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APPLICATION FOR PERMIT <br /> SAN JOAQUIN COUNTY FINAL DATE 118224Give This Number When <br /> BUILDING INSPECTION DEPT. INSPECTOR Calling for Inspection <br /> CALL 24 HOURS IN ADVANCE <br /> 1010 E. HAZELTON AVE., STOCKTON, CALIFORNIA- PHONE(209)844-2153 <br /> DATE ISSUED_ <br /> APPL. DATE <br /> APPLICANT <br /> � �_ R SS r PHONE <br /> JOB LOCATION �/ � <br /> A.P.# <br /> OWNER <br /> ADDRESS PHONE <br /> SCOPE OF WORK <br /> BUILDING 138// <br /> Accepted By <br /> Approved By Date Permit Fee $ <br /> Remarks Plan Check $ <br /> By — <br /> S.M.I.P. <br /> Microfilm $ = <br /> Size Const. Val. $ a j� �— <br /> MOBILE HOME INSTALLATION rY $ J <br /> Pian Dept. Ref. # Zone <br /> PLUMBING <br /> PW: Encr Drain/Flood Own. Rel, Fixtures ... GD ... DW ... $ <br /> SJLHD Fire N Excay. a _Water Heater <br /> —Water Line <br /> aint Dist _ b City Letter Gas Piping <br /> HIS SECTION TO BE COMPLETED BY APPLICANT FOR DEPT. Sewer Line <br /> USE ONLY Sewer/Water Conn. <br /> Check s Applicable: Ins. Cert. <br /> I 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 Comb- Unit $ <br /> become void. <br /> Furnace/A.C. <br /> My employee(s) will do the work. OWNER <br /> I will have a Licensed Contractor do the Range/Dryer _ <br /> work. Hood/Fan/Vent <br /> CONTR. <br /> NAME Gas Piping <br /> LICENSE CLASS NUMBER $� <br /> I am a Licensed Contractor. Nun-hire ELECTRICAL <br /> Statement Fluor Flood <br /> LICENSE CLASS NUMBER On File: <br /> p Incadescent <br /> (Sec. 3800 Total Outlets <br /> Construction Lender KALIF. C.C.P. 11793) Labor Code) Motors H.P. <br /> I hereby acknowledge that I have read this application and state that Amp. Service <br /> the content is correct. I agree to comply with all applicable laws and Range/Oven <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 <br /> NOT STARTED IN 120 DAYS, IF WORK IS ABANDONED FOR A Panel <br /> PERIOD IN EXCESS OF 120 DAYS, OR IF NO INSPECTIONS ARE Feeder <br /> CALLED FOR IN A PERIOD IN EXCESS OF 120 DAYS. IF RK IS <br /> NOT TO BE DONE REFUND MUST BE APPLIED FOR WITH'1 120 <br /> DAYS. <br /> Signed Sub-Total $ <br /> Plan Check $ $ <br /> By i <br /> AUTHORIZED AGENT 1 Receipt No.--!�— TOTAL FEES $�� <br /> ,t <br />