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BUILDING PERMIT APPLICATION <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1810 E. HAZELTON AVENUE, STOCKTON CA 95205 <br /> BUSINESS PHONE: (209) 468-3121 <br /> c4t'iF'oa# INSPECTION REQUEST-24 HOUR RECORDER: (209)468-3165 <br /> THE APPLICATION MUST BE COMPLETELY FILLED OUT BY THE APPLICANT IN ORDER TO APPLY FOR <br /> BUILDING PERMITS. <br /> Scope of Work: Construction of new exterior and interior improvements <br /> Project Address: 236 Lincoln Center Stockton, CA 95207 <br /> Project Valuation: ContactE-mail: ron@rdrbuilders.com <br /> OWNER NAME AND ADDRESS APPLICANT NAME AND ADDRESS <br /> Name: Market Tavern LLC Name: Owner / Phillip Wong <br /> Address: 236 Lincoln Center Address: <br /> City: Stockton State: CA City: State: <br /> Zip: 95207 Ph#( ) ZIP: Ph#(209) 481-6564 <br /> CONTRACTOR INFORMATION Ph#(209 ) 367-7561 Mobile (209) 810-0500 <br /> Lic. No: 954377 Company Name: RDR Builders LP <br /> Address: 1806 W Kettleman Lane, Suite F City.Lodi St: CA Zip: 95242 <br /> DESIGNER INFORMATION Ph#(209) 483-3418 <br /> LIC. No: 17165 Company Name: vR[Design (Rex Ramsey)rex.ramsey@vrdesignusa.com <br /> Address:231 Market Place, #255 City: San Ramon St: CA ZIP: 94583 <br /> LENDING AGENCY Ph#(209) 483-3418 <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 Identification Number: <br /> be signed and submitted along with copy of the owner's <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 ❑ a California licensed contractor or❑the property owner or❑ authorized to act on the property owner's <br /> behalf(requires written approval and OwnerlBuilder Verification Form signed and submitted). <br /> I have read this construction permit application and the informa ion I have provided is correct. <br /> I agree to comply with all applicable county ordinances and stkte laws relating to building construction. I authorize <br /> representatives of this city or county to enter the ntified property for inspection purposes. <br /> Applicant's Signature / / Date <br /> For your convenience checklists detailing any additio a sub ittal requirements for various budding permit types <br /> are available at the Building Division counter. Dem itio rmit and mobile home on foundation require check- <br /> list. <br /> F:4lpplication Forms&Handouts\HANDOUTS\Building Permit Application.docPage 1 of 2 <br /> (Revised(07-08-10) <br /> I <br /> i <br />