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BUTTE COUNTY SCHOOLS -DEVELOPMENT FEE CERTIFICATION FORM
(One Form pe'r Building)
A.P. Number Building Department No. Lf��
School District �� .� City Q County Q Jurisdiction
Property Owner z�4 �,p
Project Location/Address
Subdivision Lot Number
Residential Development:';
Sq. Footage
y # of Living MHI Addition (Group R)
Units
Commercial/Industrial: a Sq. Footage
New Addition (Including Exterior
a
Roofed Areas) ;
'4L
Building Department Representative Date
f •
District Id No.cmvt&
t
'7 � _,dW,,�4�, S.chool District certifies_ that
(Applicant Name) ,� 'ti. (Phone Number) j
d r 1
4 �•
(Street Address)
(City) (State) (Zip Code)
has complied with the requirements of Resolution No.
by the payment of $ 29 7a representing o2�square feet.
S,c ool Distr;W Representative Date
PAID BY CHECK NO. %,
BANK NO
PAID BY CASH
REMARKS:' r '
r
white -applicant, yellow -building department, pink -school district
SCHOOL . FEE (5/88)
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COUNTY OF BUTTE - Department of Public Works
7 County Center Drive, Oroville, CA 95965 Phone: 916-538-7541
OWNER -BUILDER VERIFICATION f.
Attention Property Owner:
An 'owner -builder" building permit has-been applied for in your name and bearing
your signature.
- r
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 ma' labor and materials for construction of
the proposed property improvement yes or no)
2. Ihave not) signed an application for a building permit
foeproposed 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 Sejcurity Nu --
Date h" rq_;_
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 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 • F
Property Owner.
Social Securit Numbgr -'
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.