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APPLICATION FOR PERMIT <br /> �3uIfING INSPECTION DIVISIOO 14093? <br /> FINAL DATE Give This Number Whenj, t' <br /> SAN JOAQUIN COUNTY PLANNING AND INSPECTOR Calling for Inspection I <br /> BUILDING INSPECTION DEPARTMENT CALL 24 HOURS IN ADVANCE <br /> 1810 E. HAZELTON AVE.,STOCKTON, CALIFORNIA-PHONE(209)944-3701 i <br /> DATE ISSUED <br /> APPL. HATE <br /> APPLICANT DA 8 <br /> ADORE � PHONE _ <br /> JOB LOCATION t' I! J/; �_ .__. /OSL . <br /> A.P.# "' C, uC. <br /> OWNER <br /> CONTACT PHONE <br /> ADDRESS�, _ <br /> -� J -- - PHONE —.^...._, <br /> SCOPE OF WORK <br /> Acc. By App. By tY- Date BUILDING <br /> Permit Fees S—�_Sc HE $ S <br /> Remarks Plan Check $ <br /> BY: TA.$ $ <br /> S.M.1.P. (Zeoif) $MicrofilmCent. H/A $ $Size Const. Val. $ BILETALLATION # $ 1 ' <br /> Plan. Dept. Ref. # Zone t <br /> , i <br /> PW Dept—Drain/Rood Own. Rel:A". Fixtures—GD—DW $ <br /> SJLHD Fire # Excay. # City Water. Heater <br /> Water Line 2 <br /> THIS CTION TO BE COMPLETED BY APPLICANT: DEPT. USE ONLY <br /> Cl <br /> n Gas Piping <br /> — I am owner of the property. Sewer/Drain Line <br /> 14 <br /> ® ___ I will do the work myself. If I hire anyone te: T Y,� <br /> without complying with Workers Comp- ater Conn.enation Laws, my permit will becomeA,�OW <br /> void. Contr <br /> My employee(s) will do the work. <br /> I will have a Licensed Contractor do the (Conn. # ) Maint. Dist.work. <br /> Contr. Clhire MECHANICAL <br /> Address ile Comb. Unit/Heat Pump $City Ph. (—) L80 Furnace/A.C. <br /> Lic. Class Number <br /> I am a Licensed Contractor: Gas/Water Piping <br /> Name Ph a ;_1 <br /> Range/Dryer <br /> Address y Hood/Fan/Vent <br /> License Class Number 8 . <br /> Arch/Eng Lic# ELECTRICAL <br /> Address Phone I—) Fixtures: Mcand. $� - <br /> Fluor. Flood <br /> Construction Lender Outlets: Light o/I <br /> Calif. C.C.P.Iction <br /> Switches Recept. <br /> I hereby acknowledge that I have readapplication and state that the Motors HP <br /> content is correct. I agree to comith all applicable laws and —Service <br /> -----Amp <br /> regulating building const /plumbing/mechanical/elec- .. _Amp s <br /> trical installations. _,_Range/Oven/Dryer/Wtr. Htr. I <br /> I UNDERSTAND THAT THIS PERMIT BECOMES VOID IF WORK IS Temp Pole—Yes—No <br /> NOT STARTED IN 180 DAYS, IF WORK IS ABANDONED FOR A Panels-Panels <br /> PERIOD IN EXCESS OF 180 DAYS, OR IF NO INSPECTIONS ARE i <br /> CALLED FOR IN A PERIOD IN EXCESS OF 180 DAYS. IF WORK IS Feeders__..-.._Amp <br /> NOT TO BE DONE REFUND MUST APPLIED FOR WITHIN 180 <br /> DAYS. <br /> •Signed % OTHER FEES_ Sub-Total <br /> R ❑ T ACTOR <br /> r Rec # Amt $ Ian Check S <br /> By Rec # Amt $ <br /> AUTHORIZED AGENT Rec32AG–Amt $ TOTAL FEES$__ 2 2.150' <br />