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APPLICATION FOR PERMIT 117367 C- <br /> SAN JOAQUIN COUNTY FINAL DATE Give This Number When <br /> Calling for Inspection <br /> BUILDING INSPECTION DEPT. INSPECTOR CALL 24 HOURS IN ADVANCE <br /> 1810 E. HAZELTON AVE., STOCKTON, CALIFORNIA - PHONE 1209;844 2153 —� . <br /> DATE ISSUED <br /> APPL. DATE?d <br /> APPLICANT... —� ADDRESS q_ I PHO <br /> JOB LO <br /> CATIO 1 Q , 'ice-_L, � <br /> A.P.N�>ll '^ I _ <br /> OWNER — < — <br /> ADDRESS PHONE <br /> SCOPE OF WORK <br /> BUILDING <br /> Accepted By Approved By Date � Permit Fee $ <br /> —( !/ <br /> Plan Check $ <br /> Remarks <br /> By <br /> S,M.I.P.01 $ <br /> Microfilm <br /> Size 1 o st. Val. $ �� MOBILE HOME INSTALLATION W $�- <br /> Plan Dept. �� Ref. N Zone <br /> PLUMBING <br /> PW: Encr in/Flood—Own. Rel. Fixtures ... GD -.. OW ... <br /> �— Excay. q W ter Heater <br /> SJLHD Fire k <br /> Wate e <br /> aint Dist N City Letter Gas Piping <br /> HIS SECTION TO BE COMPLETED BY APPLICANT FOR DEPT. Sewer Line <br /> USE ONLY Sewer/Water Conn. <br /> Check Items Applicable: Ins. Cert. $ <br /> 1 am 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 Com . Unit S <br /> become void. Futnac C. <br /> My employee(s) will do the work. OWNER Range/Dryer <br /> I will have a Licensed Contractor do the / <br /> work. ! Hood/Fan/Vent _. <br /> CONTR. Gas Piping <br /> LICENSE CLASS NUMBER <br /> Non-hire ELECTRICAL <br /> I am a Licen ed Contractor, Statement FIki <br /> Flood <br /> 5 On File: In <br /> LICENSE CLASS NUMBER ❑ <br /> (Sec. 3800 T --Construction LenderLabor Code) M(CALIF. C.C.P. p11931 p. Service1 hereby acknowledge that I have read this application and state that Rthe content is correct. I agree to comply with all applicable lawsandDHtrordinances regulating building construction/plumbing/mechanical/elec- <br /> trical installations. T ...Yes ... NoI UNDERSTAND THAT THIS PERMIT BECOMES VOID IF WORK IS PNOT STARTED IN 120 DAYS, IF WORK IS ABANDONED FOO A FPERIOD IN EXCESS OF 120 DAYS, OR IF NO INSPECTIONS ARECALLED FOR IN A PERIOD IN EXCESS OF 120 DAYS. IF WORK IS <br /> NOT TO BE DONE REFU D MUST BE APP IED FOR WITHIN 120 <br /> DAYS. � Sub Total $ <br /> Signed Plaan�Check$ $ <br /> B Receipt No.% �Dty! TOTAL FEES $ <br /> A D AGEN <br /> \l <br />