HomeMy WebLinkAbout017-270-028
COUNTY OF BUTTE - Department of Public Works
7 County Center Drive, Oroville, CA 95965 Phone: 916=538-7541
0TTNER-.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 major labor and materials for construction of
the proposed property improvement (yes or no) g
2. I (have/have not) /-f%Qj/�� 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 Nu —r
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 per-
mitted to issue the permit:
MOBILEHOME INSTALLATION ACCEPTANCE
COUNTY OF BUTTE
DEPARTMENT OF PUBLIC WORKS — 7 COUNTY CENTER DRIVE
OROVILLE, CALIFORNIA 95965 — TELEPHONE: (916) 538-7541
PERMIT NO. - I f ""
Address or location of mobilehome 551 �1 11J 9 k/ R L-411)
Owner's name 11\ A (Z S
Owner's address e5 S 4 H " A/
Insignia or hud number Z860 S86 AS 7 1)
Manufacturer's name SKV L(,j e
Serial number of V.I.N. P-� lo — () 14 q v Year of manufacture
(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.
I
I— 513B White - Owner, Yellow - Instoller, Pink - D.P.W.
_COUNTY OF BUTTE - Department of Public Works
7 County Center Drive, Oroville, CA 95965 Phone: 916=538-754.1
0TMER-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 major labor and materials for construction of
the proposed property improvement (yes or no)
2. I (have/have not) HAA, 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
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 -per-
mitted to issue the permit:
w+7 :'fit :31 '.0 ti2 Z 69 43125
PLAZA, REALTORS P.02
• BUTTE COUNTY �';-HOOLS DEVELOPMENT FEE CERTIFICATION FORM
- (One_Form°pe.r Suiidinq)
A.P. Number m���"�,,��.�. Building Department No.�-
School. District LI) City County Jurisdiction
Property Owner PS
i
Project Location/Address ,j .5 ,� '�I ec.. o
Subdivision. Lot Dumber
Residential Development:
r°' Sy, �]
Footageof Lzvzng MHI Addition (Group R
Units
Commercial/Industrial:
New
J
uilding Departmento'RqVrdsentative
A InSq5 Footage
ion (Including Exter or
Roofed Areas)
e
ii�+l�t�z'k�rdr�i�tY+��riF'fi#'kA't�*•kle�rrt�Mtr'k•lr�rwa•�k�Y�t�rw�rrts�ttk�krrvrttw�F'krY�,t�:r�xit*��r&��a��§'�§
(Floor Plans reviewed by School District Personnel)
Di$trict Id No.
School District certifies that
/ 11z
-(Applicant Name) {Phone Number)
- - - ( Street Address
c'a—
C.ty (StateD zip Co e)
has complied with the requirements of Resolution No. '0-90
by the prnent of representing quare eet®
6
School District Representative Date
PAID BY CHECK NO.
BANK NO
PAID BY CASH
REMARKS:
white -applicant, yellow -building department, pink -school district
SCHOOL.FEE (8/88)
.41
N