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!I <br /> t� AUTHORIZATION FOR APPLICATION FOR PERMIT(S ) <br /> a BY OTHER THAN OWNER OR LICENSED CONTRACTOR <br /> TO: San Joaquin County <br /> Department of Planning and <br /> Building Inspection <br /> 181011E. Hazelton Avenue <br /> Stockton, CA 95205 <br /> Phone ( 209) 944-3701 <br /> j <br /> it <br /> I, as thej�owner of the property, understand or have been <br /> informed that the application for a Building, Plumbing and/or <br /> Electricals Permit must be signed by the owner of the <br /> property, .'his duly authorized agent or a licensed contractor. <br /> K I am also 'laware that I may designate a third party, such as a <br /> tenant or '�pQrson in my employ, to sign the application for a <br /> permit on my behalf. I understand that that person ' s only <br /> responsibility or function is to acquire a permit on my <br /> behalf. ` <br /> I am aware that the responsibility for the construction and <br /> compliance to codes and ordinances is entirely mine and I <br /> agree to accept the same. <br /> Therefore, as the owner of the property located at <br /> Stockton, CA <br /> (addre s ) ' <br /> f <br /> I do hereby authorize <br /> name) <br /> to obtain a in my name by affixing <br /> ( type of permit <br /> my name followed by his or her signature on the application ' <br /> for S � <br /> type of permit <br /> OWNER ' S SIGNATURE r <br /> OWNER' S ADDRESS S r, <br /> OWNER'S PHONE NUMBER � _14� DATE <br /> II <br />