HomeMy WebLinkAbout065-400-023�9 65 40-23, 92-&-3,9 BPEM
065-400-0 S60
Conv S a o permits FIS HER, Stan
Jack Pine Way, Magalia
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• " " ' " " • " " " ` 'COUNTY OF BUTTE -
.r, BUILDING DIVISION
DEPARTMENT OF DEVELOPMENT SERVICES^
411 Main Street - Chico; CA! (530) 891-2751j_,- - ,,�
7 County Center Drive - Oroville, CA - (530) 538-7541
' ;µ=Vi
CORRECTION NOTICE -
OWNER V PERMIT NO.
A routine inspection indicates that the following violations of butte county Ordinances exist at the
above address and should be corrected. Please notice this office when correction of work is
completed. If you have any questions pertaining to this matter, or need additional explanation,
Please contact this office immediately.
r
1t
R
Date Inspector d
S{
REV 10/92
.:1
AIn u cc i.n
JFIS
0-23 92-$-39 BPEM
! S6 O
HER, Stan
Jack Pine Way, Magalia
sf 3 Z
r
t
RESIDENTIAL
65-40-23'
92-8,40
BPEM
FISCHER, Stan
16--981 Jack Pine
Way, Magalia
I new sf
iT
OFFICE COPY
Address
GAS
Meter By
Date
ELECTRIC
Meter By
Date
GAS
Meter By
ELECTRIC
Date
Date
Meter By
JOB FINALED (Date)
Signature
lst,
Owner
ICY;
Roof•
MATERIAL BRAN ,IAM E
THICKN VEsS THERMAL RES.
A. P.. ;Io.
EXTERIOR WALL
MATEP.I.1L FIBERGLASS BRAND. NAME CERTAINTEED
THICK,NESS THERMAL Rrr, /
CEILINGCERTAINTEED
BATT OR BLANKET TIPE-Fiber-lasBRAND' NAP•["
THICKNESS /D � THERMAL RES. J
LOOSE FILLTYPE. INS -SAFE IIIBRAND NATE CERTAINTEED
THICKNESS ,l THERMAL RES.
FLOOR,ELEVATED
MATERIAL FIBERGLASS BRAND NAME CERTAINTEED
THICKNESS �rji THERMAL 'RES. /
FLOOR, SLAB
MATERIAL BRAND NAME
THICKNESS' THERMAL RES.
WIDTH
FOUNDATION WALL
MATERIAL BRAND NAME
THICKNESS THERMAL RES.
I HEREBY, CERTIFY THAT THE ABOVE INSULATION WAS INSTALLED IN THE ABOVE
BUILDING' IN CONFORMANCE WITH THE STATE OF CALIF. ENERGY REQUIREMENTS.
HAWKINS INDUSTRIES INC. #62.2184
WF1
APl !JNE STATE CONTR. LICENSE NO.
/9=Z
I hereby ertify the above insulation and all required items as shown
on the Building Depart. 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 Calif.
--------------------------------
FIRM NAME/OWNER (PLEASE PRINT) STATE CONTRACTOR'S LICENSE NO.
Or GENERAL CONTRACTOR/ OWNER DAT
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
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Orovi Ile — Phone: 538-7541
747 Elliott Road, Paradise— Phone: 872-6307 s
CORRECTION NOTICE
f-1sc
OWNER PERMIT NO.
A routine inspection indicates that the following violations of County Ordinance =:
•x
exist at the above address and should be corrected. Please notify this office
="a
when correction of work is completed. If you have any question,pertaining to this '=4
matter, or need additional explanation, please contact this office immediately.
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4
A
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S�
Date Inspector
,c8
.COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 MemorialWay, Chico — Phone: 891-2751
7 County Center'Drive, OroviIle— Phone:. 538-7541
747 Elliott Road, Paradise — Phone: 872-6307
CORRECTION NOTICE
//'.s c 4-d� ,
OWNER
..
Sco - SZ4
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 correc on of work is completed. If you have any question pertainin.g'to this
zr"�
need additional explanation, please contact this office immediately.
e—A rJ J P (i (.j / 7 / �G 4 ¢�✓
Date / G / Inspector
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^y
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2
T
Date / G / Inspector
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L
r
tate Inspector
s' - w
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
196 Memorial Way, Chico — Phone: 891-2751
7 County Center Drive, Oroville — Phone: 538-7541'
1
747 Elliott Road, Paradise— Phone: 872-6307
CORRECTION NOTICE°'
?` OWNEF� J �" PERMIT NO.
A routine[ inspection indicates that the following violations of County Ordinance
'-
above address and should be corrected. Please notify this officer
on of work is completed. If you have any question pertaining to this
ed additional explanation, please -contact this office immediately.
V
A
•',�a
�L �
�f
�r
L
r
tate Inspector
s' - w
'J OK
O=Not OK
= Not Applicable
Not Ready RESIDENTIAL
' =
Date uy6ERFLOOR (Plans) OK except a's
-t oning-Setbacks-Easeme is -Flood -Slope
tg., Main; Soils-Elec. Gr d.- " Ftg. Depth
Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth
4. Ftg., Porches & Decks; Soils -Steel-/ /Ftg. Depth
Stemwalls, Main; Steel -Bloc kouts-Wra pped
Stemwalls, Garage; Steel-Blockouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab; Steel
06. Pie -Fireplace Ftg.-Steel
.�V.: Fall -Fitting -Test -2 Way C/O -Sewer Test
F as Pipe; Size -Anchors - yard gas piping: size -test
m . ater Pipe; Test -Anchor -Regulator -Service Test
12. EI etfic; Underground
Pi hums & Ducts; Clearance -Material -Support -Ins.
Gi ders-Sills-Anchor Bolts -Joists -Vents -Cripples
Access & Ventilation
C* 16. Insulation
Date j Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date PLUMBING (Permit),OK except ff's
jAr"Water Htr.: Vent -Access -Combustion Air -Baffle
--------- ------------------------
1� Pipe: Test & Anchor -Nail Prote.cNe
1 .W.V.: Test -Fittings & Anchor -N it Protec
19. Shower Pan; Test. First Floor -Tub Access
20. Test Tub & Shower. Second Floor -Tub Access
21. Gas Pipe: Size & Anchors
---------- ----77----------------- ----
Date Z Card B 1 G-- -- Date - Card -B- 1
Date Card B-1 Date Card B-1
Date ELECTRICAL (Permit) OK except p's
22. Fixture & Transformer Clearance -Ins. Protection
23. Elec. Receptacles Spacing -Lights & Switches at Doors
-- ----------------------------------------------------- --------------
24. Size Boxes & No. of Conductors -Stapled
- ------ 25. mex Installed Close to Edge of Studs & C.J.
Equip Ground made'up w!Mech. Fastners d G &Water
--------- ---------------- ------- ----------------- -------------
27. 2 Appliance Circuts in Kitchen & Conductor Size/GFI
------------------------ --- '-------------------------
28. Subfeed Wire Size 1 ga. Cu or AI-A.C. Wire Size ! ! ga.
Cu or At
- - ----------=-----
2 Range Circ. 1 ga. Cu or AI- en Circ. /%/ ga. Cu or Al.
�sulated Neutral �s ❑ No
----------------------------------------------------------- ----------------------
30. Service -Riser Conductors & Ground -Main Disconnect t
------------------------------------------------------------------------------ -
31. Equip. Clearances Panels -Motors -Meeh. Equip.
32. Clothes Closet Light -Shower Light -Spa Light
----- ------------ --------------------- ------ --------------------
3a�Smoke Detector
------- -
-------------- - -
- - ------- - -----------------------------------
CardDate B-1 z -J Date Card B-1
s
--------- ----- -------------------- j
Card B-1 Date Card B-1
Date MECH ICAL (Permit) OK except ft's
3 .C. Ducts Insulation & Support
------------------- - - - ----
------------------------------- --- -------------------
-- 3 ent Fan: Exhaust above insulation
f---------- ------- ----- ---- --------------------------------_
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 4's
39�Sils. Proper Material & Anchors --
----------------------------------------------
Walls Studs _Nailing_ Spacing &-Bracing-Plates-Sound
-------------
4Y Bearing Walls over Girders & Floor Nailing
-------- -------------------------- ---------------------------------
42�aft Stop in Walls (rat proof)
---------------- -----------------------
- 43%Fire Stops: Ceilings -Stairs -Chases -Tub
------ ---------------------------------
4 . Headers & Beam -Size & Bearing
Single & Duplex)
Date FRAMING (Continued)'
45. Hangers -Post Caps -Anchors -Connectors
46TC g. Joist-Rftr. ties-Purlint roof Brac-Truss-Shthng.-Ring.
----�_ . yF1-'replace Ties or Type A Flue -Fireplace Throat clearance
4i3!All r. Access; Size & Romex Protection -Draft Stop -Ins. Baffles
oel-drm. Windows or Exiting Doors -Sill Hgt. & Dimensions
-
52.,AFire Protection Framing
---- - -- 51. roopperty Line Firewall & Openings
52 1. Doors -One 3' -Check Garage -3rd Story, 2 Exits
_ _5�3IairWidth-Headroom -Rise-Run-Landing-Fire Protection
54.0111wood on Roof Overhang -Attic Vents -Rafter Outriggers
----------
Siding -Nailing Veneer
56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access
---
57. Glazing Area -Glass Protection -Skylights- Plastic
eang-
---- - 58. Shr Walls; Nailing -Bolts
A Insulation -Walls -Ceilings 146- IV
--------- ---------------
60. Infiltration -Walls -Windows
Date Date Card B-1
Date �r!/ �' Card B-1 c, -z,, Date Card B-1
Date FINAL (Plans) OK except ft's
6 xt. Steps -Door & Sidelight Protection -Landings
6Smoke Detector
QX Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage: Above Floor -Ducts -Meeh. Protection
--------- - --
6�Bedroom Exiting
-------------
. ---
65. G.F.I. & Bath Fixtures & Tub Access -Spa
66. Elec. Trim & Sub_panel; Breaker Sizes & Labels
-----------------
-------
67. Stairs & Rails
68. Fireela a or Slov : Clearances -Hearth
69. Ele Outlets Wood Panel: Int. &Ext.
70. it.Fix liance: Grnd_Air Gap -Cooking Clearance
7 ec. t & Receptacles at Kit. Counter ---
72�Garage Fire Door Swing -Landing -Closer
Duct in Garage -Damper
-------------- ---------------------------------
7,4' Wtr. Htr.: Vents -Clearance -Comb. Air-Connector-P.R.V. .
In Garage_ Above Floor-Mech. Protection
---------------
7$ Plb.. Elec. & Mech._Equip. Listed for Location
76 Elec. Receptacles in Garage: (G.F.I.)-Romex Protection
- --
-------------------------------- ---
771 Insulation -Foam -Looked in Attic ❑ Yes
7i?Guard Rails & Deck Construction -Post Caps
----------------------------------------
79�Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth
/Clearance Looked under Floor ❑ Yes
atY Following instld. Drive Yes ❑ No; Walks 0 -"Yes ❑ No;
Planters--O-Yes r'B'NO
81. Stucco Brown -Finish
-- -- --
&V A. -C. - Unit: Disconnect. Electrical, Plumbing ---
8a- Vents Above Roof.; Plbg.-Appliance-Fireplace.-Clearance to
Openings
84- Water Well: -Disconnect, Electrical, Plumbing
----------------------
-_
85�Exterior Elec. Trim; G.F.I. Receptacle -Underground
------------------------------------------ - ----
BCvVentilation Throughout House
-----------------------------------
87--Glass Protection
8�orrections from Previous Inspections
---------------------------------------------------------
ByiGas Test -Meters Tagged: Gas -Electric
9,yWater & Sewer Connected -C/O to Grade -HD Approval
9�nergy Compliance Certificate -Other Certificates
--te--_
---- _-------------
-----
Date T) rd B-1 Date _Card B-1
Date and B-1 Date Card B-1
Dated B-1 Date Card B-1
Comments at Final:
J=OK
O = Not OK
- = Not ApplReady MOBILE HOMES
' Not Ready ,
Date
MOBILE HOME UTILITIES (Plans) OK except 4's
1. Zoning Requirements -Setbacks -Easements
2. Soils; Special MH Support Sketch
3. Sewer; Location -Test -Fall -C/O Concrete
4. Water; Location -Test -Easement Needed (Sketch)
5. Electricity; Location -Clea rences-Gmd-/ /Amp -Concrete
6. Gas; Location -Test -Wrap: ; /" L" ft.
/ /"Nat. or/ /"L"ft./ /"LPG
7. Well Clearance & Disconnect
8. Utility Clearance
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
Date
MOBILE HOME INSTALLATION (Plans) OK except #'s
1. Zoning Requirements -Setbacks Easements
2. Footings; Size -Spacing -Marriage Line
3. Gas; MH Test -Demand -Valve -Connector
4. Electricity; MH Test -Crossovers -Breakers -Clearances
5. Drain; MH Test -Fall -Flex Connector
6. Water; MH Test -Regulator -Connector
7. Water and Sewer Connected -C/O to Grade -HD Approval
8. Gas and Electricity Tagged
9. Exits; Insp.-Sketch
10. Cert. of Occupancy
Date
Card B-1 Date Card B-1
Date
Card B-1 Date Card B-1
MISCELLANEOUS
1
Date DECKS, COVERS, CARPORTS, GARAGES, (Plans)OK'except #'s
1. Zoning Requirements -Setbacks -Easements
2. Footings; Soils-Siie-Depth-Spacing-Connectors-Steel
3. Decks; Griders and/or Joists -Decking -Bracing -Stairs -Rails
4. Wood Awn.; Posts- Bea ms- Rftrs.-Connectors
Shthg.-Rfg.-Bracing
5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures
6. Carports; Windows -Doors
7. Electric
8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distances-GFI
5: Elec.; Pool Lighting; 15 volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -Listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
_ Boxes -Enclosures -Panel boards -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
'.3
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916.'538-7541
APPLICATION AND PERMIT
PERMIT NO.
92-860
ASSESSOR PARCEL NUMBER
65-40-23
ZONIN '
RT 1
BUILDING PERMIT
OWNER
STAN FISCHER
TELEPHONE
872-2389
SQ. FT. OCC. BUILDING VAL ATION
1380 R 70,380
OWNER'S MAILING ADDRESS
1831 FOSTER ROAD PARADISE 95969
484 M 8,712
CONTRACTOR'S NAME
TELEPHONE
128 0 896
CONTRACTOR'S MAILING ADDRESS
Fireplace "At' 1,500
CONSTRUCTION LENDER
UNKNOWN
Total Valuation Is 81,488
Filing Fee $ 15,00
LENDER'S MAILING ADDRESS
Permit Fee $ 916-50
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee $
exxxox
Energy Plan Checking. Fee $ 20.00
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS 1 JACK PINE WAY MAGALIA 95954
Permit fee $
PLUMBING PERMIT Filing Fee 15.00
Each Trap 8 5.00 40.00
Solar or heat pump water heater 20.00
LOT NO.
134
SUBDIVISION NAME
PP UNIT 3
PARCEL MAP
35-79
Water piping 7.00 7.00
Each pas water heater or vent 7.00 7.00
USE OF STRUCTURE
SF91 Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets 5.00 5.0
Building sewer 15.00 15.00
Mobile Home I S I G I Wv7--d 615.00
TYPE OF WORK
New `k Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other ❑
Describe work: 1 BDRM _
Permit Fee $ 89.00
Contractor
ELECTRICAL PERMIT Filing Fee 15.00
Main service 600VORLESS 18.50 18.50
200A OR LESS
Main service 200A TO loo0A)
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)
U", as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
_37.50
NEW CONST.DWELLING OCCUR.&) ,
OR ADDNS. ( ACC. BLDGS. 3.6Qsq.ft. 65 00
NEW CONSTF ULT' -OUTLET
NON.RESID BRANCH CIRC ITS @ 5.00
POWER APPARATUS &
(SINGLE OUTLET C'R. )
Ex. Occup(OUTLETS OR FIXTURES20 @ 76x1
FIXED APLNS.
EX. OCCup. OUTLETS P(RESID )REA.) 1 3.00
Temporary service 15.00
Mobile Home Facilities 15.00
Misc. Wiring
g '15.00
Permit Fee $ 98.50
-
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
eCoolin
�f Consent to Self -Insure.
€'_I ' shall not employ any person in any manner so as to become subject
to the W. C. laws of California.
Notice to Applicant: If after making this statement, should you become subject
to the W. C. provisions of the Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
Contractor
MECHANICAL PERMIT Filing Fee 15.00
Heating lo nn 9 -on
DUAL PACK
g 4 TnN 17.50 7.50
Hood 6.50
Ventilation
permit Fee $
48.00
LContractor
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
all liabilities, judgments, costs, and expenses which may in any way accrueHAz
against said County in consequence of the granting of this permit.
X Date 3. �� < Z
Signature of Applicant - Owner Contractor ❑ Agent El'
An OSHA permit is required for excavatio over 5'0" deep m itiDn Dr construct-
ion of structures over 3 stories in height.
Receipt No. 1 0 12
Mobile Home Installation Fee $
Energy Inspection Fee $ 40.00
occ
CONST TYPE
TOTAL FEE $ 1085.25
DFEES
j/
IMP
FLOOD
COF PARCEL
H SUE
This permit is hereby issued under the applicable provi-
sions of the Butte C unty Code and/or resolutions to do
work indicate b e for whi h fees have been paid.
R OR F PU IC WORKS
By Date -�
PE IT EXPIR Date %
WHITE-D.P.W., YELLOW -ASSESSOR. PINK -INS CTOR, GOLDENROD -APPLICANT
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Orovllfe, Cellfornia 95965 - Telephone: 916.`538-7541
APPLICATION AND PERMIT
PERMIT NO.
ASSESSOR PARCEL UMBER
410 2-3-,
ZONj
_ %
BUILDING PERMIT
OWNER
TE E HONG
BUILDINGVALUATION
/QOWNER'S
•
O9,11831
MAILING ADDRESS
//mss -.e i?�� }011AISdIlse �X5.69
WSQ.FT.OCC.
l3 -7 1 ZC
NTRAC TOR'SNAME
TELEPHONEb
D C>
CONTRACTOR'S MAILING ADDRESS
Fireplace
/ SOco
CONSTRUCTION LENDER
UNKNOWN
Total Valuation $ ZfQ S
Filing Fee
$ 15.00
LENDER'S MAILING ADDRESS
Permit Fee
$ 6.5-4
ARCHITECT OR ENGINEER
LICENSE NO.
Plan Checking Fee
$ -%-fig, ZS
Energy Plan Checking Fee
$
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS
Permit fee
$ e 09. 75'
PLUMBING PERMIT
Filing Fee 15.00
Each Trap
4A 5.00 A -1a
Solar or heat pump water heater
20.00
LOT NO.
l � I
SUBDIVISION NAME
.t
Ug,
PARCEL MAP
�^ �7
�J ! G
Water piping
7.00 -7
Each qas water heater or vent
7.00
USE OF STRUCTURE
SF EJ/Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets5.00
Building sewer
15.0015
Mobile Home S G W
@ 15.00
TYPE OF WORK
New ?�_Addition❑ Remodel(] Utilities❑ Installation❑ Other❑
Describe work: 3 _
Permit Fee
$
Contractor
ELECTRICAL PERMIT
Filin ee 15.00
Main service 600v OR LESS
200A OR LESS
18.50 Isfo
Main service 200A TO IOOOAI
37.50
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 .Jo. 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
or sale. (Sec. 7044)
V, 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 oC�.�}P. \ 3.6Qeq.II.
OR A_DONS. ACC. BLDG K yeq)
NEW CONSTR. ULTI.OUTLET
NON-RESID BRANCH CIRC ITS @ 5.00
POWER APPARATUS e
(SINGLE OUTLET CIR.
Ex. Occup(OUTLETS OR FIXTURE S 20 76
Ex. Occup. FIXED P -OUTLETS IRESID IEA.� I 3.00
Temporary service 15.00
Mobile Home Facilities 15.00
Misc. Wiring 15.00
Permit Fee $ 7
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.
RL�1' 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 FiIingFee 15.00
Heating Y'- (00
1)AIL 1044_c
Cooling cJ , 75'� %%So
I Hood
6.50 65-0
I Ventilation
—
Pernit Fee
$ Q -
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
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
Z� Q�
Signoture of Applicant — Owner f` Contractor ElAgent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee
$
Energy Inspection Fee $
Vqc
coNsT rP
TOTALPEE $ Q S�
HA
DFEES
IMP
_11—
Flo
CDF
PARCEL D
o
ISSUE
This permit is hereby issued under
sions of the Butte County Code
work indicated above for which
DIRECTOR OF PUBLIC
By
PERMIT EXPIRES Date
the applicable provi-
and/or resolutions to do
fees have been paid.
WORKS
Date
`
Receipt No. II / 2 __
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILL•E, CALIFORNIA 95965 - TELEPHONE: 916/538-7541
•i
PERMIT APPLICATION DATA SHEET
Permit No.
OWNER1�� A.' P. No, 6S`- Z3
Proposed Building Uses ��� S//:- 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
ApplicantDate _537 ✓�
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 o rmit s ance- (C rc n item of ecked above).
1. Index permit for above items No. �r
2. Additional items required:
Contractor, designer, owner, was advised of above required data by_phone---nail—counter by ..date
Contractor, designer, owner, was advised of above required data by—phone _mall—counter by date
Plans checked by Date Plans approved by o,5 Date
Sets of plans on hold in File cabinet AP folder
Copy—DPW 4
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 .......................................
X1'2.
13.
Park fees paid
/dk:w,c School Distri t fees paid .............. ��� �� !�•
14.
Sanitation approval from 1AA_441s'c 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: ......
8.
19.
Improvements may be,required. Contact Land Development Section DPW
Driveway S-31 1t Z
permit (construction approval required prior to occupancy) �i
20.
request
Pre -Inspection for required ... Pre-inspec. quest t°
Building Inspector (Date)
.21.
Contractor's license information (No., Name Style, Classifications ...
22.
Certificate of Workmans Compensation Insurance ....... -......
bt23.
A4.
Owner -Builder Verification (Given to owner o, Mail to owner ❑) .. _
Recorded copy of Agricultural Acknowledgment Statement .........'7 �3/— �Z
25.
26.
Letter of signature authorization .. .
f" -S, 3 %.a .� ...sk .//0!:r�4r —3TL.
27.
d c
When yqu issue the permit, process as follows: Mail to owner. Mail to contractor.
elephone2-N'Lnd hold for pickup at office. Deliver w/inspector.
Other
ApplicantDate _537 ✓�
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 o rmit s ance- (C rc n item of ecked above).
1. Index permit for above items No. �r
2. Additional items required:
Contractor, designer, owner, was advised of above required data by_phone---nail—counter by ..date
Contractor, designer, owner, was advised of above required data by—phone _mall—counter by date
Plans checked by Date Plans approved by o,5 Date
Sets of plans on hold in File cabinet AP folder
Copy—DPW 4
TO: Building Department
FROM: Encroachment Permit Section
RE: Driveway Clearance
J,4cK i fir, G+ Y
owner location
Driveway permit `1 Z- 0Z !rL -6--'-
si ature
AP #
has been issued for.the above property.
date
TO: Building Department
FROM: Encroachment Permit Section
RE: Driveway Clearance
owner location
Driveway permit ?2- D Z L(� i!�- has been issued for the above property.
All
siature date
RESIDENTIAL.PLAN CHECKING GUIDE
(S.F., DUPLEX & MISC. ONLY)
OWNER r'
GEN RAL
Zoning requirements: (sideyards and number
aluation.
Plans signed by designer.
.4'� roper description of work on application.
Existing violations on property.
Bldg. Permit # ! a -d���
A. P. #S
Plan Checker S
of permitted living units).
8/91
Items on data sheet. (W.C., fees, Health, Developer Fees, License law, etc).
Recorded notice of violation.
PLOT PLAN
mplete parcel size and dimensions.
Setbacks, sideyards, easements, etc.
Other buildings or structures.
Grading, fills, drainage.
Flood hazard.
Special conditions on creation map,
ible, and foundations).
F & FAS road setback.
(noise, CDF, fire sprinklers, non -comb
Building or utilities across lot lines (Record form).
i
FLOOR PLAN
T Complete to scale plan with dimensions.
equired windows for light and ventilation (Sec. 1205).
_ Required windows for second exit (Sec. 1204).
Skylights (Chapter 34 & Sec. 5207).
?---Human impact glass (Sec. 5406).
Required room sizes, ceiling heights (Sec. 1207).
�FCIs in baths, garage, kitchen, and exterior outlets (Article 210-8).
Light fixtures, switches, receptacles, and exterior receptacles for main-
• enance of mechanical equipment.
Locations of water heater, heating and cooling equipment, other electrical
��gas equipment.
�'Ga-rage firewall, door size, and closer (Sec. 503(d)(3)).
rr 1 3'0" exterior exit door (sec. 3304 (f).
—F*replace and wood stove location, alcoves, and clearance.
�: Smoke detectors (Sec. 1210).
Plumbing fixtures, water closet clearances and shower size.
STRUCTURAL DETAILS
andard bracing or engineered design (Table 25V)
V
usual shape, size, or split level house requiring lateral design.
erestory requiring balloon framing and/or engineering.
ree story building requiring engineered calculations and plans.
undation plan complete enough to construct building.
oor construction details complete enough to construct building.
evations and wall construction details complete enough to construct
of construction details complete enough to construct building.
replace construction details and calcs if necessary.
.—.'Rafter ties or bearing ridge beam.
.�arage door or porch header sizes.
tud heights.
Vobe soils - special foundation design.
taining walls requiring design.
pecial Inspection required.
building- bCe
G)/Mt�i�
8/91'
RESIDENTIAL PLAN CHECKING GUIDE
MISCELLANEOUS ITEMS TO LOOK OUT FOR
Stairway details: landings, rise and run, head clearance, handrails
(Sec. 3306).
Guardrail details (Sec. 1711 & 3306(j).
Brick or stone veneer (Chapter 30).
terior plaster - weep screeds (Sec. 4706).
fl
er roof pitch for roof convering (Chapter 32).
covering type - (fire hazard).
insulation - protection.
halls and stairways.
ng area over garage - complete 1 -hour separation required on garage side
udingsupporting walls and posts, etc.
exits on three-story dwellings (sec. 3303& see Mezannines - 1716).
c access and ventilation (Sec. 3205).
rfloor access and ventilation (Sec. 2516).
ustion air for fuel burning appliances - L.P.G. requirements.
e requirements on duplexes.
,46'. Energy design.
Flashing at all exterior openings.
a
OF responsible area requirements.
���
ENCROACHMENT PERMIT
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS
7 County Center Drive — Oroville, California 95965
Phone: (916) 538-7681
O APPLICATION
Permit No. Z - 0
I, WE, the undersigned, hereby apply to the County of Butte for an encroachment permit to do the following work under or over
the county roads and highways, all in accordance with county ordinances and general laws.
NAME
1 ............. ---...-.......................................SIGNATURE �,.
i .l��! 5........_.......
........._---`�,_� �3j.......i r'c ��r.......i i ....................
MAILING ADDRESS....
Phone.......... � -� J.. .� �. ... .................... _..... Date .....--•- =7 - =-�1 �) ------------------------------ ----------------_...._
Location of work to be done -----.L._/4Lf1.�........ /_.-....ie-_. .......... ...%_.............�._....................
... __... _..... ......
-------------------- - ._ G-... 4 °.-. t 3 ..................... _.._.... -....... .........._. _._... ------ -- ..-..._.--•-
1. Curb
�SOPi�. J /c �ii✓� K = 1--' ....................
t
Gutter
TYPE OF WORK TO BE DONE
Sidewalk
"Please check"
2. Driveway (List type) _ ..
...._......_._. G� �2 =rr - - 3 ........ ._.. '....------------------- _------ __--- _.-_............_...........
3. Underground Conduit
4. Other ........................... ......................... ............ ........... ................................................. ...... -............................... ...............................
PERMIT GRANTED
In compliance with your above request, and subject to all terms, conditions, or special conditions written below or printed on
the back of this form, permission is hereby granted.
SPECIAL CONDITIONS
.a/.... -CA..
`Mit d. , .... . /o ..... at ............. L( r ! N! L✓. ......
PRIVATE CONTFIACTOR SHALL
OBTAIN HIS -OWN•RURMM........
NOTIFY COUNTY
. ..........2;4 .HOLIRS ... ; .:... .
uEFORE WORK IS
. ........ TO - BE •DON& ..........
C',+ 916/538-768,
Date Issued ..... l.. /.A Z ....................... .
Surety....................................................
PERMIT. EXPIRES ......... .��� y'�
...........................
ALL V.OiWC 131VAL1, CONFORM
...................
S, .AV -D l ITACHI+,'D
......................
S ONI'iI'I'I(!NS.
DIRECTOR OF PUBLIC WORKS
�.,..--r.....cryr , sz.rrq►��'�'F�"rim'�L-��Y"R^'"ii�'�%��J'�"' ��4Ws'gyp"f"r`,�'iY"%'�"°'rgy+**R,...: FF'.a�-++so«.-.-.—�rsstl�is: $rte` *� r pF'K;a'Wt4• .....--+w.t,. ..
t.
BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM
(One Form per Building)
A.P. Number Ste` 'Z� Building Department No.
School District ' ,go%I e_ City D County Jurisdiction
Property Owner Spw.' JSG�
Project Location/Address 19-G %JD/..ie LJ cam ^11!i5
Subdivision %%P Okse, A"We.) Lot Number 43
,Residential,Development:
Sq. Footage 3 y
4 • # of Living MHI Addition (Group R)
Units R
Commercial/Industri"al: O Sq. Footage
�,. New Addition (Including Exterior
Roofed Areas).
L7/0 _r/�7 Z_
BuQ(ing Department Representative Da
(Floor Plans reviewed by School District Personnel)
District Id ' No. VOL_. 677
0.
�.�vw�xl W -f
(Street(Applicant N�'
Address)
has complied with
,by the payment of
School Dist
School District certifies
�-Z�-';�'38
(Phone Numbe
State
,�
Zip C
that
the requirements of Resolution No.
$ aft, /��0 representing 3 d square feet.
,(1, , a� 131
rict Representative Dat
PAID BY CHECK NO. )
BANK NO 1( -
PAID BY CASH
white -applicant, yellow -building department, pink -school district
SCHOOL.FEE (8/88)
COUNTY OF BUTTE - DEPARTMENT OF'PUBLIC WORKS - BUILDING DIVISION
7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (916)5387541
OWNER j��r✓ /4/,S ue,
PROPOSED BUILDING USE NCS 5 �'
1
1
A. P. NO.
DATE
REC. # DATE REC
1. School District Fees pfd R/a��f e
(paid at District Office)
2. Sheriff Fees U ^j C—
(paid at Building Department)
Residential ......... _X ),6
unit amt.
Commercial(per sq.ft.)
035 3.31-92-
X =$ `
sq.ft. amt.
3. Urban Area Fees
(paid at Building Department
Residential (per unit) X =$
# units amt.
Commerical(per sq.ft.) X =$
sq.ft. amt.
4. Recreation District Fees
(paid at District Office) ........
5. Drainage District Fees
(Contact Land Development) .........................
6. Other
7. Other
At time of permit application, I was advised the above fees are required to be paid prior
to issuance of the permit.
APPLICANT �- �Sr:� DATE, 2 J - /
Return to DPW AGRICULTURAL STATEMENT OF ACUTOWLEDGEMENT 9 2 f 3 8 17
,,,- FOR RESIDEMAL DEVELOPMENT
•r• 'Section 26-8.1 of the Butte County Code
requires this acknowledgement be recorded
prior to issuance of a building permit.
7
All 'th-At real_:pro.perty,.-situate in the County of Butte, State of California, described as
follows:
SEE ATTACHED LEGAL DESCRIPTION.
Date:
State of Californla
SS.
County of Butte )
MICHELLE A. AL MILLER •
NOTARY PUBLIGCALIFORNIA •
&d=Offiffie in BUTTE Co. •
. .00T. 20,1995 •
.••••••.•..••••• ••
PROPERTY OWNERS:
On this the 31st day of March , 1992 , before me, the
undersigned Notary Public, personally appeared
S.C. Fischer
C] Personally known to me. U Proved to me on the basis
of satisfactory evidence.
to be the person(s� whose name4) 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. .
Present A.P. No. 65-4,0-23,-7
Notary Public
92-013817
1 Rec Fee 8.00
The property described herein is adjacent
I Check 8.00
to land or included within an area zoned
Recorded
I
for agricultural purposes, and residents
Official Records
I
of this property may be subject to incon-
County of
I
veniences or discomfort arising from the
Butte
I
use of agricultural chemicals, including,
Candace J. Grubbs
I
but not limited to herbicides, pesticides,
Recorder-
I
and fertilizers; and from the pursuit
10:39am 31 -Mar -92
I PUBL XX 2
of agricultural operations including,
but not limited to cultivation, plowing,
spraying, pruning, and harvesting which
occasionally generate dust, smoke, noise, and odor. Butte County
has established agricul-
tural zones which have as a priority use for
productive agricultural
purposes, and residents
within said zones and on adjacent property
should be prepared to accept such inconvenience
or discomfort from normal, necessary farm operations.
All 'th-At real_:pro.perty,.-situate in the County of Butte, State of California, described as
follows:
SEE ATTACHED LEGAL DESCRIPTION.
Date:
State of Californla
SS.
County of Butte )
MICHELLE A. AL MILLER •
NOTARY PUBLIGCALIFORNIA •
&d=Offiffie in BUTTE Co. •
. .00T. 20,1995 •
.••••••.•..••••• ••
PROPERTY OWNERS:
On this the 31st day of March , 1992 , before me, the
undersigned Notary Public, personally appeared
S.C. Fischer
C] Personally known to me. U Proved to me on the basis
of satisfactory evidence.
to be the person(s� whose name4) 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. .
Present A.P. No. 65-4,0-23,-7
Notary Public
82 13817 '
The land referred to herein is described as f ollowst
s r All that certain real
Unincorporated, Statof Butte,
erOfeCalifornia, deneribeduasyfollowal
Lnt 134, as shown on that certain:Map entitled, "PARADISE PINES
UNIT NO. 3^, which Map was filed in the office of the Recorder of
the County of Butte, State of California, June 17, 1970 in nook 35
Of Ataps, at pages 78, 79, 80, 81 and 82,
EXCRIrrING AND RESERVING THEREFROM all of the valuable minerals
beneath the surface of said land with the right to mine and extract
said minerals, it being agreed and understood that In all mining
operations the surface of said land will be protected against
damage and that all mining shall be carried
or drifts having on from tunnels, shafts
their orifices outside of the surface area of the
above described realty, all as excepted and reserved in that
certain Deed from the Magalia Mining Company,
Storts, et ux, recorded September 9 199p y' a corporation to E.D.
County official Records, at Page 385.7 in Book 9a3 of Butt@
EN® OF. ®®CUBA MNT
COUNTY OF BUTTE -
DEPT. OF PUBLIC WORKS
APR 66 1992
TO Buildina Department Go
FROM: Environmental Health-`
SUBJECT: Sanitation Clearance
a3
Owner Location
Plan Approved for. Sewage Disposal vl�Water Supply
Hold final for:
Final clearance O.R. for:
Clearance for -2 bedroom 4", home. Other
MOTE * a
I
Water Supply
Water Supply /
Sanitarian Date
1. Ceiling Insulation
F2 lactor
Number of stories
i
R -value
One
Two
Three
R-0
-103
-49
32
R-19
-8
-4
-2
R-30
-2
-1
-1
R-38
0
0
0
U -value
0.40
12
8
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
5
13
27
2. Wall Insulation
-17
-9
-2
Single
Single-
26
-49
Famiy
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
8
15
22
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
-1
3
8
12
3. Raised Floor Insulation
16
-20
Insulation in Floor
4
9
13
Number of stories
15
R -value
One
Two
Three
R-0
-17
-8
-5
R-11.
-3
-2
-1
R-19
0
0
0
R-30
3
1
1
U -value
-9
6
9
0.60
-144
-70
-46
0.50
-120
-58
38
0.40
-95
-46
30
0.30
-69
-34
-22
0.20
-43
-21
-14
0.10
-17
-8
-5
0.08
-11
-6
-4
0.06
-6
-3
-2
0.04
-1
0
0.
0.02
4
2
1
0.00
10
5
3
Controlled Ventilation Crawispace
-9
1
Number of stories
1
R -value
One
Two
Three
R-0
-11
-7
-5
R-5
-4
-4
3
R-11
-2
-2
-2
R-19
-1
-2
-2
4. Slab Edge Insulation
3.8
HWR
-23
Number of Stories
-8
R -value
One
Two
Three
R-0
0
0
0
R-5
8
5
2
R-7
8
6
3
F2 lactor
Single-
Slab Floor
Raised Floor
0.90
-4
-3
-1
0.80
-1
-1
0
0.70
2
2
1
0.60
6
4
2
0.50
9
6
3
0.40
12
8
4
S. Infiltration (Air Leakage)
Specification Points
Standard 0
6. Glass Heat Loss
Total
Single-
Slab Floor
Raised Floor
Mass
U -value
%Glass North
Percent
South :West
Skylight
.51 to
.41 to
.31 to 0.30 or
Glass
Single
Double
.60
.50
.40
less
50
-121
-53
-39
-24
-10
4
40
-90
-37
-26
-14
3
8
35
-75
-29
-19
-9
1
10
30
-61
-21
-13
-4
4
12
29
-58
-20
-12
-3
5
12
28
-55
-18
-10
-2
5
13
27
-52
-17
-9
-2
6
13
26
-49
-15
-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
-6
0
5
10
16
19
-29
-4
1
6
11
16
18
-26
3
2
7
12
16
17
-23
-1
3
8
12
17
16
-20
0
4
9
13
17
15
-17
1
6
10
14
17
14
-14
3
7
10
14
18
13
-12
4
8
11
15
18
12
-9
6
9
12
15
19
11
3
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)
Effective Percent Glass
(Percent &last x SC)
Effective
Single-
Slab Floor
Raised Floor
Mass
Wall
%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
9
10
4.0
3
1S. Shading (Shade Closed)
8
9
'10
Effective Peremt Glass
4.5
3
7
(Percent
glaat x SC)
11
11
5.0
4
7 .
..9
11
%Gcfive
len
North East
South
West
Skykht
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
-6
-8
-7
-23
3
0
-4
-5
-4
-16
2,
1
-1
-2
-1
-9
1
1
1
1
1
-4
0
2
3
4
3
0
9. Interior Thermal Mass
Interior
Single-
Slab Floor
Raised Floor
Mass
Wall
Stories
Family
Multi
Stories
Mass
1CFA
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
-1
2
4
5
6
7
2.5
0
3
5
7
7
8
3.0
1
4
6
8
8
9
3.5
2
5
7
9
9
10
4.0
3
6
8
9
'10
10
4.5
3
7
8
10
11
11
5.0
4
7 .
..9
11
_
12
12
5.5
5
8
9
11
12
12 '
6.0
5
8
10
12
13
13
6.5
6
9
10
12
13
13
7.0
6
9
11
13
13
14
7.5
6
10
11
13
14
14
8.0
7
10
11
13
14
14
8.5
7.
10
12
13
14
15
10. Exterior Wall Thermal Mass
Exterior
Single-
Single -
SC
Eff. % Glass
Wall
Family
Family
Multi
-4
Mass
Detached
Attached
Family
0.00
0
0
0
2
0.20
3
2
1
-4 io
0.40
5
4
3
.15 1 .6
0.60
8
6
4
-14
0.80
10
8
5
8.5
1.00
13
10
7
-3
1.20
13
12
8
-2
1.40
12
13
9
-2
1.60
10
13
11.
0 0
1.80
10
12
12
4
2.00
10
11
13
10.5
11. Heating System
6 5
4
3
2
SE or KSPF
10
9 7
(assumes duets In attic)
4
3
'- 120
Sum of 1.6
13 11
9
7
-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
-25 -21
Effective SE or HSPF
-13
(SE or HSPF x duct eflIciency)
6.0
Effective -25 or -24 to -14
to :4 to
+6 b 16 or
SE HSPF less -15
-5 +5
+15 more
0.30 2.75
-73 -64
-56 -47
-38
-30
na 3.41
-45 -39
-34 -29
-24
-18
0.40 3.67
-34 -30
-26 -22
-18
-14
0.50 4.58
-10 -9
-8 -7
-5
-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
Zonal Control Adjustment,
_ Type
System Type
10
8 7
6
4
Resistance
10 9,
7 6
4
3
Other
6 5
4 3
2
2
12. Cooling Systim
% Glass
SC
Eff. % Glass
a. North
SEER
One
-5
-4
-4
-3
(assume' ducts
In aide)
Two +
3
3
Stlm of 7-10
2
2
1
Single -Family
-25 or -24 to r' 1410
-4 io
+6 to
16 or
SEER
less
.15 1 .6
+5
+15
more
8.0
-14
-12 9 -10
-8
6
4
8.5
-9
-7 -6
-5
-4
-3
8.9
-5
-4 -4
-3
-2
-2
9.0
-4
-3 -3
-2
-2
-1 i
9.5
0
0 0
0
0
0
10.0
4
3 3
2
2
1
10.5
7
6 5
4
3
2
11.0
10
9 7
6
4
3
'- 120
1.5
13 11
9
7
5
13.0
20
17 14
12
9
6
Solar
-1
-1
-1
0
0
1.1
HWR
EffeLveSEER
-12
-9
-7
(SEER xduet effielency)
2.S
WSB.
-25
S1411 of 7-10
-12
-10'
-8
Effective -25 or ,24 to -1410
-4b
+6 b
16 or
SEER
less
-15 I -6
+5
+15
more
5.0
30
-25 -21
-17
-13
-9
6.0
-12
-11: -9
-7
-6
4 .
6.6
-5
-4 -4
3
-2
-2 .
7.0
0
0 0
0
0
0
8.0
9
8 6
.5
4
3,
9.0
16
14 12
9
7
5
10.0
22
19 16
13
10
7
11.0
26
23 19
15
12
8
12.0
30
26 22
18
14
9
13.0
33
29 24
20
15
10
to
Zonal
Control Adjustment
Type
_ Type
less
10
8 7
6
4
3
No Cooling System Installed
-Stories
% Glass
SC
Eff. % Glass
a. North
O
One
-5
-4
-4
-3
-2
-2
Two +
3
3
�; 2
2
2
1
Single -Family
tached and Attached
=
e. Skylight
$y Unit Size (sQ
X
Water
;9. -Interior Thermal Mass
. 12W
1700
2200
2700
Heater
U-9dit
or •
to
to
to
or
Type
Type
less1699
2199
2699
more
SG
None
0
1 0
0.
0
0
or
Solar
12
8
6
5
4
HP
HWR
8
5
4
3
3
! J�
WSB
5
3
3
2
2
30%
POU
8_
5
4
3
3
SE
None
-37
-24
-18
-15
-12
100% 105% 110Y. 11S% 120% 125`
Solar
-1
-1
-1
0
0
1.1
HWR
-18
-12
-9
-7
-6
2.S
WSB.
-25
-16
-12
-10'
-8
4
POU
-18
_-12
-9
-7
-6
IG
None
. -5
-3
-2
-2
-2
1.4
Solar
7'
5
4
3
2
2.9
POU.
3 _.
2
1
1
1
IE
None
-28
-19
-14
-11
-9
0.3
Solar,
8
5
; 4
3
3
1.8
POU
-10c
-6
-5
-4
-3
3.3
Mulct-Faml;V
(Individual units)
3.9
4.1
4.3
4.5
Unit Size (sQ
5
5.2
Water
56
699
700
1200
1700
2200
Heater
Credit
or
b
to
10
or
Type
_ Type
less
1199
1699
2109
more
SG
None
0?
0
0
0
0
or
Solar
14
7
5
4
3
HP
HWR
9
5
3
2
2
3.2
WSB
9
.` 4
3
2
2
4.7
POU
9
5
3
2
2
SE
None
-45
-23
-15
-11
-9
21
Solar
2.
•. 1
1
0
0
3.8
HWR
-23
-12
-8
3
-5
5.1
WSB
-25
-13
-8
-6
-5
0.9
PQU
-23
_`12_.-8
.
-6
-5
IG
None
-8
-4
-3
.2
; -2 '
3.9
Solar
6
3
2
1
1
5.3
POU
1_._0
6
0
0
0
IE
None
-30
-15
-10
-8
-6
2.7
Solar
18
9
6
4
4
4.2
POU
-8
. .4.
-3
-2
.2
Point System Summary: Climate Zone 11
SCORE CARD
Measures
1. Ceiling Insulation '�U or -
R -value [38] U -value [0.0301
2. Wall Insulation R 13 or -
R -value (111 U -value (0.098)
3. Raised Floor Insulation ( or
-value [ 191 U=value [0.0371
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)
or
R -value [0] F2 factor [0.771
Standard
Type [double] - U -value [0.65] % Total Glass [ 161
% Glass SC Eff. % Glass
3 • o x
vZ- X = vv
X = va
B1 X =
Point Scores
C)
% Glass
SC
Eff. % Glass
a. North
O
x
,
b. East
A
x
InteriorMass/CFA
5
'
3-A
X
d. West
11Z k -
S TTPR 2 PASS
=
e. Skylight
0 . a
X
• '% _
;9. -Interior Thermal Mass
a
TYPE 1 MASS AREA. _ $
n` f
p /.
InteriorW- ss/CFA
COND. FLOOR
AREA
10. Exterior. Wall Mass
TYPE 2 MASS AREA = $
Ex_eror Wall Mass
11.7-UiwC-.. 21
Iw:pet.d .1.b1
AREA
11:4HeatingSystem' r !/(� .;
. ?a-
�
X
75
9
Zonal Control (Y./ N)
R TYPE 1 MASS
(UIMC6 4.2,
exposed
ie: sed
Slab)
_-
10.72/6.61
. D ..�'
HSPF [0.5615.15]
12. Cooling System ' , �'
Q '
x
! J�
0%
S%
109.
157E
207E
2S%
30%
35%
40%
45Y.
50%
55%
60%
60.
70%
75%
80%
MY.
90%
95%
100% 105% 110Y. 11S% 120% 125`
OY.
0
0.2
0.4
0.6
0.8
1.1
1.3
1.5
1.7
1.92.1
23
2.S
-2.7
2.9,
3.2
9.4
3.6
3.8
4
4.2
4.4
4.6
4.8
5
53
Me
0.2
0.4
0.6
0.8
1
1.2
1.4
1.8
1.9
21
23
`25
2.7
2.9
3.1
3.3
3.5
3.7
4
4.2
4.4
4.6
4.8
5
5.2
5.4
20%
0.3
0.6
0.8
1
1.2
1.4
1.6
1.8
2
2.2
24
27
29
3.1
3.3
3.5
3.7
3.9
4.1
4.3
4.5
4.8
5
5.2
5.4
56
30%
0.S
0.7
0.9
1.1
1.4
1.6
1.8
2
2.2
24
26
28
3
3.2
3.5
3.7
3.9
4.1
4.3
4.5
4.7
4.9
S.1
5.3
5.6
58
40%
0.7
0.9
1.1
1.3
1.5
1.7
1.9
2.2
2.4
26
2.8
3
3.2
3.4
9.6
3.8
4
4.3
4.5
4.7
4.9
5.1
5.3
5.5
5.7
5.9
.50y.
0.9
1.1
1.3
1.5
1.7
1.9
21
23
25
27
9
3.2
3.4
3.8
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
3.9
4.1
4.3
4.5
4.7
4.9
5.1
5.3
5.6
5.8
6
6.2
60%
1
1.2
1.4
1.7-
1.9
21
2.3
2.5
2.7
2.9
3.1
3.3
3.5
3.8
4
4.2
4.4
4.6
4.8
5
5.2
5.4
5.6
5.9
6.1
63
65%
1.1
1.3
1.5
1.7
1.9
2.2
24
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
5.5
5.7
5.9
6.1
6.4
70Y..
1.2
1.4
1.6-
1.8
2
22
2.5
27
2.9
3.1
3.3
3.5
3.7
3.9
4.1
4.3
4.6
4.9
5
5.2
5.4
5.6
So
6
6.2
64
75%
1.3
1S -
,1.7
1.9
21
2.3
25
2.7
3
3.2
3.4
3.6
3.8
4
4.2
4.4
4.6
4.8
5.1
5.3
5.5
5.7
5.9
6.1
6.3
6.5
80X.
1.4
1.6
1.8 •
2
2.2
2.4
26
2.8
3
3.3
13.5
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
85X. •
1.4
1.7
1.9
2. t
2.3
25
2.7
2.9
3.1
3.3
3.5
3.8
4
4.2
4.4
4.6
4.6
5
5.2
54
5.6
5.9
6.1
6.3
65
67
.90Y."
1.5
1.7
'2
2.2
2.4
26
2.8
3
3.2
3.4
3.6
3.8
4.1
4.3
4.5
4.7
4.9
5.1
53
5.5
5.7
5.9
6.2
6.4
66
68
95y.
1.6
1.8
'2
2.2 •
2.5
27
2.9
3.1
3.3
3.5
3.7
3.9
4.1
4.3
4.6
4.8
5
5.2
5.4
5.6
5.8
6.
6.2
6.4
6.7
6.9
100%
1.7
1.9
21
2.3
25
28
3
3.2
3.4
3.6
3.8
4
4.2
4.4
4.6
4.9
5.1
5.3
53
5.7
5.9
6.1
8.3
6.5
6.7
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
se
7
110%
1.9
2.1
2.3
2.5
27
29
&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
6.9
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
4.9
5.1
5.3
5.5
S.7
5.9
6.2
-6.4
6.8
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
S
5.2
5.4
5.6
50
6
6.2
6.S
6.7
6.9
7.1
7.3
125%
21
2.3
25
2.8
3
9.2
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 '�U or -
R -value [38] U -value [0.0301
2. Wall Insulation R 13 or -
R -value (111 U -value (0.098)
3. Raised Floor Insulation ( or
-value [ 191 U=value [0.0371
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)
or
R -value [0] F2 factor [0.771
Standard
Type [double] - U -value [0.65] % Total Glass [ 161
% Glass SC Eff. % Glass
3 • o x
vZ- X = vv
X = va
B1 X =
Point Scores
C)
0
Point Total:
Surfs 13
Sum 7-10
7
% Glass
SC
Eff. % Glass
a. North
O
x
,
b. East
A
x
- _
5
c. South
3-A
X
d. West
11Z k -
X
=
e. Skylight
0 . a
X
• '% _
;9. -Interior Thermal Mass
TYPE 1 MASS AREA. _ $
n` f
p /.
InteriorW- ss/CFA
COND. FLOOR
AREA
10. Exterior. Wall Mass
TYPE 2 MASS AREA = $
Ex_eror Wall Mass
ND. R
AREA
11:4HeatingSystem' r !/(� .;
. ?a-
�
X
75
9
Zonal Control (Y./ N)
_' SE or HSPF
Duct Efficiency
Effective SE or
10.72/6.61
. D ..�'
HSPF [0.5615.15]
12. Cooling System ' , �'
Q '
x
! J�
Zonal Control? ( Y / N)
SEER [9.5]
Duct Efficiency [0.14]
Effective SE [7.03] ,
13. Water Heating
S J
Type [SG]
Credit [none]
0
Point Total:
Surfs 13
Sum 7-10
7
Certificate of Compliance: Residential ClimateZone 11
Project Title ../ �
Building Permit Al
Checked By / Date
Enforcement Agency Use Only
Component Insulation LocatioNcommo"nts
Type R -Value (asdts..to garage, mita. etc.)
Wall ..............
Roof............
Roof .............
Floor .............
Floor ............. _
Slab Edge .....
GLAZING Shading ]Devices
Glazing Area Glass Type Interior' Exterior Overhang Framing Type
North
North ( )
East ( ) 'C21
East ( )
South ( ) a _
South ( )
West
West ( )
Skylight.......
THERMAL MASS
Type/Covering Area Thickness
(slab/exposed, tile. etc .L� (SO (inches) LOCation/DCSCription (kitchen. bath. etc.)
wo VTI
HVAC SYSTEMS Minimum Duct
Type (furnace, air Efficiency . Location Duct Output Manufacturer / Model #
conditioner. hent um) (SE, SEER,HSPF,) (attic, etc.) R -Value tuh or approved equal)
y
o . 7A _ gni
Maximum Furnace Heating Output:
HOT WATER SYSTEMS Tank Manufacturer/Model # � . "
Svstem Tvne (storage pas, etc.) Capacity (or approved equal) SpC,Ci(s
SPECIAL FEATURESIREMARKS (Add extra sheets if necessary)
Mandatory Measures Checklist: Residential MF -1R
NOTE: Lowrisc residential buildings subject to the Standards must contain these rrmesatres regardka of the compliance
approach used. Items marked with an asterisk (•) may be superseded by mare stringent compliance mqutrernents luted
on the Certificate of Compliance. When this checklist is incorporated into the permit documents. the features noted shall
be considered by all parties as binding minimum component performance speaGcations for the mandatory measures
whether they are shown elsewhere in the documents or on this checklist only.
DESCRIPTION I DESIGNER ENFORCEMENT
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 waltz R -I I weighted average (does not apply to
exterior mass walls).
§2.5352(k): Slab edge insulation - water absorption rate no greater than 0.396, water vapor
transmission rate no greater than 2.0 permlumch.
§2-5311: Insulation specified or installed meets California Energy Commission (CEC) quality
standards. Indicate type and form.
§2.5352(p: Vapor barriers mandatory in Climate Zones 14 and 16 only.
§2-5317: InrmltratioNExfiltration Controls
a. Doors and windows between conditioned and unconditioned spaces designed to limit air
leakage.
b. Doors and windows certified.
c: Doors and windows weathers[ripped: all joints and penetrations caulked and sealed
§2-5352(e): Special infiltration barrier installed to comply with 112-5351 meets CEC quality
standards.
§2-5352(d): Installation of Fireplaces
1. Masonry and factory -built rMlaces have:
a. Tight fitting, closeable metal or glass door
b. Outside au intake with damper and contra
e. Flue damper and control
2. No continuous burning gas pilots allowed.
HVAC and Plumbing System Measures
§2-5352(8) and 2-5303: Space conditioning equipment sizing: attach calculations.
§2-5352(h) and 2-5315: Setback thermostat on all applicable heating systems.
• §2-5316(a): Ducts constructed. installed,and insulated per Chapter 10. 1976 UMC.
62-5316(b): Exhaust systems have damper controls.
§2-5314(c): Gas-fired space hating equipment has intermittent ignition devices.
§2-5314: HVAC equipment. water heaters, showerheads and faucas 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(Exception 1): Pipe insulation on steam and steam condensate retum At recirculating
piping.
§2-5318(d): Swimming Pool Heating
1. System has:
a. On/off switch on heater.
b. Weatherproof instruction plate on heater:
c. Plumbed to allow for solar.
2. 75 percent thermal efficiency.
3. Pool cover.
4. Time clock.
5. Directional water inlet.
Lighting and Appliance Measures
§2-5352(1): Lighting - 25 lumens/watt or greater for general lighting in kitchens and bathrooms.
§2-5314(c): Gas fired appliances equipped with intermittent ignition devices.
12.5314(a): Refrigerators. refrigerator -freezers, freezers and fluorescent lamp ballasts certified
by the CEC. Indicate make and model number.
COMPLIANCE STATEMENT
This certificate of compliance lists the, ixuiding 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
Name: -570N
Title/Fimt: r
Address:
Telephone:
Lic. 0:
(signature) r (date)
Documentation Author
Name:
Tide/Fum:
Address:
Building Owner
Telephone:
(signature) (date)
Enforcement Agency
Name:
Agenry:
Telcowne:
Glass Area
9b Glass
BUILDING DATA
BU
North
Oil,
3,0
' Condition Area �bv
Number of Stories /
East
,?
Slab ' ed
Number of _Units
South
[ Single Family Detached (SFD)
[ ] Addition Alone
West
-- e
—
D�
(] Single Family Attached (SFA)
(] Existing Building
T tyahlght
'
[ ] Multi-Family(MF)
[ ] Existing -Plus -Addition
B UII.DING SHELL INSULATION,
Component Insulation LocatioNcommo"nts
Type R -Value (asdts..to garage, mita. etc.)
Wall ..............
Roof............
Roof .............
Floor .............
Floor ............. _
Slab Edge .....
GLAZING Shading ]Devices
Glazing Area Glass Type Interior' Exterior Overhang Framing Type
North
North ( )
East ( ) 'C21
East ( )
South ( ) a _
South ( )
West
West ( )
Skylight.......
THERMAL MASS
Type/Covering Area Thickness
(slab/exposed, tile. etc .L� (SO (inches) LOCation/DCSCription (kitchen. bath. etc.)
wo VTI
HVAC SYSTEMS Minimum Duct
Type (furnace, air Efficiency . Location Duct Output Manufacturer / Model #
conditioner. hent um) (SE, SEER,HSPF,) (attic, etc.) R -Value tuh or approved equal)
y
o . 7A _ gni
Maximum Furnace Heating Output:
HOT WATER SYSTEMS Tank Manufacturer/Model # � . "
Svstem Tvne (storage pas, etc.) Capacity (or approved equal) SpC,Ci(s
SPECIAL FEATURESIREMARKS (Add extra sheets if necessary)
Mandatory Measures Checklist: Residential MF -1R
NOTE: Lowrisc residential buildings subject to the Standards must contain these rrmesatres regardka of the compliance
approach used. Items marked with an asterisk (•) may be superseded by mare stringent compliance mqutrernents luted
on the Certificate of Compliance. When this checklist is incorporated into the permit documents. the features noted shall
be considered by all parties as binding minimum component performance speaGcations for the mandatory measures
whether they are shown elsewhere in the documents or on this checklist only.
DESCRIPTION I DESIGNER ENFORCEMENT
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 waltz R -I I weighted average (does not apply to
exterior mass walls).
§2.5352(k): Slab edge insulation - water absorption rate no greater than 0.396, water vapor
transmission rate no greater than 2.0 permlumch.
§2-5311: Insulation specified or installed meets California Energy Commission (CEC) quality
standards. Indicate type and form.
§2.5352(p: Vapor barriers mandatory in Climate Zones 14 and 16 only.
§2-5317: InrmltratioNExfiltration Controls
a. Doors and windows between conditioned and unconditioned spaces designed to limit air
leakage.
b. Doors and windows certified.
c: Doors and windows weathers[ripped: all joints and penetrations caulked and sealed
§2-5352(e): Special infiltration barrier installed to comply with 112-5351 meets CEC quality
standards.
§2-5352(d): Installation of Fireplaces
1. Masonry and factory -built rMlaces have:
a. Tight fitting, closeable metal or glass door
b. Outside au intake with damper and contra
e. Flue damper and control
2. No continuous burning gas pilots allowed.
HVAC and Plumbing System Measures
§2-5352(8) and 2-5303: Space conditioning equipment sizing: attach calculations.
§2-5352(h) and 2-5315: Setback thermostat on all applicable heating systems.
• §2-5316(a): Ducts constructed. installed,and insulated per Chapter 10. 1976 UMC.
62-5316(b): Exhaust systems have damper controls.
§2-5314(c): Gas-fired space hating equipment has intermittent ignition devices.
§2-5314: HVAC equipment. water heaters, showerheads and faucas 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(Exception 1): Pipe insulation on steam and steam condensate retum At recirculating
piping.
§2-5318(d): Swimming Pool Heating
1. System has:
a. On/off switch on heater.
b. Weatherproof instruction plate on heater:
c. Plumbed to allow for solar.
2. 75 percent thermal efficiency.
3. Pool cover.
4. Time clock.
5. Directional water inlet.
Lighting and Appliance Measures
§2-5352(1): Lighting - 25 lumens/watt or greater for general lighting in kitchens and bathrooms.
§2-5314(c): Gas fired appliances equipped with intermittent ignition devices.
12.5314(a): Refrigerators. refrigerator -freezers, freezers and fluorescent lamp ballasts certified
by the CEC. Indicate make and model number.
COMPLIANCE STATEMENT
This certificate of compliance lists the, ixuiding 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
Name: -570N
Title/Fimt: r
Address:
Telephone:
Lic. 0:
(signature) r (date)
Documentation Author
Name:
Tide/Fum:
Address:
Building Owner
Telephone:
(signature) (date)
Enforcement Agency
Name:
Agenry:
Telcowne: