HomeMy WebLinkAbout017-260-178COUNTY OF BUTTE - Department of Public Works
7 County Center Drive, Oroville, CA. 95965
OWNER -BUILDER VERIFICATION
Attention Property Owner:
Phone: 916-534-4541
An "owner -builder" building permit has been -applied for in your name "*and bearing
your signature.
Please complete and return this information in the envelope provided.at your
earliest opportunity to avoid unnecessary delay in.processing and issuing your build-
ing permit. No building permit will be issued until this verification is received.
1. I.personally plan to provide the major la or and materials for construction
of the proposed propertyimprovement Wes r no
2. I (have/have not) signed an application for a building
permit for the proposed work.
3. I have contracted with -the following person (firm) to provide -the proposed
constru ion:
Name
Address City
Phone Contractors License No.
.4. I plan to'Ovide portions of this work, but I have hired the following
person coordinate, supervise, and provide the major work:.
Name
5. I will provi
persons to p
Name
City
Contractors License No.
some of the work but I have. contracted (hired) the following
de the work indicated:
Address Phone Type of•Work
Signed:
Property Owner
Social Security iCmber
Date
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831 .
and 19832 of the California Health and Safety Code.
This verification must be completed and returned to our office before we are
permitted to issue the permit.
COUNTY OF BUTTE-- Department of Public Works
7 County Center Drive, Oroville, CA. 95965
OWNER -BUILDER VERIFICATION
Attention Property Owner:
Phone: 916-534-4541
An "owner -builder" building permit has been applied for in your name and bearing
your signature.
Please complete and return this information in the envelope provided at your
earliest opportunity to avoid unnecessary delay in processing and issuing your build-
ing permit. No building permit will be issued until this verification is received.
1. I personally plan to provide ther=ajar labor and materials for construction
of the proposed property improvement or no)
2. I (have/have not) signed an application for a building
permit for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed
construction:
Name
Address. City
Phone Contractors License No.
4. I plan to provide portions of this work, but I.have hired the following
person to coordinate, supervise, and provide the major work:
Name
Address City
Phone Contractors License No.
5. I will provide some of the work but I have contracted (hired) the following
persons to provide the work indicated:
Name Address Phone Type of Work
S igned :
Property Owner -
Social Security4nuer - -
Date / A?
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831
and 19832 of the California Health and Safety Code.
This verification must be completed and returned to our office before we are
permitted to issue the permit.
COUNTY OF BUTTE - Department of Public Works
7 County Center Drive, Orcville, CA.' 95965 Phone;• 916-534-4541
OWNER -BUILDER VERIFICATION
Attention Property Owner:
. An "owner -builder" building permit has been applied for in your name and -bearing
your signature.
Please complete and return this information in the envelope provided at your
earliest opportunity to avoid unnecessary, delay in processing and issuing your build-
ing permit. No building permit will be issued until this verification is received.
1. I personally plan to provide the major labor and materials for construction
of the proposed property improvement or no)'
2. I (have/have not) signed an application for a building
permit for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed
construction:
Name
Address. City
Phone Contractors License No.
4. I plan to provide portions of this work, but I have'hired the following
person to coordinate, supervise, and provide the major work:
Name
Address City
Phone Contractors License No.
5. I will provide some of the work.but I have contracted (hired) the following
persons to provide the work indicated:.
Name Address Phone Type of Work
Signed:
Property Owner
Social Security number
Date�—
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831
and 19832 of the California -Health and Safety Code.
This verification must be completed and returned to our office before we are
permitted to issue the permit.
COUNTY OF.BUTTE Department of Public Works
7 County Center Drive, OrdVille, CA. 95965 Phone: 916-534-4541
OWNER -BUILDER VERIF ICAT ION
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name "and bearing
your signature.
Please complete and return this information in the envelope provided at your
earliest opportunity to avoid unnecessary delay in processing and issuing your build-
ing permit. No building permit will be issued until this verification is received.
1. I personally plan to provide the major labor and materials for construction
of the proposed property improvement y s or no) `
2. I have/have not) signed an application for a building
pe for the proposed work.
P P P
3. I have contracted with the following person (firm) to provide the proposed
construction:
Name
Address City
Phone Contractors License No.
4. I plan to provide portions_of this work, but I have hired the following
person to coordinate, supervise, and provide the major work:
Name
Address City
Phone Contractors License No.
5. I will provide some of the work but I have contracted (hired) the following
persons to provide the work indicated:
Name Address Phone Type of Work
Signed: a �
Property Owner
Social Security number °
Date
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831
and 19832 of the California Health and Safety.Code.
This verification must be completed and returned to our office before we are
permitted to issue the permit.
COUNTY OF BUTTE - Department of Public Works
7 County Center Drive, Oroville, CA. 95965 Phone: 916-53474541
OWNER -BUILDER VERIF ICAT ION
Attention Property Owner:
An "owner -builder" building permit has been applied for in,your name and bearing
your signature.
Please complete and return this information in the envelope provided at your
earliest opportunity to avoid unnecessary delay in processing and issuing your build-
ing permit. No building permit will be issued until this verification is received.
1. I personally plan to provide the major r and materials for construction
of the proposed property improvement Alies Ar no)
6•
..2. I (have/have not) signed an application for a building
permit for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed
co6truction: r
Addrss City
Phone Contractors License No.
4. I plan o provide portions of this work, but I have hired the following
person t coordinate, supervise, and provide the major work:
Name
Address
Phone
5. I will prov
persons to
Name
C ity
Contractors License No.
some of the work but I have contracted (hired) the following
ide the work indicated:
\ Address Phone Type of Work
- S igned : /
Property Owner p
Social Security n ber
Date Z�_ — ( 1�_ -T
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831
and 19832 of the California Health and Safety Code.
This verification must be completed and returned to,our office before we are
permitted to issue the permit.
11
COUNTY OF BUTTE - Department of Public Works
j 7 County'Center Drive, Oroville, CA. 95965 Phone: 916-534-4541
OWNER -BUILDER VERIF ICAT ION
Attention Property Owner:
An "owner -builder" building permit has been applied for in your name and bearing
your signature.
Please complete and return this information in the envelope provided at your
earliest opportunity to avoid unnecessary delay in processing and issuing your build-
ing permit. No building permit will be issued until this verification is received.
1. I personally plan to provide the major labor and materials for construction
of the proposed property improvement 0791's?r no)
2. I (have/have not) signed an application for a building
permit for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed
construction.
Name
Address City
Phone Contractors License No.
4. I plan to provide portions of this work, but I have hired the following
person to coordinate, supervise, and provide the major work:
Name
Address City
Phone Contractors License No.
5. I will provide some of the work but I have contracted (hired) the following
persons to provide the work indicated:
Name Address Phone Type of Work
Signed: &'a
Property Owner
Social Security numb
Date 9_6
NOTE: This Owner -Builder Verification is sent to you as required by Sections 19831
and 19832 of the California Health and Safety Code.
This verification must be completed and returned to our office before we are
permitted to issue the permit.
T•
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BUTTE COUNTY IFor Action 1, 2, 3)
Public Works Dept. (For�'ofqrmation of
Director
Dep. Dir.
Sec.
Rd. & Br. Mtce.
Shop & Yards
Bldg. Insp. Admin.
Design Engr.
Bridge Engr.
Constr. Engr.
Surveys
Mapping
Transp.
Land Dev.
Drng. /S.I.
Sub.& Pc 1. Map
Permits
Addr.
•
\�ow1'
iCOUNTY OF BUTTE - Department of Public Works
'r CA 95965 Phone: 916-
7.County Center Drive, Oroville, 538-7541
OWNER -BUILDER VERIFICATION
Attention.Property Owner:
An `owner=builder" building permit has been applied.for in your name and.bearing
your signature..
Please complete and return this information at your earliest opportunity to.avoid
unnecessary delay in processing and issuing your building permit. No building permit
will be issued until this verification is received.
1 I personally plan to provide the=64-0- labor and materials for construction of
the proposed property improvement ( es r no)
2. I (have not) signed an application for a building permit
for the proposed work.
3. I have contracted with the following person (firm) to provide the.proposed.
construction:
Name
Address City
Phone Contractors License No.
4. I plan to provide portions of this work, but I have hired the following person
to coordinate, supervise, and provide the major work:
Name
Address City
Phone Contractors License No.
5. I will provide some of the work but I have contracted (hired) the following
persons to provide the work indicated:
Name Address Phone Type of Work,
Signed:
Property Owner
Social Security NVIAer
Date X- - Z9-
NOTE: This -Owner -Builder Verification is sent to you as required by Sections 19831 and
19832 of the California Health and Safety Code.
This verification must be completed and returned to our office before we are per-
mitted to issue the permit.
1
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