HomeMy WebLinkAbout018-440-085y
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) i
2. I Cave ` ave not) Pf signed an application for a building permit
fo proposed work.
3. I have contracted with the following person (firm) to provide the proposed
construction: /
Name / 114-
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 i 1A
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 r
Date 3-iie 5V
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.
TO Buildina Department
FROM: , Environmental Health
SUBJECT: Sanitation Clearance
eJ
'r Owin a Locatioft, AP#
plan Approved for: Sevace Disposal Water Supply
Hold final for:
Final clearance O.K. for:
Water Supply
Water Supply
Clearance for 2 bedroom mdtit�- home. Other
NOTE * * *
2-z-- —
Date
sanitarian
TO: Building Department
FROM: Encroachment Permit Sectio -n
RE: Driveway Clearance
own4Wr location
//- /0 - 6 -5.- �-
AP #
BUTTE COUNTY SCHOOLS DEVELOPMENT FEE CERTIFICATION FORM
(One Form per Building)
A.P. Number /Q `- $ Building Department No.
School District C1�/r_City County [E& Jurisdiction
Property Owner
Project Location/Address.
Subdivision Lot Number
Residential Development:E:1 a
Sq. Footage 124 Oa
# of Living MHI Addition (Group R)
..Units'
Commercial/Industrial: Sq. Footage
New Addition (Including Exterior
Roofed Areas)
3 Y -Z/
Date
(Floor Plans reviewed by School District Personnel),
District Id No.
AID
ySchool D: strict certifies that
�y . 3a-399�
(A/Wz'
pplicant` me) (Phone Number)
/DOS
(Street Address)
(City) (State) (Zip Code)
has complied with the requirements of Resolution No.�..
by the payment $ representing IDQD square feet.
ec 31/ 9!
School bistri&t PEpire!rentative ate
PAID-fiBY CHECK NO. REMARKS:
BANK NO 10
PAID BY CASH
white -applicant, yellow -building department, pink -school district
SCHOOL.FEE (8/88)
�L '"r`ibT"`"'"'V�'flta'�i:►^`'�willwl�"'�7 �'r''�'�' r.�•'F:,�;�7y71i'`""�14�'�i.'�''"'�•jr`�`14'I�'r'��i�`i.�I+�trh.��rs'tu;.f1'Jz--..w-v-•^�r-t.•Y^'nrl-<-.(`�r*ri •4 ,�.,
. i - - :�d1,•A•ta'T1.5•.r. ta.t.- :i:r •.i,....1 +..-,'<,,yR,••
' BUTTE,-tOUNY PARKS DEVELOAMENT FEE CERTIFICATION.FORM
CH1Gb' AREA RECREATION AND PARK DISTRICT
Assessor Parcel Number (s)
Property Owner
Project Location/Address
Subdivision
Residential Development: (check one)
4New Development
Mobilehome(s)
Total Number of Dwelling Units
Lot Number(s)
Alteration/Addition
Non -Residential to Residential
Comment:
Buildin � _
g �a ent Representative Date
• - �ktk�k�t7k.��k��k�1'�Yr�k�t�Yr7cYr�cyYYrYrYr*Yr Yr�YYrYrYc��kMrYr�rk�Wik�lr�lrlr.��trr���k���kyr�k��kk�tt�klrksr�rtlkYr�k�lr�ktlr�lrrc�lr
Chico Area Recreation and Park District(CARD) certifies that
G Y �1'I R vZS 9/ 3I -A 37 � F�
(Applicant Name) (Phone Number)
100k 0(027 Do: VG- ` (Street Address+' . r
3.
f CEf�Ca << CA
(City) (State) (Zip Code)
has complied with the requirements of Butte Co. Resolution No. 89-081, by
.�� payment for dwelling units @ $-7-2-2.-fortotal payment of
CARD Representative
PAID BY CHECK NO. � REMARKS:_
BANK NO.
PAID BY CASH
RECEIPT NO.
park.fee (7/89)
Date
OWNiRS NAME: RECEIVED BY: DATE:
A.P. # PERMIT # TIME:
RESIDENTIAL NON RESIDENTIAL RECEIPT #
--------------------------------------------------------------------------------
REQUIRED PRIOR TO PERMIT ISSUANCE
FROM DATA ,�EQUESTED BY PLAN CHECKER ENGINEERING
OTHER .44 00V
------------ 0 0s, 0"n L - - -------------------------------------------------------
REQUESTED BY 0gC1ION YES NO ITEM:
LOCATION IN BUILDING WHERE CHANGE OCCURS:
WHEN APPROVED, PROCESS AS FOLLOWS:
Mail to owner
Mail to contractor
C and hold for pickup at the office.
C-0 Deliver withn ex inspection.
REVISED PLAN CHECK FEES PAID:
$20.00 $40.00 Additional Fees Not Required