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Home My WebLink About001-120-031t� BUTTE COUNTY AREA DEPARTMENT OF DEVELOPMENT SERVICES 1 INSPECTION CARD MUST BE ON JOB SITE 24 Hour Inspection Line (IVR)_: 530.538.4365 (Cut off time for inspections is 3pm) Development Services cannot glarantee inspections on the date requested Office: 530.538.7601 Fax: 530.538.7785 www.ButteCounty.net/dds Permit No: B 17-2176 Issued: 9/13/2017 APN: 001-120-031 Address: 2922 4TH ST, BIGGS Owner: THOMAS LONNIE D & RHONDA L Permit Type: RE -ROOF RESIDENTIAL Description: TEAR OFF AND REPLACE COMP 22 Flood Zone: None SRA Area: No SETBACKS for Zon*�g_ AG_ SRA_ PW i Front: Centerline of Road: Rear: SRA: j Street: AG: Interior Total Setback from Centerline of Road: ALL PLAN REVISIONS MUST BE APPROVED BY THE COUNTY BEFORE PROCEEDING Inspection Type IVR INSP DATE Setbacks - 131 Foundations / Footings 111. Pier/Column Footings 122 Eufer Ground 216 Masonry Grout 120 Setbacks 1131 Do Not Pour Concrete Until Above are Signed Pre -Slab 124 Gas Test Underground/floor 404 Gas Piping Underground/floor 403 Underfloor Framing 149 Underfloor Ducts 319 Shear Transfer 136 Under Floor Plumbing 412 Under Slab Plumbing 411 Blocking/Underpining 1612 Tiedown/Soft Set System ':611 Do Not Install Floor Sheathing or Slab Until Above Signed ShearwallB.W.P.-Interior 134 Shearwall/B.W.P.-Exterior 135 Roof Nail/Drag Trusses 129 1417 Manometer Test Do Not Install Siding/Stucco or Roofing Until Above Signed Rough Framing 153 Rough Plumbing 406 Rough Mechanical 316 Rough Electrical 208 4 -Way Rough Framing 128 Gas Piping House 403 Gas Test House 404 Shower Pan/Tub Test 408 Do Not Insulate Until Above Signed Permit Final 802 Electrical Final 803 Mechanical Final 809 Plumbing Final 813 Fire Sprinkler Test or Final 702 Swimmin iPools �I Inspection Type IVR INSP DATE T -Bar Ceiling;145 Stucco Lath i 142 e I Swimmin iPools Setbacks 1131 Pool Plumbing Test i 504 Gas Test ; 404 Pre-Gunite 506 Pre -Deck 505 Pool Fencing/Alarms/Barriers 503 Pre -Plaster 507 i Manufactured Homes Setbacks 1131 Blocking/Underpining 1612 Tiedown/Soft Set System ':611 Permanent Foundation System 1613 Underground Electric 1218 Sewer !407 Underground Water 1417 Manometer Test 1605 Continuity Test • 602 Skirting/Steps/Landings I i610 Coach Info Manufactures Name: Date of Manufacture: 1 Model Name/Number: Serial Numbers: Length x Width: Insignia: rumic worxs rmai Fire Department/CD ► Env. Health Final Sewer District Final -rrolect rtnai is a PERMITS BECOME NULL AND VOID 1 YEAR FROM THE DATE OF ISSUANCE. IF WORK HAS CI RENEWAL 30 DAYS PRIOR TO EXPIRATION 8.7681 8.6226 8.7281 iYOU MAY PAY fOR A 1 YEAR 1 BUTTE;COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION (IVR)#:530.538.4365 i OFFICE #: 530.538.7601 FAX#:530.538.7785 www.ButteCounty.net/dds BILL'S ROOFING 1073 CAMPBELL AVE GRIDLEY, CA 95948 5308463981 LICENSED CONTF Contractor (Name) BILL'S ROOFING BILL'S ROOFING Buildinj 1073 CAMPBELL AVE 0 GRIDLEY, CA 95948 Other 5308463981 0 ACTOR'S DECLARATIOW' ._ ¢} i.: r tt i :°''.�:I. <<OWNER / BUILDER State Contractors License No. I Class I ExpiresI I hereby affirm under penalty of perjury that I am exempt the reason(s) indicated below by the checkmark(s) I have 801512 / C39 / 11/30/2017 70315B d f CdA I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license in full force and effect. X Contractors Signature Date I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:' I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Policy No. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier. STATE- Policy Numb9QaQ832 Exp. gS1/2017 ❑I certify that, in the performance of the work for which. this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. - - X Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (8100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name and Address Lender's Name & Address City ' State Zip . , usiness an ro essions o e. ny sty or coui improve, demolish, or repair any structure, prior to its issi permit to file a signed statement that he or she is license State License Law (Chapter 9 (commencing with Section Professions Code) or that he or she is exempt from licen: 'Any violation of Section 7031.5 by any applicant for a pei 'not more than five hundred dollars ($500).): Garage Q,' PROJECT_IINFORMATION 0 0 Site Address: 2922 4TH ST 0 Owner: , Permit NO: B 17-2176 APN: 001-120-031 THOMAS LONNIE D & RHOND Permit type: MISC PO BOX 766 _ Issued Date: 9/13/2017 By DAH Subtype: RE -ROOF RESIDENTIAL BIGGS, CA 95917 Expiration Date: 9/13/2018 Description: TEAR OFF AND REPLACE COMP Occupancy: Zoning: gl BILL'S ROOFING 1073 CAMPBELL AVE GRIDLEY, CA 95948 5308463981 LICENSED CONTF Contractor (Name) BILL'S ROOFING BILL'S ROOFING Buildinj 1073 CAMPBELL AVE 0 GRIDLEY, CA 95948 Other 5308463981 0 ACTOR'S DECLARATIOW' ._ ¢} i.: r tt i :°''.�:I. <<OWNER / BUILDER State Contractors License No. I Class I ExpiresI I hereby affirm under penalty of perjury that I am exempt the reason(s) indicated below by the checkmark(s) I have 801512 / C39 / 11/30/2017 70315B d f CdA I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am licensed under provisions of Chapter (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license in full force and effect. X Contractors Signature Date I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations:' I have and will maintain a certificate of consent to self -insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Policy No. I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier. STATE- Policy Numb9QaQ832 Exp. gS1/2017 ❑I certify that, in the performance of the work for which. this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions. - - X Signature Date WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (8100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES. I hereby affirm under penalty of perjury that there is a construction lending agency for the performance of the work for which this permit is issued (Section 3097, Civil Code). Lender's Name and Address Lender's Name & Address City ' State Zip . , usiness an ro essions o e. ny sty or coui improve, demolish, or repair any structure, prior to its issi permit to file a signed statement that he or she is license State License Law (Chapter 9 (commencing with Section Professions Code) or that he or she is exempt from licen: 'Any violation of Section 7031.5 by any applicant for a pei 'not more than five hundred dollars ($500).): Garage RemdUAddn 0 0 Porch/Patio Total 0 0 - :CL•ARATION 1 . m the Contractors' State License Law for aced next to the applicable item(s) (Section that requires a permit to construct, alter, ice, also requires the applicant for the ursuant to the provisions of the Contractors' X00) of Division 3 of the Business and e and the basis for the alleged exemption. t subjects the applicant to a civil penalty of I, as owner of the property, or my employees with wages as their sole compensation, will do U all of or U portions of the work, and the structure is not intended or offered for sale (Section 7044, Business and Professions Code: The Contractors' State License Law does not apply to an owner of property who, through employees' or personal effort, builds or improves the property, provided that the improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the Owner -Builder will have the burden of proving that it was not built or improved for the purpose of sale.). I - - 1 1, as owner of the property, am exclusively contracting with licensed Contractors to construct the project (Section 7044, Business and!Professions Code: The Contractors' State License Law does not apply to an owner of property,,who builds or improves thereon, and who contracts for the projects with a licensed Contractor rursuant to the Contractors' State License Law.). i ❑ I am exempt from licensure under the Contractors' State License Law for the following reason: j Owner's Signature i Date �PERMIVAPPLICANTDECLARATION: By my signature below, I certify to each of the following: I am L) a California licensed contractor or U the property owner' or U authorized to act on the property owner's behalf"'. have read this construction permit application and the information I have provided is correct. i agree to comply with all applicable city and coupty ordinances and state laws relating to building construction. i authorize representatives of this city or county io enter the above -identified property for inspection purposes. California Licensed Contractor, Property Owner' or Authorized Agent": 'requires separate verification form "requires separate authorization form I' i X Names of PermiHee rSIGNI Print Data �,-•_sr`-": ,rte a,,ty. ,Ci .. rg 7 i `� -' tf �;,�"• f'i� ��' f..,•- �: r•> � f. �t: a' eu t ;f j. �. '�,-�.. # ...:� � tr. _ a_.,,: �#. }.,t` •�.ihl . x RFEE�INFORMATION+Sf=•� .�t '�I.i;;. .�-:i3 � I � F r; ,1. sx 1� I::� �`.e :; ,•. Total Fees: $203.98 Fees Paid: $203.98 Balance Due: (None) Job Value: $8,854.00 • r • i CF-GR4ZNV-M- ROOFING MWALLATiON CERTIFICATE (RevWd for rco ft mW CF -SR -EMM M Envelope – Roofing atm Azarme: Enthroortemt A"W. I Pemdt Nmubes: ffmom then of Me items on MiaAftefe, each person s1Wpmpsra mrd dp a certiifule ewe to Me poeft of cotrslntdba fcrmVM Mey ere responslbAs; abmAVety. Me pawn wdh ddef responeWy forconsh u ilon doffpmeper s mrd stgn Mce&kderorftenftwmkdbn.AlqWftMMwdatoWWommwMdtockbwmmquftetobodwdiedibwmmftmanda&y measures have been met ATTIC ROOF INSULATION AND/OR ATTIC RADIANT BARRIER ferret Brand Now. Materlak Brand Nemo: 71dalstese (): . 7lterrrtaf R "tante (R�Vakw). O §118(a): doAdon 6tat$Qed meets for= Matettal. O IINW: wridetory Vapor banter Inswad In Chide Zone 18 Desorbfflon of Roa to Ptoducbs CRRCProdaat Mawfix4m Br=dMbdd Piomnal Roof Raaf Product Itt dSolar Agpd8dw Tbamal ID Nwnben Infammflon TWO Ana Slow WeW a Ra$a*mz Resor Bmdtte= 1.71re CRRC Rodud m fYtenbercmr M otJt�tedfirm the Caolfasa/Rudhrg AQtatc�a RaMd iloQuct 06ee0ory9 wwax oofa 2 Ilia wel�ld Ar 60s pereguete that ofMe roo!?ng product be6tg Ats>�d 3. Cfreckbaz NMaABedRelIl�a d value a�Me agttafAortbefaw.lbofrtote 4. 4. If Me apd reRedanae to not eta 6e Me Cool Rooffieffitg CoAxft Rdled Product Db dmy then on Me b"taftgkow VaAte from the dbeotory mrd use Me equdbn (22#47&MW-0.4 to obtlsbr a Wadded aged Vahte. OCHECKAPPLWAMEBA1(f3ELOWfFf> FROM7HERQOF O�$Qf)----fiE6lWf WMr _ _--- D Ilia roof area covered by bu5dhV Integrated ptiotovrlldla pmtefs and flu WbV Integrated solar thmrttal parcels are wwMP frorn the above Cao! orbria. • Roof !—MR mass ow the root mwrtbreate vAM a WOW at least 28 bW Is eooampted from the above Cool To epptyL*W RWAAWed CoaMm Me coafblgmast be app6fadwr'8r a m8Mlaratess of 20 nMm9oss Me erre roof w -db– e meet n*1&wmpe►f6mtancemqukerter*83fedIn§11809andTable118 So*dit ecaotbr8 O tented Asotaft Root Coedtusg O Cement Based Roof Coattng OOltter QtSRG4 Label Attaelted to CF -BR Me lfao CRRCGI A"Is m a la b k A b o w wftm ins 0WcatbWba reed mrd mtadherr»ef/md Is b rued DECLARATION STMEAM 1' • I eerdfy under peuteft)r of peupsy. coder Ow laws of the State of (effondt On bdornm8ao provtwe.0 on note form Is bur Ord correct. ■ I Om allgMb under DMslon 1 of to Bustrmss and Ptalbadons Code to accept mepwtsN*r for or an mdtfmd tepr of the person teuporadble for corta Ovcon (r®porsamb pereon)• ■ I ow* that Itte Installed feakn% .nalmCde. ash or tfevtoes lderr98ed on mis antlmda (tire bmteaa9on) a nfomts to ad OppOmWe codes end mgdaga a. and Bte Installation is con sWent vdth the plans end sperm aaprowd by ttte erdOtoene+rd agency. • I mv6ewad a Copy of the CeMcete of Canp tKv (CF -IR) form approved by the enforcement agerwy OW Merc&a Bre apedfte ratiutremente for the tnsWkftL I am* Mit the regt*'en wb data Red on the CF4 R W apply to the trtsbMan haus been met • I w® onswe that a coapteeed, algned oW of Mb budalWan eanlltaats aeon be posted, or made avWbtbte wIth the bulldtng perndge) Issued for the bum and made evatblue to the a dorwrted agency for all epplIe bre linspet5ofts. I undwstand Ilia! a signed copy of dile bobddlon CeANkebe Is regtrbed to be Included with the dRV rcard ®on the btdider provides to the bugdbV owner at occupancy. Com any Nance:(tnetetangSaarsmarfororcowndConhactororetedwOw" RB 8 Person`s Slgnalum CBI.B Lkenw.IJdB 1!@Eh COfl�a�!)ij; k ddw or 'ds-lanrbngt 01'(K.IIHIIIt fOltutn Pluglaw hn tatMUas Ccruticafi• i;'F-fA-F.:R di 41 OB Iq IVJS J Butte County Department of Development Services PERMIT CENTER 7 County Center Drive, Oroville, CA 95965 • Main Phonc (530) 538-7601 Fax (530) 538-7785 DlvllOW(M f[v�f ..ww�v:buttccoun tY.ncdddc. COOL REROOF INFORMATION SHEET Project Address: Slope of Roof # of: Existing, Layers f,Vie Existing RoofingWaterial Check all that applies to NEW roof: FORM. NO DPI -3 Composition a Tile o Shake . o Wood Shingle, ,a Built up a Bi umen ..... n Metal o Other A. a Tear off existing a Overlay l'o. • New Sheathjng n f The California Energy Commission (CEC) has adopted new requirements for re -roofing projects. Beginning January -1, 2010 -when more than 50% of,the exterior, surface of the roof or more than''1,000-sq. it of roof is replaced, whichever is less, the new, roofing area must meet the roofing product 'Cool Roor requirements of §152(b).1Hi; 152(b)1Hii';or 152(b)l HiiL " For roof slopes of greater than 2:12: Roofing products wllh'a density of lass'than 51bs/sq.fHi.e. Roofing products with a density of 5lbs/sq.k or more (,e: Asphalt shingles) shall have a minlinum 3 -year aged solar Concrete, day Tiles or slate) shall.have a minimll 3 it reflectance of 0.20 and a minlmuin them l emlltance of aged solar reflectance of 0.15 and.a minimum.thermal' O 0.75, or a. Solar, Reflectance Index (SRI) of 16. emitlance of 0.75, ora SRI of 10. or check alternate (alt) or check. alternate (alt) Note: Manufacturers specification for Cool Roof compllance whenrequiredshall be provided for Inspector. Packaging materials•iWCRRClabelvmust be left on the job site to demonstrate compliance with the specification for the cool roof rating If applicable. ALTERNATE (ALT)Attematives•to §152(b)1HI and §1"52(b)HII; Steep-slape roof (pitch > 2:12) Alternatives to the Cool Roof requirement may be one of the follows Bulding with at leas( R:30 ceairig inwalion If In climate, Zone 11', R-3 org(eater roof deck insulation aft O (approhomately;,11>(or mo(e),thkk ifblown n) all o above vented attic' Existing ducts Insulated with R=6 and H.E.R.S. Building has no HVAC ducts in ft attic aft O dud tested to verify ducts are sealed _ It (evaporative cooling duct exempt) alto Building with a radiant barrier In stlicmeeting the requirements o Insulation over roof deck or atleast '/. inch air -space is of §151(1)2;all added to the roof deck over an attic Other Exceptions • Roofing area covered by building Integrated; photovoltaic panels and solar thermal panels are exempt from the below Cool Roof criteria. ■ Roof constructlons that have, thermal mass over the roof membrane with at least 25 Ib/ft2 Is exempt from the below Cool Roof criteria`. 'Butte County areas with/n Climate Zone 11 per T-24. Part 6, 2008 Califomia Energy Code: Bangor, Berry Geek.' Biggs, Centerville Powerhouse, Cherokee, Chfco, Cohasset, Dayton, De Sabla, Durham, East Biggs, Forest Ranch, Gridley, Honcut, Lake,OtoWle, Lake Wyandotte, Las Plumes, Magalla, Nelson, Nord, Oroville, Oroville East, Palerrno, Paradise, Penh, Richardson Sprngs, R/chva/e, south Oraw&, Themratilo ThermalltoARerba y arid . e.. -ThermahtoForeba.TJperCreek.Powerhousean. CLIMATE ZONE 16 (ONLY) Cool roof requirements apply ONLY when Roofing products with a density of 5lbs/sq.ft. or more (i.e. Concrete, day tiles or slate) shall have a minimum 3=year aged solar reflectance of 0.15 and a minimum thermal emitlance of 0.75, or a SRI of 10. or check alternate (alt) as applicable. _T INSTRUCTIONS FOR COMMERCIAL PROJECTS - --- • Commercial roofs on decks with a slope of 2:12 or less must meel the 2008 Building Energy Efficiency Standards by being a certified Cod Roof_ Acoav of the slandaLls. slined by the aPdlcart rtuM a=pffy w (his ompflcallon. • Overlays that exceed 100 pounds per square must be accompanied by calculations performed by a California, licensed Civil or Structural Engineer. All overlays must be approved by the Building Official and other requirements listed within Appendix Chapter 15, California Building Code. • A specification from the roofing manufamrer must a®rrr<kmw tis appNcalion. The specification shadd list the fire class of the material, a description of the materials or layers that must be Installed, the Cool Roof certification (If required because of the slope of the root), and installation requirements. • Packaging materials w/CRRC labels must be left on the job site to demonstrate compliance with the speciflcatlon for the cool roof rating if applicable. — I agree that the Information pro)rIded 0 s curve t is accurate and true. - /y Applicants Signature: Date: ��0�" Buue County Butte County Department of Development Services PERMIT. CENTER 7 County Center Drive, Oroville, CA 95965 Main Phone (530) 538-7601 Fax (530) 538-7785 www. buttecounty. net(dds Declaration "of Installation for Smoke Alarms and Carbon Monoxide Alarms FORM NO DBI -01 The newly adopted 2016 California Residential Code requires the installation of Carbon Monoxide Detectors indwelling units and in sleeping units within which fuel -burning appliances. are installed and in dwelling units that have attached garages. The policy for Carbon Monoxide Alarms in Butte County states: "Any permit obtained in which the value of work exceeds $1000 associated with a Residential Group R Dwelling Unit or Sleeping Unit shall conform to the following 2016 California: Residential Code requirements for Smoke and Carbon Monoxide Alarms (Section R314 & 2016 California Residential Code requirements for Carbon Monoxide Alarms: R315.1 New construction: An approved carbon monoxide alarm shall be installed in dwelling units and in sleeping units within which fuel -burning appliances are installed and in dwelling units that have attached garages. " R315.1.2 Power supply For new construction required carbon monoxide alarms shall receive their primary power from the building wiring where such wiring is served from a commercial source and shall be equipped with a battery back-up. Alarm wiring.shall be directly connected to r the permanent building wiring without a'disconnecting switch other than as required for over - current protection. Exceptions: 1. In dwelling units where there is no commercial power supply the carbon monoxide alarm may be solely battery operated. 2. In existing dwelling units a carbon monoxide alarm is permitted to, be solely battery operated where repairs or alterations do not result in the removal of wall and ceiling finishes or there is no access by means of attic, basement or crawl space. R315.1.3 Interconnection. Where more than one carbon monoxide alarm is required to be installed within the dwelling unit or within a sleeping unit the alarm shall be interconnected in a manner that activation of one alarm shall activate all of the alarms in the individual unit. Exception: 1. Interconnection is not required in existing dwelling units where repairs do not result in the removal of wall and ceiling finishes, there is no access by means of attic, basement or crawl space, and no previous method for interconnection existed. ' R315:2 Where required in existing dwellings: Where a permit is -required for alterations, repairs or additions exceeding one thousand dollars ($1,000)„existing dwellings or sleeping units that have attached garages or fuel burning appliances shall be provided with a carbon monoxide alarm in accordance with Section R315.1. Carbon monoxide alarms "shall .only be required in the specific dwelling unit or sleeping unit for which the permit was obtained. . R315:2.6 Alarm requirements: No person shall install, market, distribute, offer for sale or sell any carbon monoxide device in the State of California unless the device and instructions have been approved and listed by the State Fire Marshal. Page 1 of 2 Revised 12.19.2016 Carbon monoxide alarms required by Sections R315.1 and R315.2 shall be installed in the following locations: 1. Outside of each separate dwelling unit sleeping'area in the immediate vicinity of the bedroo.m(s). 2. On every level of a dwelling unit including basements. R315.1.5 Multiple -purpose alarms: Carbon monoxide alarms combined with smoke alarms shall comply with' Section R315, all applicable standards, and requirements for listing and approval by the Office of the State Fire Marshal, for smoke alarms. Butte County's Interpretation of 2016 CRC, Sections 314 & 315` for Smoke Alarms & Carbon Monoxide Alarms: Where alterations, repairs or additions exceeding $1,000 in valuation, existing dwellings shall be retrofitted with smoke alarms and those that have attached garages or fuel -burning appliancesshall have carbon monoxide alarms installed. Existing smoke alarms can be replaced with dual function alarms for Smoke and Carbon Monoxide and in most cases will comply with the aforementioned code requirements for Carbon Monoxide Alarms. DECLARATION OF INSTALLATION UNDER THE PENALTY OF PERJURY As Owner/Contractor, Ilwe affirm and declare under the penalty of perjury, under the laws of the State of California, by our signatures below as Owner/Contractor, that I/we will comply prior to final inspection with Items A & 1B as specified herein: A. Both Owner/Contractor have read and clearly understand the aforementioned 2016 California: Residential Code (CRC) Carbon Monoxide Alarm requirements. B. Both Owner/Contractor are responsible for installing Carbon Monoxide Alarms prior to final inspection as per the aforementioned building code and maintaining such installation. Smoke Alarms will also be installed prior to final inspection as per the 2016 CRC. oke and Cfflboh Monoxi a►►� are now installed in the follow' g locations` ' CL1V,*!ice : rl W Zr : s ,,e r <., 7.9 �+/0—,y�.), ✓l Owner's name (print): Owner's signaturce!___"y11J14,.\V f 'mate: " 12.,o I 1 Contractor's name (print): /� �' w CSLB License: VOI-� 1�2 Contractor's signature: ��i� Date: f Permit #:1X(/ Z Z,2 CL y 7 Project Address: Page 2 of 2 Revised 12.19.2016