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Home My WebLink About065-280-014 065 28-0 014 �. G I LBERTSQNri°K:URT '.CONTR: OWNER 1,4821 MAGNOLIA RD, MAGAL"I WOODSTOVE_%.CABANA ,a S T E FJ2• ' 1644-72B 31 Magnolia, Lot 27> g alfa Unit 1 Ma - p CONrR: Poulson &Sons, Inc., Magalia (ramada over mobile home)` W• A 1 f 0 August 29, 2002 Lynn Holsinger 14821 Magnolia Dr. Magalia, CA. 95954 RE: ' Formal Warning Notice Butte County Code Violation 14821,Magnolia-Dr:, Magalia, CA. P# 065-2 A80=0.1_41 Dear Ms. Holsinger: ,butte C L A N D O F NATURAL WEALTH A N D B E A U T Y PLANNING DIVISION DEPARTMENT OF DEVELOPMENT SERVICES 7 COUNTY CENTER DRIVE • OROVILLE, CALIFORNIA 95965-3397 TELEPHONE: (530) 538-7601 FAX: (530) 538-7785 Through our courtesy notice on July 29, 2002, you were notified pursuant to Section 41-2 of the Butte County Code of the presence of code violations on your above -referenced property. According to our records, the courtesy notice has not resulted in abatement or correction of the keeping of junk and the accumulation of garbage for more than seven (7) days in public view. Your failure to eliminate the stated violations are cause for the issuance of this formal warning notice. As of this date, our records indicate that the following violations to the Butte County Code still exist: Butte Countv Code, Chapter 24, Section 24-65 - Applicability of zoning regulations. All uses of land within a zoned district not specifically authorized or permitted by regulations are prohibited. Butte County Code, Chapter 24, Section 24-130 — The RT -1 (Residential Mobile Home) zone does not "specifically authorize" large accumulations of junk. The storing of more than 100 square feet of "junk" on a parcel is one of the items used to determine that a "junkyard" condition exists. A "junkyard" is not an allowed use in the RT -1 zone without a Use Permit. "Automobiles and other vehicles, dismantled, in whole or in part" are considered to be "junk." Chapter 11, Section 11-4 forbids people, whether at a licensed junkyard location or not, from storing junk in public view. The determination that this violation exists on the property is based on the following definition in the Butte County Code: Butte County Code, Chapter 24, Section 24-305.240 - Junk. Any worn-out and discarded material in general that may be turned to some use including, but not limited to, any old iron, wire, copper, tin, lead, rags, paper, bags, lumber, empty bottles, bones, parts of bicycles, tricycles, baby carriages, automobiles; and other vehicles, dismantled, in whole or in part, kept, stored, located, situated or piled in public view, and all other similar personal property ordinarily defined and classified as "junk" kept, stored, located, situated or piled in public view and not screened from public view by a fence. Lynn Holsinger August 29, 2002 Page 2 Butte Countv Code, Chapter 24, Section 24-305.170 - Garbage. "Garbage" means every + accumulation of animal or vegetable waste, matter that attends or results from the preparation, consumption, decay, dealing in, or storage of meat, fish, fowl, fruits, vegetables or other food products and shall include any food container in which there is putrescible material either solid or liquid. Butte County Code, Chapter 24, Section 24-305.370 - Rubbish. "Rubbish" shall mean all nonputrescible solid wastes, combustible, or noncombustible, including, but not limited to, paper, cardboard, yard clippings, grass, ashes, wood, bedding, crockery, glass, metal and other similar materials, excepting compost boxes. Butte County Code, Chapter 24, Section 24-305.360 - Refuse. "Refuse" shall mean and include any solids or semi-solid waste other than domestic sewage, including, but not limited to, garbage, rubbish and trash. Butte County Code, Chapter 24, Section 24-305.451 - Violator. An adult owner, tenant, occupant, resident or other person having possession, control or any other ownership interest in or the right of access to the premises, who is suspected or alleged to have violated or to be in violation of any Butte County Code provisions of the Chapters specified in Butte County Code Section 24-305.451. In order to bring the property into compliance with the Butte County Code and avoid further enforcement actions, you are hereby requested to take the following abatement or correction actions: Remove all garbage, rubbish and refuse from your property and maintain a regular removal schedule in accordance with Butte County Code, Chapter 31, Section 31-50. 2. Remove all "junk" in accordance with the Butte County Code, Chapter 24, Section 24-305.240. This is your final warning. Unless you contact this office and make the proper arrangements to correct or abate the violation(s) voluntarily, within ten (10) days from the date of this letter, enforcement shall be pursued through the issuance of a citation (ordering you to appear in court) for said violation(s) and for failing to comply with this warning letter. Upon conviction of said violation(s) or of failing to comply with this letter, the court shall impose penalties (fines) and a Notice of Violation shall be recorded in accordance with Butte County Code Section 41-7. The Notice of Violation will include a description of the premises the violation concerns, a description of the violation, the date of your convictions and the action necessary to correct or abate the violation(s). Should you have any questions concerning this matter, please contact me at the address or telephone number listed above. 4er,ely, E. -Frank Cook Code Enforcement Officer EFC: kj cc: Department of Development Services, Code Enforcement • 1 2 3 4 5 6 7 8 9 10 11 12 13 14 15. 16 17 18 19 20 21 22 23 24 25 26 27 28 PROOF OF SERVICE BY MAIL I am a citizen of the United States and employed in the County of Butte; I am, and was at the time of the service hereinafter mentioned, over the age of eighteen years and not a party to the within action. My business address is Department of Development Services, Building Division, 7 County Center Drive, Oroville, California 95965. 1 am readily familiar with the County's practice for collection and processing of correspondence/documents for mailing with the United States Postal Service and that said correspondence/documents are deposited with the United States Postal Service in the ordinary course of business on the same day. On August 29, 2002, 1 served the foregoing 10 Day Letter on the person(s) named below by placing a true copy thereof in a sealed envelope, with first class postage thereon fully paid, addressed as indicated below, and by placing said envelope X In the appropriate place within the Department of Development Services where mail is collected for mailing with the United States Postal Services on the same day. In the United States Postal Service Mail in Oroville, California. Lynn Holsinger 14821 Magnolia Dr. Magalia, CA. 95954 I declare under penalty of perjury under the laws of the State of California that the foregoing is true and correct and that this declaration was executed on August 29, 2002, at Oroville, California. G __�,�.�-�•""*K`7,.,��`yr,k=w;�'�a✓+rt.,r-ctk "�»`J.`�'.si'+e''0 '.��s��y��s"�e^dy!'n"" ��i*�+b�°"r*}qtr-",�,`;+�"w�,•;��°�'�^tii`�.�"f'$.f'airy'�*"'y"r.'W`r.-'�r•n�xr-uM,� • t f `t 065-28-0-014 91-4192.• GILBERTSON, KURT �. CONTR: OWNER 14821 MAGNOLIA RD, MAGALIA ' WOODSTOVE/CABANA 3 r COUNTY OF'BUTTE - DEPARTMENT OF PUBLIC WORKS �3A 7 -County Center Drive - Orovllle, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. APSE >! R• R L NUMZONING 65-28-014 DE -W BUILDING PERMIT OWNER >�m CILHBRTSOI�i TELEPHONE 872-6320 SQ. FT. OCC. _.ay BUILDING VALUATION OWNER'S MAILING ADDRESS P.O. BOX 1729 PARADISE 115969 CONTRACTORR''SS NAME TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace "All itsm 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 14821 MAGN01A ROAD MAGALIA Permit fee $ $. 06-1 PLUMBING PERMIT Filing Fee 15.00 Each Trap 1 5.00 Solar or heat pump water heater 20.00 LOT NO. 27 SUBDIVISION NAME SIERRA DRI" ORO UNIT 1 PARCEL MAP Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex[ --I Mobilehome❑ Other LAMA 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 El Other ❑ Describe work: WDIN)STIM Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A OR LESS 18.50 Main service 200A TO t000A) 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 No. Classification Pq 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) ED 1, 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.ef\ 3.64sq.ft. OR ADONIS.l ACC. BLDGS. // NEW CONSTR OUTLET 5.00 NON•R ESID . ANC BRANCH CIRC ITS @ POWER APPARATUS &) (SINGLE OUTLET CIR. Ex. Occup(OUTLETS OR FIXTURES 20 76 FIXED APPLNS. OR EX. OCCUp. OUTLETS (RESIO.) EA.) I 3.00 Temporary service 15.00 Home Facilities 15.00 Misc. Wiring g 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 Filing Fee 15.00 Heating Coolin 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,Coun in se ence of the granting of this permit. C XL• Date r /� �/ Signature of Applicant — OWneryCll Contractor ❑ Agent ❑ fT 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 $ 45.00 HAz I DFEEs I IMP I FLOOD I CDF PARCEL I PD HD ISSU This permit is hereby issued under the applicable provi sions of the«Vutte County Code and/or resolutions to do +r f work indicated above #which fes have been paid. • r DIRECT• V P BLIC 1(Y&KS ByXzw/ Date PER IT!EXPIRES Date 97 -5 -Oct I Receipt No. 7 WHITE-D.P.W.. YELLOW-ASe[3SOR, PINK -INSPECTOR, GOLDENROD -APPLICANT 3COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS PERMIT NO. 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT ASSESSOR _PARCEL NUMBER 65-28-014 ZONING RMH—W BUILDING PERMIT OWNER KURT GILBERTSON TELEPHONE 872-8320 S0. FT. OCC. BUILDING VALUATIO , OWNER'S MAILING ADDRESS P.O. BOX 1729 PARADISE 95969 CONTRACTOR'S NAME OWNER TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace "All 1,500 CONSTRUCTION LENDER UNKNOWN Total Valuation $ LENDER'S MAILING ADDRESS Filing Fee $ 15.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS 14821 MAGNOLA ROAD MAGALIA Permit fee $ 45.00 PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 LOT NO. 27 SUBDIVISION NAME SIERRA DEL ORO UNIT 1 PARCEL MAP Water piping 7.00 Each pas water heater or vent 7.00 USE OF STRUCTURE SF ❑ Duplex❑ Mobilehome❑ Other CABANA �SPECI FY 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: WOOD.STO-VE _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A OR LESS 18.50 CONTRACTORS LICENSE LAW I declare under penalty ofperjury 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 Pq 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) ❑ 1 am exempt under Sec. , Business and Professions Code for this reason Main service 200ATO1000A, 37.50 NEW CONST. ( DWELLING OCCUP& OR ADDNS. ACC.BLDGS. 3.60 sq.ft. NEW CONSTR ULTI.OUTLET NO N•RESID BRANCH CIRC ITS @ 5.00 PO APPARATUS 9 (SINGWLE OUTLET cIR. Ex. Occup(OUTLETS OR FIXTURES 20 76 FIXED APPLNS. OR Ex. OCCUp. OUTLETS (REST D.) E0 1 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): XThe 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 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 oun Hence of the granting of this permit. X Date /'Z � �/ Signature of Applicant — Ownery�/J Contractor ❑ Agent ❑ An iiTT is ion ofstructuresuc urestovGer 3gstor�esoinehe excavations over 5'0" deep and demolition or construct- Mobile Home Installation Fee S Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 45.00 HAz I DFEES I IMP I FLOOD I CDF I PARCEL I Po I HD ISSU This permit is hereby issued under the sions of th utte County Code and/or work i is ed abo hich fe DIRE P ch ByZ"'I'40 PER RES Date — applicable provi- re olutions to do a been aid. KS p Date f 11 -4-,7 A Receipt No. % 7�0 � WNITE-D.P.W., YELLOW -ASSESSOR. PINK -INSPECTOR, GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS.- BUILDING DIVISION 7 COUNTY CENTER DRIVE - ORj�VI LIE;'G°ALIFORNIA 95985 - TELEPHONE: 918/538-7541 OWNER Proposed Building Use PERMIT APPLICATION DATA SHEET < u94srID Building Inspector_ Permit No.— A. o. A. P. No. 2 (Z J CS../ Date 1Z' r At time of ermit application, I was advised the following�data must be submitted prior`to permit processing and/or issuance: DATE RECEIVED APPROVED 1. All items have been submitted. ......... 2. Plot plans in duplicate/triplicate, signed by preparer of plans ........ 3. Complete plans in duplicate/triplicate, signed by preparer. of plans . . 4. Complete engineered plans and calci, with wet signature on plans . . 5. Hazardous Material Form .......................................... 6. Energy Design Compliance and supporting documentation ......... 7. Statement of Intent for Non -Heated and AC Buildings ............... 8. Engineered truss details and layout in duplicate (required prior to plan check) 9. Mobilehome installation data including manufactu'rer's installation instructions ..............!... '..... `........... ;.................. 10. Fees of $ 4 /' ° .................. 11. Chico Urban Area fees paid .. f .. `.............................. . 12. Park fees paid .................................................. 13. School District fees paid .... ........ . 14. Sanitation approval from Health Department 15. City of Chico plumbing permit.+ ................................... 16. Plot plan and business license, approval from City of (see City for other requirements) 17. Planning approval for (A) Use:-, (B) Parking: ...... 18. Improvements may be required.lContact Land, Development Section DPW 19. Driveway permit (construction approval: required prior to occupancy) 20. Pre -Inspection fo'r 3 "required Pre-inspec.request to Building Inspector (Date) 21. Contractor's license information (No., Name Style, Classifications ... 22. Certificate'of Workmans Compensation Insurance .................. 23. Owner -Builder Verification'`(.Given to owner ❑, Mail to owner ❑)..... 24. Recorded copy of Agricultural Acknowledgment Statement ......... 25. Letter of signature authorization .................................... ' 26. 27. f When you issue the permit, process as follows: ail to owner. Mail to contractor. Telephone and hold for pickup at office. Deliver w. /inspector. Other if i Applicant/?i�2 Date Copy of Haz-Mat form sent Health Dept. Fire Dept. ----Air Pollution Date Copy of plans sent Health Dept. Fire Dept. Other Date ' By The following data must be submitted prior to permit issuance 1. Index permit for above items No. 1 2, Additional items required: b (Circle new item not checked above). Contractor, designer, owner, was advised of above required data by_phoneJnail—counter by ..date Contractor, designer, owner, was advised of above required data by —phone _maII—counter, by date Plans checked by Date Plans approved by Date Copy—DPW Sets of plans on hold in File cabinet AP folder I I ....._ .............._.. • COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovlller Cellfornla 96986 - Telephone: 918/638.7641 APPLICATION AND. PERMIT PERMIT NO. ASSESSOR R 6NG _ - . 0/y Z N /Yl - BUILDING PERMIT OWNER TCLEPHONE SQ. FT. OCC. BUILDING VALUATION OWNER'S �M' AI LGDDRESS ��D /� ` Cl 9s�s 9 - 9 ,C CONTRACTOR'S NAM Dw(dCA , TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace sp O CONSTRUCTION LENDER UNKNOWN Total Valuation $ Filing Fee $ 15.00 LENDER'S MAILING ADDRESS Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ 30 Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS "t Penalty $ BUILDING ADDRESS ., A Permit fee $ S PLUMBING PERMIT Filing Fee 15.00 Each Trap 5.00 Solar or heat pump water heater 20.00 L9JNO. SUBDIVISION NAME / PARCEL MAP S/,fm/4 e �� V� �� ` Water piping 7.00 Each qas water heater or vent 7.00 USE OF STRUCTURE SF ❑ DDuplex[]Mobilehome❑ l tt`h r� �" �lod�In//' SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 15.00 Mobile Home S G W 15.00 TYPE OF WORK New❑ Addition[] Remodel❑ Utilities❑ Installation❑ Other Describe work' 1�loot�sp-o�1, EJJ@ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 15.00 Main service 200A 2600A OR LESS OR LESS 16.50 Main service 200AT01000A1 37.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury ): p y p l y (check one ❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business/POWER and Professions Code and my license is In full force and effect. License No. 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 NEW CONST..I DWELLING OCCUPM LDGS 3.6Qeq.1t. OR ADDNS. ACC. NEW CONSTR LOUTLET I-0UT NON.RES D BRANCH CIRCUITS) @ 5.00 APPARATUS e (SINGLE OUTLET CIR. I Ex. Occup(OUTLETS OR FIXTURES 20 76 FIXED APPLNS. OR EX. Occup. OUTLETS (RESID.) EA.1 3.00 Temporary service 15.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 g Permit Fee $ Contractor — 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. MECHANICAL PERMIT Filing Fee 15.00 Heating Cooling g Hood 6.50 Ventilation penult Fee f 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 said C ty pc quen a of the granting of this permit. X/�f"'/��w► Date l2 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 $ Ener Inspection Fee $ Energy P OCC CONST TYPE TOTAL FEES " HA2 0FEES IMP FLOOD CDF PARCEL PD HD ISSUE This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicated above for which fees have been paid. DIRECTOR OF PUBLIC WORKS By Date PERMIT EXPIRES Date Receipt No. Cf 5_0 / WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - Department 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. -r. I personally.pian to provide the major labor and materials for construction of the proposed property improvement(yes or no) f' J 2. I have have not) /i�(% signed an application for a building permit for a 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.