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HomeMy WebLinkAbout072-050-014COUNTY 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 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 A 2. I (have/l*a. rent)yC 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 l Signed: Property Ownq��.�s 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 .. m .. . , . , r i-+ . 1.- ;`tt-`t sa "':'"!h'4S'« ^"_'' • .--•c7gc ��r.r.`t+^c-r"-� .--.-v-rr--rr= BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM ` (one Form per Building) A.. P. Number 7 7_<,: a Building Department No. School 'District City County © Jurisdiction Property Owner Project Location/Address J E4 C 09 Z) Subdivision Lot Number Residential Development: / Sq. Footage z0S� # of Living MHI Addition .(Group R) Units Commerciai/Industrial:. 0 Sq. Footage New Addition (Including Exterior Roofed Areas) 1 Build,Yng Dep rtment Representative Date (Floor.Plans reviewed by School District Personnel) District Id No. m School District certifies that (Applicant Name) (Phone Number) (Street Address) (City) (State) (Zip Code) has complied with the requirements of Resolution No. vd by the payment of $ � .rj representing a 0S"Q square feet. School Distri/ Representative Date PAID BY CHECK NO. BANK NO PAID BY CASH REMARKS: IL white? applicant, yellow -building department, pink -school district SCHOOL.FEE (8/88) COUNTY OF BUTTE - DeaartAlent of Public Works 7 County Center Drive,•Orovil,le, CA 95965 Phone: 916-538-7541 ' OWNER -BUILDER VERIFICATION ,r 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/ha*e—n.&t) 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 P�/}one D Type f /Wo k -e SDm! �•C 4, -:)B4, -:)CCL L �. rwi. ��t /in „A�i /0 L ��� Signed: Property Own Social Security Number Date.oc 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. COUNTY OF BUTTE*- Department of.Pu.blic 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 applied for in your name and bearing your signatur-e. 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/ham) aipe_ 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 ddress Phone/ Type of Work Signed: Property Owner,�� a 9 Social Security Number Date ►� 9 V g 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. COUNTY OF BUTTE - Depattment 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 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) Yes . _4 2. I (have/h�) �otlo e - signed an application for a building permit for he proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction: Name �' • ` ��� Address Cit 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 Ty)e / Work Signed: Property Ow Social ity Number - Date /? -/9 -,Pp— NOTE: ,'Y 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.