HomeMy WebLinkAbout058-830-142
COUNTY OF BUTTE - Department of Public Works
7 County Center Drive, Oroville, 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 (yes or no)
2. I (have/have not) f '9L),0= 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 coordina e, 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 requir6d by Sections 19831
and 19832 of the California Health and Safety'Code. r
This verification must be completed and returned to our office before we are
permitted to issue the permit.
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