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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 th major labor and materials for construction of the proposed
property improvement: YES NO 1
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 proposSd construction:.
- �
NAME: a � %—�_ k ,/.5/Jmu6
r,),/ /p/ L'A vk7 - � � o&-7- 1 „ Y% .
ADDRESS:
CITY: hon �Q,4 /D 16
PHONE: CONTRACTOR'S 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: :A
PHONE:
CONTRACTOR'S LICENSE NO.
5. I will provide some of the work but I have contracted (hired) the following persons to provide
the work indicated:
_NAME ADDRESSPHONE _ TYPE OF WORK
S
W
S f- 14 d %cE
SIGNED: l
PROPERTYOWNER: ` ,C - S
~ SOCIAL SECURITY NUMBER:%- �. -
DATE:— %.� / % F
NOTE: This Owner -Builder Verification is required by Section 198.31 and 19832 of the
California Health and Safety Code. This verification must he completed and
returned to our office before we are permitted to issue the permit.
OVER
COUNTY OF BUTTE
BUILDING DIVISION
411 Main Street - Chico, CA-;* (530) 891-2751
7 County Center Drive Oroville, CA (530) 538-7541
CORRECTION NOTICE
C OWNER PERMIT NO.
A routine inspection indicates that the following violations of butte county Ordinances exist at the
above uoumox and should be corrected. Please oonoo this vmoo when vvnovnon of work is
� vomn|omu. If you have any questions pertaining m this matter, v,need additional explanation,
pleas6 contact this office immediately.
� oote_---
REV 10/92
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Inspector-
- �
THIS'IS TO CERTIFY THAT INSUUATION PAS BEEN INSTALLED IN CONFORMAKE WITH THE CURRENT ENERGY REGULATIONS*
CALIFORNIA ADIIINISTRATIVE CODE, TITLE 2S. STATE OF CALY6RNIA. 1W TH� BUILDING LOCATED AT:
R 4 -rR a c i n e
Rreer Lot Number Tracrm—.
EXTERIOR WALLS
glass
Manufacturer i — m Thickness/Type 3 f i b e r R Value
2
CEILINGS
Batts: Manufacturer Thickness R Value
ei—gs 2 --w—a Big:j 0
Sq. Ft. Covered 1430 R Value 19
FLOORS 9, lass
Manufacturer i - m Thickness/Type 3 f i b e r R Value 1
SLAB ON GRADE
Manufacturer Thickness/Type R Value
Width of Insulation . Inches .
FOUNDATION WALLS
Ma f turd+;� Thickness/Type R Value - 11
G!NE�LION I M I OR/ ZZ"'., Z'-7— LICENSE NUMBER -� 44 A0 h'2
By TITLE DATE
I 7M
,:212
,!NTRACT NICHOLSON IN81RATIONICENSE NUMBER 212461
6/77
ei: -Owner DATE