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CHECK LIST -DEMOLITION PERMIT <br />SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br />1810 E.HAZELTON AVENUE,STOCKTON CA 95205 <br />BUSINESS PHONE:(209)468-3121 <br />INSPECTION REQUEST 24-HOUR RECORDER:(209)468-3165 <br />CHECKLIST <br />THE FOLLOWING INFORMATION AND DOCUMENTATION MUST BE SUBMITTED TO DEVELOPMENT SERVICES Check- <br />BEFORE YOUR APPLICATION CAN BE PROCESSED.off <br />1.One completed Application. <br />2.Obtain Environmental Health Department Approval on Demolition Permit Application.The [mal <br />disposition of the well and septic system must be identified prior to application approval. <br />3.Obtain a Debris Diversion Plan form (Form B)at Public Works Solid Waste Division office to be <br />completed with release signature,PRIOR to obtaining Building Permit. <br />4.Obtain Air Pollution Control District Approval on Demolition Permit Application.(Residential <br />structures with four or less dwellings are exempt from this requirement.HOWEVER,if <br />the structure is to be burned,or if the property involved has been used for or is being <br />cleared for a commercial or public use,the approval is required.) <br />5.It is the applicant's responsibility to notify P.G.&E.and have utilities disconnected.It is also the <br />applicant's responsibility to insure P.G.&E.notifies the Building Inspection Division that these <br />utilities have been properly disconnected.Please contact P.G.&E.at (209)942-1526. <br />Scope of Work:D~o s »:«.ArPA!;//J/-/1"2'),'(11 <br />Project Address:~b55 Bt!'vZI(L/f~L S~C/C7ZJ,J IC/f, <br />DEPARTMENTS LISTED BELOW MUSTI'GIV~rpROVAL PRIOR TOjlSSUING DEMOLITION,PERMIT <br />Environmental Health Department Approval Signature~~V~~J Date Issued:?7!~/;H)n: <br />Solid Waste Division Approval Signature:Date Issued:I , <br />San Joaquin Valley Unified Air Pollution Control Date Issued: <br />District Approval Signature <br />AIR POLLUTION CONTROL DISTRICT ENVIRONMENTAL HEALTH DEPARTMENT <br />4800 Enterprise Way 600 E.Main Street <br />Modesto,CA Stockton,CA 95202 <br />(209)557-6400 (209)468-3420 <br />PUBLIC WORKS DEPARTMENT,SOLID WASTE DIVISION <br />1810 E.HAZELTON AVENUE <br />STOCKTONCA <br />(209)468-3066 <br />FF:\8UILDING\HANDOUTS\Check List Demolition Permit.doc (Revised 4-07-09)