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o BUILDING PERMIT APPLICATION <br /> ;G <br /> a SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1810 E. HAZELTON AVENUE, STOCKTON CA 95205 <br /> BUSINESS PHONE: (209)468-3121 <br /> c F...... INSPECTION REQUEST-24 HOUR RECORDER: (209)468-3165 <br /> THE APPLICATION MUST BE COMPLETELY FILLED OUT BY THE APPLICANT IN ORDER TO APPLY FOR BUILDING <br /> PERMITS. <br /> Scope of Work: in Ground Swimming Pool With(400k BTU)Heater and(1.5")Gas Line,(70k BTU)Firepit and(3/4")Gas Line <br /> Project Address: 854 W.Turner Rd, Lodi CA 95242 <br /> Project Valuation: $144,274 Contact E-mail: Ipanasci@ppas.com <br /> OWNER NAME AND ADDRESS APPLICANT NAME AND ADDRESS <br /> Name: Lauri Merrill Name: Lynn Panasci <br /> Address: 854 W.Turner Rd. Address: 5057 Kiernan Court, Suite D <br /> City: Lodi State: CA City: Salida State: CA <br /> ZIP: 95242 P114 209-471-4178 ZIP: 95368 Ph#i 209-284-0335 <br /> CONTRACTOR INFORMATION Ph#(209-284-0335 <br /> Lic. No: 589234 Company Name: Premier Pools&Spas <br /> Address:5057 Kiernan Court,Suite D City:Salida St: CA ZIP: 95368 <br /> DESIGNER INFORMATION Ph#916-287-1445 <br /> Lic. No: KW-06061715 Company Name: Lenehan Engineering <br /> Address: 2975 East Bidwell St. City: Folsom St: CA ZIP: 95630 <br /> LENDING AGENCY Ph#( ) <br /> Company Name: <br /> Address: City: St: ZIP: <br /> Permit will be issued to an"Owner-Builder" Yes ❑ No ❑ OFFICIAL USE ONLY <br /> If yes, a completed Owner-Builder Verification Form must <br /> be signed and submitted along with copy of the owner's Verified owner's identification: <br /> identification prior to issuance of the building permit. <br /> DECLARATION BY CONSTRUCTION PERMIT APPLICANT <br /> By my signature below, I certify to one of the following: <br /> I am 0 a California licensed contractor or❑ the property owner or❑ authorized to act on the property owner's <br /> behalf(requires written approval and Owner/Builder Verification Form signed and submitted). <br /> I have read this construction permit application and certify the information I have provided is correct. I also agree to comply <br /> with all applicable county ordinances and state laws which govern this project. During the course of construction I will also <br /> takes steps to preserve all survey monuments. In addition, I authorize representatives of this county to enter the above- <br /> identified property for inspection purposes. <br /> Applicant's Signature LI Pav asci Date 6-16-20 <br /> For your convenience checklists detailing any additional submittal requirements for various building permit types <br /> are available at the Building Division counter. Demolition permit and mobile home on foundation require check-list. <br /> F:\Application Forms&Handouts\Building Forms and Handouts\Building Permit Application 10-17.doc(Revised(10-6-17)Page 1 of 2 <br />