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017-180-024
J . PAWLEDGE KAREN AND JOSE MATA �i. E ADMINISTRATIVE PERMIT .1� f Honey Run Rd, app a- m A, TEMPORARY E ered Bridge, Chico 4/4/99 Perwit #6154-77P,E (relocate util 011-110-024 99-2636 existin site) S ELEC . A Qm _ 0 011-110-024 99-1101 :. MATA, TONY GAS l j-26 - 3 �� PAWLEDGE, Jack 1869 HONEY RUN ROAD, CHCO SUPPORT STRUCTURE REQ .c Honey Run Road, Chico CONTR: JIM HAASE �� Q COMPACTION TEST REQ.— ND Contr: Slycrest i'• �� ,A _ OPEN DECK Y 1�I�1{i MHI (MHU 99-1100)''"1 011-110-024 99-2637 ` Permit #6155-j771T] %l7/%g MATA, TONY y, Issued B08-0590 017-180-024 �� 1869 HONEY RUN ROAD, CHICO MISCELLANEOUSi CONTR: JIM HAASE 11-11-24 Remodel; GARAGE CONVERSION (611) FIRE SPRINKLERAC & _ S _ _ JOLETTA PAWLEDGE 011-110-024 99-2652 gy�pp' 1869 Hone n Rd, Chico 1867 HONEY RUN RD MATA, TONY Q f, (util,, MH) , p �� MATA, JOSE A &KAREN LEE Permit#773-89 h y"y �I 1 ELEC. vZGbff cJ �f �ec(� 1869 HONEY RUN ROAD, CHICO GAS CONTR: OWNER SUPPORT STRUCTURE REQ. CHANGE OCCUPANCY COMPACTION TEST REQ. o .. _11-11-2' % ContR: �F:�e - Per #1229-89MBI/ ' ,011-11.0.024 99-0755 W,,11 A., '.Cony & Karen 186911c�.cy Run Road, Chico Contr: James M. Haase P New Single Family `� 011-110-024 100 PAWLEDGE, Jack (1 .-t&' Honey Run Road, Chico 7 Contr: Skycrest MHU ELECTRIC GAS COMPACTION TEST R SUPPORT STRUCTURE Iry allot BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT 24 HOUR INSPECTION (IVR): (530) 538-4365 OFFICE: (530) 538-7541 FAX#: (530) 538-2140 ONLINE PERMIT/RENEWAL PAYMENTS: www.buttecounty.net\dds PROJECT INFORMATION Site Address: 1867 HONEY RUN RD Owner: Permit NO: B08-0590 APN: 017-180-024 MATA, JOSE A & KAREN LEE Issued Date: 05/29/2008 By KCG Permit type: MISCELLANEOUS 1867 HONEY RUN RD Subtype: Remodel CHICO, CA 95928 Expiration Date: 05/29/2009 Description: GARAGE CONVERSION (611) (530) 345-1459 Occupancy: Zoning: Contractor Applicant: Square Footage: TROUDY CONSTRUCTION INC TROUDY CONSTRUCTION IP Building Garage Remdl/Addn 29 PORCHLIGHT COURT 29 PORCHLIGHT COURT 611 CHICO, CA 95973 CHICO, CA 95973 Other Porch/Patio Total (530)624-3228 (530)624-3228 611 FEE INFORMATION DBEH Building Review Fee $78.90 DBMSC Remodel -Residential $1,024.83 Total Charged: $1,103.73 Fees Paid: $1,103.73 Balance Due: $0.00 Receipt No: B6887 LICENSED CONTRACTOR'S DECLARATION OWNER / BUILDER DECLARATION Contractor (Name) State Contractors License No. / Class / Expires I HEREBY AFFIRM UNDER PENALTY OF PERJURY that I am exempt from the Contractor's License TROUDY CONSTRUCTION INC 479078 / B / 10/31/2009 Law for the following reason (Sec. 7031.5), Business and Professions Code: Any city or county that requires a permit to construct, alter, improve, demolish, or repair any structure prior to its issuance, also requires the applicant for such permit to file a signed statement that he or she is licensed I HEREBY AFFIRM UNDER PENALTYgF PERJURY that I am licensed under provisions of Chapter 9 (commencing with Section 70 0 Sion 3 of the B ' ess and Professions Code, and my license is in fj effect pursuant to the provisions of the Contractor's License Law [Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code) or that he or she is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects 05/29/2008 the applicant to a civil penalty of not more than five hundred dollars [$500]; Please check one of the following: Contractor's S[gnat re Date ZI ❑ I, AS OWNER OF THE PROPERTY, OR MY EMPLOYEES WITH WAGES AS THEIR SOLE COMPENSATION, WILL DO THE WORK, AND THE STRUCTURE IS NOT INTENDED OR WORKERS' COMPENSATfaN DECLARATION OFFERED FOR SALE (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of the property, who builds or improves thereon, and who does I HEREBY AFFIRM UNDER PENALTY OF PERJURY one of the following declarations: the work himself or herself or through his or her own employees, provided that such improvements ❑I HAVE AND WILL MAINTAIN A CERTIFICATE OF CONSENT TO SELF -INSURE FOR are not intended or offered for sale. If, however, the building or improvement is sold within one WORKERS' COMPENSATION, as provided for by Section 3700 of the Labor Code, for the year of completion, the owner -builder will have the burden of proof that he or she did not build or performance of the work for which this permit is issued. improve for the purpose of sale.). I HAVE AND WILL MAINTAIN WORKER'S COMPENSATION INSURANCE, as required by ❑ I, AS OWNER OF THE PROPERTY, AM EXCLUSIVELY CONTRACTING WITH LICENSED CONTRACTORS TO CONSTRUCT THE PROJECT (Sec. 7044, Business and Professions Code: 1:!L -Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. The Contractors License Law dows not apply to an owner of the property who builds or improves My Workers' Compensation insurance carrier and policy number are; thereon, and who contracts for the projects with a contractor(s) licensed pursuant to the Carrier: State Fund policy Number: 3004410 Exp. Date -.01/01/2009 Contractor's License Law.). (This section need not be completed if the permitis or one e�llars ($100) or less.) ❑ I AM EXEMPT under Section B. & P.C. for this reason: ❑I CERTIFY THAT IN THE PERFORMANCE OF THE WORK FOR WHICH THIS PERMIT IS ISSUED, 1 shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California, and agree that if I should become subject to the workers' X 05/29/2008 compensation provisions of Section of the Labor Code, I shall forthwith comply with those Owner's Signature Date prow s' X 05/29/2008 I hereby certify that I have read this application and state that the above information is correct. I agree comply with all City and County ordinances, rules, regulations, and State laws relating to building Signature Dateto N COVERAGE IS UNLAWFUL, WARNING: FAILURE TO SECURE WORKERS' COMPE CNA)IES construction, and with any and all conditions of permit. I agree to defend, indemnify, and hold harmless Butte Coun ty, its agents and employees from any and all claims and liability for personal AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL P AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS (5100,000), IN ADDITO THE COST OF COMPENSATION, Bath,officea, injury, including death, and property damage caused by, arising out of, or in any way cennected with the issuance of this permit. I hereby acknowledge that issuance of this permit does not authorize the DAMAGES AS PROVIDED FOR INSECTION 3706 OF THE LABOR CODE, INTEREST AND use or occupancy of any sidewalk, street, or subsidewalk. I hereby authorize representatives of Butte ATTORNEY'S FEES. County to enter�theabve me ' ned property for inspection purposes. I hereby certify that I am the p o eruth .z to act o the property owners behalf. ;t T" 05/29/2008 CONSTRUCTION LENDING AGENCY I HEREBY AFFIRM UNDER PENALTY OF PERJURY that there is a construction lending agency for Name of Wrffiftee IS Print Date the performance of the work for which this permit is issued. (3097 civ, code) OwnerContractor OR Agent for Owner Agent for Contractor LLL����`� FILE COPY Lender's Address City State Zip BUTTE COUNTY DEPARTMENT OF DEVELOPMENT SERVICES BUILDING PERMIT APPLICATION* OFFICE #: (530) 538-7541 FAX #: (530) 538-2140 A FEE WILL BE REQUIRED AT TIME OF APPLICA TION Website: www.buttecounty.net/dds PLEASE PRINT CLEARLY PERMIT o _ 6576 BIN # "When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. OWNER INFORMATION Last Name— First ONS Mailing Address City _ St Zips // Phone 1` Fax E-mail ARCHITECT/ENGINEER CONTRACTOR NameE,. �3 c--.� t�� Ul J Address � � � �. City O State ct Phone J �..5 Fax E -mai �uvJ 5/3C, t�ir L Lic. #/I Class G f ARCHITECT/ENGINEER Name _fie L A /`t� Address city i� �✓ / Phone�22-� Fax Phone 72 E-mail State License Number APPLICANT INFORMATION Name Address 7 �� City ` C _ �✓ / Zi,� Phone 72 Fax i E /' ' r� s c APP /CANT NATURE X PROJECT LOCATION Property Address City FA WORKER'S COMPENSATION Policy Numbe Carrier �dU j b 1 (off— (JI 10� If hiring anyone other than licensed contr cto , a certificate of worker's compensation must be shown at the time of permit issuance. LENDING AGENCY Name Address q DESCRIPTION OR SCOPE OF WORK.- Lee' ORK. n Scl FT- Living Garage Open Cov ❑ Structure Built without Permits ❑ Proposed Change of Occupancy (Note previous use): For office use only: Zoning Flood Zone SRA No Occ. Type Const. z N1 v vrs.l. I Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds NOTICE TO BUILDERS" Before your building permit can be issued, your plans must be checked for compliance with the California Building Codes. In addition, your plans are routed to other regulatory entities including but not limited to Planning, Public Works, Environmental Health, and the California Department of Forestry for their clearances and approvals. There are some things you can do to expedite your permit: 0 Make sure your application is complete. O Be responsive to requests from County departments for any additional materials or requirements. The Building Division places its highest priority on processing building permits as quickly as possible and each day that passes without a complete application adds to processing time. Every permit issued by the Building Official shall expire and become null and void if the work authorized by such permit is not started or completed within one year from the date of issuance of such permit. A permit may be renewed (for a fee) prior to expiration an indefinite number of times, provided construction progress has been documented by the Building Division during each year during scheduled inspections. No changes may be made in the original plans and specifications for such work. In order to reinstate action on a permit after expiration, the permittee shall pay a new full permit fee and additional plan checking and documentation may be required. Upon completion of work covered by this permit, please contact this office for final inspection. As a reminder to you, it is illegal to occupy this building or any portion of the building for which this permit is issued without a final inspection. EXPIRATION OF PERMIT APPLICATION AND REFUND POLICY" Application for which a permit has not been issued will expire one year after date of application. Refunds may only be made upon written request by the person who originally paid the fees. Refunds for permit applications, if the permit has not issued, but not after 180 days from the date of fee payment. Fees paid at the time of application are for Plan Check and administration. The Plan Check portion of fees is refundable only if the permit is cancelled or withdrawn before any plan checking is done. Building Division costs will be deducted prior to authorizing a refund and a charge to process the refund application will be assessed. Refunds on permits (issued) may be requested prior to the expiration of the permit, provided no work has been done pursuant to the permit. An Inspection may be required (and deducted from any refund amount) to determine no work was done. Fee/refund information can be read on-line at http://municiDalcodes.lexisnexis.com/codes/butteco/ "When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. Reference Number: B08-0590 Date: 04/02/2008 Location: 1867 HONEY RUN RD Parcel Number: 017-180-024 Owner Name: MATA, JOSE A & KAREN LEE Phone: (530) 345-1459 Description: GARAGE CONVERSION (611) Signature of Applicant: Date: 04/02/2008 FI Butte County Department of Development Services TIM SNELLINGS, DIRECTOR I PETE CALARCO, ASSISTANT DIRECTOR 7 County Center Drive Oroville, CA 95965 (530) 538-7601 Telephone (530) 538-2140 Fax www.buttecounty.net/dds "PERMIT APPLICATION DATA SHEET" Reference Number: B08-0590 Date: 04/02/2008 Location: 1867 HONEY RUN RD By: KEJ Parcel Number: 017-180-024 Sub Type: Remodel Owner Name: MATA, JOSE A & KAREN LEE Phone: (530) 345-1459 Description: GARAGE CONVERSION (611) 171 The above permit application has the following Clearances required prior to permit issuance. Please contact each department indicated below regarding specific requirements pertaining to your permit application. Yes No SEWER DISTRICTS ❑ M Thermalito Irrigation District, 410 Grand Avenue, Oroville CA 95965 - (530) 533-0740 ❑ ❑ LOAPUD, 1960 Elgin Street, Oroville CA 95966 - (530) 533-2000 City of Chico, PO Box 3420, 411 Main Street, Chico CA 95927 - (530) 879-6700 PARKS & RECREATION DISTRICTS ❑ Chico Area Recreation District, 545 Vallombrosa, Chico CA 95926 - (530) 895-4711 ❑ Durham Park & Recreation District, 9447 Midway, Durham CA 95938 - (530) 345-1921 ❑ Feather River Recreaction & Park District, 1200 Myers Street, Oroville CA 95966 - (530) 533-2011 ,l ❑ Paradise Parks & Recreation, 6626 Skyway, Paradise CA 95969 - (530) 872-6393 Recorded copy of Agricultural Acknowledgment Statement- See Attached Instructions City of Biggs Planning Department, 3016 Sixth Street Biggs CA 95917 - (530) 868-5447 Other: ❑ Other: "When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. T _ Z--� Signature of Applicant: FILE Date: 04/02/2008 SCHOOL DISTRICTS Biggs Unified School District, 300 B Street, Biggs CA 95917 - (530) 868-1281 0 Chico Unified School District, 1163 East 7th Street, Chico CA 95926 - (530) 891-3006 ❑ Durham Unified School District, 4920 Putney Drive, Durham CA 95938 - (530) 895 4675 El ❑ Gridley School District, 429 Magnolia, Gridley CA 95948 - (530) 846-4723 ❑ Marysville School District, 1919 B Street, Marysville CA 95901 - (530) 741-6000 171 Oroville Elementary School District, 2795 Yard Street, Oroville CA 95966 - (530) 532-3000 Oroville Union High, 2211 Washington Ave, Oroville CA 95966 - (530) 538-2300 Ext:105 Paradise Unified School District, 6696 Clark Road, Paradise CA 95969 - (530) 872-6400 OTHER Recorded copy of Agricultural Acknowledgment Statement- See Attached Instructions City of Biggs Planning Department, 3016 Sixth Street Biggs CA 95917 - (530) 868-5447 Other: ❑ Other: "When filed, this application and all supporting material becomes subject to the California Public Records Act. All public information related to this application is subject to public inspection and will be posted on the County's website for electronic access. T _ Z--� Signature of Applicant: FILE Date: 04/02/2008 ELECTRICAL 5YN00L5 6 swuc ann vnrrua � anr:. wrarruc •e vs roranrnrae •S rwnn rvcmncle •ecrl artn �mrnerrraornrmaon •B:»+ lmv wnPx rrim,vae b uaEwaVtRx nv[rrnnt O aorn antr ¢ osorwo eeveesc rusrt uax p aecm rv+msravr ue«ruox ¢ wuaaxr elcvuxort te«ruax. adi nvrm�srlmsmacwx area xrwv ow Wvsrauisrone«r n'(.1 MLrlunrlxN¢ �IL fIOq NatfuM[ 513nfE N?.xf®ND2YA R[rlfE f f f ! swur; rN¢crox. rert Ine oaro� p w!a y.rol � nr enrar swrul. .e aaoa ( nryelrioi a.ra �avmor. a ry une ry ra: prat ramae.ucc -ero wsnewr o ur x unrtca remoio: avx O rrtacsrnr Off Cowni rw ¢v vwc wreowsr rwv. uur pp xoi w sra:e arr ra ,S erre m.wr F r o m eae. a wsost A5 -BUILT 210 FLOOR PATI (E) BEDROOM 05 I (E) BEDROOM !4 OFFIC II u (E) FAMILY ROOM n II II (E) BEDROOM !b (E) HALL E BA n3 H (E) LIVIN6 ROOM II II II NTRY I i i (E) NOOK () M. BEDROOM 0 BATH (�DCJ�� u n u (E) BEDROOM 02 I I I I I I E KITCHEN I I I r I r 1 I r____J HALL I (E) BEDROOM c3 M) GAME ROOM�!��r+'!J W rwver o.E_Q rtl �_ rac.scr®ncna i' \ 'W rw:r:Kln nsuwu icor 9 .—wmovcc rel W ¢cc. FRONT ELEVATION SECTION "A" ]GIdE V�' • I'O' (E) DINING ROOM (E) COVD PORCH Is' FLOOR PLAN YNLV.' • fV N W r10pR!]M!P W IY RroR n001ttN. 00lP ftLle Nmx, W 1®6ECL Up0lf vae, nu W lwu.i¢ xw.r lu u. r.ca vew wa.ca M) GAME ROOM�!��r+'!J W rwver o.E_Q rtl �_ rac.scr®ncna i' \ 'W rw:r:Kln nsuwu icor 9 .—wmovcc rel W ¢cc. FRONT ELEVATION SECTION "A" ]GIdE V�' • I'O' i COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NO. .Rev. 12/96) APPLICATION AND PERMIT 99-2637 ASSESSOR PARCEL NUMBER 011-110-024 Z°�"" rN c, BUILDINGPERMIT OWNER !BATA, TONY TELEPHONE SO. FT. OCC. BUILDING VALUATION (� /� {�'ytry��T /y OWNER'S MAILING ADDRESS 186CA HONEY RUN, t; iit✓(� 3594 r: SURIN CONTRACTOR'S NAME JUNES fIAASr TELEPHONE CONTRACTORS 11IDRY621 HENSHAW AVE:, CHIC? 95973 CONSTRUCTION LENDER LENDER'S MAILING ADDRESS w Fireplace Total Valuation 1$5750.40 ARCHITECT OR ENGINEER LICENSE NO. —Filing Fee $ 20.00 Permit Fee S1 )i 3 $ 243.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 52.65 BUILDING ADDRESS 1869 HONKY RIP1 RC)AD, C.-IT10 i Energy Plan Checking Fee $ $ PERMIT FEE $ 315.65 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF IQ Duplex ❑ Mobilehome ❑ Other- SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other O Describe Work: FIRE SPRINKLERS Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G W 920.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service *".A' OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury thd! I am liconsed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.POWER License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. WF I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service To 46.00so CCU000A NEW CONST. DWELLING OCCUP. W: OR ADDNS. ( a ACC. S. SO 3.50F T. NON-RESID. MULTI.OUTLET 97,50 APPARATUS a SINGLE OUTLET CTR. Ex. Occup. OUTLET OR FWTUREs 20 00 SAL @ ,. 0 Ex. Occup. o Ixu Aa °EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) 'RI 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall f hwith comply with those provisions. •' X Date Signature of Applicant - A Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEt $ Mobile Home Installation Fee $ Energy Inspection Fee $ OCC CONST. TYPE TOTAL FEE $ 315.65 HAZ. J= IMP I FLOOD I CDF PARCEL I PD I HD ISSU This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. /fl, By.. l ./ _1 �----. Date PERMIT EXPIRES ON pate ReceiptNo.2 AQje(, 7 WHITE-D.D.S.-B.07.7 CANAR -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT 0. 061-1" ,COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville„ California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT 99-2637 ASSESSOR PARCEL NUMBER 011-110-024 ZONINGFR 5 BUILDING PERMIT OWNER MATA, TONY TELEPHONE SO. FT. OCC. BUILDING 3594 R 5750 40_ VALUATION OWNERS MAILING ADDRESS 1869 HONEY RUN, CHICO CONTRACTOR'S NAME JUNES HAASE TELEPHONE CONTRACTORS MAILING ADDRf621 HENSHAW AVE, CHICO 95973 1 CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ 5750.40 ARCHITECT OR ENGINEER LICENSE NO. Fee $ 2 0.0 0 —Filing Permit Fee 81 X 3 $ 243.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 52-69 BUILDINGADDRESS 1869 HONEY RUN ROAD, CHICO Energy Plan Checking Fee $ $ PERMIT FEE $ 315.65 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF §J Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: FIRE SPRINKLERS Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home 19161 W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service 200AoRlESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.P License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages astheir sole compensation, will do the work, and the structure is not intended or offered for sale. 14, 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project.. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Main Service 200A TO IOOOA 46.00 NEW CONST. DWELLING OCCUP. OR ADDNS. ( 8 ACC. BLDS. s0 3.50 FT.. p�IDT' MULTI -OUTLET @7,50 OWER APprWATUS 8 SINGLE OUTIET CSI R. Ex. Occup. OUTLET OR FIXTURES20 00 @ 1' BAL @ .50 Ex. Occup. OFlxurrs Ae DEA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring23.00 PERMIT FEE $ MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE S Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) X I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that f I should become subject to the wor rs' compensation provisions of section 3700 of the Labor Code, I shall f ith comply with those provisions. Date Mqlm Signature o Applican - Owner ❑ Contractor ❑ Agerh I- An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 315.65 HAZ. D. FEES IMP FLOOD COF PARCEL PD HD ISSU This permit is hereby issued under the applicable provisions ofthe Butte County Code and/or Resolutions to do work indicate above fo which fees have been paid. BZ*6) at / Z� PERMIT EXPIRES ON Oate Receipt No./$315.65 WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 `PERMIT NC (Rev.12heis) . `'y'<. APPLICATION AND PERMIT N 9!s W II PAi1Ca NU�161 BUILDING PERMIT �►� �^ O ' TQBJgN! SO. FT, OCC. BUILDING e. VALUATION owNe17 MALJIq AD � / Gm OOWRACT' ORI low TlLSIgN! Fire Ines Total valuation S O, G 0 Firing Fee eglo- S 20.00 Permit Fee S Z ao OONTRACTOR7 MALMO ADORM /y/ � Z / S'W 0ON/TftJCnOM U%Q8k leroora WANG AMP&M ��� OR �M ��! NO. AACI1 =OR vaNEMS MALMO ADORM SIALONGAW 18,6 7Energy d Plan Checking Fee $ Plan Checking Fee $ `S 6 ' $ PERMIT FEE $ / IDT N0. lIAONrI0N7/N1! ►AMM yAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ®/Duplex O Mobilehome O Other Soec� Each Trap 7.00 Solar or heat Pump water heater 23.00 Water piping 15.00 TYPE OF WORK New O Addition O Remodel O UdN" O Instillation O Other O Describe Work: �"L yo S Each gas water heater or vent 15.00 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W tg720.00 PERMIT FEE S ELECTRICAL PERMIT I Filing Fee 20.00 Main Service O00V OR LESS 200A OR LESS 23.00 _ ...... - — — -- - \�, b �O Main Service 20" TO 1000A 46.00 NEW CONST. OR .coN9. D"a �cc, o�.'e P� ,eL 3.5CR NOKRESID.MUI.TFOIJREfBRAWN CNIQUITS @7.SO PUMA APPARATLe A9--- --- -010. EX. OC:CLJ . OVnZr OR FOMMEs 20 0 1.00 aw .w A" Ex. Occu . of T. MLS 5.00 Temporary Service Facilities E23.Home irin 23.00 PERMIT FEE S MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 1 6.50 PERMIT FEt S Mobile Home Installation Fee $ Energy Inspection Fee $ RC CONST_ TYPE TOTAL FEE $ w12. D. PEES IMP I FL000 I COF I PARCEL PO 16SL,E This permit is hereby issued under the applicable provisions Of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By Date PERMIT EXPIRES ON /DAJtJ ti'y'. _ 1} r'.. r!' f��x1 ''r `':.�.��..:;�+.... " ....; /'._�;�e+�� �y,.� .iti;;,.v.�i'T�;v�"tiw��I7 v.,.,.'r^f 'V . + �'" � • . .. � . rr.. � � M,.COUINTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 PERMIT APPLICATION DATA SHEET OWNER:ASSESSOR PARCEL NUMBER: a i/ _ //p Proposed Building Use: G y<._ gZgg t ,'u E FApBuilding Inspector: CZ, At time of permit application, I was advisT ed the following data must be submitted prior to permit processing and/or issuance: Date Received By ❑ 1. All items have been submitted -------------------------------------------------------------------------------------- 112. Plot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------ ❑ . - plete plans, 3/4 sets, signed by the preparer of plans. ----------------------------------------------------- . Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. �U_W(` g l S ❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------ ❑ 6. Energy Design Compliance and supporting documentation. ---------------------------------- 0 7. Statement of Intent for Non -Heated and A/C Buildings. --------------------------------------- ❑ 8. Hazardous Material Form. ------------------------------------------------------------------------ ❑ 9. Manufactured Home data and installation instructions including Tie Down Specifications. ❑ 10. Fees of $------------------------------------------------------------------- ❑ 11. Impact fees as shown on the attached schedule. ------- ❑ 12. California Department of Forestry plan approval/fees. ❑ 13. Flood elevation certificate. ------------------------------- ❑ 14. Sanitation and plot plan approval Health Department. ------------------- ❑ 15. City of Chico plumbing permit. ---------------------------------------------------------- ❑ 16. Plot plan and business license approval from the City of Biggs. ---------------------- ❑ 17. Planning approval for (A) Use: (B) Parking: - ❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ❑ 19. Encroachment Permit for driveway (construction approval prior to occupancy). ---• ❑20. Pre -inspection for required Request to Building Inspector on 021. Contractor's license information. (Number, Name Style, Classification). 022. Workers' Compensation carrier and policy number. ----------------------- 023. Owner -Builder Verification (Given to owner ❑, Mailed to owner ❑). -. ❑24. Letter of signature authorization. -------------------------------------------- ❑ 25. Recorded copy of Agricultural Acknowledgment Statement.-------------- E126. ------------- ❑26. Letter of intent on building use. ---------------------------------------------- ❑27. Manufactured Home utility clearance. --------------------------------------- 1328. Existing violations and/or expired permits. --------------------------------- ❑29 ❑433 ; U. Other Deed, ❑ M.H. Title, ❑ Check to H.C.D $ -�- &a 6Q .Sr' -9 a0 6 V C°- 16 o .- p tj Kt.- I - 'en you isssue,the,permit, process as follows El Mail to owner, ❑Mail to contractor. Telephone .�y 3 — b y yc% and hold for pickup at office. ❑ Deliver with inspector. Applicant: Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: Date: By: Date: By: 1. Index permit application for the above items numbered: ❑ Plan Check List 2. Additional items required: acto 'gner, owner, was advised of the above required data by Oflone, ❑ mail, ❑ Building Division counter, Date/Z_ or, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Plans reviewed by: Date:7zl- Plans approved by: Date: Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: Yellow Copy - Department of Development Services, Building Division. (Date) HYDRONICS: RESIDENTIAL FIRE SPRINKLER HYDRAULICS 2.1 - SUBMITTAL. Page 1 `CONTRACTOR: WILLIAM F. SQUYRE,S, JR. FIRE PRO'. FCTTON ( 530 ) 345-1 012 ADDRESS:.,PO BOX 3176, C11ICO, CA 95927-3176 Date 11-24-1999 File: MATA-1 JOB : HAASE-MATA HOUSE, 1 HEAD FLOWING STATIC : 55.0 Psi RESIDUAL 40.0 Psi FLOW 30 Gpm SPRINKLER MANUF RELIABLE MODEL : F1/RES/CC MIN SPR FLOW 16.0 Gpm MIN SPR PRES : 16.8 Psi NODE ELEVATION K- PRESSURE DISCHARGE NO. FEET FACTOR Psi Gpm ------------------------------------------------------------------------------- 1 10.0 3.90 16.8 16.0 2 10.0 20.1 3 10.0 20.6 4 10.0 25.6 5 19.0 21.8 6 19.0 23.1 7 •10.0 27.4 8 1.0 SOURCE 3 3. 6O%ON G®�A'Q Q� "P SPRINKLERS FLOWING 1 El �UAre AREA PER SPRINKLER 324 Sq. Ft . �`�ot ' Ix TOTAL DESIGN AREA 324 Sq.Ft. ryi�L raCi`6 y/�p Lic. No. 275206 / � REQUIRED DENSITY .05 Gpm/Sq.Ft. ! '16 COMPUTED DENSITY .05 Gpm/Sq.Ft. TOTAL S PRINKLER FLOW 16 . 0 G m P .GFCi'-�-�F®� .r. TOTAL DOMESTIC FLOW 0.0 Gpm TOTAL WATER REQUIRED 16.0 Gpm TOTAL SPRINKLER PRESS 31.6 Psi WATER METER LOSS 2.0 Psi @ SOURCE VALVE FIXED LOSS 0.0 Psi @ SOURCE Copyright(1991) SUPPLY PRESS AVAILABLE 50.3 Psi by DEMAND PRESS REQUIRED 33.6 Psi Hydronics Engineering PRESSURE CUSHION 16.7 Psi 34119 Fremont B1, Suite 609 Fremont, Ca., 94555 (415) 487-9160 MAXIMUM VELOCITY 8.4 FIS HYDRONICS;: FIRE SPRINKLER HYDRAULIC GRAPH PSI 100 + 90 + 80 + 70 + 60 + X Static X 50 + X X X X 40 + X Resid 1* Spr Sys 30 + 20 + 10 + * Elev Loss 0++--+---+----+------+-------+--------+---------+----------+------------+ 0 200 300 400 500 600 700 800 900 1000 1.85 FLOW -(GPM) JOB : HAASE-MATA HOUSE, 1 HEAD FLOWING X - Water Supply Curve * - Water Demand Curve HYDRONICS: RESIDENTIAL FIRE SPRINKLER HYDRAULICS 2.1 - SUBMITTAL. Page 2 CONTRACTOR: WILLIAM F. SQUY.RES, JR. FIREE PROTECTION ( 530 ) 345-1012 ADDRESS:..PO BOX 3176, CHICO, CA 95927-3176 Date: 11-24-1999 File: MATA-1 JOB : HAASE-MATA HOUSE, 1 HEAD FLOWING PIPE BEG FLOW K -FACTOR LENGTH C -FACTOR PRESSURE NO. Gpm FITTING TYPE FTG FR- LOSS Psi END DIAMETER TOTAL (Psi/Ft) ------------------------------------------------------------------------------ 1 q= 16.0 K= 3.90 L= 9.5 Pt 16.8 Pt 16.8 1 Q= 16.0 F=2LR F= 15.0 C= 150 Pe 0.0 Pv -0.5 Vel= 8.4 D= 0.884 TL= 24.5 0.1310 Pf 3.2 Pn 16.4 2 Pt 20.1 ------------------------------------------------------------------------- 2 q= 0.0 K= 0.00 L= 5.0 Pt 20.1 Pt 20.1 2 Q= 16.0 F=RB F= 6.0 C= 150 Pe 0.0 Pv -0.2 Vel= 5.3 D= 1.109 TL= 11.0 0.0434 Pf 0.5 Pn 19.9 3 Pt 20.6 ------------------------------------------------------------------------- 3 q= 0.0 K= 0.00 L= 74.0 Pt 20.6 Pt 20.6 3 Q= 16.0 F=13R4L F= 41.0 C= 150 Pe 0.0 Pv -0.2 Vel= 5.3 D= 1.109 TL= 115.0 0.0434 Pf 5.0 Pn 20.4 4 Pt 25.6 ------------------------------------------------------------------------- 4 q= 0.0 K= 0.00 L= 5.0 Pt 25.6 Pt 25.6 4 Q= 16.0 F=L F= 8.0 C= 150 Pe -3.9 Pv -0.1 Vel= 3.3 D= 1.400 TL= 13.0 0.0140 Pf 0.2 Pn 25.5 5 Pt 21.8 ------------------------------------------------------------------------- 5 q= 0.0 K= 0.00 L= 48.0 Pt 21.8 Pt 21.8 5 Q= 16.0 F=6R4L F= 38.0 C= 150 Pe 0.0 Pv -0.1 Vel= 3.3 D= 1.400 TL= 86.0 0.0140 Pf 1.2 Pn 21.8 6 Pt 23.1 ------------------------------------------------------------------------- 6 q= 0.0 k= 0.00 L= 21.0 Pt 23.1 Pt 23.1 6 Q= 16.0 F=RL F= 9.0 C= 150 Pe 3.9 Pv -0.1 Vel= 3.3 D= 1.400 TL= 30.0 0.0140 Pf 0.4 Pn 23.0 7 Pt 27.4 ------------------------------------------------------------------------- 7 q= 0.0 K= 0.00 L= 9.0 Pt 27.4 Pt 27.4 7 Q= 16.0 F=4RS F= 14.0 C= 150 Pe 3.9 Pv -0.1 Vel= 3.3 D= 1.400 TL= 23.0 0.0140 Pf 0.3 Pn 27.3 8 Pt 31.6 ------------------------------------------------------------------------- Meter = 2.0 Valve = 0.0 ------------------------------------------------------------------------- ------------------------------------------------------------------------- 8 Q= 16.0 <<< SOURCE >>> Pt 33.6 E=>45-Elb L=>90-Elb B=>TeeBch R=>TeeRun C=>CouPlg S=>SwgChk G=>GatVly 50.3 Psi @ 16.0 Gpm 33.6 Psi @ 16.0 Gpm 16.7 Psi Flow 55.0 Psi Avail Press Static 40.0 Psi Req'd Press Residual 30.0 Gpm Press Cush'n HYDRONICS: RESIDENTIAL FIRE ,SPRINKLER HYDRAULICS 2.1 - SUBMITTAL. Page 1 CONTRACTOR: WILLIAM F. SQUYRES, JR. TIRE PRO`.L'EC`i'ION (530) 345-1012 ADDRESS:..PO BOX 3176, CHICO, CA 95927-3176 Date:"I1-24-1999 File: MATA-2 JOB : HAASE-MATA HOUSE, 2 HEADS FLOWING STATIC 55.0 Psi RESIDUAL 40.0 Psi FLOW 35 Gpm SPRINKLER MANUF RELIABLE MODEL : Fl/RES/CC MIN SPR FLOW 13.0 Gpm MIN SPR PRES : 11.1 Psi NODE ELEVATION K- PRESSURE DISCHARGE NO. FEET FACTOR Psi Gpm ------------------------------------------------------------------------------- 1 10.0 3.90 11.3 13.1 2 10.0 3.90 13.5 14.3 3 10.0 14.8 4 10.0 28.4 5 19.0 25.0 6 19.0 28.2 7 10.0 33.3 8 1.0 SOURCE 40.0 SPRINKLERS FLOWING 2 AREA PER SPRINKLER 324 Sq.Ft. TOTAL DESIGN AREA 648 Sq.Ft. REQUIRED DENSITY .04 Gpm/Sq.Ft. COMPUTED DENSITY .04 Gpm/Sq.Ft. TOTAL SPRINKLER FLOW 27.4 Gpm TOTAL DOMESTIC FLOW 0.0 Gpm TOTAL WATER REQUIRED .27.4 Gpm TOTAL SPRINKLER PRESS 38.0 Psi WATER METER LOSS 2.0 Psi @ SOURCE VALVE FIXED LOSS 0.0 Psi @ SOURCE Copyright(1991) SUPPLY PRESS AVAILABLE 45.4 Psi by DEMAND PRESS REQUIRED 40.0 Psi Hydronics Engineering PRESSURE CUSHION 5.4 Psi 34119 Fremont B1, Suite 609 Fremont, Ca., 94555 (415) 487-9160 MAXIMUM VELOCITY 9.1 FIS HYDRONICS: RESIDENTIAL FIRE SPRINKLER HYDRAULICS 2.1 - SUBMITTAL. Page 2 CONTRACTOR: WILLIAM F. SQUYRES, JR. FIRE PROTECTION ( 530 ) 345-1 012 ADDRESS:..PO BOX 3176, CHICO, CA 195927-3176 Date:-11-24-1999 Nile: MATA-2 JOB : HAASE-MATA HOUSE, 2 HEADS FLOWING PIPE BEG FLOW K -FACTOR LENGTH C -FACTOR PRESSURE NO. Gpm FITTING TYPE FTG FR- LOSS Psi END DIAMETER TOTAL (Psi/Ft) ------------------------------------------------------------------------------ 1 q= 13.1 K= 3.90 L= 9.5 Pt 11.3 Pt 11.3 1 Q= 13.1 F=2LR F= 15.0 C= 150 Pe 0.0 Pv -0.3 Vel= 6.8 D= 0.884 TL= 24.5 0.0902 Pf 2.2 Pn 11.0 2 Pt 13.5 ------------------------------------------------------------------------- 2 q= 14.3 K= 3.90 L= 5.0 Pt 13.5 Pt 13.5 2 Q= 27.4 F=RB F= 6.0 C= 150 Pe 0.0 Pv -0.6 Vel= 9.1 D= 1.109 TL= 11.0 0.1173 Pf 1.3 Pn 13.0 3 Pt 14.8 ------------------------------------------------------------------------- 3 q= 0.0 K= 0.00 L= 74.0 Pt 14.8 Pt 14.8 3 Q= 27.4 F=13R4L F= 41.0 C= 150 Pe 0.0 Pv -0.6 Vel= 9.1 D= 1.109 TL= 115.0 0.1173 Pf 13.5 Pn 14.3 4 Pt 28.4 ------------------------------------------------------------------------- 4 q= 0.0 K= 0.00 L= 5.0 Pt 28.4 Pt 28.4 4 Q= 27.4 F=L F= 8.0 C= 150 Pe -3.9 Pv -0.2 Vel= 5.7 D= 1.400 TL= 13.0 0.0377 Pf 0.5 Pn 28.2 5 Pt 25.0 ------------------------------------------------------------------------- 5 q= 0.0 K= 0.00 L= 48.0 Pt 25.0 Pt 25.0 5 Q= 27.4 F=6R4L F= 38.0 C= 150 Pe 0.0 Pv -0.2 Vel= 5.7 D= 1.400 TL= 86.0 0.0377 Pf 3.2 Pn 24.7 6 Pt 28.2 ------------------------------------------------------------------------- 6 q= 0.0 K= 0.00 L= 21.0 Pt 28.2 Pt 28.2 6 Q= 27.4 F=RL F= 9.0 C= 150 Pe 3.9 Pv -0.2 Vel= 5.7 D= 1.400 TL= 30.0 0.0377 Pf 1.1 Pn 28.0 7 Pt 33.3 ------------------------------------------------------------------------- 7 q= 0.0 K= 0.00 L= 9.0 Pt 33.3 Pt 33.3 7 Q= 27.4 F=4RS F= 14.0 C= 150 Pe 3.9 Pv -0.2 Vel= 5.7 D= 1.400 TL= 23.0 0.0377 Pf 0.9 Pn 33.0 8 Pt 38.0 ------------------------------------------------------------------------- Meter = .2.0 Valve = 0.0 ------------------------------------------------------------------------- ------------------------------------------------------------------------- 8 Q= 27.4 <<< SOURCE >>> Pt 40.0 E=>45-Elb L=>90-Elb B=>TeeBch R=>TeeRun C=>CouPlg S=>SwgChk G=>GatVly HYDRONICS FIRE SPRINKLER HYDRAULIC GRAPH X Static X 50 + X X X X 40 + X Resid 40 +* Spr Sys 30 + 20 + 10 + * Elev Loss 0++--+---+----+------+-------+--------+---------+----------+------------+ 0 200 300 400 500 600 700 800 900 1000 1.85 FLOW -(GPM) JOB : HAASE-MATA HOUSE, 2 HEADS FLOWING X - Water Supply Curve * - Water Demand Curve ^ .. ' 45 . A Psi � @/ 37 � 4 gpm ^ ` Static � 4O.0 1?oi VV 27.4 Qpm S . 4 Psi 55.0 �o i �vail /�v Press Residual � 40.0 P�i ' ` Re(- Flow � 35.0 �p�n Press r �u�b'o 9g_��� �c �w•,wv- 4NTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 s Telephone (530) 538-7541 ! PERMIT ER IT NO., (Rev. 12/96) APPLICATION AND PERMIT 7� ASSESSOR PARCEL NUMBER 011-110-024 ZONING 5 BUILDINGPERMIT OWNERMALA, �T/►NY TELE➢NONE y SO. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1869 HONEY RUN ROAD, CHICC 959,)9 1{:i � 776 I • 432 COMPACTORS NAME JIM HAASE TWIT6449 CONTRACTOR'S MAILING ADD j RTb21 HUSHAW, CHIC) 95973 CONSTRUCTION LENDER LENDER'S MAKING ADDRESS - Fireplace Total Valuation $ 5.432 ARCHITECT OR ENGINEER LICENSE NO. F Filing Fee $ 20.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Permit Fee � $ 243.00 Plan Checking Fee $ BUILDINGADDRESS - 1869 HONT.Y RIJN ROAD, CHICOEnergy Plan Checking Fee $ PERMIT FEE $ 315.65 LAT NO. SUBDNISIONSNAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE Each Trap 1 7.00 1 Solar or heat pump water heater 23.00 SF M Duplex ❑ Mobilehome ❑ Other Water piping 15.00 Each as water heater or vent 15.00 SPECIFY TYPE OF WORK Gas piping stem 1 - 5 outlets 15.00 New X7 Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Building sewer 15.00 Describe Work: OPEN DECK Mobile Home I S I G I W I @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service 200AORLE:s 23.00 LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class :`_ u'�'. rr )� Lic. No. OWN WILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Main Service TO 46.00 WEE200A CCU000A NEW CONST. DWELLING OCCUP. OR ADDNS. ( & ACC. BUDS. SO .50SO 3.5a FT. LN1OP1 R�Ip. MULTI.OUTLET @7,50 POWER APPARATUS 8 SINGUE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES 20 ® 1.00 BAL @ .50 Ex. Occup. ouTtEEDTs AsID.cEw 5.00 Temporary Service 23.00 Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. Mobile Home Facilities 20.00 Misc. Wiring 23.00 ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION PERMIT FEE S MECHANICAL PERMIT Filing Fee 20.00 Heating 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performan6e of the work for which this permit is issued. Cooling Hood 6.50 Ventilation ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier PERMIT FEE $ Mobile Home Installation Fee $ Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall Energy Inspection Fee $ Gcc coNST. TYPE i TOTAL FEE $ 315.65 HAZ. ,r D. FEES IMP D r_ CDF P/IRgEL i/ PD HD- �; ISSU forthwith comply with those provisions. This permit is hereby issued under the applicable provisions / I-; - t Date r ,�- r of the Butte County Code and/or indicated above for which fees have Resolutions to do work been paid. Sig ure of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height.,,- �' ,►T ,, —,� PERMIT EXPIRES ON 1 �� , Date r A7 rReceipt No. 0 • WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT pgfe v COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION D 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 �9PERMI NO. (Rev. 12/96) APPLICATION AND PERMIT � AS SESSOR PARCEL NUMBER 011-110-024 ZONING GFR 5 BUILDING PERMIT OWNER MATA, TONY TELEPHONE SQ. FT. OCC. BUILDING VALUATION 77 0 5, 432 OWNER'S MAILING ADDRESS 1869 HONEY RUN ROAD, CHICO 95928 CONTRACTOR'S NAME JIM HAASE T343N8449 CONTRACTORS MAILING ADDRY621 HENSHAW, CHICO 95973 l CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ 5,432 ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ 243.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 52 69 BUILDINGADDRESS 1869 HONEY RUN ROAD, CHICOgy Ener Plan Checking Fee g $ $ PERMIT FEE $ 315.65 LOT NO. SUBDNISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF 00 Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New K] Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: OPEN DECK i Gas piping sy2tem t - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 Main Service 200A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.PSINGLE License Class � Lic. No. .�7 q� � OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service TO i000A 46.00 NEW CONST. DWEWNG OCCUP. WOEL OR ADDNS. ( a ACC. BLDS. SO 3.5¢FT. p10µRESID. T.MULTI-OUTLET 97.50 OWER APPARATUS a OUTLET CIR. Ex. Occup. OUTLET OR FDTTURES 20 @ 1•00 BAL @ .50 UNS Ex. Occup. FIXED .AP RESID.OEA. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirina Lf�t PERMIT FEE $ WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE S Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. Date �/ —j / Sig ture of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE 15.65 HAZ. i MP FLO D D• FEES IDF C P I PD H ISSU This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicateA above fo which fees have been paid. By Date PERMIT EXPIRES ON ete 'ReceiptNo.' d /315.65 WHITE-D.D.S.-B.D. CAN RY-ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PERMIT NC (Rev.12/196) APPLICATION AND PERMIT - 1y A.�e:soRPARonNUMee� �l / — //p — 02 Cl '7,e--5 ( ,e,j BUILDING PERMIT owNlR O 1 rVLAP"CN! SO, FT, OCC. BUILDING VALUATION GL OWME117 MALM ADOWU (137 00NTRA=WS NAM! 1 TllalgN! 00mrp x0117 MAUNo oRess 02 5 001N.TMACIrIM 1!x061 1EFOOrs MAns+o ADOWN Fire lace Total Valuation S ARawrEcr oR lNoueel uceNse No. FGn Fee $ 20.00 6+ ARPermit Fee 2' 3 GfTlCT 0x1 onrsls s MAi1No ADOr1ESs = � Plan Checkin Fee $ 6r S euao++oAooREss / Ener Plan Checking Fee i b I T / KCti ��.�_ �_ 9Y 9 IOr NO. I suaONle"Mm! USEOFSTRUCTURE SF telex ❑ Mobilehome ❑ Other sPECry TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities; ❑ Installation ❑ Other ❑ Describe Work: Y -e-, S FEE I S PLUMBING PERMIT Ftlng Fee 20.00 Each Trap 7.00 Solar or heat urnp water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 Gas Piping system 1 - 5 outlets 15.00 Building sewer i 5.00 Mobile Home S G W (9720.00 PERMIT FEE $ ELECTRICAL PERMIT Main Service °0w OR LESS a00A oR u:ss Main Service 200A TO 1000A i 23.00 46.00 I.SeFr. 37.50 20.00 EX. Occup. I ovr oR F 200 1.00nEnU aAL a .00 EX. Occu o�m EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Filing Fee 20.00 Coolin I Hood 1 1 6.50 PERMIT FEt I S Mobile Home Installation Fee $ Energy Inspection Fee $ occ co�T. TYPE TOTAL FEE $ tom' '!�s —F—F.—17-0—FEES. I IMP I AX)00 I COf I PARCEL I PO 1 10 1 SSLE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By PERMIT EXPIRES ON Date ..`•"r Tr -,,, .. ...rt.r.r �' 1•_+r•'�iw-�F- •.•I -•-r. �.�,ryY „fs.•.,rl`�� r+N r��� �� ;� y� •ti .. 1-� S li l� .- COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 PERMIT APPLICATION DATA SHEET OWNER: A:L ASSESSOR PARCEL NUMBER: U / / - 116 r () 2 - Proposed Proposed Building Use: Building Inspector: Date: / I Q . g At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: Date Received By ❑ 1. ms have been submitted-------------------------------------------------------------------------------------- Plot plans, 3/4 sets, signed by the preparer of plans. ----------------------------------------------------- : Complete plans, 3/4 sets, signed by the preparer of plans. ----------------------------------------------------- 04. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. -------- ❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------ El 6. Energy Design Compliance and supporting documentation. ---------------------------------------------------- ❑ 7. Statement of Intent for Non -Heated and A/C Buildings. --------------------------------------------------------- 118. Hazardous Material Form. ------------------------------------------------------------------------------------------ ❑9. Manufactured Home data and installation instructions including Tie Down Specifications ------------------- 0 10. Fees of $------------------------------------------------------------------------------------- ❑ 11. Impact fees as shown on the attached schedule. ------- ❑ 12. California Department of Forestry plan approval/fees. ❑ 33. 1 e l'elevation certificate. ------------ -------------------------------------------------------------------------- Sanitation and plot plan approval Health Department. ------------------------------------------- Ell 5. ------------------------------------------❑15. City of Chico plumbing permit.----------------------------------------------------------------------------------- ❑ 16. Plot plan and business license approval from the City of Biggs. 1117. Planning approval for (A) Use: (B) Parking: ❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ❑ 19. Encroachment Permit for driveway (construction approval prior to occupancy). --- ❑20. Pre -inspection for required Request to Building Inspector on ❑21. Contractor's license information. (Number, Name Style, Classification). ❑22. Workers' Compensation carrier and policy number. ----------------------- E123. Owner -Builder Verification (Given to owner ❑, Mailed to owner ❑). -• ❑24. Letter of signature authorization. -------------------------------------------- E325. ------------------------------------------- ❑25. Recorded copy of Agricultural Acknowledgment Statement. ------------- ❑26. Letter of intent on building use. ---------------------------------------------- 027. Manufactured Home utility clearance. --------------------------------------- ❑28. Existing violations and/or expired permits. --------------------------------- ❑29. 0433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ E130. Other: Wh ou issue the permit, process as follows El Mail to owner, ❑Mail to contractor. Telephone,3 Z/3 r 6 7 y a/ and hold for pickup at �r� office. ❑ Deliver with inspector. (Date) Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air$ollution Date: By: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other Date: By: 1. Index permit application for the above items numbered: ❑ Plan Check Lis 2. Additional items required: GQQ/j�9_ Contractor, designer, owner, was advised of the above requireft data by ❑ phone, ❑ mail, 06 nuilding Division counter, by ate: 21(115- Contractor, lrSContractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, 13 mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ B rld' s' n counter, by Date: Plans reviewed by: Date: Plans approved by: Date: Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: Yellow Copy - Department of Development Services, Building Division. TO: Building Department FROM: Environmental Health SUBJECT: Sanitation Clearance ;;�'- , r E.H. USE ONLY Plot Plan Attashad Floor Plan Attached D Sent to B.D. it Ig69 Oil- /10 -024 Owner Eocation AP# Plan Approved for: Sewage .Disposal /r Water Supply: Public Private Well Clearance for' Q. Other . QUI P 46) e' 4A-'- . Hold final for: Final clearance O.K. for: NOTE: �-� Z%t� / R6 Al-Y,Environmental Health Specialist 8/96 11-2-7-'-99 Date COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION D 7 County Center Drive • Orbville, California 95965 • Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT W a_ 6e15' ASSESSOR PARCEL NUMBER 011-110-024 ZONING R 5 BUILDING PERMIT OWNER MATA, TONY 343-7044 SO. FT. OCC. BUILDING VALUATION EST 1,000 .OWNERS MAILING ADDRESS 1869 HONEY RUN RD., CHICO 95928 CONTRACTOR'S NAME OWNER FAX: 899-9986 TELEPHONE CONTRACTORS MAIUNG ADDRESS CONSTRUCTION LENDER Fireplace LENDER'S MAIUNG ADDRESS Total Valuation $ 1.000 ARCHITECT OR ENGINEER LICENSE NO. Filen Fee $ 20.00 Permit Fee $ 25.00 ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 23-00 BUILDINGADDRESS 1869 HONEY RUN* ROAD Energy Plan Checking Fee $ $ PERMIT FEE $ 68.00 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: CHANGE SINGLE FAMILY TO R 2.1.1 OCCUPANCY (PER M.V.) Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W ri PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.00 0UE Main Service . ' OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.PSING License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors license Law Ki the following reason: 2/ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forth it comply with those provisions. (( X _ Date Signature ofApplicant - Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service 200A TO 1000A 46.00 NEW CONST. OW %NG OCCUP. sO OR ADDNS. ( a Acc. BLDs. 3.5QFT; NOµgESID. T.MULTI-OUTLET . CIBCUITS @7.50 a OUTLET CIR. OWELER APPARATUS OUTLET 20 @'•0° Ex. Occu SAL o .50 Ex. Occup. OIRIEEDTS R D) EA 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE S MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ Q%� CONST. PE TOTAL FEE $ Ile 68.00 HAZ. D. FEES IMP FLOOD _ f A - CDF PARC PO HD ISS This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By Date PERMIT EXPIRES ON Dae Receipt No. 280882 8 • GG WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 - Telephone (530) 538-7541 PERMIT N A r1rLL L/�w�LAu w LLr• r%1-�ae19r �Gr° �� (Hev.1Y/96) I1rti"LIV/111V"MNV Cr -1111v11 1 msnsoRPAR46NuuW Ul `� `W �.-- BUILDING PERMIT OWNER 5/7) 70/�j () 7 .T�"0NE SD. FT. OCC. BUILDING VALUATION OWNER'S HALM ADORM OO141TRA OR'1 NAM TVJWMNE 00MRACTORI HALM ADC 0 k V OONiTRUCTION 1D461 tZme s MMUM ADDRess Fireplace Total Valuation 600 ARCNrtlCTORENMNM ucENseNO. Filing Fee $ 20.0( Permit Fee S , ARC► = OR 0401M (1 KAUNo ADOREaL Plan Checking Fee OULOMAWAM Energy Plan Checking Fee i i PERMIT FEE (oTNo sueavrLxreNAre PARca MAP PLUMBING PERMIT FlUng Fee 20.0( USEOFSTRUCTURE SF O Duplex O Mobllehome O Other °PEOFY Enc rap 7.00 Solar or - t pump water heater 23.00 Water piping 15.00 Each gas water hen vent 15.00 New O Addition O Remoodr(ell 0 Describe Work: &�Zl 1C�ee TYPE OF WORK Utilities O� Instillation0 J/�GLG 1�Z Other O / / /w//z, LJ Gas piping system 1 - 5ou is 15.00 Buildingsower 15.00 Mobile Home IS G I W @20.00 PERMIT FEE S ELECTRICAL PERMIT Filing Fee 20.0( Mal rvice =ooRL,, 23.00 _ _ ......... _...... --- -- v I t 1 oe n - - - - --- - — - - J Main Se ice 2WA To r -O -A 46.00 NEW CONST. OWEtir+a =P. ADONS. A ACC. MDB. 3.50Fgo. oR NON-AESID. ' MULT�OUr(ET ro APPARATw @7.50 EX. OCCu ovnzr oR ©T Ex. OCCU o.°� Temporary ServiceMobile Home FacilitiesMisc. Wirin PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.0( Hee Coolin Hood 6.50 Ventilation PERMIT—PEL S Mobile Home Installation Fee S Energy Inspection Fee S_ occ CONST. rrPE TOTAL FEE _ -Z. 0. FEES I4P f1D00 Cof, PARCEL PO Mo I � This permit is hereby Issued under the applicable provision - of the Butte County Code end/or Resolutions to do worl indicated above for which fees have been paid. By PERMIT EXPIRES ON Date 5 �Grnti �o r nrjc`f °`'Ic`l I 12.2 • �• � C Health 9 cn Tnature �6 3sz?4- tiovsc E x isf;,q ` r ,. M y�l, qAI -Met gap ave Yl.V e" "4�E COU �4* 1 L' 9 ROLLING DEPA4 -N'-� w e l � � IE Z.00P 1069 Hoocy Rum Road STATE OF CALIFORNIA • HEALTH AND HUMAN SERVICES AGENCY CALIFORNIA DEPARTMENT OF SOCIAL SERVICES r �- • COMMUNITY CARE LICENSING FACILITY SKETCH (Floor Plan) Applicants are required to,provide a sketch of thefloor plan of the home or facility, and outside yard. The floor sketch must label rooms such as the kitchen, bath, living room, etc. Circle the names of the rooms that will be used by staff/residents/clients/children: Door and window exits from the rooms must be shown'in case of an, emergency (see, Emergency Disaster Plan). Show room sizes (e.g. 8.5 x 12). Keep close to scale. Use the space below. See�back for yard sketch. t FACT NAME: ADDRESS: �. 1 :!wf nn 0-"R- i6m-( 1 K&d Chcto cfi 9513$ ... ' LIC on c1Wl V1 v'1 s A o>n 12 2 .1.1 - Resp de*1+1 a. ► t `- �t 6C � � 4 i ce4-7secl ,. c o mmool c�41;-,� 5'�x or less Y1o>1- r°,vhb �1a-l-ory c'1ie�� 5. Sec 'FMV t de G �prrnl�ler sis�-ens C A pp uc&:k-\ oh ged'i eve ci To lot 'issued concurren+1 wli441 �72.Yrv�i't OC,�A 14QJYYY�i �' -{'or OIe�C. . 2 . Ii 6c Sec. lota -2S.ec 100 -7 -to -3.2-2. �rov� ci►e, ex.'s -�- s�oo�v�.s a.� eae�t-� �d�oom cicer whi ch direc,+t -}o 4+-p-ex.+eri or cn\ tfle,. 122,1. l occufaricy. e Sc.cA-i d%nS 100 3. 2.8.3 1 100 3.2 . $ re w►re. rnen'tD �'o r a, rove ci 3h" .e.` anti, 1 l l u rr� �na.i-1 oh �, Sow,rce p� . • • • 3, (,lr6c Sec. too 3.2.E Means of rem ; t1U.rni064iort `%hrbugcJhoO' F°Z.l.1 arecc o�- rUtdemrze' a-S� Shot,0r. on 14. Lkr�>C Sze. lOD 3.3• l•-1 - �r ,n off" Ot00rs. l.•anc4, n� 5ti0.t1 h�u+e. • len rne.c.recf ,ne ct1►� c.io� o� •fit -a u'�I . r�o'E lc�s 4+ar n 144 i nc. t -A . cJ , u,Y� C ►CA 3.3 • l . Lv - ' Floor- t•eve l a* doors - h rm hz lc# ..5 ka l l n6 e -ceect 1 v c h ai- all doors �k7 12 2. I.) cveA. p t reAt dLmce . L)ecy- must nat be lokx r t « Flo„ +�-trkA ho i dl . . lo03. t`lo oleccd lel td rti�c lct.�- kz or securi �-y c�afns u�, C Sic 3 8 af• Gll?Or5 , vn . R ?. I .� I aIre- cL o� yt,J ICkt&lCe . �e Butte County Building Department 25 County Center Drive Oroville, Calif. 95928 To Whom It May Concern, 11/15/99 My husband, Jose Mata, and I are having Mr. Jim Haase build our home on 1867 Honeyrun Road in. Chico. Our intent for this property has always been to continue operating a Small Family Home, which we have done for twelve and one half 'years. This is a state licensed foster home for disabled children. I have held this license since 1987 and continue at the present time. I do not operate a health care facility. I am not a nurse. I am a foster mother loving disabled children. In fact, I have legal guardianship of one nonambulatory girl, and we are working on obtaining legal guardianship of another child who is nonambulatory and both are in wheelchairs. So we will need the special items that we have included in the design of our home for our own chidlren as well as foster children. Community Care Licensing, the agency who issues my state license, has always grouped Small Family Homes and Family f=oster Homes together. The home we are in, now ,and. have been living in for the past eight years, is a regular residential home that I had built to care for disabled children, is in a, regular housing development. I never had any problems clearing my Y:t 0 r RECEIVED NOV' 16 1999 BUTTE COUNTY BUILDING DIVISION F t license with either Community Care Licensing or the State Fire Marshall. I have always been licensed for nonambulatory disabled children. These could be children that had the physical capacity to walk, but perhaps not the mental capacity to know what to do if someone asked them to leave the house because of fire. A Family Foster Home has the same option to take nonambulatory children without being grouped with a health care facility, for example an ICF-DDN or ICF -DDH facility. These facilities are like step- down hospitals. They have health care licenses. I do not. I am not a nurse. We are just a state licensed foster home for disabled children. Please help us clear this up, so we can move into our home. We would love to continue to care for our disabled children and disabled .foster children in our new home. Thank -you for your consideration in this matter. Sin erely yours, ��-; Karen Mata 345-6044 RECEIVED NOV 1.6 1999 BUTTE COUNTY BUILDING DIVISION 80001 DEFINITIONS. (Continued) 80001 (2) "Small Family Home" means any residential facility in the licensee's family residence providing 24=hour a day care for six or fewer children who are mentally disordered, developmentally -disabled or " physically handicapped and who require special care and supervision as a result of such disabilities" (3) _ "Social Rehabilitation Facility" means any facility which provides 24 -hour -a -day nonmedical care and supervision in a group setting to adults recovering from mental illness who temporarily need assistance, guidance or counseling. (4) "Social Worker" means a person who has a graduate degree from an accredited school of social work. (5) "SSI/SSP" means the Supplemental Security Income/State Supplemental Program which is a federal/state program that provides financial assistance to aged, blind and/or disabled residents of California. " (6) "Substantial Compliance" means the absence of any serious deficiencies. - (7) "Substantiated Complaint" . means a complaint which has been investigated by the licensing agency,. and as a result, a violation of regulations has been found. (1) "Transfer Trauma" means the consequences of the stress and emotional shock " caused by an abrupt, involuntary relocation of " a client or resident from one facility to another. u. (1) "Universal Precautions" means "an approach to infection .control that treats all human blood. and body fluids as if they are infectious. ' Generally, Universal Precautions consist of regular hand -washing after coming into contact with another person's body fluids (mucous, saliva, urine, etc.) and includes the 11. use of gloves when handling blood or body fluids that contain blood.. Specifically, Universal Precautions consist of the following four basic infection control guidelines: (A) Hand -washing - Staff should wash their hands: 1. After assisting with incontinent care or wiping a client's nose. 2. Before preparing or eating food. 3. After using the toilet. 4: Before and after treating or bandaging a cut. 5. After wiping. down surfaces, cleaning spills, or any other housekeeping. 6. After being in contact with any body fluids from another person. 7. Even if they wore gloves during contact with.body fluids. (B) Gloves = Staff should always wear gloves: 1. When they come into contact with blood or body fluids that contain blood. 2. When they have cuts or scratches on their hands. RECEIVE® Nov 16 1999 BUTTE COl JNTY BUILDING DIVISION RECEIVEI NOV 16 1S^� BUTTE COUNTY BUILDING DIVISION ri a � • . .M.� 1A�4' RECEIVEI NOV 16 1S^� BUTTE COUNTY BUILDING DIVISION 80001 DEFINITIONS (Continued) 80001 (4) "Licensing Agency" means the State.. Department of Social Services or . any . state, county or other public agency authorized by the.. Department to assume specified. licensing responsibilities. pursuant to Section 15.11. of the Health: and Safety. Code. in. (1) "Mental Disorder" means any, of. the disorders set forth in the Diagnostic and Statistical Manual of Mental. Disorders (Third Edition) of the American-,. Psychiatric Association and a degree: of functional impairment which renders a person eligible for the services enumerated under the Lanterman- Petris-Short Act, commencing with Section 5000 of the Welfare and Institutions Code. n. (1) "Needs. and Services Plan" means a written plan.that identifies the specific needs of an individual client, including, those items specified in Section 80068.2; and delineates those services .necessary..to meet the client's identified. needs. (2) . "Nonambulatory Person" means a person s defined in- Health and SafetyCode Section 13131. (A) A, person who uses postural supports ..as. specified in Section 80072(a)(8) is deemed nonambulatory. (B) A person is not deemed nonambulatory solely, because he/she is deaf, . blind, or' prefers. to use a mechanical aid: - HANDBOOK BEGINS HERE (C) Health and Safety Code Section 13131 provides: " Nonambulatory persons" means persons unable _ to leave a building unassisted under emergency... conditions. It includes any person who is unable, or likely to be unable, to physically and mentally respond to a sensory. signal approved by the State Fire Marshal, or an oral instruction relating. to fire danger, and persons who depend upon . mechanical aids, such as crutches,_ , walkers, and wheelchairs. The determination of ambulatory or nonambulatory, status of persons with. developmental disabilities shall. be. made . by the Director of . Social . Services or his or her designated representative, in consultation with the Director of Developmental Services or his or her. designated , representative. The determination of ambulatory or nonambulatory status of all other disabled persons placed after January 1, 1984 who are not developmentally -disabled shall be made by the Director of Social Services or his or . her designated, representative. HANDBOOK ENDS HERE (3) "Nutritionist" means a person who holds . a . master's degree in. food and nutrition, dietetics, or public health nutrition, or who is employed as a nutritionist .by a. county health department. o. (Reserved) . P. (1) "Physician" means a person licensed as a physician and surgeon by the California Board of Medical Examiners or by the California .Board of Osteopathic Examiners. e •.. � - IS tY' E r h t . `1MM[lAi•Or�9� V RECEIVE® NOV 16 1999 BUTTE COUNTY BUILDING DIVISION M DEPARTMENT OF JUSTICE FEES RELATED TO CHILD CPRE LICENSES Listed below are the forms that must be submitted to the Department of Justice (DOJ) when applying for clearances for employment, licensing, or. certification purposes related to child care or foster care. For specific information please contact your local licensing agency. CHILD ABUSE INDEX CHECK FOR STATE LICENSED FACILITIES - 515 each (LIC 198) Effective January 1, 1993, Senate Bill 1184 (Presley -Chapter 1338 of the 1992 statutes) authorized DOJ to charge a $15 processing fee for EACH LIC 198 received.. This fee applies to ALL facilities using the LIC 198 forms; including, but not limited to: 0 Family Day Care 0 After School Programs a Child Care Centers a Foster Homes B Preschools ■ Group Homes FINGERPRINT (BID 7) STATE CLEARANCE - 552 each 1 Under the provisions of Penal Code Section .2:1105, DOJ is authorized to charge agencies submitting non -criminal applicant fingerprints a fee for State Clearance. Effective May 1, 1995, this fee has been increased to $52. The $52 _inae_r✓rint nrocessi_nc_ fee apDlles to applicant fingerprints, clearances for emplovment, licensing or certification purposes except for the exemptions specified in Sections 1522 and 1596.871 of the Health and Safety Code. Those facilities REQUIRED TO PAY the 552 fee include but are not limited to: S Child Care Centers ■ Group Homes With More Than Six Children N Pr:.sc tools ■ Foster Family P_cency Employees ■ After School Prccrams E74 ee include: * W' Small 7amily FamilyHomes ■ ' Foster Family Agency Certified, ed Family 'Homes 9 _am-l-F7 are -Tumes ■ Temporary Shelter Care Facilities A Foster Family Hc,m,es ■ Group Homes With'Six or Less Children FINGERPRINT (BID 7 ) FBI CLEARANCE - 524 each The Federal Bureau of Investigation (FBI) Clearance fingerprint fee 1s $24. Anyone who is aDplyi ng for an employment clearance, license, or certification and who has resided ___ California for less than two years is reo-uired to obtain an FBI clearance. This clearance is" obtained by submitting a second complete set of fingerprints along with the $24 fee to DOJ. Ali fingerprint cards (BID 7), Child Abuse Index Forms (LIC 198), and appropriate fees must be mailed to: Department of Justice Bureau of Criminal Identification and Information P.O. Box 903417 Sacramento, CA 94203-4170 All fees can be incl -,.:,zed on the same check made payable to the Department of Justice. The above f^:ms submitted without the appropriate fees will be =eturne to the appli__nt. rev. 5/95 doj.fees Y�. T i . lP c..�YIRMIK .aA:'.'iAV�'�'+► `M�M.fi RECEIVED NOV 16 1999 BUTTE COUNTY BUILDING DIVISION J STATE OF CALIFORNIA - HEALTH AND WELFARE AGENCY DEPARTMENT OF SOCIAL SERVICES COMMUNITY CARE LICENSING RECORDS TO BE MAINTAINED AT THE FACILI — Small Family Home and Foster Family Home THE FOLLOWING INFORMATION, which is required under Sections of Title 22, California Code of Regulations, MUST BE KEPT IN THE FACILITY, COMPLETE AND CURRENT, AND READILY AVAILABLE FOR REVIEW. Child's Records A. A copy of the birth certificate, if available B. Preplacement Appraisal and Appraisal Needs and Services Plan (LIC 625) - updated at least annually with authorized signatures. C. Pbysician Report for Community Care Facilities (LIC 602) - Medical assessment, including record of illnesses and immunizations. Records of medical care provided; evidence of periodic medical and dental examinations; record of dental care; record of changes in physical, mental, emotional and social functioning of child; ambulatory status; diet restrictions. D. Identification and Emergency Information (LIC 601). E. Current admission agreement with authorized signatures - Admission Agreement Guide for Residential Facilities (LIC 604), or placement agreement. F. Personal Rights - Community Care Facilities (LIC 613), receipt, signed and dated. G. ReQord of Client's/Resident's Safeguarded Cash Resources (LIC 405) and Client/Resident Personal Property and Valuables (LIC 621). Record of child's safeguarded cash resources, personal property, or valuables, if any, including supporting receipts of expenditures and of cash resources given to the child or the authorized representative. H. Centrally Stored Medication and Destruction Record (LIC 622). I. Unusual Incident/Injury/Death Report (LIC 624). J. Consent for Medical Treatment (LIC 627). K. Release of Client/Resident Medical Information (LIC 605A) II. For The Licensee And Staff, If Any A. Health- Screening Report — Facility Personnel (LIC 503) and Tuberculosis (TB) clearance. B TB clearance and "good health" statement from volunteers in a Small Family Home. C. Appropriate driver's license for person(s) transporting children. D. Verification of training in first aid for persons responsible for providing direct care and supervision in a Small Family Home. Verification of training in first aid and CPR for at least one person in a Foster Family Home. E. Verification of education, training, and/or experience for licensee and staff, if any. F. Emergency Disaster Plan for Small Family Homes (LIC 610) and Foster Family Homes (LIC 610A). 'G. Personnel Report (LIC 500) showing current roster. 'H. Licensee affidavit regarding persons exempt from fingerprint requirements, (if not on LIC 500). 'l. Criminal Record Statement (LIC 508). (Completed for staff and any adult residing in the home.) 'J. Personnel Record (LIC 501). K. Documentation of waivers and exceptions (LIC 956/LIC 971). L. Statement Acknowledging Requirement to Report Suspected Child Abuse (LIC 9108). 'Information required on staff only. over LIC 311 E (3!97 ., ,. I VP Yw+eti-�wwMAw�w;�'Yfae/nM�M" J'C 's rk e. ;►kr RECEIVED NOV 16 1999 BUTTE COUNTY BUILDING DIVISION State of California Department of Social Services Facility Number: 041374179 Effective Date: 09/11/93 Total Capacity: 6 In accordance with applicable provisions of the Health and Safety Code of California, and its rules and regulations; the Department of Social Services, hereby issues this License to MATA9 KAREN LEE to operate and maintain a SMALL FAMILY HOME Name of Facility KAREN'S SPECIAL CARE 451 PALISADES DR. CHICO CA 95928 This License is not transferable and is granted solely upon the following: AMBULATORY/6 NONAMBULATORYt AGES 0 THROUGH 17 YEARS. DEVELOPMENTALLY DELAYED CHILDREN? SPECIAL HEALTH CARE NEEDS• Client Groups Served: DEVELOP DISABLED Complaints regarding services provided in this facility should be directed to: CHICO — RESIDENTIAL DISTRICT OFFICE (530 —503 J�=e MARTHA LOPEZ - _r Deputy Director, AuthorizeRepresentative Community Care Licensing Division of Licens ng Agency RECEIVED NOV f-6 1999 BUTTE COUNTY 01 111 n1ki + n�. .._._ State of California Department of Social Services Facility Number: 041374179 Effective Date: 09/11/93 Total Capacity In accordance with.applicable provisions of the Health and Safety Code of California, and its rules and regulations; the Department of Social Services, hereby issues this License to MATAs KAREN LEE to operate and maintain a SMALL FAMILY HG11E Name of Facility KAREN'S SPECIAL CARE 451 PALISADES DR. CHICO CA 95928 This License is not transferable and is granted solely upon the following: AMBULATORY/6 NONAMBULATORY9 AGES 0-18 YEARS T! Client Groups Served: DEVELOP.OISABLED Complaints regarding services provided in this facility should be directed toj CHICO — RESIDENTIAL DISTRICT OFFICE (916) X3 MARTHA LOPEZ Deputy Director, Authorize Representativ Community Care Licensing Division of Licens g Agency State of California Department of Social Services Facility Number: 041374179 Effective Date: 09/11/93 Total Capacity: In accordance with applicable provisions of the Health and Safety Code of California, and its rules and regulations; the Department of Social Services, hereby issues this License to MATH, KAREN LEE to operate and maintain a SMALL FAMILY HOME Name of Facility KARENOS SPECIAL CARE 451 PALISADES OR- CHICO CA 95928 This License is not transferable and is granted solely upon the following: AMBULATORY/4 NONAMBULATORY• AGES 0-18 YEARS Client Groups Served: DEVELOP DISABLED Complaints regarding services provided in this facility should be directed to: CHICO — RESIDENTIAL DISTRICT OFFICE (916) 895-5033 MARTHA LDP€Z Deputy Director, AA-o-ri-z6I Representative Community Care Licensing Division of Licensing Agency 4 State of California Department of Social Services Facility Number: 041374179 Effective Date: 09/11/93 Total Capacity In accordance with applicable provisions of the Health and Safety Code of California, and its rules and regulations; the Department of Social Services, hereby issues this License to PANLEDGEv KAREN to operate and maintain a SMALL FAMILY HOME Name of Facility KAREN'S SPECIAL CARE 451 PALISADES DRIVE CHICO CA 95926 This License is not transferable and is granted solely upon the following: AMBULATORY/4 NONAMBULATORY9 AGES 0-18 YEARS 4 Client Groups Served: DEVELOP DISABLED Complaints regarding services provided in this facility should be directed to: CHICO DISTRICT OFFICE (916) 895-5033 MARTHA LOPEZ _ Deputy Director, Authorize Representative Community Care Licensing Division of Licensing Agency State of California Department of Social Services Facility Number: 041374179 Effective Date: 09/11/93 Total Capacity: In accordance with applicable provisions of the Health and Safety Code of California, and its rules and regulations; the Department of Social Services, hereby issues this License to HOWELL• KAREN to operate and maintain a SMALL 'FAMILY HOME Name of Facility KAREN•S SPECIAL- CARE 451 PALISADES DRIVE CHICO CA 95926 This License is not transferable and is granted solely upon the following: AMBULATORY/4 NONAMBULATORY9 AGES 0-18 YEARS Client Groups Served: DEVELOP DISABLED Complaints regarding services provided in this facility should be directed to: CHICO DISTRICT OFFICE MARTHA LOPEZ Deputy Director, Community Care Licensing Division (916) 8955033 Authorizedl Representative of Licensing Agency 4 E J�§tatr of Tatifornia ,Bepartment of iocial �&erbicee Facility Number: 041374179 Effective Date: 09/11/92 Total Capacity: 4 Expiration Date: 09/10/93 In accordance with applicable provisions of the Health and Safety Code of California, and its rules and regulations, the Department of Social Services, hereby issues �► t4ili 1 1 to HOWELL* KAREN to operate and maintain a SMALL FAMILY HOME Nttrnr of -yttritity KARENRS SPECIAL CARE 451 PALISADES DRIVE CHICO CA 95926 This License is not transferable and is granted solely upon the following: AM3ULATORY/4 NONAMBULATORY• AGES 0-18 YEARS Client Groups Served: DEVELOP. OISABL�D Complaints regarding services provide in this acility should be directed to: LCHICO DISTRICT OFFICE 1916! 895-5033 F Z Deputy Uirector, Authoriz presentative Community Care Licensing Division of Licensing Agency tatr of Tatifort is Department of �$ocial ieri)im Facility Number: 041370904 Effective Date: 01/26/92 Total Capacity: 4 Expiration Date: 01/25/93 In accordance with applicable provisions of the Health and Safety Code of California, and its rules and regulations, the Department of Social Services, hereby issues tn�$ ��irrn�e t� HOWELL. KAREN LEE to operate and maintain a SMALL FAMILY HOME Rupp of arititg KAREN• S SPECIAL CARE 114.52 CHALAIR DR- OROVILLE CA 95965 This License is not transferable and is granted solely upon the following: AMBULATORY/4 NONAMBULATORY, AGES 0-'17 YEARS Client Groups Served: DEVELOP DISABLED Complaints regarding services provided in this facility should be directed to: CHICO DISTRICT OFFICE (916) 895-5033 1-800-4—CCL—NOW r I c j k RED Wo MILLER ,V 1.l�'���- (�11 ��� I eputy Director, Authorized R resentative Issue Date ommunity Care Licensing Division of Licensing gency T'i J�kntr of Tatifornia Department of �$ocial �$er jirn Facility Number: 041370904 Effective Date: 8/12/91 Total Capacity: 4 Expiration Date: 1/25/92 In accordance with applicable provisions of the Health and Safety Code of California, and its rules and regulations, the Department of Social Services, hereby issues ti�t,S � to HOWELL, KAREN to operate and maintain a SMALL FAMILY HOME .. anmr of Rttrilitg KAREN'S SPECIAL CARE 11452 CHALAIR DR. OROVILLE, CA 95965 This License is not transferable and is granted solely upon the following: ALL NONAMBULATORY, AGES 0-17 YEARS Client Groups Served: DEVELOP DISABLED Complaints regarding services provided in this facility should be directed to: CHICO DISTRICT OFFICE (916) 895-5033 1-800-4—CCL—NOW FRED W. MILLER Deputy Director, Community Care Licensing Division Authorized Representative of Licensing Agency Issue Date J, r. rii2 �tatr of Tatifornitt Department of �$ociaf "11-6erbim Facility Number:041370904 Effective Date: 01/2 6/9 1 Total Capacity: 2 Expiration Date: 0 1/2 5/9 2 In accordance with applicable provisions of the Health and Safety Code of California, and its rules and regulations, the Department of Social Services, hereby issues t4i,i 4 to ��rrnli� HOWELL* KAREN LEE to operate and maintain a SMALL FAMILY HOME -Nd III r of arilitg KAREN'S SPECIAL CARE 11452 CHALAIR DR, GROVILLE CA 95965 This License is not transferable and is granted solely upon the following: iaON ABULATORYq AGES 0 THROUGH 17 YEARS. Client Groups Served: DEVELOP DISABLED Complaints regarding services provided in this facility should be directed to: CHICO DISTRICT OFFILE (916) 895-5.0,33 1-dUO-4—CCL—NO FRED W. MILLER Deputy Director, Community Care Licensing Division �� Authprized Representative Issue Date Of LiEensing Agency •r..l i�§tatr of Tatifornia Department of �$ocial $erbim Facility Number: 041370904 Effective Date: 01/26/90 Total Capacity: 2 Expiration Date: 01/25/91 In accordance with applicable provisions of the Health and Safety Code of California, and its rules and regulations, the Department of Social Services, hereby issues TF - ti 0 to .larrui r HOWELL• KAREN LEE to operate and maintain a SMALL FAMILY HOME Name of Y arilitg KAREN'S SPECIAL CARE 11452 CH ALA I R DR. OROVILLE CA 95965 This License is not transferable and is granted solely upon the following: NONAMBULATORY• AGES 0 THROUGH 17 YEARS. J�1 Client Groups Served: DEVELOP DISABLED Complaints regarding services provided in this facility should be directed to: CHICO DISTRICT OFFICE [9161 895-5033 1-8004-CCL—NOW FRED W. MILLER MoDeputy Director, Community Care Licensing Division Autjiorized Representative Iss a Date of Licensing Agency �ttttp of C�niifornitt Department of iorial �ert�ires Facility Number: 041.37 0904 Effective Date: 01/26/89 Total Capacity: Expiration Date: 01/25/90 In accordance with applicable provisions of the Health and Safety Code of California, and its rules and regulations, the Department of Social Services, hereby issues 140 to HOWELL• KAREN LEE to operate and maintain a SMALL FAMILY HOME .Nttnte of .ynrititg KAREN•S SPECIAL CARE 11452 CHALAIR DR. OROVILLE CA 95965 This License is not transferable and is granted solely upon the following: NONAMBULATORY• AGES 0 THROUGH 17 YEARS. �10 Client Groups Served: DEVELOP DISABLED Complaints regarding services provided in this facility should be directed to: CHICO DISTRICT OFFICE ( 916) 895503.3 1-800-4r—CCL—NOW FRED W. MILLER /4 > t / y Sx7- Deputy Director, Authorized Representative Issue Date L A Community Care Licensing Division of Licensing Agency 4�tatr of Tatifornia pepartment of �$acinl �$erbim Facility Number: 041370904 Effective Date: 01/26/88 Total Capacity: 2 Expiration Date: 01/25/89 In accordance with applicable provisions of the Health and Safety Code of California, and its rules and regulations, the Department of Social Services, hereby issues Imo' !! I tip to HOWELL, KAREN LEE to operate and maintain a SMALL FAMILY HOME Name of Yarititg KAREN'S SPECIAL CARE 11452 CHALAIR DR. OROVILLE CA 95965 This License is not transferable and is granted solely upon the following: NONAMBULATORY, AGES 0 THROUGH 17 YEARS. Clienti Groups Served: DEVELOP DISABLED Complaints regarding services provided in this facility should be directed to: CHICO DISTRICT OFFICE 1916) 8955033 1-800-n4—CCL—NOW IkL FRFs d_ Mit l ER Deputy Director, Community Care Licensing Division ROBERT GOMEZ Authorized Representative of Licensing Agency 2-1-88 Issue Date 161580 �§tdtP of Tatifornia ,Vepartment of social �Sertlicrs Facility Number: 041370904 Effective Date: 1-26-87 Total Capacity: 2 Expiration Date: 1-25-88 In accordance with applicable provisions of the Health and Safety Code of California, and its rules and regulations, the Department of Social Services, hereby issues A t4i" tD HOWELL, KAREN LEE & NORMAN PAUL to operate and maintain a SMALL FAMILY HOME Nnnir of YarilitB KAREN'S SPECIAL CARE 11452 CHALAIR DR. CROVILLE, CA 95965 This License is not transferable and is granted solely upon the following conditions and limitations: NON AMBULATORY, AGES 0 THROUGH 17 YEARS Complaints regarding services provided in this facility should be directed to: DEPT SOC SVCS COMM CARE LIC (916) 895-5033 Initial Issue Date:-�% JOHN W. HAGERTYcr.'.. Deputy Director, Authorized Representative Community Care Licensing Division of Licensing Agency LIC 203A (12/82) PUBLIC tett!' of cf atiforimi 1vpartntmit of �ttCul l �VnlI.Cm Facility Number: 041-570904 Effective Date: 1—P;i—uj Total Capacity: Expiration Date: 1�"� In accordance with applicable provisions of the Health and Safety Code of Cal fornia, and its rules and regulations, the Department of Social Services, hereby issues tllify71 16,♦ rl " til KARU-1 11.1 &NORMAN .PAUL to ope,ate and maintain a 6114A—Iia FAXILI HOI*' VcilIIr tit Y leaf iltti� 1,4,;P UHkLA rR OE<.. 0';::1.:x, c,; 9r;965 I is L --ense is not transferable and is granted solely upon the following conditions and limit,rtlons. :'.t Pi „?;t3�JI,ATO4tY, A.Gr'".5 0'i'H-ROUGH 1'] '?C;itki,�i .0 j (M.L Tiff. cy&;S.ia vVed : Cc•,1;1,, lnts regarding services provided in this facility should be directed to: b-11 i (X; .ilICS COMM "Ak;: l,lt: l l'•?i 7'=)?•- �Gx3 Initial Issue Date: ;. +N 1WRACi;:r:T D, Duty Director, Authorized Representative LXC nanunity Care Licensing Division of Licensing Agency 20--A 112/82! PUBLIC NOV. -08' 99(&ION) 11:42 CCL CHICO D. 0. TEL:530 895 5934 P.001 STATEOFCAUFORNIA ! IRE.SAFETY INSPECTION RECUEST CLPARANCEIDENWLCODE sTD aso(REv. +o eal See instructions on reverse. AGENCY CONTACTS NAME DSS/COMMUNITY CARE LICENSING TELEPHONENUMBEsi REOVESTOATE 19-8-99 PRWAAM FIRE 530 895-5033 ATTN: TED CRAWFORD EvALUATORSNAME REQUESTING AGENCY FACIUTYNUMBER REGUESTGOOE 0303/ 581371952 5A NAME AND CODES LICENSING DEPARTMENT OF SOCIAL SERVICES T- ORIGINAL A. FIRE CLEARANCE AGENCY COMMUNITY CARE LICENSING 2. RENEWAL S. LIFE SAFETY NAME AND 520 COHASSET RD., SUITE 6 3_ CAPACITY CHANGE ADDRESS CHICO, CA 95926 4. OWNERSHIP CHANGE ' L S. ADDRESS CHANGE J B. NAME CHANGE 7. OTHER -- - C. FIRE ALARM AMBULATORY NONAMBULATORY ��^^'^^�-• --- FAOUTYNAME HONEYRUN CARE HOME SfRETs7ADDRESS fAaaWLawt(w) 451 PALISADES DRIVE CITY CHICO, CA 95928 FACILITY CONTACT PERSON'S NAME KAREN MATA 345-6044 SPECUILCONDMONS CAPACITY PREVIOUS 6 TO BE COMPLETED BY INSPECTING AUTHORITY 6 UCENSECATL-0ORY 710/SMALL FAMILY HOME NUMBER OF BUILDINGS 1 RESTRAINT NO HOURS 24 CLPARANCEIDENWLCODE F BUTTE COUNTY FIRE CODES FIRE ATTN: TED CRAWFORD AUTHORITY 176 NELSON AVENUE T. FIRE CLEARANCE GRANTED NAME AND OROVILLE, CA 95965 - 2. FIRE CLEARANCE DENIED - ADDRESS A. E)OTS L 0. CONSTRUCTION -• -- - C. FIRE ALARM INSPECTOR'S NAMEf►yneoorprwad) TELEPHONENUMBER CFIRS NUMBER OCCUPANCY CLASS D. SPRINKLERS E. HOUSEKEEPING F. SPECIAL HAZARD INSPEMNOATE INSPECTOR'SSIGNATUREfrypeoorPmtW) - - G OTHER INTER -DEPART AL MEMORANDUM TO: BUILDING DIVISION, OROVILLE FROM: —Scy 1� %� , ENVIR. HEALTH, CHICO DATE: It - 30 -99 RELEASE ENV, HEALTH HOLD ON BU LDING FINAL FOR: OWNER NAME: WELL:SEPTIC: Aft Or 1- t [) - 02-4'ADDRESS/LOCATION: Comments, GUmemoskeleawhold ' 11-11-24 773-89P,E PAWLEDGE, Jack & Koletta 1869 Honeyrun Rd, Chico ` Contr: Executive Homes (util, MH) PERI r _ �2INALED:- i PERMIT EXPIRES �— - r OWNER t CONTR. ASSESSOR PARCEL LOCATION Temp. Power Pole Called PG&E Temp. Elec. Service Called PG&E Temp. Gas Service C Called PG&E JOB FINALED (Date) Signature a = OK 0 = Not OK - = Not Applicable = Not Ready Date MOBII I MOBILE HOMES TOME UTILITIES (P%at� OK except #'s )Requirements -Se s-Easamanf¢ 3pesi - L.oa on -T - a o et Lqoation-miasernent Needed etch .it Lo on -Clea ances d .-/,% Am ocation s p' / /"L"ft. Vat. or iL" ft:/% P,LPG Clearan e Card -131 6H Daterof f -vCard-B1 Date Card -81 / Dat �,/.� and -131 Date Date M0"140ME INSTALLATION (Plans) OK except #'s Oo"Zoning Requirements -Setbacks -Easements 2. Footings; Size -Spacing -Marriage Line 3. Gas; MH Test- Dgm-Sh—cl-Vats - owed icity; MH Test-Crossg_vers=Breakers-Cleax MH Tesfi=Fall-Flex Connector y MH Te& -R =and_ Sewer Connected -G40 -to -Grade -HD .-Sketch M Card -61 Dat -rte, %Card -B1 Date Card -81 — Date Card -131 Date "vAYW 41114 vS�d - MISCELLANEOUS /U• G 4A/, S OIC k ct�,&�e 6 I p 3 Date DECKS,COVERS,CARPORTS,GARAGES, (Plans)OK except #'s 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Connec.- Shthg.-Rfg.-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Elec. 8. Frmg; Sills-Anchors-Studs-Rftrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings Card -131 Date Card -131 Date Card -131 Date Card -81 Date 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-Panelboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test Card -81 Date Card -131 Date Card -61 Date Card -131 Date I UK o 0 = Not OK Not'Applicable RESIDENTIAL (.Single and Duplex) - = = Not Ready Date UNDERFLOOR (Plans) OK except #'s Date FRAMING (Continued) 1. Zoning -Setbacks; -Easements -Flood -Slope 45. Hangers -Post Caps -Anchors -Connectors 2. Ftg., Main; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 46. Ong. Joist-Rftr. Ties-Purlin-Roof Brac.-Truss-Shthng.-Rfng. 3. Ftg., Garage; Soils -Steel-/ /" Ftg. Depth 47. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 4. Ftg., Porches & Decks; Soils -Steel-/ /"Ftg. Depth 48. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 5. Stemwalls, Main; Steel-Blockouts-Wrapped 49. Bdrm. Windows or Exiting Doors -Sill Hgt. & Dimensions 6. Stemwalls, Garage; Steel-Blockouts-Wrapped 50. Garage Fire Protection Framing 7. Slab; Steel -Wrapped 51. Property Line Firewall & Openings •8. Piers -Fireplace Ftg.-Steel 52. Ext. Doors -One 3' -Check Garage -3rd story, 2 exits 9. D.W.V.; Fall -Fittings -Test -2 way C/O -Sewer Test 53. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 10. Gas Pipe; Size -Anchors 54. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 11. Water Pipe; Test -Anchors -Regulator -Service Test 55. Siding -Nailing Veneer 12. Electric; Underground 56. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 13. Plenums & Ducts; Clearance- Mated al -Su pprt-Ins. 57. Glazing Area -Glass Protection -Skylights -Plastic 14. Girders -Sills -Anchor Bolts -Joists -Vents -Cripples 58. Shear Walls; Nailing -Bolts 15. Insulation 59. Insulation-Walls-Clg. 60. Infiltration-Walls-Wndws Card -B1 Date Card -B1 Date Card -131 Date Card -131 Date Card -131 Date Card -131 Date Card -B1 Date Card -131 Date Date PLUMBING Permit OK except #'s - 16. Water Ht. Vent -Access -Combustion Air -Baffle Date FINAL (Plans) OK except #'s 17. Water Pipe; Test & Anchors -Nail Protection 61. Ext. Steps -Door•& Sidelight Protection -Landings 18. D.W.V.; Test-Fttngs & Anchors -Nail Protection 62. Smoke Detector 19. Shower Pan; Test, First Floor -Tub Access 63. Furnace; Vents -Clearance -Comb. Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 20. Test Tub & Shower, 2nd Floor -Tub Access 21. Gas Pipe; Size & Anchors 64. Bedroom Exiting 65. G.F.I. & Bath Fixtures & Tub Access -Spa 66. Elec. Trim & Subpanel; Breaker Sizes -Labels Card -131 Date Card -131 Date 87. Stairs &Rails Card -81 Date Card -131 Date 68. Fireplace or Stove; Clearances -Hearth Date ELECTRICAL (Permit) OK except #'s 69. Elec. Outlets at Wood Panel; Int. & Ext. 22. Fixture & Transformer Clearance -Ins. Protection 70. Kit. Fixt. & Appliance; Grnd. -Air Gap -Cooking Clearance 23. Elec. Receptacles Spacing -Lights & Switches at Doors 71. Elec. Outlets & Receptacles at -Kit. Counter 24. Size Boxes & No. of Conductors -Stapled 72. Garage Fire Door; Swing -Landing -Closer 73. A.C. Duct in Garage -Damper 25. Romex Installed Close to Edge of Studs & C.J. 26. Equip. Ground made up w/Mech. Fasteners -Bond Gas &Water 74. Wtr. Htr.; Vents -Clearance -Comb. Air-Connector-P.R.V.- In Garage; Above Floor-Mech. Protection 27. 2 Appliance Circuts in Kitchen & Conductor Size/G.F.I. 75. Plb., Elec. & Mech. Equip. Listed for Location 28. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / /ga. Cu or Al 76. Elec. Receptacles in Garage; (G.F.I.)-Romex Protec. 29. Range Circ. / / ga. Cu or AI -Oven Circ. / / ga. Cu or Al. Insulated Neutral Yes No 77. Insulation -Foam -Looked in Attic ❑ Yes -78. Guard Rails & Deck Construction -Post Caps 30. Service -Riser Conductors & Ground -Main Disconnect 79. Fdn. Vents & Crawl Hole Door -Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 31. Equip. Clearances Panels-Motors-Mech. Equip. 32. Clothes Closet Light -Shower Light -Spa Light 80. Following instld.; Drive ❑ Yes ❑ No; Walks ❑ Yes ❑ No; .Planters ❑Yes .13 No 33. Smoke Detector 81. Stucco; Brown -Finish Card -B1 Date Card -B1 Date 82. A.C: Unit; Disconnect, Electrical, Plumbing Card -B1 Date Card -B1 Date 83. Vents Above Roof; PIbg.-Appliance-Firep [.-Clearance to Openings. Date MECHANICAL (Permit) OK except #'s 84. Water Well; Disconnect, Electrical, Plumbing 34. A.C. Ducts Insulation & Support 85. Exterior Elec. Trim; G.F.I. Receptacle -Underground 35. Vent Fan; Exhaust above insulation 86. Ventilation throughout House 36. Condensate Drain & Overflow; Size & Grade 87. Glass Protection 37. Furnace -Vent; Access -Comb. Air -Return Air Vent -115 outlet 88. Corrections from Previous Inpections 38. Attic Access & Platform if Furnace in Attic 89. Gas Test -Meters Tagged; Gas -Electric 90. Water & Sewer Connected -C/O to Grade -HD Approval 9i. Energy Compliance Certificate -Other Certificates Card -B1 Date Card -B1. Date 92• Roofing Certificate Card -B1 Date Card -81 Date Card -81 Date Card -61 Date Card -131 - - Date Card -131 Date Date FRAMING (Plans) OK except #'s 39. Sills, Proper Material & Anchors Card -B1 Date - Card -81 Date Comments at Final: 40. Walls Studs -Nailing, Spacing & Bracing -Plates -Sound 41• Bearing Walls over Girders & Floor Nailing 42. Draft Stop in Walls (rat proof) 43. Fire Stops; Furred Ceilings -Stairs -Chases -Tub 44. Header & Beam -Size & Bearing r ' MOBILEHOME INSTALLATION ACCEPTANCE x COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE OROVILLE, CALIFORNIA — 534-4541 PERMIT /NO. Address or location of mobilehome , //"),JF ` / /`cf ',•��� ��- Owner's name C� C �� �l t tr ZF Wr, "r Owner's address ��� /7 0f� S X,, / / ter — K/ i / c Insignia or hud number Manufacturer's name Serial number of.V:I.N. (Official Approving/Installation F'/ Cf " fl 7 rl— — Year of manufacture/9 r. / 4 — (Date) IF THE MOBILEHOME IS MOVED OR RELOCATED, THE MOBILEHOME INSTALLATION ACCEPTANCE SHALL BECOME INVALID. THIS FORM SHALL NOT BE USED WHEN THE MOBILEHOME IS INSTALLED ON A FOUNDATION SYSTEM. 513B White - Owner, Yellow - Installer, Pink - D.P.W. I f_! 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 A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office when correction of work is completed. If you have any question pertaining to this matter, or need additional explanation, please contact this office immediately. Inspector (-�?/f A�� Date -4Z:1-2,1 ',� COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS s 196 Memorial Way, Chico — Phone: 891-2751 7 County Center Drive, Oroville — Phone: 538-7541 747 Elliott Road, Paradise— Phone: 872-6307 dew - CORRECTION NOTICE A ej, X,L/o..i v.v 77.E -- OWNER —� PERMIT r A routine inspection indicates that the following violations of County Ordinance exist at the above address and should be corrected. Please notify this office y} when correct- of work is completed. If you have any question pertaining to this matter, o eed additional explanation, please contact this office immediately. Inspector Da J �. 1 COUNTY OF BUTTE-'DEPAf�TMENT OF PUBLIC WORKS P RMIT NO 7 County Center Drive - Oroville. California 95965 - Telephone: 916/538-7541 77.E / APPLICATION AND PERMIT ASS SSOR PA CEL NUMBER ��� %' _ O 2 ZONING �_ S BUILDING PERMIT OWNER TELEPHONE -sack A- 3q3 6so3 SQ. FT. OCC, BUILDING VALUATION OWNER'S MAI LI G ADDRESS !p (e D.ve 955'z C".TR ACT R'5 NAM T EPHONE AX e e_ c.L 4 /1 V -e— CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $` Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ i74Ci PLUMBING PERMIT Filing Fee 10.00 Oye Each Trap 2.00 eh Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION VISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STgUCTURE Gas piping system 1 - 5 outlets 5.00 SF ❑ Duplex❑ Mobilehome Other Building sewer 5.00 SPECIFY Mobile Home S G W 0.00ea 30, O.O TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities LZ__ Installation❑ Other ❑ Permit Fee $ Describe work: Q 6x- 02 Contractor .ai< X S<o me -&o ELECTRICAL PERMIT Filing Fee 10.00 Main service 6100 AMP ORSLESS:�Ov l 10.00 /Q. c -o A Main service EA, ADD'L 100 AMP 2.50 a.5 a CONTRACTORS LICENSE LAW NEW CONST. DWELLING OCCUP.d , /20sgft of perjury I declare under penalty p y (check one): OR ADDNS. ACC. BLDGS. NEW CONSTR U TI.OUTLET 2,50 ea 2.50 ea ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Bushes$ NON-RESID BRANCH CIRCUITS) IRC ITSPOWER APPARATUS e POWER (SINGLE and Professions Code and my license is in full force and effect. OUTLET CIR. License No. Classification / Ex. OCCUp\OUTLETS OR FIXTURES 200701 5AL030 ❑ I, as the owner, or my employees with wages as their sole compen- Ex. Occup. OUTLETS FIXED P(RESID )REA.1 2.00 sation, will do the work,and the structure is not intended or offered Temporary service 10.00 or sale. (Sec. 7044) Mobile Home Facilities 15.00 ontract- I, as the owner, am exclusively contracting with licensed contract- Misc. Wiring 15.00 ors.(Sec. 7044) ors. ❑ I am exempt under Sec. , Business and Professions Code for this reason Permit Fee $ 2• $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): MECHANICAL PERMIT Filing Fee 10.00 ❑ The permit is for $100.00 (valuation) or less. Heating ❑ 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. Cooling 211 shall not employ any person in any manner so as to become subject Hood 3.00 to the W. C. laws of California. Ventilation Notice to Applicant: If after making this statement,should you become subject permit Fee $ to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor I certify that I have read this application and state that the above information Mobile Home Installation Fee $ is correct. I agree to comply to all County Ordinances and State Laws relating Energy Inspection Fee $ to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. TOTAL PERMIT FEE 5 1 also agree to save, indemnify and keep harmless the County of Butte against OCCuP. CONST.TYPC FLo AV PD ND ISSUE all liabilities, judgments, costs, and expenses which may in any way accrue JSCHOOL against said County in cons ence of the granting of this permit. XDate �./ g c[ This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do Signature of Applicant — Owner �Contr Dtor ❑ Agent ❑ work indicated above for which fees have been paid. An OSHA permit is required for excavations over 5'0" ee o 'tion or construct- DI TOR "F IC WORKS ion of structures over 3 stories in height. -5 ` Zo /� Receipt No. � -7 V y 00 By Dati� PERMIT WRITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR, G ENROD-APPLICANT EXPIRES Date !.,✓ COUNTY OF BUTTE -DEPARTMENT OF PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 fr. PERMIT APPLICATION DATA SHEET Permit No. OWNER �6c k A. P. No. d- n - 6 a q Proposed Building Use ZV /q qBuilding Inspector 4-13,Date 1 ' k9 At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . .................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer of plans .. 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Energy Design Compliance and supporting documentation ......... 6. Statement of Intent for Non -Heated and AC Buildings .............. 7. Engineered truss details and layout in duplicate (required prior to plan check) 8. Mobilehome installation data including manufacturer's installation instructions....................................................... 9. Fees of $ .......................... 10. Chico Urban Area fees paid ........................................ 11. Park fees paid ................................................... 12. C C- School District fees; aid ..( ''13. Sanitation approval from C �L f rc). Health Department ... F.-trt 14. City of Chico plumbing permit ...................................... 15. Plot plan and business license approval from City of (see City for other requirements) 16. Planning approval for (A) Use: (B) Parking: ......... 17. Improvements may be required. 18. Driveway permit (construction approval required prior to occupancy) ... 19. Pre -Inspection for required .... Pre-Inspec. request to l p q . Building Inspector _______-__ (Date) 20. Contractor's license information (No., Name Style, Classification) ....... 21. Certificate of Workmans Compensation Insurance 1 22. wner-Builder Verification (Given to owner ❑, Mail to owner ❑) ........ 23. ecorded copy of Agricultural Acknowledgment Statement ............ Let r f si natyXe authorization ..................................... 6 /�`�1 When you issue the permit, process as follows: Mail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w/inspector. Other Applican Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitted pri 1. Index permit for above items No. 2. Additional items required: Date to-Wmit iAs+ce: (Circle new item not checked above). e� �rc designer, owner, was advised of above required data by_phone_jnail—counter b� date C,designer, owner, was advised of above required data by—phone —mal l—counter by date Plans checked Sets of plans on hold in Copy—DPW Date Plans approved by Date File cabinet AP folder N TO Buildinv Department FROM: Environmental Health SUBJECT: Sanitation Clearance Owner Locatio Ap Plan Approved for: Sewage Disposal Water Supply Hold final for: Water Supply Final clearance O.K. for:. Water Supply Clearance for _ bedroom mobile home. Other 1'ylQ -c4 . NOTE * * * S . anTtarian Date Rc urn i.o DPW AGRICULTURAL STATEMENT OF ACKNOWLEDGEML•'NT FOR RIES'EDENTTAL DEVI LOPMENT Section 26-8.1 of t:he Butte County Code requires Lhi.s acknowledgement be recorded pr.:ior to issuance of a building permit. 'rile property described herein is adjacent 89-009727 I Rec Fee 7.00 to land or :included within an area zoned Check 7.00 .for agr:i_cu].tural purposes, and residents Recorded ; of this property may be subject to incon- Official Records ; veniences or discomfort arising from the County of ; use or agricultural chemicals, Lncluding, Butte ; PARTY SHOWN but not limited to herbicides, pesticides, Candace J. Grubbs ; and (:erLi.l-izer.s; and from the pursuit Recorder ; of agr:icultural. operations including, 9:50am 20 -Mar -89 ; BG 2 but not limited to cultivation, plowing, spraying, pruning, and harvesting which occasionally generate dust, smoke, noise, and odor. Butte County has esLabl.i shed ;1gr i ru I Lural zones which have as a priority use for productive agricultural purposes, ;incl rr:;idc•nl:c w i.t.hin said zones and on adjacent I property should be prepared, to. accept such i n(-oIIVc1I i c'ncc• or disconform .from normal, necessary farm operations. All. that. real properly situate in. the. County of Butte, State of Calif or. n i a , (I r i bbl as follows: I . i s .,7 t, a�_ 0 Date: March 17, 1989 PROPERTY OWNERS: Jack Winn Pawledge cwt, Kolletta M. Pawledge State of Calif. ) On this the 17th day of March 19 89 before me, ) SS, the undersigned Notary Public, personally appeared County of Butte ) Jack Winn Pawledge and Kolletta M. Pawledge /........•.•s•..••. 9.0...•.........-.•a•u... q� OFFICIAL SEAL JEANIE KENDRICK b Personally known to me. Q Proved to me on the basis NOTARY PUBLIC — CALIFORNIA . PRINCIPAL OFFICE IN of satisfactory evidence. BUTTE COUNTY �o be the person(s) whose name(s) are My Commission Expires Sopt. 28, 1992 subscribed to the within instrument and acknowledged Lhal. they ' executed the same for the purposes therein contained. IN WITNINS. WHEREOF, I hereunto set my hand and official seal.. Present A.P. No. 011 -110 OZ4-000 No Lary P blic Jeanie Kendrick L t ^ q that certain reel ,property s#tu is in the Count q of Butte, State of California, described as follows, to -wit: P.,,. t, "" ' -'A portion of- Section--254-Township-22' North, -Range 2 East, M. -D. --B,& M described as follows: Commencing at the intersection of the centerline of Honey Run County ''. Road as the same existed in September 26, 1946 with the Easterly line of said Section 25; thence Westerly along the centerline of said Honey t Run County Road a distance of 1150 feet to the true point of beginning for the parcel of land herein described; thence from said point of beginning R Westerly along the centerline of said Honey Run County Road, a distance of 200.00 ' feet more or less, to a point which bears South 26° 22' East from the most Easterly corner of that certain.parcel of land described in deed from Walter. F. Dussault et al to Clay K, Buchanan, a widower, dated October 28, 1958 and -recorded November 5, 1958 .in Book 966 of Official Records, page 253 records of Butte County, California; thence North 260 22' West to the center of ;.�.+ Little -Butte Creek as the same. existed in September 26-, 1946; thence Easterly along -•thecenter. of '.said Little Butte,Creek to a: point which, bears North and parallel with the) East .line of said Se4ion' 25, from the point of ,beginning; 'thence ,'South And,kp�t jl.lel, with the East.•;xine•-of said 'Secfion 25 • to,,the, point' .t'+, ., .,L - t't y', .qf t i �1.. '•ti'' i i 4 , .e . . _ e `,. i� {. ......... 1:L 7J;�• 4.(; e - - - • fi A+,:....awvr:,/tLk ... t. ,w:.<.+•i �yyi 1 V - �, l 4 r -. . �!/ I_� � C.C/Y� �.�JC7���✓-� � ,--`i-"rti�-c.�-.P- _ ^�•1 � G �^�� Z [.- P� _�/ -- OWNER PERMIT 0 Nei UT IL . CLEARA -E DATE INSPECTO ✓% ELECTRIC GAS N. Support Struc. Compaction Test Re . Service Size Other Load Type Pipe Size Length YES NO S NO ff,90 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO� 7 County Center Drive - Orovil9e, CalArnia 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER /— Ho — CA ZON BUILDI PERMIT OWNSFL 4 lfe k Alul&d TELEPHONE 7,4113 -os SQ. FT. UCC. BUILDING VALUATION OWNER'S MAILING ADDRESS hb(ywaE CCaRACTOR'S TELEPHONE CONTRACTOR'S MAILING ADDRESS Q �/,rm/ /- Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee ,$ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT FIIingFee 10.00 Each Trap 2,00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAMEPARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE O'F STRUCTURE SF❑ Duplex[] Mobilehome& Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 0.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installations Other ❑ Describe work: Lo / 73��� Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 1000V OR 0 AMP ORSLESS 10.00 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 C de nd my license is in full force and effect. %/'©�p ,,//�� License No—s— Classification �L% ❑ 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 Main service EA. ADD'L 100 AMP 2.50 NEW CONST. DWELLING OCCUP.S S. , /20sq ft A New oL TLET � CONSTR. UC TI .50 ea NON.RESID .BRANCH CIRC TS 2.50 ea POWER APPARATUS .&) SINGLE OUTLET CIR. Ex. OCCU OUTLETS OR FIXTURES 20050t p� SAL030 FIXED ALNS. Ex. OCCUp. OUTLETS P(RESID.)REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 9 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. 1 have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation Permit Fee s 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. alsoexharmlessnn of Butte ilttand labites, jdgree to mens, coss,and epenses which may in any against against s 'd County in consequen e f the granting of this permit. X 21 �.+�/—" Date `"' !! Sig tore of Applicant — Owner ❑ Contractor 1�? 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 $ TOTAL PERMIT FEE $ tJ OCCUP. CONST.TYP! JscN oJPA'J FLOpJNOal ✓ ISSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which DIRECTPR OF PUBLIC PER46 EXPIRES Date the applicable provi- resolutions to do fees have been paid. WORKS Date Receipt No.BY WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT P V COUNTY OF BUTTE - DE+PARTPAF.NT..Ofr, PUBLIC WORKS - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE: 916/538-7541 PERMIT APPLICATION DATA SHEET Pa % Permit No. OWNERMI C) A. P. No. Proposed Building Use i�k / Building Inspector Date At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted . .................................... 2. Plot plans in duplicate/triplicate, signed by preparer of plans........ 3. Complete plans in duplicate/triplicate, signed by preparer of plans .. 4. Complete engineered plans and calcs, with wet signature on plans .. 5. Energy Design Compliance and supporting documentation ......... 6. Statement of Intent for Non -Heated and AC Buildings .............. 7. Engineered truss details and layout in duplicate (required prior to plan check) 8. Mobilehome installation data including manufacturer's installation instructions....................................................... 9. Fees of $ .......................... 10. Chico Urban Area fees paid ........................................ 11. Park fees paid ..................................................... 12. School District fees paid ................. 13. Sanitation approval from Health Department ... 14. City of Chico plumbing permit ...................................... 15. Plot plan and business license approval from City of (see City for other requirements) 16. Planning approval for (A) Use: (B) Parking: ......... 17. Improvements may be required. 18. Driveway permit (construction approval required prior to occupancy) ... Pre-Inspec. request to 19. Pre -Inspection for required ...... Building Inspector 20. Contractor's license information (No., Name Style, Classification) ....... 21. Certificate of Workmans Compensation Insurance .................... 22. Owner -Builder Verification (Given to owner ❑, Mail to owner ❑) ........ 23. Recorded copy of Agricultural Acknowledgment Statement ............ 24. Letter lof/ si natured uthorization..................................... 25. 0 When you issue theerg 211—g ssas follows: Mail to owner. Telephone and hold for pickup at OCC office. Other Applicant Mail to contractor. S Date) Deliver w/inspector. Date Copy of plans sent Health Dept., Fire Dept., Other Date The following data must be submitted prior to permit issuance�ircle new item not checked above). 1. Index permit for above items No. 4i 2. Additional items required: Contractor, designer, owner, was advised of above required data by_phone---naiI—counter by date Contractor, designer, owner, was advised of above required data by—phone —mal l_counter by date Plans checked by Sets of plans on hold in Copy—DPW Date Plans approved by Date File cabinet AP folder BUTTE COUNTY SCHOOLS DEVELOP.MENT•FEE CERTIFICATION FORM (/One Form per Building) A.P. Number //- �-�i Y Building Department No. School District k' (o City D County® Jurisdiction Property Owner 7T Ar_/Z.- d- A'10Ile 4/4 10,3" /2J Project .Location/Address—,44 CJ , h. -g OPI '.'I Subdivision 141 114 / Lot Number r Residential Development: E:]/ . � Sq.. Footage # of Living MHI Addition (Group R) Units Commercial/Industrial: D Sq. Footage New Addition (Including Exterior Roofed Areas) Building Department Representative Date ******************************************************************* (Floor Plans reviewed by School District Personnel) District Id No. /L11,4 ^/ I School District certifies that _T 4 A do v- 3 q (Applicant Name) 4 (Phone Number) Ar /':V / f_k �' 1,1 44, (Sttreet'Addressy , r"e : 6,0 (City) (State) -(Zip Code) has complied with the requirements of Resolution No. 36,� -d by the payment of $ �.Pf,,, Qd' representing Z-3 J6 square feet. J4 4V a i ,S"chooll District-Represeritativ / Date PAID -BY CHECK NO. BANK NO PAID BY CASH C REMARKS: . f'Y' D �.�� n i-► / Fes, /a l white -applicant, yellow -building department, pink -school district SCHOOL.FEE (8/88) April 12, 1989 COUNTY OF BUTTE Department of Building #7 County Center Drive Oroville, California 95965 ATTN: Mr• Jim Glander RE: CARL LEVERONI AP# 11-11-24 Flood Plain Elevation Dear Jim: iii BACHMAN ASSOCIATES We have made a topographic survey of the subject property based on U.S.G.S. DATUM at the Honeyrun Bridge in Chico. A bench mark was set in a power pole approximately 100.00 feet East of the mobilehome site. The subject benchmark is a "PK" nail whose elevation is 373.56. It has been determined that any mobilehome established on the site should have a minimum elevation of 351.56 for the finish floor. This elevation would be above the 100 year flood elevation in this area. If I can answer any further questions for you, please let me know. Very truly yours, &4601L C.W. BACHMAN CWB:trb ENGINEERING SURVEYING PLANNING DESIGNING 3012 The Esplanade, Chico, California 95926 Telephone: (916) 342-4136 Q1> �k NOTE -,All Mall'eria'15 & Wor.:rnor,TYi Sh-11 Be in , Accordance wr;h Re-ogn;-a ces and of a qualify prescri',_-;.� fc, use in the Uniform Building, Plurn'oing & idiechanical Codes and the National Electrical Code. specifications MUST '66 ans a Sp e co, f p1 ns SL ois unlawful to kept onins on same vnih!Du` I Dew-Lmont of Pu� IV - 01 tic or!,.S, Councy of Pui-"e- A setback of 5 ft. from the oroperty lines and a setb,5dk,:!!f_7___.wMw of 50. -. from the road centerline shall be clear of structures or equipment except for a 2 ft. ea,e overhang. 677ZC, 61"X .0-40 Pw I 2.0 .9,vO 119 Z BEd kcom 5 - 2ft WCICK S*P Mo ILI 6 qE 4- j.1 'ZOO 4 A-EACR 4i,10S =iffd RVI,- Ev �aZ Utility connections shall be nrithin 4 ft. of the mobilehome, ether directly directly behind or withi 'the rear half of the roadside (le,, of the mobilehome. v Z4L ocw PP _ .000 - wlmv. 30 -DING DS_PA.PTMW rp*. P ROVEQ BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA PHONE: 538-7541. MOBILEHOME INSTALLATION SHEET 1. Owner's Name: 2. Installer's Name: 3. Is the site currently under permit? Yes No (If yes, furnish permit number / ,J—f'� ) OR Is the site an existing site? Yes P?] No F-1 (If yes, furnish two plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes No (If no, clarify 1 5. What is the mobilehome electrical rating? --------------- Amps 6. What is the mobilehome site service rating? ------------- Amps 7. What is the mobilehome site circuit breaker rating? ----- /!r%� Amps 8. Is there any other electric load to be served by the," ` mobilehome site service? -------------------------------- Yes No ('If yes, identify the load and size: ` (Load) (Amps) 9. What is the mobilehome site gas pipe size? --------------- (in.) 10. What is the type of gas service? ------------------- Natural LPG 11. What is the gas pipe length from meter or tank to the mobilehome?--------------------------------------------- IS (ft.) * 12. What is the mobilehome gas demand? ---------------------- *(This information not required if pipe length less 3th n—ACS�Ukp; Rjy natural gas or less than 50 ft. on LPG.) (BTU) MOBILEHOME SUPPORT .BATA , If other than single wide, Mobilehome Mfr, !'lee AwroC/ furnish Setup Model No. ��� Year Width (ft.) Box Length 5 � (ft.) Tagalong or Expando Size ft. x ft. On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of Butte). FOOTINGS (check one)® 1. Wood -pressure treated or foundation grade. a 2. Other (specify) SUPPORTS (check one)[21. Concrete block. F] 2. Other (specify) Pier Footing Sizes and Locations SINGLE -WIDE MULTI -WIDE Line 1 Main Beams Line 2 -� Main Beams — — — — — — — — — �Line 4 Tag or Triple ------ � lin Line 1 Line 1 Piers: Line 1 Openings: Size -Min. ------------ „x „ Size -Min. ------------------ x " Spacing -Max. --------- _ Each Side of Openings From Ends -Max. ------- ' " With Width Over --------- Line 2 Piers://�� Line 3 Piers: (Under Bearing Wall Only) Size -Min- ------------ %�'k V Size -Min ------------------- k Spacing -Max.--------- _® Spacing -Max---------------- From Ends -Max.------- -� From Ends -Max .------------- _ Line 3 Roof Loads ;3&X30 30 Size -Min. ------------ [`l?am �j Location (From Front) -166 -0 - - Line 4 Piers: Size-Min------------- Spacing-Max ---------- From ------------ Spacing-Max.--------- From Ends -Max. ------- e 5 Piers: (Under Bearing Walls On y) Size -Min .------------------ Spacing -Max.--------------- _ From Ends -Max .------------- " Line 5 Roof Loads: Size -Min------------- Location (From Front) _ _ DOUBLE WIDE PIERING h1UFTSrIEET , ,; 3ti - --3 0- PSF. ROOF zMD PLAIC t - 7 -- '-o" 6'-0"o. c J 2'-8" MAX. MAX REAR aULlikNG (TYP) - - -� = - • - - .- - -. -- - -4 - - . MATING LINE PIERING TABLE — — •— — --� — —4- — —0- MATING 4► — i— PIER.W,, PLAN DRAI%MC FUR WMZ RAS SUPPO?,T -F09I'ING SIZES. MATING IM& PMM r]G TABIX xm s -W nnZZAL P= in n7mum 2m nammm 3ro nmmaR 4TH WIMCIR 57-H u.�u M R WM L 'ST UrAmm s AT FROM POET POET POST POST POST - POST ER LOAD IN 1W 2700 33oo .417-5- 33c 2-4x 116 24 x 34 2-4x 36 24A34-- 24� o' - 14- S' Qum T Footing sizes based on 1000PSF soil bearing value. If soil conditions differ see the piering plan drawing or the Name Tectinical Installation Manual for method of calculation PERMIT NO. 61 54-77P,F: PERMIT EXPIRES OWNER JACK W _ PAWLEDGE CONTR. owner LOCATION (A.P. 46-57-24 ) NIS Honey Run Rd, app 32- mi. E of Covered Bridge, Chico Temp. Power Pole Called PG&E Temp. Elec. Serv. Called PG&E 'I ft. Gas Serv. 7 � J Called PG&E �',,�Fol NALED 7-7--7 I _. (Date) (Signal re) COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS BUILDING INSPECTION RECORD ISUILDING BUILDING (Cont'd) PLUMBING Setback Firewall Soil Piping Forms Parapets 1st Floor Main Bldg. Restroom Finish 2nd Floor Footings Windows 3rd Floor Stemwall Siding To out Slab Roof Sheathing Water Piping Piers Roofing Sewer Garage Fdn. Vents Fixtures Footings StemwaI I Garage Vents Insulation Water Htr. Heaters Slab Carport Footings Prov. for ph sically handicaped Conformance of ex. structure Appliances Gas Piping & Test Temp. Gas Slab Final Sanitation Patio FIREPLACE Final Footings Footinq ELECTRICAL Reinf. Steel Final Fixtures Bond Beam FIRE SPRINKLERS Motors Framing Test Water Htr. Stucco Final Subpanels Mesh MECHANICAL Grd. Fault Prot. Scratch Heating Service Brown Coolinq Tema. Pole Door Closer I Final Final MOBILEHOME UTILITIES ------------------ Elec_ Service —' Elec. Pedestal --/-7 Water Piping 7 Sewer — Gas Piping ME INSTALLATION - - - - - - - - - - - - - - Support Elec. Continuity Water Piping °7 --� .? — 7 rainage —�7 .r 1 — —7 Gas Piping 7 —�— DATE z REMARKS OR CORRECTIONS _3 --7 (NOTE: An entry must be made on this form each time you visit the job site.) I 9.Electr' al A. service large enough to provide adequate amperage -to mobilehome mobilehome with a minimum of 10" p) and other facilities on lot, garage cabana, etc.? Yes__ B:, there proper clearances around panels? Yes 4/No (must equal rating of i.e., water pumps, C. power supply cord,or feeder assembly properly fused? Yes 4�1No_ D.continuity test satisfactory as per the following procedure? Yes_ o 1. De -energize electrical wiring system of the mobilehome at the pedestal. ke sure that the power supply cord or feeder assembly conductors, including neutral conductor, have been disconnected. Switch all breakers and switches in the mobilehome to the "on" position. 4 nect one lead of a test instrument to the mobilehome grounding conductor and apply t e other lead to each mobilehome supply conductor, including neutral. 5.1 1 non-current, carrying metal parts of the mobilehome (aluminum siding, gas line, water line), including fixtures and appliances, shall be tested for continuity from such equipment and the grounding conductor. 6. Upon completion of the above procedure, the power supply cord*or feeder assembly conductors shall be connected to the site service equipment. A further continuity test shall then be made between the grounding electrode and the chassis of the mobilehome. Upon satisfactory completion of the electrical tests, the lot or site service equipment may be approved for energizing. 10. Is job card signed by Health Department for water and sanitation?NCS�� 11. If everything okay, sign off card and tag services. MOBILEHOME DATA I -----� --�-�- Manufacturer and/or Namestyle / & ti / J C Length COCA Width Vehicle Serial No. State Identification No.19� Additional Information or Comments: 11 w MOBILEHOME INSTALLATION INSPECTION CHECK LIST 1. Is the mobilehome located with fired separation from lot lines and buildings and generally conform to plot plan? Yes_ o 2. Does the mobilehome have.required clearances above ground? (Sec.5085) Yes/,-- No 3. Are footings and supports properly sized, spaced, and braced as per approved plans? (Note possible variation at spring shackles..) (Sec. 5082 & 5083) Yes_ o 4. Is the mobilehome level? (Sec. 5088) Yes 5. If more tha n unit, are crossover connections properly installed? (Sec. 5088) Yes_ No 6. Water A. Is fle ' e connector of adequate size and properly installed (1/2" ID min.)? (Sec. 5566) Yes_ No B. Test - Does water piping withstand working pressure or 50 lbs. air test? Yes vNo C. BackfloWue o 's not State of California approved, does station have backflow device and pre f valve? Yes -'\-No 7. Wastes and Drains A. Is connection made with Schedule 40 DWV and have flex connectors at each end? Yes No B. Does it have minimum" per foot slope and is it properly supported? Yes_ o C. Are any leaks detected in drainage system after running 3 -gall s of water through each fixture including washing macj�ine standpipe? Yes No1�n D. If coach is not S e ��' ornia approved, does station have required trap and vent? Yes No 8. Gas Piping and Gas Vents A. Connector - Is mobilehome connected to the gas supply with an approved 3/4" minimum mobilehome connector not more than 6 ft. long? Note: All piping is to be at least as large as the mobilehomme gas line iiilet without reductions other than the mobilehome connector. Yes _�l�0 B. Test OK as per following procedure? Yes_ o_ 1. Open all appliance connector valves. 2. Shut off appliance burner and pilot valves. 3. Air test with manometer to 10"-14" water column, or test with slope gauge (minimum 6oz.-maximum 8 oz.) calibrated in tenth pound increments. Test for 10 min. without drop. 4. Connect gas meter to mobilehome with connector, turn on gas, test connections with soapy water. C. Are all appliance vents properly installed? Yes '* 4 o COUNTY OF BUTTE DEPARTMENT OF PUBLIC WORKS 7 COUNTY CENTER DRIVE r OROVILLE, CALIF. - 534-4541 CERTIFICATE OF OCCUPANCY This mobilehome has been installed in accordance with the requirements of the California Administrative Code, Title 25, Chapter 5, under permit number(- f 5 'j7 —7for the following location: /�� w14eE •/_41_s, f ;�-, wx) - X7 /A." C X') Owner JA e- / Owner's Address / 'J q Moliilehome Mfg. U /1 / Model Year���rn� Insignia No. Serial No. 'It is hereby certified for occupancy at the above described location and may be occupied. i Director of Public Woeks Date __71 _7 R_ By e` ��� THIS CERTIFICATE IS VOID WHEN MOBILEHOME IS RELOCATED White -Owner, Yellow - Installer, Pink - D.P.W. COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS �. 7 County Center Drive - Uroville, California 95965 r Telephone: 534-4541 APPLICATION AND PERMIT mpiesmnauves 01 Ule VUunLy UI butte to enter upon the above- entioned property for inspection purposes. X Date 0 7 Signature of Permitee WrAgent Receipt No. / 7% n 0 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIR TOR�,OF BLIC WORKS ry By Date_L�! Building permit expires Date /e_�7=22 BUILDING Owner dG SQ. FT. OCC. BUILDING VALUATION Mai I i ng Address 2 A•P J,.-�-T �� [e, Tele hone No. _O5'O Fireplace Contractor 011124 Total Valuation Mai I i ng Address 'e- >/ Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee Building Address PLUMBING No. @ FEE PERMIT FILING FEE $3.00 PA-0k..�- G O F v C%, r� Each Trap 1.50 Repair drainage or vent piping 1.50 Water piping 1. Each gas water heater or vent 1.50 pp 6 — S_7 Z 4, A. P. No.Za n 9 Gas piping system 1 - 5 outlets +1-3d (Q c Each additional outlet .30 F t5r±C. Sa n Fire Dept. Fire Zone Use Permit Building sewer EQA IParking Parcel Plans Declaration Parcel Ma P 60' R..W Im rovements. P Lawn sprinkler system 2.00 Bldg. Feans Rec'd Parcel ApprovalIVIT Plans Ap royal Permit Fee $ 33.q$ $ NEW ❑ ADDITION ❑ UTILITIES OTHER ❑ ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 Main service 100 AMP OR0V OR LESS5.00 , �+ Main service EA. ADD'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service OVER 1100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 S t �r►� �. ( J ) QJL fLr ,7/�i w )� NEW CONST. DWELLING OCCUP. & OR ADDNS. ACC. BLDGS. 20syft NEWCONSTR. /MULTI -OUTLET NON .RESID. % BRANCH CIRCUITS) 2.50ea G B ,-, NEW CONSTR. POWER APPARATUS & NON.RESI D. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Ex. Occup(OUTLETS OR FIXTURES)@@25C BAL N' 1 Ex. Occu FIXED APPLNS. OR P'(OUTLETS (RESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00p License No. Classification Misc. Wiring 6.25 I am exempt from the Contractors License Laws of the State of California. Permit Fee $S ;�'- $ 2 WORKMEN'S COMPENSATION INSURANCE I am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ I have placed on file with the County of Butte a certificate of kmen's Compensation Insurance. certify that in the performance of the work for which this kI permit is issued I shall not employ any person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No.1 @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 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 n„tk .i LAN ��LVP we yr_1 ®C TOTAL PERMIT FEE $ �3 �o mpiesmnauves 01 Ule VUunLy UI butte to enter upon the above- entioned property for inspection purposes. X Date 0 7 Signature of Permitee WrAgent Receipt No. / 7% n 0 White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIR TOR�,OF BLIC WORKS ry By Date_L�! Building permit expires Date /e_�7=22 . t a NOTE:—qll Materials $ Workmanship Shall Je h s Accordance with Recognized • qualify g Good Practices an p of a q y prescribed for the S Uniform Building, Plumbing Pacified use i ' #h Me National Elect ' al C e Mechanical Coder 01 tee• = o Cr This set of plans and specifications MUST .b�`� c kept on the job at all times an -J 4 is uniawfirl "c 'make any changes or alterations on same without written permission from the Department of Put � d'S lic Works, County of Bufte. 0.0 N Q . a All utility conneLdions Shan be locates! "within 4. ft. outside the rear third section of the mobile home on the left (road) side of the mobile home. Septic system a, to be as per Butte County Health Dept. g" quirements. Ta Q � • 1 �il"+a' S j4cc4, -vP vj,-R< JD X SD / a13; OF f i 7-o 8,F fizQ F -b .1195_�,v $ G tr: 13 5E7 = f�) es v I c ' —R -DO 3 71Z 4 C !f Lis E i M H, ,o - ias rt-� z The. Setback shall b . from the side property line and 50 from the center line of the road, permitting a maxi- mum of a 2 ft. eave overhang but entirely ' out of all easements. I � Q 1 9, P Fr BUTTE COUNTY BUILDING DEPARTMEN 1 APPROVED i�, COUNTY OF BUTTE " — DEPARTMENT OF PUBLIC WORKS .7 County Centerbrive — OroviIle, California 95965 Telephone: 534-4541 APPLICATION AND PERMIT .+ ivFlvavntauvcJ UI the UOUNILY UI butte to enter upon the above-mentioned property for inspection purposes. �X Date Signature of Permitee Agent Receipt No./ 7/ White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have ?)pad.DIRECTORLIC WORKS BY Date S Z' -7-F B i - Ing permit expires Date t - — 7f BUILDING Ownerg- CK FAL SQ. FT. OCC. BUILDING VALUATION Mailing Address I Hf! h4�✓ .,57._q-46 C f� h G o Telephe No. on 3 " �S Fireplace Contractor Total Valuation Mailing Address Permit Fee Plan Checking Fee &/or Penalty Telephone No. Permit Fee Building AddressPLUMBING �0v8 4t �" No. @ FEE PERMIT FILING FEE $3.00 l' 9- A4 L .ems AL1 Each Trap 1.50 13 rt J6 2 Repair drainage or vent piping 1.50 Water piping 1.50 IG0 Each gas water heater or vent 1.50 .— A. P. No. 6 •� J 7 — '� Zoning & Planning Gas piping system 1 - 5 outlets 1.50 Each additional outlet .30 F s C. Sa ation I Fire Dept. FireZone Use Permit Building sewer 5.00 EQA Parking Plans Parcel claration Parcel Ma P 60' R/W ImprovementsLawn sprinkler system 2.00 Bldg. Plops Recd I Parcelproval PlansAitroyal Permit Fee $ NEW ❑ ADDITION ❑ UTILITIES ❑ OTHER ELECTRICAL No. @ FEE PERMIT FILING FEE $3.00 ' ` Main service 800V OR LESS 100 AMP OR LESS 5.00 Main service EA. ADD'L 100 AMP 2.50 Single Family ❑ Duplex ❑ Mobil Home Others ❑ Main service OVER 600V 100 AMP OR LESS 25.00 Main service EA. ADD'L 100 AMP 1.00 NEW CONST OR ADDNS. ( ACCLBLDGLING OCCUP. &) 22sgft NEW CONSTR. MULTI -OUTLET NON-RESID. BRANCH CIRCUITS) 2.50ea NEW CONST. POWER APPARATUS & NON.R RESID. (SINGLE OUTLET CIR. CONTRACTORS LICENSE LAW I am licensed under the provisions of Chapter 9, Div. 3, of the State of California Business & Professions Code under the name style of: Ex. Occup(OUTLETS OR FIXTURES)@�Q BAL@1 Ex. Occu FIXED ALNS. OR P'(OUTLETS (PPRESID.) EA) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 License No.Classification Misc. Wiring 6.25 1 am exempt from the Contractors License Laws of the State of California. Permit Fee $ WORKMEN'S COMPENSATION INSURANCE 1 am aware of the provisions of Section3700 of the California Labor Code which requires every employer to be insured against liability for Workmen's Compensation. ❑ I have placed on file with the County of Butte a certificate of Workmen's Compensation Insurance. I to an certify that in the performance of the work for which this ermit is issued I shall not em p employ y person in any manner so as to become subject to the Workmen's Compensation Laws of California. MECHANICAL No. @ FEE PERMIT FILING FEE $3.00 Heating Cooling Ventilation Hood 2.00 Permit Fee $ $ 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 ��Vf3�`A�G►✓ TOTAL PERMIT FEE $ .+ ivFlvavntauvcJ UI the UOUNILY UI butte to enter upon the above-mentioned property for inspection purposes. �X Date Signature of Permitee Agent Receipt No./ 7/ White-D.P.W. — Yellow -Assessor — Pink -Inspector — Goldenrod -Applicant This permit is hereby issued under the applicable provisions of the Butte County Code and/or resolutions to do work indicated above for which fees have ?)pad.DIRECTORLIC WORKS BY Date S Z' -7-F B i - Ing permit expires Date t - — 7f BUTTE COUNTY DEPARTMENT OF PUBLIC WORKS 7 County Center Drive, Oroville, CA. PHONE: 534-4541 MOBILEHOME INSTALLATION SHEET 1. Owner's name: fACZ ud - -PAaIL�D GE 2. Installer's name: 'W LL .E�A'ST��— 002S'ECF 3. Is the site currently under permit? Yes / r No (If yes, furnish permit number ) OR Is the site an existing site? Yes No (If yes, furnish two (2) plot plans.) 4. Will the mobilehome be located at least 5 ft. away from septic tank and leach fields and clear of all setbacks and easements? Yes / / No (If no, clarifye,7 �i� ) 5`Z,) ) 5. What is the mobilehome electrical rating? ----------------------- /0 Amps Alg6. What is the mobilehome site service rating? -------------------- �3TFA C7 Amps 7. What is the mobilehome site circuit breaker rating? ------------- 100 Amps 8. Is there any other electric load to be served by the mobilehome site service? --------------------------------------------------- W o?C S.UoP (If yes, identify the load and size: " 'p (Load) 9. What is the mobilehome site gas pipe size? -=-------------------- Yes /7--r', No ly O (Amps) 3/� (in.) 10. What is the type of gas service? ----------------------------- Natural / / LPG /1-/ 11. What is the gas pipe length from meter or tank to the mobilehome? 12. What is the mobilehome gas demand? ------------------------------ 2D (ft.) (This o at�on n re uired if pipe length less than 6 ft. on natural gas or ess than 50 ft. on LP . (BTU) MOBILEHOME SUPPORT DATA Mobilehome Mfr. to U R,`re Setup Model No. Year / 9�0 Width -(ft.) Length O (ft.) Expando Size A,14> ft.x f ft. (Draw support details below) On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets (if not on file with the County of Butte). (ft) (in)i *If center piers are other than drawn above, draw in locations, spacing, and dimensions. Footings (check one) 1. Wood either pressure treated or fdn. grade. 2. Concrete pad. 3. Other, specify Supports (check one) / r/' 1. Concrete block 2. Concrete piers 3. Steel piers 4. Other, specify �l;�- x 3d Footing Sizeort in.)Zin.) - U ` ( Max. (ft.) Cin-.') _ .. Max. f.3 -0 Overhang (ft.#C_ ) BUTTE COUNTY . 9U1 1,^1 9 DFp A,RTn jENT APPROVE® �e . ,&TlEle o.47 J OA • '��/sem 77�-�1SS=77 �e l 2 9 /V/;m S /amu) i r, I 8 X30 S� �J aO a J , a , I 8 X30 S� �J aO a J , �"Ir /el /971 °`" 0-14 R ,� ✓fie ax opell -�- u Y COUNTY OF -BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (530) 538-7541 PERMIT NO. (Rev. 12/96) APPLICATION AND PERMIT ASSESSOR PARCEL NUMBER 011-110-024 ZONING 5 BUILDINGPERMIT OWNER MATA, TONY X 6€044 SO. FT. OCC. BUILDING VALUATION . OWNER'S MAILING ADDRESS 1869 HONEY RUN RD., CHICO 95928 EST 1000 CONTRACTOR'S NAME OWNER FAX: 899--9986 TELEPHONE CONTRACTORS MAILING ADDRESS CONSTRUCTION LENDER [,Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Flin Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDINGADDRESS 1869 HONEY R ROAD Energy Plan Checking Fee $ $ PERMIT FEE S 68 nn LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping ,.,,15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: CHANGE SINGLE FAMILY TO R 2,1.1 OCCUPANV (pER M.V.)PERMIT Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W 920.00 FEE $ ELECTRICAL PERMIT Fling Fee 20.00 LE Main Service . 'OR V OF'LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.PSING License Class Lic. No. DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: 001 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed 4 the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' laws of California, and agree that if I should become subject to theV workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those 1provisions. f -� ( ` X - �t i-1 l� `(t \ ,�Date � ` C — � I i i Signature of Applicant - Cl Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service 200A To 1000A 46.00 NEW CONST. DWELLING OCCUP. s0 OR ADDNS. ( a Acc. eLos. 3.50Fr. NON -ID. MULTI -OUTLET 97.50 8 OUTLET OWELER APPARATUCIRS . zo @ 1.00OWNER-BUILDER Ex. Occup. OUTLET OR FIXTURES BAS 50 Ex. Occup. OUTELELS ,.,D.oE, 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEI= $ Mobile Home Installation Fee $ Energy Inspection Fee Is occ F���,i. co NST . TYPE ( TOTAL FEE $ 68.00 �HAZ. D. FEES IM`P FLOOD CDF, PARCEL PO HD}compensation V This permit is hereby Issued under the applicable provisions in the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. }, ' By �/( �/�---_ Date /7y/ PERMIT EXPIRES ON r•A/�"/ZOO�I Date ReceiptNo. xvvoo� /uv.vv WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT V NOTES f� RESIDENTIAL 9 0755 011-110-024 9 - PERMIT NO. MATA, Tony & Karen - 1869 Honey Run Road, Chico Contr: James M. Haase New Single Family i !t 101 vW& - 11 SPECIAL CONDITIONS 11 CHECKED BY ✓ A FLOOD CERTIFICATE REQ. FIRE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER 1"4't Eleja,�t6nica�.2 /a/i/9y �/ JOB FINALED (Date) 4 Signature /III ✓ = OK 0 = Not OK - = Not Applicable =Not Ready MOBILE HOMES Date ' MOBILE HOME UTILITIES (Plans) OK except #'s 5. \t. Zoning Requirements -Setbacks -Easements : 6. 2. Soils; Special MH Support Sketch 7. 3. Sewer; Location -Test -Fall -C/O -Concrete 8. 4. Water; location -Test -Easement Needed (Sketch) 9. 5. Electricity; Location-Clearances-Grnd-/ /Amp -Concrete 10. 6. Gas; Location -Test -Wrap;-/ /" L'ft. / /'Nat. or/ /"L"ft./ PLPG 11. 7. Well Clearance & Disconnect 12. 8. Utility Clearance Date Card B-1 Date Card B-1 ' Date Date Card B-1 Date Card B-1 Card B-1 Date Card B-1 Date FINAL (Plans) OK except ti's 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. Tie Downs -Type -Installation Cen. 10. Exits; Insp.-Sketch 11. Cent. of Occupancy 12. Permanent Foundation Only; License Decal Date Card B-1 Date - Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 r MISCELLANEOUS Date + DECKS, COVERS, CARPORTS GARAGES (Plans) OK except N's 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts-Beams-Rftrs.-Connectors Shthg.-Frg-Bracing 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 7. Electric 8. Frmg.; Sills-Anchors-Studs-Rttrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh 10. Roof; Shthg-Roofing 11. Ext.; Steps -Doors -Landings 12. Braced Wall Panels Date Card B-1 Date Card B-1 ' Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except ti's 1. Setbacks -Easements 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Panelboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test 11. Light Niche Date Card B-1 Date - Card B-1 Date Card B-1 Date Card B-1 V = OK 0 = Not OK - = Not Applicable = Not Ready RESIDENTIAL (; Date IVKderfloor (Plans) OK except #'s 1. ° oning-Setbacks- Ease ments lood-Slope V Ftg., Main; Soils-Elec. Gr .-/ I V Ftg. Depth MEC NICAL (Permit) OK except #'s Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils -Steel-/ /" Ftg. Depth . temwalls, Main; Steel-Blockouts-Wrapped emwalls, Garage; Steel- Blockouts-Wrapped Se HolqDowns and Special Anchors Fu ce-Vent Access -Comb. Air -Return Air Vent 115 outlet lab, Steel -Wrapped 8. Pie -Fireplace Ftg.-Steel Lk!fW.V.; Fall -Fitting -Test -2 Way C/O -Sewer Test 10. UF, Gas Pipe; Size Anchors - Yard Gas Piping; Size Test 11. Water Pipe; Test -Anchors -Regulator -Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance -Material -Support -Ins. 14. Girders -Sills -Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date ') `j Card B-1 LAS` Date Card B-1 Date Card B-1 Date Card B-1 10 Date ��� ,PLUM ING (Permit) OK except #'s 0. ater Ht.; Vent -Access -Combustion Air Baffle 1 er Pipe; Test & Anchor -Nail Protection •1D.W.V.; Test Fittings & Anchor -Nail Protection 'U1.U11 9r/1/\ Zi Shower Pan: Test, First Floor -Tub Access Q� 21. Test Tub & Shower, Second Floor -Tub Access 22. Gas Pipe; Sixe & Anchors Date S Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date XECTRICAL (Permit) OK except #'s 21. F' ture & Transformer Clearance -Ins. Protection ae'Ejec. Receptacles Spacing -Lights & Switches at Doors 25/Size Boxes & No. of Conductors Stapled 2§/Romex Installed Close to Edge of Studs & C.J. 27/ Equip. Ground made up w/Mach Fasteners -Bond Gas & Water 2$/ 2 Appliance Circuits in Kitchen & Conductor Size GFI 29 Subfeed Wire Sizel "/ ga. Cu or A0 .CC.. Vire Size / / oa Cu or AI 30.44;8nge Circle / iga Cu or Al -Oven Circ. / / ga Cu or At Insulated Neutral ❑ Yes O No rj/K _ 31. �ervice-Riser Conductors & Ground Main Disconnect 32.,Equip. Clearances Panels-Motors-Mech. Equip. 33/el hes Closet Light -Shower Light -Spa Light 3 Smoke Detector Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MEC NICAL (Permit) OK except #'s 3 -C. Ducts Insulation & Support 36. ant F n, Exhaust above insulation 37 ondensate Drain & Overflow, Size & Grade 38. Fu ce-Vent Access -Comb. Air -Return Air Vent 115 outlet Attic Access & Platform if Furnace in Attic Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FOAMING (Permit) OK except #'s 40. Sits Proper Materials & Anchors Walls Studs -Nailing Spacing & Braces -Plates -Sound 47/Bearing Walls over Girders & Floor Nailing I?kaft Stop in Walls (rat proof) ire Stops, Furred Ceilings -Stairs -Chasers -T s �Ueaders & Beams -Size & Bearing jingle & Duplex) Date RAMING (Continued) gars -Post Caps -Anchors -Connectors 404 Cling. Joist-Rttr. Ties- Purlin-Roll Brac. hting.-Rfng. —*13 -Fireplace Ties or Type A Flue -Fireplace Throat Clearance ttic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 5 . Windows or Exiting Doors -Sill Ht. & Dimensions Garage Fire Protection Framing v 52 --Property Line Firewall & Openings 5 Doors -One 3' -Check Garage 3rd Story, 2 Exits Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection W-Irlywood on Roof Overhang -Attic Vents -Ratter Outriggers ailing Veneer cco Mesh -Drip Screed -Fd. Vents-Underflr. Access Gla 'ng Are lass Protection -Skylights -Plastic 5 hear s; Nailing -Bolts 60. Br nterior/Exterior Wal nets Ineula1itvh-WnIIQ.rPi1innc Date 1015 Card B-1 C_,S Date Card B-1 Date Card B-1 Date Card B-1 Date AL ans) OK except #'s Ext eps-Door & Sidelight Protection -Landings Sm Detector urnace Vents -clearance -Comb, Air -Connector - In rage; Above Floor -Ducts -Meth. Protection m Exiting G.F ath Fixtures & Tub Access -Spa lec. Trim & Subpanel, Breaker Sizes & Labels 69. Stairs & Rails . ep aqq or Stove, Clearance -Hearth 7 ec. outlets at Wood Panel, Int. & Ext. U,Ki'tF.j, Appliance; Ground -Air Gap -Cooking Clearance 14-e.—C. O Receptacles at Kit. Counter rage Door; Swing -Landing -Closure ae�D ' arage-Damper 7 . tr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Gara bove Floor-Mech. Protection 77 , Elec Mech. Equip. Listed for Location 8. c. Re rAptacles in Garage (F.F.I.)-Romex Protection 79 ulati oam-Looked in Attic 01 ar ails & Deck Construction -Post Caps dn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor es 82.—Following In rive � o/Walks es 0 No/P niers es :)No 83. c o s C. U it -Disconnect, Electrical -Plumbing nts 6twrRoof, Plbg-Appliance-Fireplace-Clearance to Openings ter ; Disconnect, Electrical, Plumbing 7 eriorec. Trim, G.F.I. Receptacle -Underground 8 ntila ' wThroughout House 9 ass P tion orrec' ns'from Previous Inspections 1 s T eters Tagged, Gas -Electric ate ewe r. Connected -C/O to Grade -HD Approval ner mpliance Certificate -Other Certificates ddress Posted Date Dates �T'Card Card B-1 Date Card B-1 B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: LOERKE INSULATION CO., INC. 1869 Honey Run Rd. Number and StFe-et r• �r - INSULATION CERTIFICATE "Y Chico Citv County Subdivision Lot Number DESCRIPTION OF INSTALLATION 1. ROOF Material Thickness (inches 2. CEILING Brand Name Thermal Resistance (R -Value) Batt or Blanket Type Fiberglass Batts Brand Name Johns Manville Thickness (inches) 13" Thermal Resistance (R -Value) R38 Loose Fill Type Fiberglass Brand Name Johns Manville Contractor/s min. installed weight/ft sq. .659 Ib. Minimum Thickness 16.25" inches. Manufacturer's installed weight per square foot to achieve Thermal Resistance (R Value) R38 3. EXTERIOR WALL Material Fib_erg.lass Batts Brand Name ,boli - Manville Thickness (inches) 3.5" Thermal Resistance (R -Value) R13 4. RAISED FLOOR Material Fiberglass Batts Brand Name Johns Manville Thickness (inches) Thermal Resistance (R -Value) 5. SLAB FLOOR / PERIMETER Material Brand Name Thickness Thermal Resistance (R -Value) Perimeter Insulation Depth (inches) 6. FOUNDATION WALL Material Brand Name Thickness (inches) Thermal Resistance (R -Value) DECLARATION I hereby certify that the above insulation was installed in the building at the above location in conformance with the current Energy Efficienc Standards for residential buildings (Title 24,Part 6, California Code of Regulations) as indicated on the Certificate of compliance, where applicable. C.L.#499150 LOERKE INSULATION CO., INC. Item #s Signature, Date OCT 2 8 1999 InstallingSubcontractor (Co. Name) Or General Contractor (Co. Name) Or Owner Item #s Signature, Date Installing Subcontractor (Co. )ame) Or General Contractor. Co. Name Or Owner Item #s Signature, Date Installing Subcontr( ctor�Co. ) ame) Or General Contractor Co. ame Or Owner V COUNTY OF BUTTE BUILDING, DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 411 Main Street • Chico, CA • (530) 891-2751 7 County Center Drive • Oroville, CA • (530) 538-7541 'CORRECTION NOTICE 99 - 76 5 OWNER 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. Date Inspector REV 10/92 w SECTION E CERTIFICATION This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation information when the elevation information for Zones Al—A30, AE, AH, A (with BFE),Vl—V30,VE, and V (with SFE) is required. Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the certification. In the case of Zones AO and A (without a FEMA or community issued BFE), a building official, a property owner, or an owner's representative may also sign the certification. Reference levei diagrams 6, 7 and 8 - Distinguishing Features—If the certifier is unable to certify to breakaway/non-breakaway wall, enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list the Feature(s) not included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered. I certify that the information in Sections B and C on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. , CERTIFIER'S NAME C W BACHMAN LICENSE NUMBER (or Affix Sea]) RCE # 16803 TITLE . COMPANY NAME Professional Engr BACHMAN & ASSOCIATES ADDRESS CITY STATE ZIP' 13647 Garner Lane Chico CA 95973 SIGNATURfQa, fIj DATE PHONE Copies should be made of this Certificate for: 1) community official, 2) insurance agenVcompany, and 3) building owner. COMMENTS: ON SLAB A V ZONES ZONES , REFERENCE LEVEL -A BASE FLOOD ADJACENT ELEVATION REFERENCE ADJACENT GRADE LEVEL GRADE Wmi ON PILES, BASEMENT PIERS, OR COLUMNS A A V hr ZONES ZONES ZONES BASE I FLOOD LEVELCE I, � RE LEVEL FLOOD .ELEVATION ADJACENT The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zones should be measured at the top of the reference level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. Page 2 HOUSE ELEVATION CERTIFICATE O.M.B. No. 3067.0077 FEDERAL EMERGENCY MANAGEMENT AGENCY Expires July 31, 1999 NATIONAL FLOOD INSURANCE PROGRAM ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to pro- vide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to determine the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR). You are not required to respond to this collection of information unless a valid OMB control number is displayed in the upper right corner of this form. Instructions for completing this form can be found on the following pages. BUILDING OWNER'S NAME SECTION A PROPERTY INFORMATION I FOR INSURANCE COMPANY USE I POLICY NUMBER STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER I COMPANY MAIC NUMBER OTHER DESCRIPTION (Lot and Block Numbers, etc.) CITY CHICO sCA 95928 ZIP CODE SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM (See Instructions): 1. COMMUNITY NUMBER 2. PANEL NUMBER 3. SUFFIX 4. DATE OF FIRM INDEX S. FIRM ZONE 6. BASE FLOOD ELEVATION 06007 530 C 06108198 A (in AO Zones, use depth) 349.0 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): 0NGVD..'29 ❑Other (describe on back) 8. For Zones A or V, where no BFE is provided on the FIRM, and the community has established a BFE for this building site, indicate the community's BFE: I I III I .0 feet NGVD (or other FIRM datum—see Section B, Item 7) SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level 2(a). FIRM Zones Al -A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diag(arn is at an elevation of r3�U . U feet NGVD (or other FIRM datum—see Section B, Item 7). (b). FIRM Zones V1 -V30, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram, is at an elevation of I I I I U feet NGVD (or other FIRM datum—see Section B, Item 7). (c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is I I I.H feet above ❑ or below ❑ (check one) the highest grade adjacent to the building. (d). FIRM Zone AO. The floor used as the reference level from the selected diagram is U feet above ❑ or below ❑ (check one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference level) elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations: QNGVD'29 ❑ Other (describe under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than that used on the FIRM (see Section B, Item 77, then convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.) 4. Elevation reference mark used appears on FIRM: �I ❑ Yes E�i No (See Instructions on Page 4) 5. The reference level elevation is based on: C actual construction ❑ construction drawings (NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which case this certificate will only be valid for the building during the course of construction. A post -construction Elevation Certificate will be required once construction is complete.) 6. The elevation of the lowest grade immediately adjacent to the building is:II I 3 41$ •I6L feet NGVD (or other FIRM datum -see Section B, Item 7). SECTION D COMMUNITY INFORMATION 1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1 is not the "lowest floor" as defined in the community's floodplain management ordinance, the elevation of the building's "lowest floor" as defined by the ordinance is: j I I I I I .;J feet NGVD (or other FIRM datum—see Section B, Item 7). 2. Date of the start of construction or substantial improvement FEMA Form 81-31, MAR 97 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 PERMI 6 (Rev.12/96) ` APPLICATION AND PERMIT 7 ASSESSOR PARCEL NUMBER 011-110-024 ZONING FR 5 BUILDING PERMIT OWNER MATA, TONY & KAREN TELEPHONE SO. FT. OCC. BUILDING VALUATION -3594 X T94,076 OWNERS MAILING ADDRESS 1869 HONEY RUN, CHICO CA CONTRACTOR'S NAME JAMES M. HAASE TELEPHONE ' ' CONTRACTOR'S MAILING ADDRESS 1021 HENSHAW AVENUE, CHICO 95973 CONSTRUCTION LENDER BUTTE COMMUNITY BANK Fireplace LENDER'S MAILING ADDRESS ' Total Valuation $ ARCHITECT OR ENGINEER BOB METZGER LICENSE NO. 329055 Filing Fee $ 20.00 Permit Fee $ 1,021 -00 ARCHITECT OR ENGINEER'S MAILING ADDRESS Plan Checking Fee $ 66365 BUILDING ADDRESS 1869 HONEY RUN ROAD, CHICO Energy Plan Checking Fee $911.00 $ PERMIT FEE $ LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SFXX Duplex ❑ Mobilehome ❑ Other SPECIFY Each Trap 1 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New 15[XAddition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other ❑ Describe Work: NEW SINGLE FAMILY 6 BEDROOM Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home I S I G I W 920.00 ' PERMIT FEE 1 P -5-M ELECTRICAL PERMIT Fling Fee 20.00 Main Service ioonoa�ss 23.00 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class _g / Lic. No. ��g 5z OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason Main Service TO I000A 46.00 NEW CONST. DWELLING UP. W OR ADDNS. ( g ADD. gLpS. p SO 148.33 3.50'5 NEW CONST. NON -RES D. ANCI CII CUT @7.50 POWER APPARATUS d SINGLE OUTLET C.R. EX. OCCU OUTLET OR FIXTURES � Q I.00 SAL Q .50 EX. Occup. pUTIETS ORES D.APPLNSOEa 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ 191.33 WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier MECHANICAL PERMIT Filing Fee 20.00 Heating 2 30.00 Cooling 2 30.00 Hood 6.50 6.50 Ventilation 4 18.00 PERMIT FEE $ 124.50 Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shell forthwith comply with those provisions. X _ - . �� ,e ,__ Date ��-� ?0 Signa re of Applicant - ❑ caner ❑ Contractor ❑ A ent An OSHA permit is required for excavations over 5'0" dee d demolition or construction of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ 46.0 occ _ CONST. TYPE V T TAL FEE $ 2 274.15 HAZ. D.N FIE IMP FLOOD A - PARCEL PD X HD ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By EXPIR ON ""I the applicable provisio s Resolutions to do ork been paid. _ Date I. 5 `- a O ate Receipt No. Pc , Qw- '^ 2 T i q "' -PERMIT WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INS TOR GOLDENR D•APPLICANT t (Rev.12/96) COUNTY OF BUTTE -DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California 95965 - Telephone (916) 538-7541 WV -'L,2 1 PERMITS� APPLICATION AND PERMIT U� l� ASSESSORPMC UMBER -- ZONING R BUILDING PERMIT OWNERTELEPHONE ti ala SO. FT. OCC. BUILDING VALUATION OWNFAS MAIOle UNG DRES9 , , COM CTOR'S NAME ! I TELEPHONE / CONTRACTORS MAILING APQJRESS , 14 CO NS UCTION DEA as - 2 zs. Fireplace ---- LENDER'S UNGADDRESS Total Valuation b71 111 MCHR CT OR INE P.r LICENSE NO. Z Filing Fee $ 20.00 Permit Fee $ t�2 . AR HITECT OR ENGINEERS MAILING ADtIAESS Plan Checking Fee $ V BUILDING ADDRESS �"i �� Energy Plan Checking Fee $ 11 - C q-1 C 0 $ r7,2 1 - PERMIT FEE S LOTNO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF tKDupl,, ❑ Mobilehome ❑ Other SPECIFY Each Trap ( 7.00 105— p —Solar Solaror heat pump water heater 23.00 Water piping 15.00 15 - Each gas water heater or vent 15.00 TYPE OF WORK New Addition ❑ Remodel ❑/Utilities ❑ Installation ❑ Other C3�r Work: / e I i 6 6a- w -1 >�� QJ YI liA I S 1 Desccrnrib, eJ !4V Gas piping system 1 - 5 outlets 15.00 Buildingsewer 15.00 l Mobile Home ISI GI W @20.00 PERMIT FEE S ELECTRICAL PERMIT Fling Fee 20.00 Main Service 2200AORLLESS 23.00 - , LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class LIC. NO. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ I am exempt under Sec. Business and Professions Code for this reason Main Service 200A TO 1000A 46.00 NEW CONST ^ DWEWNG OCCUP. OR ADDNS. F� ( a ACC. BLDS. SO 3.5¢,. NEW CONST. MULTI -OUTLET NON-RESID. @7.50 POWER APPARATUS b SINGLE OUTLET CIA. Ex. OCCU OUTLET OR FIXTURES O BAS Ex. Occup.DFlxUs A oD� 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wirino 23.00 PERMIT FEE _ �j WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: ❑ I have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person In any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X Date Signature of Applicant - ❑ Owner ❑ Fontractor ❑ Agent An OSHA permit is required for excavatio so er 5'0" deep and demolition or construction of structures over 3 stories In height. MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling 249) Hood 6.50 Ventilation -- r PERMIT FEt $1 Mobile Home Installation Fee $ Energy Inspection Fee $ CONST. PE TOT FEES 8 S , _r FEES IM FL000 DF PMC HD SSUE I t This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON thape cable provisions t Resolutions to do work been paid. Date (Data) ReceiptNo. Q 2 F& 71717 WHITE-D.D.S.-B.D. CANARY-ASSE PINK -INSPECTOR GOLDENROD -APPLICANT �-,s',Sr �j}}►, „i'*. ��;�.; „ .•Ti'` ,•.vim t,,,•r„y1Ki;'Sl.-:•'.7�' t �+r,,.... ,,, :.r:lr`a'x.�Afr•*it"�;�*r+�" 'i' y.'a ;�Yii�iy .Y�r�W"-_• ,, �-ti_ . •�., •,�... b ' COUNTY OF.BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 4 Jr 7cCOUNToY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 / /-4 % q. PE"IT"PLICA TION DATA SHEET, OWNER: I n A L� af,l N ASSESSOR PARCEL NUMBER: O I I Proposed Building se: Gw /,- Building Inspector: Date: 41 / ! �G, At time of permit application, I was advised the following data must be submitted prior to permit p essilog and/or issuance: Date Received By ❑ 1. All items have been submitted -------------------------------------------------------------------------------------- E12. Plot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------ ❑ 3 . Complete plans, 3/4 sets, signed by the preparer of plans. -- ------------------------------------------------- 114. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. -------- 0 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------ 116. Energy Design Compliance and supporting documentation. ---------------------------------------------------- ❑ 7. Statement of Intent for Non -Heated and A/C Buildings.--------------------------------------------------------- ❑ 8. Hazardous Material Form. ------------------------------------------------------------------------------------------ ❑9. ctured Home data and installat instructions including Tie Down Specifications.------------------ .2 U. ees of $ `" 9 y / fl . Impact fees as shown on the attached schedule. -------------- ---------------- ---------------------------- alifornia Department of Forestry plan approval/fees. --v`- �-� ______________________ - 3. Flood elevation certificate.--------------------------------------------------------------------------- Sanitation --------------------------------------- h.10 lU•vlcncc d (� 4. Samtation and plot plan approval (W 6, 0flealth Department. �-�----------------------A--�f(6-- i S' ❑ 15. City of Chico plumbing permit. ---------- --------------------------------------------------------------------- ❑ 16. Plot plan and business license approval from the City of Biggs. ---------------------------------------------- t4W. Planning approval for (A) Use: (B) Parking: Z 18. Contact Land Development about Improvements, ❑ Drainage, MLegal Parcel. ----------------------- ❑ 19. Encroachment Permit for driveway (construction approval prior to occupancy) ❑20. Pre -inspection for required Request to Building Inspector on ❑21. Contractor's license information. (Number, Name Style, Classification). ❑22. Workers' Compensation carrier and policy number. ----------------------- ❑23. Owner -Builder Verification (Given to owner ❑, Mailed to owner ❑). -. 1124. Letter of signature authorization. -------------------------------------------- E125. ------------------------------------------- ❑25. Recorded copy of Agricultural Acknowledgment Statement. ------------- ❑26. Letter of intent on building use. ---------------------------------------------- 0 27. ---------------------------------------------❑27. Manufactured Home utility clearance. --------------------------------------- 028. Existing violations and/or expired permits. -------------------- El 29. -------------------❑29. 0433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H. C.13 $ 030. Other: When you issue the permit, process as follows ❑ Mail to owner, ❑Mail to contractor. ❑Telephone rand hold for pickup at office. ❑ Deliver with inspector. (Date) APplic Date: r f�- Copy of Haz-Mat form sent 11Health Departrnent, ❑ Fire Department, ❑ Air Pollution Date: By: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: Date: By: 1. Index permit application for the above items numbered: I lt-o ❑ Plan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, o er, was of the above re� data by ❑ phone, ❑ mail, ❑ B 1 vis'o o , by Date: Plans reviewed by: Date: �j Gip Plans approved by: Date: Sets of plans on hold ❑ Plan Cabinet, ❑ A.P. folder.Note transfer by: Date: ""'IE.H. USE ONLY Plot Plan Attached Floor Plan Attache A Sent to B.D. / TO: Building Department 04vv� FROM: Environmental Health — Cleo OLU SUBJECT: Sanitation Clearance 11b4 - 2 Owner ocation AP Plan Approved for: Sewage Disposal Water Supply: Public Private Well Clearance fo&--L dwelling. Other NOTE: Environmental Health Spe ialist Date F-13MV COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE CA 95965 TELEPHONE (916) 538-7541 SCHEDULE OF FEES DUE OWNER sl PROPOSED BUILDING USE 1. BUILDING PERMIT FEES -- Balance Due ................ $ -- Additional Fees Due ........... $ -- Additional Fees Due ............ $ -- Revised Plan Checking Fee ....... $ eta 2. SCHOOL DISTRICT FEES (-05,0 ` (paid at District Office) /h Ad r -o C, -j j c'p�-G 't'o`t., 3. SHERIFF FEES (paid at Building Division) Residential ........ l x $360.00 = $ 6O Units Commercial (sq.ft.)... x $0.03 = $ Sq.Ft. 4. URBAN AREA FEES (paid at Building Division) Residential (per unit) . x : _ $ #Units Amt. Commercial (sq.ft.) .. x =$ Sq.Ft. Amt. 5. RECREATION DISTRICT FEES (paid at District Office) 6. THERMALITO DRAINAGE DISTRICT FEES 510.00 (paid at Building Division) 7. SRA FIRE INSPECTION' AND PLAN CHECK $89.00 (paid at Building Division) /0 '� 8. WATER TENDER FEES (Battalion # ) $200.00 (paid at Building Division) 9. CSA 87 TRAFFIC FEE $2500.00 (paid at Building Division) 10. OTHER A.P. # O 1 1 — 110— O-Lq DATE Lit/ GI g RECEIPT # DATE REC 526 q (o--7 0?_65099 �//w9q Y i 'Z 5-90 Yys y� VI q9 At time of permit application, I was advised the above fees are required to be paid prior to issuance of the building permit. These fees may be changed during the plan checking process. APPLICANT DATE`��C%C/ Pursuant to Government Code Section 66020, you are hereby notified that items 2,3,4,5,6,8,9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Div. 2nd Copy - Applicant 3rd Copy - Owner (Rev. 2/97) A April 26, 1999 James M. Haase 1021 Henshaw Ave. Chico, Ca. 95973 Assessor Parcel Number: 011-110-024 Building Permit Number: 99-0755 BEAUTY DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE • OROVILLE, CALIFORNIA 95965-3397 TELEPHONE: (530) 538-7541 FAX: (530) 538-2140 The above referenced building plans were reviewed by this office. Please respond in writing to each comment by creating a response letter. Indicate which detail, specification, or calculation shows the requested information. Your complete and clear responses will expedite the re -check and approval of this project. Please be sure to include on the resubmittal the engineer's "wet" stamp, signature, registration number and expiration date on all sheets of plans depicting the designed elements and cover sheets of calculations. Provide additional information and/or make revisions to plans, specifications and calculations as follows: 1. This property is located in a flood zone. Provide a flood elevation certificate prepared by a licensed professional. Finish floor must be a minimum of one foot above the established flood elevation. Plans are to reflect how this is to be accomplished. /2. Provide manufacturer's specifications on the HVAC which show AFUE and SEER reflected in the calcs. (9ermits required for new mobile home and new garage. ,4"'Enclosed is your school fee form. Pay any fees at school district office and return yellow copy to the building department. .,�Permit shows you applying for "unfinished area" but plans do not indicate any unfinished area. Fees have beeen modified to reflect what is shown on the plans. If you have questions about any requirements, you may contact me at (530) 538-7541 between the hours of 1:00 p.m. and 4:00 p.m., Monday through Friday. �0-9.99 F10+ PJ-0,1�,n �,-e,�-�,�- ►� eA& --t0 (4 D 4 Sincerely, Martha Whitney Plans Examiner cc Karen and Jose Mata 2' RESIDEi IAL PLAN CHECKIIi GUIDE j SINGLE FAMILY, DUPLEX AND MISCELLANEOUS ONLY OWNER: 11A a+&- BUiLDINGP EW. 9 9=07 SS PLAN CHECKER. A. P. NUMBER: GENERAL: 1. Zoning requirements: (side yards and number of permitted living units). 2. Valuation. ,d --l" Plans signed by designer. Proper description of work on application. 5. Existing violations on property. Items on data sheet, (Impact Fees, Environmental Health, Developer Fees, etc.). /Y Recorded notice of violation. PLOT PLAN: 1. Complete parcel size and dimensions. Setbacks, side yards, easements, etc. Other buildings or structures. " Grading, fills and/or drainage. Flood hazard. 6. Special conditions on creation map (Noise, SA.A., Fire SprirWers, Water Tender, Trees, etc.). �7. F.A.U. & F.A-S. road setback. Building or utilities across lot lines (Record form). FLOOR PLAN: A Complete to scale plan with dimensions. x Required windows for light and ventilation (Section 1203). Required windows for second exit (Section 310.4). Skylights (Section 2409 & 2603.7). Glazing in Hazardous Locations (Section 2406). fa'� Required room sizes, ceiling heights (Section 310.6). G.F.C.I. in baths, garage, kitchen, wet bar and exterior outlets (N.E.C. 210). Lights, switches, receptacles, and exterior receptacles for maintenance of mechanical equipment Location of water heaters, heating and cooling equipment, other electrical or gas equipment Garage firewall, door size and closer (Section 302.4). Minimum of one 3'0" exterior door (Section 1004.6). Fireplace and wood stove location, alcoves and clearance. >3� Smoke detectors (Section 310.9.1). Plumbing factures, water closet clearances and shower size. S UCTURAL DETAILS: , Conventional Construction - Unusually Shaped Buildings (Section 2326.5.4). Standard bracing or engineered design (Section 2326.11.3). Clerestory requiring balloon framing and/or engineering. Three story building requiring engineered calculations and plans. ,Y Foundation plan complete enough to construct building. Floor construction details complete enough to construct building. Elevations and wall construction details complete enough to construct building. Roof construction details complete enough to construct building. Rafter ties or bearing ridge beam. ,l15"' Fireplace construction details and calc. if necessary. XGarage door and/or porch header sizes. JZ. Stud heights. Adobe soils - special foundation design. Ig! Retaining walls requiring design. Special Inspection requirements. 1k� Header size. June 1997 3.2 NIISCELLANEOUS ITEMSTO LJ& 7UT FOR: • Stairway details: landinand run, head clearance, handrails (Section 10t"". Guardrail details (Section 509). Brick or stone veneer (Section 1403). - Exterior plaster - weep screeds (Section 2506). Proper roof pitch for roof covering (Section 1501). ' Roof covering type - (fire hazard). " Foam insulation - protection. 36" halls and stairways. - Living area over garage - complete 1-hour separation required on garage side including supporting walls and posts. �0 Two exits on three - story dwellings (Section 1003). Underfloor access and ventilation (Section 2317.7). Attic access and ventilation (Section 1505). Combustion air for fuel burning appliances - L.P.G. requirements. Noise requirements on duplexes. Energy design. Flashing at all exterior openings. 17 C.D.F. responsible area requirements. 18. Automa 'c Fire Sprinkler Systems (Section 310.10) 19. For 1j4peltion Jacket: VV/AloodHazard/Elevation Certificate SRA Requirements Special Inspection Requirements Automatic Fire Sprinklers June 1997 3.2 BUTTE COUNTY DEPARTMENT OF PUBLIC HEALTH DIVISION OF ENVIRONMENTAL HEALTH SEWAGE DISPOSAL PERMIT P. O. Box 5364 7 COUNTY CENTER DRIVE CHICO, CALIFORNIA 95927 OROVILLE, CALIFORNIA 95965 Telephone (530) 891-2727 Telephone (530) 538-7281 Date Issued (b - 2 - 99 EXPIRES ONE YEAR FROM DATE OF ISSUANCE Permit Issued to teame s W cin- s e, 1 ozi w At, - _ _ Cju * W CA -9f9 73 To construct a sewage disposal system for: (, b lkhi�ae Located at: % 8 69 tea. AA vt A.P. # /71- i 10 - n7 4 - c 5U Teet of the center line of any county Road. SEWAGE SEWAGE DISPOSAL SYSTEM REQUIREMENTS SEPTIC TANK Liquid capacity: gallons Material- C.e7'�t C. LEACHING. FIELD Total length: (�(J� feet Trench width: 2-+ inches Minimum No. of lines: (� Rock under pipe inches i NOTE: Satisfactory inspection by the Health Department is required before backfilling or putting the system into use. Occupancy of a new building is not permitted until the system is approved. Permit Fee $ 1+40 _ Penalty Fee $ TOTAL FEE $ 4-4-0. Additional Fee $ X14 " Receipt No. U 71-4-6 ENVIRONMENTAL HEALTH SPECIALIST S31 - 278R (Rev.4/98) + vie- �l�9 � ZOD 186 9 Hooey Rum Road 11A 1 Environmental Health C� • JUN -.1 1999 Chi��Op California A°ROVED Environw;e - ai H2�'th Date �� --- j,, Signature PvoPose-d S 4- $ 4. #bowl hovsc E x fk by j w s' �• Grave/ \ Dri 'Ve" + vie,�� ZOO 86 9 Hoocy Rum Road 1i BUTTE COUNTY DEVELOPMENT SERVICES �•PPXO • • �• .L i Location TYPE: []Building [,]Health [,]Planning COMPLAINT: _ Taken By: A.P.#: OI 1- ( (U -OZ. L Zoning: PR -5, General Plan: ?n-tTi-t 04. e -P _Caution: Yes[ ] No[ Permit History on File: [ ]None [x]As follows: Vin P1 , hyo rnu� PjnaA- cn4toLL4 UA om f ` INSPECTOR'S REPORT 16%A UAB Tenant Description of Violation: AjmV1,8?,�—e _. Address: Approximate Building/Mobile Home size: Approximate Building/Mobile Home age: Under construction: Built by/for: [ ]Present owner [ ]Previous owner [ ]Occupied [ ]Vacant Has Electricity: [ ]Yes [ ]No Has Gas:[ ]Natural [ ]Propane [ ]None Has Sanitation: [ ]Yes [ ]No Obvious sewage problems? [ ]Yes [ ]No Hazards: [ ]Yes { ]No Person Contacted: Describe Action Taken: INSPECTOR MUST ATTACH A COPY OF THE CORRECTION NOTICE! Inspector: Date: ACTION RECOM NDED: [ ]Information Only, File [ ]Hold for Days [ ]Complaint Unfounded [ ]Other [ ]Resolved per Inspector's Report [ ]Send Letter for Compliance BUTTE COUNTY DEVELOPMENT SERVICES Complainant: Address: ; t, Phone Number: Other Comments: - :.:..... .:. ..:::::::.. .... ►::5..:... .}}}t :i}.:.r]J'.'?]:.]}:' ..,....... r...:. ..}: :: }Y:`Y :•.+iii: ::Ji}i:}}: is}]}F:::::, ...,.:.:,:...,.:,;..:..:.:•:,..:..,,....::;r..........:... :... :............. .. ::i?iiiiiii<:si:Yiiiiii'•i: ]: ]:.y....,.. . ... }.,...:.:.::..::......::... .:.:....:.::.. ::::............. i]}Y:::w:]::::::::::: r:: ]: }: is :S.Y :;:.; ..,.;:.�:., ;•::::}.}:}::::::: T' Additional ormatron>ss::�at:avazlab�e::irx:�he s�blrcf' ::..:...::::::.: r:n........ n....,.. :..:: .�...,.: q::. v. - ......... Additional comments from Inspector: 2• I rte_ ... � fl - /106 JUN -30-99 01:04 PM CHICO BUILDING SYSTEMS' 530 342 9174 P-02 MOBILE HOME ELEVATION CERTIFICATE O.M.B. No. 3067.0077 FEDERAL EMERGENCY MANAGEMENT AGENCY Expires July 31, 1999 NATIONAL FLOOD INSURANCE PROGRAM ATTENTION: Use Of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to pro- vide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to determine the proper insurance premium rate, andlor to support a request tot a'Lener of Map Amendment of Rviis+on (LOMA or LOMB). You are not required to respond to this collection of information unless a valid OMB control number is displayed in the upper right corner of this form. Instructions for completing this form can be found on the following pages. SECTION A PROPERTY INFORMATION SOA INSURANCE COMPANY USE BUILDING OWNER'S NAME POLICY NUM86R JACK PAWLEDGE STREET ADORESS (Including Apt.. Unit. Suds and/or Bldg. Nurnoer) OR P.O. ROUTE ANO BOX NUMBER COMPANY MAIC NUM8ER 1869 HONEY RUN ROAD_ OTHER DESCRIPTION (Lot and Block Numbers. etc.) GTS' CHICO _ STATE ZiP CODE CA 95928 SECTION 8 FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM (See instructions): 1. COMMUNITY NUMBER 2. PANEL NUMBER 3. SUFFIX k DATE OF FIRM INDEX 5. FIRM ZONE G BASE FL000 ELEVATION 06007 530 C 06/08/98 A (in AO Zones, use*aM) 349.0 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): 9�NGVD'29 C] Other (describe on back) 8. For Zones A or V, where no BFE is provided on the FiRM, and the community has established a BFE for this building site, indicate the community's BFE: 1 LJ feet NGVD (or other FIRM datum -see Section B, item 7), SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level -5..- 2(a). 5.._2(a). FiRM Zones At -A30. AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation of ! 1315..3.J feet NGVD (or other FIRM datum -see Section B. item 7). (b). FiRM Zones V1 430, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram, is at an elevation of!! I .i J feet NGVD (or other FIRM datum -see Section 8, Item 7). _ (c)_ FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is LL.1.LJ feet above'_! or below (check one) the highest grade adjacent to the building. (d). FIRM Zone AO. The floor used as the reference level from the selected diagram is I� .LJ feet above C or below 7-7-j (check one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference level) elevated in accordance with the community's floodplain management ordinance? 77 Yes [] No ( 3 Unknown 3. Indicate the elevation datum system used in determining the above reference level elevatlons:J& NGVD '29 �D Other (describe under Comments on Page 2). (NOTE: It the elevation datum used in measuring the elevations is diNerenr than (hat used on tare FIRM (see Section B. Item 7], then convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.) _ _ a. Elevation reference mark used appears an FiRM: ' ._ Yes 'c. No (See Instructions on Page 4) S. The reference level elevation is based on. x� actual construction construction drawings (NOTE: Use of construction drawings is only valid it the building does not yet have the reference level floor In place, in which case this certificate will only be valid for the building during the course of construction. A post -construction Elevation Certificate will be required once construction is complete.) S. The elevation of the lowest grade immediately adjacent to the building is: L_L_L'U81. 0,;_; feet NGVD (or other FIRM datum -see Section B. Item 7). SECTION D COMMUNITY INFORMATION 1. if the Community official responsible for verifying building elevations specifies (hat the reference level indicated in Sedan C, Item 1 is not the -lowest floor" as defined in the community's floodplain management ordinance. (he elevation of the building's 'lowest floor" as defined by the ordinance is: L i j l 1,.:11 feet NGVD (or other FiRM datura -see Section S. item 7). 2. Oate of the start of construction or substantial improvement _ FEMA Form 81.31, MAR 97 REPLACES ALL PREVIOUS EDMCNS sEE REVERSE SIDE FOR COMINUAIICN En JUN -30-99 01:04 PM CHICO BUILDING SYSTEMS 530 342 9174 SECTION E CERTIFICATION P.03 This cortittcation is to be signed by 1 land surveyor. engineer, or architect who is authorized by state or local law to certify elevation information when the elevation information for Zones At -A30. AE, AH. A (with 8FE),V1-V30,VE. and V (with SFE) is required. Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the certification. 1n the case of Zones AO and A (without a FEMA or community issued SIZE). a building official, a property owner, or an owner's representative may also sign the certification. Reference level diagrams 6. 7 and S • Distinguishing Features -If the certifier is unable to certify to breakaway/non-breakaway wall, enclosure size, location of servicing equipment, area use. wall openings, or unfinished area Feature(s), then list the Features) not included in the certification under Comments below. The diagram number. Section C. Item t, must still be entered. I certify that the information in Sections 6 and C on this certificate represents my best efforts to interpret the data available. i understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 7001. CERTIFIER'S NAME LICENSE NUMBER (or Alfa Seal) C.W.BACHMAN RCE # 16603 TITLE Professional Engr •ooREss 13647 Garner Lane COMPANY NAME Bachman 8 Associates CITY Ch1Co 6/02/99 CAE 9597F 516E 342-4136 Coples should be made of this Certificate for- 1) community official, 2) insurance agenticompany, and 3) building owner. . ON BLAU A v ZONES ZONES qEa EuChC� rti.6 -�s MSf �lOx tLEV.710k REFERENCE .6kCENT LEVE GR.O( wfTk BASEMENT A ON PALES, PMAS. OR COLUMNS A v The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zones should be measured at the top of the reference level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. Page 2 November 23,1999 William F. Squyres P.O. Box 3176 Chico, CA 95927 Department of Development Services Building Division 7 County Center Drive Oroville, CA 95965 (530) 538-7541 (530) 538-2140 FAX Building Permit Number: 99-2637 Assessor's Parcel Number: 011-110-024 Re: Mata/Haas This office reviewed the above referenced building plans. Provide additional information and/or make revisions to plans, specifications- and calculations as follows: 1. Your calculations need to be corrected per our conversation of 11-23-99. 2. Please refer to the 1996 NFPA 13D on the plans, and any others in the future. Plan check will continue upon receipt of the above items. Additional items may be required when plan check is resumed. If you wish to discuss any requirements, you may contact me at (530) 538-7541 between the hours of 1:00 p.m. and 4:00 p.m., Monday through Friday. Sincerely Linda Sexton Building 1 C Health 9 �o mia crt !gnature 35 4 41 �o x/sf;,9 ' Yam 9•�1� Strop ..�,� ' 6 .oa I � l lZ01 i \l v�lJ �-'c J � •\ r JL C'70 r�. NO DEER fiEN E'X►• fiH9 � �. + we�� Zoe /K 106 9 �Y00cy Rum Road T( G PLYWOOD CC EXT. h' I Y t'. 4"X V � zo FRMN G. CLIP _.7 9 V x 12" STAIR STRINGER. 48'o -c, -MAX: 70P VIEW HALIPRAIL NOT SHOWN FOR CLARITY. 1u 4 'w&; F,�Z-2ptV DECKING (ALT) 3/S" 130I T GIRDERS I'/s' T1 G PLYWOOD CC EKT. q^,cg • w MOBILE NOME MNG �r =rOR DECK �'' a `9 I 48". MTL. FRMiJ MAX. x CLIP (EA. DE y -MIN. ``� 4• (o. 4'X4' POST • , �C z. u X I F Z 2",C4" PRESSURE- _ GUARDRAIL 2D - (2) 3/6' TRTATCP vR 60LT5 RFD WOOD 1-11/17F j4"MAX. AK% DECKIWG , GIRDER �`'1' 14 MIN. s 6 - 11 -•?O r . 4 PRECAST 4'x9" POST fk PIER ADFQU4TF DIAL ONA 1. �NI�• BRACING. TYPICAL RESIDEWrI111 COUNTY OF BUTTE — DEPARTMENT OF PUBLIC WORKS 9 it 7 County Center Drive — Orovitle, California 95965 �o r n�NS 14" x 14`r MIN. FOOTING Telephone: rIR-7 SG t i� 0 R CO � (S( � ID 1 ft.?. C,: 6j APPROVED Butte County Environmental Healti EM?0 ",77!,... ' MEALTH Date N O V 1 9 1999 --- � ---- C� • Chico, California Signatures 'Nd Ile PI-opose-W "now hoc?5c 09.R1. Slav Grave/ kO� -�- we Zoo / 1069 Hooey Ruh Road MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES BUILDING DIVISION — COUNTY CENTER DRIVE OROVILLE, CA 95965 — PHONE (530) 538-7541 APN: D / / + (/r/ 0 02-4 PERMIT NO.: f ` 0 0 Owner's Name: Aq L -t 4M 5 4L - Owner's Address: / 469 Mobilehome Manµ€=Vrer: / ,1, Year of Manufacture: 15 � S Serial Number orV.1.N.:I D � Insignia or, HUDNumber:����� Official approving installation: Date: If the mobilehome is moved or relocated, the mobilehome installation acceptance shall become invalid. This form shall not be used when the mobilehome is installed on a foundation system. 513B White -Owner, Yellow -Installer, Pink -Bldg, Gold -Assessor ye� LrLL� MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES BUILDING DIVISION — COUNTY CENTER DRIVE OROVILLE, CA 95965 — PHONE (530) 538-7541 APN: D// - l f O D2. Y.. PERMIT NO.: V O O t t Owner's Name: pew led Owner's Address: � I 4G9 M0,4e7 Mobilehome Man facturer: Year of Manufacture: Serial Number or V.I.N.:' n .' Insignia or HUD Number: �'� 411/ A Official approving installation:Date: / w 5 If the mobilehome is moved or relocated, the mobilehome installation acceptance shall become invalid. This form shall not be used when the mobilehome is installed on a foundation system. 513B White -Owner, Yellow -Installer, Pink -Bldg, Gold -Assessor k 1 MOBILEHOME INSTALLATION ACCEPTANCE COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES BUILDING DIVISION — COUNTY CENTER DRIVE OROVILLE, CA 95965 — PHONE (530) 538-7541 APN: C) / / t//l j 0 o� wl PERMIT NO.: / Owner's Name: Nuled5e_ Owner's Address: Mobilehome Manufacturer: Year of Manufacture: Serial ((��Number orV.I.N.:� � ( 96 /yV� � � Insigniaor,R��/j�� 4111 A y HU�DNumber: Number - • �V Official approving installation: Date: ez If the mobilehome is moved or relocated, the mobilehome installation acceptance shall become invalid. This form shall not be used when the mobilehome is installed on a foundation system. 513B White -Owner, Yellow -Installer, Pink -Bldg, Gold -Assessor PHN E Heating & Cooling FEATURES AVAILABLE SIZES: Nominal sizes are available from 024 through 060 to meet the needs of residential and light commercial applications. CERTIFICATION: All models are listed with UL, c -UL, ARI, CEC, and CSA-EEV. ELECTRICAL RANGE: Units are offered in 208-230v, sin- gle phase. FAN MOTOR: The totally enclosed fan motor means greater reliability under rain conditions and dependable performance for many years. Per- manent split capacitor type motors provide more economical operation. CABINET: A weather protective cabinet of steel is protected with a galva- nized coating and treated with a layer of zinc phosphate. A coat of modified polyester powder coat- ing is then applied and baked on, providing each unit with a hard, smooth finish that will last for many years. All screws on cabinet exterior are coated for a long-last- ing, rust -resistant, quality appear- ance. UNIT DESIGN: The copper tube, enhanced sine wave, aluminum fin coil is de- Q Z N r a d 13O signed for optimum heat transfer. Vertical air discharge carries sound and hot condenser air up and away from adjacent patio areas and foliage. The base pan is designed for easy removal of water, dirt, and leaves. COMPRESSOR: Each compressor is protected with internal temperature- and current -sensitive overloads. An internal pressure relief valve pro- vides high-pressure protection to the refrigerant system. SERVICEVALVES: Both service valves are brass, front seating type with sweat con- nections. Valves are externally located so refrigerant tube con- nections can be made quickly and easily. Each valve has a service port for ease of checking operat- ing refrigerant pressures. SERVICEABILITY: One access panel provides access to electrical controls. Removal of top gives access to fan motor, compressor, and con- denser coil. a v CC H V W J W SS-PA12-01 NOTES: 1. Allow 30 in. clearance to service side of unit, 48 in. - .3. Series designation is the 14th position of the unit above unit, 6 in. on one side, 12 in. on remaining side, model number. and 24 in. between units for proper airflow. 4. Center of gravity �. 2. Minimum outdoor operating ambient in cooling mode is'55°F max 115°F. - 30" ;EAN1-ISCHARGE AIRRDISCHARG DISCHARGE 3/B IN. DIA TIEDOWN KNOCKOUTS (2) PLACES AIR IN --30- AIR' DISCHARGE I AIR IN FIELD POWER SUPPLY CONN I� 7/8 IN. DIA HOLE WITH 1 1/8 IN. DIA KNOCKOUT AIR IN AND 1 3/a IN. DIA KNOCKOUT o E I FIELD CONTROL B o SUPPLY CONN O 7/a IN. DIA HOLE o N S %IN. DIA LIQUID LINE CONN 10" m P o 0� l z s,r 2 7/e" C 23/4" 1/4"7/1 6'. �-1111 D DIA VAPOR LINE CONN 6 1/2" 23 1/2" A95095 DIMENSIONS (IN.) UNIT SIZE - SERIES B C D M N P SHIPPING WEIGHT (Lb) 024 A 23-15/16 3-3/16 5/8 14-3/4 14 11 152 030 A 27-15/16 3-3/16 3/4 14-3/4 14 11 164 036 A 27-15/16 3-3/16 3/4 14-3/4 14 11 169 042 A 33-15/16 3-1/4 7/8 14-3/4 14 15 1 183 048 A 39-15/16 3-1/4 7/8 15-1/2 14-3/4 15 257 060 A 39-15/16 3-1/4 7/8 15-1/2 14 3/4 15 267 &OUL UL �(00 EPA DOE As an ENERGY STAR - Partner, Payne Heating & Cooling has determined that this product meets the ENERGY STAR guidelines for energy efficiency. CERTIFICATION APPLIES ONLY WHEN THE COMPLETE SYSTEM IS LISTED WITH ARI. -2- G�i`a' Cor o�B!`o' BSI APPROVALS ISO 9001 u �. EN 29001 BS 5750 PART 1 V"' ^� ANSI/ASOC 091 60900/ #P`L�0 CERTIFICATE N0. FM 28768 CERTIFICATION OF MANUFACTURING SITE. SPECIFICATIONSA�2R��03 6 UNIT SIZE 024 030 036• _`, SERIES t A A ELECTRICAL Unit Volts—Hertz—Phase 208-230-60-1 Operating Voltage Range' 187-253 j Compressor—Rated Load Ams 11.6 13.5 X17.9 Locked Rotor Amps 62.5 76.0 90.5 { Condenser Fan Motor—Full Load Amps 0.5 1.0 11.0 1 Min Unit Ampacity for Wire Sizing 1 15.0 17.8 123.31 Min Wire Size (601/75° Copper) AWG" 14/14 14/14. 12/12 Max Wire Length (600/75°) (Ft)$ 66/62 56/54 66/63, Max Branch Circuit Fuse Sizet 20 25 135_t COMPRESSOR AND REFRIGERANT Compressor—Manufacturer Copeland Type Scroll Temperature and Current Protection Internal Line Break Refrigerant—Type and Amount (Lb) @ 15 ft R-22 6.00 R-22 6.50 R-22 6.75 Refrigerant Tubes (in. 01)) Vapor and Liquid (Up to 50 Ft) 5/8 and 3/8 - 3/4 and 3/8 CONDENSER COIL AND FAN Coil Face Area (Sq Ft) 12.8 16.0 Fan Motor—HP, Type, and RPM 1/15 PSC and 800 1/8 PSC and 825 Volts—Hertz—Phase 208/230-60-1 Condenser Airflow (CFM) 2000 3000 OPTIONAL EQUIPMENT Cycle Protector KSACY0101AAA Start Assist—PTC Type KAACS0201 PTC Start Assist—Capacitor/Relay Type KSAHS1401 AAA KSAHS1501 AAA MotorMaster@) Control 32LT660004 Ball Bearing Fan Motor HC38GE230 Low -Pressure Switch KAALP0101LPS High -Pressure Switch KSAH10101HPS . Sound Hood KSASH1801COP KSASH1901CYL Time -Delay Relay KAATD0101TDR -.- Low -Ambient Controllert P251-0083 (RCD) - Winter Start Controlt KAAWS0101AAA Evaporator Freeze Thermostatt KAAFT0101AAA Crankcase Heater KAACH1201AAA Liquid Line Solenoid Valvett KAALS0101 LLS Coastal Filter KAACF0501LRG Filter Drier P502 -8083S TXV Kit (RPB) KAATX0301 RPB KAATX0401 RPB KAATX0501 RPB TXV (Hard Shutoff)tt KAATX1001 HSO KAATX1101 HSO KAATX1201 HSO Thermostat, Auto Changeover, Non -Programmable, °F/°C, 1 -Stage Heat, 1 -Stage Cool TSTATPPNAC01 Thermostat, Auto Changeover, 7 -Day Programmable, °F/°C, 1 -Stage Heat, 1 -Stage Cool TSTATPPPAC01 Outdoor Sensor TSTATBBSEN01 See notes on page 4. -3- <a, f '7 SPECIFICATIONS"Continued P1412- N40 6 0 UNIT SIZE 042 048--` 060 SERIES A ; • r AA►y.-� ELECTRICAL I Unit Volts—Hertz—Phase 208-230-60-1 Operating Voltage Range' 187-253 Compressor—Rated Load Ams - 19.9 23.7 28'81 Locked Rotor Amps 107.0 129.0 k1 -69:d Condenser Fan Motor—Full Load Amps 1.0 1.0 1X1T4l Min Unit Ampacity for Wire Sizing 25.8 30.5 jf37!4 Min Wire Size (60°/75° Copper) AWG" 10/10 8/10- 198/8 Max Wire Length (600!750) (Ft)$ 91/86 11500 91%87 Max Branch Circuit Fuse Sizet 40 45 %-501, COMPRESSOR AND REFRIGERANT Compressor—Manufacturer Copeland Type Scroll Temperature and Current Protection Internal Line Break Refrigerant—Type and Amount (Lb) @ 15 ft R-22 7.50 R-22 10.75 R-22 11.50 Ref rigerant Tubes (In. OD) Vapor and Liquid (Up to 50 Ft) 7/8 and 3/8 CONDENSER COIL AND FAN Coil Face Area (Sq Ft) 19.3 Fan Motor—HP, Type, and RPM 1/8 PSC and 825 1/4 PSC and 1125 Volts—Hertz—Phase 208/230-60-1 Condenser Airflow (CFM) 3000 3400 OPTIONAL EQUIPMENT Cycle Protector KSACY0101AAA Start Assist—PTC Type KAACS0201 PTC Start Assist—Capacitor/Relay Type KSAHS1501 AAA MotorMaster® Control 32LT660004 Ball Bearing Fan Motor HC38GE230 Low -Pressure Switch . KAALP0101LPS High -Pressure Switch KSAH10101HPS Sound Hood KSASH2101COP Time -Delay Relay KAATD0101TDR Low -Ambient Controlleq P251-0083 (RCD) Winter Start Controlt KAAWS0101AAA Evaporator Freeze Thermostat KAAFT0101 AAA Crankcase Heater KAACH1201AAA Liquid Line Solenoid Valvett KAALS0101 LLS Coastal Filter KAACF0501LRG Filter Drier P502 -8163S TXV Kit (RPB) KAATX0501RPB KAATX0601RPB KAATX0701RPB TXV (Hard Shutoff)tt KAATX1201HSO KAATX1301HSO KAATX1401HSO Thermostat, Auto Changeover, Non -Programmable, °F/°C, 1 -Stage Heat, 1 -Stage Cool TSTATPPNAC01 Thermostat, Auto Changeover, 7 -Day Programmable,'FrC, 1 -Stage Heat, 1 -Stage Cool TSTATPPPAC01 Outdoor Sensor TSTATBBSEN01 N/A—Not applicable in this application. Permissible limits of the voltage range at which unit will operate satisfactorily. Operation outside these limits may result in unit failure. t Time -delay fuse. $ Length shown is as measured 1 way along wire path between unit and service panel for voltage drop not to exceed 2%. If wire is applied at ambient greater than 30°C (860F), consult Table 310-16 of the NEC (ANSI/NFPA 70). The ampacity of nonmetallic -sheathed cable (NM), trade name ROMEX, shall be that of 60°C (140°F) conductors, per the NEC (ANSI/NFPA 70) Article 336-30. tt Do not use hard shutoff TXV with liquid solenoid valve. NOTES: 1. Control circuit is 24v on all units and requires external power source. 2. All motors/compressors contain internal overload protection. 3. Copper wire must be used from service disconnect to unit. -4- OPTIONAL EQUIPMENT USAGE GUIDELINE For tubing line sets between 50 and 175 ft, refer to Residential Split Systems Long -Line Application Guidelines. For buried line applications, refer to Residential Split Systems Buried Line Application Guidelines. Only when low-pressure switch is used. OPTIONALL EQUIPMENT DESCRIPTION AND USAGE (Listed Alphabetically) 1. Ball Bearing Fan Motor A fan motor with ball bearings which permits speed reduction while maintaining bearing lubrication. SUGGESTED USE: Required on all units where Low -Ambient kit (full modulation feature) or MotorMaster® Control has been added. 2. Coastal Filter A mesh screen inserted under the top cover and inside the base pan to protect the condenser coil from salt damage without restricting airflow. SUGGESTED USE: In geographic areas where salt damage could occur. 3. Compressor Start Assist—Capacitor/Relay Type Start capacitor and start relay gives "hand" boost to compressor motor at each start-up. - SUGGESTED USE: Installations where interconnecting tube length exceeds 50 ft. Installations where outdoor design temperature exceeds 105°F (40.60C). Replacement installations with hard shutoff expansion valve on indoor coil. 4. Compressor Start Assist—PTC Type Solid-state electrical device which gives a "soft" boost to the compressor at each start-up. SUGGESTED USE: Installations with marginal power supply. Replacement installations with rapid pressure balance (RPB) expansion valve on indoor coil. 5. Crankcase Heater An electric resistance heater which mounts to the base of the compressor to keep the lubricant warm during off cycles. Improves compressor lubrication on restart and minimizes chance of refrigerant slugging. May or may not include a thermostat control. SUGGESTED USE: When interconnecting tube length exceeds 50 ft. When unit will be operated below 55°F (12.8°C) outdoor air temperature. (Use with low -ambient controller.) All commercial installations. 6. Evaporator Freeze Thermostat An SPST temperature actuated switch which stops unit operation when evaporator reaches freeze-up conditions. SUGGESTED USE: All units where winter start control has been added. 7. High -Pressure Switch Auto reset SPST switch activated by refrigerant pressure on high side of refrigerant circuit. Cycles compressor off if refrigerant pressure rises to about 400 psig. Provides additional protection against compressor damage due to loss of outdoor airflow. To prevent rapid compressor recycling, cycle protector can be used with this switch. SUGGESTED USE: Installations exposed to very "dirty" outdoor air. Installations where condenser inlet air temperature exceeds 125°F (51.7°C). 8. Liquid Solenoid Valve (LSV) An electrically operated shutoff valve to be installed at the outdoor or indoor unit (depending on tubing configuration) and which stops and starts refrigerant liquid flow in response to compressor operation. Maintains a column of refrigerant liquid ready for action at next compressor operation cycle. NOTE: Compressor start assist—capacitor/relay type—must also be used on units with reciprocating compressors. SUGGESTED USE: For improved system performance in air conditioners for certain combinations of indoor and outdoor units. Refer to ARI Unitary Directory. In certain long line applications. Refer to Residential Split System Long -Line Application Guidelines. 9. Low -Ambient Controller This solid-state head pressure controller is a cycle control device activated by a temperature sensor. It is specifically designed to control outdoor fan motor run time in response to saturated condensing temperature. For outdoor air temperatures between 55°F and 0°F (12.8°C and –17.8°C), it maintains condensing temperature between 75°F and 130°F (23.8°C and 54.4°C). SUGGESTED USE: Cooling operation at outdoor temperatures below 55°F (12.8°C). 10. Low -Pressure Switch • Auto reset SPST switch activated by refrigerant pressure on low side of refrigerant circuit. Cycles compressor off if refrigerant pressure drops to about 27 psig. Prevents indoor coil freeze-up due to loss of indoor airflow. Also, provides additional protection against compressor damage due to loss of refrigerant charge. To prevent rapid compressor recycling, cycle protector can be used with this switch. SUGGESTED USE: Where indoor coil is exposed to "dirty" air. All commercial installations. —5— REQUIRED FOR REQUIRED FOR REQUIRED FOR REQUIRED FOR LOW -AMBIENT LONG -LINE BURIED LINE SEA COAST APPLICATIONS APPLICATIONS* APPLICATIONSt APPLICATIONS ACCESSORY (Below 55°F) (Over 50 Ft) (Over 3 Ft) (Within 2 Miles) Crankcase Heater Yes Yes Yes No Evaporator Freeze Thermostat Yes No No No Winter Start Control Yes$ No No No Accumulator No No Yes No Compressor Start Assist Yes Yes Yes No Capacitor and Relay - Low Ambient Controller ' or Yes No No _ - No MotorMaster® Control Wind Baffle See Low -Ambient Instructions No No No Coastal Filter No No No Yes Support Feet Recommended No No Recommended Liquid -Line Solenoid Valve See Long -Line _ or No Application Yes - No Hard Shutoff TXV Guideline ' Ball Bearing Fan Motor Yes No No No For tubing line sets between 50 and 175 ft, refer to Residential Split Systems Long -Line Application Guidelines. For buried line applications, refer to Residential Split Systems Buried Line Application Guidelines. Only when low-pressure switch is used. OPTIONALL EQUIPMENT DESCRIPTION AND USAGE (Listed Alphabetically) 1. Ball Bearing Fan Motor A fan motor with ball bearings which permits speed reduction while maintaining bearing lubrication. SUGGESTED USE: Required on all units where Low -Ambient kit (full modulation feature) or MotorMaster® Control has been added. 2. Coastal Filter A mesh screen inserted under the top cover and inside the base pan to protect the condenser coil from salt damage without restricting airflow. SUGGESTED USE: In geographic areas where salt damage could occur. 3. Compressor Start Assist—Capacitor/Relay Type Start capacitor and start relay gives "hand" boost to compressor motor at each start-up. - SUGGESTED USE: Installations where interconnecting tube length exceeds 50 ft. Installations where outdoor design temperature exceeds 105°F (40.60C). Replacement installations with hard shutoff expansion valve on indoor coil. 4. Compressor Start Assist—PTC Type Solid-state electrical device which gives a "soft" boost to the compressor at each start-up. SUGGESTED USE: Installations with marginal power supply. Replacement installations with rapid pressure balance (RPB) expansion valve on indoor coil. 5. Crankcase Heater An electric resistance heater which mounts to the base of the compressor to keep the lubricant warm during off cycles. Improves compressor lubrication on restart and minimizes chance of refrigerant slugging. May or may not include a thermostat control. SUGGESTED USE: When interconnecting tube length exceeds 50 ft. When unit will be operated below 55°F (12.8°C) outdoor air temperature. (Use with low -ambient controller.) All commercial installations. 6. Evaporator Freeze Thermostat An SPST temperature actuated switch which stops unit operation when evaporator reaches freeze-up conditions. SUGGESTED USE: All units where winter start control has been added. 7. High -Pressure Switch Auto reset SPST switch activated by refrigerant pressure on high side of refrigerant circuit. Cycles compressor off if refrigerant pressure rises to about 400 psig. Provides additional protection against compressor damage due to loss of outdoor airflow. To prevent rapid compressor recycling, cycle protector can be used with this switch. SUGGESTED USE: Installations exposed to very "dirty" outdoor air. Installations where condenser inlet air temperature exceeds 125°F (51.7°C). 8. Liquid Solenoid Valve (LSV) An electrically operated shutoff valve to be installed at the outdoor or indoor unit (depending on tubing configuration) and which stops and starts refrigerant liquid flow in response to compressor operation. Maintains a column of refrigerant liquid ready for action at next compressor operation cycle. NOTE: Compressor start assist—capacitor/relay type—must also be used on units with reciprocating compressors. SUGGESTED USE: For improved system performance in air conditioners for certain combinations of indoor and outdoor units. Refer to ARI Unitary Directory. In certain long line applications. Refer to Residential Split System Long -Line Application Guidelines. 9. Low -Ambient Controller This solid-state head pressure controller is a cycle control device activated by a temperature sensor. It is specifically designed to control outdoor fan motor run time in response to saturated condensing temperature. For outdoor air temperatures between 55°F and 0°F (12.8°C and –17.8°C), it maintains condensing temperature between 75°F and 130°F (23.8°C and 54.4°C). SUGGESTED USE: Cooling operation at outdoor temperatures below 55°F (12.8°C). 10. Low -Pressure Switch • Auto reset SPST switch activated by refrigerant pressure on low side of refrigerant circuit. Cycles compressor off if refrigerant pressure drops to about 27 psig. Prevents indoor coil freeze-up due to loss of indoor airflow. Also, provides additional protection against compressor damage due to loss of refrigerant charge. To prevent rapid compressor recycling, cycle protector can be used with this switch. SUGGESTED USE: Where indoor coil is exposed to "dirty" air. All commercial installations. —5— OPTIONAL EQUIPMENT DESCRIPTION AND USAGE (Listed. Alphabetically) Continued 11. MotorMaster® Control A fan speed control device activated by a temperature sensor. Designed to control condenser fan motor speed in response to the saturated, condensing temperature during operation in cooling mode only. For outdoor temperatures down to =20°F, it maintains condensing temperature at 100°F t 10°F. SUGGESTED USE: Cooling operation at outdoor temperatures below 55°F. All commercial installations. 12. Sound Hood ' Wraparound sound attenuation cover for the compressor. Reduces unit sound level by about 2 dBA. SUGGESTED USE: Unit installed closer than 15 ft to quiet areas—bedrooms, etc. Unit installed between 2 houses less than 10 ft apart. 13. Thermostatic Expansion Valve (TXV) Kits A modulating flow control valve which meters refrigerant liquid flow rate into the evaporator in response to the superheat of the refrigerant gas leaving the evaporator. Kit includes valve, adapter tubes, and external equalizer tube. Both hard shut-off and RPB type valves are available. SUGGESTED USE: For improved system performance in cooling mode for certain combinations of indoor and outdoor units. Refer to ARI Unitary Directory. 14. Time -Delay Relay An SPST delay relay which briefly continues operation of the indoor blower motor to provide additional cooling after the compressor cycles off. SUGGESTED USE: For improved efficiency ratings for certain combinations of indoor and outdoor units. Refer to ARI Unitary Directory. 15. Winter Start Control An SPST delay relay which bypasses the low-pressure switch for approximately 3 minutes to permit start-up for cooling operation under low -load conditions. SUGGESTED USE: All air conditioners where low -ambient controller has been added. METERING DEVICE UNIT SIZE -SERIES PISTON' IDENTIFICATION NO. 024-A 61 030-A 70 036-A 76 042-A 82 048-A 90 060-A 101 • Piston listed is for any approved coil non -capillary tube combination. Piston is shipped with outdoor unit and must be installed in an approved indoor coil. m RATINGS AND PERFORMANCE • See notes on page 8. =A= FACTORY SEER PAYNE GAS SUPPLIED SOUND UNIT INDOOR COOLING ENHANCE- STANDARD FURNACE OR ACCESSORY RATING SIZE -SERIES MODEL CAPACITY MENT RATING ACCESSORYTDRt TXV$ EER (dBA) CC5A/CD5A/CD5BA024' 23,200 NONE - 12.00 12.00 10.70 PFlMNA024 23,200 NONE 12.00 - 12.00 10.60 PFlMNA030 23,600 NONE 12.00 - 12.00 10.90 CE3AA024 23,400 NONE - 12.00 12.00 10.75 CE3AA030 23,600 NONE - 12.10 12.10 10.75 024-A CJ5A/CK5A/CK5BA024 23,000 NONE - 12.00 12.00 10.70 76 CJ5A/CK5A/CK5BA030 23,400 NONE - 12.10 12.10 10.90 CJ5A/CK5A/CK5BWO24 23,000 NONE - 12.00 12.00 10.70 CJ5A/CK5A/CK5BWO30 23,400 NONE - 12.10 12.10 10.90 CK3BA024 23,000 NONE - 12.00 12.00 10.70 CK3BA030 23,400 NONE - 12.10 12.10 10.90 CM5A/CM5BA024 23,400 NONE - 12.00 12.00 10.85 CC5A/CD5A/CD5BA030' 29,000 NONE - 12.00 12.00 10.60 PFlMNA030 29,200 NONE 12.10 - 12.10 10.60 PFlMNA036 29,600 NONE 12.00 - 12.00 10.55 CE3AA030 29,000 NONE - 12.00 12.00 10.55 CE3AA036 29,600 NONE - 12.20 12.20 10.70 CJ5A/CK5A/CK5BA030 29,000 NONE - 12.00 12.00 10.65 030-A CJ5A/CK5A/CK5BA036 29,600 NONE - 12.20 12.20 11.00 76 CJ5A/CK5A/CK5BNO36 27,600 NONE - 12.20 12.20 11.00 CJ5A/CK5A/CK5BWO30 29,000 NONE - 12.00 12.00 10.65 CJ5A/CK5A/CK5BWO36 29,600 NONE - 12.20 12.20 11.00 CK3BA030 29,000 NONE - 12.00 12.00 10.65 CK3BA036 29,600 NONE - 12.20 12.20 11.00 CM5A/CM5BA036 29,200 NONE - 12.00 12.00 10.95 CC5A/CD5A/CD5BA036' 35,000 NONE - 12.00 12.00 10.40 PFlMNA036 34,800 NONE 11.50 - 11.50 10.20 PFlMNA042 35,000 NONE 12.00 - 12.00 10.45 CE3AA036 34,800 NONE - 11.80 11.80 10.40 CE3AA042 35,000 NONE - 12.10 12.10 10.55 CJ5A/CK5A/CK5BA036 35,000 NONE - 12.00 12.00 10.40 A36 CJ5A/CK5A/CK5BA042 35,000 NONE - 12.00 12.00 10.40 80 -A CJ5A/CK5A/CK5BNO36 33,000 NONE 11.70 11.70 10.15 CJ5A/CK5A/CK5BNO42 34,000 NONE 12.00 12.00 10.40 CJ5A/CK5A/CK5BWO36 35,000 NONE - 12.00 12.00 10.40 1 12-00- 10.40- �1 dibBAQ 35;00 �==NONE---y-- 12:00 CK3BA042��-35,000 NONE - 12.00 12.00 10.40 CM5A/CM5BA036 35,000 NONE - 12.00 12.00 10.40 CM5A/CM5BA042 35,400 NONE - 12.00 12.00 10.45 CC5A/CD5A/CD5BA042' 40,000 NONE - 12.00 12.00 10.35 PFlMNA042 40,000 NONE 11.80 - 11.80 10.10 PFlMNA048 40,500 NONE 12.00 - 12.00 10.30 CE3AA042 40,000 NONE - 12.00 12.00 10.40 CE3AA048 40,000 NONE - 12.00 12.00 10.25 CJ5A/CK5A/CK5BA042 40,000 NONE - 12.00 12.00 10.35 042-A CJ5A/CK5A/CK5BA048 40,500 NONE - 12.00 12.00 10.40 80 CJ5A/CK5A/CK5BNO42 39,000 NONE - 12.00 ' 12.00 10.35 CJ5A/CK5A/CK5BNO48 39,500 NONE - 12.00 12.00 10.40 CJ5A/CK5A/CK5BWO48 40,500 NONE - 12.00 12.00 10.40 CK3BA042 40,000 NONE - 12.00 12.00 10.35 CK3BA048 40,500 NONE - 12.00 12.00 10.40 CM5A/CM5BA042 40,000 NONE - 12.00 12.00 10.45 CM5A/CM5BA048 40,500 NONE - 12.00 12.00 10.50 CD5A/CD5BA048' 47,000 NONE - 12.00 12.00 10.65 PFlMNA048 47,000 NONE 12.00 - 12.00 10.50 PFlMNA060 47,500 NONE 12.10 - 12.10 10.60 PFIMNA070 48,000 NONE 12.50 - 12.50 10.95 PFlMNA071 48,000 NONE 13.00 - 13.00 11.75 CE3AA048 47,000 NONE - 12.00 12.00 10.65 CE3AA060 47,500 NONE - 12.10 12.10 10.90 048-A CJ5A/CK5A/CK5BA048 47,000 NONE - 12.00 12.00 10.70 80 CJ5A/CK5A/CK5BA060 47,500 NONE - 12.10 12.10 10.85 CJ5A/CK5A/CK5BNO48 46,000 NONE - 11.80 11.80 10.50 CJ5A/CK5A/CK5BNO60 47,500 NONE - 12.10 12.10 11.05 CJ5A/CK5A/CK5BWO48 47,000 NONE - 12.00 12.00 10.70 CJ5A/CK5A/CK5BX060 48,000 NONE - 12.20 12.20 11.05 CK3BA048 47,000 NONE - 12.00 12.00 10.70 CK3BA060 47,500 NONE - 12.10 12.10 10.85 CM5A/CM5BA048 46,500 NONE - 12.00 12.00 10.85 CC5A/CD5A/CD5BW060' 57,000 NONE - 12.00 12.00 10.45 PFlMNA060 57,000 NONE 11.50 - 11.50 10.30 ^ PFlMNA070 58,000 NONE 12.00 - 12.00 10.70 060 PFIMNA071 'CE3AA060 � 58,000 X57,000 NONE NONE' 12.50 ,- - �.... 12-5(F___ 12.50 1'2`00 11.15 "10'60 80 CJSA/CKSA/CKSBA060 55,000 NONE 11=50 16.25 11:50- - CJ5A/CK5A/CK5BNO60 55,000 NONE _ 11.50 11.50 10.45 CJ5A/CK5A/CK5BX060 57,000 NONE - 12.00 12.00 10.55 CK3BA060 55,000 NONE - 11.50 11.50 10.25 • See notes on page 8. =A= Tested Combination t In most cases, only 1 method should be used to achieve TDR function. Using more than 1 method in a system may cause degradation in performance. Use either the accessory Time -Delay Relay KAAT00101 TDR or a furnace equipped with TDR. All Payne furnaces are equipped with TDR. # Requires hard shutoff TXV; based on computer simulation. EER — Energy Efficiency Ratio SEER — Seasonal Energy Efficiency Ratio TDR —Time -Delay Relay. TXV —Thermostatic Expansion Valve. NOTES: 1. Ratings are net values reflecting the effects of circulating fan motor heat. Supplemental electric heat is not included. 2. Tested outdoor/indoor combinations have been tested in accordance with DOE test procedures for central air conditioners. Ratings for other combinations are determined under DOE computer simulation procedures. 3. Determine actual CFM values obtainable for your system by referring to fan performance data in fan coil or furnace coil literature. 4. Minimum outdoor operating ambient in cooling mode is 55°F (12.8°C), maximum 115°F (46.1°C). SYSTEM DESIGN 1. Intended for outdoor installation with free air inlet and outlet. Outdoor fan external static pressure available is less than 0.01 -in. WC. 2. Minimum outdoor operating air temperature without low -ambient operation accessory is 55°F (12.8°C). 3. Maximum outdoor operating air temperature is 115°F (46.1 °C). 4. For reliable operation, unit should be level in all horizontal planes. 5. Maximum elevation of indoor coil above or below base of outdoor unit is: indoor coil above = 50 ft, indoor coil below = 150 ft. (See items 6 and 7 following.) 6. For interconnecting refrigerant tube lengihs greater than 50 ft, consult Residential Split System Long -Line Application Guideline available from equipment distributor. 7. Crankcase heater required when interconnecting refrigerant tube length exceeds 50 ft. 8. Not more than 36 in. of refrigerant tube should be buried in the ground. If necessary to bury tubes under a sidewalk, provide a minimum 6 -in. vertical rise to the valve connections at the unit. 9. Use only copper wire for electric connection at unit. Aluminum and clad aluminum are not acceptable for the type of connector provided. S Heating &Cooling 01997 Payne Heating & Cooling P.O. Box 70, Indianapolis, IN 46206 SPECIFICATIONS SUBJECT TO CHANGE WITHOUT NOTICE UNIT MUST BE INSTALLED IN ACCORDANCE WITH INSTALLATION INSTRUCTIONS Cancels: New s4 —8— PRINTED IN U.S.A. Catalog No. 52PA-120 4;97 } S 0 Heating & Cooling N FEATURES INSTALLATION The 4 -way multipoise design allows FLEXIBILITY: a model PG9MAA to be installed BURNERS: in an upflow, downflow, or hori- zontal orientation. All sizes of the PG9MAA may be installed in INTEGRATED direct vent (2 -pipe) applications. CONTROL All sizes except the 140 size may CENTER: be installed in non -direct vent (1 -pipe) applications. CASING: The casing also has the required openings for left- or right -side connection of gas, electric, drain, and vent connections. COMBUSTION Enclosed burner assembly isolates SYSTEM: operating noise without the expense of sound deadening devices. 3 -PASS This design accelerates heat trans - PRIMARY fer and extracts heat that conven- HEAT tional heat exchangers waste up EXCHANGERS: the flue. The primary heat ex- changer is made of aluminized steel for corrosion resistance. FLOW-THROUGH Each cell is laminated with our pa - SECONDARY tented polypropylene for greater HEAT corrosion resistance to help extend EXCHANGERS: the life of the furnace for years of dependable performance. The heat exchanger is positioned in the fur- nace to extract additional heat from the combustion products regard- less of furnace orientation. LIMITED The PG9MAA is backed by a Life - WARRANTY: time Warranty on the heat ex- changers in direct vent application (20 -year in non -direct vent applica- tions) and a 1 -year Warranty on all other parts. T� MONOPORT Produce precise air -to -gas mixture INSHOT which gives a clean bum. The large BURNERS: monoport on the inshot or injec- tion -type burners seldom, if ever, needs cleaning. INTEGRATED The printed -circuit board has con - CONTROL venient terminals which permit CENTER: quick -connection of a thermostat, air conditioning control circuits, a humidifier, or an air cleaner. The control has a built-in status indica- tor and self -test feature. A self -test - feature allows for a complete check of the major components in only seconds. COMBUSTION The PG9MAA advanced design AIR AND. allows Schedule 40PVC, PCV - VENTILATION: DWV, SDR -21 PVC,SDR-26 PVC (not approved in Canada), ABS- DWV, or ABS -F628 Schedule 40 pipe to bring air into the furnace for combustion and to be used for venting combustion products out- side the structure. The vent pipe can terminate through a sidewall or through the roof. CERTIFICATIONS: The PG9MAA units are A.G.A. and C.G.A. design certified for use with natural and propane gases, as well as GAMA efficiency rating certi- fied. The furnace is factory - shipped for use with natural gas. An A.G.A./C.G.A. listed gas con- version kit is required to convert furnace for use with propane gas. The model PG9MAA meets Calk fornia Air Quality Management District emission requirements. V W Q Z Oct 0 Z U) Z W D Z O (a) 0 a J SS-PG9M-02 26 "/s' 26 %- 24 'h"- 22 5Ae" 2 -IN. COMBUSTION - AIR CONN —\ Y, -IN. DIA--N GAS CONN 2 -IN. VENT CONN 16-IN. DIA THERMOSTAT ENTRY 22 "As"- ----------------- 14'b- ---------._14'h" SIDE INLET TYP 1 I L===-----ted 7 1" �►--23'/."TYP—� SIDE INLET 26 1%" TYP CONDENSATE DRAIN TRAP LOCATION (DOWNLOW 8 HORIZONTAL LEFT 3WN. DIA POWERCONN %4N. DIA ACCESSORY POWER ENTRY —CONDENSATE DRAIN TRAP 27'Ae LOCATION I TYP UAPFLOW) LTERNATE 24'h" 17I1e" 97/. TYP 4 AIRFLOW 13/18"D �15Ae" OUTLET 1 I 1 33'/." 32 aA" TYP '%" TYP 29"A5" 27 5h" TYP CONDENSATE DRAIN TRAP LOCATION (DOWNLOW 8 0 HORIZONTAL RIGHT) OR ALTERNATE 'h -IN. DIA GAS CONN NE 30'h" 28'h" 26 "As" 26'/." 22 Via" TYP L 1A" �TLET COMBUSTION - AIR AIR CONN a/le" + + Y, -IN. DIA GAS CONN 7/WN. DIA POWERCONN V\—'h-IN. DIA THERMOSTAT ENTRY 2 -IN. VENT CONN 397h" 22 'Aa" ----- 1 I I 18 1/1" SIDE INLET I I I I 1" ------------------ �NLET II CONDENSATE DRAIN LOCATION 22 'A" TYP --►I 7Ae" (UPFLOW) —245Ae" DIMPLE LOCATORS BOTTOM INLET FOR HORIZONTAL HANGING .NOTES: Minimum retum-air opening at furnace: 1. For 800 CFM--16-In. round or 141/2 x 12 -In. rectangle. 2. For 1200 CFM--20-In. round or 141/2 x 191/2 -In. rectangle. 3. For 1600 CFM--22-In. round or 141/2 x 23 1/4 -In. rectangle. 4. For airflow requirements above 1800 CFM, use both side inlets, a combination of 1 side inlet and the bottom, or the bottom only. DIMENSIONS (In.) UNIT SIZE A D E SHIP. WEIGHT (Lb) 024040 17-1/2 15-7/8 16 149 036040 17-1/2 15-7/8 16 152 024060 17-1/2 15-7/8 16 156 036060 17-1/2 15-7/8 16 163 048060 17-1/2 15-7/8 16 166 036080 17-1/2 15-7/8 16 172 048080 17-1/2 15-7/8 16 175 060080 21 19-3/8 19-1/2 197 048100 21 19-3/8 19-1/2 193 060100 21 19-3/8 19-1/2 196 060120 24-1/2 22-7/8 23 252 060140 24-1/2 22-7/8 23 252 A98121 CONDENSATE TRAP BLOWER SHELF FURNACE DOOR CONDENSATE CONDENSATE TRAP FURNACE TRAP (INSIDE) FURNACE DOOR FURNACE SIDE SIDE i i 4 %8 4DaT 5 �4 4 ..' 261/4 3/4 FIELD 26y4 i FIELD DRAIN DRAIN —ALTERNATE DRAIN CONN CONN TUBE LOCATION \ . CONDENSATE TRAP SIDE VIEW FRONT VIEW END VIEW FRONT VIEW DRAIN TUBE LOCATION DOWNFLOW AND ALTERNATE HORIZONTAL UPFLOW APPLICATIONS EXTERNAL UPFLOW APPLICATIONS APPLICATIONS SLOT FOR SCREW HORIZONTAL APPLICATION (OPTIONAL) 11/2 3/4 l 1 13/4 WIRE TIE GUIDES (WHEN USED) FRONT VIEW DESIGA, P�ERICg1 EFFICIENCY RATING GAS CERTIFIED s n lcpama `rC I Ate cERTIF\EO� SIDE VIEW Go1 Cor prall�9p� 001 APPROVALS > 1-0 U� IS09001 • e • EN 29001 '. ® "a '�� BS 5750 PART 1 ® ANSVASOC 091 09001 #P2� CERTIFICATE N0. FIA 29652 REGISTERED QUALITY SYSTEM -3- 1/4 OD COLLECTOR BOX TO TRAP RELIEF PORT Ih OD INDUCER HOUSING DRAIN CONNECTION 5% OD COLLECTOR BOX DRAIN CONNECTION SCREW HOLE FOR UPFLOW OR DOWN - FLOW APPLICATIONS (OPTIONAL) 1/2 -IN. PVC OR CPVC A93026 MEETS DOE RESIDENTIAL CONSERVATION SERVICES PROGRAM STANDARDS. Before purchasing this appliance, read important energy cost and efficiency information available from your retailer. As an ENERGY STARS"' Partner, Payne Heating & Cooling has determined that this product meets the ENERGY STAR guidelines for energy efficiency. SPECIFICATIONS UNIT SIZE 024040 1 036040 1 024060 1 036060 1 048060 j703608014 RATINGS AND PERFORMANCE Input Btuh' 40,000 40,000 60,000 60,000 60,000 8_0;004 Output Capacityt Nonweatherized ICS 37,000 37,000 56,000 56,000 56,000 74'000 [AFOEgot flow/Horizon aF D sect �swt{Appticatlo . -Nonw athenzed ICS Downflow Direct Vent Applications 92:0 91.5 91.5 92:0- .',0 91.5 91.5 92.092-0] 91.5 91?511 Upflow/Horizontal Non -Direct Vent Applications 90.0 90.0 90.0 90.0 90.01[W -0J I Downflow Non -Direct Vent Applications 90.0 90.0 90.0 90.0 90.0 90'0 Certified Temperature Rise Range 'F 30-60 15-45 45-75 30-60 20-50 4 X70 Certified External Static Pressure Heating Cooling 0.10 0.50 0.10 0.50 0.12 0.12 0.50 0.50 0.12 0.50 0715 0'.50) Airflow CFM# Heating Cooling 850 895 1125 1215 885 1065 1 900 1 1200 1 1320 1545 1 11901 1(12451 ELECTRICAL Unit Volts -Hertz -Phase 115-60-1 Operating Voltage Range Min -Max" 104-127 Maximum Unit Amps 6.1 7.3 6.1 7.1 9.5 7.6 Unit Ampacitytt 8.4 10.0 8.4 9.8 12.8 10.4 Minimum Wire Size 14 14 14 14 14 14 Maximum Wire Length (Ft)## 44 37 44 38 29 36 Maximum Fuse Size or Ckt Bkr Amps (Time -Delay Type Recommended) 15 15 15 15 15 15 Transformer (24v) 40va External Control Heating Power Available Cooling 12va 21 v Air Conditioning Blower Relay Standard CONTROLS Limit Control SPST Heating Blower Control (Off Delay) Factory Set at 135 Sec Burners (Monoport) 2 2 3 1 3 3 4 Gas Connection Size 1/2 -in. NPT GAS CONTROLS Gas Valve (Redundant) Manufacturer Minimum Inlet Pressure (In. wc) Maximum Inlet Pressure (In. wc) White -Rodgers 4.5 (Natural Gas) 13.6 (Natural Gas) Ignition Device Hot Surface BLOWER DATA Direct -Drive Motor HP (Permanent Split Capacitor) 1/5 1/3 1/5 1/3 1/2 1/3 Motor Full Load Amps 4.9 5.8 4.9 5.8 7.9 5.8 RPM (Nominal) -Speeds 1075-3 1075-4 1075-3 1075-4 Blower Wheel Diameter x Width (In.) 10 x 6 10 x 7 10 x 6 10 x 7 11 x 8 10 x 7 Filter Size (In.) -Permanent Washable (1) 16 x 25 x 1 (1) 20 x 25 x 1 FACTORY -AUTHORIZED AND LISTED, DEALER -INSTALLED OPTIONS Gas Conversion Kit -Natural -to- Propane KGANP2001ALL Gas Conversion Kit -Propane -to -Natural KGAPN1601ALL Twinning Kit-Upflow ONLY N/A I HSI KGATW0401 N/A Manufactured (Mobile) Home Kit KGAMH0101 KIT Downflow Base"' KGASB0201ALL Vent Termination Kit (Bracket Only for 2 Pipes)ttt 2-in.-KGAVT0101 BRA 3-in.-KGAVT0201 BRA Concentric Vent Termination Kit (Single Exit)ttt 2-in.-KGAVT0501CVT 3-in.--KGAVT0601CVT Condensate Freeze Protection Kit KGAHT0101CFP Side Filter Rack (Without Filter)-Upflow ONLY KGAFR0206ALL Thermostat -Programmable For Use With Air Conditioner-TSTATPPPAC01-A Thermostat -Non -Programmable For Use With Air Conditioner-TSTATPPNAC01-A L Gas input ratings are certified for elevations to 2000 ft. For elevations above 2000 ft, reduce ratings 2% for each 1000 ft above sea level. In Canada, derate the unit 5% from 2000 to 4500 ft above sea level. t Capacity and AFUE in accordance with U.S. Government DOE test procedures. # Air delivery above 1800 CFM requires that both sides, a combination of 1 side and bottom, or bottom only of the furnace be used for return air. A filter is required for each return -air supply. Permissible voltage limits for proper furnace operation. tt Unit ampacity =125% of full load amps of largest components plus 100% full load amps of all other potential operating components (EAC, humidifier, etc.). • ## Length shown is measured 1 way along wire path between unit and service panel for maximum 2% voltage drop. "' Required for installation on combustible floors when no coil box is used, or when any coil box other than a Payne CD5, CK5 or KCAKC cased coil is used. ttt For direct vent applications only. N/A -Not Applicable. Unit is not allowed in this installation application. ICS -Isolated Combustion System -4- rr_ SPECIFICATIONS Continued UNIT SIZE 048080 1 060080 1 048100 W0100A 060120 060140 RATINGS AND PERFORMANCE Input Btuh' 80,000 80,000 100,000 00,9b0 120,000 138,000 Output Capacityt Nonweatherized ICS 74,000 74,000 93,000 93,000 112,000 127,000 :AFCJE'/ofi �"U ftow/HorizontahDirectV_ent;Appfication Nonweatherized ICS Downflow Direct Vent Applications 9_2.0----92:0-""920"`92.0- 91.5 91.5 91.5 J91.5 92.0 91.5 91.0 90.0 Upflow/Horizontal Non -Direct Vent Applications 90.0 90.0 90.0 190.6 90.0 N/A Downflow Non -Direct Vent Applications 90.0 90.0 90.0 190-19 90.0 N/A Certified Temperature Rise Range OF 30-60 20-50 45-75 30 60 40-70 50-80 Certified Extemal Static Pressure Heating Cooling 0.15 0.50 0.15 0.50 0.20 0.20 0.50 10.50 0.20 0.50 0.20 0.50 Airflow CFM# Heating Cooling 1285 1525 1785 1925/2035 1315 `1690 1570 1930/2130 1720 2000/2130 1970 1990/2045 ELECTRICAL Unit Volts -Hertz -Phase 115--60-1 Operating Voltage Range Min --Max" 104-127 Maximum Unit Amps 10.0 14.1 10.2 14.8 14.6 14.3 Unit Ampacitytt 13.4 18.4 13.5 19.3 19.1 18.8 Minimum Wire Size 14 12 14 12 12 12 Maximum Wire Length (Ft)## 28 31 27 30 30 30 Maximum Fuse Size or Ckt Bkr Amps (Time -Delay Type Recommended) 15 20 15 20 20 20 Transformer (24v) 40va External Control Heating Power Available Cooling 12va 21 va Air Conditioning Blower Relay Standard CONTROLS Limit Control SPST Heating Blower Control (Off Delay) Factory Set at 135 Sec Bumers (Monoport) 4 4 5 1 5 6 6 Gas Connection Size 1/2 -in. NPT GAS CONTROLS Gas Valve (Redundant) Manufacturer Minimum Inlet Pressure (In. wc) Maximum Inlet Pressure (In. wc) White -Rodgers 4.5 (Natural Gas) 13.6 (Natural Gas) Ignition Device Hot Surface BLOWER DATA Direct -Drive Motor HP (Permanent Split Capacitor) 1/2 3/4 1/2 3/4 3/4 3/4 Motor Full Load Amps 7.9 11.1 7.9 11.1 11.1 11.1 RPM (Nominal) -Speeds 1075-4 Blower Wheel Diameter x Width (In.) 11 x 8 11 X10 11 x 8 I 11 x 10 11 x 10 11 x 10 Filter Size (In.) -Permanent Washable (1) 20 x 25 x 1 (2)16 x 25 x 1 FACTORY -AUTHORIZED AND LISTED, DEALER -INSTALLED OPTIONS Gas Conversion Kit- Natural -to- Propane KGANP2001ALL Gas Conversion Kit -Propane -to -Natural KGAPN1601ALL Twinning Kit-Upflow ONLY KGATW0401HSI N/A Manufactured (Mobile) Home Kit KGAMH0101 KIT N/A Downflow Base"' KGASB0201ALL Vent Termination Kit (Bracket Only for 2 Pipes)ttt 2-in.--KGAVT0101 BRA 3-in.-KGAVT0201 BRA Concentric Vent Termination Kit (Single Exit)ttt 2-in.-KGAVT0501 CVT 3-in.-KGAVT0601 CVT Condensate Freeze Protection Kit KGAHT0101CFP Side Filter Rack (Without Filter)-Upflow ONLY KGAFR0206ALL Thermostat -Programmable For Use With Air Conditioner-TSTATPPPAC01-A Thermostat -Non -Programmable For Use With Air Conditioner-TSTATPPNAC01-A ' Gas input ratings are certified for elevations to 2000 ft. For elevations above 2000 ft, reduce ratings 2% for each 1000 ft above sea level. In Canada, derate the unit 5% from 2000 to 4500 ft above sea level. t Capacity and AFUE in accordance with U.S. Government DOE test procedures. $ Air delivery above 1800 CFM requires that both sides, a combination of 1 side and bottom, or bottom only of the furnace be used for return air. A filter is required for each return -air supply. " Permissible voltage limits for proper furnace operation. tt Unit ampacity =125% of full load amps of largest components plus 100% full load amps of all other potential operating components (EAC, humidifier, etc.). $$ Length shown is measured 1 way along wire path between unit and service panel for maximum 2% voltage drop. Required for installation on combustible floors when no coil box is used, or when any coil box other than a Payne CD5, CK5 or KCAKC cased coil is used. ttt For direct vent applications only. N/A -Not Applicable. Unit is not allowed in this installation application. ICS -Isolated Combustion System -5- COMBUSTION -AIR AND VENT PIPING FOR DIRECT VENT (2 PIPE) APPLICATIONS MAXIMUM ALLOWABLE PIPE LENGTH (FT) ALTITUDE ABOVE SEA LEVEL (FT) UNIT SIZE TERMINATION TYPE PIPE DIAMETER NUMBER OF 90° ELBOWS (IN.)' 1 2 3 4 5 6 024040 036040 2 pipe or 2 -in. Concentric 1 5 NA NA NA NA NA 1-1/2 70 70 65 60 60 55 2 70 70 70 70 70 70 024060 036060 048060 2 Pipe or 2 -in. Concentric 1-1/2 20 15 10 5 NA NA 2 70 70 70 70 70 70 036080 048080 060080 2 Pipe or 2 -in. Concentric 1-1/2 10 NA NA NA NA NA 2 55 50 35 30 30 20 2-1/2 70 70 70 70 70 70 0 to 2000 048100 060100 2 pipe or 3 -in. Concentric 2 5 NA NA NA NA NA 2-1/2 40 30 20 20 10 NA 3 70 70 70 70 70 70 060120 2 Pipe or 3 -in. Concentric 2-1/2 one disk 10 NA NA NA NA NA 3t 45 40 35 30 25 20 3t no disk 70 70 70 70 70 70 4t no disk 70 70 70 70 70 70 060140 2 Pipe or 3 -in. Concentric 2-1/2 one disk 5 NA NA NA NA NA 3t one disk 40 35 30 25 20 15 3t no disk 60 56 52 48 1 44 40 4t no disk 70 70 70 70 70 70 024040 036040 2 Pipe or 2 -in. Concentric 1-1/2 67 62 57 52 52 47 2 70 70 70 70 70 70 024060 036060 048060 2 Pipe or 2 -in. Concentric 1-1/2 17 12 7 NA NA NA 2 70 1 67 66 61 61 61 036080 048080 060080 2 Pipe or 2 -in. Concentric 2 49 44 30 25 1 25 15 2-1/2 70 70 70 70 70 70 2001 to 3000 048100 060100 2 Pipe or 3 -in. Concentric 2-1/2 35 26 16 16 6 NA 3 70 70 70 70 66 61 060120 2 Pipe or 3 -in. Concentric 3 14 9 NA NA NA NA 3t no disk 70 70 63 56 50 43 4t no disk 70 70 70 70 70 70 060140 2 Pipe or 3 -in. Concentric 3t one disk 20 15 10 5 NA NA 3t no disk 39 35 31 27 23 19 4t no disk 70 70 70 70 70 70 0240402 036040 . pipe or 2-inConcentric 1-1/2 64 59 54 49 48 43 2 70 70 70 70 70 70 024060 036060 048060 2 Pipe or 2 -in. Concentric 1-1/2 16 11 6 NA NA NA 2 68 63 62 57 57 56 036080 048080 060080 2 Pipe or 2 -in. Concentric 2 46 4128 23 22 13 2412 70 70 70 70 70 70 3001 to 4000 048100 060100 2 pipe or 3 -in. Concentric 2-1/2 33 24 15 14 5 NA 3 70 70 70 66 61 56 060120 2 Pipe or 3 -in. Concentric 3t no disk 65 58 51 44 38 31 4t no disk 70 70 70 70 70 70 060140 2 Pipe or 3 -in. Concentric 3t one disk 11 6 NA NA NA NA 3t no disk 30 26 1 22 18 14 10 4t no disk 70 70 1 70 70 70 70 Disk usage—Unless otherwise specified, use perforated disk assembly (factory -supplied in loose parts bag). If one disk is stated, separate 2 halves of per- forated disk assembly and use shouldered disk half. When using shouldered disk half, install screen side toward inlet box. t Wide radius elbow. t Vent sizing for Canadian installations above 4500 It (1370m) above sea level are subject to acceptance by the local authorities having jurisdiction. N/A — Not Allowed. Pressure switch will not make. NOTES: 1. Do not use pipe size greater than those specified in table or incomplete combustion, flame disturbance, or flame sense lockout may occur. 2. Size both the combustion -air and vent pipe independently, then use the larger diameter for both pipes. 3. Assume two 45° elbows equal one 90° elbow. Long radius elbows are desirable and may be required in some cases. 4. Elbows and pipe sections within the furnace casing and at the vent termination should not be included in vent length or elbow count. 5. The minimum pipe length is 5 ft for all applications. 6. Use 3 -in. diameter vent termination kit for installations requiring 4 -in. diameter pipe. IS. MAXIMUM ALLOWABLE PIPE LENGTH (FT) Continued ALTITUDE ABOVE SEA LEVEL (FT) UNIT SIZE TERMINATION TYPE PIPE DIAMETER NUMBER OF 90° ELBOWS (IN.)' 1 2 3 4 5 6 024040 036040 2 Pipe or 2 -in. Concentric 1-1/2 60 55 50 45 44 39 2 70 70 70 70 70 70 024060 036060 048060 2 Pipe or 2 -in. Concentric 1-1/2 15 10 5 NA NA NA 2 64 59 58 53 52 52 4001 to 5000$ 036080 048080 060080 2 Pipe or 2 -in. Concentric 2 44 39 26 21 20 11 2-1/2 70 70 70 70 70 70 048100 060100 2 Pipe or 3 in. Concentric 2-1/2 31 22 13 12 NA NA 3 70 70 67 62 57 52 060120 2 Pipe or 3 -in. Concentric 3t no disk 53 46 40 33 26 20 4t no disk 70 70 70 70 70 70 060140 2 Pipe or 3 -in. Concentric 3t no disk 21 17 13 9 5 NA 4t no disk 69 64 59 54 49 44 024040 036040 2 Pipe or 2 -In. Concentric 1-1/2 57 52 47 42 40 35 2 70 70 70 70 70 70 024060 036060 048060 2 Pipe or 2 -In. Concentric 1-1/2 14 9 NA NA NA NA 2 60 55 54 49 48 47 5001 to 6000$ 036080 048080 060080 2 Pipe or 2 -In. Concentric 2 41 36 23 18 17 8 2-1/2 70 70 70 70 70 70 048100 060100 2 Pipe or 3 -In. Concentric 2-1/2 29 21 12 11 NA NA 3 70 67 62 57 52 47 060120 2 Pipe or 3 -In. Concentric 3t no disk 42 35 29 22 15 9 4t no disk 70 70 70 70 70 70 060140 2 Pipe or 3 -In. Concentric 3t no disk 12 8 NA NA NA NA 4t no disk 42 37 32 27 22 17 024040 036040 2 Pipe or 2 -In. Concentric 1-1/2 53 48 43 38 37 32 2 70 70 68 67 66 64 024060 036060 048060 2 Pipe or 2 -In. Concentric 1-1/2 13 8 NA NA NA NA 2 57 52 50 45 44 43 6001 to 7000# 036080 048080 060080 2 Pipe or 2 -In. Concentric 2 38 33 21 16 15 6 2-1/2 70 70 68 67 66 64 048100 060100 2 Pipe or 3 -In. Concentric 2-1/2 27 19 10 9 NA NA 3 68 63 58 53 48 43 060120 2 Pipe or 3 -In. Concentric 3t no disk 31 24 18 11 NA NA 4t no disk 70 70 70 70 70 70 060140 2 Pipe or 3 -In. Concentric 4t no disk 17 12 7 NA NA NA 024040 036040 2 Pipe or 2 -In. Concentric 1-1/2 49 44 39 34 33 28 2 66 65 63 62 60 59 024060 036060 048060 2 Pipe or 2 -In. Concentric 1-1/2 12 7 NA NA NA NA 2 53 48 46 41 40 38 7001 to 8000$ 036080 048080 060080 2 Pipe or 2 -In. Concentric 2 36 31 19 14 12 NA 2-1/2 66 65 63 62 60 59 048100 060100 2 Pipe or 3 -In. Concentric 2-1/2 25 17 8 7 NA NA 3 63 58 53 48 43 38 060120 2 Pipe or 3 -In. Concentric 3t no disk 20 13 7 NA NA NA 4t no disk 61 56 51 46 41 36 060140 NA Disk usage—Unless otherwise specified, use perforated disk assembly (factory -supplied in loose parts bag). If one disk is stated, separate 2 halves of per- forated disk assembly and use shouldered disk half. When using shouldered disk half, install screen side toward inlet box. t Wide radius elbow. t Vent sizing for Canadian installations above 4500 ft (1370m) above sea level are subject to acceptance by the local authorities having jurisdiction. N/A — Not Allowed. Pressure switch will not make. NOTES: 1. Do not use pipe size greater than those specified in table or incomplete combustion, flame disturbance, or flame sense lockout may occur. 2. Size both the combustion -air and vent pipe independently, then use the larger diameter for both pipes. 3. Assume two 45° elbows equal one 90° elbow. Long radius elbows are desirable and may be required in some cases. 4. Elbows and pipe sections within the furnace casing and at the vent termination should not be included in vent length or elbow count. 5. The minimum pipe length is 5 ft for all applications. 6. Use 3 -in. diameter vent termination kit for installations requiring 4 -in. diameter pipe. —7— MAXIMUM ALLOWABLE PIPE LENGTH (FT) Continued ALTITUDE ABOVE SEA LEVEL (FT) UNIT SIZE TERMINATION TYPE PIPE DIAMETER WITH 3/8 -IN. OR THICKER INSULATIONt 024040 036040 NUMBER OF 90° ELBOWS 1-1/2 51 (IN.)' 1 2 3 4 5 6 70 024040 036040 2 Pipe or 2 -In. Concentric 1-1/2 46 41 36 31 29 24 2 62 60 58 56 55 53 036080 048080 060080 024060 036060 048060 2 Pipe or 2 -In. Concentric 1-1/2 11 6 NA NA NA NA 2 49 44 42 37 35 34 8001 to 90001 036080 048080 060080 2 Pipe or 2 -In. Concentric 2 33 28 17 12 10 NA 2-1/2 62 60 58 56 55 53 70 048100 060100 2 Pipe or 3 In. Concentric ic 2-1/2 23 15 7 5 NA NA 3 59 54 49 44 39 34 060120 2 Pipe or 3 -In. Concentric 3t no disk 10 NA NA NA NA NA 4t no disk 35 30 25 20 15 10 060140 NA 024040 036040 2 Pipe or 2 -In. Concentric 1-1/2 42 37 32 27 25 20 2 57 55 53 51 49 47 024060 036060 048060 2 Pipe or 2 -In. Concentric 2 45 40 38 33 31 29 9001 to 10,000$ 036080 048080 060080 2 Pipe or 2 -In. Concentric 2 30 25 14 9 7 NA 2-1/2 57 55 53 51 49 47 048100 060100 2 Pipe or 3 -In. Concentric 2-1/2 21 13 5 NA NA NA 3 54 49 44 39 34 29 060120 2 Pipe or 3 -In. Concentric 4t no disk 10 5 NA NA NA NA 060140 NA Disk usage—Unless otherwise specified, use perforated disk assembly (factory -supplied in loose parts bag). If one disk is stated, separate 2 halves of per- forated disk assembly and use shouldered disk half. When using shouldered disk half, install screen side toward inlet box. t Wide radius elbow. t Vent sizing for Canadian installations above 4500 ft (1370m) above sea level are subject to acceptance by the local authorities having jurisdiction. N/A — Not Allowed. Pressure switch will not make. NOTES: 1. Do not use pipe size greater than those specified in table or incomplete combustion, flame disturbance, or flame sense lockout may occur. 2. Size both the combustion -air and vent pipe independently, then use the larger diameter for both pipes. 3. Assume two 45" elbows equal one 90° elbow. Long radius elbows are desirable and may be required in some cases. 4. Elbows and pipe sections within the furnace casing and at the vent termination should not be included in vent length or elbow count. 5. The minimum pipe length is 5 ft for all applications. 6. Use 3 -in. diameter vent termination kit for installations requiring 4 -in. diameter pipe. MAXIMUM ALLOWABLE EXPOSED VENT PIPE LENGTH (FT) WITHOUT INSULATION IN WINTER DESIGN TEMPERATURE AMBIENT FOR DIRECT -VENT APPLICATIONS* UNIT SIZE WINTER DESIGN TEMPERATURE ff) MAXIMUM PIPE DIAMETER (IN.) WITHOUT INSULATION WITH 3/8 -IN. OR THICKER INSULATIONt 024040 036040 20 1-1/2 51 70 0 1-1/2 28 70 –20 1-1/2 16 70 024060 036060 048060 20 2 65 70 0 2 35 70 –20 2 20 70 036080 048080 060080 20 2-1/2 70 70 0 2-1/2 47 70 –20 2-1/2 28 70 048100 060100 20 3 70 70 0 3 50 70 –20 3 28 70 060120 20 4 70 70 0 4 48 70 –20 4 23 1 70 060140 20 4 70 70 0 4 57 70 –20 4 30 70 Pipe length (ft) specified for maximum vent pipe lengths located in unconditioned spaces. Vent pipes located in unconditioned space cannot exceed the total allowable pipe length as specified in Maximum Allowable Pipe Length table on pages 6 8 7. t Insulation thickness based on R value of 3.5 per in. —8 VENT PIPING FOR NON -DIRECT VENT (1 PIPE) APPLICATIONS MAXIMUM ALLOWABLE VENT PIPE LENGTH (FT) ALTITUDE ABOVE SEA LEVEL (FT) UNIT SIZE VENT PIPE DIAMETER NUMBER OF 90° ELBOWS (IN.)' 1 2 3 4 5 6 024040 036040 1 5 NA NA NA NA NA 1-1/2 70 70 65 60 60 55 2 70 70 70 70 70 70 024060 036060 048060 1-1/2 20 15 10 5 NA NA 2 70 70 70 70 70 70 Oto 20006 036080 048080 060080 1-1/2 10 NA NA NA NA NA 2 55 50 35 30 30 20 2-1/2 70 70 70 70 70 70 048100 060100 2 5 NA NA NA NA NA 2-1/2 40 30 20 20 10 NA 3 70 70 70 70 70 70 060120 2-1/2 one disk 10 NA NA NA NA NA 3t 45 40 35 30 25 20 3t no disk 70 70 70 70 70 70 4t no disk 70 70 70 70 70 70 024040 036040 1-1/2 67 62 57 52 52 47 2 70 70 70 70 70 70 024060 036060 048060 1-1/2 17 12 7 NA NA NA 2 70 67 66 61 61 61 2001 to 3000 036080 048080 060080 2 49 44 30 25 25 15 2-1/2 70 70 70 70 70 70 048100 060100 2-1/2 35 26 16 16 6 NA 3 70 70 70 70 66 61 060120 3 14 9 NA NA NA NA 3t no disk 70 70 63 56 50 43 4t no disk 70 70 70 70 70 70 024040 036040 1-1/2 64 59 54 49 48 43 2 70 70 70 70 70 70 024060 036060 048060 1-1/2 16 11 6 NA NA NA 2 68 63 62 57 57 56 3001 to 4000 036080 048080 060080 2 46 41 28 23 22 13 2412 70 70 70 70 70 70 048100 060100 2-1/2 33 24 15 14 5 NA 3 70 70 70 66 61 56 060120 3t no disk 65 58 51 44 38 31 4t no disk 70 70 70 70 70 70 024040 036040 1-1/2 60 55 50 45 44 39 2 70 70 70 70 70 70 024060 036060 048060 1-1/2 15 10 5 NA NA NA 2 64 59 58 53 52 52 4001 to 50001 036080 048080 060080 2 44 39 26 21 20 11 2-1/2 70 70 70 70 70 70 048100 060100 2-1/2 31 22 13 12 NA NA 3 70 70 67 62 57 52 060120 3t no disk 53 46 40 33 26 20 4t no disk 70 70 70 70 70 70 Wide radius elbow. t Vent sizing for Canadian installations above 4500 ft (1370m) above sea level are subject to acceptance by the local authorities having jurisdiction.. NA — Not Allowed. Pressure switch will not make. NOTES: 1. Do not use pipe size greater than those specified in table or incomplete combustion, flame disturbance, or flame sense lockout may occur. 2. Assume two 45° elbows equal one 90° elbow. Long radius elbows are desirable and may be required in some cases. 3. Elbows and pipe sections within the furnace casing and at the vent termination should not be included invent length or elbow count. 4. The minimum pipe length is 5 ft for all applications. g= MAXIMUM ALLOWABLE VENT PIPE LENGTH (FT) Continued ALTITUDE ABOVE SEA LEVEL (FT) UNIT SIZE VENT PIPE DIAMETER (IN.)' 1 2 NUMBER 3 OF 90° ELBOWS 4 5 6 024040 036040 1-1/2 57 52 47 42 40 35 2 70 70 70 70 70 70 024060 036060 048060 1-1/2 14 9 NA NA NA NA 2 60 55 54 1 49 48 47 5001 to 60001 036080 048080 060080 2 41 36 23 18 17 8 2-1/2 70 70 70 70 70 70 048100 060100 2-1/2 29 21 12 11 NA NA 3 70 67 62 57 52 47 060120 3t no disk 42 35 29 22 15 9 4t no disk 70 70 70 1 70 70 70 024040 036040 1-1/2 53 48 43 38 37 32 2 70 70 68 67 66 64 024060 036060 048060 1-1/2 13 8 NA NA NA NA 2 57 52 50 45 44 43 6001 to 70001 036080 048080 060080 2 38 33 21 16 15 6 2-1/2 70 70 68 67 66 64 048100 060100 2-1/2 27 19 10 9 NA NA 3 68 63 58 53 48 43 060120 3t no disk 31 24 18 11 NA NA 4t no disk 70 70 70 70 67 62 024040 036040 1-1/2 49 44 39 34 33 28 2 66 65 63 62 60 59 024060 036060 048060 1-1/2 12 7 NA NA NA NA 2 53 48 46 41 40 38 7001 to 80001 036080 048080 060080 2 36 31 19 14 12 NA 2-1/2 66 65 63 62 60 59 048100 060100 2-1/2 25 17 8 7 NA NA 3 63 58 53 48 43 38 060120 3t no disk 20 13 7 NA NA NA 4t no disk 61 56 51 46 41 36 024040 036040 1-1/2 46 41 36 31 29 24 2 62 60 58 56 55 53 024060 036060 048060 1-1/2 11 6 NA NA NA NA 2 49 44 42 37 35 34 8001 to 90001 036080 048080 060080 2 33 28 17 12 10 NA 2-1/2 62 60 58 56 55 53 048100 060100 2-1/2 23 15 7 5 NA NA 3 59 54 49 44 39 34 060120 3t no disk 10 NA NA NA NA NA 4t no disk 35 30 25 20 15 10 024040 036040 1-1/2 42 37 32 27 25 20 2 57 55 53 51 49 47 024060 036060 048060 2 45 40 38 33 31 29 9001to 10,0001 036080 048080 060080 2 30 25 14 9 7 NA 2-1/2 57 55 53 51 49 47 048100 060100 2-1/2 21 13 5 NA NA NA 3 54 49 44 39 34 29 060120 4t no disk 10 5 NA NA NA I NA Wide radius elbow. t Vent sizing for Canadian installations above 4500 ft (1370m) above sea level are subject to acceptance by the local authorities having jurisdiction.. NA — Not Allowed. Pressure switch will not make. NOTES: 1. Do not use pipe size greater than those specified in table or incomplete combustion, flame disturbance, or flame sense lockout may occur. • 2. Assume two 45° elbows equal one 90° elbow. Long radius elbows are desirable and may be required in some cases. 3. Elbows and pipe sections within the furnace casing and at the vent termination should not be included invent length or elbow count. 4. The minimum pipe length is 5 ft for all applications. —10— COMBUSTION -AIR PIPE FOR NON -DIRECT VENT APPLICATIONS (Sizes 040 through 120 only) FIELD -SUPPLIED 2 -IN. DIAMETER PVC 90' ELBOW COMBUSTION -AIR DISC (FACTORY -SUPPLIED IN LOOSE PARTS BAG) FIELD -SUPPLIED 2 -IN. DIAMETER PVC PIPE A96211 LENGTH OF STRAIGHT PIPE PORTION OF COMBUSTION -AIR INLET PIPE ASSEMBLY (IN.) CASING WIDTH A 17-1/2 8-1/2:t 1/2 21 _ 10-1/2:t 1/2 24-1/2 12 t 1/2 MAXIMUM ALLOWABLE EXPOSED VENT PIPE LENGTH (FT) WITHOUT INSULATION IN WINTER DESIGN TEMPERATURE AMBIENT FOR NON -DIRECT VENT APPLICATIONS* UNIT SIZE WINTER DESIGN TEMPERATURE (°F) MAXIMUM PIPE DIAMETER (IN.) WITHOUT INSULATION WITH 3/8 -IN. OR THICKER INSULATIONt 024040 036040 20 1-1/2 51 70 0 1-1/2 28 70 —20 1-1/2 16 70 024060 036060 048060 20 2 65 70 0 2 35 70 —20 2 20 70 036080 048080 060080 20 2-1/2 70 70 0 2-1/2 47 70 —20 2-1/2 28 70 048100 060100 20 3 70 70 0 3 50 70 —20 3 28 70 060120 20 4 70 70 0 4 148 1 70 —20 4 123 170 Pipe length (ft) specified for maximum vent pipe lengths located in unconditioned spaces. Vent pipes located in unconditioned space cannot exceed the total allowable pipe length as specified in Maximum Allowable Pipe Length table on pages 9 and 10. t Insulation thickness based on R value of 3.5 per in. —11— ACCESSORIES CONCENTRIC VENT (Direct Vent Applications Only) BIN. DIA PVC VENT/EXHAUST ----------r-------------- ----------'--------------E C IN. DIA 13/16 11/2 D so A B IN. DIA PVC INTAKE/COMBUSTION AIR DIMENSIONS (In.) F — _ E I A97110 PART NO. A• B c Dt E F KGAVT0501CVT 33-3/8 2 3-1/2 16-5/8 6-1/4 5-3/4 KGAVT0601CVT 38-7/8 1 3 4-1/2 21-1/8 7-3/8 6-1/2 Dimension A will change accordingly as dimension D is lengthened or shortened. t Dimension D may be lengthened to 60 in. maximum. Dimension D may also be shortened by cutting the pipes provided in the kit to 12 in. minimum. —12— ACCESSORIES Continued SIDE FILTER RACK* �{ 3/3* ly, I TABS 23/Bn 25 +/3e 3V A80199 *Accepts one 16 x 25 x 1 in. filter. ACCESSORY DOWNFLOW SUBBASE LOCATING TAB Ya 9e LOCATING TAB 40 3e Ye A88207 Disassembled 1 1/4' TYP PLENUM OPENING 1111 WIN 9, N 41 • Assembled A97427 FURNACE CASING PLENUM OPENING* FLOOR OPENING HOLE NO. FOR WIDTH A B C D WIDTH FURNACE IN DOWNFLOW APPLICATION ADJUSTMENT Furnace with or without CD5, CK5 Coil 17-1/2 Assembly or KCAKC Coil Box 15-1/8 19 16-3/4 20-3/8 3 Furnace with or without CD5, CK5 Coil 21 Assembly or KCAKC Coil Box 18-5/8 19 20-1/4 20-3/8 2 Furnace with or without CD5, CK5 Coil 24-1/2 Assembly or KCAKC Coil Box 22-1/8 19 23-3/4 1 20-3/8 1 * The plenum should be constructed 1/4 -in. smaller in width and depth than the plenum dimensions shown above. —13— CLEARANCE TO COMBUSTIBLES This forced air furnace is equipped for use with natural gas at altitudes 0 -10,000 ft (0 - 3,050m), except 140 size Furnaces are only approved for altitudes 0 - 7,000 ft. (0 - 2,135m). An accessory kit, supplied by the manufacturer, shall be used to convert to propane gas use or may be required for some natural gas applications. This furnace is for indoor installation in a building constructed on site. This furnace may be installed in a manufactured (mobile) home when stated on rating plate and using factory authorized kit. This furnace may be installed on combustible flooring in alcove or closet at minimum clearance from combustible material. This appliance requires a special venting system. Refer to the installation instructions for parts list and method of installation. This furnace is for use with schedule -40 PVC, PVC-DWV, or ABS-DWV pipe, and must not be vented in common with other gas-fired appliances. Construction through which venttair intake pipes may be installed is maximum 24 inches (600 mm), minimum 3/4 inches (19 mm) thickness (including roofing materials). MINIMUM INCHES CLEARANCE TO COMBUSTIBLE CONSTRUCTION ALL POSITIONS: * Mimimum front clearance for service 30 inches (762mm). I tt 140 size furnaces require 1 inch back I clearance to combustible materials. DOWNFLOW POSITIONS: tFor installation on combustible floors only .when installed on special base No. KGASB0201ALL, Coil Assembly, Part No. CD5 or CK5, or Coil Casing, Part No. KCAKC. HORIZONTAL POSITIONS: Clearance shown is for air inlet and air outlet end. Line contact is permissible only between lines formed by intersections of top and two sides of furnace jacket, and building joists, studs, or framing. 0 120 and 140 size Furnaces require 1 inch bottom clearance to combustible materials. 323857-101 REV. C (LIT) This furnace is approved for UPFLOW, DOWNFLOW and HORIZONTAL installations. Clearance in inches —14— combustibles 0°. A97609 AIR DELIVERY—CFM (With Filter)* Air delivery above 1800 CFM requires that both sides, a combination of 1 side and bottom, or bottom only of the furnace be used for return air. A filter is required for each return -air supply. —15— RETURN- EXTERNAL STATIC PRESSURE (In. wc) UNIT SIZE AIR SUPPLY SPEED 0.1 0.2 0.3 0.4 0.5 0.6 0.7 0.8 1 side High 1075 1040 995 945 895 840 760 670 024040 or Med-Low 850 825 780 740 685 635 560 480 bottom Low 740 700 650 620 565 515 455 385 1 side High 1470 1415 1400 1285 1215 1120 995 890 036040 or Med-High 1315 1280 1235 1180 1115 1035 930 825 bottom Med-Low 1125 1110 1085 1045 990 915 830 740 Low 930 925 910 850 830 770 705 635 1 side High 1100 1065 1005 945 900 805 730 610 024060 or Med-Low 890 865 810 765 705 620 540 475 bottom Low 745 710 670 625 565 505 425 360 1side High 1430 1375 1325 1275 1200 1135 1040 935 036060or Med-High 1270 1260 1215 1160 1105 1035 950 850 bottom Med-Low 1070 1055 1045 1015 975 920 850 750 Low 915 895 885 865 840 800 720 650 1side High 1700 1695 1640 1580 1545 1450 1380 1310 048060 or Med-High 1500 1465 1435 1385 1355 1300 1250 1185 bottom Med-Low 1325 1295 1265 1230 1190 1150 1105 1050 Low 1205 1170 1145 1110 1080 1035 990 950 1 side High 1535 1470 1405 1330 1245 1160 1065 935 036080 or Med-High 1395 1350 1300 1125 1155 1080 985 880 bottom Med-Low 1200 1175 1125 1065 1030 970 890 780 Low 1040 1020 990 960 910 860 785 1 680 1 side High 1750 1685 1635 1575 1525 1445 1380 1310 048080 Med-High 1495 1455 1405 1355 1305 1250 1185 1120 or bottom Med-Low 1310 1260 1225 1170 1125 1095 1040 980 Low 1135 1105 1075 1040 995 995 910 860 High 2200 2175 2085 2025 1925 1820 1735 1635 bottom Med-High 2100 2025 1945 1865 1785 1700 1620 1540 only Med-Low 1815 1760 1720 1670 1620 1550 1480 1405 060080 Low 1560 1555 1515 1460 1435 1390 1340 1270 both sides or High 2360 2280 2210 2130 2035 1960 1875 1790 1 side and Med-High 1965 1925 1870 1830 1760 1710 1670 1575 bottom 1 side High 1740 1705 1660 1615 1570 1500 1425 1355 048100 or Med-High 1500 1470 1445 1410 1375 1330 1280 1210 bottom Med-Low 1340 1315 1300 1270 1235 1200 1140 1095 Low 1195 1175 1165 1130 1100 1070 1030 975 High 2250 2175 2090 2020 1930 1855 1760 1670 bottom Med-High 2020 1950 1900 1840 1790 1710 1640 1545 only Med-Low 1725 1690 1660 1630 1575 1520 1460 1370 060100 Low 1490 1480 1460 1440 1380 1340 1295 1230 both sides or High 2360 2315 2265 2200 2130 2055 1965 1890 1 side and Med-High 1960 1940 1930 1900 1850 1800 1740 1660 bottom High 2350 2250 2160 2070 2000 1885 1790 1635 bottom Med-High 2100 2015 1955 1875 1810 1710 1650 1540 only Med-Low 1770 1720 1675 1620 1575 1515 1450 1365 060120 Low 1545 1520 1465 1415 1365 1325 1265 1185 both sides or High 2435 2360 2285 2220 2130 2050 1965 1875 1 side and Med-High 2040 2000 1950 1905 1835 1790 1725 1650 bottom High 2285 2210 2140 2065 1990 1910 1830 1745 bottom only Med-High 2020 1970 1920 1870 1805 1730 1660 1590 Med-Low 1675 1650 1620 1590 1560 1510 1450 1390 060140 Low 1460 1445 1430 1400 1370 1320 1275 1230 both sides or High 2310 2255 2185 2120 2045 1965 1880 1800 1side and Med-High 1975 1945 1900 1860 1835 1775 1720 1640 bottom Air delivery above 1800 CFM requires that both sides, a combination of 1 side and bottom, or bottom only of the furnace be used for return air. A filter is required for each return -air supply. —15— F r S. Heating &Cooling a 1� 01998 Payne Healing & Cooling, P.O. Box 70, Indianapolis, IN 46206 V SPECIFICATIONS SUBJECT TO CHANGE WITHOUT NOTICE UNIT MUST BE INSTALLED IN ACCORDANCE WITH INSTALLATION INSTRUCTIONS Cancels: SS-PG9M-01 —1 6— PRINTED IN U.S.A. Catalog No. 52PG-9M1 6-98 • BUILDING PERMIT SITE PLAN CHECKLIST APN: d 1 1 -1 10 O__ ��^� Building Permit No.: Proposed Use: SFD O MH O Res. Accessory O Ag. Bldg. U Commercial ❑ Industrial 0 Other: Zone District: General Plan: The Proposed Use Is: Permitted: Not Permitted: Requires a Use Permit:. Requires a Minor Use Permit: Requires an Administrative Permit: Accessory Bldg. Use: Parcel Created By Map? No: Yes: * Book/Page Map Conditions? No: Yes: , See reverse side Use Permit: O Variance: Dev. Agreement: Applicable Setback Zoning Code Streets & Hwy. Fire Prevention Subdivision Map Front Px Side J� Side, street Rear Height - Parcel in Land Conservation Agreement? No: "N Yes: , Check Use Parcel in North Chico Specific Plan? No: Yes: , Check NCSP Zoning Parcel in Floodplain? No: Yes: "x , Zone: ' ' Panel No.: 0410 1 %— OSS Parcel in Enterprise Zone? No: L Yes: , Check Use Commercial/Industrial Uses Parking Requirements: OK as shown Landscaping Requirements: OK as shown _ Comments: O K ' Other. _ Other Reviewed By: Date: Li -1 &-- C - CHECK SPECIAL CONDMONS WHICH APPLY TO PARCEL. ALL. FEES TO gg pA 1p TO THE B mom Q== UNLESS / THER 1. Submit a plan of the existing on-site mature trees, located in the proposed for building and driveway area prior to grading or vegetation removal. IVtinimize the removal of mature trees, where possible. A mature tree shall be defined as a tree with a trunk measuring 4 inches in diameter, 4 feet from ground level. Mature trees removed shall be replaced by planting replacement trees of equal number and not less than _ gallon size. _2. Prior to the commencement of grading and/or construction activity, all individual or groups of oak trees wbkb are to be retained as part of the project. shall be fully protected through the use of root protection zones (RPZ). During construction, RPZs shall be established using protective fencing enclosing an area with a radius 1.5 times the distance from the trunk to the dripline. Within this protective buffer, no grading, trenching, fill, or vegetation alteration of any kind shall be allowed. * The RPZs shall be maintained after the completion of construction in order to continue to protect the oak trees, but the bearing shall be removed. _3. Fencing for areas other than residential areas shall be limited to a maximum of 5 wire strands. The lower strand shall be at _ least 16" above the ground and the upper strand shall be no higher than 48" above the ground. = _4. Pay the required CSA 87 Traffic and Drainage Mitigation fee of $2,500. _5. Prior to any clearing, grading and/or construction in a Federal or State identified 100 year floodplain and/or streambed the f6llowing entitilements must be obtained: a California Fish and Game 1604 Streambed Alteration permit and an Army Corps 404 permit or exemption certificate. _6. Pay the current West Chico Fire Station Fee of $75. —7. Pay water tender fees in the amount of $200 to Battalion Number of the Butte County Fire Department. —8. Automatic fire suppression sprinkler systems shall be installed in all residential structures in accordance with the National Fire Protection Association Standard for the installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet Fire Department specifications, serves the parcel. . —9. Obtain approval from the Department of Fish and Game for vegetation removal. Contact Fish di: Game at 916-355-7010. —10. A traffic mitigation fee for each new or additional living unit shall be paid. Pay the amount of 5750 as stated in the Oroville Area Traffic Mitigation Fee Agreement. Payment to be made to the Planning Division. _ 11. Provide information showing that proposed construction will mitigate exterior sound levels to a 45 dB interior level. —12. —13. l4. KABLDGCt(4.FR.1 7 LAND DEVELOPMENT OE / CHICO BUILDING / ENVIRONMENTAL HEALTH -PERMIT CLEARANCE Building Permit No.OWNE� lJ V NAME RS �C Lr- A. NUMBER 0 PR NT LAST NAME/RST ADDRESS / LOCATION:iV f�D' COUNTY ZONING/� DESIGNATION: �/� 5- FLOOD MAP: FLOOD ZONE: APPROVED: CONDITIONALLY APPROVED: RESOLVE PROBLEMS PRIOR TO APPROVAL: PARCEL CREATION BY DEEDS v OR MAP DEED INFORMATION: DATE OF CREATION: /%, & DEED REFERENCE: LEGAL ACCESS PROVIDED: YES NO LEGAL ACCESS REQUIRED: YES NO COMPLIES WITH COUNTY STANDARDS FOR DEED CREATION: ✓ YES NO COMMENTS/CONDITIONS:G 4 S' - Z X92,7 -k0 S�fhPnN %Ff mefrA MAP INFORMATION: DATE OF RECORDING: LOT BOOK PAGE COMPLIANCE WITH OLD SUBDIVISION LOT ORDINANCE REQUIRED? (MAP RECORDED PRIOR TO BOOK 17 OF MAPS AT PAGE 23): YES NO. IF YES, MARK APPROPRIATE ITEM(S) BELOW: A. Construct road to B. Meet parcel size required by zone. C. Meet current E.H.D. requirements. CHECK SPECIAL CONDITIONS WHICH APPLY TO MAP: ALL FEES TO BE PAID TO THE BUILDING DMSION UNLESS OTHERWISE NOTED. 1. Maintain a 50 ft. building setback from centerline of road. 2. Maintain a ft. building setback from right-of-way/centerline —3. Comply with Zoning code for building setback from road. —4. Maintain a 100 ft. leachfield setback from all existing wells. 5. Maintain a ft. leachfield setback from —6. Pay water tender fees in the amount of $ to Battalion Number of the Butte County Fire Department. 7. Meet the Fire Safe Regulations of Butte County and P.R.C. 4290. 8. Connect to a public water supply. —9. Connect to a public sewer system. —10. Automatic fire suppression sprinkler systems shall be installed in all residential structures in accordance with the National Fire Protection Association Standard for the installation of sprinkler systems in one and two family dwellings and mobile homes, NFPA Standard 13D, unless a pressurized community water system, with hydrants that meet Fire Department specifications, serves the parcel. _ 11. .Pay T.D.D. (Thermalito Drainage District) fee in the amount of $ 12. Meet the requirements of the Department of Fish and Game for the preservation of oak trees. (See phone number below) _ 13. Obtain approval from the Department of Fish and Game for vegetation removal. Contad'Fish & Game at 916-355-701,0. —14. A traffic mitigation fee for each new or additional living unit shall be paid. Pay the amount of $ as stated in the Oroville Area Traffic Mitigation Fee Agreement. Payment to be made to the Planning Division. —15. All new residential buildings shall be constructed to comply with the requirements of the Uniform Building Code for seismic safety. Mobile homes shall be constructed on a permanent foundation system which complies with the Seismic Zone 3 requirements of the Uniform Building Code. 16. Deer Mitigation fees are to be paid, if such fees have been adopted by the Butte County Board of Supervisors. X 17. Pay school impact mitigation fees. X 18. A development impact fee for sheriff facilities shall be paid pursuant to the provisions of Chapter 3, Article 11 of the Butte County Code. —19. Wood stoves and fireplace inserts shall be EPA approved and designed to meet the emission requirements of the California Clean Air Act of 1988 as amended. —20. If any cultural resources are encountered during ground disturbing activities, all work shall cease in the area of the find pending examination of the site by a professional archaeologist. This person would then be able to assess the site significance and suggest appropriate mitigation measures. 21. 22. 23. 24. 25. 26. LD 6/98 FORMS\BLDG PERMIT CLEARANCE A10 IWNO13AM aNVI 3-LLne d0 W00 666191ddd C13AI3338 BUTTE COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM (One form per Building) School District O , �,,! t Building Department No. A.P. Number 0/1 "/10 ' O p� Jurisdiction: City County Property Owner Ton (4 Vare n /ka Property Location/Address Subdivision Residential Development i Commercial/Industrial Building Department Repre /9&q New Addition moor runs reviewea ov scnooi uistnct District Identification No. / /rJ g School District certifies that (Street Sq. Footage Date t C4� (Applicant) (Phone Number) (including Exterior Roofed Areas) i2a 9 6-9 3 (City) (State) (Zip Code) has complied with the requirements of Resolution No. representing 35 square feet. School District Representative Paid by Check # rJ"—Q .,T Remarks: % �� - / d by payment of $ (/P, 9 3 6. T AS 2926 $ FULL MITIGATION S Date Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with — Government Code Section 660201a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the imposition of the fees in any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act ICEQAL this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.xis 110/98)dmm 0 Lot No. ................................................................................................................... 35g Sq. Footage / No of Living Mobile Home Addition/ 'Supplemental to (Group R) Units Installation Conversion Permit # ` ; y jA+ f ........... t + .............................................................................. '(No foundation inspection):", .+...._................ . New Addition moor runs reviewea ov scnooi uistnct District Identification No. / /rJ g School District certifies that (Street Sq. Footage Date t C4� (Applicant) (Phone Number) (including Exterior Roofed Areas) i2a 9 6-9 3 (City) (State) (Zip Code) has complied with the requirements of Resolution No. representing 35 square feet. School District Representative Paid by Check # rJ"—Q .,T Remarks: % �� - / d by payment of $ (/P, 9 3 6. T AS 2926 $ FULL MITIGATION S Date Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with — Government Code Section 660201a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the imposition of the fees in any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act ICEQAL this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform.xis 110/98)dmm 0 � AMEq� q,9C q� L Mid Valley Title & Escrow Company 601 Main Stmet, Chico, CA 95928 (530) 893-5644 FAX (530) 893-3428 FAX TRAivSMMAL DATE : June 3, 1999 TO: : BUILDING DEPT. FAX No :538-2140 AM : MARTHA WHITNEY FROM : JEANETTE FOR JIM HAASE SUBJECT: TIME: 11:20 AM TOTAL NUMBER OF PAGE& 3 (INCLUDING THIS PACE) GRAND DEED ON 1869 HONEYRUN ROAD, CHICO _ Should any of these pacers rectulre an O _WAL We will not accept an Ortglnal 51gnature on FAX paper. Thank you for your cooperation In this matter. COPY THIS MESSAGE IS INTENDED ONLY FOR THE USE OF THE INDIVIDUAL OR ENTITY TO WHICH IT IS ADDRESSED. AND MAY CONTAIN INFORMATION THAT IS PRMLFAED OR CONFIDENTIAL. IF THE READER OF THIS MESSAGE IS. NOT THE INTENDED RECIPIENT, OR THE EMPLOYEE OR AGENT RESPONSIBLE FOR DELIVERING THE MESSAGE TO THE INTENDED RECIPIENT. YOU ARE H13REBY NOTIFIED THAT ANY DISSEMINATION. DISTRIBUTION OR COMING OF THIS COMMUNICATION IS STRICTLY PROHIBITED. IF YOU HAVE READ THIS COMMUNICATION IN ERROR. PLEASE NOTIFY US IMMEDIATELY BY TELEPHONE AND RETURN THE ORIGINAL MESSAGE TO US AT THE ABOVE ADDRESS VIA THE U.S. POSTAL SERVICE. 100'd H81 268 H3131 31111 A311VA albs IZ:01 MR.1J66SO- VP !RECORDING REQUEFM BY Mid VaUey Title & Escrow Company AND VVIMN RECORDED MMM TO: KAREN LEE MATA JOSE A_ MATH 451 PALISADES DRIVE CHICO, CA 95928 .. 01 Ihin docwa t isxrdar cm tifier] copy of the origial ttktt TttratmMent tb. Q.$� Office f the Ly of � state of CAifornia. . _ 6.i - r Order No.: CHUC vai ey Title and lsacmw C Above This Line fbr Reuvrder s Use Only Escrow No.: 172996DP GRANT DEED THE UNDERSIGNED GRANTOR(s) DECLARE(s) ,n AT DOCUh113NTARY TRANSFER TAX tS: COUNTY $41.25 j X ] computed on full value of property conveyed, or E7 computed on full value less value of Lens or encumbrances remalning at time of sale, X J unincorporated area; [ ] City of _, and FOR A VALUABLE CONSIDERATION, Receipt of which is hereby acknowledged, JACK W. PAWLEDGE and KOLLE'ITA M. PAWLEDGE, Husband and Wife hereby GRANT(S) to KAREN LEE MATA and JOSE A. MATA, Wife and Husband, as Joint Tenants the foIIowing described property, in the City of UNINCORPORATED AREA, County of BtIM State of California; See legal description attached hereto and made a part hereof. IF W. PAWLEDGE 'ROELETTA M. PAWLEDGE�i" Document Date: May 24, 1999 STATE OF CALIFORI TE AS COUNTY OF ) On MAY 28, 1999 before me, DEE PALMER, VOTARY PUBLIC Personally appeared JACK _W. PAWLEDGE AND KOLLETTA M. PAWLEDGE personalty known to me (or proved to me oa the baalt ofa dsfactory evidence) to be the pctson(s) whose names) Lsrare subacribcd to the within Instrument and acknowledged to me that hehhe/th ex the same in his/her/their authorized capaeity(ies) and that by hb/her/ttek Agnature(s) on the Inetrutncutthe penun(s) or the catiry upon b f o filch the person(!,) acted, executed the Instryment. WITNESS m eW offklal seek. / �.. DEE PALMER Comm.#1195035 to r0 NOTARY PUBLIC CALIFORNIA 0 v BUTTE COUNTY -L My Comm. EVkw Ju -22, - This area for offkW notarial seal. Mail Tax Statements to: SAME AS ABOVE or Address Noted Below Z00 'd 2381 268 023 131 31111 A311VA GIN ' i Z : 01 (nH1) 66 ,20- 'Nf1P DEE PALMER #1185035 PUBLIC CAUFORMA 0 JTTE COUNTY .1 ^ 4: ..,mm. Expkea June 22, 2tW1 Mail Tax Statements to: SAME AS ABOVE or Address Noted Below Z00 'd 2381 268 023 131 31111 A311VA GIN ' i Z : 01 (nH1) 66 ,20- 'Nf1P DESCRIPTION THE LAND REFERRED TO HEREIN IS SITUATED IN THE STATE OF CALIFORNIA, COUNTY OF BUTTE, AND IS DESCRIBED AS FOLLOWS: A PORTION Off' SECTION 25, TOWNSHIP 22 NORTH, RANGE 2 EAST, M.D.B. & M., DESCRIBED AS FOLLOWS: COMMENCING AT THE INTERSECTION OF THE CENTERLINE OF HONEY RUN COUNTY ROAD, AS THE SAME EXISTED IN SEPTEMBER 26, 1946, WITH THE EASTERLY LINE OF SAID SECTION 25; THENCE WESTERLY ALONG THE CENTERLINE OF SAID HONEY RUN COUNTY ROAD, A DISTANCE OF 1150 FEET TO THE TRUE POINT OF BEGINNING FOR THE PARCEL OF LAND HEREIN DESCRIBED; THENCE FROM SAID POINT OF BEGINNING WESTERLY ALONG} THE CENTERLINE OF SAID HONEY RUN COUNTY ROAD, A DISTANCE OF 200.00 FEET, MORE OR LESS, TO A POINT WHICH BEARS SOUTH 26 DEG. 22' EAST FROM THE MOST EASTERLY CORNER OF THAT CERTAIN PARCEL OF LAND DESCRIBED IN DEED FROM WALTER F. DUSSAULT, ET AL, TO CLAY K. BUCHANAN, A WIDOWER, DATED OCTOBER 28, 1958, AND RECORDED NOVEMBER 5, 1958, IN BOOK 966, PAGE 253, OFFICIAL RECORDS; THENCE NORTH 26 DEG. 22' WEST TO THE CENTER OF LITTLE BUTTE CREEK, AS THE SAME EXISTED IN SEPTEMBER 26, 1946; THENCE EASTERLY ALONG THE CENTER OF SAID LITTLE BUTTE CREEK TO A POINT WHICH BEARS NORTH AND PARALLEL WITH THE EAST LINE OF SAID SECTION 25, FROM THE POINT OF BEGINNING; THENCE SOUTH AND PARALLEL WITH THE EAST LINE OF SAID SECTION 25, TO THE POINT OF BEGINNING. EXCEPTING THEREFROM THAT PORTION DESCRIBED AS FOLLOWS: COMMENCING AT THE MOST EASTERLY CORNER OF THAT CERTAIN PARCEL OF LAND DESCRIBED IN THE DEED FROM DONALD OWENS, ET UX, TO ROBERT CAWTHON, ET UX, DATED JANUARY 28, 1954 AND RECORDED MARCH 31, 1954, IN BOOK 713, PAGE 104, OFFICIAL RECORDS; THENCE NORTH 26 DEG. 22' WEST, 21.85 FEET TO A POINT ON THE NORTHERLY SIDE OF HONEY RUN ROAD; THENCE EASTERLY ALONG THE NORTHERLY LINE OF SAID HONEY RUN ROAD, A DISTANCE OF 390.00 FEET; THENCE SOUTH 26 DEG. 22' EAST, 20.00 FEET TO A POINT ON THE CENTERLINE OF HONEY RUN ROAD AND THE TRUE POINT OF BEGINNING FOR THE PARCEL HEREIN DESCRIBED;. THENCE FROM SAID TRUE POINT OF BEGINNING, NORTH 26 DEG, 22' WEST, 300.00 FEET; THENCE NORTH 68 DEG. 38' EAST, 40.00 FEET; THENCE SOUTH 18 DEG. 46' 20" EAST, 302.85 FEET TO THE POINT OF BEGINNING. £00 *d £381 £68 H3131 31111 A311VA GIN ZZ:01 (AH,L)66 So- 'NAP r NOTES RESIDENTIAL t .;. 011-110-024 99-1100 PERMIT NO. PAWLEDGE, Jack 1869 Honey Run Road, Chico Contr: Skycrest MHU t t. 11 SPECIAL CONDITIONS 11 XIRA LOOD CERTIFICATE REQ. RE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER \_A4 f x JOB FINALED (Date) /' �✓ 7� CHECKED BY Signature t 11 SPECIAL CONDITIONS 11 XIRA LOOD CERTIFICATE REQ. RE SPRINKLERS REQ. SPECIAL INSPECTION ITEMS VERIFY USE PERMIT CONDITIONS SUB -STANDARD HOUSING LETTER \_A4 f x JOB FINALED (Date) /' �✓ 7� CHECKED BY Signature V=OK 0 = Not OK = Not Applicable = Not Ready MOBILE HOMES Date MOBILE ME UTILITIES (Plans) OK except #'s Soils; Compaction -Structure Stability 1. ing Requirements -Setbacks -Easements Pool Structure; Steel -Connections -Thickness Dead Men -Lining Soils pecial MH Support Sketch Elec.; Receptacles and Lighting, Distance-GFI 3. ewer; Location -Test -Fall -C/O -Concrete Elec.; Pool Lighting; 15 Volts-GFI 4. W Location -Test -Easement Need (Sket ) Elec.; Enclosures; Conduit Entries -Terminals -Listed 5 lectricity; Location -Clearances- nd-/ mp-Concrete Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 6. Gas; Location -Test -Wrap;-/ Z,(/" L -ft. / /'Nat. or/ /'L'ft./-L/'LPG y 7. Well Clearance & Disconnect dity Clearance Date J Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date MOBILE HO INSTALLATION (Plans) OK except #'s 1. g Requirements -Setbacks -Easements otings; Size -Spacing -Marriage Line % MH Test -Demand -Valve -Connector Electricity; MH Test -Crossovers -Breakers -Clearances 5. Drain; MH Test -Fall -Flex Connector 6. Water; MH Test -Regulator -Connector 7. Water and Sewer Connected -C/O to Grade -HD Approval 8. Gas and Electricity Tagged 9. Tie Downs -Type -Installation Cert. 10. Exits; Insp.-Sketch 11. Cert. of Occupancy 12. Permanent Foundation nly; License Decal Date Card B-1 Date Card B-1 Date I Card B-1 Date Card B-1 MISCELLANEOUS Date DECKS, COVERS, CARPORTS GARAGES (Plans) OK except #'s I 1. Zoning Requirements -Setbacks -Easements 2. Footings; Soils -Size -Depth -Spacing -Connectors -Steel 3. Decks; Girders and/or Joists -Decking -Bracing -Stairs -Rails 4. Wood Awn.; Posts- Beams- Rftrs.-Connectors Shthg.-Frg-Braci 5. Alum. Awn.; Columns -Connections -Splice -Decal -Enclosures 6. Carports; Windows -Doors 1 7. Electric r 8. Frmo.: Sills-Anchors-Studs-Rttrs-Trusses 9. Siding; Nailing -Veneer -Stucco -Mesh ( 10. Roof; Shthg-Roofing 1 11. Ext.; Steps -Doors -Landings t 12. Braced Wall Panels Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 ,Date FINAL (Plans) OK except #'s 1. Setbacks -Easements ( 2. Soils; Compaction -Structure Stability 3. Pool Structure; Steel -Connections -Thickness Dead Men -Lining 4. Elec.; Receptacles and Lighting, Distance-GFI 11 5. Elec.; Pool Lighting; 15 Volts-GFI 6. Elec.; Enclosures; Conduit Entries -Terminals -Listed 7. Elec.; Bonding; Metal w/5' -Circulating Equip. -Heater 8. Elec.; Grounding; Equip. w/5' Circulating Equip. -Pool Lghtg. Boxes- Enclosures- Panelboards-Ins. to Main in Conduit 9. Health Department Approval 10. Plumb.; Cir. Test -Water Supply Test j 11. Light Niche 1 Date Card B-1 Date Card B-1 Date }) 1 T Card B-1 Date Card B-1 V= OK 0 = Not OK - = Not Applicable = Not Ready RESIDENTIAL (, Date 46. Underfloor (Plans) OK except #'s 1. Zoning-Setbacks-Easements-Flood-Slope 2. Ftg., Main; Soils-Elec. Grnd.-/ /" Ftg. Depth 3. Ftg., Garage; Soils-Steel-Elec. Grnd.-/ /" Ftg. Depth 4. Ftg., Porches & Decks; Soils-Steel-/ /" Ftg. Depth 5. Stemwalls, Main; Steel-Blackouts-Wrapped 6. Stemwalls, Garage; Steel- Blockouts-Wrapped 6a. Hold Downs and Special Anchors 7. Slab, Steel-Wrapped 8. Piers-Fireplace Ftg.-Steel 9. D.W.V.; Fall-Fitting-Test-2 Way C/O-Sewer Test 10. UF, Gas Pipe; Size Anchors - Yard Gas Piping; Size Test 11. Water Pipe; Test-Anchors-Regulator-Service Test 12. Electric Underground 13. Plenums & Ducts; Clearance-Material-Support-Ins. 14. Girders-Sills-Anchor Bolts-Joists-Vents-Crippies 15. Access & Ventilation 16. Insulation Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date 63. PLUMBING (Permit) OK except #'s 17. Water Htr.; Vent-Access-Combustion Air Baffle 18. Water Pipe; Test & Anchor-Nail Protection 19. D.W.V.; Test Fittings & Anchor-Nail Protection 20. Shower Pan; Test, First Floor-Tub Access 21. Test Tub & Shower, Second Floor-Tub Access 22. Gas Pipe; Sixe & Anchors 70. Fireplace or Stove, Clearance -Hearth Date 71. Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date ELECTRICAL (Permit) OK except #'s Elec. Outlets & Receptacles at Kit. Counter 23. Fixture & Transformer Clearance-Ins. Protection Garage Fire Door; Swing -Landing -Closure 24. Elec. Receptacles Spacing-Lights & Switches at Doors A.C. Duct in Garage -Damper 25. Size Boxes & No. of Conductors Stapled Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 26. Romex Installed Close to Edge of Studs & C.J. Plb., Elec. & Mech. Equip. Listed for Location 27. Equip. Ground made up w/Mech Fasteners-Bond Gas & Water Elec. Receptacles in Garage (F.F.I.)-Romex Protection 28. 2 Appliance Circuits in Kitchen & Conductor Size GFI Insulation -Foam -Looked in Attic 29. Subfeed Wire Size / / ga. Cu or AI-A.C. Wire Size / / ga Cu or AI Guard Rails & Deck Construction -Post Caps 30. Range Circle / / ga Cu or AI-Oven Circ. / / ga Cu or At Insulated Neutral O Yes O No Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth 31. Service-Riser Conductors & Ground Main Disconnect Clearance Looked under Floor ❑ Yes 32. Equip. Clearances Panels-Motors-Mech. Equip. Following Instld./Drive J Yes ] No/Walks Q Yes 0 No/Planters ] Yes rj No 33. Clothes Closet Light-Shower Light-Spa Light Stucco Brown -Finish 34. Smoke Detector A.C. Unit Disconnect, Electrical -Plumbing 85. Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date 87. MECHANICAL (Permit) OK except #'s 35. A.C. Ducts Insulation & Support 36. Vent Fan, Exhaust above insulation 37. Condensate Drain & Overflow, Size & Grade 38. Furnace-Vent Access-Comb. Air-Return Air Vent 115 outlet 39. Attic Access & Platform if Furnace in Attic 93. Energy Compliance Certificate -Other Certificates 94. Address Posted Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Date FRAMING (Permit) OK except #'s Card B-1 Date Card B-1 40. Sits Proper Materials & Anchors Card B-1 Date Card B-1 41. Walls Studs-Nailing Spacing & Braces-Plates-Sound 42. Bearing Walls over Girders & Floor Nailing 43. Draft Stop in Walls (rat proof) 44. Fire Stops, Furred Ceilings-Stairs-Chasers-Tubs 45. Headers & Beams-Size & Bearing jingle & Duplex) Date FRAMING (Continued) 46. Hangers -Post Caps -Anchors -Connectors 47. Cling. Joist-Rftr. Ties- Purlin-Rolf Brac.-Truss-Shting.-Ring. 48. Fireplace Ties or Type A Flue -Fireplace Throat Clearance 49. Attic Access; Size & Romex Protection -Draft Stop -Ins. Baffles 50. Bdrm. Windows or Exiting Doors -Sill Ht. & Dimensions 51. Garage Fire Protection Framing 52. Property Line Firewall & Openings 53. Ext. Doors -One 3' -Check Garage 3rd Story, 2 Exits 54. Stairs; Width -Headroom -Rise -Run -Landing -Fire Protection 55. Plywood on Roof Overhang -Attic Vents -Rafter Outriggers 56. Siding -Nailing Veneer 57. Stucco Mesh -Drip Screed -Fd. Vents-Underflr. Access 58. Glazing Area -Glass Protection -Skylights -Plastic 59. Shear Walls; Nailing -Bolts 60. Brace Interior/Exterior Wall Panels 61. Insulation -Walls -Ceilings 62. Infiltration -Walls -Windows Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date FINAL (Plans) OK except #'s 63. Ext. Steps -Door & Sidelight Protection -Landings 64. Smoke Detector 65. Furnace Vents -clearance -Comb, Air -Connector - In Garage; Above Floor-Ducts-Mech. Protection 66. Bedroom Exiting 67. G.F.I. & Bath Fixtures & Tub Access -Spa 68. Elec. Trim & Subpanel, Breaker Sizes & Labels 69. Stairs & Rails 70. Fireplace or Stove, Clearance -Hearth 71. Elec. Outlets at Wood Panel, Int. & Ext. 72. Kit. Fixt. & Appliance; Ground -Air Gap -Cooking Clearance 73. Elec. Outlets & Receptacles at Kit. Counter 74. Garage Fire Door; Swing -Landing -Closure 75. A.C. Duct in Garage -Damper 76. Wtr. Htr.; Vents -Clearance -Comb. Air Connector-P.R.V. in Garage; Above Floor-Mech. Protection 77. Plb., Elec. & Mech. Equip. Listed for Location 78. Elec. Receptacles in Garage (F.F.I.)-Romex Protection 79. Insulation -Foam -Looked in Attic 80. Guard Rails & Deck Construction -Post Caps 81. Fdn. VBents & Crawl Hole Door Drainage & Wood -Earth Clearance Looked under Floor ❑ Yes 82. Following Instld./Drive J Yes ] No/Walks Q Yes 0 No/Planters ] Yes rj No 83. Stucco Brown -Finish 84. A.C. Unit Disconnect, Electrical -Plumbing 85. Vents Above Roof, Plbg-Appliance-Fireplace-Clearance to Openings 86. Water Well, Disconnect, Electrical, Plumbing 87. Exterior Elec. Trim, G.F.I. Receptacle -Underground 88. Ventilation Throughout House 89. Glass Protection 90. Corrections from Previous Inspections 91. Gas Test -Meters Tagged, Gas -Electric 92. Water & Sewer Connected -C/O to Grade -HD Approval 93. Energy Compliance Certificate -Other Certificates 94. Address Posted Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Date Card B-1 Comments at Final: SECTION E CERTIFICATION This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation information when the elevation information for Zones Al -A30, AE, AH, A (with BFE),V1-V30,VE, and V (with 8FE) is required. Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the certification. In the case of Zones AO and A (without a FEMA or community issued BFE), a building official, a property owner, or an owner's representative may also sign the certification. Reference levei diagrams 6, 7 and 8 - Distinguishing Features -If the certifier is unable to certify to breakaway/non-breakaway wall, enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list the Feature(s) not included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered. I certify that the information in Sections B and C on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME LICENSE NUMBER (or Affix Seal) C.W.BACHMAN RCE # 16803 TITLE COMPANY NAME Professional Engr Bachman & Associates ADDRESS 13647 Garner Lane CITY Chico CAE 95973Z1P SIGNATURES 6 9 9 �NbE-3 4 2- 41 3 6 Copies should be made of this Certificate for: 1) community official, 2) insurance agent/company, and 3) building owner. . ON SLAB A V ZONES ZONES LEVEL O ADJACENT FLOOD GRADE ELEVATION REFERENCE ADJACENT LEVEL GRADE WITH ON PILES, BASEMENT PIERS, OR COLUMNS A A V ZONES ZONES ZONES REFERENCE BASE LEVEI REFERENCE FLOOD LEVEL REFERENCE FLOOD LEVELELEVATION The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zones should be measured at the top of the reference level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. . t Page 2 • MOBILE HOME ELEVATION 'CEPTIF CAT f O.M.B. No. 3067-0077 FEDERAL EMERGENCY MANAGgM,ENT-AGENCY Expires July 31, 1999 NATIONAL FLOOD INSLIRANCEF , O FAM ATTENTION: Use of this certificate does not provide a waiver of the flood insuranc ! f cKase requirement. This form is used only to pro- vide elevation information necessary to ensure compliance with applicable commun' floodplain management ordinances, to determine the proper insurance premium rate, and/or to support a request for a Letter of Map `Amendment or Revision (LOMA or LOMR). You are not required to respond to this collection of information unless a valid OMB control number is displayed in the upper right corner of this form. Instructions for completing this form can be found on the following pages. SECTION A PROPERTY INFORMATION I FOR INSURANCE COMPANY USE I BUILDING OWNER'S NAME I POLICY NUMBER JACK PAWLEDGE STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER 1869 HONEY RUN ROAD f� OTHER DESCRIPTION (Lot and Block Numbers, etc.) ,. CITY CHICO STATE ZIP CODE CA 95928 SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM (See Instructions): t. COMMUNITY NUMBER 2. PANEL NUMBER 3. SUFFIX 4. DATE OF FIRM INDEX S. FIRM ZONE 6. BASE FLOOD ELEVATION 06007 530 C 1 06/08/98 1 A lin AO Zones, use depth) 1 349.0 ' 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): 93NGVD'29 El Other (describe on back) 8. For Zones A or V, where no BFE is provided on the FIRM, and the community has established a BFE for this building site, indicate the community's BFE: I I I I I .0 feet NGVD (or other FIRM datum—see Section B, Item 7). SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best— describes the subject building's reference level 1_ . 2(a). FIRM Zones Al -A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation of I I ' 1315 3.0 feet NGVD (or other FIRM datum—see Section B, Item 7). (b). FIRM Zones V1 -V30, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram, is at an elevation of I I I I I I .0 feet NGVD (or other FIRM datum—see Section B, Item 7). _ (c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is �I .�J feet above El or below;." (check one) the highest grade adjacent to the building. (d). FIRM Zone AO. The floor used as the reference level from the selected diagram is I J .0 feet above ❑ or below ❑ (check one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference level) elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations: NGVD '29 ❑ Other (describe under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than that used on the FIRM (see Section B, Item 77, then convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.) 4. Elevation reference mark used appears on FIRM: ❑ Yes 9 No (See Instructions on Page 4) 5. The reference level elevation is based on: t7x. actual construction ❑ construction drawings (NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which case this certificate will only be valid for the building during the course of construction. A post -construction Elevation Certificate will be required once construction is complete.) 6. The elevation of the lowest grade immediately adjacent to the building is: I I � 4 81• Ql. U feet NGVD (or other FIRM datum -see Section B, Item 7). SECTION D COMMUNITY INFORMATION 1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1 is not the "lowest floor" as defined in the community's floodplain management ordinance, the elevation of the building's "lowest floor" as defined by the ordinance is: I I I I I I .0 feet NGVD (or other FIRM datum—see Section B, Item 7). 2. Date of the start of construction or substantial improvement FEMA Form 81-31, MAR 97 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR CONTINUATION w �. p ,�j� � � l � u''' W ` �� �� - 1�ov JUN -30-99 01:04 PM CHICO BUILDING SYSTEMS 530 342 9174 P.02 Ilk MOBILE HOME ELEVATION 'CERTIFICATE O.M.B. No. 3067.0077 FEDERAL EMERGENCY MANAGEMENT AGENCY Expires July 31, 1999 NATIONAL FLOOD INSURANCE PROGRAM ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to pro• vide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to determine the proper insurance premium rate, andior to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR). You are not required to respond to this collection of information unless a valid OMB control number is displayed in the upper right corner of this form. Instructions for completing this form can be found on the following pages. SECTION A PROPERTY INFORMATION I FOR INSURANCE COMPANY USE I BUILDING OWNER'S NAME POLICY NUMBER JACK PAWLEDGE STREET ADOQESS (Including Apt.. Unit. Swta and/or Bldg. Nurnoe3r) OR P.O. ROUTE ANO BOX NUMBER COMPANY MAIC NUMBER 1869 HONEY RUN ROAD_ . OTHER OESCRIPTION (Lot and Block Number. etc.) CITY CHICO T STATE ZIP CODE CA 95928 SECTION a FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM (See instructions): 1. COMMUNITY NUMBER 2. PANEL NUMBER a SUFFIX A. DATE OF FIRM INDEX S. FiRM ZONE S. BASF. FLOOD ELEVATION 06007 530 C 06%08/98 A (in AOZonea.usadePM) 349.0 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFI:): ONGV029 ❑Other (describe on back) B. For Zones A or V, where no BFE is provided on the FIRM, and the community has established a BFE for this building site, indicate the community's BFE: I 11 J.LJ feet NGVD (or other FIRM datum–see Section 8, item 7), SECTION C BUILDING ELEVATION INFORMATION 1. Using the Elevation Certificate instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level –5 .._ . 2(a). FiRM Zones Al -A30. AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation of tai L3J_". J feet NGVD (or other FIFIM datum–see Section S. item 7). (b). FIRM Zones V1 -V30, VE, and V (with BFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram, is at an elevation of!! _ -* _Irl feet NGVD (or other FIRM datum–see Section B, Item 7). {c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is i,__(_.j.Ll feet above' or below - (check one) the highest grade adjacent to the building. (d). FIRM Zone AO. The floor used as the reference level from the selected diagram is i !.LJ feet above 0 or below (check one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference level) elevated in accordance with the community's floodplain management ordinance? -�:3 Yes °D No f- Unknown 3. Indicate the elevation datum system used in determining the above reference level elevatlons:i NGVD '29 �:] Other (describe under Comments on Page 2). (NOTE: it the elevation datum used in measuring the elevations is different than that used on the FIRM [see Section B. Item 7], then convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.)_ _ 4. Elevation reference mark used appears on FiRM: ' ._ Yes x No (See Instructions on gage 4) S. The reference level elevation is based on: �jc actual construction 7 construction drawings (NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which case this certificate will only be valid for the building during the course of construction. A pose -construction Elevation Certificate will be required once construction is complete.) 6. The elevation of the lowest grade immediately adjacent to the building is: feet NGVD (or other FIRM datum -see Section B, item 7). SECTION D COMMUNITY INFORMATION 1. It the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item t is not the -lowest floor" as defined in the community's floodplain management ordinance, the elevation of the building's "lowest floor" as defined by the ordinance is: L 1 I i I_J .Ll feet NGVD (or other FIRM datum–see Section B. item 7). 2. Dale of the start of construction or substantial improvement FEMA Form 81.31, MAR 97 REPLACES ALL PREVIOUS EDITIONS SEE REVERSE SIDE FOR COWNUAIICN JUN -30-99 01:04 PM CHICO BUILDING SYSTEMS 530 342 9174 P.03 c SECTION E CERTIFICATION This cortilication is to be signed by a land surveyor. engineer, or architect who is authorized by state or local law to certify elevation information when the elevation information for Zones Al -A30. AE. Ali. A (with SFE).V1-V30,VE, and V (with 13FE) is required. Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the certification. In the case of Zones AO and A (without a FEMA or community issued SFE), a building official, a property owner, or an owner's representative may also sign the certification. Reference level diagrams 6.7 and 8 - Distinguishing Features -if the certifie6s unable to certify to breakaway/non-breakaway wall, enclosure size, location of Servicing equipment, area use, wail openings, or unfinished area Feature(s), then list the Feature(s) not included in the certification under Comments below. The diagram number. Section C. Item 1, must stilt be entered. I certify that the information in Sections 6 and C on this certificate represents my best efforts to interpret the data available. I understand that any false statement may be punistiabfe by tine or imprisonment under 18 U.S. Code, Section TOOT. CERTIFir:P'S NAME LICENSE NUMBER (or AMiz Seaq C.W.BACHMAN RCE # 16603_ TITLE R COMPANY NAME ^ Professional Engr. Bachman & Associates ADDRESS 13647 Garner Lane CITY Chico SCTAATE 9597 'P SIGNATURt�` - 6/�`�� 99 P��-342-4136 Copies should be made of this Certificate for- 1) community official, 2) insurance agent/company, and 3) building owner. . ON SLAB A v ZONES ZONES R _-6—C c 1= ERrA 4000 tk(W.iION REFERENCE AWAcEur LEv( GR.O( WITH • BaSE}AENT A oN PILES. PMOIS. OR COLUMNS A V The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zones should be measured at the top of the reference level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. Page 2 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538-7541 PE MIT NO. (Rev. 12/96) APPLICATION AND PERMIT �9� ASSESSOR PARCEL NUMBER 011-110-024 ZONING FR 5 BUILDING PERMIT OWNER PAWLEDGE, JACK TiitTN0503 SO. FT. OCC. BUILDING VALUATION .OWNER'S MAILING ADDRESS 1869 HONEY RUN ROAD, CHICO, CA 95926 CONTRACTOR'S NAME SKYCREST T T1694 CONTRACTORS MAILING ADDC,I T468 HIGHWAY 99, CHICO, CA 95973 l 3 CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ 23.00 BUILDINGADDRESS HONEY RUN ROAD, CHICO Energy Plan Checking Fee $ $ PERMIT FEE $ 93 00 LOT NO. SUBDIVISIONS NAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome 6 Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities 6 Installation ❑ Other ❑ Describe Work: MOBILE HOME UTILITIES �3 BEDROOMS Gas piping stem 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 0.00 PERMIT FEE S AV P 9 9, 1 D ELECTRICAL PERMIT Fling Fee 20.00 R LE Main Service za.A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in ful force and effect. c� License Class C 4 a Lic. No. ZQS 7 j Z OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors license Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 1�( 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier GPC-A�E�J eAblF Policy Number N t .3-7q-72-1-07— (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith s mply with those provisions. ^p X Date J`—Z�^7-/ Signature of Applicant - ❑ Owner ;4 Contractor ❑ Agent An OSHA permit is required for excavations over 60" deep and demolition or construction of structures over 3 stories in height. Main Service 200A TO 1000A 46.00 NEW CONST. owELUNG OCCUP. SO OR ADDNS. ( 8 ACC. BLDS. 3.50FT. NON-RESID. MULTI -OUTLET CIRCUITS @7,50 POWER APPARATUS 8 SINGLE OUTLET CIR 204 .00 EX. OCCU . OUTLET OR FIXTURES BAL O 1.50 Ex., Occup. DFlxur rs AM ) E. 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 20,00 Misc. Wiring 23.00 PERMIT FEE $ 40.00 MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ Occ CONST. TYPE TOTAL FE 113. 00 H D. FEES IMP �. FL RAFk gAR�EI HD s This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By i D tov (Q J PERMIT EXPIRES ON a7 Dafe Receipt No.L6,5005— WHITE-D.D.S.-B.O. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT Cop M, (Rev. 12/96) COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMENT SERVICES -BUILDING DIVISION 7 County Center Drive - Oroville, California •9965 - Telephone (916) 538-7541 PERMIT NO. APPLICATION AND PERMIT 'V9- `l'ao ASSESSOR PARCEL NUMBER I I O _ (! �� 20NINo BUILDING PERMIT OWNER cK 10AkJ L fir > 4 lq TELEPHONE 3y3- OSo3 SO. FT. OCC. BUILDING VALUATION OWNER'S MAll1NOgADDRESS f , 6-4ft R %W n v Gyie -oc/7 / 5-512-6 /C CONTRACTOR'S I�pME C QST 3112 TELEPHONE Z6�ly CONT 1307 6 LI AD Ss %q C/ -//C c� (7-5-923 �!J[ u CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 20.00 Permit Fee $ ARCHITECT OR ENGINEEWS MAILING ADDRESS Plan Checking Fee $ 23 BUILDINGADDRESS o t,; RD �o Energy Plan Checking Fee $ CHl L`� PERMIT FEE $ 3 LAT NO. SUBDIVISION'SNAME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 Each Trap 7.00 USEOFSTRUCTURE SF ❑ Duplex ❑ MobilehomeX Other SPECIFY Solar or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Uilities'5 Installation ❑ Other ❑ Describe Work: ��� Gas piping system t - 5 outlets 15.00 Building sewer 4415.00 Mobile Home Q20.00 'J PERMIT FEE $ $ D ELECTRICAL PERMIT Filing Fee 20.00 600V OR LESS Main Service 200A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. License Class Lic. No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ❑ 1 have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Carrier Policy Number (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those provisions. X Date Signature of Applicant - ❑ Owner ❑ Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. Main Service 200A TO 1000A 46.00 NEW CONST. DVI%NG OCCUP. SO OR ADONS. ( ACC. S. 3.5¢FT: NEW CCONST. MULTANCI.OUTLET CIRCUITS @7,50 POWER APPARATUS a SINGLE OUTLET CIR. Ex. Occup. OUTLET OR FIXTURES SAL0'.w Ex. Occup. OFIX� PR ORS 5.00 Temporary Service 23.00 Mobile Home Facilities 20.001 20 Misc. Wiring 23.00 PERMIT FEE $ yo MECHANICAL PERMIT Filing Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEE $ Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST. TYPE TOTAL FEE $ 413 HA2. 1 0. FEES PO FLOOD I CDF p ;TO ISSUE This permit is hereby issued under of the Butte County Code and/or indicated above for which fees have By PERMIT EXPIRES ON the applicable provisions Resolutions to do work been paid. Date Dole Receipt No. %ISS DOS WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT r COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) 538-7541 OKl S 0 �' PERMIT APPLICA TION DA TA SHEET OWNER: J /AGK 10 A w L f D 4 E ASSESSOR PARCEL NUMBER: 0/ 1 / t o- .o z Y Proposed Building Use: MWV 3,44 4Z /xe Building Inspector: C JA L Date: 2�/� /hig y - / 7 9 5 At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: Date Received By ❑ 1. All items have been submitted -------------------------------------------------------------------------------------- 02. Plot plans, 3/4 sets, signed by the preparer of plans. ---------------------------------------------------- 03. Complete plans, 3/4 sets, signed by the preparer of plans. --------------------------------------------- 04. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans. ❑ 5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! --------- 06. Energy Design Compliance and supporting documentation. ------------------------------------------- ❑ 7. Statement of Intent for Non -Heated and A/C Buildings. ------------------------------------------------ ❑ 8. Hazardous Material Form.--------------------------------------------------------------------------------- ❑9. Manufactured Home data and installation instructions including Tie Down Specifications ---------- 0 10. Fees of $---------------------------------------------------------------------------- 1. pact fees as shown on the attached schedule. --------------------- California Department of Forestry pl+an/ approval/fees. ...... -• �a=tatiorn vation certificate.-----------Yom`-�-- = aLCZ4 14. and plot plan approval C f1ICO Health Department. U 15. City of Chico plumbing permit ❑ 16. Plot plan and business license approval fronj the City of Biggs. --- 1117. -- ❑17. Planning approval for (A) Use: 0 k` � (B) Parking: _ ❑ 18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ❑ 19. Encroachment Permit for driveway (construction approval prior to occupancy). -- ❑20. Pre -inspection for required Request to Building Inspector on ❑21. Contractor's license information. (Number, Name Style, Classification). 022. Workers' Compensation carrier and policy number. ----------------------------------------------------------- ❑23. Owner -Builder Verification (Given to owner ❑, Mailed to owner 0) - -------------------------------------- ❑24. Letter of signature authorization. -------------------------------------------------------------------------------- ❑25. Recorded copy of Agricultural Acknowledgment Statement. -------------------------------------------------- ❑26. Letter of intent on building use. ----------------------------------------------------------------------------------- ❑27. Manufactured Home utility clearance. --------------------------------------------------------------------------- ❑28. Existing violations and/or expired permits. ---------------------------------------------------------------------- ❑29. ❑433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ .--------------- E130. -------------- ❑30. Other: S _ T (Date) S ;Whn ou issue theermit, process as follows ❑ Mail to owner, []Mail to contractor. Telephone YZ Z 6 9y and hold for pickup at GH/� office. ❑ Deliver with inspector. Applicant. Date: S -2`F -q9 Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ Air Pollution By: Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: By. 1. Index permit application for the above items numbered: ❑ Plan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the aboverequired -by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner was advised of the above req by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Plans reviewed by:Date: Plans approved by: Date: Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: Vellrnv f nnv - T1-F-t-fTlo..ol ... e s Q,...-.:--- n ... __• _ E.H. USE ONLY Plot Plan Attached Floor Plan Attached Sent to B.O. 4 A/,7 /4e-- TO: Building Department FROM: Environmental Health C� SUBJECT: Sanitation Clearance 47,1 Owner Loc tin AP# Plan Approved for: Sewage Disposal Water Supply: Public Private Well Clearance forQling. Other 7I Hold final f r: ' Final clearance O.K. for: NOTE: E vironmental Heat Specia ist t Efate 8/96 COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 County Center Drive • Oroville, California 95965 • Telephone (530) 538- 1 "RryIT NO. (Rev. 12/96) APPLICATION AND PERMIT -/ ASSESSOR PARCEL NUMBER 011-110-024 FR 5 ZONING BUILDING PERMIT OWNER pAWLEDGE, JACK ITI2N6503 SO. FT. OCC. BUILDING VALUATION OWNERS "UNG ADDRESS 1869 HONEY RUN ROAD, CHICO, CA 95926 CONTRACTOR'S NAME SKYCREST TELEPHONE 342 2694 CONTRACTORS C} MAILINGADTI1 68 HIGHWAY 99, CHICO, CA 95973 l ,,} CONSTRUCTION LENDER Fireplace LENDER'S MAILING ADDRESS Total Valuation $ ARCHITECT OR ENGINEER LICENSE NO. Fee $ 20.00 —Filing Permit Fee $ ARCHITECT OR ENGINEERS MAILING ADDRESS Plan Checking Fee $ BUILDING ADDRESS HONEY RIJN ROAD CHICO Energy Plan Checking Fee $ $ PERMIT FEE $ LAT NO. SUBON610N'S NAME PARCEL MAP PLUMBING PERMIT Fling Fee 20.00 USEOFSTRUCTURE SF ❑ Duplex ❑ Mobilehome I Other SPECIFY Each Trap 7.00 Solar or heat pump water heater 23.00 Water piping 15.00 Each as water heater or vent 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation X3 Other ❑ Describe Work: MHT MRI) 99-1100 Gas piping system 1 - 5 outlets 15.00 Building sewer 15.00 Mobile Home S G W @20.00 PERMIT FEE $ ELECTRICAL PERMIT Fling Fee 20.00 600V OR UE Main Service 200.OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.POWER License Class C Lic. No. Z 9SV I2— OWNER-BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ I, as owner of the property, or my employees with wages astheir sole compensation, will do the work, and the structure is not intended or offered for sale. ❑ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project. ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit is issued. My works s' compensation insurance carrier and policy number are: Carrier �O�D�*� � Uc Main Service 200A TO 1000A 46.00 NEW CONST. DW EtING OCCUP. SO OR ADDNS. ( 8 ACC. BLOS. 3.5¢R,. NONRESID CO BRANMUC. CYTLET 97.50 APPARATUS 8 SINGLE OUTLET C, P. EX. Occup. OUTLET OR FDRURES IBAL @ 1.00 SO Ex. Occup. OUTiEis Ro .°E 5.00 Temporary Service 23.00 Mobile Home Facilities 20.00 Misc. Wiring 23.00 PERMIT FEE $ MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FES $ Policy Number N WG 37 l Z7-0 Z.- (The above sections need not be completed if the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith mply with those provisions. X Date S^Z, / �� Signature of Applicant - ❑ Owner Contractor ❑ Agent I An OSHA permit is required for excavations over 60" deep and demolition or construction` of structures over 3 stories in height. Mobile Home Installation Fee s 100.00 Energy Inspection Fee s Occ CONST. TYPE TOT L FEE $ 143 . , HAZ D FEES I P D P c D su This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By �I D to) kk / PERMIT EXPIRES ON 2( U Defe Receipt No. SD(�S WHITE-D.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDENROD -APPLICANT r COUNTY OF BUTTE - DEPARTMENT OF DEVELOPMENT SERVICES - BUIL IN DIVISION 7 COUNTY CENTER DRIVE - OROVILLE, CALIFORNIA 95965 - TELEPHONE (530) -7541 PERMIT APPLICATION DATA SHEET OWNER: 3ACA(�A.JI rc l.'-0 ASSESSOR PARCEL NUMBER: 0 j I - l /0 - O 2-/ Proposed Building Use: yNL// ax/f,- x,;r- Building Inspector: ��n, % Date: 7- y, MAV- 1'795 At time of permit application, I was advised the following data must be submitted prior to permit processing and/or issuance: Date Received By ❑ 1. All items have been submitted .------------------------------------------------------------------------------------- ❑ 2. Plot plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------------ ❑ 3. Complete plans, 3/4 sets, signed by the preparer of plans. ------------------------------------------------------ 04. Engineered plans, 3/4 sets, with wet signature on plans. All engineering must be shown on plans.-------- 115. -------❑5. Engineered truss details and layout in duplicate (required prior to plan review) No faxes! ------------------ ❑ 6. Energy Design Comthance and supporting documentation. ---------------------------------------------------- 07. Statement of Intent for Non -Heated and A/C Buildings. --------------------------------------------------------- ❑ 8. Hazardous Material Form. ------------------------------------------------------------------------------------------ ❑9. Manufactured Home data and installation instructions including Tie Down Specifications ------------------- 0 10. Fees of $------------------------------------------------------------------------------------- ;k11. Impact fees as shown on the attached schedule.-y-Efj-©------------------------------------------------- G _�Z ❑ 12. California Department of Forestry plan approval/fees.--------------------------------------------------------- ❑ 13. Flood elevation certificate. --------------------------------------------. ❑ 14. Sanitation and plot plan approval Health Department. ❑ 15. City of Chico plumbing permit. --------------------------------------- ❑ 16. Plot plan and business license approval from the City of Biggs. ---------------------- ❑ 17. Planning approval for (A) Use: 0 r__1 (B) Parking: _. El18. Contact Land Development about ❑ Improvements, ❑ Drainage, ❑ Legal Parcel. ❑ 19. Encroachment Permit for driveway (construction approval prior to occupancy). --------------------- ❑ 20. Pre -inspection for required. Request to Building Inspector on E12 1. Contractor's license information. (Number, Name Style, Classification). ----------------------------- 0 22. Workers' Compensation carrier and policy number. ----------------------------------------------------------- 023. Owner -Builder Verification (Given to owner ❑, Mailed to owner 0) - -------------------------------------- ❑24. Letter of signature authorization. -------------------------------------------------------------------------------- ❑25. Recorded copy of Agricultural Acknowledgment Statement. -------------------------------------------------- �7. .Letter of intent on building use.------------------------------=---------------------------------------------------- Manufactured Home utility clearance. --------------------------------------------------------------------------- ❑28. Existing violations and/or expired permits. ----------------------------------- '----------------------------------- ❑29. 0433 A, ❑Grant Deed, ❑ M.H. Title, ❑ Check to H.C.D $ , --------------- 030. ______________❑30. Other: When you issue the permit, process as follows ❑ Mail to owner, ❑Mail to contractor. Telephone 3 YZ 2 6 9 y and hold for pickup at C H/L 0 office. ElPeliver with inspector. Applicant: Copy of Haz-Mat form sent ❑ Health Department, ❑ Fire Department, ❑ A Copy of plans sent ❑ Health Department, ❑ Fire Department, ❑ Other: , (Date) -- Date: s-zy-Q9 Date: By: Date: By: 1. Index permit application for the above items numbered: ❑ Plan Check List 2. Additional items required: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail,; ❑ Building Division counter, by Date: Contractor, designer, owner, was advised of the above required data by ❑ phone, ❑ mail, ❑ Building D'vision counter, by Date: Plans reviewed by: Date: Plans approved by: Date: Sets of plans on hold in ❑ Plan Cabinet, ❑ A.P. folder. Note transfer by: Date: vpUnl r (,nnv - "--*IA*- - - COUNTY OF BUTTE DEPARTMENT OF DEVELOPMENT SERVICES - BUILDING DIVISION 7 COUNTY CENTER DRIVE, OROVILLE CA 95965 TELEPHONE (916) 538-7541 SCHEDULE OF FEES DUE OWNER ve�cl( pi©Mlc,rD4F PROPOSED BUILDING USE _ 1. BUELDING PERMIT FEES -- Balance Due ................ -- Additional Fees Due ........... -- Additional Fees Due ........... .Revised Plan Checking Fee ....... /2. SCHOOL DISTRICT FEES (paid at District Office) c()s17 56-/%)C7 " C0'i FR/ic�d/I� 3. SHERIFF FEES (paid at Building Division) Residential ........ x $360.00 = $ Units Commercial (sq.ft.)... x $0.03 = $ Sq. Ft. 4. URBAN AREA FEES (paid at Building Division) Residential (per unit) . x : = $, #Units Amt. Commercial (sq.ft.) .. x =$- Sq.Ft. Amt. 5. RECREATION DISTRICT FEES (paid at District Office) _ 6. THERMALITO DRAINAGE DISTRICT FEES $510.00 (paid at Building Division) L// 7. SRA FIRE INSPECTION AND PLAN CHECK $89.00 (paid at Building Division) 8. WATER TENDER FEES (Battalion # ) $200.00 (paid at Building Division) 9. CSA 87 TRAFFIC FEE $2500.00 (paid at Building Division) 10. OTHER A.P. # ll' "_ Z/ DATE Z qI Amy_ RECEIPT # DATE REC G Sora r Z- �� At time of permit application, I was advised the above fees are required to be paid prior to issuance of the building permit. These fees may be changed during the plan checking process. APPLICANT DATE S-2- r (?9 Pursuant to Government Code Section 66020, you are hereby notified that items 2,3,4,5,6,8,9, and 10 above may have been imposed on your project. You have 90 days from the date of approval of the project or from the imposition of the above mentioned items during which you may protest. The requirements for a protest are specified in Government Code Section 66020(a). Original -Building Div. 2nd Copy - Applicant 3rd Copy - Owner (Rev. 2/97) COUNTY OF BUTTE- DEPARTMENT OF DEVELOPMEf SERVICES - BUILDING DIVISION 7 County Center Drive - Oroville, California 9591 0 Telephone (530) 538-7541 P,ERMMITNO. (Rev. 12/96) APPLICATION AND RMIT ASSESSOR PARCEL NUMSER ZONI 6 I I- 00 - 0 2 y A- 5- BUILDING PERMIT �j TELEPHONE OWNERJA C K /-/eh/ L F > 4 C 3 Y3 - 0,570SO. FT. OCC. BUILDING VALUATION OWNER'S WALLING ADDRESt 69 No-+ R0,J kv CYlcC,9 `is'y26 CONTRACTOR'S FAME TELBMONE Ct? Y2- 269y �'SCK CONTAACTC%ADs GI Q' �/ �• / CONSTRUCTIONLENDER/ LENDER'S MAIUNG ADDRESS Ffe Ince ARCHITECT OR ENGINEER LICENSE NO. Total Valuation 1fi Filin Fee b 20.00 ARCHITECT OR ENGINEER'S MAILING ADDRESS b. Permit Fee Pian Checking Fee S SUILDINGADOREss Hoijely ogLj i Energy Plan Checking Fee s CH1cI s PERMIT FEE _ LOT NO. SUBDIVeloN'SKME PARCEL MAP PLUMBING PERMIT Filing Fee 20.00 USEOF USEOFSTRUCTURE �' / � SF C3 Duplex ❑ Mobllehome✓O Other sPM�, Each Trap 7.00 Sour or heat pump water heater 23.00 Water piping 15.00 Each gas water heater or vent 15.00 TYPE OF WORK New E3 Addition ❑ Remodel ❑ Utilities ❑ Ind liation� Other D � /I L)'��i �1 Describe Work: Gas piping syatsm 1 .5 outlets 15.00 15.00 Building g Mobile Home 0.00 S G W ]J!2 PERMIT FEE : ELECTRICAL PERMIT Filing Fee20.00 Main Service 200A OR LESS 23.00 LICENSED CONTRACTOR'S DECLARATION 1 hereby affirm under penalty Of perjury that I Eun licensed under provisions of ChapterNEW 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is in full force and effect . License Class Lic• No. OWNER -BUILDER DECLARATION I hereby affirm under penalty of perjury that I am exempt from the Contractors License Law for the following reason: ❑ 1, as owner of the property, or my employees with wages as their sole compensation, will do the work. and the structure is not Intended or Offered for sale• ❑ I, as owner of the property. am exclusively contracting with licensed contractors to construct the project ❑ 1 am exempt under Sec. Business and Professions Code for this reason WORKERS' COMPENSATION DECLARATION 1 hereby affirm under penalty of perjury one of the following declarations: ❑ 1 have and will maintain a certificate of consent to self -insure for workers' compensation, as provided for by section 3700 of the Labor Code, for the performance of the work for which this permit Is Issued. ❑ 1 have and will maintain workers' compensation Insurance, as required by Section 3700 of the Labor Code, for the performance of work for which this permit Is Issued. My workers' compensation Insurance carrier and policy number we: Carrier$ Policy Number (The above sections need not be completed If the permit is for work of a valuation of one hundred dollars ($100) or less.) ❑ 1 certify that in the performance of the work for which this permit Is issued, I shall not employ any person In any manner so as to become subject to workers' compensation laws of California, and agree that if I should become subject to the workers' compensation provisions of section 3700 of the Labor Code, I shall forthwith comply with those proviafons, X Date Signature of Applicant - ❑ Owner ❑Contractor ❑ Agent An OSHA permit is required for excavations over 50" deep and demolition or construction of structures over 3 stories in height. Main Service 2WA TO 1000A 4e.00 � ADDW. - DW P• 3.50 ACC. BILDS. MULTFGUTLEr Q7•50 NOWRESID. Fob APPARATUS assxrLEo cla 11 OUTLET oR FKruREs s0 o 100 Ex. Occup. SAL •� I=APPLM. oR 5.00 Ex. Occup.OUTLErs EM. EA Temporary Service 23 00 Wbile Home Facilities 20.00 �� Wiring 23.00 PERMIT FEE 9 MECHANICAL PERMIT Fling Fee 20.00 Heating Cooling Hood 6.50 Ventilation PERMIT FEi: t Mobile Home Installation Fee D/J Energy Inspection Fee S Occ CONST . TYPE /! TOTAL FEE $ „�. D. �� IMP FLooO CDF PARCEL PD No ISSUE This permit is hereby issued under the applicable provisions of the Butte County Code and/or Resolutions to do work indicated above for which fees have been paid. By Date PERMIT EXPIRES ON DA Io Receipt No. WHITE-O.D.S.-B.D. CANARY -ASSESSOR PINK -INSPECTOR GOLDEN ROO•APPLICANT WOTE; All M'atJrialG & rkmanship t3h811 Be Tu -Accordance with R,ecogniz Good Practices and n' ,of a Quality Prescribed for 3peciEted use + I in the Uniform Building, Plum ° d! Meohanica� ad ti. lh�ta�i Gose• Environmental Health C� • J U N - 1 1999 Chip California eE of pians and speOMOOtfans Chin Yke t arP�%job at all times and it is unlawit�l ca p . • • , _ . r✓ manges or alterations on same �y� WT'i 'teIl 1� ' tiSpiOn Pram Uw DePS UeutOi a 1 �12c: t�1 7; --- •V� ��Ff*��Q� SN- P,-.:=. ->_-.' at 10 09AO 5 NSS oPOVSy-nat ur-e%PSo'O'N . Q �6 00W housc E x l k& . 09.l. Shop h, � •fan L` 6�,� s� . h , f'e- Cm_ too 14,N IZIK Finish floor, electrical, MVAC equipment artd flood ele fflfbn s °�,"' uEiel��'t� 1.Q I 4V C �?EPAR +P-00" 8 0 V F 186 9 Hoocy Ruh Road /ZOO _ ,/o / m- �7'w b* 17A 1 G CDF FIRE SAFE REQUIREMENTS 0// -- l/d - D- 1FF - // or 0 "�' ,C AP# PERMIT # NAME Under authority of PRC 4290, the following checked items are required by the Butte County Fire Department and are made a part of this permit. These requirements are minimums and will be superseded by Butte County local regulations which equal or exceed these standards. Field inspections will be made by the Butte County Building Department for compliance. 1272.00 Maintenance of Defensible Space. To ensure continued maintenance of properties in conformance with these standards and measures and to assure continued avail- ability, access and utilization of the defensible space provided for in these standards, annual maintenance must be provide for by the land owner. Driveway Standards 3.02 Surface. All driveway surfaces and structures (bridges, 1212773.07 culverts and other app-arteaant structures which supple- ment the roadway bed er shoulders) shall provide unob- structed access to conventional drive vehicles, includ- ing sedans and fire apparatus weighing up to 40,000 pounds. [ 1273.03 Grade. Not to exceed 16 percent unless paved. 1273.04 Driveway Radius ' 1. No roadway shall have a horizontal inside radius of curvature of less than 50 feet and additional sur- face width of 4 feet shall be added to curves of 50- 100 feet radius; 2 feet to those from 100-200 feet. 2. The length of vertical curves in roadways exclusive of gutters, ditches and drainage structures designed to hold or divert water shall be not less than 100 feet. 273.05 Turnarounds. If required, will have a minimum turning radius of 40 feet from the center of the road. 1273.05 Turnouts. Shall be a minimum of 10 feet wide and 30 feet long with a minimum 25 foot taper on each end. 1270.10 Width. All driveways shall provide a minimum 10 foot traffic lane and unobstructed vertical clearance of 15 feet along its entire length. Page 1 of - 3. - //o - '-Z e-1 -�1'7 - // c o AP # PERMIT # NAME fl]� 1273.10 Turnouts. Driveways exceeding 150 feet in length, but less than 800 feet in length, shall provide a turnout near the midpoint of the driveway. Where a driveway exceeds 800 feet, turnouts shall be provided no more than 400 feet apart. [,I 1273.10 Turnaround. A turnaround shall be provided at all building sites on driveways over 300 feet in length and shall be within 50 feet of the building. 1273.11 Gates [ 1. Gate entrances shall be at least two feet wider than the roadway it serves. 2. The gates must be located at least 30 feet from the roadway and shall open to allow a vehicle to stop without obstructing traffic on that roadway: 3. Where a one-way road with a single traffic lane provides entrance, a 50 foot turning radius shall be used. Fuel Modification 1276.01 Setback for Structure Defensible Space. d1J� 1. All parcels 1 acre and larger shall provide a.mini- mum 30 foot setback for buildings and accessory buildings from ul] property lines and/or the center of the road. I [ ] 2. For parcels less than 1 acre, local jurisdiction shall provide for the same practical effect. See Other Requirements below. '� 1276.02 Disposal of Vegetation and Fuels. Disposal, including chipping, burying, burning or removal to a landfill site approved by the local jurisdiction, of flammable vegetation and fuels caused by site development and construction, road and driveway construction and fuel modification shall be completed prior to completion of road construction )r f'__ial inspection of a building permit. Page 2 of 3- O // - //D - e a- V �% /leo AP # PERMIT # Other Reauirements f� If Buildincz Setback -is-15't-o-30 Feet t- - Class A or B roof - Enclosed eaves ev� NAME [ ] If Building Setback is Less Than 15 Feet Choose any 3 of the following: - Metal or no doors on side toward property line with insuffi- cient setback - Class A or B roof with enclosed eaves - Interior automatic sprinkler system per NFPA 13D - Glass area not to exceed _0% of wall area toward property line with insufficient setback - Siding from the following list: Stucco - 3 coat Hardi-Board or Plank Masonry Masonry veneer Metal Other Butte County Fire Department approved materials � Z-2 Dat 'nature Z= Page 3 of 3 MOBILE HOME ELEVATION CERTIFICATE O.M.B. No. 3067-0077 FEDERAL EMERGENCY MANAGEMENT AGENCY Expires July 31, 1999 NATIONAL FLOOD INSURANCE PROGRAM ATTENTION: Use of this certificate does not provide a waiver of the flood insurance purchase requirement. This form is used only to pro- vide elevation information necessary to ensure compliance with applicable community floodplain management ordinances, to determine the proper insurance premium rate, and/or to support a request for a Letter of Map Amendment or Revision (LOMA or LOMR). You are not required to respond to this collection of information unless a valid OMB control number is displayed in the upper right corner of this form. Instructions for completing this form can be found on the following pages. SECTION A PROPERTY INFORMATION I FOR INSURANCE COMPANY USE I BUILDING OWNER'S NAME POLICY NUMBER JACK PAWLEDGE STREET ADDRESS (Including Apt., Unit, Suite and/or Bldg. Number) OR P.O. ROUTE AND BOX NUMBER COMPANY NAIC NUMBER 1869 HONEY RUN ROAD OTHER DESCRIPTION (Lot and Block Numbers. etc.) CHICO CITY CHICO `$ATE ZIP CODE 95928 SECTION B FLOOD INSURANCE RATE MAP (FIRM) INFORMATION Provide the following from the proper FIRM (See Instructions): 1. COMMUNITY NUMBER 2. PANEL NUMBER 3. SUFFIX 4. DATE OF FIRM INDEX S. FIRM ZONE 6. BASE FLOOD ELEVATION 06007 530 C 06/08/98 A (in AO Zones, use depth) 349.0 7. Indicate the elevation datum system used on the FIRM for Base Flood Elevations (BFE): R] NGVD '29 ❑ Other (describe on back) 8. For Zones�Xo�.V,4here no BFE is provided on the FIRM, and the community has established a BFE for this building site, indicate the community's BFE: I :U feet NGVD (or other FIRM datum—see Section B, Item 7) !. ; �R j • - SECTION C BUILDING ELEVATION INFORMATION J 1. Using:the-Elevation Certificate Instructions, indicate the diagram number from the diagrams found on Pages 5 and 6 that best describes the subject building's reference level 5 . 2(a). FIRM Zones Ai -A30, AE, AH, and A (with BFE). The top of the reference level floor from the selected diagram is at an elevation offeet NGVD (or other FIRM datum—see Section B, Item 7). (b). FIRM Zones.V1-V30;.VE,-and.V (with BFE). The bottom of the lowest horizontal structural member of the reference level from the selected diagram, is.at an elevation of I I I ! I I ,� I feet NGVD (or other FIRM datum—see Section B, Item 7). (c). FIRM Zone A (without BFE). The floor used as the reference level from the selected diagram is II .0 feet above ❑ or below ❑ (check one) the highest grade adjacent to the building. (d). FIRM Zone AO. The floor used as the reference level from the selected diagram is I I LLJ feet above ❑ or below ❑ (check one) the highest grade adjacent to the building. If no flood depth number is available, is the building's lowest floor (reference level) elevated in accordance with the community's floodplain management ordinance? ❑ Yes ❑ No ❑ Unknown 3. Indicate the elevation datum system used in determining the above reference level elevations: E� NGVD '29 ❑ Other (describe under Comments on Page 2). (NOTE: If the elevation datum used in measuring the elevations is different than that used on the FIRM (see Section B, Item 77, then convert the elevations to the datum system used on the FIRM and show the conversion equation under Comments on Page 2.) 4. Elevation reference mark used appears on FIRM: ❑ Yes 0 No (See Instructions on Page 4) 5. The reference level elevation is based on: ❑ actual construction ® construction drawings (NOTE: Use of construction drawings is only valid if the building does not yet have the reference level floor in place, in which case this certificate will only be valid for the building during the course of construction. A post -construction Elevation Certificate will be required once construction is complete.) 6. The elevation of the lowest grade immediately adjacent to the building is: I I ! !4".L( feet NGVD (or other FIRM datum -see Section B, Item 7). SECTION D COMMUNITY INFORMATION 1. If the community official responsible for verifying building elevations specifies that the reference level indicated in Section C, Item 1 is not the "lowest floor" as defined in the community's floodplain management ordi v f ding's"lowest floor" as defined by the ordinance is: J . U feet NGVD (or otherFIRM 3s , 910).?. Date of the start of construction or substantial improvement 'iM near DEPAREN' FEMA Form 81-31, MAR 97 REPLACES ALL PREVIOUS EDITIONS A P P E R ID _ CONTINUATION SECTION E. CERTIFICATION This certification is to be signed by a land surveyor, engineer, or architect who is authorized by state or local law to certify elevation information when the elevation information for Zones Al—A30, AE, AH, A (with BFE),V1—V30,VE, and V (with BFE) is required. Community officials who are authorized by local law or ordinance to provide floodplain management information, may also sign the certification. In the case of Zones AO and A (without a FEMA or community issued BFE), a building official, a property owner, or an owner's representative may also sign the certification. Reference levei diagrams 6, 7 and 8 - Distinguishing Features—If the certifier is unable to certify to breakaway/non-breakaway wall, enclosure size, location of servicing equipment, area use, wall openings, or unfinished area Feature(s), then list the Feature(s) not included in the certification under Comments below. The diagram number, Section C, Item 1, must still be entered. 1 certify that the information in Sections B and C on this certificate represents my best efforts to interpret the data available. 1 understand that any false statement may be punishable by fine or imprisonment under 18 U.S. Code, Section 1001. CERTIFIER'S NAME C.W.BACHMAN LICTSE_NU BER fpr Ayix—Ije3 111 Lt COMPA Y NAME Professional Engineer Bachman & Associates ADDRESS Q;TY 13647 Garner Lane Chico s'E 95973P SiGNAIu 9AJune 1999 P342-4136 Copies should be made of this Certificate for: 1) community official, 2) insurance agent/company, and 3) building owner. COMMENTS: ON WrTH SLAB BASEMENT A vA ZONES ZONES n' ZONES REFERENCE BASE LEVEL FLOOD ELEVATION BASE �,.. :.:'.�'`. i:4.°, FLOOD "'''!�' ' ADJACENT 2:: „� REFERENCE ELEVATION REFERENCE ADJACENT GRADE LEVEL LEVEL GRADE WIN � �/%�'j CIVIL nr�w, PIERS, OR COLUMNS A v The diagrams above illustrate the points at which the elevations should be measured in A Zones and V Zones. Elevations for all A Zones should be measured at the top of the reference level floor. Elevations for all V Zones should be measured at the bottom of the lowest horizontal structural member. Page 2 1. Owner's Name: --s XC -K- Paw LLa 64- 2. Assessor's Parcel Number: a i/ /10 - D Z.4 e` 3. Installer's Name: SF--gG(ZJe.,S7- �yv.p2ts� 4. Is the site currently under permit? Yes[ ] No Permit No. x' 5. Is the site an existing site? Yes[ No(Y1 (If yes, furnish two plot plans). 6. What is the electrical rating of the. mobilehome? )00 Amperes. 7. What is the mobilehome site circuit breaker rating? 2-00 Amperes. 8. What is the electrical rating of the mobilehome site? Zc:,c7 Amperes. 9. Is the main service remote from the mobilehome site? Yes[XI No[ ] If it is, what is the rating? -Z-Cro Amperes. 10. Is there any other electric load to be served by the mobilehome site electric service (i.e. well, garage etc.)? Yes[ ] No[, -,.I. If yes, please identify the load and size: a) The mobile home site: Load- Ampergs- b) The main service: Load- Amperes - 11. Type of gas service at mobilehome site: Natural[ ] Propane[x] None[ ] 12. Size of as pipe at the mobilehome site from the meter or tank: "' inches. 13. What is the gas pipe length from the meter or tank to the mobilehome? 40 14. What is the mobilehome gas demand? B.T.U.* *(This information is not required if the pipe length is less than 6 feet on natural gas or less than 50 feet on propane). THE OTHER SIDE OF TRIS FORM MUST BE COMPLETED IN ORDER TO PROCESS THIS PERMIT APPLICATION OMW May 1995 i 8.5 Mobilehome Manufacturer: ',>K -q U t-J(r Manufacture Year: l g 9 9 If other than single wide, furnish Setup Model Number: b936 Width: 2-6 (ft.) Length: 48 (ft.) Tagalong or Expando Size (ft.) x (ft,) On all mobilehomes manufactured after October 7, 1973, furnish manufacturer's installation manual and structural setup sheets. FOOTINGS: Wood pressure treated or foundation grade[,] Other: SUPPORTS: Concrete block[A Other: Provide Tie Down Specifications for all Mobilehomes: Pier Footings Sizes and Location SINGLE WIDE Line I MULTI -WIDE Line 2 Line 1 ................................................................................................. Line 2 Main Beano Line2 ..................................................... e 2 Line 1 Line 3 Line 2 ................................................................................................ Main Beams ............................................................................................ Line 2 Line 1 ............................................Line ine S Tag or Triple e 4 I Line 1 Piers: N/A Size minimum: Spacing maximum:Ltj From ends -maximum: Line 2 Piers: Size minimum: [ ! z. ] x [ 501. Spacing maximum: q ` p ` From ends -maximum: z ` o Line 3 Roof Loads: Size minimum Location (from front): Line 5 Roof Loads: Size minimum: Location (from front): Line 1 Openings Size minimum: [ ] x ( ] Each side of openings with width over: ` Line 4 Piers: Size minimum: [ ] x ( ]. Spacing maximum: ` From ends -maximum: ` OVER ,4 P P 0-���•�*. V F - -wov". , 0-_4::D tD 1- of— 4A ko 771 t 1 7; Li 0 r U) (n L Iq I KX4 APPROVED ',',z, cQ c,� Butt@ County vironryle-1-1 &-loafth be -I t1,0 &U 0 ate S i W lgnatA Iffilmo Not 4w 0 17 H36MUM CMrf(Afj(J CS) ------------ ?cViE., B''i Ei:S'i`::'.lil„ 11 PT. 1"JED 5' :,Ll '.'.' f ScP.'i b: $ i)EPT: :IAP! 26 1996 UrlC_ WPITCRS L.A GUl:AiC:'.I CS. INC, 9'- 4' I DST DLX BATH _ FILE W1 9321 VOL. 1 SEC. 4 ILL 51 PG. 6-47F CENTERLINE SUPPORT REQUIREMENTS THIS SHEET TO BE INSERTED WITH SUPPLEMENT TO FIELD INSTALLATIG4 WANUAL FOR 20,E ROOF SNOW .LOAD. SEE ABOVE PRINT FOR LOAD REOUIREMENTS. y - o DRAM BY : RYKER s GATE:. 01-24-1996 20,E ROOF LIVE LOAD DESCRIPTION i RAWING N MER 482b-3FX-26-CATH 2236 /CT • DESIGN LISTED AND TESTED BY BSK & ASSOCIATES 31TOX I• WAYNE T. POLVADO, PE - LISTING NO. F94249 LOCK BOLTS 6' TYP. OF 3X3/4, OL TS iYP. OF 4 Q • �!:•;�. I1/4' PLAT-c6'FR BASFrn• GF'?PEP. PLATE GRIPPER BASE \ C %�^ i r_ 1 _ _'v ! _m I 9116' 0 SWI�LLH�AD \� �I/ y. Ali, ;.0( HOLE TYP. I 3' E SCHL \ D_ 40 PIPE I'0 ir'PD ROD ADJUSTER r , tSf CIVIC GRIPPER BASE MOBIL HOME COACH I SUPPORT GIRDER A 1 1' 0 HEAVY HEX NUT, PRESSED AND `N_LDED :'_CT TO CORRECTIONS.NOTED Uv70 PIPE 2 lit' Aaprcv¢1 Cec3 r.,; '^"arize or a6^r=c< any Ql oris..: �•P 3/ 4' 9/16' 0 I HOLE TYP. GRIPPER PLATE 1/2'0 X 3' GR -.D: 5 PIN, LOCK'h'r;•-i 1 /8'0 COIR PIN " 1/2' STAND BASE - PLAN VIEW 1-1/2'0 SCH 40 PIPE ` PJSFR WITH THREE CR :'CR= AD1;n.R HOLES 2'0 SCH 40 PIPE W/ 2 ADJUSTER HOLES fi 6't ifN. STAND - ELEVATION 1/2'0 HOLES FOR ATTACHMENT TO FP -I -HD CONC. FOUNDATION PAD AS SHOWN ON SHEET 4 -NOiEE # 16 TUF - 2 STAND TYPICAL INSTALLATION DETAIL KENNETH'D. REED, CIVIf ENGINEER - --- 8976 SIMMONS ROAD RCE 41063 exp. 3/31/99 REDING, CA. 96001-9715 - (530) 243-3296 A N'C771r.._,r_.,._..., ., .7. - - _ S;];; :i Cz!:!.Cr'.. SPA :.10 lam% //z 3 _� This P!=n s :r3•:ai ,z; es QP AO ZDV'✓ E. - Z TIE DOWN PER BSK TES -TING and GUS GUARD COMPANY P.O. BOX 128 CATHEY'S_VALLEY, CA 95306 G 209-966-5540 FAX 209 -966 -5r -Am E - Z BRACING SYSTEM NOTES DESIGN LOADS: WIND LOAD - 80 MPH - EXPOSURE 'C SEISMIC ZONE - 4 2. THIS FOUNDATION SYSTEM IS DESIGNED TO BE CONSTRUCTED ON A FAIRLY LEVEL SITE \4 iri H NO EXISTING SOIL PROBLEMS. 3. CHASSIS SEAN, SUPPORTS SFIAU. BE LOCATED AND SIZED FOR THE LOADS AS SHOWN IN THE 'MOBILE HOME INSTALL/ -X ON INSTRUCT IONS'. A. IN APES WHERE DIFFERENTLAL SETTL=EMENT (DS) CAN OCCJR, MANUFACTURED H01J,E SHALL BE READJUSTtD WHEN DS EXCEEDS 1/4', OR wXEN IT 'All-' ADVEFSELY AFFECT MOBILE HOME UNIT. 5. CARRY AL FOOTINGS DOWN TO FIRM, UNDISTURBED SOIL FOOTINGS ARE DESIGNED FOR l0DO PSF TOTAL LOAD SOIL PRESSU?E, AND SHAM BE COMPATIBLE WITH LOCAL SOIL CONDITIONS. 6. STRUCTURAL STEEL- FABRICATED ACCOPOING TO AISC SPECIFICAMON.1hELD ACCORDING TO AWS SPECIFICATIONS. ELEC BODES -370 PLATED -ASTM A36 BOLTS- SAE GR S=ASTM A449=A-7M A325. 7. THE E . Z ASSEMBLIES AND THE TUFF -1 SHOWN BELOW SHAL BE USTED AJND LABELED Bl' BSK o. r.SSOCi4 TES FOR THE FOLCWiNG LOADS: ASSEM8LY LOADS HOPiZ UPJ7 VERT. 4402' R 2000 LB 6000 LB 8. DUPI`:G ?--rEJl1,1:`dAR`' 1;:5?ECTiON, TF: EST;1✓,-'SOB S lG i =NSUP° TriAT- Id,OB1! HOME S _ANS Ar- Or S NDA."D S=am i iON E�L!GL TO OF. GPE-.i TE -,,-,AN 9. THE SIS -NS At?= SAFE FOR INSTALLkTION IN FLOOD PLAIN APEfS WHEF1 DEr,ri OF FLOODING DOES NOT EXCEED 3 FEET. 10. MULTIPLE UNIT INST.A'LATION 15 ACCEF-,A:S' F ?PO'AIDED THE NUMBER OF UNITS PER -CI'<<SSIS-UNITMEE'-i ThiE-%QL-;ii: t✓,Eni� SHOV✓Nd.ND-TrIE PL�,Cet1ENT-A�.D-- _..._.- _-----------.- INSTALLATION PROCEDURES AR= -r0 L OFti TD PP.OPEPLY. 11. AL1 IAEIrl COMPONENTS AND ATTACHN,=NT { T tMS SHAG BE PROT-F-7WE COATED. 12. FOP. M?G, USE' l 1 /8' UNDEP.LAYI.IENrr PLYWOOD V✓ITH WOU.0 J\11ZEJ TRT=A7MFNT OF 0.40 MAX PCF RETENTION Vi H DRYING AF T tR T R -ATN -ENT. 13. ROUND STA)25 (3/4 X 141 MAY BE USED IN PL -',CE OF THE 1' X 1/8' FLAT BAR WHEN �--� SOIL IS E)iREMELY MARD OR IN POCK 14. HOLES MAYBE PRE -DRILLED VdriEN NECESSAP.Y, WHETHER FLAT BAR OR ROUND DESIGN LISTED AND TESTED BY BSK & ASSOCIATES WAYNE T. POLVADO, PE - LISTING NO. F94249 SINGLE WIDE COACHES DOUBLE / N+ULTiPLE COACHES E=2'MIN./B'MAX. E=2't)%IN./11'wx kt$Z Lij'❑ ❑ P'DGE b:AlJ, SUPPORT AS REQ'D 61' t SAN:JF.ACi TIRE -r. TYP. O C7❑^❑C7 T0 E' NOM. Aml ,_:-o. oQ�pEESS;p.���� LLJ r��. c 05 0 ' I� Ex�:.'t £ OF C 4`-�7 STANDARD MH FOUNDATION PIERS -- 1----.-----_'.. - - 2 NOM. APS ,EC011dtiENDED BY THE MA.NUFACTUPFR OR THE ENGINE=FJNG. MPG SERIES TYPICAL THROUGHOUT, ?,ELOCATE AS / SUPPORT PAD TYP. " NECESSARYrT(fl.// PADSINANMAY BE Y FART Z TIE DOWN SYSTEM P.OTA.TrE ED 90` OR OFFSET TO � - ". E _ OTHER SIDE TO AVOID CLEARANCE PER BSK TESTING and DESIGN PROBLEMS. STAKE S USD. _.. _-__ __.T.-r-,--..-._.r-..w.m�-----�--_�---.-. �.._ �,:.-,� �-�- --- -/-- - ----- - - - - -, - --• - ----- -•- GUS GUARD COMPANY ' 15. LIGHT H-EAVY-W✓ IGHT PLASTIC AND STEEL PAD tt,AY BE USED IN PLACE OF PLYWOOD PAD. .1.6.-WHERE_S;t ND 1S PLACED ON-DOST114C-CONGA-ETF SLAB �./2'.ANCHOR BOLTS MAY_ BE ..._ USED TO SECUPE PIER BASE PLATE. A17. ATTACHMENT METHODS FOR C & J BEAMS sAP"Jd AW Sili 3. CATHEY'S VALLEY, CA 95306 KENNETH.D _REED,. CIVIL ENGINEER_ _ _ 2097966_5540_FAX 209-966-5540- 8976 SIMMONS ROAD RCE 41063 exp. 3%31 /99 REDING, CA. 96001-9715 SHEET 2 of 4 (530) 243-3296 2'X 2"X 3/16" STL. ANGLE DESIGN LISTED AND TESTED BY BSK & ASSOCIATES S1'EEC FRAME m �l/2' BOLT & NUT -,,,� WAYNE T. POLVADO, PE - LISTING NO. F94249 9/16' DIA. HOLE (8) PLACES r B. 3/16' LL�TYP. 0 0 0 STEEL FRAME TOP VIEW 1 1/2' X 1 1/2' X 3/16' X 2' TS TYP. OF 4 -- -2-1/4'X 1_-1./4'- TEK STSG 2'X2"X3/16"X6" LONG ANGLE 2-5/8"A307 3/4"0 IRON ROUND��1 �.r►'iceSTAKE 2"X2'X3/16'L TYP. OF 2 LIGHT - HEAVYWEIGHT PAD "C' B EAM COACH 'J' BEAM" 21/2'X61X3/8, -_/'Gripper Plage ;-, 2-5/$' A307' BOLTS Gus -Guard 3/4" X 3/4' X 0.062" T! SPOT WELD ALL SIDES PVC PAD (2) REQUIRED 1-1/2'x 1-1/2'x0.062'TS 1-1/4'_x 1.-1./4'.x 0,062'_TS —I t 718'X 7/8' X 1' BAR \2-1/4' X 1-1/4' No. C 051110 C Exp , ,_� �OFC�;,, E - Z TIE DOWN SYSTEM PER BSK TESTING and DESIGN GUS GUARD COMPANY BOLTS"7' TEK STS tia DRIVE STAKE " 1':"> r .y ;� a.?/� P.O. BOX 128 PIER. __ - -- - -_ _. ._ - . �/ ��� _ ... GUIDE TUBE- \: CATHEY'S VALLEY,CA 95306 f 209-966-5540 FAX 209-966-554" C -.BEAM ATTACHMENT J - BEAM ATTACHMENT KENNETH D. REED, CIVIL ENGINEER - - - — 8976-SIMMONS ROAD -----RCE 41063 exp. 3/31/99 REDING, CA. 96001-9715 SHEET 3 of 4 (530) 243-3296 8- 3/8' 0 X 2' CAD PLATED / MACH. BOLTS, COUNTERf SUNK FLUSH Q BTM TY;. —7 �� `�'.L_Lj__L_1�_ _ _ _R SIDE - MGP PAD :AVY WEIGHT DESIGN LISTED AND TESTED BY BSK & ASSOCIATES PAD WAYNE T. POLVADO, PE - LISTING NO. -F94249 ..r� .-�C7 ,"PLAN --MUF FAU V y�ET' PO/L 9 c No. C gni110 * Exp. o!'+ a_ s, civic OF E - Z TIE DOWN SYSTEM PER BSK TESTING end DESIGN i i i i i / /- // //// ;, \�1•ll- GUS GUARD COMPANY 24' x 36'x 1-1/8' ! C; int �z P.O. BOX 128 PLYWOOD PAD ''- � � , •.: _.- ....._..-;- CATHEY'S VALLEY, CA 95306 - --- -- D -MGP-- PAD -__ I�E1 H D. REED, CML ENGINEER 209-966-5540 FAX 209-966-554C 8976 SIMMONS ROAD RCE 41063--ezp:-3/3-1/99- MGP 3/3.1/99` MGP — UNDERLAYMENT GRADE PLYWD- P.& S CCA PRESSURE TREATED REDING, CA. 96001-9715 SHEET 4 Of 4 -- - (530)-243-3296_ _.__ bbkvw "h7- '4^70 - '4~to -off -/to BUTTE COUNTY SCHOOLS IMPACT, FEE CIRTIFICATION FORM C (One form per Building) School District -S' Building Department No. A.P. Number D/�... ��Jurisdiction: City County Property Owner Property Location/Address Subdivision Lot No. .................................................................................................................. Residential Development �/ I Sq. Footage � C No of Living Mobile Home Addition/ 'Supplemental to (Group R) Units Installation Conversion Permit # i '(No foundation inspection); :........:......................................................................................................... Commercial/Industrial Sq. Footage New Addition (Including Exterior Roofed Areas) Building Department Representative Date imoor runs revieweo oy scnooi uistnct rersonneu District Identification No. it r r School District certifies that ( t' (Applicant) ., 3 CD .3 -la 06 9V (Street Address) (Phone Number) 23 ICity) (State) �j (Zip Code) has complied with the requirements of Resolution No. /y(/ - / by payment of $ 4,5,x[C P7 representing /a v fql square feet. School District Representative Paid by Check # Remarks: AB 2926 $ FULL MITIGATION $ Date Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit you from challenging the imposition of the fees in any court action. If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is notified by the applicable Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQAL this project may be subject to additional school fees to fully mitigate its impact on the school district's schools. White (applicant), Yellow (building department), Pink (school district) feeform. xis 110/98)dmm ADMINISTRATIVE PERMIT for TEMPORARY MOBILE HOME TO: Karen & Jose Mata FROM: Thomas A. Parilo, Director of Development Services DATE: March 23, 1999 FILE: 99-10 PURPOSE: Administrative -Permit on AP# 011-110-024 for a temporary second dwelling to be located at. 1869 Honey Run Rd., Chico, in the FR -5 (Foothill Recreational) zone. PERMIT REQUIREMENTS: Approval for a temporary second dwelling is subject to the following requirements. 1. A mobile home certified under the 1974 National Mobile Home Construction and Safety Standards Act. Occupancy of the mobile home shall be limited to Jack & Kolletta Pawledge. An affidavit attesting to the relationship of the involved parties was submitted with the permit application. 2. No rent is to be charged to the occupant of the mobile home. The temporary mobile must meet the requirements of the Butte County Environmental Health Department for domestic water supply and sewage disposal. The granting of this permit does not remove the requirement of obtaining the appropriate permits from other Divisions, Departments or Districts. 4. The siting of the mobile home shall be exempt from the site requirements of the residential zoning district, except as required by Butte County Code Chapter 24, and the Butte County Code Chapter 28A. 5. . The mobile home is declared to be a temporary use on the property, accessory to the primary unit, and shall not be placed on a permanent foundation. Additionally, a temporary mobile home shall not be permitted on a lot or parcel where there is an approved Second Unit. 6. The permit shall be granted for a term of two years. Extensions of the term for the permit, not exceeding one year for each extension, may be granted if the application for the extension is filed, with the Planning Division, within 60 calendar days prior to the date of expiration. 7. The mobile home shall be vacated upon expiration, or revocation, of the Permit and removed within one hundred twenty (120) days after expiration of the Permit. If it is not removed within one hundred twenty (120) days, the County shall remove said mobile home and store it at the owner's expense. The Permit may be revoked if any of the terms or conditions of the Permit are violated or if any acts or omissions of the permittee in connection with the use authorized by said Permit constitute a public nuisance. 9. The applicant must maintain a bond or deposit in the amount of $1,500 for a single -wide mobile home or $2,000 for a double -wide mobile home. ro 4 q Ict I Permittee Signature Date 0/177�5* Randy Wilson, rincipal Planner Date API Devei DATE ,; APR 6 E USE PERMIT MINOR U.P. -AD PLANNING DIRECTOR DEVELON 1 Z Karen and Jose' Mata//Jack and Kolletto. •� Pawledge • 1869 Honey Run Road, Chico # 011-110-024-000 Planning Division 100000 s� h A� 0 3 1999 oroville, California LAND OF NATURAL WEALTH AND BEAUTY April 6, 1999 Karen and Jose Mata 1869 Honey Run Rd. Chico, CA 95928 Re: Administrative Permit, AP 011-110-024 Dear Mr. and Mrs. Mata: PLANNING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE • OROVILLE, CALIFORNIA 95965-3397 TELEPHONE: (530) 538-7601 FAX: (530) 538-7785 Enclosed is your validated Administrative Permit No. ADM 99-10 to allow Administrative Permit for a temporary mobile home. Should you have any questions regarding this matter, please contact this office between 8:00 a.m. and 4:00 p.m., Monday through Friday. Sincerely, Thomas A. Parilo Director of Development Services Teri Bridenhagen Office Assistant III Enc. cc: Land Development Division Building Division Environmental Health Department of Forestry