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079-370-052
92-01 Mildred R. Jones HE r"`C dd, " 4s'4od Ln, Oroville W/S Gravel Rd., app.2 mi.N.of Miners .Exemption Permit Ranh Rd., Oroville�,,,�j,"F&-op,�orH'V� - I Permit ��3� $As 4 �98,���0 d �ingle .7 family) ,,�. Y ?'DELL K I 5205 u ears Ranch Rd,_ 0 oville 0 OS- 95 Permit#2368-83P,ES(util,�MH) HEMSTALK, TODD _ ELEC 7'25'83%Z ;h 75 SHERLTWOOD LN, OROVILLE GAS 7- 2S -f'3 Cont: OWNER - — COMPACTION' TEST RE ADD LIVING RM/SF SUPPORT STRUCTURE REQ ��q� Fermi r: Mobile U;ee Center, Oroville t#2369=$3MHI' ed�'7S/3 . i i7TODD HEMSTALKo2 Permit#247-89E(new elec7sr/g 4 LitjPermit#248-89B,P,E(repair ara,— & add•on/garage) Per 't#1755-89B,i,E,M(_-iew single lily 9f32� 1015-90B 1 HEMSTALK, Todd ��q! 75 Shelterwood Ln, Oroville l (sf gar. conv.-fam rm) 03.6- 0=052 03-0246 HEMSTALK, TODD est MICHELLE 75 SHELTERWOOD, OROVILLE 2 BRA BATH ADDITION 0 04-09.00 HEMSTALK, TODD 75 SHELTERWOOD, OROVILLE CONT: OWNER ` RENEW 03=0246 a 7.4 crbI 247-89 248-89 4 PERMIT NO. PERMIT EXPIRES OWNER CONTR. ASSESSOR PARCEL LOCATION .75 1755-89B . P . E , M a r/ TODD HEMSTALK ToddHemstalk 36-23-52 Shelterwood Lane, Oroville r 247-89 248-89 4 PERMIT NO. PERMIT EXPIRES OWNER CONTR. ASSESSOR PARCEL LOCATION .75 1755-89B . P . E , M a r/ TODD HEMSTALK ToddHemstalk 36-23-52 Shelterwood Lane, Oroville b` 1' 'J. wfi .i y il fl. t j` 1 Temp. Power Pole Called PG&E Temp. Elec. Service i; Y Called PG&E Temp. Gas Service Celled PG&E JOB FINALED (Date)v 7j Signature I = O<< .. 0 = Not OK ' = Not Read�yable MOBILE HOMES 1 r. MISCELLANEOUS Date MOBILE HOME UTILITIES (Plans) OK except #'s Date DECKS,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 1. Zoning Requirements -Setbacks -Easements' 2. Soils; Special MH Support -Sketch 2. Footings; -Soils -Size -Depth -Spacing -Connectors -Steel 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-Rftrs.-Connec.- Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Gas; Location -Test -Wrap: / P'L" ft. / /"Nat. or/ /"L"ft./ /"LPG - 6. Carports; Windows -Doors 7. Utility Clearance 7. Elec. 8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh Card -81 Date Card -131 Date 10. Roof; Shthg-Roofing Card -61 Date Card -131 Date 11. Ext.; Steps -Doors -Landings Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Card -131 Date Card -131 Date 2. Footings; Size -Spacing -Marriage Line Card -131 Date Card -81 Date 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances Date POOLS (Plans) OK except #'s 5. Drain; MH Test -Fall -Flex Connector N 1. Setbacks -Easements 6. Water; MH Test -Regulator -Connector •,, ' 2. Soils; Compaction -Structure Stability 7. Water and Sewer Connected -C/O to Grade -HD Approval 3. Pool Structure; Steel -Connections -Thickness ,. Dead Men -Lining 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 4. Elec.; Receptacles and Lighting, Distances-GFI 10. Cert. of Occupancy 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.;Ground ing; Equip. w/5' -circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panel boards- Ins. to Main in Conduit Card -131 Date Card -131 Date Card -61 Date Card -81 Date 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Card -131 Date Card -131 Date Card -131 Date Card -131 Date 'k ` J •16 1 w � 'k ` J •16 = VK 0 = NotOK RESIDENTIAL (Sirfgle and Duplex) - =Not Applicable = Not Ready Date UNDERFLOOR (Plans) OK except #'s oning-Setbacks;-Easements-Flood-Slope ! g., Main; Soils-Steel-ElFtg. Depth Ftg., Garage; Soils -Steel-/ /" Ftg. Depth 4. Ft , Porches & Decks; Soils -Steel-/ /"Ftg. Depth Stemwalls, Main; Steel- Blockouts-Wrapped t 16walls, Garage; Steel- Blockouts-Wrapped lab; Steel -Wrapped 8. Pi rs-Fireplace Ftg.-Steel W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test 10. Gas Pipe; Size -Anchors 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric; Underground 13. Plenums & Ducts; Clearance- Material -Su pprt-Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Insulation Card -BDate + jcard-81 Date Card -131 Date Card -131 Date Date P MBING (Permit) OK except #'s ter Ht. Vent -Access -Combustion Air -Baffle ater 5etAdst & Anchors -Nail Protection V.• st-pitngs & Anchors -Nail Protection -Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, 2nd Floor -Tub Access 1. Gas Pipe; Size & Anchors Card -131W Dat6?i/1 Card -B1 Date Card -131 Date Card -131 Date i Date ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection C23. Flec. Receptacles Spacing -Lights & Switches at Doors 4. Size Boxes & No. of Conductors -Stapled -25-. RQmex Installed Close to Edge of Studs & C.J. c?6.,Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water] --27. 2 Appliance Circuts in Kitchen & Conductor Size/G.F.I. e28-2ubfeed-Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga. Cu or Al -29--.Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral Yes No 30. Service -Riser Conductors & Ground -Main Disconnect 31. Equip. Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 3. Smoke Detector Card -B Datee/2, and -B1 Date Card -B1 KI Date Card -131 Date Date HANICAL (Permit K except #'s A.C. Du ns io Support ' 35. Vent Fan; h' ove insulation 36. Condensate Drain & Overflow; Size & Grade Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet Attic Acces & PI V Furnace in Attic Card -131 Date),/ and -B1 Date Card -131 Date Card -81 Date Date FR ING (Plans) OK excet #'s ills, Proper Materi & chor 0. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound earing Walls over Girders & Floor Nailing Draft Stop in Walls (rat proof) 43 Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Header & Beam -Size & Bearing Date FRAMING (Continued) 5. Hangers -Post Caps -Anchors -Connectors Ing. Joist-Rftr. Ties -Purl in -Roof Brac.-Truss-Shthng.-Rfng. F' eplace Ties or Type A Flue -Fireplace Throat Clearance ttic Access; Size & Romex Protection -Draft Stop -Ins. Baffles Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions Garage Fire Protection Framing Property Line Firewall & Openings L,182. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits _53.-Stair-s-Wfidth--;ieadroom -Rise- Run -Land ing-Fire Protection Plywood on Roof Overhang -Attic Vents -Rafter Outriggers `'SSSiding-Nailing Veneer 56�-Mesh-Drip Screed -Fd. Vents-Underflr. Access 57. Glazing Area -Glass Protection -Skylights -Plastic -56. Shea -r -Wall's; Nailing -Bolts e;Z 41 59.Insulation-Walls-Clg. 60. Infiltration-Walls-Wndws Card -B Dat -/aand-81 Date1-7 Card -B1 Date r Card -B1 Date Date FIN Plans) OK except #'s E�dt. teps-Door & Sidelight Protection -Landings 6Z'.'SmQke Detector 6 urnace; Vents -Clearance -Comb. Air-Connector- In�rage; Above Floor -Ducts -Meeh. Protection 64- Bedroom Exiting 65. . .1. & Bath Fixtures & Tub Access -Spa 66.E c. Trim & Subpanel; Breaker Sizes -Labels 6 . Stairs & Rails Fireplace or Stove; Clearances -Hearth 6 Elec: Outlets at Wood Panel; Int. & Ext. 70. 't!Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance 7 . Elec. Outlets & Receptacles at Kit. Counter 7.X -garage Fire Door; Swing -Landing -Closer 7 . A:C. Duct in Garage -Damper . Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In-Garage; Above Floor-Mech. Protection 75'Plb. ,Elec. & Mech. Equip. Listed for Location 76. le -Receptacles in Garage; (G.F.I.)-Romex Protec. 77. nsulation-Foam-Looked in Attic ❑ Yes 78. and Rails & Deck Construction -Post Caps 7 dn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 80. Following instld.; Drive ❑ Yes o; Walks ❑Yes ❑ o; Planters ❑ Yes ❑ No cco; Brown -Finish A.0 Unit; Disconnect, Electrical, Plumbing 86. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Openings. $ . Water Well; Disconnect, Electrical, Plumbing Exterior Elec. Trim; G.F.I. Receptacle -Underground 8 entilation throughout House "lass Protection Ae-ICo ections from Previous Inpections Gas .Test -Meters Tagged; Gas -Electric 9q!?er & Sewer Connected -C/O to Grade -HD Approval Energy Compliance Certificate -Other Certificates Card -61 g* Date%/� ?,1Card-B1 Date Card -131 Date Card -131 Date Card -131 Date Card -61 Date Comments at Final: (NOTE: An entry must be made each time you visit lob site) �. y -b`:• .ri— .�fSy �)4.� yr+y�,�..w. tri' ..'z'Sa}�tiYT�•w l.+ w�. . r:'1"1.. , �- 4 4 COUNTY OF BUTTE + y DEPARTMENT OF PUBLIC WORKS • 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 538-7541 747 Elliott Road, Paradise — Phone: 872-6307 T' CORRECTION NOTICE :3 72 5 PERMIT NO 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. Inspector ,�� Date l �� �a COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 538-7541 747 Elliott Road, Paradise — Phone: 872-6307 VNEH PERMIT Nf 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. r Inspector. Date COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive. Oroville — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 CORRECTION NOTICE T-1 INER PERMIT NO. 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 mat or need additional explanation, please contact this office Immediately. 64. W—F'2� aj 1�4 0M. -%W ME, -r' -�� I A I . , A 1� Inspector I Date 64. W—F'2� aj 1�4 0M. -%W ME, Inspector I Date 11 Owner: Permit No ENERGY CERT IF ICAT ION 75 Shelterwood Lane Orovillen. Ca. LOCATION A.P. No. DESCRIPTION OF INSULATION ROOF Material Thickness(inches) EXTERIOR WALL Material Fiberqlass batts Thickness(inches) 3 5/8" CEILING Brand Name Thermal Resistance (R Value) Brand Name Owens-Cornina Thermal Resistance(R Value) B13 Batt or Blanket Type Fiberglass batts Brand Name Owens-Corning Thickness(inches) 12"Thermal Resistance(R Value) R38 Loose Fill Type- �� Brand Name Minimum ThicknesW nciies) Number of Bags Wt. per bag lb. Area covered(ft. ) Thermal Resistance(R Value) FLOOR, ELEVATED Material Thickness (incites) FLOOR, .. SLAB Material Thickness(inches) Width(inches) FOUNDATION WALL Material Thickness(inches) Brand Name Thermal Resistance(R Value) -Brand Name Thermal Resistance(R Value) Brand Name Thermal Resistance(R Value) I hereby certify -that the above insulation was installed in the above building In conformance with the State of California Energy Requirements. Loerke Insulation Co. 499150 FIRM NAME/OWNER STATE CONTRACTOR'S LICENSE NO. December 15, 1989 SIG TURE OF IN TALLA.TION APPLICATOR DATE I -hereby certify the above insulation and all required items as shown on the Building Department approved plana and attachments 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 California. Ile 7`"� R (Please print) STATE CONTRACTOR'S ICENSE NO. . ra � SIGNA OF QE L CONTRACTOR OWNER ATIf THIS CERTIFICATE MUST BE ON FILE WITH THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION APPROVAL. ANDA COPY SHALL BE POSTED WITHIN THE BUILDING. January 1.984 J� 1 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroyille, California 95965 - Telephone: 916/538-7541 / APPLICATION AND PERMIT ASSESPARCEL NUMB ZO ING BUILDING PERM( OWNER TELE ONE SSS-• X68°1 . S0. FT. OCC. BUILDING VALUA ON OWNER'S MAILLN,G ADDRESS - 1016 A U 7,5 CO ;ACTOR'S NAME TELEPHONE 0- /'C% / A_,� &7v pywM -� 6Q CONTRACTOR'S MAILING ADDRESS Fireplace CON T UCTION LENDER UNKNOWN Total Valuation Is V y/ LEN ER'S M ILING ADDRESS Flling Fee $ 10.00 Permit Fee $ ARC I ECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ %3 Penalty $ BUILDING ADDRESS Permit fee $ �v` h PLUMBING PERMIT Filing Fee 10.00 Each Trap 11 2.00 lb Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 J -2 Each qas water heater or vent 5.00 USE OF STRUCTURE Gas piping system 1 - 5 outlets 5.00 SF N1 Duplex❑ Mobilehonie❑ Other _ Building sewer 5.00 SPECI FY Mobile Home S I G I W 0.00 ea TYPE OF WORK New U Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑ Permit Fee $ ^ Z -- Describe work: Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V ORLESSOR 10.00 /0,00 Main service EA. ADO'L 100 AMP 2.50 CONTRACTORS LICENSE LAW oR ADDNST ACCLLILN. C 6°1� 1/20sgft a 1 declare and enalty of perjury (check one): . NEW CUNSTR-I.'- TI.OVTLET LN 2.50 ea Cr—l- am licensed under provisions of Chapt. 9, Div. 3 of the Business NON-RESID .BRA CH CIRC ITS APPARATUS e) and Professio Code and my license is in full f and effect, (POWER (SINGLE OUTLET CIR. 92Z:�! Ex. Occup(OUTLETS OR FIXTURES 20950t License No. • Classification F1 1, as the owner, or my employees with wages as their sole compen- FIXED Ex. OCCUp. OUTLETS P(RESID,)REA.) e ALO 30 2.00 sation, will do the work,and the structure is not intended or offered Temporary service 10.00 for sale. (Sec. 7044) ❑ I, the Mobile Home Facilities 15.00 as owner, am exclusively contracting with licensed contract- ontract- ors. ors.(Sec. 7044) Misc. Wiring g 15.00 ❑ I am exempt under Sec. , Business and Professions Code for this reason Permit Fee $-72 Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): MECHANICAL PERMIT Filing Fee 10.00 ❑ The permi ' for 1100.00 (valuation) or less. Heating e 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. Cooling g ❑ I shall not employ any person in any manner so as to become subject Hood 3.00 to the W. C. laws of California. , Ventilation 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 permit Fee $ > provisions or this permit shall be deemed revoked. Contractor I certify that I have read this application and state that the above information Mobile Home Installation Fee $ is correct. I agree to comply to all County Ordinances and State Laws relating Energy Inspection Fee $" to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. TOTAL PERMIT FEE $ L6 ve, indemnify and keep harmless the County of Butte against ,q!lities, ju g ts, costs, and expenses which may in any way accrue OCCUP. CONST.TYPC 9cHao FLoo i7Z PARC PD ISSUE said Count in asequence of the granting of this permit.� This permit is hereby issued under the applicable provi- Date sions of the Butte County Code and/or resolutions to do Signature of Owner ❑ Contractor gent work indicated abo for which fee's have been paid. An OSHA permit is required for excavations over 5'0" deep and demolition or construct- I C OF BLIC WORKS ion of structures over 3 stories in height. � Receipt No. � ��� B Y — Date WHITE-D.P.W.• YELLOW-ASa E33OR, PINK -INSPECTOR. GOLDENROD -APPLICANT PERMIT EXPIRES Date Aw'` COUNTY OF BUTTE - DEPARTMENT OF `PUBLIC WORKS -BUILDING DIVISIONi 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNI4,9�965 - TELEPHONE: 916/538-7541 • ` PERMIT APPLICATION DATA SHEET Permit No.__k6 OWNER A. P. No.,3 , Proposed Building Use ,C.'ra/ ST- Building Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED 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. Energy Design Compliance and supporting documentation ......... 6. Statement of Intent for Non -Heated and AC Buildings .............. i7. 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 ..................................................... 61/ ice "Z, rF 6 . Z �L,�_ �_� School District fees paid ................. 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) ... Pre-Inspec. request to 19. Pre -Inspection for required ...... Building Inspector (Cate) Contractor's license information (No., Name Style, Classification) ....... 1. Certificate of Workmans Compensation Insurance .................... _ 22. Owner -Builder Verification (Given to owner ❑, Mail to owner o) .. - 23. Recorded copy of Agricultural Acknowledgment Statement ............ 24. Letter of siqnature authorization ..................................... When you issue the permit, process as follows: X Telephone `'16,9"I and hold for Other Appl ica Mai I to owner. (`` �P�l 'V;;�3•`t'�'�, sem' Mail to contractor. ice. Deliver w/inspector. Dat 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: ontr , 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_mail cow ter by date Plans checked by DatePlans approved by ate_ Sets of plans on hold in File cabinet A!L-AP. folder Copy—DPW ... ... ... f.u.a. ^_3:�n.�n.%. c ... ..}` _.�c....J �....... ... ....... �. ..ter. .J.uw.....��..�.r.�... .�.wn «+.......s. ... ....� .J' :C....v. .., ... _... _... ... a... .s a.....i�.... .i. .. ... TO Buildina Department ` FR6tl: Environmental Health SUBJECT:. Sanitation Clearance l dd,� �� 0-7 - - __ Owner Location ,C2. AF# Flan Approved for: Sewage Disposa'daterSuPP1Y Hold `irbal for: Water Supp1Y Final clearance O.K. for: Water SupP1Y Clearance vor bedroom mobil home. Other Date . Sareitar ian BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM •�/ (One Form per Building) Number Building Department No. School Districte7galrr'/'c rce_,!�, City = County ® Jurisdiction Property Owner �jn61 116M57A-4 &;V Qod LAA— Project Location/Address�A, C1Drn,A—Gc (?A,, 959 Subdivision Lot Number Residential Development: Sq. Footage /d:4 # of Living MHI Addition (Group R) Units Commercial/Industrial: a New Building Department Representat ve Sq. Footage Addition (Including Exterior Roofed Areas) Date ******************************************************************* (Floor Plans reviewed by School District Personnel) District Id No. 1-71-5- School '.5School District certifies that (Applicant Name) (Phone Number) (Street Address) (City) (State) (Zip Code) has complied with the requirements of Resolution No. 1_14-92-12— by _1-92%/2— by the payment of $ School District Representa representing 10/6 square feet. 7 3. e 9 ive Date PAID BY CHECK NO. 391 REMARKS: BANK NO (% ) 76/77 PAID BY CASH white -applicant, yellow -building department, pink -school district SCHOOL.FEE (8/88) ❑ Complaint -Dace . Other' -Date " BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS SPECIAL INSPECTION"REPORT Owner: `J �• �` . ^^ p Address: ZONING A. P. # > b 27 —J Date of Inspection % e� -.-�7 Tenant: inspector `j c�— Building Location: .7 �77 Ito Type of Inspection requested: 1. Housing ".2. Financing Lj 3. Change of Occupancy to A 4. Work W/0 Permit / / 5. Other (specify) Present use of building: ��-��-Q- -� J"�) _ Sanitation ( sing) / 1. Water closet: o 2. Lavatory: 3. Bathtub or shower: 4. Kitchen sink: 5. Hot and cold water to fixtures: 6. Heating facilities: 7. Natural light and ventilation: 8. Room and space requirements: 9. Bedroom window or door for second exit: 10. Infestation of insects, vermin, or rodents: 11. Connection to sewage disposal: 12. Connection to water supply: 13. . Rubbish and garbage facilities: 14. Stairs:(Rise, Run, Headroom, 1HR, Tolerances,Handrails) 15. Comments: B. Structural 1. Piers and footings: 2. Floor construction: 3. Wall construction: Zx� ®/G+ ` 'DZ.�___ 4. Ceiling and roof construction: 1L vs t 5. Fireplaces: 6. Comments: C. Electricals 1. Service and ground: 2. Receptacles: 3. Fusing: 4. Comments: J1 A> 11C ill 4 4 D. Plumbing 1. Fixtures connected and vented:.. 2. Gas water heater: 3. Gas heating vents: 4. Comments: E. Other 1: Maintenance and repair: 2. Fire hazards: 3. Safety hazards: 4. Weather protection: 5. Underfloor and attic ventilation: 6. Energy:. 7. Comments: F. Commercial Buildings 1. Roof covering: 2. Distance to property lines: 3. Physically handicapped: 4. Restroom floors and walls: 5. Exits: 6. Improvements: 7. Zoning: 8. Comments: G. Field Problems or Violations 1. Problem or violation (give complete description): 2. What action taken (give complete description): 3. What action recommended: A. Information only - file. B. Hold for ten days, then write letter. C. Write letter. / / D. Other: RESIDENTIAL. X36-23-52 1015-90B t iHEMSTALK, Todd j 175 Shelterwood Ln, Oroville t(sf gar. conv.-fam rm) J I JOB Sig •J=OK O = NOFOK Not = Not Readyable MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except Its 1. Zoning Requirements -Setbacks -Easements 2. Soils; Special MH Support Sketch 3. Sewer; Location -Test -Fall -C/O Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearences-Grnd-/ /Amp -Concrete 6. Gas; Location -Test -Wrap: / /"L"ft. / /"Nat. or/ /"L"ft./ /"LPG 7. Utility Clearance Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 10. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS OVERS CARPORTS, GARAGES, Plans OK except #'s on' 'Requirements -Setbacks -Easements ootings; Soils -Size -Depth -Spacing -Connectors -Steel 3. 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 Datd"7-1 „ Q 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-Paneiboards-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 V OK O=Not OK - = Not Applicable Not Ready RESIDENTIAL (S ' = Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks -Easements -Flood -Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth 5. Stemwalls, Main; Steel -Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. Gas Pipe; Size -Anchors 11. Water Pipe; Test -Anchor -Regulator -Service Test 12. Electric; Underground 13. Pienums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 16. Water Htr.; Vent -Access -Combustion Air -Baffle 17. Water Pipe; Test & Anchor -Nail Protection 18. D.W.V.; Test -Fittings & Anchor -Nail Protection 19. Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, Second Floor -Tub Access 21. Gas Pipe; Size & Anchors Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection 23. Elec. Receptacles Spacing -Lights & Switches at Doors 24. Size Boxes & No. of Conductors -Stapled 25. Romex Installed Close to Edge of Studs & C.J. 26. Equip. Ground made up w/Mech. Fastners-Bond Gas & Water 27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral 0 Yes 0 No 30. Service -Riser Conductors & Ground -Main Disconnect 31. Equip. Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 34. A.C. Ducts Insulation & Support 35. Vent Fan; Exhaust above insulation 36. Condensate Drain & Overflow; Size & Grade 37. Furnance-Vent; Access -Comb. Air -Return Air Vent -115 outlet 38. Attic Access & Platform if Furnance in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Plans) OK except #'s 39. Sils, Proper Material & Anchors 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound 41. Bearing Walls over Girders & Floor Nailing 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 4 Headers & Beam -Size & Bearing (NOTE: An entry must be mal IM jingle & Duplex) Date FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. ties-Purlin-roof Brac-Truss-Shthng.-RIng. 47. Fireplace Ties or Type A Flue -Fireplace Throat clearance 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing 51. Property Line Firewall & Openings 52. Ext. Doors -One 3' -Check Garage -3rd Story, 2 Exits 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 54. plywood op Roof Overhang -Attic Vents -Rafter Outriggers 55. Siding -Nailing Veneer 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 57. Glazing Area -Glass Protection -Skylights -Plastic. 58. Shear Walls; Nailing -Bolts 48rfr116u lation-Walls-Ceilings 60. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 6313teps Door & Sidelight Protection -Landings Smoke Detector ,,--@5--Fu-rnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection x...64-BStlroom Exiting -O,r-G.F.1. & Bath Fixtures & Tub Access -Spa Elec. Trim & Subpanel; Breaker Sizes & Labels ----6;r-Stairs & Rails 68. Fireplace or Stove; Clearances -Hearth Elec. Outlets at Wood Panel; Int. & Ext. 0. Kit.Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance ---T91-ec. Outlets & Receptacles at Kit. Counter ---Z2-Qa;:aqe Fire Door; Swing -Landing -Closer _--73-A.C. Duct in Garage -Damper qtr.; Vents -Clearance -Comb. Air-Connector-P.R.V. In Garage; Above Floor-Mech. Protection /757-Plb., Elec. & Mech. Equip. Listed for Location BYec. Receptacles in Garage; (G.F.I.)-Romex Protection 7. Insulation -Foam -Looked in Attic 19es Guard Rails & Deck Construction -Post Caps . 79. FFA Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor 0 Yes Following instld.; Drive 0 Yes 0 No; Walks 0 Yes 0 No; Planters 0 Yes 0 No �&1-Stucco; Brown -Finish ---T2-A.C. Unit; Disconnect, Electrical, Plumbing Vents Above Roof; Plbg.-Appliance-Fireplace.-Clearance to Openings Water Well; Disconnect, Electrical, Plumbing erior Elec. Trim; G.F.I. Receptacle -Underground lk-6. Ventilation Throughout House _ 4;-. etass Protection 8. Corrections from Previous Inspections 89. Gas Test -Meters Tagged; Gas -Electric Yer & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates Date --) Card B-1 Date Card B-1 Date: Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: I le each time you visit job site) w COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891-2751 • 7 County Center Drive, Oroville — Phone: 538-7541 41 747 Elliott Road, Paradise— Phone: 872-6307 1 CORRECTION NOTICE ikm' 4L &A OW ER PERMIT NO. 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 need additional explanation, please contact this office immediately. �� Com) A 19 /1 /1_ - - A i _ r L 1 - Date& 1 _ l '-Inspector j�... Owner:., Permit No. ENERGY CERTIF I C A T ION LOCATION A.P. No. DESCRIPTION OF INSULATION ROOF Material Brand Name Thickness(inches) Thermal Resistance (R Value) X EXTERIOR WALL . � Material ,,-ir 3 2 /As5 Brand Name v Thickness(inches) Thermal Resistance(R Value)_ CEILING � Batt or Blanket Type >`/ 3K2G�A>� Brand Name Thickness(inches) Thermal Resistance(R Value) Loose'Fill Type Brand Name Minimum ThicknesWnches) Number of Bags Wt. per bag lb. Area covered(ft. ) Thermal Resistance(R Value) FLOOR, ELEVATED Material Thickness(inches) FLOOR, SLAB Material Thickness(inches) W idth(inches) FOUNDATION WALL Material Thickness(inches) Brand Name Thermal Resistance(R Value) Brand Name Thermal Resistance(R Value) Brand Name Thermal Resistance(R Value) I hereby certify that -the above insulation was installed in the above building in conformance with the State of California Ener &, Requirements, FIRM NAME/DLAT STATE CONTRACTOR'S' LICENSE NO. 'C SIGNA IONAPPLICATOR ZDAtf I hereby certify the above insulation and all required items as shown on the Building Department approved plans and attachments 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 California. 72 ? CONTRACTOR ' S, LICENSE NO. 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 r COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive ;Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 36-23-52 ZONING BUILDING PERMIT OWNER Todd Hemstalk TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 75 Shelterwood CONTRACTOR'S NAME Same TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace 0. CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 10,00 LENDER'S MAILING ADDRESS Permit Fee $ 26. 5Q ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee ,$' Energy Plan Checking Fee ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 75 Shelterwood Lane, Oroville 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❑ Other SPECI Fr Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G W 10.008 TYPE OF WORK New Addition❑ Remodel❑ Utilities❑ Installation❑ Other F] Describe work: Gar -age GeRvFamily Fe _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10:'JO Main service 8001 OR LESS 100 AMP OR LESS 10.00 - Main Service EA, ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW Id Clare 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�1�, 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 ADONS. ACC. BLDGS. 2h Qsq ft NEW CONSTR MULTI -OUTLET NON•RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS & SINGLE OUTLET CIR. Ex. X. Ccup( OUTLETS OR FIXTURES O AL@30Q S ALe FIXED EX. Occup. OUTLETS P(RESIO )PEA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring g 15.00 Permit Fee $ Contractor 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. 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. I also agree to save, indemnify and keep harmless the County of Butte against osts, and expenses hich may in any way accrue agai t aid'Count in quence of r tin of this permit. all liabi 't,,ies, judgmenDnIvu-1VTh;s X Date Signature of Applicant — Owner [:]Con actor ❑ Agent An OSHA permit is required for excavations over 5'0" deep andem litio o Pps ru ion of structures over 3 stories in height. .7 Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE 3e-00 TOTAL FEE AL E _79 AZ CUA PARK PAR HD Iss permit is nereby issued under sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By / PER T EXPIRES Date _ the applicable provi- resolutions to do have been paid. WORKS Date Gl _3 1 Y-Z� _ 4 f Receipt No. WHITE-O.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD-APPLIC T tom..-. " � � �f''!""''N`''�;�h;�vk'��■-r�'Cr:�/'N-3�.^'�(�F'�"�L �~f1ti�+✓�-•7k"yil�l�'N�'�'y-'�"�L`1M+w�v.y"�"--.ti....�ti ..... COUNTY OF BUTTE - DEPAR-TMEf Y OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENT&DINIVE - 09OVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 O PERMIT APPLICATION DATA SHEET tZ Permit No. OWNER ADD /i1STAc.i A. P No. 36 --W:!;-S� Proposed Building Use 4SAm— ddd44 Building Inspector Date C1 At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPR ED 1. All items have been submitted . .................................... . Plot plans in duplicate/triplicate, signed by preparer of plans........ 3 C I t 1 1'It /t • I' t d b arer of tans . Omp e e p ans In>Aup ca a rip Ica e, signe y prep p 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 instructions .......................... i............................ 1'0. Fees of $ ........................ 11. Chico Urban Area fees paid ....................................... Parkfees paid LE- . ........ . 3. t�� School District fees paid ........ - 4. Sanitation approval from IKU��'�'F Health Department—�� 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: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 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 .........' 25. Letter of signature authorization...................................� 26. ' 27. When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone Sn— /699 and hold for pickup at QTe0 office. Deliver w/inspector. Other /-A _ Appl ican Copy of Haz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By. The following data must be submitted prior to permit i 1. Index permit for above items,No. 2. Additional items required: (Circle new item not checked above). Contractor, designer, owner, was advised of above required data by_phone---naiI—counter by ..date Contractor, designer, owner, was advised of above required data by—phone —mal l—counter by date Plans checked by Date Plans approved byDate l� Sets of plans on hold in File cabinet G ��� ��—r Copy—DPW ��;�y�:., ��„'�. ."--w-`.,"r.,.v"V��.^`-_""""'r"l3�"'..,"'.�.i�tT,��`rP"0�i'�."'[.'Z'yw,i'„'c,w+�.+""^"...•,.•'ri”sa'�F'•�r"�JK-i'i''7.+.`ai.t.+'4..-m'Cs- i...-.--. -- BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM (One Form per Building) A.P. Number 36 --?3- Building Department No. School District(2eo City n County rX_!'_1 Jurisdiction Property Owner 7(5V1_2 11f2f,i52,24C-,K, Project Location/Address 75 '::�44647ee,,x= 4W. QQQ. '?a66 Subdivision Lot Number Residential Development: a I Sq. Footage 3QS GAre # of Living MHI Addition (Group R) QIvv► Units Commercial/Industrial: a Sq. Footage New Addition (Including Exterior Roofed Areas) �Buildin�g Departmen&'Representative L `Date (Floor Plans reviewed by School District Personnel) District Id No. 9 School District certifies that (Applicant Name) (Phone Number) (Street Address) (City) (State) (Zip Code) has complied with the requirements of Resolution No.%-/-� by the payment of $ A� A representing square feet. School-District,Representative _.-. Date PAID -BY CHECK NO. BANK NO PAID BY CASH REMARKS : CiY�j�i - ��/'�G f ao white -applicant, yellow -building department, pink -school district SCHOOL.FEE (8/88) FOR M % ADDITIONS tO RESIDENTIAL BUILDINGS ENERGY SHEET PACKAGE "A" (Additions) Owner%'� 5�,� Climate Zone Permit # Floor Area. l The following data showing mandatory and required features of Package "A" shall be installed for additions to dwellings. Additions to dwellings include room additions, converting garages and patios to living areas, house moves that add footage and attic conversions, and any space that is existing non -conditioned space that is converted to conditioned space. Remodeling of existing conditioned space is not included. ZONE 11 NE APPLIES TO NEW AREA JP CEILING R-30 R-38 ® WALL R-11 R-1� FLOOR R-11 R-19 SLAB R-7 R- 7 ®, GLAZING U-.65 (Dual) U .65(LQual) SHADING SOUTH - OPTIMUM OVERHANG or .36 Shading. Coefficient WEST - .36 Shading Coefficient, LOOSE FILL INSULATION (Density) ® INFILTRATION CONTROL (Weatherstrip doors, certified windows, caulking) VAPOR BARRIER (Zone 16) - ®DUCTS PER UNIFORM MECHANICAL CODE - Ch. 10 LIGHTING KITCHEN & BATH NOT,LESS THAN 25 LUMENS/WATT ® MAXIMUM GLAZING 16% OF -AREA PLUS REMOVED GLAZING NEW HEATING, VENTILATING,'AIR CONDITIONING AND HOT WATER.SYSTEMS IN CONJUNCTION WITH AN ADDITION SHALL BE INSTALLED AS SHOWN ON -BACK OF THIS SHEET. OTHER 12/85 *1 HEATING VENTILATING AIR CONDITIONING SYSTEM (A) Heating ❑ Central Gas Furnace (brand and model number) SE Btu/hr (heating capacity) 13 Heat Pump (brand and model number) ACOP Btu/hr (heating capacity at 47°F) 13 Active Solar type (liquid or air) Collector brand and ft2 model number solar fraction collector area collector orientation collector tilt rated y -intercept rated slope 13 Other (describe) *1 (B) Cooling 13 Electric Air Conditioner (brand and model number) (seasonal EER) Btu/hr (cooling capacity at 95°F) Electric Heat Pump EER Btu/hr (cooling capacity at 95°F) Other (describe) DOMESTIC WATER SYSTEM 13(A) Gas Only Gallons (brand and model number) (tank size) 0 Heat Pump w/Electric Backup (brand and model number) Gallons (tank size) 13 *2 Active Solar (collector brand and model number) (rated y -intercept) (rated slope) (solar fraction) ft (backup heater type, brand and model number) (collector area) (collector orientation) (collector tilt) 0 location of Solar Panels 13 Other (Describe) *1 Submit documentation of sizing heating and cooling equipment by Manual J, sizing charts (form #4) or other approved methods, section 2-5352(g), and fill out the following: Heating: Winter design temperature °, elevation ', heating load BTU elevation factor x heating load - maximum outlet capacity gas furnace 1 BTU Cooling: Summer design temperature `, cooling load BTU *2 Submit T.I.P.S.E. chart'or other approved system (form #5) to document sizing of solar panels. ® DESIGN COMPLIANCE STATEMENT: The above building design meets the requirements of Title 24, Part 2, Chapter 2-53 of the California Administration Code. SIGNATURE OF BUILDING DESIGNER OR APPLICANT Buildina Department FROM: Environmental Health SUBJECT: Sanitation Clearance - Owner Location AP# �A Plan Approved for: Sewage Disposal dater Supply Fold final for: sinal clearance O.R. for: clearance for Water Supply Water Supply 7�elt NOTES y I RESIDENTIAL 036-230-052 03-0246 PERMIT NO. f HEMSTALK, TODD & MICHELLE 75 SHELTERWOOD, OROVILLE j 2 BRA BATH ADDITION SPECIAL CONDITIONS SRA FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STAN DARD&OUSING LETTER t JOB FINALED (Date) . Signature �e . i CHECKED BY J ; OK 0 = Not OK . = otReadyable 1. MOBILE HOMES Date MOBILE HOME UTILITIES (Plans) OK except #'s 3. 1. Zoning Requirements -Setbacks -Easements Wood Awn.; Posts- Beams- Rftrs-Connectors Shthg-Frg-Bracing 2. Soils; Special MH Support Sketch 6. 3. Sewer; Location -Test -Fall -C/O -Concrete Electric 4.. Water; Location -Test -Easement Needed (Sketch) 9. 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete Roof; Shthg-Roofing 6. Gas; Location -Test -Wrap;-/ /" L 'ft. / P Nat. or / /" L "ft./ P LPG 12. 7. Well Clearance & Disconnect Elec.; Enclosures; Conduit Entries -Terminals -Listed 8. Utility Clearance Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Panelboards-Ins. to Main Conduit 9. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s 12. 1. Zoning Requirements -Setbacks -Easements • 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PERMANENT END SYSTEM (ONLY) 1. Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH Test -Demand -Valve 5. Electricity; MH Test 6. Water; MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged .9. Exits 10. License Decals 11. Verify #'s with Office Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beams- Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Panelboards-Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK = Not Applicable . = Not Ready RESIDENTIAL (Single & Duplex) Date UNDE O (Plans) OK except #'s Date o ' g -Setbacks -Easements -Flood -Slope Date tg., Main; Soils -Elea Grnd.-''Z'F tg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, % -rapped 8. P' -Fire lace Ftg.-Steel W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies Date 15. Access & Ventilation Date 16. Insulation Date MECHA (Permit) OK except #'s Date Date Card B-1 Date Card B-1 Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s ter-Htr.; Vent -Access -Combustion Air Baffle 1 _t i e; Test & Anchor -Nail Protection 2�) rOSdZ� 1 D .V.; Test Fittings & Anchor -Nail Protection Date ower Pan; Test, First Floor -Tub Access Date 21--Test'-Mb & Shower, Second Floor -Tub Access Date 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler; Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24F;0wm & Transformer Clearance -Ins. Protection 25'. Receptacles Spacing -Lights & Switches at Doors 26 ize oxes & No. of Conductors Stapled 7 o x Installed Close to Edge of Studs & C.J. 2 quip. Ground made up w/Mech Fasteners -Bond Gas & Water pliance Circuits in Kitchen & Conductor Size GFI 36-9abWd Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al 4+--R-ange Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral 0 Yes O No 32: 6emlt°e-Riser Conductors & Ground Main Disconnect 3 earances Panels-Motors-Mech. Equip. lothes Closet Light -Shower Light -Spa Light 35. oke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHA (Permit) OK except #'s 4&1'X_.C._Pmet9 Insulation & Support ue-ve`nt Fan, Exhaust above insulation 38-�lensate Drain & Overflow, Size & Grade W_Fvr_r'ac - cess -Comb. Ait-Return Air Vent 115 Outlet is Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING Permit) OK except #'s dle'li_lls_Pwper Materials & Anchors a tuds-Nailing Spacing & Braces -Plates -Sound Be alts over Girders & Floor Nailing Dr op in Walls (rat proof) Fir ops, Furred Ceilings -Stairs -Chasers -Tubs Headers & Beams -Size & Bearing Date FRAMING (Continued) _ yrs -Post Caps -Anchors -Connectors Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. j19 5pace Ties or Type A Flue -Fireplace Throat Clearance &G-Attt6"Access; Size & Romex Protection -Draft Stop -Ins. Baffles 4T_J3drTrr-Windows or Exiting Doors -Sill Ht. & Dimensions ra a Fire Protection Framing -RC Channel ropertv Line Firewall & ODeninos fit. Do s -One 3' -Check Garage 3rd Story, 2 Exits airs �dth-Headroom-Rise-Run-Landing-Fire Protection o on Roof Overhang -Attic Vents -Rafter Outriggers Ki ng -Nailing Veneer e� Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access _QAning Area -Glass Protection -Skylights -Plastic alls; Nailin - 61. Br ce Interior/Ex erior Wall Panel ulation-Walls-Ceilings 6 Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 64. Ext. Steps -Door & Sidelight Protection -Landings 65. Smoke Detector 66. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 67. Bedroom Exiting 68. G.F.I. & Bath Fixtures & Tub Access -Spa 69. Elec. Trim & Subpanel, Breaker Sizes & Labels 70. Stairs & Rails 71. Fireplace or Stove, Clearance -Hearth 72. Elec. Outlets at Wood Panel, Int. & Ext. 73. Kit. Fixt. & Appliance; Ground -Air -Gap -Cooking Clearance 74. Elec. Outlets & Receptacles at Kit. Counter 75. Garage Fire Door; Swing -Landing -Closure 76. A.C. Duct in Garage -Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 78. Plb.; Elec. & Mech. Equip. Listed for Location 79. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 80. Insulation -Foam -Looked in Attic 81. Guard Rails & Deck Construction -Post Caps 82. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor 0 Yes 83. Follo&g Instld./Drive 0 Yes O No/Walks O Yes 0 No/Planters 0 Yes 0 No ucco Brown -Finish 85. A.C. Unit Disconnect, Electrical -Plumbing 86. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 87. Water Well, Disconnect, Electrical, Plumbing 88. Exterior Elec. Trim, G.F.I. Receptacle -Underground 89. Ventilation Throughout House 90. Glass Protection 91. Corrections from Previous Inspections 92. Gas Test -Meters Tagged, Gas -Electric 93. Water & Sewer Connected -C/O to Grade -HD Approval 94. Energy Compliance Certificate -Other Certificates 95. Address Posted 96. Fire Sprinkler Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: L School District A.P. Number Property Owner Property Location/Address Subdivision ►ACT FEE CERTIFICATION FORM per Building) , „ , 1 2 ©County Lot No. ................................................�........................................................... Residential Development No of Living Mobile Home Addit� Supplemental to Units Installation Conversion Permit # *(No foundation inspection); Building Department Representative (Floor Plans reviefJ by School District Personnel) District Identification No. 15 j, R Sq. Footage 47 (Group R) Sq. Footage Including Exterior Roo �reas� (� Date School District certifies that e (Applicant) (Street Address) (Phone Number) (City) (State) (Zip Code) has complied with the requirements of Resolution No. 6 k—d1—k by payment of $ N /c— representing Lrepresenting 4V1 1J square feet. AB 2926 $ FULL MITIGATION $ School District Representative Date Paid by Check # L Remarks: Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with Government Code Section 660201a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the imposition of the fees in any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA), this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.xls (10/98)dmm O.B.-1 . OWNER -BUILDER VERIFICATION Attention Property Owner: An "owner -builder" building permit has been applied. -for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. personally plan to provide the major labor and materials for construction of the proposed rl� roperty improvement: YES 11NO 11I HAVE ❑ HAVE NOT ❑ signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: PHONE: 4. I plan to provide Porti supervise, and provide the NAME: ADDRESS: PHONE: 5. I will provide some of the work indicated: NAME SIGNED: PROP] SOCIA DATE: NOTE: CITY: CONTRACTOR'S this work, but I have h' the following person to coordinate, CITY: 'S MENSE NO. work but I have contracted (hired) ADDRESS PHONE persons to provide OF WORK This Owner -Builder Verification is required by Section 19831 and 19832 of the California Health and Safety Code. This verification must be completed and returned to our office before we are permitted to issue the permit. OVER OWNER BUILDER INFORMATION Dear Property Owner: O.B.- I An application for a building permit has been submitted in your name listing yourself as the builder of property improvements specified. For your protection, you should be aware that as "owner -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 '$300 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 Governments as an employer and you are subject to several obligations including state and federal income tax withholding, federal social security taxes, workers compensation insurance, disability insurance costs, and unemployment compensation contributions. ♦ There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to worker's compensation insurance. ♦ For more specific information about your obligations under Federal Law, contract the Internal Revenue Service (and, if you wish, the U.S. Small Business Administration). For more specific information about your obligations under State Law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed contractors are allowed to perform their work personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contracting the Contractors State License Board in your community or at 1020 N Street, Sacramento, CA. 95814. Please complete the "Owner Builder Verification" on the reverse side of this form so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. 4rely, C. Vi ira, C.B.O. r, Building Inspection NOTE. This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code OVER COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET OWNER:t.�C�-�t--L'. VG �ASSESSOR PARCEL NUMBER a` J� Proposed Building Use: s t ��/ Counter Technician: tom... Date: % �- Items required in order to apply for a permit. All boxes MUST be checked OI marked NA in order to apply. L. Plot plans, 3 or 4 sets, signed,�y the preparer of the plans. 2" Complete plans, 3 or 4 sets, signed by the preparer of the plans. /❑ 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. 4- Engineered truss details and layouts in duplicate. No faxes! �i 5. Energy compliance design and supporting documentation in duplicate. ❑ 6. Manufactured homes: (A) Data sheets and installation instructions, (B) Marriage line information, (C) Floor Plan, (D) Tie down or foundation plans, all in dualicate. ❑ 7. Metal buildings: (A) Metal Building Plans, (B) Foundation plans and calculations in triplicate, (C) Elevation views in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. Items required for initial plan review. If checked items have not been received, plan review cannot proceed. The.permit will be indexed and returned to the plan review line-up when required items are received. Date Received By A)A-8. Flood Elevation Certificate, wet -stamped and signed, in duplicate ................................ ❑ 9. Plot plan and business license approval from the City of Biggs .................................... ❑ 10. Letter of intent for non-residential buildings......................................................... ❑ 11. Detached Accessory Building Form filled out by the owner ..................................... ❑ 12. Hazardous Material Form............................................................................... _ ❑ 13. Other maining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) 4. bees as shown on the attached Schedule of Fees Due Sheet ....................................... Statement of Intent for Non -heated and A/C Buildings ............................... Sanitation and plot plan approval from the Environmental Health D;Parc ment in�� r/v 1 ❑ 7. City of Chico Plumbing permit ............................. ............ ....2. ZV 18. California Department of Forestry plan approval fiaid. Sent. by: �..1............. 19. Planning approval for (A) Use: C�IK (B)Parking: (C) Check: 2-29 0,�) ❑ 20. Contact Land Development about ❑ Improvements, ❑ Drainage .............................. ❑ 21. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 22. Pre -Inspection for required ................ ❑ 23. Contractor's license information. (Number, Name Style, Classification) ...................... j 2 °.Worker's Compensation Carrier a d Policy Number ..............:.............................. �". Owner -Builder Verification ( ,iven to owner, ❑ Mailed to owner) ..................... ❑ 26. Letter of Signature authorization.................................................................... ❑ 27. Recorded copy of Agricultural Acknowledgment Statement .................................... ❑ 28. Manufactured home utility clearance............................................................... ❑ 29. Existing violations and/or expired permits......................................................... ❑ 30. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts, ❑ Letter from Legal Owner, ❑ Check to H.C.D. $ ❑ 31. Other: When issued Telephone and hold for pickup. I have been informed of the above items and requirements for obtaining a building permit. Appl 1. Index permit application fort a above items numbered: 2. Additional items required Contractor, designer, owner, was advised cf the above data by Contractor, designer, owner, was advised of the above data by Plans reviewed by: Date: Structural reviewed by: Date: Note transfer by: Date: V,11—v u as Plan Check Letter ❑ phone, ❑ mail, ❑ counter, by Date: _ ❑ phone, ❑ mail, ❑ counter, by Date: _ Plans approved by: & X Date: _Structural approved by: Date: rn� TO: FROM: SUBJECT: Building Department Environmental Health Sanitation Clearance E. Uk� 3E ONLY Snot Stan dttecfiod Floor !fin Attachad�— sanz to ®.D. 1 --7-no 6L n�bP N ?�S Sh,� 1j, w6rt� `3 7-3-'-s 2-. Owner . Location AP# Plan Approved for: Sewage Dispos i Water Su ply: Public Pr'vate Well Clearance for dwelling. Other 3 WP Hold final for: Final NOTE Environmental Health Specialist 8/96 9LQ I -Lr,-,&? Date NOTES RESIDENTIAL y PERMIT NO. i 036-230-052 04-0900 HEMSTALK, TODD t 75 SHELTERWOOD, OROVILLE CONT: ONMNI ER- I RENEW ,03-0246 CHECKED y BY SRA ,FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER 5 o C_-3 JOB FINALED (Date) .4 Signature : R ren. Q 48.. A ' a eV n t4iq W SPECIAL CONDITIONS CHECKED y BY SRA ,FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER 5 o C_-3 JOB FINALED (Date) .4 Signature : R ren. Q 48.. A ' J=OK G Not OK = Not Applicable . = Not Ready DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 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/0 -Concrete 4. Water; Location -Test -Easement Needed (Sketch) 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 6. Gas; Location -Test-Wrap; -/ P' L'ft. / P Nat. or/ P' L "ft./ P LPG 7. Well Clearance & Disconnect 8. Utility Clearance 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Date 12. Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HOME INSTALLATION (Plans) OK except #'s Card B-1 Date Card B-1 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. ti 10. Exits; Insp.-Sketch 11. Cert. of Occupancy 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date 12. Card 6-1 Date Card B-1 , Date Card B-1 Date Card B-1 Date 1 PERMANENT END SYSTEM (ONLY) Card B-1 Date Card B-1 1. Zoning Requirements -Setbacks -Easements Card B-1 Date Card B-1 2. Footings; Size -Spacing -Marriage Line 3. Blocking 4. Gas; MH .Test -Demand -Valve 5. Electricity; MH Test 6. Water; MH Test 7. Water and Sewer Connected 8. Gas and Electricity Tagged 9. Exits f r 10. License Decals 11. Verify #'s with Office J Date Card B-1 Date Card B-1 , Date Card B-1 Date Card B-1 - I I _ 1;1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS, GARAGES (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks, Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs-Connectors Shthg-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date POOLS (Plans) OK except #'s 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance -GA 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Panel boards- Ins. to Main Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche 12. Enclosure; Fencing -Alarms Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 J=OK 0 = Not OK - = Not Applicable s = Not Ready RESIDENTIAL (Single & Duplex) Date UNDERFLOOR (Plans) OK except #'s Hangers -Post Caps -Anchors -Connectors 1. Zoning -Setbacks -Easements -Flood -Slope 49. 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 52. Garage Fire Protection Framing -RC Channel 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth 54. 5. Stemwalls, Main; Steel -Blockouts-Wrapped Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 6. Stemwalls, Garage; Steel- Bloc kouts-Wrapped 57. 6a. Hold Downs and Special Anchors Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 7. Slab, Steel -Wrapped 60. 8. Piers -Fireplace Ftg.-Steel Brace Interior/Exterior Wall Panels 9. D.W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors -Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent -Access -Combustion Air Baffle 18. Water Pipe; Test & Anchor -Nail Protection 19. D.W.V.; Test Fittings & Anchor -Nail Protection 20. Shower Pan; Test, First Floor -Tub Access 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors 23. Fire Sprinkler; Test Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s 24. Fixture & Transformer Clearance -Ins. Protection 25. Elec. Receptacles Spacing -Lights & Switches at Doors 26. Size Boxes & No. of Conductors Stapled 27. Romex Installed Close to Edge of Studs & C.J. 28. Equip. Ground made up w/Mech Fasteners -Bond Gas & Water 29. 2 Appliance Circuits in Kitchen & Conductor Size GFI 30. Subfeed Wire Size/ /ga. Cu or AI-A.C. Wire Size/ /ga Cu or Al 31. Range Circle/ /ga Cu or AI -Oven Circ. / /ga Cu or Al Insulated Neutral O Yes O No 32. Service -Riser Conductors & Ground Main Disconnect 33. Equip. Clearances Panels-Motors-Mech. Equip. 34. Clothes Closet Light -Shower Light -Spa Light 35. Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MECHANICAL (Permit) OK except #'s 36. A.C. Ducts Insulation & Support 37. Vent Fan, Exhaust above insulation 38. Condensate Drain & Overflow, Size & Grade 39. Furnace -Vent Access -Comb. Ait-Return Air Vent 115 Outlet 40. Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FRAMING (Permit) OK except #'s 41. Sills Proper Materials & Anchors 42. Walls Studs -Nailing Spacing & Braces -Plates -Sound 43. Bearing Walls over Girders & Floor Nailing 44. Draft Stop in Walls (rat proof) 45. Fire Stops, Furred Ceilings -Stairs -Chasers -Tubs 46. Headers & Beams -Size & Bearing Date FRAMING (Continued) 47. Hangers -Post Caps -Anchors -Connectors 48. Cling. Joist-Rftr. Ties-Purlin-Roll Brac.-Truss-Shting.-Rtng. 49. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 50. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 51. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 52. Garage Fire Protection Framing -RC Channel 53. Property Line Firewall & Openings 54. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 55. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 56. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 57. Siding -Nailing Veneer 58. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 59. Glazing Area -Glass Protection -Skylights -Plastic 60. Shear Walls; Nailing -Bolts 61. Brace Interior/Exterior Wall Panels 62. Insulation -Walls -Ceilings 63. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (P OK except #'s t. St oor & Sidelight Protection -Landings oke Detector / 66 onnector- Protection 8 & Fixtures & Tub Aeee'-ss-Spa 6 lec. Trim & Su el, Breaker Sizes & Labels 7n STairc R Ra'1 71Fireplace or RTrn,n C1e.,..,nr•e_Hearth ne , nt. Ext. 7 - .00kin C(parance -74 at KIL. eam ter 755 (`nrage Fire nn n - Q,Annn-1 aQQliR0-/`i.." F8 7LA C r)uM in G-a9c-Damper 77. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in 78. Plb.; Elec & Mech. Equip. I ictpd for Location 7 omex Protection 81. ons ruc ton- os aps 82. d -Earth _ Clearance Looked under Floor O Yes 8 lanters O Yes U No 85. A.C. nit Disconnect- EIeqjgjCaI-PIumLjU�L_ 86. nts Above Ro P ppliance-Fireplace-Clearance to Openings 87. Water Well, Disconne t, Electrical, Plumbing xterior Elec. TrofrG.Fl. Receptacle -Underground 8 en tion Throughout House 9Gel6lass Protection orrections from Previous Inspections 92. s Test -Meters Tagged, Gas -Electric 93 ater & Sewer Connected -C/O to Grade -HD Approval Certificate -Other Certificates Posted 96. Fire Sprinkler Date 3 ,,-, Card B-1 Date Card B-1 Date Card B-1 c Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: _ __,mar i u u5 u4: uep P.I I t Insulation Certificate.eYy) --j5+-c' (�Cj, BUHDING OWNER: 1 0�� �EmS (,�/ 1W. ZING PMET #: 0d .__0 X BUILDING LOCATION: Description of Installation ROOF Material - - - Thic3rness (orches) Brand Name Zhcrmal Resistance (R -Value) CEILING -. Batt cr Blanimt Type �—S Band Name CA'` VAS Thidm (orches) % �3 'Thermal Rest =&R value) Loose Fill Type Brand Name Comacw. s nfi wei&J& lb Minimum duchess inches Matudactuxer's installed weight per square foot to acheive Thermal Resistance (R -Value) EXTERIOR -WALL Mauxial �D� `ANs�i\b_�. BrandName > Tbidrlress (n>ches) -3 ' Z _ Thermal Resistance (R -Value) 3 RAISED FLOOR Nadal Brand Name Thickness ('orches) Z, Thermal Resistance (R -Value) SLAB FLOOR Naterial Brand Name Thidrness (orches) Therrnal Resistance (R -Value) Width (mches) FOUNDATION WALL I&771n Declaration Brand Name Resistance (R -Value) I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Building Energy Efficiency Standards for new residential buildings contained in Tide 24 of the California Administrative Code-' n' [ General Contractor (Builder) License Number' Signature and Title - Dare Sub -Contractor (Insulation Installer) license Number signature and Title Due THIS CERTIFICATE MUST .BE PROVIDED To THE BUILDING DEPARTMENT PRIOR TO FINAL INSPECTION APPROVAL AND A COPY SHALL BE POSTED WITHIN THE BUILDING. JANUARY 1993 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIV ION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538 PERMIT NO. (Rev.12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMB a 01 zO I� :J BUILDING PERMIT OWNER I TELEPHONEv SO, FT, OCC. BUILDING VALUATION . OWNERIM [J _/ CONTRACTOR'S NAME 1� TELEPHONE CONTRACTOR'S MAILING ADDRESS CONSTRUCTION LENDER LENDER'S MAIUNG ADDRESS Fireplace Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit Fee — $ Plan Checking Fee $ BUILDING ADDRESS Energy Plan Checking Fee $ $ /^ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition Aemodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: Gas piping system 1 - 5 outlets 15.00 Buildingsewer 15.00 Mobile Home IS I GI W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Filing Fee 20.00 Main Service eo.OR LESS 200AA OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in fUl rce and effect. `� License Class Lic. No. �j Z �% OWNER -BUILDER DECLARATION 1 hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service To 46.00 NEW CONST. OWEW EE NG OCCUCUP. OR ( 6 ACC. BLDS. s0 3.5¢FT; CNS. NEW CONST. MULTI -OUTLET tpµq�Ip. P7.50 POWER APPARATUS 8 SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES 00 BAL @':50 Ex. Occup. OFUX� SRM ) E 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the pee of the work for which this permit is issued. 0-1have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' cc jpen ation in Lwnce carrier and policy number are: Carrier cc MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Policy Number 4 ? Zq a4 (The above sections field "not be btnhpleted if th6 permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall erson in any manner so as to become subject to workers' compensation laws IHornia, end agree that rf I should become subject to the workers' compensation visions of section 3700 of the Labor Code, I shall forthwith comply with those p visions. Signa li��ations ❑An OSHA permit is roveep and demolition or construction �5'O" of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST.TYPE TOTAL FEE $ J HAz. D. FEES IMP FLOOD CDF 'PARCEL Po HD ISS This permit is hereby issued under of the Butte County Code and/or indicated ab for which fees have By PERMIT E I SON the applicable provisions Resolutions to do work been paid. Date��`/// CJ Date Receipt No. WHITE-D.D.S.-B.D. CANARY -A SESS R PINK -INSPECTOR GOLDENROD -APPLICANT E.M. USE ONLY F102 Plan Attached F10011 Plan Anachad X sam t0 ®.D. TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance IkSjk2.l.I(- Slfelk,v wood L� Oro✓�fle b76-2i©--Vy Owner Location AP# Plan Approved for: Sewage Disposal Water Supply:/ Public Private. e Clearance for dwelling. Other �ecfi ea G1 / 1 Hold final for: Final clearance O.K. for: NOTE: r / Vts Environmen1 Health S ci list 8/96 4 -1.( -OT Date 1--4 l ----y �-- 7D"D S &G4- 10((o tC10,6 M -7m IoiS-�o loo o p-Pn1= C� 3G �T 230 052 ti F 036 LAW OFFICE OF ANDREW T. HOLCOMBE 1339 ESPLANADE CHICO, CALIFORNIA 95926 (530) 345-5442 (530) 893-0133 FAX v c ( September 25 2001 R E C E I V E SEP 2.12001 BUTTE COUNTY Todd Hemstalk BUILDING DIVISION 75 Shelterwood Lane Oroville, CA 95966 r RE: Hemstalk vs. Sturgeon; Case No. DC 08342 Dear Mr. Hemstalk: I am writing to you on behalf of Barbara and Christopher Sturgeon regarding the above referenced matter. As you know, a default judgement was obtained against Mr. and Ms. Sturgeon. That judgement is set to be executed upon or enforced by the Butte County Sheriff's Department on Wednesday, September 26, 2001 on or after 6:01 a.m. The right to the use, possession and control of the property does not revert to you until the judgement for possession is enforced by the Sheriff's Office pursuant to the Notice to Vacate previously posted at the premises. However, I have been informed that you have already improperly and illegally retaken possession i to the property, thereby interfering with Mr. and Ms. Sturgeon's right to the use of and access to the property. Specifically, you changed the locks and/or locked gates on or about September 17, 2001. This has prevented Mr. and Ms. Sturgeon from completing their move out from the premises, and prevented them from doing the routine clean up which they otherwise would have done prior to formally and completely vacating. There are several consequences to the aforementioned improper activity. One, pursuant to Civil Code Section 789.3, there is a potential fine of up to $100.00 per day for each day you have improperly interfered with or prevented Mr. and Ms. Sturgeon's access to the property. Since your interference has been on going, and you will not have the legal right to the property until September 26, 2001, this statutory fine or penalty will have accrued for at least nine (9) days, or a total statutory penalty of up to $900.00. In addition to the aforementioned penalty, Civil Code Section 789.3 also provides for actual damages, including attorney'' fees and court costs. Actual damages in this case remain to be determined. Likewise, attorney's fees and court costs incurred as a result of your improper activity have yet to be determined. For the moment, there are only $125.00 in attorney's fees. Actual damages would be at least the value of personal property that Mr. and Ms. Sturgeon have not been able to move due to your improper conduct. Specifically, the items in question which they have been prevented from reclaiming are an ice chest ($20.00), lawn mower and gas can ($200.00), Kirby vacuum cleaner ($1,500.00), and three (3) to four (4) boxes of miscellaneous household cleaning items and personal effects ($200.00). Once the right to possession is legally and properly awarded to you as ofWednesday, September 26, 2001, you are under an obligation to properly store the aforementioned items, and under a specific statutory obligation to give Mr. and Ms. Sturgeon or their agents reasonable access to the property to remove their personal possessions. (Civil Code Section 1965; 1980 et seq.). Mr. and Ms. Sturgeon have fifteen (15) days from the date the Notice to Vacate was enforced by the Sheriff's Department within which to reclaim their property. Reasonable access to do so must be given to them by you. You are entitled to charge only for the reasonable storage value for the number of days their personal property remains at the premises after September 26, 2001. "Reasonable storage value" under these circumstances means the per day rental value of the house. However, since you prevented Mr. and Ms. Sturgeon from moving their property in a timely manner in the first place, there is a valid argument to make that you may not now charge for storage. You should contact Mr. and Ms. Sturgeon immediately to confirm a time for them to be given reasonable access to the property so that they may remove their remaining possessions. You can contact Mr. and Ms. Sturgeon care of Millard Sturgeon at 510-0055. Millard Sturgeon will be able to promptly contact either Barbara or Christopher Sturgeon to confirm the time for them to reclaim their personal property. In order to reduce your potential liability, you should confirm arrangements by phone for the pick up and removal of their property immediately. (If you wish to contact Mr. and Ms. Sturgeon by mail for any other reasons, you may do so at P.O. Box 68, Oroville, CA 95965). A second issue which needs relatively prompt attention is that of the utility bill. As you know, there is a shared meter at the premises. The imposition of this shared meter upon Mr. and Ms. Sturgeon as part of their rental agreement was not done in compliance with Civil Code Section 1940.9. Accordingly, you as well as the beneficial'user of the utilities (tenant in garage. unit) are responsible to reimburse Mr. and Ms. Sturgeon for their increased or additional utility costs. Based upon the average usage attributable only to them, the excess or reimbursable utility bills appear to be at least $1,000.00. Mr. and Ms. Sturgeon are informed and believed that there is only one utility meter because the rental in the back was built without the necessary permits. If so, that could be a further violation of your landlord/tenant responsibilities. The entire rental contract may have been an "illegal" one, meaning not in compliance with California law, or applicable zoning and code requirements. If their rental contract was an illegal one as defined above, Mr. and Ms. Sturgeon may also have a claim for reimbursement for some, if not all, of the rent they previously paid to you pursuant to that contract. Separate and apart from the foregoing, it is Mr. and Ms. Sturgeon's position that they were constructively evicted. Although a default judgement was entered against them, that judgement is capable of being set aside. Depending upon whether this dispute settles or not, a motion to set aside and vacate that default will be made. The Sturgeon's damages case would proceed thereafter as may be needed. Mr. and Ms. Sturgeon were "constructively evicted" because they were forced to move due to your ongoing harassment or interference with their peace and quiet. The level of harassment rose to a breach of the covenant of quiet enjoyment, thereby constructively evicting Mr. and Ms. Sturgeon. They were compelled to move due to your ongoing harassment and interference with their rights. Accordingly, they are entitled to reimbursement for their moving expenses, even if the underlying contract was proper, legal and enforceable. The record in this case indicates that you knew, or should have known, that the unit in the back was improper. That is, you knew or should have known that it didn't have the requisite permits. You appeared to have taken steps to affirmatively "hide" that situation by having a common meter, instead of a separate meter that would normally be required. It is actionable conduct in California not to disclose a known defect in rental premises. You, as well as your agent, are also under a duty to disclose any such known or apparent defects (code and zoning violations etc.) to prospective purchasers. As you know, Mr. and Ms. Sturgeon had a right of first refusal to purchase the property. Your failure, and the failure of your agent, to disclose known defects is a further violation of California law. Finally, at least for the moment, there is Mr. and Ms. Sturgeon's security deposit of $550..00. Pursuant to California law; that deposit must be returned to them, or properly accounted for within twenty-one (2 1) days of when they vacate. Since they were improperly a evicted by you due to your self help eviction as of September 17, 2001, the twenty-one (2 1) days should start from that date. In that regard, if Mr. and Ms. Sturgeon are obligated to pay any rent for the month of September, it would only be up to September 17, the date you improperly changed the locks. It is their position that they do not owe any rent for September, due to your breach of the covenant of quiet enjoyment, due to the utility credits they are owed, and due to the statutory penalties and damages referred to in this letter. If you fail to return the deposit or properly account for it, you can be held liable for an additional statutory penalty of up to $600.00. (Civil Code Section 1950.5). In summation, although Mr. and Ms. Sturgeon's tenancy is soon to be formally terminated, this dispute appears to be far from over. To minimize your liability, you should immediately contact Mr. and Ms. Sturgeon at 510-0055 so that arrangements can be made for them to reclaim their personal property. Presumably, your proper and timely security deposit refund will follow. Thereafter, the remaining refunds or damages claims will still need to be resolved in due course. Thank -you for your immediate attention to this matter. Sincerely, Andrew T. Holcombe ATH/km CC: Barbara and Christopher Sturgeon Butte County Sheriff's_ Office _ / Bu� un ildin BuIns to ecr Ken Ward a T Law -Office of Andrew T.. Holcom_ be 1339Esplanade Chico, CA 95926 P N1 a u' 25 Sf? Butte County Building Inspector 7 County Center Dr. Oroville, CA 95965 BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION #: (530) 538-7636 (OROVILLE) (530) 891-2834 (CHICO) OFFICE #: (530) 538-7541 FAX#: (530)538-2140 WEBSITE: www.buttecounty.net\dds PERMIT NO. BPO50950 LICENSED CONTRACTORS DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of Issued Date: 07/12/2005 APN: 036-230-052-000 the Business and Professions Code, and my license is in full force and effect. License Class: License Number: Site Address: 75 SHELTERWOOD LN ORO Date: Contractor. Map Index: Description: ADD LIVING ROOM (991)COV(680) OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors' State License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which requires a Owner: H EMSTALK TODD permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance, also requires the applicant for such permit to file a 75 SHELTERWOOD LN signed statement that he or she is licensed pursuant to the provisions of OROVILLE, CA the Contractor's State License Law (Chapter 9 commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or 95966 she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500).): 1, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Applicant: HEMSTALK TODD Code: The Contractors' State License Law does not apply to an owner of property who builds or improves thereon, and who does 75 SHELTERWOOD LN such work himself or herself or through his or her own employees, OROVILLE, CA provided that such improvements are not intended or offered for 95966 sale. If however, the building or improvements are sold within one year of completion, .the owner -builder will have the burden of proving that he or she did not build or improve for the purpose of sale.). ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code. The Contractors' State License Law does Contractor: not appiy to an owner of property who builds or improves thereon, . and who contracts for such projects with a contractor(s) licensed pursuant to the Contractors' State License Law.). O I am Exempt under Article 3 of the Business and Professions Code Date: Owner: License #: WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the.following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit Architect: is issued. Engineer: PURSELL, FRANK JAMES ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier: Total Square Ft: 1671 S. F. Policy#: Valuation: $75,295.00 Census Code: I certify that in the performance of the work for which this permit is issued. 1 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' -14 compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. �� f ] Com^ ) J < Date: 143 Applicant: WARNING: Failure to secure workers' compensation coverage is _ L unlawful, and shall subject an employer to criminal penalties and one hundred thousand dollars ($100,000), in .addition to the cost of compensation, damages as provided for in Section 3706 of the Labor ' code, interest, and attorney's fees. CONSTRUCTION LENDING AGENCY This permit is hereby issued under the applicable provisions of the Butte County Code ?nrvor I hereby affirm that there is a construction lending agency for the ind•rated a v o Resoluwork r which fees have been paid. performance of the work for which this permit is issued (Sec 3097 Civ.) Name: B Date: Address: PERMIT EXPIRES ON: Dat ❑ I hereby certify that the use of this facility shall comply with Sections 25505, 25533, and 25534 of the California Health and Safety Code, which regulate the storage, handling and use of hazardous materials. ❑ Notification in accordance with Section 19827.5 of California Health & Safety Code is not applicable to the scheduled construction of this project. ❑ Attached are copies of the required E.P.A. notification forms. 1 hereby certify that I have read this application, that the above information is correct, and that I am the owner r the duly author i agent of the owner. I agree to comply with all county and state laws relating to building construction. I acknowledge it is unlawful to alter the substance any offici r ocument of Butte Coun hereby authorize representatives of Butte County to enter upon the above mentioned property for inspection pu se Print Name:ICrirn� l�l�E �YY15�1 �L� Signalu Date: ❑ Owner ❑ Contractor ❑ Agent for Owner 13 Agent for Contractor 6/4 /07-c;L ®5 � tBUTTI(qCOUNTY PERMIT DEPARTMENT OF DEVELOPMENT SERVICES NO. BUILDING PERMIT APPLICATION AND SUBMITTAL REQUIREMENTS 5� ()9SC) 24 HOUR INSPECTION#: OROVILLE: (530) 538-7636 • CHICO: (530) 891-2834 BP OFFICE #: (530) 538-754114 A FEE WILL BE REQUIRED AT TIME OFAPPLICATION¢ 1 BIN # Website: www.buttecounty.net/dds 4�. D 00' **PLEASE PRINT CLEARLY* * OWNER Last Name irsl Name moa Address Cityav State C> Zip Phone,,,,,,,_ Phone_ _ ,L� 1 Fax SSS E-mail APPLICANT NAME CONTRACTOR Name GY-� Address Zip s City Fax State Zip Phone Book Fax E-mail Planner Lic. # Class APPLICANT NAME ARCHITECT/ENGINEER Name City D -z_ J Ll - Address Zip s City Fax State Zip Phone Book Fax E-mail Planner State License Number APPLICANT NAME Name�DQ Address City D -z_ J Ll - State Zip s Phone Fax E-mail LAPP ICA SIGNATURE For office use only: Zoning PropertyA dress �5 A..t__ E l - Flood Zone Cross Street SRA Policy Number No Occ. Type Const. Subdivision Name Map Book Page Lot # Planner Date Approved: OVER FOR SUBMITTAL REQUIREMENTS K:\FORMS\BUILDING FORMS\BldgApplSubRgmts.doc LOCATION AP# PropertyA dress �5 A..t__ E l - City Cross Street 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. Other / LENDING AGENCY Name Address Description or Scope of Work: u Sq. Footage Cla ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after the date of application. In order to renew action on an application after expiration, a new application, plans and fee will be REQUEST FOR REFUNDS Refunds can only be made upon written request by the person who paid the fee. The request must be made prior to the expiration of the permit and no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. Received by: Amount: U ' i,-;)- Bldg c< SRA Receipt #: Sheriff SMIP Dater 15165 Other / Total Page 1 of 2 REV 2-24-05 SUBMITTAL & PERMIT REQUIREMENTS ` : . The following drawings and specifications must be submitted to the Building Division in order to apply for a permit. INCOMPLETE SUBMITTALS WILL NOT BE ACCEPTED. ALL PLANS MUST BE LEGIBLE AND IN INK. ❑ 1. Site plans, 3 or 4 sets, signed by the preparer of the plans. No graph paper! ❑ 2. Complete plans, 3'or 4 sets, signed by the preparer of the plans (No graph paper!) OR Engineered plans,3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. ❑ 3. Engineered truss details and layouts in duplicate (if required). No faxes! ❑ 4. Energy compliance design and supporting documentation in duplicate. ❑ 5. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 6. Manufactured homes: (A) installation inst, (B) Marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate, ❑ 7. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 8. Flood Elevation Certificate, wet -stamped and signed, in duplicate (if required). ❑ 9. Site plan and business license approval from the City of Biggs. ❑ 10. Letter of intent for non-residential buildings. ❑ 11. Detached Accessory Building Form filled out by the owner (if required). ❑ 12. Hazardous Material Form (for Commercial Buildings only). Remaining items needed to issue the permit. Additional items may be required after Plan Check and Planning review (May require additional plan review upon receipt of the following items.) ❑ 1. Agricultural Buffer clearance and site plan approval from the Ag Commissioner's office (if required). ❑ 2. Impact Fees. ❑ 3. California Department of Forestry plan approval (if required). ❑ 4. NPDES Form. ❑ 5. Encroachment Permit for driveway from the Public Works Dept. (construction approval prior to occupancy). ❑ 6. Contractor's license information. (Number, Name Style, Classification). ❑ 7. Worker's Compensation Carrier and Policy Number. ❑ 8. Owner -Builder Verification (if required). ❑ 9. Letter of Signature authorization (if required). ❑ 10. Recorded copy of Agricultural Acknowledgment Statement. ❑ 11. ❑ Grant Deed, ❑ M.H. Title/Statement of Facts. ❑ 12. Sanitation and site plan approval from the Environmental Health Department. If you have questions or would like additional information regarding this process, please contact a Permit Assistant at (530)538.7541. _ EXPIRATION OF APPLICATION Applications for which a permit has not been issued will expire one year after date of application. In order to renew action on an application after expiration, a new application, plans and fees will be required. REQUEST FOR FEE REFUNDS • . ' - , Refunds can only be made upon written request by the person who paid the fee. The request must be made within two years from the date of fee payment on permits not issued, and two years from the date of permit issuance for permits issued; however, on issued permits refunds can only be made if no construction work has been done. Filing fees, plan check fees for work plan checked and other department costs are not refundable. OVER FOR BUILDING PERMIT APPLICATION KAFORMS\BUILDING F0RMS\B1dgApp1SubRgmts.doc Page 2 of 2 REV 2-24-05 COUNTY OF BUTTE -DEPARTMENT -OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive, Oroville, CA 95965 Phone (530)538-7541 Fax (530)538-2140 PERMIT APPLICATION DATA SHEET 4Q i r 4n 1 I� ASSESSOR PARCEL NUMBER 0 36 - G5� OWNER: �^ Proposed Building Use: / ��i l t Permit Technician: Date: '� G Items required in order to apply for a permit. All boxes MUST be checked OR marked NA in order to apply. 1� 1. Site plans, 3 or 4 sets, signed by the preparer' of the plans. ❑ 2. Complete plans, 3 or 4 sets, signed by the preparer of the plans. 3. Engineered plans, 3 or 4 sets, with wet signature on plans AND 2 sets of stamped and signed calculations. 4. Engineered truss details and layouts in duplicate. No faxesl JTP 5. Letter from Engineer or Architect for truss design review. 1$ 6. Energy compliance design and supporting documentation in duplicate. ❑ 7. Statement of Intent for Non -heated and A/C for Non -Residential Buildings. ❑ 8. Manufactured homes: (A) Installation manual, including marriage line info, (C) Floor Plan, (D) Tie down or fnd plans, all in duplicate. ❑ 9. Metal bldgs: (A) Metal Bldg Plans, (B) Fnd plans and calcs in triplicate, (C) Elevations in triplicate. (D) Floor plans in triplicate. All of these must be stamped and wet -signed by the engineer. ❑ 10. Flood Elevation Certificate, wet -stamped and signed, in duplicate. ❑ 11. Letter of intent for non-residential buildings ❑ 12. Hazardous Material Form :V 13. Acknowledgement of building permit application without required clearances. ❑ 14. Other Remaining items needed to issue the permit. (May require additional plan review upon receipt of the following items.) 15. Sanitation and site plan approval from the Environmental Health Department in ❑ Chico ❑ Oroville, as applicable Z)I ❑ 16. Fire Sprinklers............................................................................................ ❑ 17. Agricultural Buffer clr and site plan apr from the Ag Commissioner Sent by ❑ 18. Soils Report and/or Engineered Foundation required ........................................... 19. Erosion Control Plan Required........................................................................ 20. Fees as shown on the attached Schedule of Fees Due Sheet .............................. ❑ 21. City of Chico Plumbing permit........................................................................ ❑ 22. Site plan and business license approval from the City of Biggs ......... ........ . ftp' 23. California Department of Forestry. Ian approval t%J paid. Sent 24. Planning approval for (A) Use: M)Parking: (C) Parcel Check:..... 0 ❑ 25. Contact Land Development about _ Improvements, _ Drainage ......................... 26. NPDES Form............................................................................................. ❑ 27. Encroachment Permit for driveway from the Public Works Dept ........................... ❑ 28. Contractor's license information. (Number, Name Style, Classification) ................... ❑ 29. Worker's Compensation Car and Policy Number .......................................... 30. Owner -Builder Verification ( _ Given to owner, _Mailed to owner) ..................... ❑ 31. Letter of Signature authorization.................................................................... ❑ 32. Recorded copy of Agricultural Acknowledgment Statement ................................. ❑ 33. Existing violations and/or expired permits......................................................... ❑ 34. Deed Restriction.......................................................................................... ❑ 35. ❑ Legal description, ❑ M.H. Title, title search, registration or MCO ......................... ❑ 36. Other: ❑ 37. Other: When issued Tele hone C)3' V ��' and hold for pickup. I have be4infed-of-the above items and requirements for obtaining a building permit. tApplicant. ������C�--� `� Date:1. Index pation for the above items numbered: Plan Check Letter 2. Additional items re Contractor, designer(:o n as advised of the above data by phone, ❑ mail, ❑ counter, by Date: Zq Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ counter, by Date: Contractor, designer, owner, was advised of the above data by ❑ phone, ❑ mail, ❑ co to by Date: Plans reviewed by: Date: Plans approved by: :� �� Date: I Structural reviewed by: Date: Structural approved by: Date: Note transfer by: A Date: �11� Yellow: Building Division COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES — BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE, CA 95965 PHONE -(530)538-7541, FAX (530)538-2140 SCHEDULE OF RECEIPT OF FEES Website: www.buttecounty.net/dds OWNER �1�Z/Y�1 A.P. #O PROPROSED BUILDING USE 0—, 1. BUILDING PERMIT FEES --- Balance Due ..................... $ --- FEMA Flood elevation review ... $ DATE RECEIPT # --- Additional plan checking Fee.... $ ` SCHOOL DISTRICT FEESVi V� [�• (paid at School District Office) (form available after Plan Check) 3. SHERIFF.FEES (paid at Building Division) Residential............ X $360.00 =$ inns Commercial (sq. ftg.)..... X $0.03 = $ Sq.Ftg. 4. RECREATION DISTRICT FEES (paid at Recreation District Office) (form available after Plan Check) 5. RESIDENTIAL DEVELOPMENT IMPACT FEES COUNTY WIDE (per dwelling) $ CHICO URBAN AREA (per dwelling) $ EL MEDIO FIRE DISTRICT (per dwelling) $ NORTH CHICO SPECIFIC PLAN (per. dwelling) Zoning $ ;QATER C. 6. SRA FIRE INSPECTION AND PLAN CHECK FEE_f_�4 $204.98 (paid at Building Division) 7. WATER TENDER FEES BATTALION # $200.00 (paid at Building Division) 8. SMIP..� 9. OTHER 10. OTHER 11. OTHER At time of permit ap ication, I was ad tsed the above fees a required to be paid prior to issuance of the permit. These fees may be changed Our g the an ch ki�tg process. DATE Pursuant to Government Cbde Section 66020, fou are hereby notified that items, 2, 3, 4, 5, 6, 8, 9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Division Yellow -Applicant Pink -Owner (rev. 3/05) 12 IIII�D �E2I:I'C,'I.ts �....e;.�_�,��`..�c;^A:..>..i:tt'*tri �_s.+r.�"::Lfi�„>>�,:.la':a�::::«,. Attention Property Owner: An "owner -builder” building permit has been applied for in your name and bearing your signature. Please complete and return this information at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. No building permit will be issued until this verification is received. 1. I personally plan to provide the major labor and material for construction of this proposed property improvement: YES [,-]NO [ J. 2. I HAVE HAVE NOT [ ]' signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: NAME: ADDRESS: PHONE: CONTRACTOR'SLICENSE 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: T, NAME: ADDRESS: PHONE: CONTRACTOR'S LICENSE NO: 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: NAME ADDRESS PHONE TYPE OF WORK DATE: .4 —\ :S --C)"-) NOTE: This Owner -Builder verification is required by Section 19831 and 19832 of the California Health and Safety Code. ' This verification must be completed and returned to our office before we are permitted to issue the permit. Rev'd 11!4/2004 Butte County Department of Development Services ADMINISTRATION ` BUILDING ` GIS `' PLANNING 7 County Center Drive Oroville, CA 95965 (530) 538-7541 Telephone (530) 538-2140 Facsimile Dear Property Owner: �4 An application for a building pen -nit 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 pen -nit. 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 your plan to subcontract, you should be aware of the following information for your benefit and protection: o If you employ or otherwise engage any persons other than -your immediate family, and the work (including materials and other costs) is $200 or more for the entire project and such persons are not licensed as contractors or subcontractors, then you may be an employer. o 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. o There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to workers' compensation insurance. o For more specific information aboutyour 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 their own employees, without a licensed contractor or subcontractor, only under limited conditions. A frequent practice of unlicensed persons professing to be contractors is`to secure an "owner -builder" building permit, erroneously implying that the property owner is providing his or her own labor and material personally. Building permits are not required to be signed by property owners unless they are performing their own work personally. Information about licensed contractors may be obtained by contacting the Contractors' State License Board in your community or at 1020 N Street, Sacramento, California 95814. Please complete and return the enclosed owner -builder verification from so that we can confirm that you are aware of these matters. The building permit will not be issued until the verification is returned. C. Vieir4 C.B.O. , Building Inspection NOTE: This Owner -Builder Information is required by Section 19830 of the California Health and Safety Code. ok- Department of Public Works C o u n t y o f B u t t e ° ° ). Michael Crump, Director LAND DEVELOPMENT DIVISION ° / Storm Water Management Program 7 County Center Drive Oroville. CA 95965 ASCI �5 (53 47266 (FAX) National Pollutant Discharge Elimination System (NPDES) Phase II Construction Storm Water Permit and Storm Water Pollution Prevention Plan (SWPPP) Acknowledgement LLESS THAN 1 ACREI Project Description: Lly t t.��`�cx�,r• �o i� �'r �a n. Project Location and/or Parcel Number: —► 5 L -TJ By signing below, I, the project owner/owner's 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 build -outs 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 Control 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 a project that disturbs one a or more of land may result in revocation of grading and/or other permits or other sanctions provided�by law�� t Signed: U., t��l: ! .c ,v►� ��J off Title: Date:1—i3-izs i Less than l Acre NPDES & SWPPP Compliance Certification Butte County Storm Water Management Program Revised 5/24/04 Butte County Department of Development Servrces 0%3W! 0 7 Count Center Drive ° Oroville, CA 95965 ° "r (530) 538-7601 Telephone ° (530) 538-7785 Facsimile cOUN�y BUILDING PERMIT APPLICATION WITHOUT REQUIRED CLEARANCES I request and authorize the Building Division to process this building permit application through the plans examination process WITHOUT first obtaining all necessary, related permits and clearances from other regulatory entities, including but not limited to, Planning, Environmental Health, Land Development, County Fire, and Agriculture. I hereby acknowledge: 9 I need to submit applications for septic and/or well to Butte County Environmental Health immediately. • I am required to bring the approved Environmental Health site plan and approved sanitation clearance to the Building Division as soon as clearance is obtained • I am responsible for notifying Development Services, in writing, to stop processing of the application and to arrange for disposition of plans. The Building Division will process the application through the plans examination process, as submitted, without input from other regulatory entities that could prohibit issuance of the building permit or require submission of amended building plans to the Building Division. Once the plans examination process begins, there will be no refund of plans examination fees. Any changes requiring submission of amended plans to the Building Division will incur additional fees. Within one year from the date of application for a building permit, all other required permits and clearances from other entities must be obtained for the permit to be issued. Failure to obtain these permits/clearances will void the application. Typically other required permits/clearances include, but are not limited to, verification the parcel was legally created, adherence to all mitigations and conditions imposed on the parcel at time of creation, as well as zoning requirements, legal access, and applicable set -backs and environmental issues (fire, agriculture buffer zones, and habitat/species). Please print: Applicant Name: (`(1,&„E. L� 0eYy�-,-,rrm b " Building site address: `ice !�!, H ;ie wcx3j:� �-�•` APN: Q�� -- Z3b _C57_ Permit No.: I ha reread, un rstood and accept the terms and conditions as expressed herein as indicated by my sub issiop-cMd 4bove-referenced building permit application and my signature below: � n I ,f_J �- x-05 ATUREV APPLICANT DATE BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) School District f% L `' ` L���C / Building Department No.10-11- /� / �N/� A.P. Number 036--Z 0 5-2- Jurisdiction: city County Property Owner '�� Property Location/Address / J W d&,J 161, Subdivision Lot No. .........................._...............................:................................. q Residential Development �Q Q Sq. Footage / No of Living Mobile Home Addition/ Supplemental to (Group R) Units Installation Conversion Permit # *(No foundation Inspection) :.......................................................................1............................, Deed Restricted Sq. Footage (9ttach a signedycopy ofiQeedxRestriction-and,Noticerof,Limited_Use Facility�documenU _. Commercial/Industrial Q New Building Department Representative District Identification No. /1'J 0, � - 7s. } (Street Address) 0 Addition Sq. Footage (Including Exterior Roofed Areas) 7-6 -t9'5— Date School District certifies that (Applicant) (Phone Number) (City) (State) (Zip Code) has complied with the requirements of Resolution No. od -C)y- / �L by payment of $ 'qa / 9 Lf-/ representing School District R Paid by Check # square feet. Remarks: 2926 i FULL MITIGATION s - :. s� �:._ r's:'.� ..r.�.. _.� .=."'i.� s��.rvr ,n-.;, . •��i.::�.�,�-� ._.sx-,1f.• :�-`"'�.:... ...�+ arc; . 7/ll Date Notice: You may protest the Imposition of the fees Identifted above by submitting a written protest to the District, In compliance with Government Code Section 66020(x), within 90 days from the date fees are paid. Failure to submit a timely written protest wdlUprohiblt you from challenging the Imposition of the fees In any court action. N, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certlllatlon Form, the School District Is rmotlfled by the applicable Local Planning Agency that this project Is being reviewed under tit California Environmental Quality Act (CEQAh this pr n - r may be subject to additional school fees to fully mitigate. Its Impact on the school dbblct's schools. White (applicant), Yellow (building department), Pink (school district) feeform.xls 00/03)dmm WILLDAN Serving Public Agencies June 22, 2005 Scott Rutherford Butte County Building Department 7 County Center Drive Oroville, CA 95965 (530) 538-7169 (530) 538-2140 FAX SUBJECT: COUNTY OF BUTTE PLAN REVIEW APPROVAL Willdan Project No: 14353-1559-M Jurisdiction Job No: 05-0950 Assessor's Parcel No: 036-230-052 Description: Hemstalk Living Room Addition Dear Mr. Rutherford: 117 C Street Marysville, California 95901 530/749.2373 fax 530/749.2199 www.willdan.com Willdan has completed a plan review of submitted plans and documents for the above referenced project and recommends your approval with the conditions noted on the 2rid page of this letter. The plans and documents provided for this review that have been found in compliance with the applicable codes are: ➢ Plans: Two (2) copies, sheets 1 through 6 dated 12/8/04 by Jim Pursell, P.E. ➢ Structural Calculations: Two (2) copies dated 3/2212/05 by Jim Pursell, P.E. ➢ Truss Calculations: Two (2) copies dated 3/24/05 by Jarrod Holiday, P.E. ➢ Ener2y Calculations: Two (2) copies each for the existing residence and the existing plus addition, dated 04/02/05 by Barry Rubanoff The plans have been stamped with the Willdan approval stamp and dated the date of this letter. According to our previous letters relating to this project, the superseded plans and documents will be discarded within 10 days unless we receive other instructions. On the pages to follow is the identification of the codes and standards applicable to the project, a code analysis, conditions -of -approval and identification of any deferred submittals. WILLDAN Serving Public Agencies APPLICABLE CODES Unless noted otherwise, all comments are based on requirements of the 2001 California Building Standards Code found in the California Code of Regulations, Title 24: • Part 2, known as the California Building Code and abbreviated herein as CBC • Part 3, known as the California Electrical Code and abbreviated herein as CEC • Part 4, known as the California Mechanical Code and abbreviated herein as CMC • Part 5, known as the California Plumbing Code and abbreviated herein as CPC • Part 6, known as the California Energy Code, and Energy Commission Standards, and abbreviated herein as CECS CODE ANALYSIS Our plan review revealed the following information regarding the occupancy designation, type of construction, and other pertinent features. This information is not consistent with that shown on the plans and the permit application. The permit application does not list the square footage of the covered porch. Specific Type of Type of 1" Floor 2" Floor Total Sprinklers Stories Use Occupancy Construction S q Ft SQ Ft Sq Ft Addition R-3 V -N No 1 991 NA 991 Covered R-3 V -N No 1 680 NA 680 Porch CONDITIONS OF APPROVAL 1. Approval is contingent upon the review, requirements and approval of other departments and/or agencies that have jurisdiction over this project. 2. Revisions and/or notes as red -lined on the plans. 3. *Permit application building areas specified in the scope -of -work shall be reconciled with plans to Butte County's satisfaction. DEFERRED SUBMITTALS Our plan review reveals no deferred submittals noted at this time. SPECIAL INSPECTION NEEDS Our plan -review reveals no special inspection needs pursuant to CBC 1701. f Plans Examiner Ricardo Guzman, S.E. Plan Check Engineer Ce: Alice Mefford, E-mail: amefford@buttecounty.net Jim Pursell, P.E., 2360 Baldwin Ave, Oroville, CA 95966, Fax: (530) 534-0902 Todd Hemstalk, 75 Shelterwood Lane, Oroville, CA 95966, Fax: (530) 589-5681 Page 2 of County of Butte Permit Number 05-0947 Willdan PrQiect Number .14353-1558 Applicant: I Hemstalk, Todd Permit No: 05-0950 Project Type: Livin Room Addn APN: 036-230-052 100% 70% Plan Check Fees $ 428.92 $ 300.25 $ 428.92 $ 300.25 WILLDAN Fee $ 300.25 Copies Attached: Qty Chk Application Site Plan Review FEMA Elevation Certificate Building Plans Truss Calculations Energy Calculations Structural Calculations Residential Plan Review Guide Residential Construction Requirements Other Other Butte County Department of Development Services �03T TF YVONNE CHRISTOPHER, DIRECTOR o 0 o � o O 0 0 7 County Center Drive Oroville, CA 95965 (530)538-7601 TelephoneUD (530) 538.7785 Facsimile I O TO: WILLDAN ' FROM: Scott. Rutherford (530) 538-7160 srutherfordObuttecountv.neLO t SUBJECT: Plans Transmittal For Review Per Contract O DATE: 4/14/2005 Applicant: I Hemstalk, Todd Permit No: 05-0950 Project Type: Livin Room Addn APN: 036-230-052 100% 70% Plan Check Fees $ 428.92 $ 300.25 $ 428.92 $ 300.25 WILLDAN Fee $ 300.25 Copies Attached: Qty Chk Application Site Plan Review FEMA Elevation Certificate Building Plans Truss Calculations Energy Calculations Structural Calculations Residential Plan Review Guide Residential Construction Requirements Other Other "i PERM 3484-7.9B,P,E,M PERMIT EXPIRES Mildred R. Jones OWNER CONTR. owner 36-23-52 LOCATION (A.P. ) W/S Gravel Rd., app. -12- mi.N.of Miners Ranch Rd , w;*Ut�x ap p. z mi.N.of Oro Bangor Hwy, Oroville r Q � r �.o� t Temp. Power Pole Called PG&E Temp. Elea Serv. Called PG&E ' Temp. Gas Serv. Called PG&E . . i ` JOB FINALED (Date) (Signature) r . tea , COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RE'COR'D' F Fixtures H tr. Stucco BUILDING BUILDING (Cont'd) PLUMBING Setback 2 — J o Firewall Soil Piping Forms Brown Parapets 1st Floor Main Bldg. Ducts Restroom Finish 2nd Floor Footings Permanent Windows 3rd Floor Stemwall MOBILEHOIME UTILITIES ------------------ Siding To out Slab Sewer Roof Sheathing Water Piping Piers Water Piping Roofing Sewer Garage Fdn. Vents Fixtures Footings StemwaII '— — 29 Garage Vents Insulation I Water Htr. Heaters Slab Carport Footings Prov. for physically handicaped Conformance of ex. structure Appliances Gas Piping &Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footino ELECTRICAL F Fixtures H tr. Stucco Final Subpanels Mesh MECHANICAL Gird. Fault Prot. Scratch Heating Service Brown Cooling Temp. Pole Finish Ducts Underground Interior Lath Ventilation Permanent Door Closer Final Final MOBILEHOIME UTILITIES ------------------ Elec. Service Elec. Pedestal Water Piping Sewer Gas Piping �Q�1� LEO EINSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping Drainage Gas Piping DATE REMARKS OR •- • / � . •rte (NOTE: An entry must be made on this form each time you visit the job site.) COUNTY OF BUTTE - ~DEPARTMENT OF PUBLIC WORKS s _ . �7 County Center Drive Oroville, California 95965 Telephone: 534-4541 i / 7 Q APPLICATION AND PERMIT �C / Owner All ljXen 9 Mai I i ng Address ne No. /11 Contractor Mailing Address Telephone No. Building Address A. P. No. (;/ Moiling & nning S S i Ion Fire Dept. Fire Zone Use Permit EOA PPians g Declaration P rcel 60' R/W Improvements Bldg. Plans Recd arce roval Plans p A roval NEWZ ADDITION ❑ UTILITIES ❑ OTHER ❑ Single Family Duplex ❑ Mobil Home ❑ Others ❑ X CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: License No, Classification _ BUILDING SO. FT. I OCC. BUILDING V ATION X4)6 4 _ Fireplace Total Valuation Permit Fee Plan Checking Fee &/or Penalty Permit Fee PLUMBING PERMIT FILING FEE Each Trap Repair drainage or vent piping Water piping Each gas water heater or vent Gas piping system 1 - 5 outlets Each additional outlet Building sewer Lawn sprinkler system Permit Fee 'T 4" BAL@1 ELECTRICAL PERMIT FILING FEE Main service 6011 OR LESS 100 AMP OR LESS Main service EA. ADD -L 100 AMP Main service OVER600 100 AMP O1R LESS Main service EA. ADD -L 100 AMP NEW CONST. ( OR ADDNS. D CUP. AC L - S. NEW CONSTR. .nAI_RFiln_ (MULTI.OUTL T ` BRANCH CIRCUITS $3.00 1.50 1.50 1.50 1.50 1.50 .30 5.00 2.00 $3.00 5.00 2.50 25.00 1.00 "2. " FEE OC7 Ex. OCCUp OUTLETS OR FIXTURES 'T 4" BAL@1 FIXED APPLNS, OR EX. Occup. (RESID.I EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wirina 6.25 am exempt from the Contractors License Laws of the State of California. Permit Fee WORKMEN'S COMPENSATION INSURANCE r I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑I have placed on file with the County of Butte a certificate of Wo .men's Compensation Insurance. Y 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 Workmen's Compensation Laws of California. 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 County of Butte to enter upon the above-mentioned property for ins ection purposes. j' xDate Signature of Permitee 9, Agen-07-1/10 t Receipt No. L White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant MECHANICAL PERMIT FILING FEE Heating j /1 OAI Cooling rZW $3.00 00 Z Ventilation Hood 2.00 '2.00 Permit Fee $ QS $ v©O Land Development Fee $ ZS"to TOTAL PERMIT FEE $zZ This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date lA — Building permit expires Date 6 �� PERMIT NO. t2368-83P,E(MH) PERMIT EXPIRES `yJAl. OWNER JERRY O'DELL CONTR. owner F 'ASSESSOR PARCEL 36-23-5.2 LOCATION 5205 Miners Ranches Rd, Oroville Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E Temp. Gas Service Cal led PG&E JOB FINALED (Date) Signature J = OK 0 = Not OK — = Not Applicable MOBILEHOMES * = Not Ready MISCELLANEOUS Date MOBILEHOME UTILITIES (Plans) OK except #'s Date DECKS, COVERS, CARPORTS, ETC. (Plans) OK except #'s oning Requirements—Setbacks—Easements 1. Zoning Requirements—Setbacks—Easements oils; Special MH Support—Sketch 2. Footings; Size—Depth—Spacing—Connectors J er; cation—T —Fall —Concrete 3. Decks; Girders and/or Joists—Decking—Bracing—Stairs—Rails ater; Location—Test—Easement Needed (Sketch) .' 4. Wood Awn.; Posts—Beams—Rftrs.—Connec.—Shthg.—Rfg.—Bracing lectricity; Location—Clearances—Grnd.—/.2 vmp—Concrete 6. on— est— rap:/ /"L"ft./ /"Nat. or/ /"L"ft./ /"LPG _ 5. Alum. Awn.; Columns—Connections—Splice—Decal—Enclosures 6. Carports; Windows—Doors tility Clearance 7. Elec. BI e% /ASO / Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -Bl Date Date MOBILEHOME INSTALLATION (Plans) OK except #'s VZoning Requirements—Setbacks—Easements Date POOLS (Plans) OK except #'s 1. Setbacks—Easements VIootings; Size—Spacing—Marriage Line 2. Soils; Compaction—Structure Stability `e7-19as; MH Test—Demand—Valve—Connector / 3. Pool Structure; Steel—Connections—Thickness—Dead Men—Lining Electricity; MH Test—Crossovers—Bre rs—Cle ances 4. Elec.; Receptacles and Lighting; Distances—GFI &/brain; MH Test—Fall=Flex Connector 5. Elec.; Pool Lighting; 15 volts—GFI Water; MH Test—jaaguLwDr—Conti ctor ± 6. Elec.; Enclosures; Conduit Entries—Terminals—Listed k"Oater and Sewer Connected—C/0 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— Eric losures— Pane Iboards— Ins. to Main in Conduit Exits; Insp.—Sketch 10 Cert. of Occupancy 9. Health Department Approval 10. Plumb; Cir. Test—Water Supply Test Card B -12 - Date Card -BI Date Card -BI Date Card -BI Date Card B -I Date Card -BI Date Card -BI Date Card -BI Date 741, a 7-6 ja, ", *.fL �, I I "*'\f* J = OK 0 = Not OK = Not eplicable R * = Not Ready RESIDENTIAL (Single and Duplex) Date' UNDERFLOOR Plans OK except #'s Date FRAMING (Continued) 1. Zoning requirements -Setbacks -Easements 48. Property Line Firewall & Openings 2. Ftg., Main; Soils-Steel-Elec. Grnd.- / /'' Ftg. Depth 49. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 3. Ftg., Garage; Soils -Steel- / /" Ftg. Depth 50. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 4. Ftg., Porches & Decks; Soils -Steel- / /" Ftg. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped-Slab 51. 52. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers Siding -Nailing -Veneer 6. Stemwalls, Garage; Steel-Blockouts-Wrapped-Slab 53. Stucco Mesh -Drip Screed-Fdn. Vents-Underflr. Access 7. Piers -Fireplace Ftg.-Steel 54. 55. Glazing Area -Glass Protection -Skylights -Plastic Shear Walls; Nailing -Bolts 8. D.W.V.: Fall -Fittings -Test -2 way C/O -Sewer Test 9. Gas Pipe; Size -Anchors 10. Water Pipe; Test -Anchors -Regulator -Service Test 11. Electric; Underground 12. Plenums & Ducts; Clearance -Material -Support -Ins. 13. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples Card -BI Card -BI Card -BI Date Card -BI Date Date Card -BI Date Date Card -BI Date Card -BI Date Card -BI Date Date FINAL (Plans) OK except N's 56. Ext. Steps -Door & Sidelight Protection -Landings 57. Smoke Detector 58. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection Card -BI Date Card -BI Date Date PLUMBING (Permit) OK except H's 14. Water Ht.; Vent -Access -Combustion Air 15. Water Pipe; Test & Anchors -Nail Protection 16. D.W.V.; Test-Fttngs & Anchors -Nail Protection 59. Bedroom Exiting 17. Shower Pan; Test, First Floor -Tub Access 60. G.F.I. & Bath Fixtures & Tub Access 18. Test Tub & Shower, 2nd Floor -Tub Access 61. Elec. Trim & Subpanel; Breaker Sizes -Labels _ 19. Gas Pipe; Size & Anchors 62. Stairs & Rails 63. Fireplace or Stove; Clearances -Hearth 64. Elec. Outlets at Wood Panel; Int. & Ext. Card -BI Date Card -BI Date 65. Kit. Fixt. & Appliance; Grnd.-Air Gap -Cooking Clearance Card -BI Date Card -BI Date 66. Elec. Outlets & Receptacles at Kit. Counter Date ELECTRICAL Permit OK except q's 67. Garage Fire Door; Swing -Landing -Closer 68. A.C. Duct in Garage -Damper 20. Fixture & Transformer Clearance -Ins. Protection 69. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 21. Elec. Receptacles Spacing -Lights &Switches at Doors 70. Plb., Elec. & Mech. Equip. Listed for Location 22. Size Boxes & No. of Conductors -Stapled 71. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 23. Romex Installed Close to Edge of Studs & C.J. 24. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 72. Insulation -Foam -Looked in Attic ❑Yes 25. 2 Appliance Circuits in Kitchen & Conductor Size 73. Guard Rails & Deck Construction -Post Caps _ 26. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga. Cu or Al 74. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 27. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al, Insulated Neutral []Yes ❑No 75. Following instld.: Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑Yes 0 N 28. Service -Riser Conductors & Ground -Main Disconnect 76. Stucco; Brown -Finish 29. Equip. Clearances; Panels-Motors-Mech. Equip. 77. A.C. Unit; Disconnect-Clrnces-Brkr. & Cond. Size -115V Outlet 30. Clothes Closet Light -Shower Light 78. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Opngs. 79. Water Well; Disconnect, Electrical, Plumbing 80. Exterior Elec. Trim; G.F.I. Receptacle -Underground Card B-1 Date Card -BI Date 81. 82. Ventilation throughout House Glass Protection Card B -I Date Card -BI Date Date MECHANICAL (Permit) OK except N's 83. _ Corrections from Previous Inspections 84, Gas Test -Meters Tagged; Gas -Electric 31. A.C. Ducts; Insulation & Support 85. Water & Sewer Connected -C/O to Grade -HD Approval 32. _Vent Fan; Exhaust above Insulation 86. Energy Compliance Certificate -Other Certificates _ 33. Condensate Drain & Overflow; Size & Grade 34. Furnace -Vent; Access -Comb. Air -Return Air Vent -115V outlet 35. Attic Access & Platform if Furnace in Attic Card -BI - - --- -- Date _- - Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Card -BI Date Comments at Final: Date FRAMING(Plans) OK except N's 36. Sills; Proper Material & Anchors _ _40. 37. 38. 39. Walls; Studs -Nailing, Spacing & Bracing -Plates -Sound Bearing Walls over Girders & Floor Nailing _ Draft Stop in Walls (rat proof) Fire Stops; Furred Ceilings -Stairs -Chases -Tub _ 41. 42. 43. 44. Header & Beam -Size & Bearing Hangers -Post Caps -Anchors -Connectors Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. Fireplace Ties or Type A Flue -Fireplace Throat _ 45. 46. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles _Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 47. _ Garage Fire Protection Framing (NOTE: Anentry must be made each time you visit jobsite) COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE OROVILLE, CALIF. - 534-4541 'CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of the California Administrative Code, Title 25, Chapter 5, under permit number for the following location: . ��?►? .. Owner {:rs.rtr K % -4A-11 Owner's�ddre-� I -Mobilehome Mfg. �� I z+�� - :q& - �'( Model ;;e) 14 1j Year F-3 Insignia No. _��"�� �— ?f 7--_ Serial No. 1 ��" �? x i It is hereby certified for occupancy at the above described location and may be occupied. Direct�o�r ofPjub'lic Works Date / f $y ,1� T IS�CERTIFICATE IS VOID WHEN MOBILEHO E IS RELOCATED White - Owner, Yellow - Installer, Pink - D.P.W. COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 196 Memorial Way, Chico — Phone: 891.2751 7 County Center Drive, Oroville — Phone: 534-4541' Skyway and Elliott Road, Paradise — Phone: 872-2961, Ext, 57 CORRECTION NOTICE BUILDING OR PROPERTY ADDRESS A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this Inspector Da COUNTY OF BUTTE ; DEPARTMENT OF PUBLIC WORKS w + 7 County Center Drive - Oroville, California 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. �4 - ASSESSOR PARCEL NUMBER Z ZONING BUILDING PERMIT Ow TELEPHONE SQ. FT. OCC. BUILDING VALUAT OWNER'S MMAIrNG ADDRESS �W CONTRACTOR" AME ITELEPHONE CONT CTO MAILING ADDR S �% �d 60 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 l $ S -6'V Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDI�Pjb//�/DR SS ^ _ ,`/'17AV( `61.�_ et, PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar Water Heater 20.00 Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome Other SPECIFY Building sewer 5.00 Mobile Home S G W 110-00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Vtal lation Ot er Describe work: &�77L Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 2 8 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. ( DWELLING OCCUP.& OR ADDNS. C ACC. BLDGS. t 220sgft CONTRACTORS LICENSE LAW I dea under penalty of perjury (check one): IFI am licensed under provisions of Chapt. 9, Div. 3 of the Business a and Professi s ode and p�lficense is in full rce 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. MULTI -OUTLET 2.50 ea NON.RESID BRANCH CIRC ITS NEW CONSTR POWER APPARATUS &') NON -R ESID. ( SINGLE OUTLET CIR. 20®50e FIXTURES L@30qt Ex. OCCup(OUTED A POR R Ex. Occup. OU LETS (RESID )EA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ 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. 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. Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above -m • ned property for inspection purposes. I also agree to save, inde y and eep harmless the County of Butte against all liabi me is co is d expenses which may in any way accrue aga' said C y c n ence of a grantin this permit. Date aAA4Signature of Appl cont Owner ❑ Contractor Agent ❑ An OSHA permit is required for excavations over 5 0" �eep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ y,pp TOTAL PERMIT FEE $ 7V &v occuP. GROUP TYPE OF CONST. PARCEL PD ND ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which• DIREC R OF PUBLIC BY PE T EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No. o17--3 WHITE-D.P.W.. YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT BUTTE COUNTY ..DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1 Owner's name: 2. f Installer's name: ,' i�/ f n1� /� �' ✓�`'✓l i' (f } �'✓ '/c' 3. Is the site currently under permit? Yes AK' / No (If yes, furnish permit number ) OR Is the site an existing site? Yes / / Noy/�'/ (If yes, furnish two (2) plot plans.) ' ,�--r 4. Will the mobilehome be located at least 5 ft. away'lfrom septic tank and leach fields and clear of all set4cks.and easements? Yes /' / No (If no, clarify ) ( ) 5. :What is the mobilehome electrical rating? ------------------------ ,. Amps 6. What is the mobilehome site service rating? --------------------- Amps 7.. What is the mobilehome site circuit breaker rating? ------------- .� Amps S. Is there any other electric load to be served by the mobilehome siteservice? ------------------------------------- --------------- Yes �� No (If yes, identify the load and size: (Load) --- — ""` (Amps) 9. What is the mobilehome site gas pipe size? ---------------=------ 10. What is the type of gas service? ----------------------------- Natural 7- LPG 11. What is the gas pipe length from meter or tank to the mobilehome? 12. What is the mobilehome gas demand? ------------------------------ (BTU) (This information not required if pipe length less than 6 ft. on natural gas . or less than 50 ft. on LPG.) MOBILEHOME SUPPORT DATA If other than single wide, �/ ! � Mobilehome Mfr. furnish Setup Model No. SOS J Year95 Width(ft.) Box Length, �13 (ft:) Tagalong -`or Expando Size t. x —ft. (SHOW SUPPORT DETAILS BELOW) On all mobilehomes manufactured after October 7, 1973; furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of Butte). All center supports measured from front of mobilehome unless otherwise specified. Single .__. I r) - �_] (ft.)(in;) Center support locations* 3, (ft.)(in.) 33 10 (ft.)(in.) I pit (ft.) (in.) *If center piers are other than drawn above, draw in -locations, spacing, and dimensions. Footings (check one) 1. Wood either pressure treated or foundation grade. 2. Other: (specify) Supporta (check one) 1: Concrete block. -2: Other. (specify) tagalong or Expando,' show support details. -- Typical Support .) Footing Size -- Max. Pier Spacing -- Max. Overhang 231-t3 BUTTE COUNTY RUILDiNG DEPARTMENT ARPR0VEd2� 'COUNTY OF BUTTE Department of Public Works. � 7 County Center Drive Oroville ----- 534-4541 ELECTRICAL INFORMATION FOR DE -RATING MOBILEHOMES Location Mobilehome Installation Permit No. FILL IN INFORMATION FOR ITEMS 1 THRU 10 Watts 1. Width 1=;21` x Box Length 1 x 3 2. 2 Kitchen Appliance Circuits ............... = 3,000 3. 1 Laundry Circuit ............................ = 1,500 '4. Ovens ........................................ = /7 19 m o 5. Cook Stove Top ............. .............. .= 6. Hot Water Heater ........................... 7. Dishwasher & Disposal ...................... 8. Clothes Dryer ................................ 9. Other (specify, i.e., motors, exhaust fans, etc.) - Sub -total Watts .... 35706 First 10,000 wt @ 100% ................................ = 10,000 7 Remainin watts @ 40% ....................... = low. 10. Air Conditioner PA? watts @100%.. ="/I Z 8 7 Largest Demand 16C.219 Central Heat System - S watts @ 65% =.- TOTAL TOTAL DEMAND WATTS REQUIRED ............. 13 7• ZG "Demand Watts Required" 230 ............. AMPS De -rate Mobilehome to.................................?J.l.' .� / • " AMPS BUTTE COUNTY BUILDING DEPARTMENT - APPROVED /�-83 v COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California►95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. d ASSESSOR PARCEL NUMBER - ZONING BUILDING PERMIT OWNER � TELEPHONE ,SQ. FT. OCC, BUILDING VALUATION OWNER'S S� MAILING ADDRESS 157S -2-o o CONTRACTOR'S NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ &e:> Penalty $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Permit fee $ BUILDING ADDRESS 6�✓, f PLUMBING PERMIT9 Filin Fee � 10.00 1 6� R� IQ � Ou Each Trap 2.00 Solar Water Heater 20.00 c /4E;�—A,-, �,/���' - Water piping 5.00 LOT NO. SUBDIVISION NAME PARCEL MAP Each qas water heater or vent 5.00 Gas piping system 1 - 5 outlets 5.00 USE OF STRUCTURE SF ❑ Duplex[]Mobilehome� Other SPECIFY Building sewer 5.00 Mobile Home G W 10.00e TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities 19 tilities19 Installation ❑ Other ❑ Describe work: Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 NEW CONST.(DWELLING OCCUP.& OR ADONS. ACC. BLDGS. 1 2h2sq ft 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 ULT%.OUTLET 2,50 ea NON.RESID BRANCH CIRC ITS NEW CON ST R. POWER APPARATUS &' NON-RESID, %SINGLE OUTLET CIR, 20®80C Ex. Occup(o XEDTS OR FIXTURES 9AL®ao FIXED Ex. OCCUp- OUTLETS P(RESID.)REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor MECHANICAL PERMIT Filing Fee 10.00 WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Heating Cooling Hood 3.00 Ventilation Permit Fee $ 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 Countyot Butte tq enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue aga' said County i nseque ce of the granting of this per it. X Date ?J � Signature f Applic t Owner N Contractor El ❑ 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 $ D 2, C90 TOTAL PERMIT FEE $ OCCOP. GRouP I TYPE OF CONST. PA;"ILPD HD Issu This permit is hereby issued under sions of the Butte County Code and/or work indicated above for whic DIREC R OF P LIC By. ` PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date r J' Receipt NO. C//2� 0 WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT i A setback of 5 ft.;from the property lines and a setb'ack' of 50ft. from the road I centerline shall be clear of structures or equipment �xcepi fora 21ft. gave overhang. NOTE: i 1Me, -s- -�� -•rte I "81k& 40 M E C e M SZ Q CTI N prF�-r-�% 3TR Ili f� QAS { �E R R t( 0� ►.RIS 3 O kos �e , Plok ?I AN iffy connections shall be�^' it o� b, 4 ft. of the mobilehome, e=i�; 0�be directly behind or within the r: v�-half of the roadside (left) of�the mobilehome. � f GpQA'E / V\x � t J� 0'D�� A&V�� v S M1)�RS 9 S BUTTE COUNTY This seF o plans and lspecifications MUST bE NOTE ---All pEPAAII Materials & .Workmanship Shall Be in RTMENT f kept on the job at all times and iiis unlawful tr Accordance with Recognized Good Practices and of a qualifly prescriLe�e ,or the Specified use in the Q make any chanr�t , o; alterations on same wit!�c. Uniform Bui;ding, Plumbing & Mechanical Codes and ` P P R O V E D writlten perm's-,sion from the' Department of Pu:, the National Elecirical Code. tic Works, County of Butte. - k r 1 Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT FOR nSIDENTIAL DEVELOPMENT 83-23.334 OFFICIAL RECORDS Section 26-8.1 of the Butte County Code requires this acknowledgement 9t17TE COUNTY- be recorded prior' to issuance of a building permit. EC;o,F?t)5 R"�,��..7� ., i,: PARTY SHOVVRI The property described herein is adjacent to land or included Jul (q 2 a Pm 1981 within an area zoned for agricultural purposes, and residents of this property may be subject to inconveniences or discomfort arising froroCC�SA©n•°". the use of agricultural chemicals, including, but not limited to herbici es, EC( and fertilizers; and from the pursuit of agricultural operations including, but not %Fm ited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has established agricultural 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 disconform from normal, necessary farm operations. All that real property situate in the County of Butte, State of California, described as follows: Date. PR ERTY OWNERS: Lill State of California ) On this the 14th day of July 19 83, before County of Butte SS. me, the undersigned Notary Public, personally appeared ) Jerry R. O'Dell Personally known to me. ',/ Proved to me on the basis of satisfactory evidence to be the person(s) whose name(s) is subscribed to the within instrument and acknowledged that he executed the same for the purposes therein contained. IN WITNESS WHEREOF, I hereunto set my hand and official seal. 0F'' / IC.IAI �•t. �1l �QATHRYN L. RAGS uilfTE CUU^!i'i n C Cumnut;ro.Ap tis Jum! 19. Pregent A.P. No.�"' 5'1 EXHIBIT "A" All that certain real property situate in the County of Butte, State of California, described as follows: Being a portion of Section 25, Township 19 North, Range 4 East, M.D.B. & M., and being more particularly described as. follows: Parcel 3, as shown on that certain Parcel Map recorded in the office of the Recorder of the County of Butte, State of California, -on August 1, 1975, in Book 53, of Parcel Maps, at page 17. TOGETHER WITH a non-exclusive easement for road and public utility purposes as shown on said Parcel Map. ALSO TOGETI-[ER WITH a 60 foot non-exclusive easement for road arx.+. -blic :tilit purposes as shaan c: Parcel Map recorded June 27, 1974, in Book 50 of Parcel Maps, at page 12, Butte County Records. ALSO TOGETHER WITH- an easement for road purposes over Lot A of Wyandotte Acres Unit No. 1 according to the Official Map thereof, recorded in the office of the Recorder of the County of Butte, State of California, March 15, 1948, in Map Book 16 at pages 15, 1.6 and 17. ALSO TOGETHIIZ WITH a non-exclusive easement for road purposes over the Northerly 30 feet of the East half of the Southeast quarter of Section 25, Township 19 North, Range 4 East M.D.B. & M., and over the Northerly 30 feet of that portion of the Southwest quarter of Section 30; Township 19 North,,, Range 5 East, M.D.B. & M., lying Westerly of the Enter.ly hourxiary line of that certain right of way described in Deed executed by Clestel R. Howard, et ux, to Milfred W. Thomas, et ux, recorded November 3, 1958, in Book 966, of Butte County Official Records, at page 92. ALSO TOGETHER WITH a non-exclusive easement for road purposes 60 feet in width lying Southerly of and Southwesterly of.and adjacent to the following described line: BEGINNING at the Northwest corner of Lot A of said Wyandotte Acres, thence, North, 820 04'.23" West, a distance of 141.38 feet; thence, North 819 47' West 180.00 feet; thence North 38 °42' 30" West to the Northerly boundary line of the Southwest quarter of Section 30, Township 19 North, Range 5 East, M.D.B. & M., and the end of said centerline. All of the above easement granted are for the benefit of and appurtenant to land described in Deed to Clestel R. Howard, et ux, recorded June 6, 1973, in Book 1840 of Butte County Official Records, at page 589, and shall inure to the benefit of and may be used::by all persons who may hereafter become the owners of said appurtenant property or any:parts or portions thereof. N dam: tU .T. COUNTY OF BUTTE - DEPARTMEi T OF PUBLIC WORKS 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: (916) 538-7541 AGRICULTURAL BUILDING EXEMPTION PERMIT .PERMIT NO. Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to. house farm implements, hay, grain, poultry, livestock, or other horticulutral 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. ASSESSOR PARCEL NO. �� r 42 _S Z ZONING /) 45 OWNER PHONE NO. C� OWNER'S ADDRESS -�57 2d A) G LOCATION OF BUILDING - USEOFBUILDING - 1 �v SIZE OF STRUCTURE I Z12- —, X e?,__ aQ. FT. TYPE OF CONSTRUCTION: WOODFRAME_A/_STEEL CONCRETE -OTHER (Specify) TYPE OF SIDING AIVIII& ROOFCOVERING Cam10 FLOOR TYP t �. ESTIMATED COST OF CONSTRUCTION $ 20111no AG Buildings shall comply with the building front, side, and rear yard requirements of the applicable County Ordinances as follow&:. , FRONT til 0 - ^" 4-� SIDES 1 REAR /1041 AG Buildings shall be a minimum of five (5) feet from any septic tank or leach fields. 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 mobilehome, and 23 feet from a commercial building. AG Buildings greater than 1000 sq. ft. in floor area shall be located a minimum of 23 feet from a residence and a mobilehome, and 40 feet from a commercial building. 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 Department of Public Works and will obtain any necessary permits, inspections, and approvals to comply with the requirements in effect at that time and before occupancy. 22 R Date ` J Signature of Owner Permit Fee - $25'00' .S'O1-0 Receipt No. ld &6� The above described AG Building is exempt from a building p 'rmit. FLOOD PARC P.D. ROOFIN ISSUE / Director of Public Works By White - DPW, Yellow - Assessor, Pink - B. I., Goldenrod - Applicant Date � COUNTY OF BUTTE - DEPAR-,TMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLExCALIFORNIA 95965 - TELEPHONE: 916/538-7541 ' PERMIT APPLICATION DATA SHEET g — IA���,-y. "W Permit No. 2 OWNER - A. P. No. 36 Proposed Building Usef Building Inspector Date Z - 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 instructions....................................................... 10. Fees of $ 11. Chico Urban Area fees paid ....................................... 12. Park fees paid .................................................... 13. School District fees paid .............. 14. Sanitation approval from Health Department 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: ...... 18. Improvements may be required. Contact Land Development Section DPW 19. Driveway permit (construction approval required prior to occupancy) 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 ......... 25. Letter of signature authorization ................................... 26. 27. When you issue the permit, process as follows:Mail to owner. Mail to contractor. Telephone EkPk-lLdn and hold for pickup at 690 vlAffice. Deliver w/inspector. Other f( Applicant t 1-1RkA__", eJ 3 Ione, Copy of ! laz-Mat form sent Health Dept. Fire Dept. Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date By The following data must be submitted prior to permit 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---mail counter by .date Contractor, designer, owner, was advised of above required data by—phone —mal l—counter by date Plans checked by Date Plans approved by Date _ Sets of plans on hold in File cabinet AP folder Copy—DPW 247-89 PERMIT NO. — PERMIT EXPIRES TODD HEMSTALK OWNER i CONTR. owner ' i 36-23-52 ASSESSOR PARCEL r LOCATION 5-2-05,M; „o, 7?�l, Aa Oroville i I�FY^Ujo0Cl J tr x f �• { i i Temp. Power Pole M Called PG&E Temp. Elec..Service q Called PG&E f• k.Temp. Gas Service Called PG&E 1 • { � JOB FINALED (Date) Signature i l =OK^ 0 = Not OK = Not Readyable MOBILE HOMES MISCELLANEOUS Date MOBILE HOME UTILITIES (Plans) OK except #'s Date ' ` DE ,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements I. ZgAig Requirements -Setbacks -Easements 2. Soils; Special MH Support -Sketch ootings; Soils -Size -Depth -Spacing -Connectors -Steel 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-Rftrs.-Connec.- Shthg.-Rfg.-Bracing 5. Electricity; Location-Clearances-Grnd.-/ / Amp -Concrete 6. Gas; Location -Test -Wrap: / P' ft. / /"Nat. or/ P'L"ft./ P'LPG 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Utility Clearance ec. F g; Sills-Anchors-Studs-Rftrs-Trusses ing; Nailing -Veneer -Stucco -Mesh Card -131 Date Card -131 Date oof; Shthg-Roofing Card -131 Date Card -131 Date Steps- Roors-Landings Date MOBILEHOME INSTALLATION (Plans) OK except #'s 1. Zoning Requirements -Setbacks -Easements Card -B1 Dat9;Z]and-B Date-W—/,7:V 2. Footings; Size -Spacing -Marriage Line Card -B Date and -B1 Date 3. Gas; MH Test -Demand -Valve -Connector 4. Electricity; MH Test -Crossovers -Breaker's -Clearances Date POOLS (Plans) Ok except #'s 5. Drain; MH Test -Fall -Flex Connector 1. Setbacks -Easements 6. Water; MH Test -Regulator -Connector 2. Soils; Compaction -Structure Stability 7. Water and Sewer Connected -C/O to Grade -HD Approval 3. Pool Structure; Steel -Connections -Thickness - Dead -Men -Lining 8. Gas and Electricity Tagged 9. Exits; Insp.-Sketch 4. Elec.; Receptacles and Lighting, Distances-GFI 10. Cert. of Occupancy 5. Elec.; Pool Lighting; 15 volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.;Grounding; Equip. w/5' -circulating Equip. -Pool Lghtg. Boxes-Enclosures-Panelboards-Ins. to Main in Conduit Card -B1 Date Card -81 Date Card -131 Date Card -131 Date 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Card -131 Date Card -61 Date Card -131 Date Card -131 Date = OK 0 = Not OK Applicable - =Not Applicable RESIDENTIAL (Single and Duplex) = Not Ready Date UNDERFLOOR (Plans) OK except #'s 1. Zoning -Setbacks; -Easements -Flood -Slope 2. Fig., Main; Soils-Steel-Elec. Grnd.-/ /" Fig. Depth 3. Ftg., Garage; Soils -Steel-/ /" Fig. Depth 4. Fig., Porches & Decks; Soils -Steel-/ /"Fig. Depth 5. Stemwalls, Main; Steel-Blockouts-Wrapped 6. Stemwalls, Garage; Steel -Blockouts-Wrapped 7. Slab; Steel -Wrapped 8. Piers -Fireplace Ftg.-Steel 9. D.W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test 10. Gas Pipe; Size -Anchors 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric; Underground 13. Plenums & Ducts; Clearance-Material-Supprt-Ins. 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 15. Insulation Card -B1 Date Card -131 Date Card -131 Date Card -131 Date Date PLUMBING (Permit) OK except #'s 16. Water Ht. Vent -Access -Combustion Air -Baffle 17. WaterPipe; Test & Anchors -Nail Protection 18. D .V.; Test-Fttngs & Anchors -Nail Protection -/� . Shower Pan; Test, First Floor -Tub Access 20. Test Tub & Shower, 2nd Floor -Tub Access 21. Gas Pipe; Size & Anchors Card -131 Date Card -131 Date Card -131 Date Card -131 Date Date ELECTRICAL (Permit) OK except #'s 22. Fixture & Transformer Clearance -Ins. Protection 23. Elec. Receptacles Spacing -Lights & Switches at Doors 24. Size Boxes & No. of Conductors -Stapled 25. Romex Installed Close to Edge of Studs & C.J. 26. Equip. Ground made up w/Mech. Fasteners -Bond Gas & Water 27. 2 Appliance Circuts in Kitchen & Conductor Size/G.F.I. 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga. Cu or At 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral Yes No 30. Service -Riser Conductors & Ground -Main Disconnect 31. Equip. Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 33. Smoke Detector Card -81 Date Card -61 Date Card -131 Date Card -131 Date Date MECHANICAL (Permit) OK except #'s 34. A.C. Ducts Insulation & Support 35. Vent Fan; Exhaust above insulation 36. Condensate Drain & Overflow; Size & Grade 37. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet 38. Attic Access & Platform if Furnace in Attic Card -61 Date Card -131 Date Card -131 Date Card -131 Date Date FRAMING (Plans) OK except #'s 39. Sills, Proper Material & Anchors 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound 41. Bearing Walls over Girders & Floor Nailing 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Header & Beam -Size & Bearing Date FRAMING (Continued) 45. Hangers -Post Caps -Anchors -Connectors 46. Cing. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Ring. 47. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 50. Garage Fire Protection Framing 51. Property Line Firewall & Openings 52. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 54. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 55. Siding -Nailing Veneer 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 57. Glazing Area -Glass Protection -Skylights -Plastic 58. Shear Walls; Nailing -Bolts 59. Insulation-Walls-Clg. 60. Infiltration -Wal is-Wndws Card -131 Date Card -131 Date Card -B1 Date Card -131 Date Date FINAL (Plans) OK except #'s 61. Ext. Steps -Door & Sidelight Protection -Landings 62. Smoke Detector 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & Subpanel; Breaker Sizes -Labels 67. Stairs & Rails 68. Fireplace or Stove; Clearances -Hearth 69. Elec. Outlets at Wood Panel; Int. & Ext. 70. Kit. Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance 71. Elec. Outlets & Receptacles at Kit. Counter 72. Garage Fire Door; Swing -Landing -Closer 73. A.C. Duct in Garage -Damper 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 75. Plb., Elec. & Mech. Equip. Listed for Location 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 77. Insulation -Foam -Looked in Attic ❑ Yes 78. Guard Rails & Deck Construction -Post Caps 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; Planters ❑ Yes ❑ No 81. Stucco; Brown -Finish 82. A.C. Unit; Disconnect, Electrical, Plumbing 83. Vents Above Roof; Plbg.-Appliance-Firepl.-Clearance to Openings. 84. Water Well; Disconnect, Electrical, Plumbing 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 86. Ventilation throughout House 87. Glass Protection 88. Corrections from Previous Inpections 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval 91. Energy Compliance Certificate -Other Certificates 92. Roofing Certificate Card -61 Date Card -81 Date Card -131 Date Card -B1 Date Card -B1 Date Card -61 Date Comments at Final: (NOTE: An entry must be made each time you visit job site) COUNTY OF BUTTE -DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville. California 95965 - Telephone: 916/538-7541 APPLICATIDN AND PERMIT ERMIT O. ,q ASSE O PAR NUMBER ZONING BUILDING PERMIT OwN R TEL �N SO. FT. OCC. BUILDING VALUATION R OWN R'S M I G A ESS _ _ s r- n C v 'n ACTOR'S NAME TELEPHONE C TRACT R'S MAILING ADDRESS Fireplace CO RUCTION LENDER UNKNOWN Total Valuation $ LENDER'S AILING ADDRESS Filing Fee $ 1000 Permit Fee $ ARC I ECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT- OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS i 6 -Permit r7o-oo) tice 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 Gas piping system 1 - 5 outlets 5.00 ✓� SF ❑ Duplex❑ Mobilehome❑ Other I Building sewer 5.00 SPECIFY11 Mobile Home S I G I W 0.00ea TYPE OF WORK New Add ition❑ R odel❑ U/,°t'li ies Install�t\r�pn❑ Other �' Permit Fee $ (�(d �`� 1 it r✓ i C� Contractor Describe work: c _ J ELECTRICAL PERMIT Filing Fee 10.00 Main service 10Dv OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 ONTRACTORS LICENSE LAW NEW CONST. DWELLING OCCUP.8J OR ADONS. ( ) , A2sgft I declare u penalty of perjury (check one): ACC. BLDGS. NEW CONST". U TI -OUTLET I am licensed under provisions of Chapt. 9, Div. 3 of the Business NON-RESID .BRA CH CIRCUITS) APPARATUS e) 2.50 ea and Profession and my license is in full �iq;ce and effect. (POWER SINGLE OUTLET CIR. 20050 License No. Z Classification �S EX. Occup( OUTLETS OR FIXTURES p SALO30 ❑Ex. I, as the owner, or my employees with wages as their sole compen- FIXED APPLNS. Occup. OUTLETS ((RESID IREA.) 2.00 sation, will do the work,and the structure is not intended or offered Temporary service 10.00 for sale. (Sec. 7044) ❑ I, the Mobile Home Facilities 15.00 as owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) Misc. Wiring 15.00 ❑ I am exempt under Sec. , Business and Professions Code for this reason Permit Fee $ Contractor WORKME 'S COMPENSATION INSURANCE e perjury (check one): I decPa��ficate MECHANICAL PERMIT FiIingFee 10.00 mit is for $100.00 (valuation) or less. Heating placed on file with the County of Butte Building Department Certiof Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. Cooling g ❑ I shall not employ any person in any manner so as to become subject Hood 3,00 to the W. C. laws of California. Ventilation 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 permit Fee $ provisions or this permit shall be deemed revoked. Contractor I certify that I have read this application and state that the above information Mobile Home Installation Fee $ is correct. I agree to comply to all County Ordinances and State Laws relating Energy Inspection Fee $ to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. TOTAL PERMIT FEE Al eeTo indemnify and keep harmless the County of Butte against I liabilities, judKg' nts, costs, and expenses which may in any way accrue 'dag •occOP. CONST.TYPE JSCH00LJFL00oJ7ZW7 ND ssOE this per it. This permit is hereby issued under the applicable provi- Date sions of the Butte County Code and/or resolutions to do Signature cant — Owner Contractor ❑ Age work above for which f have been paid. An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ROF PU I ORKS ion of structures over 3 stories in height. Zind'ed Receipt No. B Date WNITE-D.P.W., YELLOW-Aee6330R, PINK -INSPECTOR. GOLDENROD -APPLICANT P IT EXPIRES Date COUNTY OF BUTTE - DEPARTMENTOF PUBLIC WORKS p RMIITINO,,/ 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATIONTAND PERMIT AS VJP R LNy�B�yR ZONI G BUILDING PERMIT oyurt(p H C SQ. FT. OCC. BUILDING VALUA N OW ER'S MAIL kDDRESS -s r'r10 C ACT/ORR'S NAME TELEPHONE Y C TRACTOR'S MAILING ADDRESS Fireplace CONS CTION LENDER UNKNOWN Total Valuation $ L NDER'S MAILING ADDRESS Filing Fee $ 10.00 Permit Fee ARC ECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS ` 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 < Gas piping system 1 - 5 outlets 5.00 SF ❑ Duplex❑ Mobilehome❑ Other la' Building sewer 5.00 sP I FY Mobile Home S G W 0.00 ea ' TYPE OF WORK New ❑ Addition RemodelUtilities ❑ In ation Other ❑ Permit Fee $ Or Describe wo k: ) Contractor S j ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW WEACCLLIN GSCC oa ADDNST ( DWELLING '�2¢sgft I declare and y If perjury (check one): NEW CONSTFL TI -OUTLET -' I am licensed under provisions of Chapt. 9, Div. 3 of the Business NON,RESID .BRA CH CIRCUITS) APPARATUS e) 2.50 ea and ProfessC de and my license is in full ce and effect. (POWER SINGLE OUTLET CIR. License No.io rZ— Classification Ex. Occup(OUTLETS OR FIXTURES 20®50t e ALO 30 ❑FIXED I, as the owner, or my employees with wages as their sole compen- APP LNS. OR Ex. Occup. OUTLETS (RESID.1 EA.Y 2.00 sation, will do the work,and the structure is not intended or offered Temporary service 10.00 for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- Mobile Home Facilities 15.00 ors. (Sec. 7044) Misc. Wiring 15.00 ❑ I am exempt under Sec. , Business and Professions Code for this reason Permit Fee $ WORK S COMPENSATION INSURANCE Contractor I declar�under pe of perjury (check one): MECHANICAL PERMIT FiIingFee 10.00 ❑ermit is for $100.00 (valuation) or less. Heating e 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. Cooling g ❑ I shall not employ any person in any manner so as to become subject Hood 3.00 to the W. C. laws of California. Ventilation Notice to Applicant: If after making this statement, should you becomesubject to the W. C. provisions of the Labor Code, you must forthwith comply with such Permit Fee = provisions or this permit shall be deemed revoked. Contractor I certify that I have read this application and state that the above information Mobile Home Installation Fee $ 1s correct. I agree to comply to all County Ordinances and State Laws relating Energy Inspection Fee $ to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. TOTAL PERMIT FEE $ al indemnify and keep harmless the County of Butte against al liabilities, judg s, costs, and expenses which may in any way accrue CUP. CON ST.TYP SCHOOL FIAOD" REEL PD H 9UE ainst said County in c seof this per it. XThis permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do Signature of App — OwnerContractor ❑ Agent work indicated above for which fees have been paid. An OSHA permit is required for excavations over 5'0" deep and demolition or construct- IRE TOR,(*PUBLIC WORKS ion of structures over 3 stories in height. 3Y Receipt No. Date WHITE-D.P.W.. YELLOW-ASDE330R. PINK -INSPECTOR, GOLDENROD -APPLICANT LIER IT EXPIRES Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION m 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET Permit No. / ^ OWNER_:7i�� A. P. No. Proposed Building Use `K Building Inspector0Date At time of permit application, I was advised the following data must be submitted priorto 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. 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 inl^6 1" dla Health Department ... 3 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 -Inspection for required ..... Pre-Inspec. request to 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: Mai o owner. Mail to contractor. Telephone 589-L -C' and hold for pickup at office. Deliver w/inspector. Other / App iic t —'Date / D 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 ---- mail_counter by date Contractor, designer, owner, was advised of above required data by—phone —mal l—counter by date Plans checked by Date Plans approved by Date Sets of plans on hold in File cabinet AP folder Copy—DPW A TO Buildinv Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner,Ad/lLocati(WZo AP# Plan Approved for.: Sewage Disposal Water Supply Hold final for: Final clearance O.K. for: Clearance for bedroom mobile home. %%,/ 'q Ar Al 1001 Water Supply _ Water S�u/pply. Other NOTE Sanitarian e 9 N oT A setback of 5 ft. from the m ©� � ►.� t-�o rr� : • m u T Vh E T' t=om r 31� I 11'W QII.e 40ME EO1QSZ Q C-rl N � ArF�� 3THtt��ARAS BEAR t(0 ►.Rt9 .r ��D g property lines and a setback' of 50ft. from the road 0 -Atilily connections shall be viT centerline shall be clear of ��;\4 ft. of the mebi!e!iom structures or equipment excep' direct) behind or wit! ' ora 1. tt. r Q ovc 1rhang. Y i;� O� half of the roadside (left) ofltlic � 10 mobilehome. 3to, WA�fR•--j c, AN- = 14'.x5 Plo� M AN f �5� J � 0 I sum oadktv A&VC ��. S 1 o S M S N �.lLS BUILDING i3EPARN-' �- 83 e—A 175 9 5" APP 'OSI E&TE COUNTY NOTE:—All Materials & .Workmanship Shall Be in BUILDING DEPART/VIENT( This set of plan; and f' th specifications MUS e Accordance wish Recognized Good Practices and kept on fhe job at e!I firnes and 4 is unlawful tr ' of a quVlity prescri��r„I or the Specified use in the APPROVED n n make an,, chanrt i, o; a!;c ,;tions on same wit! . Uniforrn Bui:ding, Piurriirirg i'< Mechanical Codes and (_ t+ R O V E D wrihtcn permission frc:m the' Department of FL16 the National Eleciricral Cade_ lic Works, County of Bufte.._"- k CONT. LIC. 438912 / Todd Hemstalk Construction 55 WHISPERING OAKS OROVILLE, CALIFORNIA 95966 Y/2- 4 l2 - 4 916-589-1689 ED c� o �c � o Todd Hemstalk Construction 55 WHISPERING OAKS OROVILLE, CALIFORNIA 95966 Y/2- 4 l2 - 4 916-589-1689 ED ..•t�'�'""'YR� :}'X"'[�` � 'Pi f' itC ,�FP'i:'Q.ier r grp�y �� m�..' ..�t."S • R 9 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive r4� 0 Foville, California 95965 `Telephone: 534-4541 APPLICATION FOR SPECIAL INSPECTION Owner :WZ>,D /C STALj.E� _ A. P. No 3-o�3 5.;z Mailing Address ���,,�//_�/�¢,Q/�J� ��}�, ���y/��� Telephone No.57�9-/z e Applicant %rl%W Telephone No. .Mailing Address Building Location 5c?y54421X)&7S S -`ZD fed PwoV,//fes R a_ I hereby request a special inspection -of the following building: Dwelling (if only a portion, specify) /_/ 2. Apartment House (if only a portion, specify) i 3. Commercial (specify present occupancy) /_% 4. Other (specify) I am requesting a special inspection for the purpose of: /_/ 1. Moving the building. / / 2. Financing (specify agency) Case No. 3. Change of occupancy to 4.. Other ( specify) p (7 . i I hereby certify that I will obtain the necessary permits and make `'any necessary corrections, alterations, or repairs required by the County of Butte, as a result of this inspection, to comply with building and housing code requirements'., I also certify that prior to the use or occupancy of this building, T will complete the.above required corrections, alterations, or repairs, or, if the.building is presently occupied, I will complete the above required corrections, alterations, or repairs within thirty (30) days. I cert that I have authorize representat inspection purposes. Signature of�)of�Ownee Fee paid $v read this application and state the above information is correct and hereby ve.sof the County of Butte to enter upon the above-mentioned property for 1st -DPW - 2nd -Inspector - 3rd -Applicant .` Date Receipt No. 36R,)d2 o COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS / 7 County Center Drive -� Oroville, California 95965 _ ;^ -Telephoner 534-4541 APPLICATION FOR SPECIAL INSPECTION Owner y,)r_ 7:;� /0l /y "7TH A. P. No. Mailing Address ��� /./J/�i< . /�)�' 1'5K/K 0/�d 'l_/2 / Telephone No. Y Applicant 77WW Telephone No. ,Mailing Address 5;'eg F , Building Location ����,,�)� S �Ji // W. &.I.- r /C � �J_al •.�''�4+—LOp 2: � ?- o. -- // C I �I hereby request a speinspection of the following building: �+ 1. Dwelling (if only a portion, specify) / % 2. Apartment House (if only a portion, specify) / / 3. Commercial (specify present occupancy) 4. Other (specify) ,, I amirequesting a special inspection for the purpose of: / / 1.., Moving the building. / / 2. Financing (specify agency) / / 3. Change of occupancy to 4. Other (specify)���,���,/�/)/,�� Case No. ir I hereby certify that I will obtain the necessary permits an&'make any necessary corrections, alterations, or repairs required by the County of`Butte, as a result of this inspection, to comply with building and housing code requirements. I also certify that prior to the use or occupancy of this building, I will complete the above required corrections, alterations, or repairs, or, if the building is presently occupied, I will complete the above required corrections, alterations, or repairs within thirty (30) days. I certhat I have read this application and -state the above information is correct and hereby authorize representatives of the County of Butte to enter upon*thet-above-menti ned property for inspection purposes. Date /2y' Signature of Owner___.. -1 Fee paid $ r. ,. 1st -DPW - 2nd -Inspector - 3rd -Applicant { Receipt No. 3a Ar�l� 11 y� O ��� _ �y ✓S Le 1 E 1. Ceiling Insulation F2 factor 0.90 Number of stories 3 -1 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 -24 -10 4 0.50 -176 -84 .54 0.30 -102 -49 32 0.10 -26 -13 -8 0.08 -18 -9 -6. . 0.06 -11 -5 -4 0.04 -4 -2 -1 0.02 4 2 1 0.00 11 5 3 2. Wall Insulation 5 I 27 Single- Single - -9 -2 Family Family Multi - R -value Detached Attached Family R-0 -68 -51 -34 R-11 0 0 0 R-13 2 2 1 R-19 8 6 4 U -value -40 -11 -4 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 16 17 Insulation in Floor -1 3 8 Number of stories 17 R -value One Two Three P.-0 -17 -8 -5 R-11 -3 -2 -1 R-19 0 0 0 R-30 3 - 1 1 U -value 13 -12 4 0.60 444 -70 -46• 0.50 -120 -58 - 38 0.40 -95 -46 -30 0.30 -69 34 -22 0.20 43 -21 -14 0.10 -17 -8 -5 0.08 -11 -6 4 0.06 -6 .3 -2 0.04 -1 0 0 0.02 4 2 1 0.00 10 5 3 Controlled Ventilation Crawlspace -30 4 Number of stories 3 R -value One Two Three R-0 -11 -7 -5 R-5 -4 -4 3 R-11 .2 -2 -2 R-19 -1 -1 .2 -2 4. Slab Edge Insulation 0 2 3 Number of Stories 3 R -value One Two Three R-0 0 0 0 R-5 8 5 2 R-7 8 •6 3 F2 factor 0.90 -4 3 -1 0.80 -1 -1 0 0.70 2 2 1 0.60 6 4 2 0.50 9 6 3 0.40 12 8 4 5. Inriltration (Air Leakage) Spedi cation Points Standard 0 6. Glass Heat Loss Total Saltie- . Family Detached 0 3 5 8 10 13 13 12 10 10 10 Slab Floor Raised Floor Effective Percent Glass U -value Stories Percent (percent ghm x SC) .51 to .41 to .31 to 0.30 or Glass Single Double .60 .50 .40 less 50 -121 -53 -39 -24 -10 4 40 -90 37 -26 -14 3 8 35 -75 -29 -19 -9 1 10 30 -61 -21 -13 -4 4 12 29 -58 -20 -12 -3 5 12 28 -55 -18 -10 -2 5 13 27 -52 -17 -9 -2 6 13 26 -49 -15 -8 -1 7 14 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 3 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) Saltie- . Family Detached 0 3 5 8 10 13 13 12 10 10 10 Slab Floor Raised Floor Effective Percent Glass Water Stories 1199 (percent ghm x SC) 2200 Effective One Two Three One Two %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 7 8 10 11 1B. Shading (Shade Closed) 5.0 4 7 Effective Pes cel t Glass 11 12 12 (Percent ilam x SC) 8 Effective 11 12 12 6.0 5 %Glass North East South West SltyBght 18 -14 -48 -69 -64 na 16 -12 -42 -59 -55 na 14 -10 -35 -50 -46 na 12 -8 -29 -40 -37 na 11 -7 -26 -36' -33 na 10 -6 -23 31 " -29 -74 . 9 -5 -20 -27 -25 -65 8 -5 -17 -23 -21.. -56 7 -4 -14 -19 -18 -47 6 3 -11 -15 -14 .38 5 -2 -9 -11 -10 -30 4 -1 3 -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 9. Interior Thermal Mass Interior Saltie- . Family Detached 0 3 5 8 10 13 13 12 10 10 10 Slab Floor Raised Floor Mass Water Stories 1199 12M Stories 2200 /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 J ?_ 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 Wall Mass 0.00 0.20 0.40 0.60 0.80 1.00 1.20 1.40 1.60 1.80 2-00 Saltie- . Family Detached 0 3 5 8 10 13 13 12 10 10 10 Single - Family Attached 0 2 4 6 8 10 12 13 13 12 11 Multi FamBy 0 1 1 3 4 5 7 8 9 11 12 13 11. Heating System Water SEER 1199 12M SE or KSPF 2200 2700 (assumes ducts (a numes ducts In attic) or •: to to Stmt of 1.6 Sbm of 7.111 Type Type -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 0 0 Effective SE or HSPF 0 (SE or HSPF x duct efnciency) 10.0 Effective -25 or -24 to -14 b -4 to +610 16 or SE HSPF less -15 -5 +5 +15 more 0.30 275 -73 34 -56 -47 -38 -30 na 3.41 -45 -39 -34 -29 -24 -18 0.40 3.67 -34 30 -26 -22 -18 -14 0.50 4.58 -10 -9 -8 -7 -5 -4 0.56 5.13 0 0 0 0 0 0 0.60 5.50 5 5 4 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 43 Zonal Control Adjustment 6.0 System Type -11 -9 -7 -6 Resistance 10 9 7 6 4 3 Other 6 5 4 3 2 2 12. Cooling Syst.!m (os 1a.7 Unit Size (sQ U -value [0.65] Water SEER 1199 12M 1700 2200 2700 (assumes ducts In attic) or •: to to to Sbm of 7.111 Type Type loss 1699 -25 or ,24 to -14 to -41D +6to 16 or SEER less -15 -6 +5 +15 more 8.0 -14 -12 -10 -8 -6 -4 8.5 -9 -7 -6 -5 -4 -3 8.9 -5 -4 -4 -3 -2 -2 9.0 -4 -3 .3 -2 -2 -1 9.5 0 0 0 0 0 0 10.0 4 3 3 2 2 1 10.5 7 6 5 4 3 2 11.0 10 9 7 6 4 3 �- 120 15 13 11 9 7 5 13.0 20 17 14 12 9 6 -9 _-7 Effective SEER IG None -5 (SEER x dud efficlenc7) -2 -2 -2 Sum of 7-10 Solar 7 Effective -25 or -24 to -1410 -4b +6 b 16 or SEER less .15 -5 +5 +15 more 5.0 .30 .25 -21 -17 43 -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 I 8.0 9 a 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 or Zonal Control Adjustment 14 1 10 8 7 6 4 3 9. No Cooling System Installed 3 = Stories 2 3.3 WSB 9 4 One -5 -4 4 -3 -2 -2 Two + 3 3 2 2 2 1 Single-Famlly Detached and Attached Point System Summary: Climate Zone 11 SCORE CARD Measures 1. Ceiling Insulation R 3 8 or R -value [38] U -value [0.030] 2. Wall Insulation r�2-) ?, or R-valueI11) U -value [0,098] 3. Raised Floor Insulation or R -value [ 19] U -value [0.037] 4. Slab Edge Insulation S. 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 or R -value [0] F2 factor [0.77] e,-__ _r --- L)oW (os 1a.7 Unit Size (sQ U -value [0.65] Water % Glass 1199 12M 1700 2200 2700 Heater Credit or •: to to to or Type Type loss 1699 2199 2699 more SG None 0 0 0- 0 0 or Solar 12 8 6 5 4 HP HWR 8 5 4 3 3 AREA WSB 5 3 3 2 2 ND. FLOO POU 8 5 4 3 3 SE None 37 -24 -18 -15 -12 = �. Solar -1 -1 -1 0 0 Type (SG1 HWR -18 -12 -9 -7 -6 WSB . -25 -16 -12 -10' -8 POU -18 =12 -9 _-7 -6 IG None -5 -3 -2 -2 -2 Solar 7 - 5 .4 3 2 POU 3_ 2 1 1 1 IE None -28 -19 -14 -11 -9 Solar 8 5 4 3 3 2S% POU -10 -6 -5 -4 -3 60% Multi -Family (Individual units) 10% 851/6 90% 95% Unit Size (so 0y. Water 0.2 699 700 1200 1700 2200 Heater Credd or b tob 25 or Type Type loss 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 3.3 WSB 9 4 3 2 2 4.8 POU 9 5 3 2 2 SE None -45 -23 -15 -11 -9 2.2 Solar 2 1 1 0 0 9.1 HWR -23 -12 -8 -6 '-5 5.2 WS8 -25 -13 -8 3 -5 1.1 _ QQU _23 -12 -8 3 -5 IG None -8 -4 -3 .2 1 -2 3.7 Solar 6 3 2 1 1 5.1 POU 10 58 - . 0_'-8 0 0 IE None 30 15 -10 ' -8 -6 26 Solar 18 9 6 4 4 4 POU -8 -4 -3 -2 .2 Point System Summary: Climate Zone 11 SCORE CARD Measures 1. Ceiling Insulation R 3 8 or R -value [38] U -value [0.030] 2. Wall Insulation r�2-) ?, or R-valueI11) U -value [0,098] 3. Raised Floor Insulation or R -value [ 19] U -value [0.037] 4. Slab Edge Insulation S. 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 or R -value [0] F2 factor [0.77] e,-__ _r --- L)oW (os 1a.7 Type [double] U -value [0.65] % Total Glass (16] % Glass SC Eff. % Glass -t- X 77 = t�- Interior Mass/CFA �.o X 71 = 1 •S�/ 3,o x .77 = a• 3 _ x % Glass SC Eff. % Glass (9 x -LE- _ s. l X X G3 = 1 •3Z S. b X X .7) _l TYPE 1'MASS AREA =%�•7g InteriorNiss/CFA COND. FLOOR AREA loss TYPE 2 MASS AREA __ B Exterior Wall Mass ND. FLOO AREA G •4p3 X •9t _ J. SE or HSPF Dual Efficiency 10.78) Effective SE or [0.72/6.6] HSPF [0.5615.15] 9.5- x 8 3- = �. SEER [9S] Duct E�fffficiency 10.741 Effective SEER [7.031 S . F, rru3 Type (SG1 (1.7°tK'6•=� t TYPE I MASS (U 114C & 4.2, Se: exposed slab) (carpeted .lab) -�- -- 0% 5% toY. 15% 20% 2S% 30% 35% 40% 45% 50% 55% 60% 60. 70% 75% 10% 851/6 90% 95% 100% 105% 1 toy. 115% 120./.125- 20%125•0y. 0y. 0 0.2 0.4 0.6 0.8 1.1 1.3 1.5 1.7 1.9 2.1 23 25 2.7 2.9 3.2 3.4 3.6 3.8 4 4.2 4.4 •4.6 4.8 5 5.3 101/. 0.2 0.4 0.6 0.8 1 1.2 1.4 1.6 1.9 21 2.3 25 2.7 2.9 3.1 3.3 3.5 9.7 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 27 29 3.1 3.3 3.5 9.1 3.9 4.1 4.3 4.5 4.8 S 5.2 5.4 S6 30% 0.5 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 4.5 4.7 4.9 5.1 5.3 5.6 58 401/6 0.7 0.9 1.1 1.3 1.5 1.7 1.9 22 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 5.5 5.7 5.9 50% 0.9 1.1 1.3 1.5 1.7 1.9 21 23 25 27 3 3.2 3.4 3.6 3.8 4 42 4.4 4.6 4.8 5.1 5.3 5.5 5.7 5.9 6.1 55% 0.9 1.1 1.4 1.6 1.8 2 2.2 24 2.6 28 3 9.2 3.5 3.7 3.0 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 2.9 3.1 3.3 3.5 3.8 4 4.2 4.4 4.6 4.8 5 5.2 5.4 5.6 5.9 6.1 6.3 65% 1.1 1.3 1.5 1.7 1.9 2.2 2.4 2.6 2.8 3 3.2 3.4 3.6 3.8 4 4.3 4.5 4.7 4.9 5.1 5.3 55 5.7 5.9 6.1 6.4 70% 1.2 1.4 1.6 1.8 2 2.2 25 27 29 3.1 3.3 3.5 3.7 3.9 4.1 4.3 4.6 4.8 5 52 5.4 5.6 58 6 6.2 64 75% 1.3 1.5 1.7 1.9 21 2.3 2-5 27 3 3.2 3.4 3.6 3.8 4 4.2 4.4 4.6 4.8 5.1 5.3 5.S 5.7 5.9 6.1 6.3 6.5 80%. 1.4 1.6 1.8 2 2.2 2.4 26 2.8 3 3.3 3.5 3.1 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.4 5.6 5.8 6 6.2 64 66 857 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 52 54 5.6 5.9 6.1 63 65 67 WY. 1.5 1.7 _2__ 2.2 2.4 26 2.8 3 3.2 3.4 3.8 3.8 4.1 4.3 4.5 4.7 4.9 S.1 53 5.5 5.7 5.9 6.2 6.4 66 68 95% 1.6 1.6 2 2.2 2.5 27 2.9 3.1 33 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 6.7 6.9 100% 1.7 1.9 21 2.3 2.5 28 3 3.2 3.4 3.6 3.8 4 4.2 4.4 4.6 4.9 S.1 S.3 5.5 5.7 5.9 6.1 6.3 6.5 6.1 7 105% 1.8 2 2.2 2.4 2.6 28 3 3.3 3.5 3.7 3.9 4.1 4.3 4.5 4.7 4.9 5.1 5.4 5.6 5.8 6 6.2 6.4 6.6 68 7 110% 1.9 2.1 2.3 2.5 2.7 29 3.1 3.3 3.6 3.8 4 4.2 4.4 4.6 4.8 5 5.2 5.4 5.7 5.9 6.1 6.3 6.5 6.7 69 7.1 115% 2 2.2 2.4 2.6 2.8 3 3.2 3.4 3.6 3.8 4.1 4.3 4.5 4.7 4.0 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 S.4 5.6 68 6 6.2 6.5 6.7 6.9 7.1 T.3 125% 21 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 Point System Summary: Climate Zone 11 SCORE CARD Measures 1. Ceiling Insulation R 3 8 or R -value [38] U -value [0.030] 2. Wall Insulation r�2-) ?, or R-valueI11) U -value [0,098] 3. Raised Floor Insulation or R -value [ 19] U -value [0.037] 4. Slab Edge Insulation S. 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 or R -value [0] F2 factor [0.77] e,-__ _r --- L)oW (os 1a.7 Type [double] U -value [0.65] % Total Glass (16] % Glass SC Eff. % Glass -t- X 77 = t�- �.o X 71 = 1 •S�/ 3,o x .77 = a• 3 _ x % Glass SC Eff. % Glass (9 x -LE- _ s. l X X G3 = 1 •3Z S. b X X .7) _l TYPE 1'MASS AREA =%�•7g InteriorNiss/CFA COND. FLOOR AREA TYPE 2 MASS AREA __ B Exterior Wall Mass ND. FLOO AREA G •4p3 X •9t _ J. SE or HSPF Dual Efficiency 10.78) Effective SE or [0.72/6.6] HSPF [0.5615.15] 9.5- x 8 3- = �. SEER [9S] Duct E�fffficiency 10.741 Effective SEER [7.031 S . F, rru3 Type (SG1 Credit [none] Point Scores 0 f 1'3 Sum 7.10 $3 `/8 Point Total: `� ' T000 14AW SrA L14-• woJect Title 75 SIML T A 40tmD La � Address Author Climate Zonis Bu' ermit M -a1 (aedted By / Date Enforcement Agency Use Only U11LDING DATA Class Area % Glass North $ pnditioned Floor Area Number of Stories ! East —Asak�- ab/Raised Floor Number of .Units / South ._.�3Stl�" ?� 1 Single Family Detached (SFD) [ ] Addition Alone West C, .D 1 Single Family Attached (SFA) [ ] Existing Building Skylight , Multi -Family (MF) [ ] Existing -Plus -Addition Total AfL UILDING SHELL INSULATION xnponent Insulation Location/Comments 22 R -Valle (attic. to gaga typical. eta) au .............. K/.3 )of ............. )of ............. Dor............. -- Dor............. ab Edge..... LAZING dge.....LAZING Shading Devices azing ientation Area Glass Type Interior Exterior Overhang Framing Type SO (single. double) (roller blind. etc.) (shadescreen. eta) (yes/no) (metal/wood) Drth Documentation Author Enforcement Agency Name: Name: art.h ( ) Atm': t Tcle:O one est ( )_ �aoe.tf3 r Nfiry� 4ry OS !/3r St ( ) 'u h P/. S rf uth ( ) cyst ( ) ' I►riNi �ciNO i14 fist ( ) Plight....... y fit T QERMAL MASSSF-�� pe/Covering Area Thickness ..��, t/iN�1G�ltstr /3o i ` _1�i�, �3faT�►f—� l4rS,,r,tr.PJf (AC SYSTEMS Minimum Duct pe (Nmace, air Efficiency Location Duct Output Manufacturer / Model # ditioner, heat um) (SE, SEER,HSPF)• (attic, etc.) R -Value tuh) (or approved equal) .P, 1-640w 4rtfc s, 1(.1911 fximum Fumace Heating Output: Btuh )T WATER SYSTEMS Tank:", Manufacturer/Model # item Type (storage gas, etc.) Capacity (or approved equal) Special Feature(s) ECIAL FEATURES/REMARKS (Add extra sheets if necessary) Mandatory Measures Checklist: Residential MF -111 NOTE: Lo -rise residential buildings subject to the Standards must contain these measures regardlest of the compliance approach use Items marked with an asterisk (•) may be superseded by more stringent compliance roquuemena listed ori the Certificate of compliance. When this checklist is incorporated into the permit documents, the features need shall be considered by all parties as binding minimum component performance specifications for the mandatory measures whether they are shown elsewhere in the documents or on this checklist only. DESCRJMON Building Envelope Measures §2.5352(a): Minimum ceiling insulation R-19 weighted average. §2.5352(b): Loose fill insulation manufacturer's labeled R -Value. §2-5352(c): Minimum wall insulation in framed walls R-11 weighted average (does not apply to exterior mass walls). §2-5352ft Slab edge insulation - water absorption rate no greater than 03%. water vapor transmission rate no greater than 2.0 pcmVuxh. §2.5311: Insulation specified or installed meets California Energy Commission (CEC) quality standards Indicate type and form. 62-5352(f). Vapor barriers mandatory in Climate Zones 14 and 16 only. §2.5317: Infiluation/Exfiltration Controls a. Doors and windows between conditioned and unconditioned spaces designed to limit air leakage. b. Doors and windows certified. c. Doors and windows weatherstripped: all joints and peneoations caulked and sealed 42-5352(e): Special inrdiration barrier installed to comply with 12.5351 moats CEC quality standards §2-5352(d): Installation of Fueplaces I. Masonry and factory -built fireplaces have: a. Tight fitting, closeable meal or glass door b. Outside au intake with damper and control c. Flue damper and control 2. No continuous burning gas pilots allowed. HVAC and Plumbing System Measures 42-5352(8) and 2-5303: Space conditioning equipment sizing: attach calculations. §2-5352(h) and 2-5315: Setback thermostat on all applicable heating systems. 42-5316(a): Ducts constructed, installed and insulated per Chapter 10. 1976 UMC. §2-5316(b): Exhaust systems have damper controls. §2-5314(c): Gas -furl space heating equipment has intermittent ignition devices. §2-5314: HVAC equipment, water heaters, showerheads and faucets certified by the CEC. §2-5352(1): Water heater insulation blanket (R-12 or greater) or combined interior/exterior 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. System has: a On/off switch on heater. b. Weatherproof instruction plate on heater. e. Plumbed to allow for solar. 2. 75 percent thenal efficiency. 3. Pool cover. 4. Time clock. 5. Directional water inlet. Lighting and Appliance Measures 12-5352(1): Lighting - 25 tumcns/watt or greater for general lighting in kitchens and bathrooms. §2.5314(c): Gas rued appliances equipped with intermittent ignition devices. §2.5314(x): Refrigerators, refrigerator -freezers, freezers and fluorescent lamp ballasts certified by the CEC. Indicate make and model number. COMPLIANCE STATEMENT DESIGNER I ENFORCEMENT This certificate of compliance lists the building features and performance specifications needed to comply with Title 24. Chapter 2-53 and Title 20, Chapter 2. Subchapter 4. 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 purchaser of the building. Designer Building Owner Name: Name Tuk/Funx Address: Tttk/Fum- Address: Tek ho= Lic. 8: ne. 4 � (date) (signature) (date) (si6rtautre) Documentation Author Enforcement Agency Name: Name: ISde/Fum Atm': Address: Tcle:O one _.. .. .... r.,.... cai V� nV. 1WV17 (:LCARVRIRTGD _ /// �+.,. '; �. 7 �e�'. / � S _ i V --- _ � _ __. _ _ _ _ i � I s i M y ' r t fiiY�i.i.�p..p.{i.r��6�.f,.«.o..#I:Mz,...F�11t'YY,It•.r,�M.6r..a.:,. ii�rY�6���Y����'I fill i��C,o���«II yGi:l+ig6ii t�l� i��i�tt.l�pi "F kF1�IR11 x+AFY ���� � � py �� �{ � '�' �����,� j� ��r � j � �r Si • - �S {•n�'� �S�'i� 1\�'� ``� � A 1 r� "aV'�Iad 06 88 98 1t8 ZIR 013 €r! ,� d'=Lo i w � ,•+� w,,y;«. , ' ��': Yk3S, Y 'w � a r F � � „ a r �-4�h�}�* "«�h° ;°(�«t«;• C x'♦ 4, W ' rdYs'rv'• ' a.. ' .-""�s•x'�FpK;1��4". . ;r ��yF{�,�,', h nx:.aira t x w. k K tlu. i�� s'• � - S x � .� .f���« �G �' k,+x; . .. .. �C. _ hau° y.., ,, ,n'� .� i - � Y. vrr' p,w.q 10 Nor, . • ;Yn>. '?,`fir Y�4. � R=" � e;�; m 4.m.�� A p.r�a.ida«Iw •.��-# �tl: °iY � i�' 1' ^�:., °.ax n MIK x.,w+' BETTER HOMES FOR ALL AMERI .16: PLANT NO. 19718 fetter domes & Gardens q) Meredith Pub6iO.iry Cc, t+) e 3A.t! , 911(1 100YOd P"Aled in umltld M31" haAmn•10e This 'plan hos been pn7 pared o m,:Pt top pro- COV E R fessianal standordi and prCactiv-s. However, [()cal «tariations may recluire minor chdngesx EEOr Verify dimensions on job, �...r' 36' 7 w ynL;%� �,..._. WEB N01E8 3X5 341 il" WEB14g0+2X4 #3 NEM-rIRf mg -LARCH, OR 3X4 30' �9" f"'ft' SO. -PINE. ��t sJ'� f.: r.• o.a i. �! rr rr,N,�. .\lVYR �'�.✓ f'1%rWl44 t�� t `� � ` ,df , ,. RLPINE ENGINEERED PRODUCTSo INC, 22 PUMPRND BEA FLORIDA 33DG;1 LOCATE TOP CHORD OFF -PANEL SPLICE WITHIN . Sw OF PANEL 1/4-POINTMIEN CRITERIA UBC _ TC LIVE LOAD r lb:s P51" DDASHES IRECTIONbOF TC DEAD LOAp 7,# P$F �t BC DEAD LEAD D 50 P$. MIN tAG SPAN -- 5306 361 yJ'A2 MC-lS 36 7a K «gyp 41 3b 7 e3.5� i�.. 1 " 33 1tN s we uai7 a1y, akf Iii ti1'i am Him nod spAit IiS20' `!" . 2 139 3 2 31 0 l3► b" M2 ika4 104', 9_ C1.0 asc i-8 it f A4ti).16C600 WhEw PUT* HOa6 Ht,sE{�li oN i11GH #�ti9 ENGlfEAEQ PROIX1CiB'�OrC. tie) - PROVIDE fog UORIXOa�TAL PA. OUX 9225" li00N4N! Ar ous OUPPONr powi A, "EM FLORIDA 3�Wj 3mler -3333 Lotw& Too C11090 orr-ohmaL dpi.1c' 01THI" i" dr PAREL 114401Or pReYtd11 CRS?ilt?<A tbOC .! !iPe.. VC LIVE; 1AAii w , ol►axaeeuob sc Asea LO�►ID •� �� Pee