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HomeMy WebLinkAbout031-244-0020 31 244-02 Q q/- a ` 7 `7 "®� 92-1309P tiOROTEMGa ry`'L 1 :.. .650.6 fih `ST ... Ther malrto has line/sf 72- 2-. 7 2 `� 031-2441002 93-308B�' WROTEN, Gary CONTR ,Lawson & Sparks: 1650 6th St, Oroville (sf/reroof-hot mop/misc'repairs) i i � Mar; % / �� i •� � 1 COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, Californ a 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. / 93— 30e.k ASSESSOR PARCEL NUMBER '- ZONING BUILDING PERMIT GARY OTEN TELEPHONE SQ. FT. OCC. BUILDING VALUATION G DDRESS OWNE M@1eet, 16 Oroville CA 95965 Q �e CONTRACTOR'S NAME Lawson and Sparks TEL PH 58-0NA CONTRACTOR'S MAILING ADDRESS P 0 box 782, Oroville, CA 95965 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ A LENDER'S MAILING ADDRESS ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 15,00 Permit Fee $ 45.00 Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty 3 BUILDING ADDRESS 1650 6th. Street, Oroville Permit fee $ 60 00 PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE -OF STRUCTURE SF 9A Duplex F-1 Mobilehome❑ Other 3 SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W I @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other71 Describe work: Reroof w/ hot mop, repair siding, replacc dryrot in overhang & walls & replace door Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 jamb Main service 600V OR LESS 200A OR LESS 18.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. y � i? Classification 1, as the owner, or my employees with wages as their sole COmpen- sation, will do the work, and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason Main service 200ATO 1000AI 37.50 NEW CONST. ( DWELLING OCCUP.N� 3.64 sq.ft. OR ADDNS. ACC. BLDGS. CONSTR ULT' -OUTLET NEW NON•RESID BRANCH CIRCITS @ 5.00 (POWER APPARATUS el SINGLE OUTLET CIR. / EX. OCCUp(OUTLETS OR FIXTURES 20 @ 76 EX. OCCU FIXED APPLNS. OR P• OUTLETS (RESID.) EA.) 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. h7t I have placed on file with the County of Butte Building Department }� a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 15.00 Heating Cooling Hood 6.50 til ation PermitVentiI Fee ; Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in Consequence of the grantOg of this Perm 't. X �+��""�"" f�`" tee"` Date / Z Signature of Applicant — Owner Contractor ® Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee S Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 60.00 HAz I DFEES I IMP I FLOOD I CDF PARCEL PD I HD ISS This permit is hereby issued under the applicable provi sions of the Butte County Code and/or resolutions to do Work indicated abo_ve�fon,which fees Pave been paid. By�/iDIRECTOR CSF PBLIC'WORKS2/8/93 ? }.�1,4;P1/J/`­/ � Date PER IM T EXPIRES' Date _ /:Q:/ n 1, - 135323 Receipt No. WHITE-D.P.W.. YELLOW-ASSE330R. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPR;R;VMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California.95965 - Telephone: 916/538-7541 APPLICATION AMD PERMIT PERMIT NO. 93- '30 ASSESSOR PARCEL NUMBER ZONING BUILDING PERMIT O GARY WROTEN TELEPHONE s4. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1650 6th. Street, Oroville CA 95965 CONTRACTOR'S NAME Lawson and Sparks TELEPHONE 589-0784 CONTRACTOR'S MAILING ADDRESS P 0 box 782, Oroville, CA 95965 Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS ARCHITECT OR ENGINEER LICENSE NO. Filing Fee $ 15,00 Permit Fee Plan Checking Fee $ 45.00 $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS 1650 6th. Street, Oroville Permit fee $ 60-00 PLUMBING PERMIT Filing Fee 115.00 Each Trap 5.00 Solar or heat pump water heater 1 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF [:XX Duplex F1 Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation❑ Other Describe work: Ri rnnf w/ hot mnR,repair siding, replacE dryrot in overhang & walls & replace door Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 iamb Main service 200A OR LESS 18.50 CONTRACTORS LICENSE LAW I declare under enalt of ur p y p er I y (check one): 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Sf�_ Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ 1, 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 200A TO 1000A, 37.50 NEW CONST. / DWELLING OCCUPM OR ADDNS. l ACC. SLOGS. 3.64sq.ft. NEwCONSTR "'ULT' -OUTLET NON -RES' - BRANCH CIRCUITS @ 5.00 POWER APPARATUS f} (SINGLE OUTLET CIR. EX. OCcup(OUTLETS OR FIXTURES 20 76 FIXED APLNS EX. Occup. OUTLETS PRESID IKEA.) 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring -15.00 Permit Fee $ WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT FiIingFee 15.00 Heating Cooling Hood 6.50 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against sa'd County in consequence o the grant' g of this perm t. X Date � Z' Signature of Applicant — Owner Contractor Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Mobile Home Installation Fee S Energy Inspection Fee $ OCC CONST TYPE TOThL FEE $ 60.00 HAz OFEES IMP FLOOD coF PARCEL PD Ho ISS This permit is hereby issued under the sions of theutte County Code and/ work in Ca d ab o hick f IRE P BLI By, PER PIR S Date - ap licable provi- r r olutions to do s e been paid. KS Date2/8/93 8/94 Receipt No. 135323 WHITE-D.P.W.. YELLOW-ASSCSSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916.'538-7541 APPLICATION AND PERMIT r PERMIT NO. ASSESSOR PARCEL NUMBER 031--244-002 ZONING ? BUILDING PERMIT OWNER GARY WROM TELEPHONE 532-9440 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1650 6TH ST T11IFRIMLETO CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE No. ARCHITECT OR ENGINEER'S MAILING ADDRESS . Plan Checking Fee I Energy Plan Checking Fee Penalty $ $ $ BUILDING ADDRESS 1650 6TH Sr THERMOLITCr Permit fee PLUMBING PERMIT Each Trap Solar or heat pump water heater $ Filing Fee 15.00 1 5.00 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP ' Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF LJ Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 5.00 Building sewer 15.00 Mobile Home S I G I W @ 15.00 TYPE OF WORK New] I AdditionEl Remodel D Utilities ❑ InstallationC_ Other ❑ Describe work: NEW GAS LINE Permit Fee $ 20•W Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS18.50 200A OR LESS Main service 200A TO 1000A) 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check . p y per � y (econe): � ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. ,License No. Classification I, as the owner,'or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ 1, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ 1 am exempt under Sec. , Business and Professions Code for this reason NEW CONST./ DWELLING OCC ACC. OR ACDNS. l ACC. BLDGS. // 3.64sq.ft. NEW CONSTRULTI-OUTLE NON.RESI BRANCH CIR ITS @ 5.00 APPARATUS e� SINGWLE OUTLET CIR. (SINGLE Ex. Occup(OUTLETS OR FIXTURES 20 75 Ex. Occup. OUTLETS ( RES I0.)R F )RE A.� I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ — WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. -Q;Kl shalt 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 FiIingFee 15.00 Heating Cooling g Hood 6.50 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue agai t said County in conse uence of the granting of this permit. %� . 11 Date 1 Signature o �Applicanf — Owner � Contractor [I Agent ❑ Si 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 S Energy Inspection Fee $ OCC CONST TYPE TOTAL FEES 20 00 I HAz DFEES IMP I FLOOD cDF PARCEL PD HD IssuE This permit is hereby issued under the applicable prov - sions of a Butte County Code and or resolutions to do work,indi ted;a e r whic f s have been paid. / DIR OF PU WORKS �,( By Dated /� PERMIT EXPIRE Date �..J Receipt No. 115714 ' WRITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovllle, California 95965 - Telephone: 916.'538-7541 APPLICATION AND PERMIT Ci R6---� ND ASSESSOR PIARCEL NUMBER 031-244-002 I'D N I N G A R- '- BUILDING PERMIT OWNER GARY WROTEM TELEP HONE 532-9440 SQ. FT. OCC. BUILDING VALUATION OWNER'S MAILING ADDRESS 1650 6TH ST THERMOLETO CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 15,00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 1650 6TH ST THERMOLITO Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 1 5.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ® Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 5,00 Building sewer 15.00 Mobile Home S G W @ 15.00 TYPE OF WORK New 7, Add ition❑ Remodel[] Utilities[] Installation El Other E] Describe work: NFW (,Aq T TNF Permit Fee _ $ 20.00 Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS 200A OR LESS 18.50 Main service 200AT01000A) 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License .Jo. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST./ DWELLING OCCUPM OR ADDNS. l ACC. BLDGS. 3.64 sq.ft. NEW CONSTR. MULTI -OUTLET NON -REST BRANCH CIRC ITS @ 5 00 POWER APPARATUS &) SINGLE OUTLET CIR. Ex. Occup(OUTLETS p OUTLETS OR FIXTURES 20 760 FIXED APLNS. EX. Occup. OUTLETS P(RESID )REA.) I 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ - WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. -.[VI 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 FiIingFee 15.00 Heating Cooling g Hood 6.50 Ventilation penult Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue agai t said County ip consuence of the granting of this permit. X _ Date % '3 Signature o pplicant — Owner Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. Receipt No.115711 WHITE•D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT Mobile Home Installation Fee S Energy Inspection Fee $ OCC CONST TYPE TOTAL FEE $ 20.00 HAz I DFEES I IMP I FLOOD COF PARCEL PO I HD ISSUE i This permit is hereby issued under the applicable prov - sions of a Butte County Code and or resolutions to do work dl ted faVe rwhic f shave been paid. DIRF PU WORKS ByDate PERMIT XPIR Date COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone- 916 '536-7541 APPLICATION- AND PERMIT ASSESSOR �PaacE=N�yQe R —00� `'J' ZO _;01^ i BUILDING PERMIT OWNER C I Y w TE,L^L P�Yy7" 10 s SQ. FT. OCC. BUILDING VALUATION OWNER'S M ILI G ADD ESS c / CONTRACTOR'S NAMETELEPHONE its e CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 15.00 LENDER'S MAILING ADDRESS I Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Cnecking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS/ J�� ��` Permit fee $ PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Soiar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SFIACI. Duplexi,J Mobilehome❑ Other J,_ SPECIFY . Gas piping system 1 - 5 outlets Building sewer 15.00 Mobile Home S ! G W @ 15.00 TYPE OF WORK New, Addition-;_] Rernro�deli-/ UtilitiesU Installation[] Other Describe work: /�OGf� (S 4«l PS iii Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 600V OR LESS I 200A OR LESS 18.50 Main service 20GATO 1000A, 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): II j I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License .Jo. Classification ;J I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure' is not intended or offered for sale. (Sec. 7044) [] I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) I am exempt under Sec. , Business and Professions Code for this reason NEW CONST.( DWELLING OCCUP.&\ OR ADONS. ACC. BLDGS. I 3.6G sq.ft. NEW CONSTFLMULTI-OUTLET NON.P.ESID BRANCH CIRCUITS) @ 5.00 (POWER APPARATUS &\ SINGLE OUTLET CIR. / Ex. Occup( OUTLETS OR FIXTURES 75d RAL_ aB 45 FIXED P-LNS. X. Occup. EOUTLETS (RESID )REA.� ! 3.00 Temporary service 15.00 Mobile Home Facilities15.00 Misc. Wiring 9 15.00 Permit Fee $ - WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): !! j The permit is for $100.00 (valuation).or less. U 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. 1 shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 15.00 Heating Cooling g Hood 6.50 Ventilation Permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue against said County in consequence of the granting of this permit. X Date Signature of Applicant — OwnerC Contractor G Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structuresover3 stories in height. Mobile Home Installation Fee S Energy Inspection Fee $ occ I CONST TYPE TOTAL FEE rIAZ DFEES IMP ! ! FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the sions of the Butte County Code and/or work indicated above for which fees DIRECTOR OF PUBLIC By PERMIT EXPIRES Date applicable provi- resolutions to do have been paid. WORKS Date Receipt No. J����Cl ��icsa WHITE-D.P.W.• YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - Department -of Public Works 7 County Center Drzve, Oroville, CA 95965 Phone: 916-538-7541 OWNER-BUILDERVERIFICATION Attention Property Owner: s 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) hy 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 -per- mitted to issue the permit.