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F1 FILL OUT BOTH SIDES IF CHECKED HERE <br />AUTHORIZATION FOR APPLICATION FOR PERMITS) <br />BY OTHER THAN OWNER OR LICENSED CONTRACTOR <br />TO: San Joaquin -County <br />Department of Planning and <br />Building Inspection <br />1810 E. Hazelton Avenue. <br />Stockton, CA 95205 <br />-Phone (209) 958-3123 <br />I, as the owner of the property, understand or have been <br />informed that the application for a Building, Plumbing and/or <br />Electrical Permit must be signed by the owner of the <br />property, his duly authorized agent or a licensed contractor. <br />I am also aware that I may designate a third party, such as a <br />tenant or person in my employ, to sign the application for a <br />permit on my behalf. I understand that that person's only <br />responsibility or function is to acquire a permit on my <br />behalf. <br />I am aware that the responsibility for the construction and <br />compliance to codes and ordinances is entirely mine and I <br />agree to accept the same. <br />Therefore, as the owner• of the property located at <br />Stockton, CA <br />(address) <br />I do hereby authorize <br />name <br />td -obtain a in my name by affixing <br />type of permit <br />my name followed by his or her signature on -the application <br />for <br />type of permit <br />OWNER'S SIGNATURE <br />OWNER'S ADDRESS <br />OWNER'S PHONE NUMBER DATE <br />