ARCHIVED REPORTS_XR0012311 - Laserfiche WebLink

Home Browse Search

CITY OF TRACY - CALIFORNIA BUILDING PERMIT APPLICATION roved by 19 I hereby make application for a Budding Permit for work to be done at the following address • --__- - - - - - _ legally described as Class of Work: (Check one) RESIDENTIAL COMMERCIAL INDUSTRIAL ' Type of Work: (Check one) NEW _, ALTERATIO14 ADDITION—, DEMOLISHr�� REPAIR , 14OVE t '.Further particulars Yare : IZONING—Tj=�. Occupancy Group (Circle one) A B C D E F G H T ,FIRE ZONE (Circle one) 11 III NOTE: When there is employment in connection with this work, the State of California requires, as a condition to the granting of a Building Permit by the #kmen' s of Tracy , that the applicant dust have on file proof of the compliance IC the provisions of the Labor Code (Section 3800) requiring the carrying of Compensation Insurance. Except on - when value of permit is less one hundred dollars ($100 . 00) , or signed affidavit by Applicant that no ,than one will be employed, ESTIMATEp VALUATION $_ IM.ATED COMPLETION TIME ' I hereby certify that the above statement is true and I hereby cer- tify to having read the above statement and agree to comply with all laws of 'the State of California concerning employment, and, if the Building Permit is granted, do further agree that all materials and construction be strictly in accordance with all the rules, regulation and City Ordinances pertaining to such work. Also, that the surface of the street, sidewalk or alley (if any) e left in the same condition as found. I further agree to save the City of racy harmless from ail costs and damages which may accrue from the use of said Public Rights of Way an such work. ' THIS APPLICATTOIN MUST BE SIGNED BY 0W]dER OR HIS AUTHORIZED AGENT a NAME CONTRACTOR _.._ By r OWNER S ADDRESS -- -�— tPAID $ -T^ - � CONTPA.CTOR' S ADDRESS *IT ISSUED IN(J. _ DATED- ,, 19 i 1