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APPLICATION FOR PERMIT <br /> 279 <br /> SAN JOAQUIN COUNTY FINAL DATE ^ 3wbThis Number Whan <br /> BUILDING INSPECTION DEPT. INSPECTOR Calling for Inspection <br /> 1810 E. HAZEL TON AVE.,STOCKTON,CALIFORNIA-PHONE(209)944-2153 CALL 24 HOURS IN ADVANCE <br /> DATE ISSUED — 3— <br /> APP . DATE "/� p. <br /> ^APPLICANT- r PHONE <br /> tz <br /> JOB LOCATION <br /> A.P.N <br /> OWNER _ <br /> ADDRESS PHONE <br /> SCOPE OF WORK <br /> Ace-. By App. By Date BUILDING <br /> Permit Fee $�J�. <br /> Remarks Pian Check S <br /> By TA.S� S <br /> S.M.I.P. (State of Calif.) 9 <br /> Microfilm 5 S <br /> Size Const. Val, $ MOBILEHOME INSTALLATION A $ I <br /> Plan. Dept. Rei.4 one <br /> PLUMBING <br /> PW Dept Drain/flood Own. Rel. Att. —Fixtures—GD—DW 6 <br /> SJLHD Fire A Excev. q City .—.—Water Heater <br /> THIS SECTION TO BE COMPLETED BY APPLICANT: DEPT. USE ONLY —Water Una <br /> —Gas Piping <br /> I am the owner of the property. Cl IRS Carton _Sewer/Drain Line <br /> 1 will do the work myself. It I hire anyone File, Exp Date: <br /> without complying with Workers Camp- —Sewer/Water Conn. 1 <br /> enation Laws, my permit will become <br /> void. ❑ Owner ❑Contr <br /> My employee(s)will do the work. <br /> _I will have a Licensed Contractor do the OR (Conn. N 1 Maint. Dish 9 <br /> work. <br /> Contr. ❑ Contr. No-hire MECHANICAL <br /> Address Stmt. on File _Comb. Unit/Heat Pump S <br /> City Ph. l_I Labor Code 380 —Furnace/A.C./Lic. Class Number —Gas/Water Piping <br /> !� I am a Licensed Contractor: <br /> Addres 'F 6 2 L��4 SSL �-Phone�( ! —Range/Dryer <br /> an/V <br /> Address �,E6jLLk�ILCity_2�" /f'�� —Hood/Fen/Vent <br /> License Class'—`JQ Number___;Z_Z]9-g) <br /> S�— <br /> Arch/Eng Phone (_) ELECTRICAL <br /> Address City Fxtures:_Incand. <br /> _Fluor. —Flood <br /> Construction Lender Outlets:—Light o/I <br /> Calif. C.C. P. 81193 _Switches—Recept. <br /> I hereby acknowledge that I have read this application and state that the —Motors-442HP r <br /> content is correct. I agree to comply with all applicable laws and <br /> ordinances regulating building construction/plumbing/mechanicaltelae- —Service,4tVAmp <br /> trical Installations. —Range/Oven <br /> I UNDERSTAND THAT THIS PERMIT BECOMES VOID IF WORK IS _Dryer/Wtr. Htr. <br /> NOT STARTED IN 180 DAYS, IF WORK IS ABANDONED FOR A <br /> PERIOD IN EXCESS OF 180 DAYS, OR IF NO INSPECTIONS ARE Temp Pole—Yes—No <br /> CALLED FOR IN A PERIOD IN EXCESS OF 180 DAYS. IF WORK IS —Panels—Amp <br /> NOT TO BE DONE REFUND MUST BE APP D FOR WITHIN 180 „Feeders—Amp <br /> DAYS. <br /> '�Igned r — OTHER FEES Sub-Total <br /> ❑ NER CONTRACTOR Rea N =atv $ Plan Check--$ <br /> By Rec#LKY.9 Amt$ r - _ <br /> AUTHORIZED AGENT Rec N—Amt 9 TOTAL FEESS • <br /> V <br />