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AUTHORIZATION FOR AppLICATIObI FOR PERMIT(S) <br /> BY OTHER� THAN OWNER OR LICENSED CONTRACTOR <br /> F <br /> +. TO: Sari Joaquin Courity r �• , � <br /> Departineri.t of r1"'j <br /> Planning and <br /> Building Inspection c� <br /> 1810 E• Iia zel ton Avenue <br /> Stockton,ii[CA 95205 <br /> Phone ( 209) 468_3123 <br /> t r <br /> as the owner; of the property, understand or have teen <br /> informed that the application for a Building, Plurnbin <br /> Electrical Pertriit must be signed Property, r by the owner of the g and/or <br /> hi,, duly authorized - <br /> agent or. a Iicensed 'contractor. <br /> I `jun al :��� ;iwarei that 1 ini�y desi nate <br /> t_ei. <br /> narit or- pc.,rsori i n my ernf)Zp 9 i third party, sitcli as a <br /> permit on my bet;ia]. f under. standto sthatthe thatpplicati.nn for <br /> a <br /> responsibility ter. Function is . acquire a person 's only i <br /> behalf. q permit .on my <br /> L <br /> 1 aryl aware that the responsibility .for the <br /> compliance to cosies ant] Ordinancconstruction and <br /> es is entirely, mine and :C <br /> agree to accept the same . <br /> Therefore, as the a of the property located at <br /> a dress) <br /> Stockton, CA <br /> I do hereby au tl' <br /> name <br /> to ohtain a J <br /> _.-.___.._- --�� inn my name by affixing <br /> f t-Yf'c' 0 PC,r ri t 0 <br /> my narrie. fr)llowet3 lb Y'. i�► is or .Zer signature on the application p <br /> t t <br /> for 'U; <br /> ( type o.f errriit ) ' <br /> OWNER ' S SIGNATURE <br /> OWNER' S ADDRESS 'E �0 <br /> OWNER'S PHONE NUMBER DATE <br />