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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 d�*
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 jY NO
2. I HAVE A HAVE NOT ❑ signed an application for a building permit for the proposed vHortt.
3. I have contracted with the following person (firm) to provide the proposed construction: t�.
NAGE:
ADDRESS: CITY:
PHONE: . CONTRACTOR'S LICENSE NO.
4. I plan to provide portions of this work, but I have hired the following person to cooudia te,
supervise, and provide the major work: : r.
NAME:
ADDRESS: CITY.-
PHONE:
ITY:PHONE: CONTRACTOR'S 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:
PROPERTYOWNER:
SOCIAL SECURITY NUMBER:__
'.DATE:_
NOTE: This Owner -Builder Verification is required by Section 19831 and 19832 of the
California Health and Safety Code. This verification must be completed asd
returned to our office before we are permitted to issue the permit.
OVER
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 jor labor and materials for construction of the proposed
property i�mproov ment : YES NO ❑
2• 1 HAVF�e" 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:
CITY:
CONTRACTOR'S 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: r
PHONE:
CONTRACTOR'S 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:
PROPERTYOWNER:
SOCIAL SECURITY NUMBER:
DATE: L
NOTE. This Owner -Builder Verification is required by Section 19831 and 19832 of the.
California Health and Safety Code. This verification must be completed and
returned to our office before we are permitted to issue the permit
OVER
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 X 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: CONTRACTOR'S 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: CONTRACTOR'S 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:
PROPERTYOWNER:
—L7�,n r --a4
SOCIAL SECURITY NUMBER:—,
DATE:
NOTE. This Owner -Builder Verification is required by Section 19831 and 19832 of the
California Health and Safety Code. This verification must be completed and
returned to our office before we are permitted to issue the permit.
OVER
O.B.-1
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 la and materials for construction of the
proposed property improvement: YES [+I ].
2. I HAVE[ V 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: CONTRACTOR'S LICENSE NO.
4. I plan to provide portions of this work, but I have hired the following person to
coordinate, supervise, and provide the TaJor work:
NAME: ,
ADDRESS: V CTI'Y:
PHONE: CONTRACTOR'S 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: L -f / -
NOTE: This owner -Builder Verification is required by Section 19831 and
19832 of the California Health and Safety Code.
This verification must be completed and returned to our office before
we are permitted to issue the permit.
OVER
COUNTY OF BUTTE
DeQartment of DevWonment Services
Building Division
Oroville: 7 County Center Dr., Oroville CA 95965 Ph: 916-538-7541
Chico: 1469 Humboldt Rd., Chico 'CA 95928 Ph: 916-891-2751
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) _���
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 Contractor's 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 Contractor's 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 4//
Social Security Number
Date
NOTE: This Owner -Build 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 permitted to issue the
permit.
r•
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 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) 64
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, 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 e _
Date /_/ — / z
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 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)
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, and provide.the major work:
Name
Address City
Phone Contractors License No.
5. I will pr.ovide 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 -- !Z—
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 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
2. I (have/have not signed an application for a building permit
for the proposed ork.
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, super se, and provide the major work:
Name 1,4
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
11
Signed:
Property Owner
Social Security umber --
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.
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 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 wo .
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.
---_-_-__'-_--_-_''_^_---'_^-._--'_-__-----'�__--__-__�_-'--__-_-- ._
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BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM
(One Form per Building)
A. P. Number 7_ <<1 Building Department No.
School District 611n city] County Jurisdiction
Property Owner_ k 3 Vr
Project Location/Address
Subdivision Lot Lot Number
Residential Development:
. � a � Sq. Footage � 2$
# of Living MHI Addition (Group R)
Units
Commercial/Industrial: Sq. Footage
New Addition (Including Exterior
Roofed Areas)
uild
artment Representative
i/2 ... ,:: �/�"-)
- -
Date
*******************************************************************
4r (Floor Plans reviewed by School District Personnel)
District Id No.
School -District certifies that
(Applicant Name) (Phone Number)
,(MStr�eet Address)
(City) (State) (Zip Code)
has complied with the requirements of Resolution No. o 6 f 7-/-L
03
by the payment of $ /Q cj a representing 7 square feet.
LI., ou�� 31)9 o
Sdhool Dist'r�Act Representative Date
PAID BY CHECK NO.
BANK NO
PAID BY CASH /
REMARKS:
Y
white -applicant, yellow -building department, pink -school district
SCHOOL.FEE (8/88)
COUNTY OF BUTTE - Department 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 improvement (yes or no),
2. I (have/have not),4,a,� 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
Signed:
Property Owner
Social Security umber
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.
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