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SU0011517
EnvironmentalHealth
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EHD Program Facility Records by Street Name
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2600 - Land Use Program
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PA-1700204
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SU0011517
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Entry Properties
Last modified
5/7/2020 11:35:13 AM
Creation date
9/6/2019 10:04:52 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
2600 - Land Use Program
RECORD_ID
SU0011517
PE
2631
FACILITY_NAME
PA-1700204
STREET_NUMBER
12685
Direction
S
STREET_NAME
MANTHEY
STREET_TYPE
RD
City
LATHROP
Zip
95330-
APN
19123007
ENTERED_DATE
9/29/2017 12:00:00 AM
SITE_LOCATION
12685 S MANTHEY RD
RECEIVED_DATE
9/28/2017 12:00:00 AM
P_LOCATION
99
P_DISTRICT
003
QC Status
Approved
Scanner
SJGOV\rtan
Supplemental fields
FilePath
\MIGRATIONS\M\MANTHEY\12685\PA-1700204\SU0011517\APPL.PDF \MIGRATIONS\M\MANTHEY\12685\PA-1700204\SU0011517\CDD OK.PDF \MIGRATIONS\M\MANTHEY\12685\PA-1700204\SU0011517\EH COND.PDF \MIGRATIONS\M\MANTHEY\12685\PA-1700204\SU0011517\EHD PERM.PDF
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EHD - Public
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PA 'in'•c APPLICATION - COMMERCIAL COA=STOCKTON <br /> DING PERMIT <br /> r. ential Mobile Unit) <br /> SAN JOAQUIN COUNTY COMMUMENT DEPARTMENT <br /> 1810 E. HAZELTTOCKTON CA 95205 ONE: (209)468.3121INSPECTION REQUEST-2DER: (209)4683165 <br /> PERMIT NO, <br /> THIS PORTION OF THE APPLICATION MUST BE COMPLETELY FILLED OUT BY THE APPLICANT IN ORDER TO APPLY FOR PERMITS <br /> REQUIRED TO INSTALL A COMMERCIAL COACH. <br /> Scope of Work: <br /> Business Name(DBA):. ' V, B,ls. Lia No: <br /> OWNER AME AND ADDRESS APPLICANT NAME AND ADDRESS <br /> Name: PeA Ne C Name: -5 r? t n S <br /> Address: Address: 3 --],A <br /> Ci : State: AA- Cit : State: <br /> ZIP: 9 Ph: q ZIP: Ph: <br /> CONTRACTOR INFORMATION Ph: <br /> Lic. No: Com an Name: �P <br /> Address: Cit : s St: ZIP: 3f <br /> — — <br /> CHECKLIST-- _ <br /> THE FOLLOWING INFORMATION AND DOCUMENTATION MUST BE SUBMITTED TO DEVELOPMENT SERVICES BEFORE YOUR Check <br /> APPLICATION CAN BE PROCESSED. -off1. One com leted Ilption for a CommerGal Coach Bulldin Permit. <br /> 2. Three coples of a Site Plan,drawn to scale,showing property lines,north arrow,easements,all existing and proposed <br /> develo men*andhandica ed arkin and si na e. <br /> 3. Three corn late sets of the followln Information: <br /> a. .Foundation plans and calculations prepared and wet stamped by a licensed en (neer. - <br /> b. Com late floor 21ans. <br /> C. Handica ed access tans and details. <br /> d. Details of all decks,seconds exits,stairs,steps,etc. <br /> e. State a roved use ands eclficatlons. <br /> 4. Flood Certificate if—u-1. <br /> 5. School Certificate If re uired . <br /> 6. Section 72 of the Revenue and Taxation Code now requires=a <br /> complete floor plan to be submitted to the County <br /> Assessor. Therefore, an additional floor Ian shall be submitthe standard plan submittal requirements. <br /> 7. Permit Deposit(The permit cost Is based on%the Valuation for the type of use as stated in the Building Valuation Data <br /> Sheet published by the International Conference of Building OfflGals) <br /> WHO MAY APPLY 7 <br /> ONLY THE OWNER OF THE PROPERTY OR A LICENSED CONTRACTOR MAY TAKE OUT BUILDING PERMITS.. <br /> i <br /> Owner-Builder must submit the following with the application: Contractor must submit the following with the application: <br /> • A property tax statement or a recorded deed • Current license numbers and a workefs compensation <br /> • A completed and signed"Owner-Builder Verifica0on"form Insurance certification(this is not necessary ff this Information is <br /> • A completed"Authorization for Application"font If other than already on file with the Department) <br /> the owner applies • A waiver form If the contractor is not subject to worker's <br /> compensation laws <br /> • A completed "Authorized to Sign" form If other than the <br /> contractor applies (this Is not necessary if this Information is <br /> alreadyon file with the De arVnenl) <br /> raewax�wmowwrlum,wR-cpAuv WAMMxr•.nz•(R.e.t1 ao 2) Page l of 2 <br /> i <br />
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