HomeMy WebLinkAbout068-344-010School District
A.P. Number
Property Owner
BUTTE. COUNTY SCHOOLS IMPACT FEE CERTIFICATION FORM
(One -form per:.Bullding)
rf = Building Department No.
�...� Jurisdiction: City County
Property Location/Address
Subdivision
Lot No.
:..............................................................................................................
Residential Development I% Sq. Footage
No of Living Mobile Home Addition/ 'Supplemental to (Group R)
_ Units Installation Conversion Permit #
{ s•tl •(No foundation inspection)
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CommerciaUlndustrial F-1 Sq. Footage
New Addition
(Floor Plans reviewed by School District Personnel)
District Identification No. 9
44:7 t�e,,�,, , ,,rte-, School District certifies that
(City)
has complied with the requirements of Resolution No.
(State)
(Including Exterior
Roofed Areas)
Date
(Phone Number)
(Zip Code)
by payment of $
representing p (J square feet. v/ AB 2926 $
s FULL MITIGATION
' - -• r - _i -- ) __ _.,qi ` �,, _ Vis- "_� . v�� s� ;` - - _ � ,.. ' - -Y, 4..
w
Sch of D strict Representative Date
Paid by Check #�%� Remarks:
Notice: You may protest the imposition of the fees identified above by submitting a written protest to the District, in compliance with
Government Code Section 66020(a), within 90 days from the date fees are paid. Failure to submit a timely written protest will prohibit
you from challenging the imposition of the fees in any court action.
If, subsequent to the School District Representative signing this Butte County Schools Impact Fee Certification Form, the School District is
notified by the applicable.Local Planning Agency that this project is being reviewed under the California Environmental Quality Act (CEQA),
this project may be subject to additional school fees to fully mitigate its impact on the school district's -schools
White (applicant)., Yellow (building department), Pink (school district) feeform.xis (10/98)dmm
COUNTY OF BUTTE - ,,,epartment of Public Works
7 County Center Drive, Oroville, CA 95965
OWNER -BUILDER VERIFICATION
Attention Property Owner:
Phone: 916-538-7541
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 improvemen yes or 'no) PiS
2. I (have/have not: V`e signed an.Applicatio'n 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-��-�--
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 ..vim �;:0
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'app.lied 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 es r no)
2. I haves 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 Work
I
Signed: c _
Property Owner
Social. Security Numb r
Date I
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.
Vi dot PQ.
• a.
COUNTY OF•BUTTE - Department of Public Works
7 County Center 'Drive, Oroville, 'CA 95965 Phone: 916-11 538-7549
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 inf6rmation 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 rece'iVed.
1. I personally plan to provide the major labor ind'mater'ials 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 City '
Phone, Contractors License No.
4.- I plan to provide.portions of this work,�but I have hired the following person
to coordinate, supervise,.andIprovide 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 o
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. '