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/ <br />CHECK LIST -DEMOLITION PERMIT <br />SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br />1810 E.HAZELTON AVENUE,STOCKTON CA 95205 <br />BUSINESS PHONE:(209)468-3121 <br />INSPECTION REQUEST 24-HOUR RECORDER:(209)468-3165 <br />CHECKLIST <br />THE FOLLOWINGINFORMATIONAND DOCUMENTATIONMUST BE SUBMITTEDTO DEVELOPMENTSERVICES Check- <br />BEFORE YOURAPPLICATIONCAN BE PROCESSED.off <br />1.One completed Application. <br />2.Obtain Environmental Health Department Approval on Demolition Permit Application.The final <br />disposition of the well and septic system must be identified prior to application approval. <br />3.If your demolition project is 1200 sq.ft.or more you must obtain an approved Debris Diversion <br />Plan from Public Works Solid Waste Division office at 1810 E.Hazelton Ave.,Stockton,468-3066, <br />PRIOR to obtaining your Demolition Permit. <br />4.Obtain Air Pollution Control District Approval on Demolition Permit Application. <br />5.It is the applicant's responsibility to notify P .G.&E.and have utilities disconnected.It is also the <br />applicant's responsibility to insure P.G.&E.notifies the Building Inspection Division that these <br />utilities have been properly disconnected.Please contact P.G.&E.at (209)942-1526. <br />Scope of Work:De Itt/t')(:sl,.it1&ClJe t se JI)+/c-~"",l( <br />Project Address:2~FII'e.W'~GOtM 1'/h~FI/~cl.rL:.MAA "(_4 q)2.~t <br />DEPARTMENTS LISTED BELOW MUST GIVE APPROVAL PRIOR TO ISSUING DEMOLITION PERMIT <br />Environmental Health Department Approval Signatu~:~(JI\,~Date Issued:41~~(2--, <br />San Joaquin Valley Unified Air Pollution Control ~Date Issued: <br />District Approval Signature <br />AIR POLLUTIO CO TROL DISTRICT ENVIRONMENTAL HEALTH DEPARTMENT <br />4800 Enterprise Way 600 E.Main Street <br />Modesto,CA Stockton,CA 95202 <br />(209)557-6400 (209)468-3420 <br />-¥:[Ak0---Co 1J;&~~$W~~~~4ffUaJ-vT <br />,e{' <br />F:\Application Forms &Handouts\HANDOUTS\Check List Demolition Penmit.doc (Revised 1-11-11)