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BUILDING PERMIT APPLICATION <br />N: <br />SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br />, 1810 E. HAZELTON AVENUE, STOCKTON CA 95205 <br />•., z;'r BUSINESS PHONE: (209) 468-3121 <br />INSPECTION REQUEST -24 HOUR RECORDER: (209) 468-3165 <br />Scope of Work: Construction of new single-family residence <br />Project Address: 29703 Norton Avenue, Escalon, CA <br />Project Valuation: $370,900 <br />Contact E-mail: cnbasore@woodlandconstruction.net <br />OWNER NAME AND ADDRESS <br />APPLICANT NAME AND ADDRESS <br />Name: Daniel & Jaclyn Da Silva <br />- Name: Woodland Construction <br />Address: 5507 Greco Lane <br />Address: PO BOX 289 <br />City: Salida <br />State: CA <br />City: Salida <br />State: CA <br />ZIP: 95368 <br />Ph#(209) 872-1047 ZIP: 95368 <br />Ph#(209) 545-1987 <br />CONTRACTOR INFORMATION <br />Ph#( 409 ) 545-1987 <br />Lic. No: 375135 <br />Company Name: <br />Woodland Construction <br />Address: PO BOX 289 <br />City: Salida <br />St: CA ZIP: 95368 <br />DESIGNER INFORMATION- <br />Ph#(209 ) 577-4661 <br />Lic. No: 023440 <br />Company Name: <br />API, Architecture Plus, Inc. <br />Address: 4335-B North Star Way <br />City: Modesto <br />St: CA ZIP: 95356 <br />LENDING AGENCY <br />Ph#( ) <br />Company Name: n/a <br />Address: <br />City: St: Zlp; <br />Permit will be issued to an "Owner -Builder' Yes ❑ No ® OE <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 />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 Owner/Builder Verification Form signed and submitted). <br />I have read this construction permit application and the information I have provided is correct. <br />I agree to comply with all applicable county ordinances and state laws relating to building construction. I authorize <br />representatives of this city or county to enter the above -identified property for inspection purposes. <br />Applicant's Signature_ Date 1 8 I <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- <br />list, <br />FAApplication Forms & HandoutslHANDOUTS1Bullding Permit Application.docPage 1 of 2 <br />(Revised (07-08-10) <br />