦ --. , 533-2000
North Burbank Public Utility District
1960 Elgin Street
OROVILLE, CALIFORNIA 95965 266080
DISTRICT APPROVAL AND
VERIFICATION OF INSPECTION
BUILDING SEWERS
This verification form must be submitted to the Butte County Department of
Public Works - Building Department prior to issuance of a building or occupancy
permit, whichever is applicable.
Prior to final approval by Butte County of a Building or an Occupancy Permit, a
copy of this verification form, signed off by North Burbank Public Utility District,
must be submitted to Butte County.
Applicant: HILTON E. SIMMONS
Applicant Address: P^ 0. BOX 2466 QROVT7 3.P� CA or%QAS
Applicant Phone No.: 589-0418
Property Location (s): 1226 MT. TDA ROM),
A. P. No. (s):
Fees Paid:
SIMMONS SUBDIVISION UNIT 2. LOT 3
036-67-0-028-0
Application for service approved:
DECEMBER 24, 1980 j North Burbank r
Public Utility District
w 1
Inspection(s) made and successful test(s) observed:
Location: r3 2��.�i7�� Date: 49t
By:�
North Burbank Public Utility District release to close permit:
Date: 3- r�--8'/ By: a
JCOUNTY OF BUTTE - DEPARMENT OF PUBLIC WORKS PERMIT O.
7 County Center Drive - Oroville, Ckjiforna 95965 - Telephone 916/534-4541
APPLICATION AND PERMIT
ESS R P R L NUM ZO ING
L
BUILDING PERMIT
TELEPHONE
-r)
IIS
SQ. FT. OCC. BUILDING VALUATION
OW R'S MA LI G ADORES
CON'TRACTOR'S N E
1A SIT—
TELEPHONE
I
,
CONTRACTOR'S MAILING ADDRESS
Fireplace
CONSTRUCTION LENDER
UNKNOWN
Total Valuation is
Filing Fee $ 10.00
LENDER'S MAILING ADDRESS -
•
.Permit Fee $
ARCHITECT OR ENGINEER.LICENSE
oy
NO.
Plan Checking Fee $
Penalty $
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Permit fee $
BUILDING,A RESS
PLUMBING PERMIT Filing Fee 10.00
Each Trap 2.00 Q
Repair drainage or vent piping 5.00
Water piping
LOT NO.
SUBDIVISION NAME
PARCEL MAP
Each qas water heater or vent 5.00 '
Gas piping system 1 - 5 outlets
—� USE OF STRUCTURE
SF IBJ Duplex❑ Mobilehome❑ Other
SPECIFY
Building sewer
Lawn sprinkler system 5.00
TYPE OF WORK
New ❑ Additiemodel ❑ Utilities ❑ Installa ' n❑ Other
Describe work: on IU
Permit Fee $ , ID
Contractor
ELECTRICAL PERMIT Filing Fee 10.00
Main service 6001 OR LESS 5.00
100 AMP OR LESS
�. Iwo a
aA.nA
Main service EA. ADD'L 100 AMP 2.50
NEW CONST. DWELLING OCCUP.y) 20 sq ft
OR ADDNS. ACC. BLDGS.
CONTRACTORS LICENSE LAW
I declare under penalty of perjury (check one):
❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business,
and Professions Code and my license is in full force and effect.
License No. Classification
❑ I, as the owner, or my employees with wages• as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONSTR -OUTLET 2.50 ea
NON-RESID BRANCH CIRCUITS)
NEW CONSTR.POWER APPARATUS S
NON-RESID. (SINGLE OUTLET CIR.
Ex. Occup OUTLETS OR FIXTURES 150L@;
FIXED APP LHS. OR
Ex. Occup.(OUTLETS (RESID.) EA. 2.00
Temporary service 10.00
Mobile Home Facilities 15.00
Misc. Wiring 7.50
Permit Fee $
Contractor
MECHANICAL PERMIT FiIirig Fee 10.00
WORKMEN'S COMPENSATION INSURANCE
I declare under penalty of perjury (check one):
❑ The permit is for $100.00 (valuation) or less.
❑ I have placed on file with the County of Butte Building. Department
a Certificate of Workmen's Compensation Insurance or a Certificate
of Consent to Self -Insure.
I shall not employ any person in any manner so as to beccme subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Heating
Cooling
Hood 3.00
Ventilation
Permit Fee S
Contractor
1 certify that I have read this application and state that the above information
is correct. I agree to comply to all County Ordinances and State Laws relating
to building construction, and hereby authorize representatives of the County of
Butte to enter upon the above-mentioned property for inspection purposes.
I also agree to save, indemn' y and keep harmless.the County of Butte against
all liabilities, jud osts, and expenses which may in any way accrue
ars a'. ount mi e�quencA of the granting of this pe L
X DateZZ-
Signature of Applicant — Owner ElContractor EJAgentork
An •OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 s ories in height.
Mobile Home Installation Fee $
TOTAL PERMIT FEE $ Lt, DO
OCCUP. GROUP
TYPE OF CONST.
F,
PARCEL
PD
HD
ISSUE
This ermit is hereby issued under the applicable provi-
s' ns of the Butte County Code and/or resolutions to do
indicated above for which fees have been paid.
B ECTOR OF PUBLIC WORKS
Date
—'
PERMIT EXPIRES Date
Receipt No. q3 5
WHITE-D.P.W.. YELLOW-ASSESSOR.PINK-INSPECTOR. GOLDENROD -APPLICANT
RES IDENT IAL
ENERGY CONSERVATION STANDARDS
CONSTRUCTION COMPLIANCE CERTIFICATE
THIS IS TO CERTIFY THAT ENERGY CONSERVATION REQUIREMENTS HAVE BEEN
INSTALLED IN CONFORMANCE WITH CURRENT, ENERGY CONSERVATION REGULATIONS
(loc tion)
BUILDING PERMIT NO. o os — yo
A P. NO. 3(0 —e,7—Z0'
THE FOLLOWING HAVE BEEN INSTALLED AS PER APPROVED PLANS:
(Check each item or write N/A if not applicable)
INSULATION:
Slab Edge
Fdn. Walls
Floors
Mails — S
Ceiling/Roof
Ducts
Circulating Pipes
APPROVED HEATER
APPROVED WTR.HTR.
GLAZING:
Single Glazed
Special (Insulated) —
CERT. & LABELED WDS.
& SLIDING DRS.
WEATHERSTRIPPED DRS.
BACK DAMPERED FANS _
INTERMITTENT IGNITION DEVICES —
CERT. APPLIANCES
I DECLARE THAT ALL REQUIRED ITEMS AS NOTED ABOVE HAVE BEEN INSTALLED
IN ACCORDANCE WITH THE ENERGY CONSERVATION REQUIREMENTS AND AGREE TO
THE COMPLETENESS OF THIS CERTIFICATE AS SUBMITTED.
Insulation Applicator Name
Signature of (please print)
Insulation Applicator
State Contractors
TArPn.QP Nn_
� General Contractorh
Signature of
General Contractor/
License No.
THIS CERT IF ICATE MUST BE ON FILE WITH THE BU ILD ING DEPARTMENT PRIOR TO
REQUESTING FINAL INSPECTION AND SHALL BE POSTED IN A CONSPICUOUS LOCATION SFr/
WITHIN THE DWELLING.
1
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