HomeMy WebLinkAbout042-630-011COUNTY OF BUTTE - DepartMent of Public Works
..7 County Center Drive,.Oroville, CA 95965 Phone:
OWNER" -BUILDER VERIFICATION
916 -538 -7541 -
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 at�rials for construction of
the proposed property improvement (yes or no)
2. I (have/have not) Coif/ signed an application for a building permit
for the proposed work.
3. I have contracted with the'follo41ng 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 o:f Work
Signed: t
Property Owner
Social SecuritNu!pker
Date %�% �%-cc
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:
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