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APPLICATION FOR PERMIT 117367 <br /> SAN JOAQUIN COUNTY' FINAL DATE –ice– _ 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 1209) B44.2153 <br /> DATE ISSUED_ t_ r <br /> APPL. DATE% <br /> APPLICANT <br /> ADDRESS PHONE <br /> JOB LOCATION <br /> A.P.q <br /> OWNER —� ADDRESS ;' d' PHONE <br /> SCOPE OF WORK <br /> I} R 71 <br /> BU LDING <br /> Accepted By Approved By �� Dateit Fee <br /> • <br /> Remarks <br /> /Plan Check S <br /> 1 <br /> By— <br /> S.M.1.P. <br /> .- Microfilm $ <br /> ri r <br /> Size r / LrftC109L Val. $ MOBILE HOME INSTALLATION q $�L <br /> Plan Dept. Ref. # Zone <br /> PLUMBING <br /> PW: Encr Drain/Flood Ow Rel. Fixtures ... GO ... DW ... S <br /> SJIHD Fire 11cav, q Water Fleeter <br /> Water Line <br /> aint Dist q City Letter 11, <br /> Gas Piping <br /> IS SECTION TO BE COMPLETED BY APPLI -ANT FOR DEPT. Sewer Line <br /> USE ONLY Sewer/Water Conn. <br /> Check Items Applicable: <br /> IV USE <br /> Cert. S <br /> I 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 Wort en's MECHANICAL <br /> Compensation Laws, my Dermit will Comb. Unit $ <br /> become void. Furnace/A.C. <br /> My empioyee(s) will do th L. OWNER Range/Dryer <br /> I will have a Licensed Co tractor do the <br /> work. 1� 1 / 1 Hood/Fan/Vent <br /> CONTR. Gas Piping <br /> NA E S� <br /> LICENSE C4LASS <br /> I am a Licensed Contrac or. <br /> Non-hire ELECTRICAL <br /> Statement Fluor Flood <br /> On File: Incade§cent <br /> LICENSE CLASS NUMBER ❑ <br /> (Sec. 3800 TotalOutlef9-,. <br /> Construction Lender Labor Code) Motors H`.P <br /> ICA IF. C.C.P. #1193) Amp. Service <br /> I hereby acknowledg that 1 have read this application and state that Range/Oven <br /> the content is corre t. I agree to comply with all applicable laws and `.� <br /> ordinances regulatin 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 FOR IN A PERIOD IN EXCESS OF 120 DAYS. IF WORK IS <br /> NOT TO BE DONE REFU D MUST BE APPLIED FOR WITHIN 120 <br /> DAYS. f' <br /> Sub-Total S <br /> Signed • ; ' ' I, �1''' ' '1 ti f 5 Plan Check S S <br /> ByAUTHORIZED AGENT rReceipt No. TOTAL FEES $ i{ <br />