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BUILDING PERMIT APPLICATION <br /> ri — <br /> Q: SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1810 E. HAZELTON AVENUE,STOCKTON CA 95205 <br /> •'. <br /> i BUSINESS PHONE: (209)468-3121 � <br /> oq"`•'A`P INSPECTION REQUEST-24 HOUR RECORDER: (209)468-3165 <br /> LrFOR <br /> THE APPLICATION MUST BE COMPLETELY FILLED OUT BY THE APPLICANT IN ORDER TO APPLY FOR BUILDING <br /> PERMITS. <br /> Scope of Work: Temporary tent and equipment storage for air cargo <br /> Project Address: 5000 South Airport Way <br /> Project Valuation: $50,000 Contact E-mail: ewohle@ldpartners.com <br /> OWNER NAME AND ADDRESS APPLICANT NAME AND ADDRESS <br /> Name: County of San Joaquin Name: LDA Partners, LLP <br /> Address: 5000 Airport Way Address: 222 Central Court <br /> City: Stockton State: CA City: Stockton State: CA <br /> Zip: 95206 Ph#( 209)468.4700 ZIP: 95204 Ph#(209) 943.0405 <br /> CONTRACTOR INFORMATION Ph#( ) <br /> Lic. No: I Company :ame: TBD <br /> Address: City: St: ZIP: <br /> DESIGNER INFORMATI )N Ph#( ) <br /> Lic. No: 28388 Company Jame: LDA Partners, LLP <br /> Address: 222 Central Court City: Stockton St CA ZIP: 95204 <br /> LENDING AGENCY Ph#( ) <br /> Company Name: N/A <br /> Address: City: St: ZIP: <br /> Permit will be issued to an"Owner-Builder" Yes ❑ No ❑ OFFICIAL USE ONLY <br /> If yes, a completed Owner-Builder Verification Form must Identification Number: <br /> be signed and submitted along with copy of the owner's <br /> identification prior to issuance of the building permit. <br /> DECLARATION BY CONSTRUCTION PERMIT APPLICANT <br /> By my signature below, I certify to one of the following: <br /> I am ❑ a California licensed contractor or❑the property owner or ❑X authorized to act on the property owner's <br /> behalf(requires written approval and Owner/Builder Verification Form signed and submitted). <br /> Y � <br /> Ifaue read this construction permit application and certify the information I have provided is correct. I also agree to comply <br /> t alt apRl(cable county ordinances and state laws which govern this project. During the course of construction I will also <br /> s((e $-to.preserve all survey monuments. In addition, I authorize representatives of this county to enterlhe above- <br /> inspection purposes. <br /> p IOa�1 [ tlCLO <br /> For youNc°otivemencpCfieeklists detailing any additional submittal requirements for various building permit types <br /> are availanpourter. Demolition permit and mobile home on foundation require check-list. <br /> F:1Application Forms&Handouts\HANDOUTSVBuilding Permit Applicdtion 1-2015.doc page 1 of 2 <br /> "(Revised(01-78-15) <br /> r <br /> ,�.� . <br />