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Home My WebLink About066-030-033COUNTY 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 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) rr s 2. I (have/have not) 14/IJX,_ 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 r' 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: Namec- 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: 1 Property Owner Social •Securit Number , Date �5 — J J — k 9. `� ' s 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. r i P9 DAVCO BUSINESS FORMS • (916) 7438511 Received from The Sum of For Received: CASHEl &(e COUNTY OF BUTTE OFFICIT RECEIPT azt OFFI R D PAR MENT ISSUING RECEIPT Received By Title CHECK CQP By DAVCO BUSINESS FORMS • (916) 743-8511 36545 - � .'' '--^- '-- ''��-''^~~----~-�-^�__�-`°_-�_-'-' -' -------- ---- ---'-----r----''-----�- --_ ______| y-- - --- � -'z' ---'----- - ''-` —`--- ��---'- � __-___-___-_____-__ ______-_ - _-___________'-_______�, | ---------'-- �--- '---------------------------------'�- } ��_�.��__&____ _-''-_'__ __--- � . ------------ ---------------------------�-------'------- i _-____-' _-'__ ' -_____- _ __-�_____'_--___'�__-__-� .| ---'-------''-----------'--------------------'------'----' -1 �� '�� ___-__-_--______-- _______-___.--'_-__-____-_________----'� ---- --- ------------ �i -___ ___-_____-__ _ _-_____--.__'-__. _-^_______- __-____ . - _-_--___-_--___ ' _________--_-___----_-_--__-____- ___ � — --------------- �---------------�--' --� ------'---------� ! __'-_'_-__-__'__-__-_--____�____-______-___--�-_�__-_-__'___ ! -____'_'_-_--_ - - . -___-_ _--_ ' - _ _ -- � -____�_--'_-- � -___�_-_--,_____-_- '_.___-_____-____ __.___-.___-_--__ - __- _____'__�--__-� -____-____'_-^__�__-__�'____-__'_______ _� _�-____�__� _ ___ _------� -_-_-_-__-_______�-___-'____-___-_--__- - . � -_-'_'_ '___-_-_- _-�-____-_-__`�_---__-__--'_-_-__�____-__ ''-----------'-------------'------ ---- - ---------- - _____.----__---_ _____�___�__�_ -_____.___-__�_ _- � ___�_____�______� ____________________________________ - - ' _-___-- - ' - '--_____--___-- _-____-'_-'__-'___-� _ ------------'- -- - --------'- --- --- - --4-------- - -- - _-__��_-___-___ _'___-_-____--__'__-____.__-.__-_ _-_- �� _�� _�� - _ __-_- _' '-- -_________ _____--___-_______ - -� _ _ -_ _ - ._-_-_____ -_-_- _-�-___'_-____________-_- _ - _ _ --_ ' _ - ��_-_- ___ _____ - _-_' __ __ _ _ ___�_____�___ ______________ ____�_________'_____ __ --------'- -- -- ------ - - -- - --'-------- ' . - -- ' -' --- - ---- - - - --- ------ -----' - _ _ _ - _-- - _ -__-_ . - - -__-__----____-___'.___-_ _ � � � ' �_�� _ �� ' � ' � � �� ` ��`� � ' ` ' � ��' �� `� � ---- ------- -- ---------- ------'-----`--------``---- -- ' -----'------' - ---- -- - -- -- ---------- - _ --_-_ .__- _- --____-' _ -- `�' '-_____'__' -___- ' _ --_- - -'____ � � - ' �-_- -__- �- __- ' ' � � - _-_-___- _ -_'______ � ___--�' _-'___--_____- . � � �� _�� _ � �� _ �� -^ - -- _�_-_ _ ' -_-__- '__ __-_- __-- ~�` ' __ _ --°�_ -____ _-_ -___-_______-__� __-'_--_'___`____-_ _____- ' _-__ __- '____-_-___� __-_ �� '� � �_� � _ _ ��'�� __ �_--_-__ - _ _ '___-�_- _�-`__-_ �&�'�� ' . � uxr mxv�o � o^rcxsvm�u � ' n� � mn`pnpmwopxcr.n=onowp�mv COUNTY OF BUTTE - Department of Public Works 7 County Center Drive, 9roville, CA. 95P65 Phone: 916-534-4541 OWNER -BUILDER VERIF ICAT ION 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 AAbor and materiia-lls—for construction of the proposed property improvement (yes !eror no) 2. I (have have not) r: signed an application for a building pe for the propose'd work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name &C) g r - 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: 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 S igned : Property Owner Social Securit Date / 41 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 VERIF ICAT ION 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) .Vr:I 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 X i Address ` City Phone Contractors License No. 4. I plan person Name Addres Phone to provide portions of this work, but have hired the following to coordinate, supervise, and provide the major work: Contractors License No. City, 5. I will provide some of the work but I have contracted (hired) the following persons to provide the -work indicated: S igned : ,p Property Owner2_�7?qq„ 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 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 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 maj s, labor and materials for construction of the proposed property improvement ( es or no) 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 Address T 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 `9;LezZ �l_, .u� — /^ 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. r' 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 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. 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 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 W rk A Signed: .. Property Owner Social Security Number — Date / — _a...tS_R 6 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 out office before we are per- mitted to issue the permit. 6ruse