Laserfiche WebLink
ATION <br />02010 <br />Scope of Work: New Office and Lirjht PriM <br />Project Address: 3800 East Malipeaa <br />pCA <br />kT 91 'I. 1 ENT52o 5 <br />20 ,:716215 <br />= <br />Name; Oldcastle Precast <br />Address: 3800 East Mariposa Rd, Stockton, CA 95215 <br />City; Stockton, CA 95215 <br />ZIP: 95215 Ph#( 209) 466-4212 <br />Lie. No; 979224 1 Company Name: Mid-Cal Contractors <br />' CONTRACTOR INFORMATION Pht1( 209) 941-8421 <br />Address: 3416 Newton Rd. <br />DESIGNER INFORMATION <br />Company Name: Justin W. Capp Engineering & Design <br />Company Name: N/A <br />Address: N/A <br />ZIP: 95364 pritff 209) 52 <br />City: Stockton I St; CA ZIP: 95205 <br />City: N/A <br />Permit will be issued to an "Owner-Builder" Yes D No E <br />If yes, a completed Owner-Builder Verification Form must <br />be signed and submitted along with copy of the owner's <br />identification prior to issuance of the building permit. <br />OFFICIAL USE ONLY <br />Identification Number: <br />DECLARATION BY CONSTRUCTION PERMIT APPLICANT <br />By my signature below, I certify to one of the following; <br />additional submittal requirements for various building permit types Demolition pert -nit and mobile home on foundation require check-list. <br />F:\Appiicaticn Forms & HandoutaTIANDOUTSIBufiding Permit Applicairon 1-2015.d (Revised (01-28-15) <br />are available at the Building Division counter. <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 constructio'n I will also <br />takes steps to preserve all survey monuments. In addition, I authorize representatives of this county to enter the above-Identified property for inspection purposes. <br />Applicant's Signature <br />.0/ For your convenience checklists detailing any <br />I am M a California licensed contractor or D the property owner or D authorized to act on the property owner's behalf (requires written approval and Owner/Builder Verification Form signed and submitted). <br />Page lot- 2 <br />Date 1/2 0/16