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APPLICATION FOR PERMIT <br /> 11381.1 <br /> SAN JOAQUIN COUNTY FINAL DATE __ Give This Number When <br /> BUILDING INSPECTION DEPT. INSPECTOR Calling for Inspection <br /> CALL 24 HOURS IN ADVANCE <br /> 1810 E. HAZELTON AVE., STOCKTON, CALIFORNIA PHONE(209)8442153 � ` <br /> DATE ISSUED !/ <br /> • e APPL. DATE 7 <br /> AP?LkCANT t w <br /> A OR SS <br /> PH*OE <br /> JCff f A N ` <br /> A.P.# CQ — 1 <br /> OWNERZ41t d S — <br /> ADDRESS PHONE <br /> SCOPE OF WORK <br /> BUILDING <br /> Accepted By eApproved B Dat./12?— Permit Fee $ <br /> Remarks Plan Check $ <br /> By <br /> - S.M,I.P. <br /> Microfilm $ <br /> Size Const. Val. $ MOBILE HOME INSTALLATION # $ <br /> Plan Dept. Ref. a Zone <br /> PLUMBING <br /> PW: Encr Drain/Flood Own. Rel. Fixtures ... GO ... OW ... S_ <br /> SJLHD Fire X _Excay. # Water Heater _ <br /> Water Line <br /> _Maint Dist ^# City Letter / Gas Piping <br /> HIS SECTION TO BE COMPLETED BY APPLICANT FOR DEPT. L_Sewer Line <br /> USE ONLY Sewer/Water Conn. <br /> C ck Items Applicable: Ins. Cert. <br /> I a the owner of the property On File _._ $ <br /> _I will do the work myself. If I hire anyone Exp. Date: <br /> without complying with Workmen's MECHANICAL <br /> Compensation Laws, my permit will <br /> Comb. Unit <br /> become void. <br /> My employee(s) will do the work. OWNER Furnace/A.C. <br /> I will have a Licensed Contractor do the Range/Dryer <br /> work. Hood/Fan/Vent _ <br /> AME CONTR. Gas Piping <br /> LICENSE CLASS NUMBER <br /> I am a Licensed Contractor. <br /> Non-hire ELECTRICAL <br /> Statement Fluor Flood <br /> On File: Incadescent <br /> LICENSE CLASS NUMBER CI - <br /> (Sec. 3800 Total Outlets <br /> Construction Lender Labor Code) <br /> (CALIF. C.C.P. #1193) Motors H.P. <br /> Amp. Service r <br /> I hereby acknowledge that I have read this application and state that Range/Oven <br /> the content is correct. I agree to comply with all applicable laws and <br /> ordinances regulating building construction/plumbing/mechanical/elec- Dryer/Wtr. Htr <br /> trical installations. Temp. Pole ...Yes ... No <br /> I UNDERSTAND THAT THIS PERMIT BECOMES VOID IF WORK IS Panel <br /> NOT STARTED IN 120 DAYS, IF WORK IS ABANDONED FOR A <br /> PERIOD IN EXCESS OF 120 DAYS, OR IF NO INSPECTIONS ARE Feeder <br /> CALLED F PE I DIN EXCESS 120 DAYS. WORK IS <br /> NOT TO E PONE R ND MUS 8 PL1ED ITHIN 120 <br /> DAYS. <br /> Sub-Total $ <br /> Signed G Plan Check$ <br /> S <br /> By AUTHORIZED AGENT Receipt No. ��Q�' p6 TOTAL FEES $--5_ <br />