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BUILDING DIVISION
COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES
' 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 -TELEPHONE: (916) 536-7541
AGRICULTURAL BUILDING EXEMPTION PERMIT
PERMIT NOj(
2 _ _z � 3
Agricultural building is defined as follows: Agricultural building is a structure designed and constructed to house farm
implements, hay, grain, poultry, livestock, or other horticultural products. This structure shall not be a place of human
habitation or a place of employment where agricultural products are processed, treated, or packaged, nor shall it be a
place used by the public.
ASSESSOR PARCEL NO. 73 _ 0 _ r f
ZONING
OWNER
i� 0 L `0 s
PHONE NO
ta4 �.
OWNER'S ADDRESS N,�D Q \ Cr V
LOCATION OF BUILDING
USE OF BUILDING S"S o f1'E ("Q C v�� �. �e `� `s d- u •� ... G LJ -
SIZE OF STRUCTURE DA) L i�
c� O � X � O = � � O SO. FT.
TYPE OF CONSTRUCTION:
WOOD FRAME STEEL CONCRETE OTHER (Specify)
TYPE OF SIDING
Sl E e—'_
ROOF COVERING T�R
TYPE
ESTIMATED COST OF CONSTRUCTION
$ 1'O 4 c o 0
AG Buildings shall comply with the building front, side, and rear yard requirements of the applicable County Ordinances
as follows:
FRONT -O'Af - - SIDES ��� REAR
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.
AG Buildings must comply with Flood Zone requirements. Finish floor elevation must be at or above elevation
USGS Datum.
I declare under penalty of perjury that the building will be used as stated above and the purposed use conforms with the AG
Building definition. If any change in use or occupancy of the building is made, I will contact the Building Division and obtain
any necessary permits, inspections, and approvals to comply with the requirements in ect at that time and before occupancy.
Date Z`� 9 '�— Signature of Owner>C
Permit Fee - $50.00
Receipt No.! 1 1777
The above described AG Building is exempt from a building permit.
Manager Building Division
By—
White — DPW, Yellow — Assessor, Pink — B. I., Goldenrod — Applicant
FLOOD PARCEL P.D. R00!q ISSUE
Date 7-2-9 e -z—,
RESIDENTIAL
73-18-131 664 -91B,P,E,m
REYNOLDS, Lew
160 Big Fir Rd, Forbestonw
Cont: Barry Scott
(new sf)
OFFICE COPY
Address
GAS
Meter By—
Dat
ELECTRIC
Meter By
Date
JOB FINAL
Slqr4iure
OFFICE Copy
Address
4-,-��—�
GAS
Meter By—L6�� Date.
ELECTRIC
Meter By Date
1 4
' v=OK
O=Not OK
Not =
MOBILE HOMES
Not Ready MOBILE
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: / /" 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. Zonind 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/0 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, COVERS, CARPORTS, GARAGES, (Plans)OK except it's
1. Zoning Requirements -Setbacks -Easements
2. Footings; 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-Eric'losures
6. Carports; Windows -Doors
7. Electric
8. Frmg; Sils-Anchors-Studs-Rftrs-Trusses
9. Siding; Nailing -Veneer -Stucco -Mesh '
10. Roof; Shthg-Roofing
11. Ext.; Steps -Doors -Landings
Date Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date POOLS (Plans) OK except #'s
1. Setbacks -Easements
2. Soils; Compaction -Structure Stability "
3. Pool Structure; Steel -Connections -Thickness
Dead Men -Lining
4. Elec.; Receptacles and Lighting, Distances-GFI'
5. Elec.; Pool Lighting; 15 volts-GFI
6. Elec.; Enclosures; Conduit Entries -Terminals -listed
7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater
8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg.
Boxes-Enclosures-Pane Iboards- Ins. to Main in Conduit
9. Health Department Approval
10. Plumb.; Cir. Test -Water Supply Test -
T
Date Card B-1 Date Card B -f
Date Card B-1 Date Card B-1
'J OK
O=Not OK
= Not Applicable
= Not Ready
Date UNDE$WLOOR (Plans) OK except #'s
RESIDENTIAL (Single & Duplex)
1-.10 i -Setbacks-Easements-Flood-Slope
tg., in; Soils-Elec. Grnd.-/ /" Ftg. Depth at'
g. e; Soils-Steel-Elec. Grnd.-/ P' Ftg. Depth
45t—g, Porches & Decks; Soils -Steel-/ /Ftg. Depth
`?moi Fmwalls, Main; Steel-Blockouts-Wrapped
emwalls, Garage; Steel- Bloc kouts-Wrapped
6a. Hold Downs and Special Anchors
7. Slab; Steel -Wrapped
8. Pie ireplace Ftg.-Steel
8. .W.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test
as Pipe; Size -Anchors
11. Water Pipe; Test -Anchor -Regulator -Service Test
12. Electric; Underground
13. Pie ,ums & Ducts; Clearance -Material -Support -Ins.
irders-Sills Anchor Bolts -Joists -Vents -Cripples
15. Insulation
Dat Date Card B-1
DatP4 i%2 i Card Date Card B-1
Date PLUMBING Permit OK except #'s
ater Htr.; Vent -Access -Combustion Air -Baffle
1 ater Pipe; Test & Anchor -Nail Protection
W.V.; Test -Fittings & Anchor -Nail Protection
hower Pan; Test, First Floor -Tub Access
2p_,T,s Tub & Shower, Second Floor -Tub Access
1. Gas Pipe; Size & Anchors
Dat L Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date ELECTRICAL (Permit) OK except #'s
x ure nsformer Clearance -Ins. Protection
ec. Receptacles Spacing -Lights & Switches at Doors
a Boxes & No. of Conductors -Stapled
Romex Installed Close to Edge of Studs & C.J.
2 -p. Ground made up w/Meth. Fastners-Bond Gas & Water
ppliance Circuts in Kitchen & Conductor Size/GFI
ZL_Sub1ead_W1re_SU&4- / ga. Cu or AI-A.C. Wire Size / / ga.
Cu or Al
a. Cu or AI -Oven Circ. / / ga. Cu or Al.
Insulated Neutral 11 Yes No
,3@ -Riser Conductors & Ground -Main Disconnect
quip. learances Panels-Motors-Mech. Equip.
o es Closet Light -Shower Light -Spa Light
moke Detector
Dat Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date MECHANICAL (Permit) OK except #'s
,�A.C.Dwcts Insulation & Support
3 ' engin; Exhaust above insulation
3&--topgensate Drain & Overflow; Size & Grade
ur ante -Vent; Access -Comb. Air -Return Air Vent -115 outlet
3 . Attic Access & Platform if Furnance in Attic
Date �Q Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date FRAMING (Plans) OK except #'s
s
j1s, Proper Material & Anchors
Wall vds-Nailing, Spacing & Bracing -Plates -Sound
At -B_ ing Walls over Girders & Floor Nailing
Dr ft Stop in Walls (rat proof)
%i Stops; Furred Ceilings -Stairs -Chases -Tub
4 eaders & Beam -Size & Bearing
Date FRAMING (Continued)
ange -Post Caps -Anchors -Connectors
4 ng. Joist-Rftr._ties-Purlin—roof Brac-Truss-Shthng.-Rfng.
p ace Ties or Type A Flue -Fireplace Throat clearance
sAccess; Size & Romex Protection -Draft Stop -Ins. Baffles
. Windows or Exiting Doors -Sill Hgt. & Dimensions
age Fire Protection Framing
,AJrPT15'p`erty Line Firewall & Openings
Doors -One 3' -Check Garage -3rd Story, 2 Exits
53.eW ; Width -Headroom -Rise -Run -Landing -Fire Protection
%y -w -on Roof Overhang -Attic Vents -Rafter Outriggers
iding-Nailing Veneer
IT Stucc Mesh -Drip Screed -Fd. Vents-Underfir. Access
jZea,' Area -Glass Protection -Skylights -Plastic
hear Walls; Nailing -Bolts
A Insulation -Walls -Ceilings
60. Infiltration -Walls -Windows
Da Card B-1 Date Card B-1
Date Card B-1 Date Card B-1
Date FIN lans OK except #'s
E teps-Door & Sidelight Protection -Landings
wr_ernel<6 Detector
Furnace; Vents -Clearance -Comb. Air -Connector -
In Garage; Above Floor -Ducts -Meeh. Protection
Bedroom Exiting
BFIG.F.I. & Bath Fixtures & Tub Access -Spa
afi--I�Iec..Trim & Subpanel; Breaker Sizes & Labels
r6B�Ftf"eplace or Stove; Clearances -Hearth
T§te c Outlets at Wood Panel; Int. & Ext.
it.Fjed� ADDliance: Grnd.-Air Gap -Cooking Clearance
at Kit. Counter
Fire Door;
7d- A C�pCtnfi Garage -Damper
tr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.
In ge; Above Floor -Meth. Protection
Ib ec. & Mech. Equip. Listed for Location
ec._Receptacles in Garage; (G.F.I.)-Romex Protection
V-Tin`suAA1io-Foam-Looked in Attic 0 Yes
7 . uard Rails & Deck Construction -Post Caps
79 Vents & Crawl Hole Door -Drainage & Wood -Earth
Cleara ce Looked under Floor O Yes
ollowing instld.; Drive es ❑ No; Walks Yes ❑ No;
Planters 13 Yes o
n -Finish
C. U wisconnect, Electrical, Plumbing
Is Above Roof; Plbg.-Appliance-Fireplace.-Clearance to
Opening
Dis onnect Electrical Plumbing
Exter Elec. Trim; G.F.I. Receptacle -Underground
enti ' n Throughout House _
lass protection
r tions from Previous Inspections
�as est -Meters Tagged; Gas -Electric
90'*`W_aIer & Sewer Connected -C/O to Grade -HD Approval
Energy Compliance Certificate -Other Certificates
Date' r- rd B Date Card B-1
Dat Card B-1 Date Card B-1
Date Card B-1'Date Card B-1
Comments at Final:
(NOTE: An entry must be made each time you visit job site)
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 >
�q a �S
FIE
T NO.
A routine inspection indicates that the following violations of County Ordinance
,E exist at the above address and should be corrected. Please notify this office
when cor�ed
of work is completed. If you have any question pertaining to this
r` matter, oadditional explanation, please contact this office immediately.
3 �/ ler L v o S�vv�
_c.
x
M
�. Date 1 Inspector
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
CORRECTION NOTICE
�OWNE
�PERM�ITNO.
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, pleas contact this office immediately.
Date (.-Z— 2—Inspector41, f 6;
—
.,
. `
'
. `
^
INSULATION CERTIFICATION
/{J��_�L.u|k\`
_
/
' �� ' l
NUMBER AND SEET CITY COUNvY
�
---------------------- ____________________________________________
�
SUBDIVISION LOT NUMBER
-DESCRIPTION OF INSTALLATION
ROOF
MATERIAL
RANU NAME
THICKNESS (INCHES)
HERMAL RESISTANCE—
EXTERIOR WALL
'
MATERIAL- FIBERGLASS
BRAND NAME____CERTAIN
THICKNESS Tv 170 F HERMAL RESISTANCE
CEILING
`
BATT OR BLANKET TYPE—FIBERGLASS
__BRAND NAME RTAINTEED_____ '
THICKNESS
THERMAL RESISTANCE
LOOSE FILL TYPEEBRANDNA_ME_______CERTA[NTEE[
___3,Q
nImlnun THICKNESS ___ NUMBER
u+ PER BAG 2.LB .
AREA COVEREDHERMAL
RESISTANCE`
FLOOR ELEVATED
MATERIAL FIBERGLASS
NAME_____CERTAIN EED___________
THICKNESS /b
_BRAN})
THER|40- RESISTANCE___
FLOOR SLAB
'
MATERIAL'
BRAND NAME '
THICKNESS
HERM/V- RESISTANCE
WIDTH ( INCHES)__
FOUNDATION WALL
MATERIAL
BRAND NAME
THICKNESS
THERMAL RESISTANCE
HEATING SYSTEM gas furnace
MAKE '
MODEL DESCRIPTION
'
RATED BONNET CAPACITY
DECLARATION
I hereby certify that the above insulation
was installed in the
building at the above location in
conformance with the current
regulations setting Enery Cbnservation
Standards for new residentia
buildings (lo&At6d 'in Title 24 of
the California Administrative Code) .
GENERAL CONTRACTOR (BUILDER)
LICENSE NUMBER
SIGNATURE AND TITLE
..
HAWKINS INDUSTRIES INC 79407
(owner)
/SIGNATURE AND TITLE DATE
~
,I
/ COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
APPLICATION AND PERMIT
PERMIT NO.
t
ASSESSOR PARCEL NUMBER
73-18-131
ZONI G
U
BUILDING PERMIT
OWNER
Lew olds 818
TELEPHONE
341-4343
SQ. FT. OCC. BUILDING VALUATION
1776 R 71 040
OWNER'S MA TNG A.DDR ESS
.10561 Limerick Ave. Chatsworth CA 91311
8(70 M 12,180
CONTRACTOR'SNAME
Bnrry Scott
TELEPHONE
692-1405
172 C 1,920
350 1 0 1,750
CONTRA OR'S NAILING ADDRESS _
Oregon House CA 95962
Fireplace 11All 1,000
CONSTRUCTION LENDER
Nnnp
UNKNOWN
Total Valuation $ 87,8 0
Filing Fee $
10.00
LENDER'S MAILING ADDRESS
Permit Fee $
3977.00
ARCHITECT OR E.,I,INEER
LINonp CENSE No.
Plan Checking Fee $
190.50
Energy Plan Checking Fee $
15.00
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty $
BUILDING ADDRESS
Big Fir Rd., Forbestown
Permit fee $
620.50
PLUMBING PERMIT Filing Fee
10.00
Each Trap 1 2.00
90.00
Solar or heat pump water heater 20.00
LOT;7. .
SUBDIVISION NAME
PARCEL MAP,
Water piping 5.00
5.00
Each qas water heater or vent 5.00
9.00
USE OF STRUCTURE
SFf Duplex❑ Mobilehome❑ Other
SPECT FY
Gas piping system 1 - 5 outlets 5.00 1
9 -no
Building sewer 5.00
Mobile Home S G W 10.00 ea
TYPE OF WORK
New)M Addition ❑ Remodel ❑ Utilities ❑ Installation[] Other ❑
Describe work: 3BR _
Permit Fee $
90.00
Contractor
ELECTRICAL PERMIT Filing Fee
10.00
Main service 100V OR LESS 10.00
100 AMP OR LESS
Main service EA. ADD'L 100 AMP 2.50
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 No. �� ` ��� Classification.
❑ i, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. , Business and Professions Code
for this reason
NEW CONST. (DWELLING OCCUP.e/
� ,
OR ADDNS. ACC. BLDGS. h2sgft
NEW RESID.CONSTU NCH CIRCUITS)2.50 ea
NON .R ESID BRANCH CIRC ITS
/POWER APPARATUS 6
(SINGLE OUTLET CIR. /
EX. OCCU o 200500
p OR FIXTURES eALO 30
FIXED A
Ex. Occup. OUTLETS P(RESID ILISIS REA.) 2.00
Temporary service 10.00
in nn
Mobile Home Facilities 15.00
Misc. wiring 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 FiIingFee
10.00
Heating 1
6.00
attic dual ht. Pak
lin
Coog T 1
6.00'
Hood 3.00
3.00
Ventilation 113. 00
3._00
Permit Fee $
34.00
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 County of0
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
agains aid County in onsequence of the granting of this permit.
X Date 8
licant - Owner El Contractor s Agent ❑
Signature Ji,
An OSHA is required for excavations over 5'0" a an d tion or construct-
ion of structures over 3 stories in height.
Mobile Home Installation Fee $
Energy Inspection Fee $ 30.00
CON E
TOTAL F E $
833.15
HAL
un PARK SCJ.H
F D coF
r-�
PA
Po H ISSUE
This permit is hereby issued unser the applicable provi-
sions of the Butte County. Code and/or resolutions to do
work indicated abov for which fees have been paid.
DI .€ 0R LIC WORKS
By. / Date Lf
PE IT EXPIRES Date ` 2 - I
Receipt No. Z `Oc3 /5 X40
WHITE-D.P.W.. YELLOW-ASSE330R. PINK -INSPECTOR. OLDS O LI ANT
;� f �
.;
TO Builditla Department
FROM: Environmental Health
SUBJECT: Sanitation Clearance
O er ocation
AP# ��yy
yu�l.A-
Pian Approved for: Sewaqe Disposal Water Supply
G
Hold final for: Water Supply
^anal clearance O.K. for: Water Supply
Clearance for bedroom mobil ome Other
-NOTE ***
Sanitarian D to
T0: Building Department
FROM -: Encroachment Permit Section
RE: Driveway Clearance
L �s
(� �
owner rocation AP #
Driveway permit has -been -issued for the above property. .
si ature date
�w..Ti.1sr�+ - - J �' W ' •r lS/I ' r�"! l �.IS Y �., S4 1%j;
..i
COUNTY OF BUTTE---DEPARTMENT.OF PUBLIC WORKS - BUILDING DIVISION
.7 COUNTY CENTER DRIVE ,,.OROVILL"E, CALIFORNIA 95965 - TELEPHONE: 916/538-7541
PERMIT APPffl0N
L-IC,DATA SHEET
' Permit No.
OWNER f L� /` �y/l/O�%x� A. P. No.
Proposed Building Use S Building Inspector Date 3
At time of permit application, I was advised the following data must.be submitted prior to permit processing and/or issuance:
- DATE RECEIVED APPROVED
All items have been submitted.
k2!,'.............
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 .........
'3. 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 ...... ....................
A4,412 -YC, V11_ L> School District fees paid .............. `
14.Sanitation approval from 0%z- n 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 Improvements may be required. Contact Land Development Section DPW
W<119. 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 ❑) ..... _ Z
4. Recorded copy of Agricultural Acknowledgment Statementvr:in
25. Letter of signature authorizati n .. U
27.
Whe i issue the permit, process as follows: - '\ Mail to owner. Mail to contractor.
Telephone Nor -'and hold for pickup at �i/�D office-._\ Deliver w./inspector.
Other
Applicant Date
Copy of Haz-Mat form sent Health Dept. Fire D Ir Pollution Date
Copy of plans sent ----- Health Dept. _Fire Dept. Othar Date By
The following data must be submitted prior p ' 1i e: (Circle new item not checked above). f .
1. Index permit for above items No.
2. Additional items required:
Contractor, designer, owner, was advised of above required data by_phone—nai1_counter by date
Contractor, designer, owner, was advised of above required data by—phone —ma II—counterby date
Plans checked by Date Plans approved by Date Date 6'
'Ww"Is of plans on hold ' ile db% eta AP folder
- 833 , i 5 Ps
'00
Copy—DPW 0 C�_
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. !
• 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541
• APPLICATION AND'PERMIT E
ASSESSOR PARCEL N� BER /� ZONING
73
BUILDING PERMIT
OWNELEPHONE
3v44
SO. FT. OCC. BUILDING VALUATION7e�
OWNER'S MAILING ADDR S
/6 �q / 1_ 14, el2/ ek AAC . 6 s 4e)ne
CO4W S NAME 9e0/ 1 (?16),
/ QA
PI CQcJ
1
CON RACTOR MAILING ADDRE
,6 //1?6 9, 6 Z
Fireplace I �/ QO
CONSTRUCTION L.EpIDER
UNKNOWN
Total Valuation $
Filing Fee
I0.00
LENDER'S MAILING ADDRESS
ARCHITECT OR L:,',INEER
LICENSE NO•
Plan Che -,;'King Fee
$ L�
i
Energy Plan Checking Fee
$ /,z;-,Q�
ARCHITECT OR ENGINEER'S MAILING ADDRESS
Penalty
$
BUILDING ADDRESS Q
ermlt fee
$ •® t
PLUMBING PERMIT
Filing Fee 10.00
Each Trap
2.00 o?O,Jj
Solar or heat pump water heater
20.00
LOT N.O.
SUBDIVISION NAME
PARCEL MAP
Water piping
5.00 70
Each qas water heater or vent
5.00 <r 0 0
USE OF STRUCTURE
SIX Duplex❑ Mobilehome❑ Other
SPECIFY
Gas piping system 1 - 5 outlets
5.00 1 1014
Building sewer
5.00 ,Q
Mobile Home S I G I W
10.00 ea
TYPE OF WORK
New Addition ❑ Remodel ❑ Utilities ❑ Installation[] .Other ❑
Describe work:
Permit Fee
$ ��,100
Contractor
ELECTRICAL PERMIT
Filing Fee 10.00
Main service 1100 OR LESS
100 OROR LESS
10.00 ,Q
Main service EA. AOD'L 100 AMP
2.50 r
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.
❑ 1, as the owner, or my employees with wages as their sole compen-
sation, will do the work,and the structure Is not intended or offered
for sale. (Sec. 7044)
❑ I, as the owner, am exclusively contracting with licensed contract-
ors. (Sec. 7044)
❑ I am exempt under Sec. Business and Professions Code
for this reason
NEW CONST. ( DWELLING OCCUP..)
OR ADDNS. ACC. BLDGS. I
yZ¢sgf-
NEW.CONSTR ULTI.OUTLET
NON-RESID . BRANCH CIRC ITS
2 -SO ea
POWER APPARATUS &)
(SINGLE OUTLET CIR,
Ex. OCCup(OUTLETS OR FIXTURES
°A1030
2ALI 30
FIXED APLNS.
Ex. OCCUp. OUTLETS P(RESIO.)REA.)
2.00
Temporary service
10.00 10,06
Mobile Home Facilities
15.00
Misc. Wiring
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
/ Ip
A
Cooling
0 Q
Hood
3.00 -3,a
Ventilation
3, CV 3,a
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
all liabilities, judgments, costs, and expenses which may in any way accrue
against said County in consequence of the granting of this permit.
X Date
Signature of Applicant – Owner ❑ Contractor ❑ Agent ❑
An OSHA permit is required for excavations over 5'0" deep and demolition or construct-
ion of structures over 3 stories In height.
Mobile Home Installation Fee
$
Energy Inspection Fee $ G,
OCC.
CONST TYPE
`2
TOTAL FEE $ p -
HAL
CUA
I PARK
I SCHL
I FLD
I COF PAR PD
i HD.
ISSUE
This permit is hereby issued unser
sions of the Butte County. Code and/or
work indicated above for which
DIRECTOR OF PUBLIC
By
OCORIIT Cw01011=C rn..1„
the applicable provi-
resolutions to do
fees have been paid.
WORKS
Date
Receipt No.
MARYSVILLE JOINT UNIFIED SCHOOL DISTRICT
CERTIFICATION OF COMPLIANCE
SCHOOL DISTRICT DEVELOPMENT IMPACT FEES
TO BE COMPLETED.BY APPLICANT AND TAKEN TO MJUSD
PART I 1919 B Street, Marysville
Property Owner's Name: LE W
Owner's Address:/ 41,1 1 C/e H LG CP67`;W0leILI C—A'713
Project Address: / k' U 1J� 6 F 112- p %—/9/,?AeC-,-M Luvcff 2`4:11
Parcel No.:
Lot No.: City or County:
Building Dept.:
Permit #:
TYPE OF CONSTRUCTION: /
Residential Construction V
Residential Reconstruction
Commercial Construction
Commercial Reconstruction
TOTAL NUMBER OF HABITABLE SQUARE FEET:
Single Family Dwelling
Multiple Family Dwelling
No. of Units
Mobile Home
(-7 1�
(7
THIS CERTIFICATION COVERS ONLY THE AMOUNT OF SQUARE FOOTAGE INDICATED ABOVE.
ANY ADDITIONS OR CORRECTIONS TO THE SQUARE FOOTAGE FOR THE PROJECT WILL
REQUIRE AN AMENDMENT TO THE CERTIFICATION OF COMPLIANCE. FALSIFICATION OF
THE SQUARE FOOTAGE AND/OR TYPE OF CONSTRUCTION IS CAUSE FOR REVOCATION OF
CERTIFICATION OF COMPLIANCE.
Applicant's Name: LP J ��=,.<.r ,1.. �c1 _°. Date:
Applicant's Signature: /
PART II TO BE COMPLETED BY BUILDING DEPARTMENT (Optional)
Total number of habitable squarefeet /-7--)(,J City of Marysville
County of Yuba
Signature ���?1_nt e'Ll �c.� � r 1 County of Butte j
PART III TO BE COMPLETED BY SCHOOL DISTRICT
Certification of Compliance No. (Receipt No.):
Fees Collected:
#-`�' square feet x's $1.--00,
Exempt from fees: Reason:
AS THE AUTHORIZED SCHOOL DISTRICT OFFICIAL, I HEREBY CERTIFY THAT THE
REQUIREMENTS OF GOVERNMENT CODE SECTION 65996 HAVE BEEN COMPLIED WITH
BY THE ABOVE SIGNED APPLICANT.n
Signature:i,
Title: t",
Original - School District
Yellow - Applicant
Pink - Building Dept.
SD: co
3/21/88
Date:
RESIDENTIAL PLAN CHECKING GUIDE 12/90
(S.F., DUPLEX_MISC. ONLY)
. Bldg. Permit #
OWNER =-r ODDS A.P. # 73-1 131
Plan Checker
GENERAL
Y oning requirements: (sideyards and number of permitted living units).
aluation.
3: Pans signed by designer.
Proper description of work on application.
x1sting violations on property.
6 Items on data sheet. (W.C., fees, Health,
-7. Recort --notice of violation.
PLOT PLAN
Vl.. 6omplete parcel size and dimensions.
Z: Setbacks, sideyards, easements, etc.
Orh-c buildings or structures.
4�rading, fills, drainage.
Flood hazard.
Special conditions on creation map,
ustible, and foundations).
7. FAS road setback.
k
Developer Fees, License law, etc).
a,
(noise, CDF, fire sprinklers, non -comb -
Building or utilities across lot lines (Record form). ;
FLOOR PLAN -'
1. �emplete;to scale plan with dimensions.
2equired windows for light and ventilation (Sec. 120.5).
3. Re uired windows for second exit (Sec. 1204).
4. � lights (Chapter 34 & Sec. 5207).
ReH man impact glass (Sec. 5406).
quired room sizes, ceiling heights (Sec. 1207).
7. GFCIs in baths, garage, kitchen, and exterior outlets (Article 210-8).
8 4--h±-gTift fixtures, switches, receptacles, and exterior receptacles for main-
t�hce of mechanical equipment.9. Locations of water heater, heating and cooling equipment, other electrical
or gas equipment. i
1 �ge firewall, door size, and closer (Sec. 503(d)(3))..
11. 3'0" exterior exit door (sec.. 3304 (f).
1 ep ace and wood stove location, alcoves, and clearance.
1 SS oke detectors (Sec. 1210).
14 Plumbing fixtures, water closet clearances and shower size.
STRUCTURAL DETAILS
T�! :nusual
t dard bracing or engineered design (Table 25V)
shape, size, or split level house requiring lateral design.
3.�ndation plan complete enough to construct building.
4Le Floor construction details complete enough to construct building.
5�vations and wall construction details complete enough to construct building.
6 Roof construction details complete enough to construct building.
. r/'eplace construction details and talcs if necessary.
8lK,,Ra-fter ties or bearing ridge beam.
9V C�a-rage door or porch header sizes.
1�.d`obe
fights.
1 oils - special foundation design.
1R� ng walls requiring design.
1_'+-.pecial Inspection required.
12/90 .
RESIDENTIAL PLAN CHECKING,GUIDE
MISCELLANEOUS ITEMS TO LOOK OUT FOR
1 Stairway details: landings, rise and run, head clearance, handrails
(Sec. 3306).
uar rai details (Sec. 1711 & 3306(j).
3. D� tone veneer (Chapter 30).
4. error piaster - weep screeds (Sec. 4706).
�Pyr --PP-er roof pitch for roof convering (Chapter 32).
6. ---Roof covering type - (fire hazard).
nSUlation - protection.
8 36" halls and stairways.
ving area over garage - complete 1 -hour separation required on garage side
inclu upporting walls and posts, etc.
1 .Two'—exits exits on three-story dwellings (sec. 3303 & see Mezannines - 1716).
access and ventilation (Sec. 3205).
12. Unn floor access and ventilation (Sec. 2516).
P.En
o bustion air for fuel burning appliances - L.P.G.
irements on duplexes.
1ash design.
16. lashing at all exterior openings.
4-7—.-eD responsible area requirements.
NIsML
r
. ,.
PAI CF N
requirements.
MOTc g 'gc'D c, .-----
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
7 County Center Drive, Oroville, CA 95965 PHONE: 916-538-7541
Barry Scott DATE March 13, 1991
P.O. Box 118 "
Oregon House, CA 95962 RE:building permit application #664-91
A.P. # 73-18-131
With reference to the above subject:
V Attached is:
Application for permit Mobilehome Utilities Installation Sheet
Building Plans Mobilehome Installation Information Sheet
Engr. Calcs Typical Plan Sheet
Owner -Builder Verification Form List of Codes Enforced
OTHER one copy of plans as submitted
We need the following information:
Permit application signed and completed where indicated with all copies returned.
Fees of $ payable to Butte County Treasurer.
Certificate of Workmen's Compensation Insurance or check exemption statement.
Contractor's License Law information or check exemption statement.
Complete plans in including plot plans.
Plot plans in
Structural details in
Complete plans and calcs in by registered -engineer or architect.
Energy design including
Street and drainage improvement plan approval from Land Development Section (DPW).
sets of plans in accordance with the changes marked in red.
�-.Sanitation approval from Butte County Health Department at:
196 Memorial Way, Chico
-%T 7 County Center Dr., Oroville
Skyway & Elliott Rd., Paradise
Planning approval from Butte County Planning Department, 7 County Center Drive,
Oroville, for
Completed Owner -Builder Verification form.
Recorded copy of deed showing
Recorded copy of agricultural acknowledgement statement.
OTHER Submit 2 sets of --plans of--plansdrwwn and printed. representative of bldo
. applied for.
Plans must be to enciled i an ed not Dermittedth
sq. ft. of o en eck Iocati o garage walls? C.E.C. cal s do not match
this bldg. nn
Driveway perms
Marysville School fees
Should you have any questions concerning the above, please contact Bob Keith9,
of this office.
cc: Lew Reynolds
10561 Limerick Ave.
Chatsworth, CA 91311
JFG/aj
Yours very truly,
William Cheff
Director of Public Works
J.F. Glander
Chief Building Inspector
COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS
,� 7 County Center Drive, Oroville, CA 959'65 PHONE: 916-538-7541•
t34 � 5&iT- DATE '311-5.11
�o �x r I Ce RE: 9,
di2�G4u N�ovs� 1
A.P. #
With reference to the above subject:
Attached is:
Application for permit Mobilehome Utilities Installation Sheet
Building Plans Mobilehome Installation Information Sheet
Engr. Calcs Typical Plan Sheet
Owner -Builder Verification Form List of Codes Enforced
V 'O
We need the following information:
Permit application signed and completed where indicated with all copies returned.
Fees of $ payable to Butte County Treasurer.
Certificate of Workmen's Compensation Insurance or check exemption statement.
Contractor's License Law information or check exemption statement.
Complete plans in including plot plans.
Plot plans in
Structural details in
Complete plans and calcs in by registered engineer or architect..
Energy design including
Street and drainage improvement plan approval from Land Development Section (DPW).
sets of plans in accordance with the changes marked in red.
_ Sanitation approval from Butte County Health Department at:
196 Memorial Way, Chico
- 7 County Center Dr., Oroville
Skyway & Elliott Rd., Paradise
Planning approval from Butte County Planning Department, 7 County C"enter Drive,
Oroville, for
Completed Owner -Builder Verification form. _
Recorded copy of deed showing
Recorded copy of agrictrltural acknowledgement statement.
Should you have any questions concerning the above, please contact
of this office.
e 0 e
Yours very truly,
40; 1&yuouo s
/ 0510/ I-Ime t c/C A✓v-
G#54TSkIOM7+ c4
9/V I
JFG/aj
William Cheff
Director of Public Works
J.F. Glander
Chief Building Inspector
� � '1 .
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All; that
follows:
real :property: --situate in the County of Butte, State of California, described as
DESCRIPTION:
All that certain real property situate in the County of Butte, State
of California, described as follows:
PARCEL I:
Parcel 4, as shown on that certain ParcelMaP entitled, "r 1/2 of the SE
1/4 of. the NF. 1/4 of Section 11, T.19N., P..6E., M.D.B. 6 P!.", said
Parcel Map was filed in the Office of the Recorder of the County of
Butte, State of California, on December 20, 1977, in Book 63 of Parcel
Maps, at Page 61.
Date: u I Z — =r)
State of Cald.
SS.
County of )
PROPERTY OWNER
On this the (at) day of , 19c1I , before me, the
undersigned Notary Public, peIrsonally appeared
OFFM SEAL E] Personally known to me.P roved to me on the basis
a---
Wf♦RENOEI tEMEI1. /��NHI��E�$py�� NOTARY �� CAUFORIM
YM CWN11r
MY OOtAA1. EXPIRES ALLY 41991
73 4 /31
Present A.P. No. V9AA D,1�
Notary Public c
EN® ®F DOCUMENT
of satisfactory evidence.
to be the person(s) whose name(s)
subscribed to the within instrument and acknowledged that
executed the same for the purposes therein contained. IN WITNESS
WHEREOF,
I hereunto set my hand and official seal.
9
Return to DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEMENT
FOR RESIDPTIAL DEVELOPIMM
Section 26-8.1 of the Butte County" Code
requires this acknowledgement be recorded
prior to issuance of a building permit.
91-014209
' . Rec Fee 5.00; £,
The property described herein is adjacent
: Check, 5.00
to land or included within an area zoned
Recorded
r
I '!
for agricultural purposes, and residents
Official Records
of this' property may be subject. to incon-
County of
t
veniences or discomfort arising from the
Butte
i
use of agricultural chemicals, including,
� J. Grubbs
but not limited to herbicides, pesticides,.
i Candace
and fertilizers; and from the pursuit
er
XX 1
of agricultural operations including,
10:3gamc12aApr-91
f
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; that
follows:
real :property: --situate in the County of Butte, State of California, described as
DESCRIPTION:
All that certain real property situate in the County of Butte, State
of California, described as follows:
PARCEL I:
Parcel 4, as shown on that certain ParcelMaP entitled, "r 1/2 of the SE
1/4 of. the NF. 1/4 of Section 11, T.19N., P..6E., M.D.B. 6 P!.", said
Parcel Map was filed in the Office of the Recorder of the County of
Butte, State of California, on December 20, 1977, in Book 63 of Parcel
Maps, at Page 61.
Date: u I Z — =r)
State of Cald.
SS.
County of )
PROPERTY OWNER
On this the (at) day of , 19c1I , before me, the
undersigned Notary Public, peIrsonally appeared
OFFM SEAL E] Personally known to me.P roved to me on the basis
a---
Wf♦RENOEI tEMEI1. /��NHI��E�$py�� NOTARY �� CAUFORIM
YM CWN11r
MY OOtAA1. EXPIRES ALLY 41991
73 4 /31
Present A.P. No. V9AA D,1�
Notary Public c
EN® ®F DOCUMENT
of satisfactory evidence.
to be the person(s) whose name(s)
subscribed to the within instrument and acknowledged that
executed the same for the purposes therein contained. IN WITNESS
WHEREOF,
I hereunto set my hand and official seal.
COUNTY OF BUTTE
DEPT. OF PUBLIC WORKS
APR 18 1991
i
COUNTY OF BUTTE
DEPT. OF PUBLIC WORKS
APR 18 1991
- - ---'"'-"-
--•-- -•- -. •.._ Number of stories
R -value . One Two
R-0 -103 -49
R-19 _8 -4
P30 •2 .1
Three
32
.2
1
a S.intinrauon(Air.Lea ks _•
g ::._._
Points
Star7dard 0
~
._ .
R -value
One
... .. _
Three
. Gis�•Heat-boss...
-17
-8
0. 0-...._....
---...0.30
-176::_..._.
84 :-=:-.:-
-54_
.Total---- -
R-19
0
0
R-30
-102
-49
32
Percent
.51 b
.41 to
.31 to
0.30 or
0.10
-26
-13
-8
Glass Single Double
.60
.50
.40
less
0.08
-18
-9
"5
-6
-4
50 -121 -53
•39
-24
•10
4
O.C6
0.02
-11
2
-135
40 -90 37
.26
-14
3
8
t 0.02
d
2
1
•75 -29
30 -61 -21
•19
-13
•9
-t
1
4
10
12
I O.CO
11
5
3
29 -58 -20
-12
-3
5
12
2 4
2
3
4
28 -55 18
-10
2
5
13
0
1 2
1
3
27 -52 -17
-9
.2
6
13
2. Wall Insulation
-1
-1 -1
26 -49 -15
_8
-1
7
14
-2
Single-
Single-
2
25 -46 -14
-7
0
7
14
.2
Family
Family
Multi-
24 -43 •12
-5
1
8
14
R -value
Detached
AttachedFamiy
0
- 23 -40 -11
22 37 -9
-t
3
2
3
8
15
R-0
-68
-51
34-
21 -04 •7
-2
4
9
10
15
15
R-11
0
0
0
20 31 -6
0
5
10
16
R-13
2
2
1
19 -29 -4
1
6
it
i6
R-19
8
6
4
18 -26 3
2
7
12
16
U -value
7
5
4.0
17 •23 -1
16 -20 0
3
4
8
9
12
13
17
17
0.80
-153
-114
-76
15 -17 1
6
10
14
17
0.50
.91.
-68
-i6
14. -14 3
7
10
14
18
• 0.30
-47
-36
-24
13 -12 4
8
11
15
18
0.10
0
0
0
12 -9 6
9
12
15
19
0.08
4
3
2
11 -6 7
10
13
16
19
US
9
7
5
10 3 9
11
14
17
19
' 0.04
14
11
7
9 7 -1 10
13
15
17
20
0.02
19
14
10
8 2 12
14.
16-
18
20
i 0.00
24
18
12
1 •• - -
less -15 S +5
+15
more
8.0
3. Raised Floor Insulation
Insulation in Floor
0.60 .
-144-
Number of stories
-46
R -value
One
Two
Three
R-0
-17
-8
-5
R-11
3
-2
.1
R-19
0
0
0
R-30
3
1.
i
U -value
-11
-6
-4
0.60 .
-144-
-70
-46
0.50
-120
-58
38
0.40
.-95
-46
30
0.30
-69
-34-
-22
0.20
-43
-21
-14
0.10
-17
-8
-5
0.08
-11
-6
-4
0.06
-6
-3
.2
0.04
-1
0
0
0.02
A.
1 2
1
0.00
10 .
5
3
Controlled Ventilation Crawlspace
-4
3 .1
Number of stories
-i
R -value
One
Two
Three
R-0
-11
-7
-5
R-5
-t
-4
3
R-11
2
-2
•2
R-19
-i
-2
.2
4. Slab Edge Insulation
na
i6
4.
Number of Stories
1
R -value
One
Two
Three
• R-0
0
0
0
R-5
8
5-
2
R-7
8
6 .
3
F2 facmr
0.90
-4
3 .1
0.60
-i
-1 0
0.70
2
2 1
0.60
6
4 2
0.50
9
6 3
0.40
12
8 4
7.,Shading (Shade Open)
Single.
Single -
12. Cooling Syst•!m
---
Wectlye Fes em it Gt xu
%Gust
North
East
(percent ylltss x SC)
West
Skylight
Effective
-14
_11.8
-69
-64
a Glass
North
East South- :West
-12
Skylight
18
5.
. _ . 1 . 4
1
na
i6
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 i
0
3
1
-1
-1 -1
-1
2
0
-1
-2 -4
-2
0
na - not allowed
2
3
4
& Shading (Shade Closed)
EfrectlYe Percent Glow
(percent &lass x SGS
Edectim
Single.
Single -
12. Cooling Syst•!m
Wall
Family
%Gust
North
East
Soud1
West
Skylight
18
-14
_11.8
-69
-64
ria
i6
-12
-12
•59
-55
na
14
-10
35
-50
-116
na
12
-a
-29
-110
-37
na
11
-7
-26
-36
-33
na
10
3 -
-23
31
-29
•74
9
-5
-20
-27
-25
05
8
-5
.17
-23
•-21
-56
7
-1
-14
-19
-18
-47
6
.3
-it
-15
id
-38
5
.2
-9
-11
-10
-30
d
1
-6
-8
-7
.23
3
0
.4
-5
-4
•16
2
1
1
2
t
•9
1
1
1
1
1
-4
0
2
3
4
3
0
9. Interior. Thermal Mass
Single.
Single -
12. Cooling Syst•!m
Wall
Family
interior
Mufti
Slab Floor
Detached
Raised Floor
Family
0.00
0
0.
Mass
0.20
Slodes
2
1
Ssxies
5
4
SEER
0.60
8
/CFA
One
Two Three
One
Two
Three
1.00
(issumel ducts In attic)
10
0.0
-8
-5
-4
-2
-t
-1
13
I Sim of 7-10
1.60
10
0:1 • - $ -.
.._43_7_____.
- -5 �-^.i
---1
p ....._
0
12
-25 or •24 to A4 b -4 b'-
+6 E0
16 of
� ._...
-2___.-.0.._.._
_1 __. L.-.
�;.. SEER_ fess:--•t5•c:f ��---+5.._+ -_
7
0.95
8.71
20
18
15
13
11
8
HWR
8
_ b7 -
- 5...,..:2.,._._._1.•:--1
3
: -- 2
-2..__
8.0--°14• .12 -t0 .. -8
3
-d ..
0.9
-5
.1
0
2
3
3_
85
•9 -7 -6 .5.
-4
3
1.1
-4.
-1
1
3
4
4
8.9
-5 -t -4 3
-2
-2
1.3
-3
0
2
3
4
5
9.0
.A 3 3 -2
.2
-1
1.5
•3
1
2
4
5
5
9.5
0 0 0 0
0
0
20
-1
2
4
5
6
7
10.0
It 3 3 2
2
1
25 •
0
3
5
7
7
6
10.5
7 6 5 4
3
2
3.0
1
4
6
8
8
9
11.0
10 9 7 6
4
3
3.5
2
5
7
9
9
10
-. 120 '
15 13 11 9
7
5
4.0
3
6
8
9
10
10
13.0
23 17 14 12
9
6
4.5
3
7
8
10
11
11
Cf 864
-
b
- -
5.0
4
7
9
11
12
12
2189
EftedlYe SEER
SG
None
5.5
5
8
9
11
12
12
14
(SEER xluct etTiciene7)
5-
6.0
5
8
10
12
13
13
2
2
16
WSa
6.5
6
9
10
12
13
13
9
Sim of 7-10
3
2
7.0
6
9
11
13
13
14
Efiecive•25 or -24 to -1410 -4b
+6b
16 or
7.5
6
10
11
13
14
14
SEER
less -15 S +5
+15
more
8.0
7
10
11
13
14
14
-5
EQU
-23
8.5
7
10
12
13
14
15
5.0
30 -25 -21 -17
•13
.9
4.2
Soiar
6
3
2
1
1
6.0
•12 -11. -9 -7
3
-4
0
0
0
IE
None
30
15
6.6
Ta.
-5 -4 .4 3
0 0 0 0
6 5
..-2
0
4
.2
0
3
Solar
10. Exterior Wall Thermal Mass
Exterior
Single.
Single -
Sum of 1.6
Wall
Family
Family
Mufti
Masa
Detached
Atbdied
Family
0.00
0
0.
0
0.20
3
2
1
0.40
5
4
3.
0.60
8
6
4
0.80
10
8
5
1.00
13
10
7
1.20
13
12
8
1.40:
12
13
9- t,
1.60
10
13
11..
1.80
10
12
12
2.00
10
11
13
11. Heating System
SE or RSPF
(assumes ducts In atUc)
Zonal Control Adjustment
System Type
Resismnce 10 9 7 6 4 3
Other 6. 5 4- 3 2 2
8.0
9.0
9
16
8
14
Sum of 1.6
9
7
5
10.0
_
.25 or
-24 to
-14b -4 to
+6 b 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
HWR
8
Etrective
SE or HSPF
3
3
(SE or HSPF x duct
of Iciene7)
5
EfTec�ve -25
or -24 to -14 to
-4to
+6 to
16 or
SE
HSPF
less
-15
-5
+5
As.
more
0.30
275
-73
•64
-56
-17
38
-30
na
3.41
-45
-39
-34
•29
-24
-I8
0.40
3.67
-34
-30
-26
-22
-18
-14
0.50
4.58
-10
-9
-8
-7
•5
-t
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
i.00
9.17
37
32
28
24
19
. 15
Zonal Control Adjustment
System Type
Resismnce 10 9 7 6 4 3
Other 6. 5 4- 3 2 2
8.0
9.0
9
16
8
14
12
9
7
5
10.0
22
19
i6
13
10
7
11.0
26
23
19
15
12
8
120
30
26
22
18
14
9
13.0
33
29
24
20
15
10
1200
Zonal
Control
Adjustment
Heater
Credit
10
8
7
6
4
3
Point System Summary: Climate Zone 11
SCORE CARD
Measures
1. Ceiling Insulation or
R -value (381 U -value 10.0301
2. Wall Insulation' `-' or
R -value (111 U -value 10.0981
3.
\'o Cooling System Installed
-Stories
Eff. % Glass
a. North
R -value (19)
=
U -value (0.0371 . .
One
-5
-t
d
-3
-2
-2
Two +
3
3
2
2
2
1
Single -Family
Detached and
Attached
x
=
Unit Sita (sq
- '�
Water
1139
1200
1700
2200
2700
Heater
Credit
-or •1
b
to
to
or
Type.
Type
lass
',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
5%
INS8
5
3
3
2
2
50%
POU
8_
5
J.
3
3
SE
None
37
.24
-18
-15
-12
0.6
Solar
-1-1
_:2.7.._Z9_
-1
0
0
HWR
18
•12
-9
•7
•6
-, 1.S
WSa
-25
-is
-12
-10'
-a
POU_
•18
_ -12
•9
•7
-6
1G
None
•5
-3
.2
-2
•2
1.4
Solar
7
5
4
3
2
•
POU
3
2
1
1
1
IE
None
-28
-19
•14
-11
-9
0.5
Solar
8
5
4
3
3
222
POU
•10
-6
•5
-4
-3
3.5
Multi-Famitl
(Indlvldual
units)
4.3
4.5
4.7
4.9
Unit Size (sq
5.3
56
Water
40%
699
700
1200
1700
2200
Healer
Cf 864
or
b
to
to
or
TYPe
Type
less
1199
1699
2189
mare
SG
None
0
0
0
0
0
or
Solar
14
7
5-
4
3
HP
HWR
9
5
3
2
2
16
WSa
9
4
3
2
2
S.1
POU
9
5
3
2
2
SE
None
-45
-23
'-15
-11
•9
24
Solar
2
1
1
0
0
19
HWR
-23
.12
-8
3
•5
5.3
wsa
.25
-13
-a
-6
-5
EQU
-23
_12,.
_8
•6
-5
C
None
-8
-4
.3
•2
-2
4.2
Soiar
6
3
2
1
1
S6
POU
t
0
0
0
0
IE
None
30
15
-t0
-8
-6
3
Solar
18
9
6
4
4
4.S
POU
-a
-4
-3
-2.
-2
Point System Summary: Climate Zone 11
SCORE CARD
Measures
1. Ceiling Insulation or
R -value (381 U -value 10.0301
2. Wall Insulation' `-' or
R -value (111 U -value 10.0981
3.
Raised Floor Insulation
or
Eff. % Glass
a. North
R -value (19)
=
U -value (0.0371 . .
'
Slab Edge Insulation
x
Interior MassICFA
c. South
R-Y&Iuc (01
=
F2 !scut (0.771
5'.
Infiltration
. Ty" 2 "SS
=
-
6.
Glass Heat boss -
x
=
• •
- '�
Type [dcublel
U -value 10.651 90 Total Glass (161
7.
Shading (Shade Open)
TYPE 1 `LASS
-:
%Glass
SC: Eff. % Glass
AREA
a. North`- -.: " :
10. Exterior Wall Mass
x
I1. 7.uIK •.. 71
ie. rv.e.a •tent
TYPE 2 KASS
b. East
x
=
�
AREA
't TTI'C
1 KASS
(UIMC
1 4.2,
let exposed
sIa0)
=
'
e. Skylight
Duct Efficiatcy,[0.781
x
=
8.
Shading (Shade Closed)
0%
5%
110%
IS% 20%.
15%
30%
35% 40%
4SY.
50%
55%
60%
65x
17%
7S%
60%
85%
90%
95% t00% 105%
1101. 115% iM 125:!
0.2-0.4._
0.6...
0.6
1.1. -1.1-13-
_.1.7 .1.9•-21-•...23-..25
_:2.7.._Z9_
12.14..._J.8'_='.3.8
10%
10":" a2
' 0.4_ -'air
:
0.d.: 1 _ 1.2.'•.1.4
-, 1.S
:„1.9 _.21:_.21:.
25....27.._29..
11...13...15_.
17 -
4-•-- 4.2: 4.4:-
4.6•-•4.6....5-"-52'-_
5'4
1
1.2
1.4
1.5
1.6
2
22 24
21
29
3.1
3.3
SS
17
19
4.1
4.3
4.5
4.6
5
52
5.4
56
30%
0.5
0.7
0.9
1.1
1.4
1.6
1.6
222
24
26
26
3
3.2
3.5
17
39
4.1
4.3
4.5
4.7
4.9
5.1
5.3
56
S 8
40%
0.7
0.9
1.1
1.3
1.5
1.7
1.9
22
24
26
116
3
12
3.4
16
3.6
4
4.3
4.5
4.7
4.9
5.1
5.3
5.5
5.7
5 9 i
50%
0.9
1.1
1.3
15
1.7
1.9
21
- Z3
2S
27
1
31
14
16
16
4
42
4.4
4.6
4.6
S.1
5.3
5.5
5.7
5.9
6.1 i
SS%
0.9
1.1
1.4
1.6
1.8
2
22
24
26
28
3
12
SS
3.7
19
4.1
4.3
4.5
4.7
4.9
S.1
5.3
5.6
58
6
62
60%
11.2
1.4
1.7
1.9
2.1
23
25
27
29
11
13
1S
1.6.
4
4.2
4.4
4.5
4.6 '
S
5 2
5.4
S6
5.9
6.1
63
65%
1.1
1.3
1.5
1.1
1.9
22
24
2626
3
12
14
36
3.6
4
4.3
4.S
4.7
4.9
S.1
53
55
5.7
5.9
6.1
6 4
70%
1.2
t.4
1.6
1.8
2
22
2S
27
29
11
13
1S
17
19
4.1
4.3
4.6
4.6
S
52
5.4
56
so
6
6 2
64
75%
1.1
15
1.7
1.9
21
23
25
27
3
3.2
14
15
16
4
4.2
4.4
C6
4.8
5.1
5.3
SS
5.7
5.9
6.1
6.3
65
wy.
1.4
1.8
1.6
2
22
24
'25
26
3
13
15
17
19
4.1
4.3
4.S
4.7
4.9
5.1
54
56
5.6
6
62
64
66
85Y.
1.4
1.7
1.9
21
2.3
25
27
29
11
3.3
3.S
11
4
4.2
4.4
4.5
4.1
5
S 2
54
5.6
59
6.1
63
6 S
6 7
90Y.'
1.51.7
2-
22
24
28
28
3
3.2
14
16
1t
4.1
4.3
4.5
4.7
4.9
5.1
53
55
5.7
5.9
62
64
66
66
95 Y.
1.6
1.8
2
22
25.
27
29
11
33
15
11
19
11
4.3
4.6
4.8
5
5.2
5.4
5.6
5.8
6
6.2
6.4
6 7
69
1100 .7:.
141
19
2.1
2.3
25
26
3
12_
14
- 3.6
16
l
42
4.4
4.6
49
S.1
5.3
55
5.7
5.9
6.1
43
6.5
6.1
7
105%
1.6
2
22
2.4
26
26
3
13
3.5-
17
19
4.1
4.3
4.5
4.7
4.9
S.1
5.4
Se
5.8
6
62
6.4
66
6 6
7
110%
1.9
21
23
1.5
27
29
3.
13
3.6
3.8
4
4.1
4.4
4.8
4.8
5
5.2
5.4
5.7
S.9
6.1
6.3
65 .
6.7
69
7.1
1115%
2
22
24
26
28
3
3.2
14
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
6.6
6.8
7•'
72
120%
2
23
25
2.7
29
3.1
3.3
15
17
3.9
4.1
4.4
4.6
4.8
S
5.2
5.4
5.6
5 8
6
6.2
61
6.7
6.9
7.1
73
125Y.
21
23
25
26
3
3.2
14
3.6
18
4
42
4.4
4.6
4.9
5.1
5.3
55
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 or
R -value (381 U -value 10.0301
2. Wall Insulation' `-' or
R -value (111 U -value 10.0981
3.
Raised Floor Insulation
or
Eff. % Glass
a. North
R -value (19)
=
U -value (0.0371 . .
4.
Slab Edge Insulation
x
or
c. South
R-Y&Iuc (01
=
F2 !scut (0.771
5'.
Infiltration
Standard
=
-
6.
Glass Heat boss -
x
=
Type [dcublel
U -value 10.651 90 Total Glass (161
7.
Shading (Shade Open)
TYPE 1 `LASS
-:
%Glass
SC: Eff. % Glass
AREA
a. North`- -.: " :
10. Exterior Wall Mass
x
=
TYPE 2 KASS
b. East
x
=
c. South.
AREA
x
=
d. West
x
=
SE or HSPF
e. Skylight
Duct Efficiatcy,[0.781
x
=
8.
Shading (Shade Closed)
HSPF (0.5615.151
12. Cooling System
Point Scores
PniirrTnrnl•
Sum 7.10
% Glass
SC
Eff. % Glass
a. North
x
=
b. East
x
=
c. South
x
=
d. West
x
=
e. Skylight
x
=
9. Interior Thermal Mass
TYPE 1 `LASS
AREA 9
IntcriorWiwCFA
COND. FLOOR
AREA
10. Exterior Wall Mass
TYPE 2 KASS
AREA 5
r
_-
Exterior Wall Mast
N0. FLOOR
AREA
11. Heating System
x
Zonal Control? ( Y IN
SE or HSPF
Duct Efficiatcy,[0.781
Effective SE or
(0.7116.61 . -
HSPF (0.5615.151
12. Cooling System
x
Zonal Control? (YIN)
SEER (9.51
Dua Efficiency (0.741
Effective SEER (7.031
13. Water Heating
=_
_ .. .
Type (.IGI- - Credit (noncl. -
Point Scores
PniirrTnrnl•
Sum 7.10
Certificate of Compliance: Residential _ -
'Climate Zone 11
Project Tlun
_._- _ -- _ ._ _.. _ • Buildin Permit all
no -jest Aadresa
Checked By/ Data
Documentation Author Telephone Enforcement Agency Use Only
BUII.,DING DATA
Conditioned Floor Area
Slab/Raised Floor -
[ ] Single Family Detached (SFD)
[ ] Single Family Attached (SFA)
[ ] Multi -Family (NIT)
Number of Stories
Number of .Units
[ ] Addition -Alone
[ ] Existing Building
[ ] Existing -Plus -Addition
Glass Area 9b Glass
North
East
South
West
Skylight
Total
BUILDING SHELL INSULATION- '
Component Insulation L ocatzorVr_--:lmmencs .. .
Tyke _ R -Value (esac. to garage, =ice?, etc -j:
.
Wail .............. _....
Wall ..............
:. _.. -Roof ...:.........
Roof ............. _
Floor.............
Floor r ..............
Slab- Edge ... _
X ..._.GLAZING Shading Devices -
_ Glazing "Area Glass Type Interior .. Exterior Overhang Framing Type -
Orientation (sf) (single, double) (Tolls blind, etc.) (shatdescreen, etc.) YeVno) (rnetaltwood)
Yo flit C )
No nth ( )
East C )
East C )
South ( )
South ( )
West ( )
West ( )
Skylight.......
THERMAL MASS
"Type/Covering Area "'Thickness
(slab/exposed, tile, etc.) (sf) (inches) Location/Description (kitchen, bath, etc.)
HVAC SYSTEMS Minimum Duct
Type (furnace, air Efficiency Locadon Duct Output Manufacturer / Model #
conditioner, hen pump) (SE, SEER,HSPF) (attic, etc.) R -Value (Btuh) (or approved equal) n
Maximum Furnace Heating Output: Btuh
HOT WATER SYSTEMS Tank Manufacturer/Model#
System T (storage gas, etc.) Capacity (or approved equal) Special Feature(s)
SPECIAL FEATURES/REMARKS (Add extra sheets if necessary)
Mandatory Measures Checklist: Residential MF -IR
NOTE. Lo.aist residential buildings subject to the Standards must cor=n these meesturs mprdksa of the mmpt'tance
agprwe4uscd._ltemtm�rtnt ...:th.an.este:ssY (•) taay.beatpascded by tnotesauttmtcon+9lian¢ roquuemmafisted ._..
on the Cuurw-= of Compliance. When this chocsrn
is inoxpaated into the permit documatts, the (enures ttoeat than
.. •-etxuidereQDr alt paRnes asbimmngminaaurn component pcformu+a spoarw",on• fee the mandatory meistsei ._ .._.r
_ __.y_they,a�rsho�+rasa.l+ereinwseoocmmmaoroan+iacneahisternly-:.—_._-_.�._.��_....__.-��.r.�--__.....••-..--.---.--_ _ ... .-- .. - -.-• -
oESCRIrnom DESIGNER ENMItC049 r
auitdinL Envelope Measures .
•
12.3332(3). Minimum coling insulation R-19 weighted avenge.
§2.5352(b): Loose fill insulation muwfaaurrt's tabckd R.Vahte.
§2.5352(c): Minimum .wall insulation in fraancd vralta R -I I weighted average (dors not apply to -
e3tenor nus walls).
§2.5352(k): Stab edge insulation - wuet absorption rate no greater than 03%. water vapor
uansmtsslon rate no greater than 2.0 pznr.(u ch.
12-5311: Insulation spoetrted or installed mccss California EntcW Commission (CEQ quality
stadudL Indicate type and form.
42.5352((): vapor barriers mandatory, in Climate Zones 14 and 16 only.
12.5317: lnaltr tJOWEsrtlts26«,Ccnnols
a. Doors and windows between conditioned and unconditioned spaces designed to limit air
leakage
b. Dom" windo-s rrrtiftr_d.
c. Doors and windows wc2u ersuipp:d: au joints and penetrations caulked and sealed.
12-5352(c): Special inrdaation burin installed to comply with 12-5351 moxas CEC quality
surtdards.
12-5352(d): Installation oaf Fireplaces
1. Masonry and fatsory-built rucplxes have
a.Tight rating, closeable meal or glass door
b. outside au intake with damper and control
e Flue damper and control
2. No continuous twitting gas pilus allowed.
HVAC and Plumbing System Measures
12-5352(8) and 2.5303: Space corndiuitrting equipment sizing: atach csicvlations.
§2-5357(h) and 2-5315: Seth—, thermoset on all applinbte heating systesns.
•
12-5316(x): Ducts cans meted, installed and insulated per Chapter 10. 1976 UMC.
§2.5316(b): Eahuust systems have tramper controls.
42.53I4(c): Gas -rued space heating equipment has intermittent ignition devices.
42-5314: HVAC equipment., waterheaters, showchcads and faucets certirtod by the CEC.
§2.33520: water heater insulation blanket (R. 12 or greater) or combined inoerialuteriee
insulation (R-16 or grater): rasa 5 feet of pipes ctoscu to uruk inadated (R-3 or great").
J2.J312(Faccption 0: Pipe insulation on steam and steam condensate return &recirculating
piping.
§2.5319(d): Swimming Pool Heating
I. System
a_ On/off switch on heater. .
b. Weathcrproof instruction plate on heater.
e Plumbed to allow for solar. _
2. 75 percent thermal etrieieney.
3. Pool cover. - -
a, Time clock.S. Directional water inlet
Uthtint and Appliance Measures
12.5352tax Lighting - 25 lumerts/waa or greater for general lightint in kitchens and bathrooms.
42.5314(c): Gu rued appliances equipped with intermittent ignitiow devices.
12.5314(a): Refrigerators, mfrigrrator-frtoer"s, freezers and fluorescent lamp baltasu certified
by the CEC Indicate make and model number.
COMPLIANCE STATEMENT
This certificate of compliance lista ter building feat= and performance sp c:ifications 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 de individual widi overall. design responsibility and the building owner. who Shall
retain a copy of it and aarLshnit the certificate to my subsequent purrtlaser of the.: building -
Designer Building Owner
Name Name
Tstk/Fum: TttkJF m -
Adders:: Address:
Tcte•phonc "Tctephonc
U_ 1-
(sirstantrc) (date) a (sibnanae) _ _- (date)
Documentation Author Enforcement Agency
Name -: Nuns
TiticJFum - -Acency -