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WHO MAY APPLY <br /> ONLY THE OWNER OF THE PROPERTY OR A LICENSED CONTRACTOR MAY TAKE OUT BUILDING PERMITS.. <br /> Owner-Builder must submit the following with the application: Contractor must submit the following with the application: <br /> • A property tax statement or a recorded deed. • Current license numbers. <br /> • A completed and signed"Owner-Builder Verification"form. • A completed"Authorized to Sign"form if other than the j <br /> • A completed"Authorization for Application"form if other than contractor applies(this is not necessary if this information is <br /> the owner applies. already on file with the Department). <br /> THIS PAGE TO BE FILLED OUT BY DEVELOPMENT SERVICES STAFF <br /> PROPERTY INFORMATION <br /> Job-Site Address: 314 1 Kai S 1),nC APN:- _ ,3 ti/L)_ d) <br /> Cross-Street: Pay: ZIP: <br /> Precise Location: cS <br /> Ob D E 20 <br /> Subdivision Name: r ✓/�"S Ma BI/Lot# <br /> Zoning and Setbacks Zone: 'Ll Front: 3 Left: 3 Ri ht: Rear: Hei ht: <br /> School District a istrict: <br /> Sewer District: Water District: <br /> Approved Use: <br /> SPECIAL AREAS <br /> i <br /> Subsidence :Yes: O No: Rz2 Expansive Soil Area: Yes: No: O <br /> Fire Haza d Area:Yes' No: Airport Zone: Yes: No: ❑ <br /> Planning/No: SJAFCA: Yes: ❑ No: <br /> COMMENTS <br /> D0- <br /> iAPPROVED <br /> This a roval extends <br /> escribed hereon, but does n sown and <br /> callY slon or deviation of requirements of pUgl Ir <br /> WORKS DEPARTMENF, County of San Joaquin. <br /> FLOeE) ZONE DATA <br /> D <br /> Plan Check Only YES File# <br /> Technician: I A,,O Date: <br /> rVMW0** anV1MT AM-nwe""ur4XFftn22(RVAS o+uwc2) Page 2 of 2 <br />