HomeMy WebLinkAbout065-050-019COUNTY -OF BUTTE - De artment.of Public Works
.7 County Center Drive; Oroville, CA 95965 Phone: 916-538-7541 '
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 the major labor and materials for construction of
the proposed property improvement (yes or no) _ P.
2. I (have/have not) h ay P signed an application for a buildingpermit
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. 1 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.
COUNTY OF BUTTE - Department -of Public Works
7 County Center Drive, Oroville, CA 95965
OWNER -BUILDER VERIFICATION
Attention Property Owner:
Phone: 916-534-4541
• 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
2. .I (have/have not) Act, e- 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 mb
Date O 1� 2
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. i
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 mat rials for construction
of the proposed property improvement (yes or no)_.
2. I (have/have not) signed an application for a building
permit for the proposed worc.
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.
IK 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 Sec ity ifumber :!
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
permitted to issue the permit.
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) IeA
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 proposed
construction:
Name —rf3-
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 —A— l'-- .4 f-�/
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
permitted to issue the permit.
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 material for construction
of the proposed property improvement (yes or no)
2. I (have/have not) Yom- 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 <<-S-BZ
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 beforewe are
permitted to issue the permit.-