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HomeMy WebLinkAbout066-360-093COUNTY OF BUTTE ;--,;Department of Public Works 7 County Center Drive, ©roville, 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) C 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 Phone -Contractors--License-No. City '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 Na. 5. I will provide.some of the work but I have contracted (hired) the following persons to provide the.work indicated: Name' - Address-.- Phone / II��Na Type of Work �AlICE/11_i_ j l -%-/e11_311 11;7_- i /=/RAl"w'r- Signed: Property Ownerli„rC`� Social Security Number Date �!-zz 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.