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HomeMy WebLinkAbout069-100-067Attentior An ' your sigr Plea unnecessa will be i 1. 2. 3. 4. 5. S igr NOTE • Tt M T1 m: F1 ; a I COUNTY OF BUTTE,- Department of Public Works '. 1 7 County Center Drive, Oroville, CA 95965 Phone: 916-538=75, OWNER -BUILDER VERIFICATION t Property Owner: owner -builder" building pe mit has been applied for in your name and bearing ature. se complete and return thi information at your earliest opportunity to avoid ry delay in processing and issuing your building permit. No building permit sued until this ver ificat i on is received. I personally plan to provi a the major labor and ate ials for construction o. the proposed property impr vement (yes or no).L I (have/have not) signed an application for a building permit for thle proposed work. I have contracted with the following person (firm) to provide the proposed construction: Name I Address City Phone Contractors License No. I plan to provide portions of this work, but I have hired the following perso to coordinate, supervise, and provide the major work: Name Address City Phone Contractors License No. I will provide some of th work.but I have contracted (hired) the following persons to provide the wo k indicated: Nana_ Addres Phone Type of Work ed: Property Owner Social Security umber — — Date 1 is Owner -Builder Verification is sent to you as required by Sections 19831 an 832 of the California He lth and Safety Code. is verification must be ompleted and returned to our office before we are pe .tted�to issue the permit. F1 ; a I 1f JJr.Hd t7�OM 3,'A I+AJ • ` \ tk�r� a ♦ . • tt • t y 1137N1JYa A HTlrt ., -�. A HT1W ?tJC`JgAA '•BOJ T2 •) ter. '.t•. r i2' <-'-`-' F w^ .k_ r ,ur�Aw 3oAHrU a J]3 ���j'1, •r• .; •' 1117 TJ OO • AAA 301 J ,? 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