HomeMy WebLinkAbout069-430-018COUNTY OF BUTTE - Department of Public Works
7 County Center Drive, Oroville, CA 95965
OWNER -BUILDER VERIFICATION
Attention Property Owner:
Phone: 916-534-4541
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 Contr ors License No. OJT
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 749
27
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. ,
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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 be ing
your signature.
P1 a complete and return this information at your earliest opportunit to avoid
unnecessar elay in processing and issuing your building permit. No build'ng permit
will be issue until this verification is received.
1. I persona plan to provide the major labor and materials fo construction of
the propose property improvement (yes or no)_.
2. I (have/have no signed an application f r a building permit
for the proposed rk.
3. I have contracted wi
construction:
Name
Address
Phone
the following person (firm) to/provide the proposed
City
ntractors License/No.
4. I plan to provide portions of t's work, but/ have hired the following person
to coordinate, supervise, and o 'de ATI Afhewm or work:
Name
Address
,Phone Contrac
5. I will provide some of the work but
persops to provide the work indicat
Name Address
Signed:
Property Owner
Social Security
Date 14, /,P
ber
- - city
r License No.
h \econtracted (hired) the following
Phone Type of Work
NOTE: This Owner- ilder Verification is sent to you as required by Section\wea
and
19832 of t California Health and Safety Code. This ver fication must be completed and returned to our office beforeper-
mitted .o issue the permit.
r-