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HomeMy WebLinkAbout078-220-009LEW PRATT�_./n�J\ �q a�D-o0� V i% 9r 'r { 18 Las Plumas Way, / ` Permits#2 782-86B (reroof /SF) e 3932-90B f PRATT, Lew 18 Las Plumas Way, Oroville (siding/sf) o e �D � COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND. PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER 36-55-09 ZONING R1 BUILDING PERMIT { OWNER - LEW PRAW TELEPHONE 533-5531 SQ. FT. OCC. BUILDING VALUATION Est. $500 OWNER'S MAILING ADDRESS 18 Las Plumas Way, Oroville CA 95965 CONTRACTOR'S NAME Owner TELEPHONE CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER None UNKNOWN Total Valuation is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee $ ARNCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS Penalty $ BUILDING ADDRESS 18 Las Plumas Way, Oroville Permit fee $ 20.00 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. S UBDIVISION,NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF RX Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 1 110-00e TYPE OF WORK. New❑ Addition❑ Remodel❑ Utilities❑ Installation[] Others® Describe work: Re—Siding on Portions Of SAF _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 sOOV OR LESS Main service 10.00 100 AMP OR LESS Main service EA. ADD'L 100 AMP 2.50' CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect.SINGLE License No. Classification 1, as the owner, Or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason oR ADDNST DWEACCLLIN GOCCUP.es S. 2'/20sgft NEW CONSTR ULTI.OUTLET 2,50 ea NON.RESID BRANCH CRC" POWER APPARATUSa OUTLET CIR. EOccu 20@500 Ex. Occup(OUTLETS OR FIXTURES eAL@30 FIXED APPLNS. OR \ Ex. Occup. OUTLETS (RESID.) EA./ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. byirin 9 15.00 Permit Fee $ � WORKMEN'S COMPENSATION INSURANCE I declare finder penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. Ipl I shall not employ any person in any manner so as to become subject !'' to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling g Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the Countyot Butte to enter upon the above-mentioned property for inspection purposes. also agree to save, indemnify and keep harmless the County of Butte against all liabiliti judgments, co d expenses which may in any way accrue against s ' County in c nse ue a of the granting of this permi . X Date Signotur /of Applicant — Owner Contractor ❑ Agent An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures over 3 stories in height. g Mobile Home Installation Fee $ Energy Inspection Fee $ occ CONST TYPE TOTAL FEE $ 20.00I HAz CUA PARK SCHL FLo PAR PD HD ISSUE This permit is hereby issued under the applicable provi- sions of the Butte County Code and/or resolutions to do work indicted above for which fees have been paid. DIRECT.OR`OF PUB 'WORKS N` r By /Iif?1�!`�/i;1,% Date l 1/1 q PERMIT EXPIRES Date � ` `? /� � Receipt No.mo� WHITE-O.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR, GOLDENROD -APPLICANT .__ / COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916/538-7541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER ZONING `r 36-55-09 R1 - BUILDING PERMIT OWNER TELEPHONE SO. FT. OCC. BUILDING VALUATION LEW PRATT 533-5531 :] Est. $500 OWNER'S MAILING ADDRESS tl 18 Las Plumas Way, Oroville CA 95965 CONTRACTOR'SNAME TELEPHONE Owner CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Nonp Filing LENDER'S MAILING ADDRESS Fee $ 10.00 Permit Fee $ ARCHITECT OR ENGINEER LICENSE NO. I Plan Checking Fee $ None ARCHITECT OR ENGINEER'S MAILING ADDRESS Energy Plan Checking Fee $ Penalty $ BUILDING ADDRESS Permit fee $ 20.00 18 Las Plumas Way, Oroville PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 SF ba Duplex❑ Mobilehome❑ Other Mobile Home S G W 10.00e SPECIFY TYPE OF WORK New ❑ Addition ❑ Remodel ❑ Utilities ❑ Installation ❑ Other)M Permit Fee $ Describe work: RP—Ri di no an Pnrti ons of 911F _ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 100 AMP OR1 OR LESS10.00 Main service EA. ADD•L 100 AMP 2.50 CONTRACTORS LICENSE LAW NEW EOR ADDNSCONSTDWEACCLLIN S./ 2y22sgft I declare under penalty of perjury (check one): GOCCUP.&\ NEW CONSTR ULT' -OUTLET 2.50 ea ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business NO N.RES'D BRANCH CIRC ITS POWER APPARATUS &) and Professions Code and my license is in full force and effect. (SINGLE OUTLET CIR. License No. Classification Ex. Occup(OUTLETS OR FIXTURES 20@502 9ALe 30 1, as the owner, or my employees with wages as their sole compen- FIXED APPLNS. OR Ex. Occup. OUTLETS (RESID.) EAJ 2.00 sation, will do the work,and the structure is not intended or offered Temporary service 10.00 for sale. (Sec. 7044) ❑ I, Mobile Home Facilities 15.00 as the owner, am exclusively contracting with licensed contract- ors.(Sec. 7044) Misc. Wiring g 15.00 ❑ I am exempt under Sec. , Business and Professions Code for this reason Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): MECHANICAL PERMIT Filing Fee 10.00 ❑ The permit is for $100.00 (valuation) or less. Heating ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. Cooling g INA I shall not employ any person in any manner so as to become subject Hood 3.00 to the W. C. laws of California. Ventilation Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such permit Fee ; provisions or this permit shall be deemed revoked. 6 1 Contractor I certify that I have read this application and state that the above information Mobile Home Installation Fee $ is correct. I agree to comply to all County Ordinances and State Laws relating Energy Inspection Fee $ to building construction, and hereby authorize representatives of the County of occ Butte to enter upon the above-mentioned property for inspection purposes. CONST TYPE 20.00 I also agree to save, indemnify and keep harmless the County of Butte against AL TOTAL $ E FEE all liabiliti judgments, co d expenses which may in any way accrue HAZ CUA PARK L PAR PD HD IssuE against s ounty in c nse ue a of the granting of this permi . %� This permit is nereby issued under the applicable provi- Date sions of the Butte County Code and/or resolutions to do Signatur of Applicant — Owner Contractor ❑ Agent Y I work in ' ted above for which fe s have been paid. An OSHA permit is required for excavations over 5'0" deep and demolition or construct- DIRT F PUB 1 ORKS ion of structures over 3 stories in height. Receipt No. BY1. i Date WHITE-D.P.W.. YELLOW -ASSESSOR. PINK -INSPECTOR. GOLDENROD -APPLICANT PERMIT EXPIRES Date A SSE4TR PARCEL NUMBE OW ER (`a O R'S MAIL EING RESS 1 c C Oh TRACTOR'S NAME F y/' CONTRACTOR'S MAILING ADD •i CON T UCTION LENDER 7 LENDER'S MAILING ADDRESS ARC%41 ECT OR ENGINEER UILDING ADOR COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California 95965 - Telephone: 916.'538-7541 APPLICATION AND PERMIT ZONI MAILING ADDRESS PERMIT NO. BUILDING PERMIT TELEPHONE ft SO. FT. I OCC. I BUILDING VALUATION 14. LEP 1 UNKNOWN V ,Vhn LOT NO. SU BOIVISION NAME I PARCEL MAP USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other � SPECIFY TYPE OF WORK }�,( New❑ Addition❑ Remod� 1�1tilities❑ Installation❑ OtherW Describe work: 5 ! (-.!/ 1 YI a n V h CONTRACTORS LICENSE LAW I declare under penalty of perjury (check one): ❑ 1 am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification ❑ I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for S100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Cart;'; t Fireplace Total Valuation $ Filing Fee S 10.00 Permit Fee $ /010 Plan Checking Fee $ Energy Plan Checking Fee $ Penalty I $ Permit fee S "jn n/ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2,00 Solar or heat pump water heater 20.00 Water piping 5,00 Each gas water heater or vent 5,00 Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S G W 10-00ea Permit Fee $ ; Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 8001 OR LESS 100 AMP OR LESS 10.00 I Main service EA. ADD'L 100 AMP 2.50 j NEW CONST. / DWELLING OCCUP.d,\ OR AODNS. 1 ACC. BLDGS. lI 'h2sgIt NEW CONSTR. ULTI-OUTLET N O N.R ESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS e SINGLE OUTLET CIR. ' Ex. OCCUp(OUTLETS OR FIXTURES 20050t e ALO 30t EX. DCCUp. OU L TS (R ESIO )REA.) 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee S Contractor MECHANICAL PERMIT Filing Fee 10.00 Heating I Ica e of Consent to Self -Insure. ❑ I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. Cooling Hood Ventilation permit Fee Contractor I certify that i have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County oT Mobile Home Installation Fee Energy Inspection Fee i Butte to enter upon the above-mentioned property for inspection purposes. DCC CONST TYPE TOTAL FEE $ A9, o I also agree to save, indemnify and keep harmless the County of Butte against all liabilities, judgments, costs, and expenses which may in any way accrue "Az cuA PARK sc"JFLD PAR I Po I Ho I ISSUE against said County in consequence of the granting of this permit. XThis permit is nereby lssuea uraer the applicable provi- Date sions oT the Butte County Code and/or resolutions to do Signature of Applicant — Owner 01 Contractor ❑ Agent ❑ work indicated above for which fees have been paid. An OSHA permit is required for excavations over 5'0" deep and demolition or construct. DIRECTOR OF PUBLIC WORKS ion of structures over 3 stories in height. Receipt No. By Date WMIT[-O.P.W., T[LLOW-A3e[33001, PINK-INSPLCTOR, COLa[NROO-APPLICANT PERMIT EXPIRES Date COUNTY OF BUTTE - Depaxtment of Public Works 7 County Center biive, Orovill;;2,, CA 95965 Phone: 916-538-754.1 MMER-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,.7v /have not) L,-' signed an application for a building permit for the proposed work. 34 -Name 1 have contracted with the following person (firm) to provide the proposed construction: 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 mb r 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. Permit#2782-86B Lew Pratt 18 Las Plumas Way COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Orovi I I e,0.3aIiforn)a 95965 - Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. ASSESSOR PARCEL NUMBER ZONING _ BUILDING PERMIT OWNEWR" "I n... nA74A TELEPHONE SO. FT. OCC. BUILDING VALUATION OWNER'SS.'M AILING ADDRESS-• O CONTRAC- / r /V/ TELEPHONE `r CONTRACTOR'S MAILING ADDRESS Fireplace CONSTRUCTION LENDER UNKNOWN Total Valuation Is Filing Fee $ 10.00 LENDER'S MAILING ADDRESS Permit Fee 5 7 ARCHITECT OR ENGINEER LICENSE NO. Plan Checking Fee $ Energy Plan Checking Fee $ ARCHITECT OR ENGINEER'S MAILING ADDRESS A _ l Penalty $ BUILDING ADDRESS / A/J A �� �� / 1 .{j/ r Permit fee ^ $ ; 1 PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 Solar or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCEL MAP Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SFE Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 0.00 ea TYPE OF WORK New ❑ Addition ❑ Remodel ❑ UtilAies ❑ Installatiion❑ Other-[ Describe work: i -j i L �- f Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 600V OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penalty of perjury (Check One): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Business and Professions Code and my license is in full force and effect. License No. Classification Q I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. OR ADDN5. ( DWELLING OCCUP.&) ACC. BLDGS. yZcsgft NEW CONSTR. MULTI -OUTLET 2,50 ea NON-RESID BRANCH CRC ITS /POWER APPAIRATUS h (SINGLE OUTLET CIR. / 2ooaoe Ex. Occup OUTLETS OR FIXTURES eAL@30 FIXED APPLNS. Ex. OCCUp. R OUTLETS ((RESID )EAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT FiIingFee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to save, indemnify and keep harmless the County of Butte against all liabilities judgments, costs, and expenses which may in any way accrue against saitl:County iii /consequenceof thegranting of this perrm`it. �y/ X �_z Ie"/t ��A_71/ Date - /;/n r',• Signature f Applicant - Owner D' Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition or construct- ion of structures overnn3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ Occup. CONST,TYPIJ IFI-0.131PARC111 PD NO SSUE This permit is hereby issued under sions of the Butte County Code and/or work indicated above for which / DIREC O OF PUBLIC'WORKS B y +an I / PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. Date / y Receipt No. L .Y%�7 i WHITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT COUNTY OF BUTTE - DEPARTMENT OF PUBLIC WORKS 7 County Center Drive - Oroville, California�95965 -Telephone 916/534-4541 APPLICATION AND PERMIT PERMIT NO. ASSW.9R PARCrUMEq ZONING BUILDING PERMIT O WNET„E P¢t°NE OWN LI G ADDR J SQ. FT. OCC. BUILDING VA ATION CONTRACTO S A TELE CONTRACTOR'S MAILING ADDRESS I Fireplace CONSTRUCTION LENDER UNKNOWN LENDER'S MAILING ADDRESS Total Valuation $ Filing Fee Permit Fee ' $ 10.00 $ 50 ARCHITECT OR ENGINEER LICENSE NO. ARCHITECT OR ENGINEER'S MAILING ADDRESS Plan Checking Fee Energy Plan Checking Fee Penalty $ $ $ BUILDING ADDRESS Permit fee $ PLUMBING PERMIT Filing Fee 10.00 Each Trap 2.00 ` SolaY or heat pump water heater 20.00 LOT NO. SUBDIVISION NAME PARCE A Water piping 5.00 Each qas water heater or vent 5.00 USE OF STRUCTURE SF Duplex❑ Mobilehome❑ Other SPECIFY Gas piping system 1 - 5 outlets 5.00 Building sewer 5.00 Mobile Home S I G I W 10.00 ea TYPE OF WORK New ❑ Addition ❑ Rem el ❑ Uti ties ❑ Instal at' ❑ 0th rA Describe work:- _ Permit Fee $ Contractor ELECTRICAL PERMIT Filing Fee 10.00 Main service 1111 OR LESS 100 AMP OR LESS 10.00 Main service EA. ADD'L 100 AMP 2.50 CONTRACTORS LICENSE LAW I declare under penaltyof perjury p f y (check one): ❑ I am licensed under provisions of Chapt. 9, Div. 3 of the Bus(neSS and Professions Code and my license is in full force and effect. License No. Classification I, as the owner, or my employees with wages as their sole compen- sation, will do the work,and the structure is not intended or offered for sale. (Sec. 7044) ❑ I, as the owner, am exclusively contracting with licensed contract- ors. (Sec. 7044) ❑ I am exempt under Sec. , Business and Professions Code for this reason NEW CONST. DWELLING OCCUP.p , OR ADDNS. ACC. BLDGS. �Z¢sgft NEW CONSTR MULTI -OUTLET NON-RESID BRANCH CIRC ITS 2.50 ea POWER APPARATUS tr (SINGLE OUTLET CIR. Ex. Occu 20®5/e Occup(OUTLETS OR FIXTURES eAL030 FIXED APLNS. Ex. OCCup. OUTLETS P(RESID )REAJ 2.00 Temporary service 10.00 Mobile Home Facilities 15.00 Misc. Wiring 15.00 g Permit Fee $ Contractor WORKMEN'S COMPENSATION INSURANCE I declare under penalty of perjury (check one): ❑ The permit is for $100.00 (valuation) or less. ❑ I have placed on file with the County of Butte Building Department a Certificate of Workmen's Compensation Insurance or a Certificate of Consent to Self -Insure. I shall not employ any person in any manner so as to become subject to the W. C. laws of California. Notice to Applicant: If after making this statement, should you become subject to the W. C. provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. MECHANICAL PERMIT Filing Fee 10.00 Heating Cooling Hood 3.00 Ventilation permit Fee $ Contractor I certify that I have read this application and state that the above information is correct. I agree to comply to all County Ordinances and State Laws relating to building construction, and hereby authorize representatives of the County of Butte to enter upon the above-mentioned property for inspection purposes. I also agree to ave, indemnify and keep harmless the County of Butte against all liabilit'e , udgments sts, and expenses which may in any way accrue against s ounty one ence of the granting of this per fit. �y %� Date Signotuy Df Applicant — Owner Contractor ❑ Agent ❑ An OSHA permit is required for excavations over 5'0" deep and demolition of construct- ion of structures over 3 stories in height. Mobile Home Installation Fee $ Energy Inspection Fee $ TOTAL PERMIT FEE $ 7CCUP. CONST.TYPE FLOOD PARCEL NO M This permit is hereby issued under sions of the Butte County Code and/or work indi ted above for which DIRE F PU B PERMIT EXPIRES Date the applicable provi- resolutions to do fees have been paid. 1 WORKS Date 00, Receipt No. �l WNITE-D.P.W., YELLOW -ASSESSOR, PINK -INSPECTOR. GOLDENROD -APPLICANT r O. 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 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 an materials for construction of the proposed property 'mprovement (yes or no) ' 2. I (have/have not) igned an application for a building permit for the proposed w rk. 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 N b 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.