Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
Home
My WebLink
About
079-370-055
� l RENA BOWMAN DPP!— -5 `O 0 SS y 55 Shelterwood Lane, Oroville 4 Permit#2795-89P,E(util, MH) temp 't EL. EC .- GAS SUPPORT STRUCTURE REQ.r— COMPACTION TEST REQ. y 3279-90B,P,E,M BOWMAN, Rena 165 Shelterwood Ln, Oroville Contr: Best Line Builders ( new sf ) -a d -qui B07-2008 079-370-055 MISCELLANEOUS LPG Tank (AbvGrnd) r NEW PROPANE TANK & HVAC 165 SHELTERWOOD LN FREGOSO FRANK F & BO, B08-0009' 079-370-055 MISCELLANEOUS Ag Exempt AG EXEMPT BUILDING 50X 100' FOR 165 SHELTERWOOD LN. FREGOSO FRANK ,F'& BO, MISCELLANEOUS Fireplace/Wood Stove INSTALL WOOO)3URNING STOVE 165 SHELTERWOOD LN FREGOSO FRANIC F & BONNIE 15 G L ®i �a ^. ="$I �� BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES AGRICULTURAL BUILDING EXEMPTION 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 PROJECT INFORMATION Site Address: 165 SHELTERWOOD LN Owner: permit No: B08-0009 APN:079-370-055 FREGOSO FRANK F & BO, Permit type: MISCELLANEOUS 165 SHELTERWOOD LN Issued Date: 12/17/2008 By KEJ Subtype: Ag Exempt OROVILLE, CA 95966 Expiration Date: Description: AG EXEMPT BUILDING 50X100' F( (530) 589-4165 Occupancy: Zoning: AR5 Contractor Applicant: Square Footage: FREGOSO FRANK F & BO, Building Garage Remdl/Addn 165 SHELTERWOOD LN OROVILLE, CA 95966 Other Porch/Patio Total (530)589-4165 FEE INFORMATION DBEH Building Review Fee $75.70 DBOMSCF Ag Exemption Permit $115.98 a Total Charged: $191.68 Fees Paid: $191.68 Balance Due: $0:00 Receipt No: B5967 ' LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that Ila exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter 9 also requires the applicant for such permit to file a signed statement that he or she is licensed (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects X 12/17/2008 the applicant to a civil penalty of not more than five hundred dollars [$500]; Contractor's Signature Date Please check one of the following: I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE WORKERS' COMPENSATION DECLARATION PL COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractor's License I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: Law does not apply to an owner of the property, who builds or improves thereon, and who does the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building'or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for th year of completion, the owner builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED / I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: Section 3700 of the Labor'Code, for the performance of the work for which this permit is issued. The Contractor's License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractor's License Law.). Carrier. Policy Number. Exp. Date: (This section nee not a competed if the permit is or one hundred dollars (s100) or ess. I ❑IAMEXEMPT under Section B. 8 P.C. for this reason: [`�lV I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS WL4SSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation laws of California, agree that if I should become subject to the workers' X 12/17/2008 comp anon provisions of Se on 700 of the Labor Code, I shall forthwith comply with those Prov' io Owners g e Date � X - L 12/17/2008 1 hereby certify that I have read this application and slate that the above information is correct. 1 agree i natufe Date to comply with all City and County ordinances, rules, regulations, and State laws relating to building WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CML FINES UP TO ONE Butte County, its officers, agents and employees from any and all claims and liability for personal injury, including death, and properly damage caused by, arising out of, or in any way connected with HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupanc o ny sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to r a ova mentioned property for inspection purposes. 1 hereby certify that 1 am the CONSTRUCTION LENDING AGENCY t property or m uthorized to act on the property owner's behalf. - E-YL?~;ntiL 9C4_W 12/17/2008 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Pe i ee [SI N] Print Date the performance of the work for which this permit is issued. (3097 civ. code) 91 Owner F� Contractor OR; Agent for Owner Agent for Contractor Lender's Address City State Zip FILE COPY 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 AGRICULTURAL BUILDING EXEMPTION STATEMENT Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm implements, hay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of human habitation or a place of employment where agricultural products are processed, treated or packaged, nor shall it be a place used by the public. Buildings used for purposes other than described above or that are located in a flood hazard zone are not eligible for an agricultural exemption. Authorization of an agricultural exemption permit by the Department of Development Services does not preclude any requirements and/or review by the Butte County Public Works Department, Butte County Fire Department, Butte County Environmental Health, or any state and federal agencies. Initials AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. -Initials AG Buildings less than 1000 sq. ft. in floor area shall be located a minimum of 6 feet from a residence, 10 feet from a manufactured home, and 23 feet from a commercial/industrial buildings Initials AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum 23 feet from a �—� residence and a manufactured home, and 40 feet from a commercial/industrial buildings Site Address: 165 SHELTERWOOD LN Permit No: B08-0009 APN: 079-370-055 Square Footage: 0 Permit Type: MISCELLANEOUS Occupancy: Permit Subtype: Ag Exempt Zoning: AR5 Description: AG EXEMPT BUILDING 50X100' FOR LIVI Required Setbacks: Applicant: FREGOSO FRANK F & BO, Front: Side: 20' Rear: 20' 165 SHELTERWOOD LN Type of Construction: OROVILLECA95966 (530) 589-4165 Type of Siding: T-111 Owner: FREGOSO FRANK F & BO, Est. Const. Cost: $ 8,500.00 165 SHELTERWOOD LN OROVILLE, CA 95966 Roof Covering: Compostion (530) 589-4165 Floor Type: Roadbase I declare under penalty of perjury that the building will be used as stated above, and the proposed use conforms with the AG Building definition. If any change in use or occupancy of the building is made, I will contact the Building Division and obtain the necessary permits, inspections and approvals to comply with the requirements in effe t at time and prior to occupancy. Signature of owner: Date: 01/03/2008 FILE COPY BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION" OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 '�+: — A FEE WILL BE REQUIRED AT TIME OF APPLICA TION Website: www.buffecounty.net/dds CDU 0-K PLEASE PRINT CLEARLY "When filed, this application and all supporting material becomes subject to the California Public Records Act. All related to this application is subject to public inspection and will be posted on the County's website for electronic access. OWNER INFORMATION Last Name .� 1 -RC -6050 First Name F MY— Mailing Address 1 b5 S'N�Z.TEt2ub ZEN City ©kytL state zip Gf 5966 Phone 55q - Ii / b 5 Fax SSM 1= E-mail SSYCSO 6W1A L zCOA^- CONTRACTOR Name Address City State Zip Phone Fax E-mail Lic. # Class APPLICAN IGNATURE Ix BIN # PROJECT LOCATION AP# o - 310 -- 055 Property Address 1,65- S,4EL I r= Q b L�bu City 0>26v12i_F WORKER'S COMPENSATION Policy Number NA - Carrier 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 NA. Address DESCRIPTION OR SCOPE OF WORK: ,4LsP_SGvL,T-vt?a [r BUZLDjA1&- 5T0124-e—i9- A -Y Ug<OJes ZM [.1=7MeAJ_r Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office u e ARCHITECT/ENGINEER Name A' Address �AJOnO v4A'V- City Z� State Zip Phone S g, 6 Fax E-mail y S7 �(OSb @i State License Number APPLICAN IGNATURE Ix BIN # PROJECT LOCATION AP# o - 310 -- 055 Property Address 1,65- S,4EL I r= Q b L�bu City 0>26v12i_F WORKER'S COMPENSATION Policy Number NA - Carrier 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 NA. Address DESCRIPTION OR SCOPE OF WORK: ,4LsP_SGvL,T-vt?a [r BUZLDjA1&- 5T0124-e—i9- A -Y Ug<OJes ZM [.1=7MeAJ_r Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office u e APPLICANT INFORMATION Name 1:7 - NF— Address �AJOnO v4A'V- City Z� Stated zp 9W61 Phone S g, 6 Fax SAr-1 er- E-mail y S7 �(OSb @i APPLICAN IGNATURE Ix BIN # PROJECT LOCATION AP# o - 310 -- 055 Property Address 1,65- S,4EL I r= Q b L�bu City 0>26v12i_F WORKER'S COMPENSATION Policy Number NA - Carrier 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 NA. Address DESCRIPTION OR SCOPE OF WORK: ,4LsP_SGvL,T-vt?a [r BUZLDjA1&- 5T0124-e—i9- A -Y Ug<OJes ZM [.1=7MeAJ_r Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office u e Zoning Flood Zone SRA Yes No Occ. Type Const. 0 Y - C C) YY roa�h 4 Butte County Department of Public Works J. MICHAEL CRUMP, DIRECTOR LAND DEVELOPMENT DIVISION Storm Water Managment Program 7 County Center Drive Oroville, CA 95965 (530) 538-7266 Telephone (530) 538-7171 Fax www.buttecounty.net/dds C psi S trc wvp'"� National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgment [LESS THAN 1 ACRE 1 J Reference Number: B08-0009 Date: 1/3/2008 Location: 165 SHELTERWOOD LN By: GLB Parcel Number: 079-370-055 Sub Type: A2 Exempt Owner Name: FREGOSO FRANK F & BO, Phone: (530) 589-4165 Description: AG EXEMPT BUILDING 50X100' FOR LIVESTOCK AND EQUIPMENT By signing below, I the project owner/owners' agent, certify that this project WILL NOT DISTURB 1 acre or more of land and that I therefore, do not need to apply for a Construction. Storm Water Permit from the State of California Regional Water Quality Control Board. Phased projects that contain multiple site buildouts of less than one acre but when combined with subsequent phases total more than one acre of disturbed soil will require a Construction Storm Water Permit from the state of California Regional Water Quality Board. I am aware that submitting false and/or inaccurate information or failure to apply for a Construction Storm Water Permit from the State of California Regional Water Quality Control Board for this project that disturbes one acre or more of land may result in revocation of grading and/or other permits or other santions provided by law. Signed: Title: FILE Date: 1/3/2008 Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds NOTICE TO BUILDERS Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental Health, and the California Department of Forestry for their clearances and approvals. There are some things you can do to expedite your permit: 0 Make sure your application is complete. 0 Be responsive to requests from County departments for any additional materials or requirements. The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes without a complete application adds to processing time. Every permit issued by the Building Official shall expire and become null and void if the work authorized by such permit is not started or completed within one year from the date of issuance of such permit. A permit may be renewed (for a fee) prior to expiration an indefinite number of times, provided construction progress has been documented by the Building Division during each year during scheduled inspections. No changes may be made in the original plans and specifications for such work. In order to reinstate action on a permit after expiration, the permittee shall pay a new full permit fee and additional plan checking and documentation may be required. Upon completion of work covered by this permit, please contact this office for final inspection. As a reminder to you, it is illegal to occupy this building or any portion of the building for which this permit is issued without a final inspection. EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY** Application for which a permit has not been issued will expire one year after date of application. Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications (not yet issued) must be requested within two years from the date of fee payment. Fees paid at the time of application are for Plan Check and administration. The Plan Check portion of fees is refundable only if the permit is cancelled or withdrawn before any plan checking is done. Building Division costs will be deducted prior to authorizing a refund and a charge of $54.99 to process the refund application will be assessed. Refunds on permits (issued) may be requested prior to the expiration of the permit, provided no work has been done pursuant to the permit. An Inspection may be required (and deducted from any refund amount) to determine no work was done. Fee/refund information can be read on-line at http://municit)alcodes.lexisnexis.com/codes/butteco/ "When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. Reference Number: B08-0009 Location: 165 SHELTERWOOD LN Parcel Number: 079-370-055 Owner Name: FREGOSO FRANK F & BO, Date: 1/3/2008 Phone: (530) 589-4165 Description: AG EXEMPT BUILDING 50X100' FOR LIVESTOCK AND EQUIPMENT Signature of Applicant: Date: 1/3/2008 FILE A&WEO ASC.4r--'°°� ljb� RVZOsals P NING DIVISION - UILDING; N APP OVAL s : Date. Prking: andscaping: Qther: � / ignature: � wEta. Z;�CL-St�N6 QE�OBIGE r Z So SSL TIC p6t 56 FRAN k :P)2 f: GoG p {tP o -7q - 3TO -o ss �i�. 589- ylbS I6 5 51{ E 6i E�.wbOD l�N�" 0P0VrtiF, C4, 9 5°I 6,6 BUTTE COUNTY NN 0.1 200 SERVICES N Irs- BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION (IVR): (530) 538-4365 OFFICE: (530) 538-7541 FAX#: (530) 538-2140 ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 165 SHELTERWOOD LN Owner: Permit No: B08-1703 APN: 079-370-055 FREGOSO FRANK F & BONNIE Issued Date: 08/20/2008 By TMP Permit type: MISCELLANEOUS 165 SHELTERWOOD LN Subtype: Fireplace/Wood Stove OROVILLE, CA 95966 Expiration Date: 08/20/2009 Description: INSTALL WOOD BURNING STOVF (530) 589-4165 Occupancy: Zoning: AR5 Contractor Applicant: Square Footage: FREGOSO FRANK F & BONN Building Garage Remdl/Addn 165 SHELTERWOOD LN ' OROVILLE, CA 95966 Other Porch/Patio Total (530)589-4165 FEE INFORMATION DBMSC Fireplace Pre-fab/Metal $119.00 Total Charged: $119.00 Fees Paid: $119.00 Balance Due: $0.00 Receipt No: B8333 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, , also requires the applicant for such permit to file a signed statement that he or she is licensed 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 pursuant to the provisions of the Contractors License Law [Chapter 9 (commencing with Section 7000) is in full force and effect. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects X 08/20/2008 the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: Contractors Signature Date I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE LLYY COMPENSATION, WILL DO THE WORK AND THE STRUCTURE IS NOT INTENDED OR r WORKERS' COMPENSATION DECLARATION OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of the property, who builds or improves thereon, and who does I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code: Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractors License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Contractors License Law.). Carrier: Policy Number: Exp. Date: (This section nee not a completed if the permit is or on�ndreed dollars ($100) or est s.) ❑ I AM EXEMPT under Section B. 8 P.C. for this reason: 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 the Workers' Compensation Laws of California, and agree that if I should become subject to the workers' X �)�/20/2008 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those Owners Signature Date Prov ions.I X 08/20/2008 I hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Signature Date WARNING: FAILURE TO SECURE WORKERS' CO PENSATION COVERAGE IS UNLAWFUL, WARNING: FAILURE TO SECURE WORKERS'CO)PENSATION COVERAGE IS UNLAWFUL,Butte construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, injury, including death, and property damage caused by, arising out of, or in any way connected with DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the Prof owner or arQauthorize act on the property owners behalf. CONSTRUCTION LENDING AGENCY `� 08/20/2008 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Permittee [SIGN) Prin Date the performance of the work for which this permit is issued. (3097 civ. code) Owner Contractor OR; ElAgent for Owner Agent for Contractor FILE COPY Lenders Address City State Zip BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION" OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OFAPPLICA TION Website: www.buttecounty.net/dds PLEASE PRINT CLEARLY PERMIT NO. Ir i BIN # "When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. OWNER INFORMATION Last Name n .� o S L 1` F' t Name . 90AnIR, Mailing Address Sh 1 -� (1 L4 V City O� 1 � State e fl Zip G� �1 Phone ) lv Fax S.3D _ I -(( lam E-mail C� i X 0 S 0L+ Co ® M OL. APPLICANT INFORMATION CONTRACTOR Name City 0P -)D J ; I Address Zip 9,;� City Fax 5,30_ _rq4, _ 4 I le State Zip Phone Fax E-mail State License Number Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City 0P -)D J ; I Address Zip 9,;� City Fax 5,30_ _rq4, _ 4 I le State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name 60 0 n `ler --FC-e_D S O Address llo S LN 1 `K City 0P -)D J ; I State cp, Zip 9,;� Phone S�d�— Fax 5,30_ _rq4, _ 4 I le E-mail S �oC pS O ® �. � >✓ -C-Orn APPLICANT SIGNATURE X -� PROJECT LOCATION API - 3:Z0 - D Property Address ( 1a S C-(\) City 0 RO U i ) 1'e, t= A 5 -el Le Lp WORKER'S COMPENSATION Policy Number Carrier If hiring anyone other than licensed 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: ='ros4-c4 I I Wooe kr ' h s+�\j Z Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning r Flood Zone SRA I Yes I No Occ. Type Const. Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. ° If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal ° income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. 1. I PERSONALLY PLAN TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY IMPROVEMENT(YE OR NO) 2. I HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. 3. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: NAME Off/ %a ADDRESS CITY PHONE CONTRACTORS LICENSE NO 4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WQ NAME ff VV ADDRESS ICITY PHONE CONTRACTORS LICENSE NO 5. I WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED: NAME i / �. / ADDRESS PHONE TYPF. OF WORK _ Description: INSTALL WOOD BURNING STOVE Reference Number: B08-1703 Applicant Name: FREGOSO FRANK F & BONNIE Owner's Name: FREGOSO FRANK F & BONNIE AP ; Signature of Property Owner: w Date :079-370-055 D o� 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 PROJECT INFORMATION Site Address: 165 SHELTERWOOD LN Owner: Permit No: B07-2008 APN: 079-370-055 FREGOSO FRANK F & BO, Issued Date: 9/24/2007 By AAM Permit type: MISCELLANEOUS 165 SHELTERWOOD LN Subtype: LPG Tank (AbvGrnd) OROVILLE, CA 95966 Expiration Date: 9/23/2008 Description: NEW PROPANE TANK & HVAC (530) 589-4165 Occupancy: Zoning: AR5 Contractor Applicant: Square Footage: MC CLELLAND AIR CONDITIONING I FREGOSO FRANK F & BO, Building Garage Remdl/Addn 801 MARAUDER STREET 165 SHELTERWOOD LN CHICO, CA 95973 OROVILLE, CA 95966 Other Porch/Patio Total (530)891-6202 (530)589-4165 FEE INFORMATION DBM Heat Pump (Package Unit) $58.00 DBP Gas System (enter outlets) $58.00 Total Charged: $116.00 Fees Paid: $116.00 Balance Due: $0.00 Receipt No: B4729 LICENSED- CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License MC CLELLAND AIR CONDITIOI 345121 / C20 / 1/31/2008 Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed 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 pursuant to the provisions of the Contractors License Law (Chapter 9 (commencing with Section 7000) is in full force and effect. of Division 3 of the Business and Professions Code] or that he or she is exempt therefrom and the X basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil of not more than five hundred dollars 9/24/2007 penalty [$500]; Please check one of the following: Contractor's Signature Date 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 License Law does not apply to an owner of the property, who builds or improves thereon, and who does WORKERS' COMPENSATION DECLARATION 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: HAVE AND the work himself or herself or through his or her own employees, provided that such improvements ❑I WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). 11I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by Section 3700 ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Provessions Code: of the Labor Code, for the performance of the work for which this permit is issued. My Workers' Compensation insurance carrier and policy number are; The Contractors License Law dows not apply to an owner of the property who builds or improves thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Carrier: State Fund Policy Number: 272-0000642 Exp. Date:10/112007 Contractors License Law.). (This section need not be competed if the permit is for one undred dollars ($100) or ess. ❑IAM EXEMPT under Section B. 8 P.C. for this reason: CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS 44 ISSUED, I shall not employ any person in any manner so as to become subject to the Workers' Compensation laws of California, and agree that if I should become subject to the workers' X 9/24/2007 compensati ons of Section 3700 of the Labor Code, I shall forthwith comply with those � wners Si re Date provision . 9/24/2007 hereby certify that I have read this application and state that the above information is correct. I agree to comply with all City and County ordinances, rules, regulations, and State laws relating to building Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte County, its officers, agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, injury, including death, and property damage caused arising out of, in any way connected with DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND the issuance of this permit. I hereby acknowledge thatt is issuance of this pea rmit does not authorize the use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter the above mentioned property for inspection purposes. I hereby certify that I am the property owner or am authorized to act on the property owners behalf. 9/24/2007 CONSTRUCTION LENDING AGENCY 1 HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name Of Permittee [SIGN] Print Date the performance of the work for which this permit is issued. (3097 civ. code) Owner1-1 Contractor OR; DAgent for Owner Agent for Contractor FILE COPY Lenders Address City State Zip Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds OWNER -BUILDER INFORMATION An application for a building permit has been submitted in your name listing yourself as the builder of the property improvements specified. For your protection you should be aware that as "owner -builder" you are the responsible party of record on such a permit. Building permits are not required to be signed by property owners unless they are personally performing their own work. If your work is being performed by someone other than yourself, you may protect yourself from possible liability if that person applies for the proper permit in his or her name. Contractors are required by law to be licensed and bonded by the State of California and to have a business license from the city or county. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own work, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and protection: ° If you employ or otherwise engage any persons other than your immediate family, and the work (including materials and other costs) is $500 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. C If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal n income tax withholding, federal social security taxes, workers/ compensation insurance, disability insurance costs, and unemployment compensation contributions. There may be financial risks to you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. ° For more specific information about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U.S. Small business Administration). For more specific information about your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through thier own employees, without a license contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractor is to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board's automated telephone information system at 1-800-321 -CLSB (2752) or by accessing thier website at www.CSLB.ca.gov. PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER -BUILDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED UNTILL THE VERIFICATION IS RETURNED. OWNER BUILDER VERIFICATION PLEASE COMPLETE THIS FORM AS REQUIRED BY THE STATE OF CALIFORNIA (SENATE BILL NO. 831 EFFECTIVE JULY 1, 1980). NO BUILDING PERMIT WILL BE ISSUED UNTIL THIS VERIFICATION IS RECEIVED. I PERSONALLY PLO TO PROVIDE THE MAJOR LABOR AND MATERIALS FOR CONSTRUCTION OF THE PROPOSED PROPERTY �� IMPROVEMENT. OR NO) 2. / 4(9/HAVE NOT) SIGNED AN APPLICATION FOR A BUILDING PERMIT FOR THE PROPOSED WORK. 3. I HAVE CONTRACTED WITH THE FOLLOWING PERSON (FIRM) TO PROVIDE THE PROPOSED CONSTRUCTION: ADDRESS CITY PHONE CONTRACTORS LICENSE NO 4. I PLAN TO PROVIDE PORTIONS OF THE WORK, BUT I HAVE HIRED THE FOLLOWING PERSON TO COORDINATE, SUPERVISE, AND PROVIDE THE MAJOR WORK: NAME ADDRESS CITY PHONE CONTRACTORS LICENSE NO 5. 1 WILL PROVIDE SOME OF THE WORK BUT I HAVE CONTRACTED (HIRED) THE FOLLOWING PERSONS TO PROVIDE THE WORK INDICATED: NAME ADDRESS PHONE TYPE OF WORK Description: NEW PROPANE TANK & HVAC Reference Number: B07-2008 Applicant Name: FREGOSO FRANK F & BO, Owner's Name: FREGOSO F & BO, AP # Signature of Property Owner: Date: X P vX - 079-370-055 6q yo BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIJUE OF APPLICATION Website: www.buttecounty.net/dds **PLEASE PRINT CLEARLY** OWNER INFORMATION Last Name -HZ1e 3O`J0 First Name F_VZA1jV_ I Mailing AddressLA r�►� I �S S r► -G i.T'� tz_W o� O City D(20vI-LLE State 6A Zip gS�16b Phone Fax AAMC E-mail CONTRACTOR Name M C ti*- s: LAN n Aq�g- Address City State Zip Phone Fax E-mail Lic. # Class APPLICANT INFORMATION ARCHITECT/ENGINEER Name City 0C0Vj1tL19_ Address Zip City Fax es State Zip Phone Fax E-mail State License Number APPLICANT INFORMATION Name Address � I{ -f✓ r✓-i�(�ytJO(�� 1.�+� City 0C0Vj1tL19_ State C -A Zip Phone�_3 O �� t Fax es E-mail APPLICANT SIGNATURE P PERMIT NO. m _ a0y BIN # PROJECT LOCATION AP# d ' U -0 SG Property Address 9 S � LT 12wOGLD Z.. A-'JlE— City (y2c�V�L2 E WORKER'S COMPENSATION Policy Number Carrier 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: TALL 9120P,4r_� Flood!ETy—peConst. SRA Yes No Occ. Sq FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): CQ For office use only: Zoning Flood!ETy—peConst. SRA Yes No Occ. 36-23-55 3279-90B,'P; E,M_ -. x BOWMAN, Rena Y 165 ShelterwoodfLn, Oroville Contr: Best Line Builders (new sf) I a. F `o Y; 'i F I if T OFFICE COPY Address I } I GAS Meter By Date, a ELECTRICA, Da WQ-3 2) Meter By 'j JOB FINALED ,r Signatur vl=.7 It CT _ A61' OW Not Not Readyable MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete.- - Amp -Concrete._ , 6: Gas; Location -Test -Wrap: / /%"ft. f / /"Nat. or/ /,:'L"ft./ P'LPG 7. 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 -Fell -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch f 10. Cert. of Occupancy Cate 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 i + 13. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Coonectors Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distances-GFI 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures-Pane Iboards- Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, OroviIle— Phone: 538-7541 747 Elliott Road, Paradise — Phone: 872-6307 CORRECTION NOTICE �)dw ER A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. ) Ped V / 01E W I,/ Date V Inspec Owner ROOF MATERIAL THICKNESS ENERGY Permit No. CERTIFICATION r DESCRIPTION OF INSULATION BRAND NAME THERMAL RES. 4 EXTERIOR WALL MATERIAL F.BERGLASS BRAND NAME 6ERTAINTEED THICKNESS THERMAL RES. 141 CEILING BATT OR BLANKET TYPE BRAN'�..,NAME CERTAINTEED THICKNESS THERL,RES. LOOSE FILLTYPE INSUL-SAFE IIIBRAND NAME` CYZTAINTEED THICKNESS, LZ THERMAL RES.. — 3 Z FLOOR,ELEVATED MATERIAL FIBERGLASS THICKNESS FLOOR, SLAB MATERIAL THICKNESS WIDTH FOUNDATION WALL MATERIAL THICKNESS BRAND NAME CERTAINTEED. THERMAL RES. BRAND-NAME THERMAL RES. BRAND NAME THERMAL RES. I HEREBY CERTIFY THAT THE ABOVE INSULATION WAS INSTALLED IN THE ABOVE BUILDING IN CONFORMANCE WITH THE STATE OF CALIF. ENERGY REQUIREMENTS. SHASTA INSULATION INC. #530235 FIRM NAMEIOWNYLR STATE CONTR. LICENSE NO. I hereby cer.tify the above insulation and all required items as shown on the Building Depart. approved. plans. andattachments have been installed as required by the State of California Energy Requirements. All equipment, devices and materials are of the quality prescribed or are specifically approved by the State of Calif. Sasf _L_t'oe. '&�-----Ste_ l� /'k)G. ------------ -- �5_�------- FIRM NAME/OWNER (PLEASE PRINT) STATE CONTRACTOR'S LICENSE NO'. SIGN URE OF GENERAL CONTRACTOR/OWNER DATE This certificate must be on file with the BUILDING DEPARTMENT prior to final inspection approval and a copy shall be posted.within the. building. JANUARY. 1984 %%Itt Is two. I ITt ITE OF s = C 0 0. R M A N C41 4S/6NED MA NUFA C TURER I-IEREB Y CER TIFIES ified below and on attached sheets No:,_. are marked irk of the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION (AITC) �', d in conformance with applicable provisions of American National Standard 1983, Structural Glued Laminated Timber, and that such manufacture V a u ghrL.__ft=a.tL__ ........_ . ,which plant has a quality control system . ;.= . ction Bureau of .the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION Ily by such Bureau, The manufacture of these members complies with the manufacturing and fabricating provisions of Chapter 25 of the Uniform Building Code. P-roof loaded end joints, .J09NAMr JOU LOCATION 165 Shelterwood SAC 52914 16/90 54-4473 CUST(WGA'YORDER NO _.._ •.__._.._ OATS - /. __......._ _.._ MfOR'S ORDER NO.._...._.._-........_..__..—.�—._..-.._..__ - ;;-__ 24F-V4 ���� BohIe miaInc. i1GNAiURE —� /-......_...----. _.r...._._ CUMVANY _. _1_.__..._ .._r.. Clair ..,- L. Pittman Su�ervi sr Vau hn Oregon ,_.•oATe 4/13Z90 WWI ' AI TC HERE13 Y CERTIF/RS that the said company at its said plant is licensed by the . '1 AMERfCAN INSTITUTE OF TIMBER CONSTRUCTION to use the AITC Collective Mark in respect'' of products which comply with applicable provisions of said Standard, that the adequacy of the quality .',° j control system in effect at said plant is periodically inspected and verified by the Inspection Bureau of -'the AMERICAN INSTITUTE OF TIMBER CONSTRUCTION, and that, in the judgirrient of AITC.:`::-'``: said company is capable of complying with 'applicable manufacturing and testing provisions of said Standard in respect of products manufactured at said plant. Conformance with the Standard in respect ; of any specific or particular product is the sole responsibility of the manufacturer; AlTC's guarantee hereunder being that the said company is qualified to produce a product meeting the said Standard and that its plant is periodically inspected and verified by the AITC Inspection Bureau._Uh m Me.4*611LOAITC Cettn/lcare No. 6 3 4 3 5 A AMERICAN INSTITUTE OF TIMBER CONSTRUCTION 0 1903 AMERICAN INs I rrIXI F OF TIMULA CONSTRUCTION ;d-AA11t.;..if1. 1.19•..hotvn ole ttoo typical 4u3llly marks Gulo•v is root `',,j it 4qj malt ot-sI is h;Id (mly Iof Ilt/ pllr00241 of ill usrratio/1!.i-M. '•' ' 'YP-ICA1. CUSTOM PRODUCT QU•4LITY MAR ,..,, P• 143 I RITC dar.9lwUvn of. g4milil flint 'QUALITY .' �• .� ,'�S: INSPECTED d ANSI�AITC 1 u,' A190.1--19 .,, , i •,,,.;,• lr• r• •�r•. • u• ..;rdc.:J 'trtilr.;•ti {Jl-n; • �•�, ... �-�. �•'.'iln i rN: 1 ..I+llla't ....tt, tur fl LJ��f•t•al:up. \• .. �� 11�. 1'•�•�l:a•,1•� jl. •l.•t;+;%tulit ytw%its rC•tl�•..I `�, 1 � ' ��, t I:Idcale.1 confalltrt;lttp, to ANSLA Oldf t .�I:,..:. ,, Ir:a ••:+1i.:�l�y •�,Il••r.letl by ` �. " A t y0.1 • t 9t3� Su utaural Glued 1.....;�.. attd Timtux TYP'ICAL NON -CUSTOM PRODUCT QUALITY MARK Identification of structural uft,., •+affil try syntuolS: g•-simpid spirt bending member; i. :.`_ Il.l.•nptrtslau rnumt>,,., T-1.:••,1prt fn0 Ler` W--c6ritinuous or cantilerel se, Y USE ARCH Ir:nAinym•.11111:r L•.•'.l}w ,;' • t) •.iyn,11!M omt waticu tion fs INf .. . KF , fJ. A3 it.Juaa1J.. ARCD •Archi *, i,.,�tlCtul a�.. f FtlAi i'lun)tullt .._?� /" t.0 1..�J . �... ,` t: u•.•..y,� t of lluAlitij Iit,utN. •�a� j.lo+ll atal �.c• ll�•r Jtli11N1�.'•.'�cj�?' . �'.; I�If11 Sta a J.V t11Alh I11�•: 000-00 GOF-XX-- a:.tft,t ;:• ; r l'1 N �' l Z�:,.tt ;,t .rpG.l spl•t:.c>' 41t.J . ... rt; A 1 TC _ .4 A190.1 1983 tin:" atif+ t �;;�,.;, _ :.;• � I.pc•t:ila.atturr ,Irllf �t)ttlbin.lfitxl�'•SYt11!>r�i for example; "117.85, 24F V3,. iq!:ttitlt,;:•. :11:1'•1-A: al I'11.1iY:.1 PI•/:t( 1•1IJtr'J:::b t.:)1.I.r111tdtXj- to ANSLA11fi '� t¢i `,flt I•, );.rC; la r.> `ur /judlfficihrtn A190.1- 1;183. Slo-ur-tur,ll GI,:J loin:•• ;. Jt^tfT'i.V:• _'� •.y.'1•t.l• 't. twU•t'.,11y t•tsjnn :.,1: I,Y - ~,.yr , • • ,L.•tt t,t.11'tiCh.. !'•• ti• :;,.I• t••..•'•.n.l +I.l• , :.; UU•.1 t •..1u;jrlJt•:: .1 +t' , .C,,bl¢ dvLU111Cr►If, w tlon-custat11 products. essential dela-15 aft. indud•!d 0.1 me sS;.mp. + ^Y. ;Rti• COUNTY OF BUTTE - DEPARTN�ENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND,,PERMIT PERMIT NO. �� ASSESSOR PARCEL NUMBER _ _ ZONA+G- _ BUILDING PERMIT ' OWNER RENA BOWMAN TELEPHONE SO. FT. OCC. BUILDING VALUATIOPC 64 R 42,560 OWNER'S MAILING ADDRESS CtNTR C�TOR'S AME estLine ui__ dens TELEPHONE CWT 220 CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN c Total Valuation $ f Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ 283.00 AeECT OR ENGINEER LICENSE No. Plan Checking Fee ,$ 141 50 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS - Permit fee $ Aa r1r) PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 16.00 Solar or heat pump :ter heater 20.00 LOT NO. SUBDIVISION NAME PARCELMAPWater i,D "/cam piping 5.00 5.00 Each qas water heater or venti,,g, 5.00 USE OF STRUCTURE SF ®X Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outl 5.00 Building sewer 5.00 5.00 Mobile Home I S I G JW I i 10.00 e TYPE OF WORK New OX Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe work: ` 3 bedroom _ I I Permit Fee -i $ 36.00 Contractor ELECTRICAL PERMIT Filing Fee 10.00 - Main service 11101 OR LESS 100 AMP OR LESS 10.00 .0 Main service EA. ADO'L 100 AMP 2.50 2.50 CONTRACTORS LICENSE LAW 1 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 8rce and effect. License No. W ?,t5 A"D Classification t ❑., I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. ( DWELLING OR ADDNS. l ACC. BLDGOS.«uP.9S 4 21/2¢sgft 37.60 NEW CONSTRULTI-OUTLET NON-RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS &) (SINGLE OUTLET CI R. ) Ex. Occup(OUTLET.S OR FIXTURES BAL@30 FIXED APPLNS. Ex. OCCUp. OUTLETS RESID )REA.) 2.00 Temporary service 10.00 10,00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ 70.10 WORKMEN'S COMPENSATION INSURANCE ` I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. •� I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating 6.00 Cooling g Hood 3.00 Ventilation 66 permit Fee $ob3 ' Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against a Iiabiiities, judgments, costs, and expenses which may in any way .accrue a nst said Co my in con quence of the granting of this permit. X t r I f , 9 q Date / `7 Sig ture of Applicant - Owner ❑ Contractor X Agent ❑ An SHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in h'ei t' Mobile Home Installation Fee $ Energy Inspection Fee $ 30.00 occ CONST TY E TOTAL FEE $ 613.60 HAz cuA PARK -.-.d SCHL FLD PAR HD Issue This permit is nereby issued under the applicable provi- sions or the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DI CT OF. B IC WORKS By Dat l �� PERMIT EXPIRES 64te 0 .•� Receipt NO.M-7Z5 wl1 6.50/1 .''~/,f1I6 Z- lyy-716 WHITE-D.P.W., TELLOW-AsSESSOR, PI NK -IN SPECTOR, GOLD ENROD.APPLICANT r`:y C3 .. '.'a� ivY � it :'?i-�✓":1Pt'.: i uw 'Xj" •�y . 'S_.!3.;�. +P'AT 77 . a 3W,;. i EY Ctii COUNTY OF BUTTE - DEPARTMENT.QF PUBLIC WORKS - BUILDING DIVISION s� 7 COUNTY CENTER DRIVE - dhOVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLIGA-T-1IN DATA SHEET ---� Permit No. � OWNER 80 W W1 a 12_ A. P No. Proposed Building Use P V-) Building Inspector Date ` 1 At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . .................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings .............. 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufacturer's installation 'nstructions........................................ 10. eesof$��.�Q ........................ae — 1. Chico Urban Area fees paid ....................................... 1 ark ees paid f ........................................... `�' hool Dist/i fees paid .............. 16 "`�a itation approval from U rot/ i (�C Health Department Il)- 15 15. City of Chico plumbing permit ..................................... 16. Plot plan and business license approval from City of (see City for other requirements) 17. Planning approval for (A) Use: (B) Parking: ...... 1 Improvements may be required. Contact Land Development Section DPW 19. eway permit (construction approval required prior to occupancy) n —/S(- 9°6 Z=� 20. Pre -Inspection for required Pre-Inspec. request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate of Workmans Compensation Insurance .................. 23. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... Z 25 Letter of s,ggnature authorization ! _�� /•la�cJ N�-tr PG lf/t1 Sk7n1G- bt_{ZG : G��'z- �f`''7L�C I0 27. When you issue the permit, process as follows: Mail to owner. Mail to contractor. TelephoneS34-006 and hold for pickup at office. Deliver w/inspector. Other r ApplicanNtap QJ01WAJ5 Date_ Copy of Haz-Mat form sent Health Dept. ire Dept. Air Pollution Date Copy of plans sent _Health Dept. Fire ept. Other Date _ By The following data must be submitted ri r top mi. 'ss an e: (Cir le new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contrac designer, owner, was advised of above required data by phone�nail—counter by�..date actor, designer, ow r, s advised of above required data by—phone—mall r by date Plans checked by O L�'9� Date Plans approved by Date Sets of plans on hold in File cabinet AP folder 7,W� Copy—DPW TO Buildina Department FROM: Environmental Health SUBJECT: Sanitation Clearance 60 k) 1�_4 Owner Location i AP# Lc-i:7� / Plan Approved for: Se Q wa a Disposal Water Supply v . p Hold final for: Water Supply Final clearance O.K. for: Water Supply Clearance for 3 bedroom home. Other NOTE * * * Sanitarian Date TO: Building Department FROM: Encroachment Permit,Section RE:. Driveway Clearance. 53 owner locution AP # Driveway permit - has been issued for the above property. i si ature _ date '`/. ���"/,*!'1r,`+�1r�',`'Fty'•.rr�q"iisnr.-r:a,,�,-t,e.�f'r-ii;�Nc'V'wz-r.... �•.,,K.....--.r.....wv t�r,�s....-a�•+vrw'^ Lrw BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTI�CATION FORM (One Form per Building) A.P. Number �/� 'sJ Building Department No. School District ��',? -f ell Y!!� City �' County Jurisdiction Property Owners YlQ n0f:. �3 rr s �lt� . Project Location/Address nod,_4, Subdivision , Lot.Number ' Residential Development: a' El Sq. Footage # of Living - MHI x Addition (Group R) Units • Commercial/Industrial*Sq. Footage I '' r New`_ Addition (Including Exterior `.r Roofed Areas) Building Department Representative ., Date (Floor•Plans reviewed by School District Personnel)' District Id- No. ���'% •; " _,.�. School -District certifies that -», (Applicant Name), - (Phone Number) �• (Street Address) (City) y (State) (Zip Code) has complied. with the requirements of Resolution"No. -� by the p_yment of $ llp,?I, /,:2 - representing lOjp� square feet. ' School District Rep.�osentative Date PAID BY CHECK NO. BANK NO 9D_,;�-069ZI.2_/� REMARKS PAID BY CASH- t white -applicant, yellow -building department, pink -school district SCHOOL.FEE (8/88) t 96-43206 ..;,-,Return to DPW AGRICULTURAL STATEMENT OF ACLNOWLEDGEi`B;iVT 0. - FOR RESIDENTIAL' DEVELOPMENT Section 26-8.1 of the Butte County Code requires this acknowledgement be recorded prior to issuance of a building permit. The property described herein is adjacent to land or included within an area zoned 90-043206 Rec Fee 7.00 for agricultural purposes, and residents Cash 7.00 of this property may be subject to incon- Recorded t, veniences or discomfort arising from the Official Records 1 ; use of agricultural chemicals, including, County of ; but not limited to herbicides, pesticides, Butte 1 and fertilizers; and from the pursuit Candace J. Grubbs of agricultural operations including, I Recorder but not limited to cultivation, plowing, I 1:56pm 8 -Oct -90 X. 2 spraying, pruning, and harvesting which �— --- — — -- -- occasionally generate dust, smoke, noise, and odor. Butte County has established agricul- tural zones which have as a priority use for productive agricultural purposes, and residents within said zones and on adjacent property should be prepared to accept such inconvenience or discomfort from normal, necessary farm operations. All that real property. situate in the County of Butte, State of California, described as follows: Date: 10/8/90 Please see attached for legal description PROPERTY State of Calif.) On this the 8th day of _ Oc_tober I 19ACL_, before me, the Butte ) SS. undersigned Notary Public, personally appeared County of ) Personally known to me.lxl Proved to me on the basis OFFICIAL SEAL of satisfactory evidence. PATSY LCARTER t be the person(s) whose name(s) is m NOTARY PUBLIC - CALIFORNIAs bscribed to the within instrument and acknowledged that shA nU1T(: �UNN T T �1 C t.='y comm. expires MAY 13, 16g2ej ecuted the same for the purposes therein contained. 1N ,JIT:�E�S �[ iEREOF, I hereunto set my hand and official seal. 1680 Ud*_4 Qr4,vv:. rA 95966 Present A.P. No. 036-230-055 ,lotary Public EXHIBIT "A" '0 43706 The land referred to herein is described as follows: operty All that certain real."prsituate in the County of Butte, State of California, described as follows: A portion of P. the East 1/2 of the Northeast 1/4 of Section 25, Township 19 North, Range 4 East, M. D. B & M., being more particularly described as follows: he Parcel One, as shown on thatfceertainte, ParcStatel ofmap recornia,iontDecemberelof the Recorder of orded the Countya a es 15 and 16. .1976, in Book 60 of Maps, p 9 TOGETHER WITH a 60_' non-exclusive easement for road and public utilities purposes as shown'on said map recorded in the office of the Recorder of -the County of Butte, State of California on December 1, 1976, in Book 60 of Maps, at pages.15 and 16. r^C ALSO TOGETHER WITH a 60' non-exclusive easement for road and public the utilities purposes as .shown on saidapofecordedCalifoinathe office une of 1974 in Recorder of the County of Butte,State Book 50 of Maps, at page 12. ALSO TOGETHER WITH easements for road and public utilities purposes as described in the Deed recorded May 16, 1974, in Book 1910, of Official Records, at page 299. AP No. 036-230-055 FC(o)rnp- . ....._...- . END OF DOCUMENT END OF DOCUMENT aosE#-Oe cn tL, O-1 �a J o F® ��CD uj. 0 l Au ON a 'aI COUNTY OF BUTTES DEPA13TMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLIChONYAND•PERM(T v/ ASSESSOR PARCsUM � !3 • ZO BUILDING PERMIT OWNS - l� JA J TELEPHONE S� •— SQ. FT. OCC. BUILDING VALUATION OW ER'S MAILING ADDRESS CO A TOR 'S NAME TEL PHONE CONTRA T R'S AILING ADDRESS Fireplace CONSTRUCTION LENDER KNOWN U Total Valuation $ Filing Fee $ 1000 LENDER'S MAILING ADDRESS i V ` Permit Fee $ -✓ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDR ESS 06 Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome, Q Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home is G W 10.00e TYPE OF WORK New ❑ Addition ❑ emodel ❑ Utilitile ❑ Ins allatiorOther ❑ Describe work: /a _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP ORSLESS 10.00 Main service EA. ADD'L too AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): El am licensed under provisions of Chapt. 9, Div. 3 of the BuslnesS and Professions Code and my license is in full force and effect.SINGLE License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.& OR ADDNS. ACC. BLDGS. 2/, zQsgft NEW CONSTR. MULTI -OUTLET NO N.RESID BRANCH CIRC ITS 2,50 ea POWER APPARATUS e OUTLET CIR. Ex. Occup(OuTLETS OR FIXTURES 9L0 30 2AL@30 FIXED APLNS Ex. Occup. OU LETS P(RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 9 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject LW to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3,00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue again said County in consequence of the granting of this permit. X� !/i� aiZ�� t/JyG,r,— Date Signature of Applicant — OwnerO' Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ S ---- Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ HAZ I CUA PARK SCHL I FLD I PAR4 PD HD IssuE This permit is hereby issued under sions of the Butte County. Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date Receipt No. 44911 WMITC-D.P.W., YELLO 990R, PINx-IN9PECTOR, GOLD EXROD-APPLICANT I COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRLV.E.- OROVIL'.I ,.CAL4iPORNIA 95965 - TELEPHONE: 916/538-7541 , — PERMIT APPLICATION DATA SHEET I Permit No. OWNER Proposed Building Use A. P. ' o. Building Inspector Date t At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: • —I— DATE RECEIVED APPROVED 1. All items hav bAbn s�ubmit�d�.� ........................ 2. Plot plans in td p�l.i)caie/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer of plans .. 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Energy Design Compliance and supporting documentation ......... 6. Statement of Intent for Non -Heated and AC Buildings .............. 7. Engineered truss details and layout in duplicate (required prior to plan check) 8. Mobilehome installation data including manufacturer's installation instructions....................................................... 9. Fees of $ .......................... 10. Chico Urban Area fees paid ....................................... . �. Park fees;4(:eaid ........... s ........ p ................... . 12. 0� �School District fees aid ................. 13. Sanitation approval from Health Department ... 14. City of Chico plumbing permit ...................................... 15. Plot plan and business license approval from City of (see City for other requirements) 16. Planning approval for (A) Use: (B) Parking: ......... 17. Improvements may be required. 18. Driveway permit (construction approval required prior to occupancy) ... 19. Pre -Ins ection for re ulred ... , Pre-Insperequest to p q •Building Inspector (Date) 20. Contractor's license information (No., Name Style, Classification) ....... 21. Certificate of Workmans Compensation Insurance .................... 22. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ........ 23. Recorded copy of Agricultural Acknowledgment Statement ............ 24. Letter of signature authorization ..................................... 25. 26. When you issue the permit, process as follows: Mail to owner. Mail to contractor. X_ Telephone 531 !PCO2 and hold for pickup at office. Deliver w/inspector. Other Appl icant�w->s`�`�.� �,,� Date � T ; i ;- - Copy of plans sent Health Dept., Fire Dept„ Other Date The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone_-nail counter by date Contractor, designer, owner, was advised of above required data by—phone —ma II—counter by date Plans checked by Copy—DPW Sets of plans on hold in Date Plans approved by File cabinet AP folder Date ti COUNTY OF BIUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, Caliiorn&95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PER ITN_O. L , P ASSESSOR RCEL N MBER 1'I G - BUILDING PERMIT OWNER /�J TELEPHONE 4, SQ. FT. OCC. BUILDING VALUATION OW R' MMA 1 DDR SS C CONTRAi5a NA E ) JA? TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS coo Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 �✓ Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Ga— Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF ❑ Duplex[] Mobilehome Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home 10.00e j TYPE OF WORK New❑ Addition[:] Remodel Utilities Installation❑ Other❑ Describe work: 0117, j _ (' p ; (,/SeE Azg�- , Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 ��� CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license IS In full force and effect. License No. Classification 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)�f I, as the owner, am exclusively contracting with licensed contract- ontract- ors. ors.(Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING occuP.e OR ADDNS. ACC. BLDGS. q It /:2sea NEW CONSTRES,., BRANCH NON•R ESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS 6 SINGLE OUTLET CIR. EO Ex. ccu po UTLETS OR FIXTURES 200500 BAL030 FIXED APLNS.❑ EX. Occup. OUTLETS P(RESID )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 / Misc. Wiring 9 15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling g Hood 3.00 Ventilation. permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. 1 also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue agai said County in consequence of the granting of this permit. 4 41 Date r --2S 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 $ Energy Inspection Fee $ occ CONST TYPE s� TOTAL FEE $ H - CUA J.PAR 1. SCHL "— L PAR PD HD IssuE This permit is hereby issued under sions of the Butte County. Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date the applicable provi- resolutions to do have been paid. WORKS Date Receipt No. 1AQM I WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMPENTPF p&PLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - dROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET Permit No. OWNER AVT1 s 0W✓t✓f ,Q✓�, A P. o. K Proposed Building Use A4hj1 Building Inspector Date do At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: � jjll� DATE RECEIVED APPROVED . All items havekbeern submitted; .. U1,.:� D.- 4112. ...............Plot plans inpd plicat tri licate signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer of plans . . 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Energy Design Compliance and supporting documentation ......... 6. Statement of Intent for Non -Heated and AC Buildings .............. 7. Engineered truss details and layout in duplicate (required prior to plan check) 8. Mobilehome installation data including manufacturer's installation instructions....................................................... 9. Fees of $ .......................... 10. Chico Urban Area fees paid ........................................ 11. Park fees paid ..................................................... 2. School District fees paid ............ _ 3. Sanitation approval from (Z)Zr_A Health Department ... L 14. City of Chico plumbing permit ...................................... 15. Plot plan and business license approval from City of (see City for other requirements) 16 Planning approval for (A) Use: (B) Parking: ......... 7. Improvements may be required. 18. Driveway permit (construction approval required prior to occupancy) ... Pre-Inspec. request to 19. Pre -Inspection for required ...... Building Inspector (Date) 20. Contractor's license information (No., Name Style, Classification) ....... 21. Certificate of Workmans Compensation Insurance .................... 22. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ........ 23. Recorded copy of Agricultural Acknowledgment Statement ............ 24. Letter of signature authoriz ion .............. ................... . 25. N 4-C> T 26. W hr When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone <n — SO2, and hold for pickup at office. Deliver w/inspector. Other 1,9 AppIicantm, 11/1 ?1� Date Copy of plans sent Health Dept., Fire Dept„ Other Date The following data must be submitted prior to permit issuance: (Circle new item not checked above). 1. Index permit for above items No. - 2. o. 2. Additional items required: Contractor, designer, owner' �was advised of above required data by_phone_—nail—counter by date Contractor, designer, owner, was advised of above required data by_phone_mall_counter by date 0/1 Plans checked by Date Plans approved by 5 Date �3 t7T Sets of plans on hold in File cabinet AP folder .w Copy—DPW To Buildinv Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Location AP#. Plan Approved for:- Sewage Disposal Water Supply (aed Hold final for: Final clearance O.R. for: Clearance for bedroom mobil ome Other NOTE * * * Sanitarian Water Supply Water -supply Date 9-3 loff CD CL - 0 rof ap CD bm 70 tr 0 0, CD 0 .mom MR 1. Ceiling Insulation 2. Wall Insulation -14 Number of stories I R -value One Two Three . R-0 -103 -49 -32 R-19 -8 -4 .2 R-30 -2 -1 .1 R-38 . 0 0 0 U -value 2 1 R-19 0.50 -176 -84 -54 0.30 -102 139 �32 ' 0.10 -26 -13 -8 ` 0.08 -18 -9 _ -6 .. . 0.06 -11 -5 -4 0.04 -4 -2 .1 0.02 4 2 1 0.00 11 5 3 2. Wall Insulation -14 Number of stories Number of stories Single- Single - Two Three Family Family Multi - R -value Detached Attached Family R-0 -68 -51 -34 R -it 0 0 0 .R-13 2 2 1 R-19 8 6 4 U -value 0.50 -120 -58 0:80 -153 -114 -76 0.50 -91 68 ' -46 0.30 -47 -36 -24 0.10 0 0 0 0.08 4 3 2 0.06 9 • 7 5 0.04 14 11 7 0.02 19 .14 10 0.00 .24 18 12 3. Raised Floor Insulation Insulation in.Floor Controlled Ventilation'Crawispace -14 Number of stories Number of stories R -value One Two Three R-0 -17 -8 -5 R-11 -3 -2 -1 R-19 0 0 0 R-30 3 1 1 U -value 4. Slab Edge Insulation 4 , ----.0.60 _ -144 -70 -46 0.50 -120 -58 38 0.40 .-95 -46 -30 0.30 -69 -34 .22 0.20 -43 -21 -14 0.10 -17 -8 -5 0.08 -11 -6 . • -4 - 0.06 -6 -3 -2 0.04 .1 0 0 0.02 4 2 1 0.00 10 5 3 Controlled Ventilation'Crawispace -14 48 Number of stories -64 R -value One Two Three R-0 -11 -7 -5 R-5 -4 -4 3 R-11 .2 -2 -2 R-19 -1 -2 -2 4. Slab Edge Insulation 4 -" -90 Number of Stories -26 R -value One Two Three R-0 0 0 0 R-5 8 5 2 R-7 8 6 3 F2 factor 29 -58 -20 0.90 -4 3 -1 0.80 -1 -1 0 0.70 2 2 1 0.60 6 4 2 0.50 9 6 3 0.40 12 8 4 S. Infiltration (Air Leakage) Specification Points shard 1 - 6. Glass Heat Loss Total -14 48 -69 -64 U -value East Percent :West Skylight .51 to .41 to .31 to 0.30 or Glass Single Double .60 .50 .40 less 50 -121 -53 -39 -24 -10 4 40 -90 37 -26 -14 3 8 35 -75 -29 -19 -9 1 10 30 -61 -21 -13 -4 4 '12 29 -58 -20 -12 -3 5 12 28 -55 -18 -10 .2 5 13 27 -52 -17 -9 -2 6 13 26 -49 -15 3 -1 7 14 25 -46 -14 .7 0 7 ' 14 24 -43 -12 -5 1 8 14 23 -40 -11 -4 2 8 15 22 -37 -9 -3 3 9 15 21 -34 -7 .2 4 10 15 20 31 -6 0 5 10 16 19 -29 -4 1 6 11 16 18 -26 3 2 7 12 16 17 -23 -1 3 8 ' 12 17 16 -20 0 4 9 13 17 15 -17 1 6 10 14 17 14 -14 3 7 10 14 18 13 -12 4 8 11 15 18 12 -9 6 9 12 15 19 11 -6 7 10 13 16 19 10 -3 9 11 14 17 19 9 -1 10 13 15 17 20 8 2 12 14 16, 18 20 7. Shading (Shade Open) Elirectlre Percent Class (percent glas6 x SC) Effective ' -14 48 -69 -64 %Glass North East South :West Skylight 18 5 1 4 1 na 16 4 2 5 1 na 14 4 2 5 1 na 12 3 3 5 2 na- 11 3 3 5 2 : na 10 2 3 5 2 1 9 2 3 5 2 2 8 2 3 5 2 2 7 1 3 4 2 2 6 1 3 4 2 3 5 1 2 4 .2 3 4 0 2 3 1 3 3 0 1 2 1 3 2 0 0 1 0 3 1 -1 -1 -1 -1 2 0 -1 -2 -4 -2 0 na = not allowed 2 3 4 3 )B. Shading (Shade Closed) . FNective Percent Class (Percent LWS x SC) Effective %Glas6 North E&M South We6t Skylight 18 -14 48 -69 -64 na 16 -12 -42 -59 -55 na 14 -10 -35 -50 -46 na 12 -8 -29 -40 .37 na 11 -7 -26 -36 -33 na 10 -6 -23 31 -29 -74 9 -5 -20 -27 .25-65 -3 8 -5 -17 -23 -21.. -56 7 -4 -14 -19 -18 -47 6 3 -11 -15 -14 -38 5 .2 .9 .11 -10 -30 4 -1 -6 -8 -7 -23 3 0 -4 -5 -4 -16 2 1 -1 -2 -1 -9 1 1 1 1 1 -4 0 2 3 4 3 0 na . not allowed 9. Interior Thermal Mass Interior Exterior Slab Floor Raised Floor Mass Family Family Stories Mass Detached Attached Stories 0.00 /CFA One Two Three One Two Three 0.0 -8 -5 -4 -2 .1 -1 0.1 -8 -5 3 -1 0 0 0.3 -7 -4 -2 0 1 1 0.5 -6 -3 -1 1 1 2 0.7 -5 -2 -1 1 2 2 0.9 -5 -1 0 2 3 3 1.1 -4 -1 1 3 4 4 1.3 -3 0 2 3 4 5 1.5 -3 1 2 4 5 5 2.0 -T 2 4 5 6 7 25 0 3 5 7 7 8 3.0 1 4 6 8 8 9 3.5 2 5 7 9 9 10 4.0 3 6 8 9 10 10 4.5 3 7 8 10 11 11 5.0 4 7 9 11 12 12 5.5 5 8 9 11 12 12 6.0 5 8 10 12 13 13 6.5 6 9 10 12 13 13 7.0 6 9 11 13 13 14 7.5 6 10 11 13 14 14 •, 8.0 7 10 11 13 14 14 8.5 7 10 12 13 14 15 10. Exterior Wall Thermal Mass Exterior Single- Single - East Wail Family Family Mutt Mass Detached Attached Family 0.00 0 0 0 0.20 3 2 1 0.40 5 4 3 0.60 8 6 4 0.80 10 8 5 1.00 13 10 7 1.20 13 12 8 1.40 12 13 9 1.60 10 13 11.. .. 1.80 10- 12 12 200 10 11 13 11. Heating System 8.9 -5 SE or ASPF 3 -2 (assumes ducts in attic) ' 9.0 -4 _ Sum of 1.6 _ -2 -25 or -24 to -14 to -4 to +6 to 16 or ' SE HSPF less -15.. -5 +5 +15 more 0.72 6.60 0 0 0 0 0 0 0.75 6.88 3 3 3 2 2 1 0.80 7.33 8 7 6 5 4 3 0.85 7.79 13 11 10 8 7 5 0.90 8.25 17 15 13 11 9 -7 0.95 8.71 20 18 15 13 11 8 6 Effective SE or HSPF (SE or HSPF x duct efficiency) Effective -25 or -24 to -1410 -4 to +6 b 16 or SE HSPF less -15 -5 +5 +15 more 0.30 2.75 -73 -64 -56 47 -38 -30 na 3.41 -45 -39 -34 -29 -24 -18 0.40 3.67 -34 -30 -26 -22 -18 -14 0.50 4.58 -10 -9 -8 -7 -5 -0 0.56 5.13 0 0 0 0 0 0 0.60 5.50 5 5 4 3 3 2 0.70 6.42 17 15 13 11 9 7 0.80 7.33 25 22 19 16 13 10 0.90 8.25 32 28 24 20 17 13 1.00 9.17 37 32 28 24 19 15 Zonal Control Adjustment System Type Resistance 10 9 7 6 4. 3 Other 6 5 4 3 2 2 12. Cooling Systim b. East c. South One SEER -4 -4 -3 -2 (asspmei ducts In attic) 3 3 :_. 2 s Stm of 7-10 2 1 Single-FamilyIAetached -25 or -24 to 04 to -4 b +6 to 16 or SEER less -15 [ •6 +5 +15 more 8.0 -14 -12 i -10 -8' -6 4 8.5 -9 -7 -6 -5 • -4 -3 , 8.9 -5 -4 -4 3 -2 -2 ' 9.0 -4 -3 -3 -2 -2 -1 i 9.5 0 0 0 0 0 0 10.0 4 3 3 2 2 1 I 10.5 7 6 5 4 3 2 11.0 10 9 7 6 4 3 120 13.0 15 20 13 11 .t� 1412 9 7 9 5 6 SE None �17 -24 -18 -15 _ -12 4.4 Effedtive SEER -1 -1 -1 (SEER xduct eMcfency) 0 0.4 HWR Sim of 7-10 -12 -9 -7 Effective -25 or -24 to -14b 410 +6b 16 or SEER less -15 t -5 +5 +15 more 5.0 -30 -25 .21 -17 -13 -9 6.0 -12 -11• -9 -7 -6 -4 6.6 -5 -4 -4 3 ... -2 -2 7.0 0 0 0 0 0 0 8.0 9 8 6 5 4 3 9.0 16 14 12 9 7 5 10.0 22 19 16 13 10 7 11.0 26 23 19 15 12 8 12.0 30 26 22 18 14 9 13.0 33 29 24 20 15 10 i. Zonal Control Adjustment 1200 1700 10 8 7 6 4 3 No Cooling System Installed - 'Stories North b. East c. South One -5 -4 -4 -3 -2 -2 Two + 3 3 :_. 2 s 2 2 1 Single-FamilyIAetached U -value 10.0981 and Attached or ,I.7.UIUC 1.21 Ic.�r .tw .1.0 1 Unit Size (sQ Water ii39 i 12 1700 2200 2700 Heater Credit or , b to to or . Standard Type less ;1699 2199 2699 more _Type. SG None 0 i? 0 A. 0 0 or Solar 12 ' 8 6 5 4 HP --HWR 80% 8 5 4 3 3 WSB 5 3 3 2 2 1.5 POU 8 5 4 3 •3 SE None -37 -24 -18 -15 _ -12 4.4 Solar -1 -1 -1 0 0 0.4 HWR -18 -12 -9 -7 -6 1.9 WSB... -25 -16 -12 -10 -8 3.3 POU _ -18 _,12. -9 __7 -6 IG None -5 -3 -2 -2 -2 0.8 Solar 7, .'5 4 3 2 2.2 POU .3 2 1 1 1 IE None -28 -19 -14 -11 -9 5.2 Solar 8 5 4 3 3 1.1 POU -10 -6 -5 _4 .3 26 Multi -Family (individual 3.2 units) 3.7 3.9 4.1 4.3 I Unh Size (sQ 4.7 Water 5.1 699 700 1200 1700 22M Heater Credd or b to 10 Or TYPO TYPO less 1199 1699 2199 more SG None 0 0 0 0 0, or. Solar 14 7 5 4 3 HP HWR 9 5 3 2 2 21 WSB 9 4 3 2 2 4.2 POU 9 5 .3 2 2 SE None -45 -23 -15 -11 .9 1.6 Solar 2 1 1 0 0 3 HWR -23 -12 -8 -6 '-5 4.5 WSB -25 -13 -8 -6 .5 _PQU.. 6.2 _23 -12 -8 _-6 -5 IG None -8 -4 -3 .2 "-2 - Solar 6 3 2 1 1 4.8 POU 1 _ _.0 - 0 0 . ' 0 IE None -30 -15 -10 -'-8 1.7 -6 22 Solar 18 9 6 4 . = • 4 3.6 POU -8 -4 -3 . -2 2 Interior Mass/CFA t rrrt 2 P"s North b. East c. South d. West e. Skylight U -value 10.030] `J S=7-10 or R -value 111] U -value 10.0981 l or ,I.7.UIUC 1.21 Ic.�r .tw .1.0 R-value[19) U -value [0.037] 1!�r'- t °TYPE Vm)�SS WINC a 4.2. ie: exposed Slab) F2 factor [0.77] Standard I'74�F?x 1�z - 0% 5% 10% 15% 20% 2S% 30% 35% 40% 459. 50% 55%,W% 06 70% 75% 80% 85% 90% 95% 'M% 1059'. 110% 115% 120% 125- 011.0 0.2 0.4 0.6 0.8 1.1 1.3 1.5 1.7 1.9 21 23 25 2.7 2.9 3.2 3.4 3.8 3.8 4 4.2 4.4 4.6 4.8 5 5.3 10% 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.9 21 23 2S 27 2.9 3.1 3.3 3.5 3.7 4 4.2 4.4 4.6 4.8 5 5.2 5.4 20% 0.3 0.6 0.8 1 1.2 1.4 1.6 1.8 2 2.2 24 21 29 3.1 3.3 3.5 3.7 3.9 4.1 4.3 4.5 4.8 5 5.2 5.4 56 30% O.S 0.7 0.9 1.1 1.4 1.6 1.8 2 22 24 26 28 3 3.2 3.5 3.7 3.9 4.1 4.3 4.S 4.7 4.9 5.1 5.3 5.6 S.8 40Y. 0.7 0.9 1.1 1.3 1.5 1.7 1.9 2.2 24 26 2.8 3 3.2 3.4 3.6 3.8 4 4.3 4.5 4.7 4.9 5.1 5.3 S.S S.7 5.9 .50% 0.9 1.1 1.3 1.5 1.7 1.9 21 23 2.5 21 3 32 3.4 3.6 3.8 4 4.2 4.4 4.6 4.8 5.1 S.3 5.5 5.7 5.9 6.1 S5% 0.9 1.1 1.4 1.6 1.8 2 2.2 24 2.6 28 3 32 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.3 5.6 5.8 6 6.2 60% 1 1.2 1.4 1.7 1.9 21 23 2.5 2.7 Ill 3.1 3.3 3.S 3.8 4 4.2 4.4 4.6 4.8 ' 5 5.2 5.4 5.6 S.9 6.1 63 65% 1.1 1.3 1.5 1.7 1.9 22 2.4 2.6 2.8 3 3.2 3.4 3.6 3.8 4 4.3 4.5 4.7 4.9 5.1 5.3 S.5 5.7 5.9 6.1 6.4 70% 1.2 1.4 1.6 1.8 2 22 2.5 27 2.9 3.1 3.3 3.5 3.7 3.9 4.1 4.3 4.6 4.8 5 5.2 5.4 5.6 58 6 6.2 64 75% 1.3 1.5 1.7 1.9 21 2.3 2S 2.7 3 3.2 3.4 3.6 3.8 4 - 4.2 4.4 4.6 4.8 5.1 5.3 5.5 5.7 5.9 6.1 6.3 6.5 80% 1.4 1.6 1.8 2 2.2 2.4 26 2.8 3 3.3 3.5 3.1 3.0 4.1 4.3 4.5 4.7 4.0 5.1 5.4 5.6 5.8 6 6.2 85% '" 1.4 1.7 1.9 2.1 2.3 2.5 2.7 2.9 3.1 3.3 3.5 3.8 4 4.2 4.4 4.6 4.8 5 5.2 54 5.6 5.9 6.1 63 64 6 6 90Y. 1.5 1.7 2 2.2 24 26 2.8 3 3.2 3.4 3.6 3.8 4.1 4.3 4.5 4.7 4.9 5.1 S 3 5.5 5.7 5.9 6.2 6.4 65 6 67 95% 1.6 1.8 2 2.2 2.5 27 2.9 3.1 3.3 3.5 3.7 3.9 4.1 4.3 4.6 4.8 5 5.2 5.4 5.6 5.8 6 6.2 6.4 6 68 1009. 1.7 1.9 21 2.3 2.5 28 3 3.2 3.4 3.8 3.8 4 4.2 4.4 4.6 4.9 5.1 5.3 53 5.7 5.9 6.1 6.7 6.9 6.3 6.5 6.7 7 105%1.8 2 2.2 2.4 2.6 2.8 3 '3.3 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.4 5.6 5.8 8 6.2 6.4 6.6 68 7 ,to./. 1.9 21 2.3 2.5 2.7 29 3.1 3.3 3.6 3.8 4 4.2 4.4 4.6 4.8 ' 5 5.2 5.4 5.7 5.9 6.1 6.3 6.5 6.7 69 7.1 115% 2 2.2 2.4 2.6 2.8 3 3.2 3.4 3.8 3.8 4.1 4.3 4.5 4.7 4.9 5.1 5.3 5.5 5.7 5.9 6.2 6.4 6.6 6.8 7 7.2 120% 2 2.3 2.5 2.7 2.9 3.1 3.3 3.5 3.7 3.9 4.1 4.4 4.6 4.8 5 5.2 5.4 5.6 50 6 6.2 6.5 6.7 6.9 7.1 7.3 125% 2.1 2.3 25 2.8 3 3.2 3.4 3.6 3.8 4 4.2 4.4 4.6 4.9 5.1 5.3 5.5 5.7 5.9 6.1 6.3 6.5 • 6.7 7 7.2 7.4 rolnt System Summary: Climate Gone n SCORE CARD 1. Ceiling Insulation 2. Wall Insulation 3. Raised Floor Insulation 4. Slab Edge Insulation 5. Infiltration 6. Glass Heat Loss 7. Shading (Shade Open) a. North b. East c. South d. West e. Skylight 8. Shading (Shade Closed) a. North b. East c. South d. West e. Skylight 9. Interior Thermal Mass 10. Exterior Wall Mass 11. Heating System Zonal Control? ( Y / N ) .12. Cooling System.. Zonal Control? ( Y / N ) 13. Water Heating Measures $3 30 or R -value (38] U -value 10.030] `J S=7-10 or R -value 111] U -value 10.0981 l or R-value[19) U -value [0.037] 1!�r'- or R -value (o] F2 factor [0.77] Standard I'74�F?x 1�z 4 l ' Type [double] U -value [0.65] % Total Glass (16] % Glass SC Eff. % Glass �t X q X X -9 7 X X 4 _ % Glass SC Eff. % Glass 0"t X t%�' = 5, 3.S °6;- X .t -C, = c9 Y. X ,&f- - �-97 le- X-t�- TYPE 1 MASS AREA InteriorNlss/CFA COND. FLOOR AREA TYPE 2 MASS AREA $ Exterior Wall Mass ND . FLUOR AREA X _83 = S. VE SE or HSPF Duct Efficiency [0.78] Effective SE or [0.72/6.6] HSPF [0.56/5.15] SEER [9.5] Duct Efficiency [0.74] Effective SEER 17.03] ?Uwe Type [SG] -- Credit [none] Point Scores r -H- $3 S=7-10 Point Total: l Certificate of Compliance: Residential Project Title Project Address Documentation Author Telephone r-- Climate Zone 11 a79P4 0 Buil >� ermit N p 1 Checked By / Date Fnforoeanent Agency Use Only Slab Edge..... GLAZING Shad ng Devices Glazing Area Glass Type Interior Exterior Glass Area % Glass BUILDING DATA single, double) (Zoller blind. etc.) (shadescreen, etc.) North_ No rT-h 81V_ Conditioned Floor Area / 6 G `I Stab/Raised Floor �5 Number of Stories / Number of / Fast South*v- : [ A)"Single Family Detached (SFD) ,Units [ ] Addition Alone East ( ) West [ ] Single Family Attached (SFA) [ ] Existing Building __Q_> Skylight Total 19- lop- South ( ) [ ] Multi -Family (MF) I ] Existing -Plus -Addition I r t Sou th BUELDING SHELL INSULATION' West Component Insulation LocatiiorVComments West Type R -Value (am:2! to garage, rTical, etc.) Skylight ....... Wall .............. / �— { THERMAL MASS Wall ............. Type/Covering Roof ............. (slab/ex22sad, tile, etc.) 00 (inches) L ocadon/Description (kitchen, bath, etc.) Roof ............. _ _14 - Floor ............. Floor ............. Slab Edge..... GLAZING Shad ng Devices Glazing Area Glass Type Interior Exterior Overhang Framing Type Orientation (sf) single, double) (Zoller blind. etc.) (shadescreen, etc.) (yes/no) (metal/wood) No rT-h No rLh( ) N East ( ) East __Q_> South ( ) 4Al I r t Sou th West West Skylight ....... �— { THERMAL MASS Type/Covering Area Thickness (slab/ex22sad, tile, etc.) 00 (inches) L ocadon/Description (kitchen, bath, etc.) _14 - HVAC SYSTEMS Minimum Duct Type (furnace, air Efficiency Location Duct Output Manufacturer / Model # conditioner, heat um) (SE, SEER,HSPF) (attic, etc.) R -Value tuh or approved equal) -5-.? /7 7ol Maximum Furnace Heating Output: /-� Btuh HOT WATER SYSTEMS Tank Manufacturer/Model # etc. SPECIAL FEATURES/REMARKS (Add extra sheets if necessary) i Mandatory Measures Checklist: Residential , , MF -1R NOTE: Lowrise residential buildings subject to the Standard: must contain these measures regardless of the compliance approach used. Items marked with an asterisk (•) may be superseded by more stringent eompliarke requirements listed on the Certificate of Compliance. When this checklist is incorporated into the permit documents. the features noted shall be considercd by all paries as binding minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. DESCRIMON DESIGNER ENFORCEMENT Building Envelope Measures • §2.5352(a): Minimum ceiling insulation R-19 weighted avenge. §2.5352(b): Loose fill insulation manufacturers labeled R -value. ' §2-5352(c): Minimum wall insulation in framed walls R-11 weighted average (does not apply to exterior mass walls). ' §2.5352(k): Slab edge insulation - water absorption rate no greater than 0.3%. water vapor transmission rate no greater than 2.0 perm(mch. §2.5311: Insulation specified or installed mats California Energy Commission (CEC) quality standards. Indicate type and form. §2.5352((): vapor barriers mandatory in Climate Zones 14 and 16 only. §2.5317: InfiltrabontExfiltration Controls a. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage - b. Doors and windows certified. c. Doors and windows wcatherstrippcd: all joints and penetrations caulked and seakA. §2-5352(0): Special infiltration barrier installed to comply with §2-5351 mets CEC quality standards. §2-5352(d): Installation of Fueplaces 1. Masonry and factory -built fireplaces have: a. Tight fitting, closeable metal or glass door b. outside air intake with damper and control c. Flue damper and control 2. No continuous burning gas pilots allowed. HVAC and Plumbing System Measures §2-5352(g) and 2-5303: Space conditioning equipment sizing: attach calculations. §2-5352(h) and•2-531 S: Setback thermostat Gn all applicable heating systems. • §2-5316(a): Ducts constructed, installed and insulated per Chapter 10, 1976 UMC. §2.5316(b): Exhaust systems have damper controls. §2-5314(c): Gas-fued space heating equipment has intermittent ignition devices. §2-5314: HVAC equipment. water heater, showerheads and faucets certified by the CEC. §2.5352(i): Water heater insulation blanket (R-12 or greater) or combined interior/cxterior insulation (R-16 or greater): fust 5 feet of pipes closest to tank insulated (R-3 or greater). §2.5312(Excepdon 1): Pipe insulation on steam and steam condensate return & recirculating piping. §2-5318(d): Swimming Pool Heating 1. Systcm has: a. On/off switch on hcatcr. b. Weatherproof instruction plate on heater: c. Plumbcd to allow for solar. 2. 75 percent thermal efficiency. 3. Pool cover. 4. Time clock. 5. Directional water inlet. Lighting and Appliance Measures §2-5352(1): Lighting - 25 lumens/watt or greater for general lighting in kitchens and bathrooms. §2.5314(c): Gas fired appliances equipped with intermittent ignition devices. 12-5314(a): Refrigerators, refrigerator -freezers, freezers and fluorescent lamp ballasts certified by the CEC. Indicate make and model number. COMPLIANCE STATEMF.Nr This certificate of compliance lists t1x building feature% and performance specifications needed to comply with Title 24. Chapter 2-53 and Mile 20, CliptcrZ SubchapW4. Article 1 of the California Administrative code- This certificate has been signed by the individual with overall design responsibility and the building owner, who shall retain a copy of it and transmit the certificate to any subsequent purdiaser of the building. Designer Natters Tttk/Fum Address:rte/? Ti i Telephone: ter_ — N: s -77 "l Sr5 C'a: Ci I-� (date) Documentation Author Name: rldc/Firm: Address: Building Owner Name: TttklFum: Address: Telephone: (signature) (date) Enforcement Agency Name: Agency: Telephone: