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��"^�-n^..�..w'r*'Ya��t+w—�-__ �,. na-�� �..s.+.x.a+rar.�+av�..1.- .. �� -.- --.�-Y-/L-y.ow''r�i+V`v^.cR7P�s'�'K7r++•r-�.A'ri7'�d�: l^�rvr.�rs..y-'xTL <br /> r <br /> r� f <br /> CITY BUILL JG INSPECTION DEPARTME f; <br /> OF APPLICATION FOR PERMIT 1 (209) 858-5595 <br /> LATHROP 16776 Howland Rd , Suite One * Lathrop, CA 95330 <br />' 1 Job Address 00115 SEVLIITB ST Bldg 4 Suite# Subdivisiton Lot# <br /> Assessor's Parcel No lin-25U-fi115�- <br /> 2 Project Description Or Comments BUILDING N£11Pj1 {TION i SITE RENEDiATIA4 <br />' 3 Permit Class New/Add or Atter/Conversion/Re model NEW CONS1 NOT ION _ <br /> 4 Permit Type Building Mechanical Electrical Plumbing Sign <br /> Pool/Spa Demolition Reroof/Siding Other <br />' 5 PropertyOwner(s) 1 L311itST011 JAMES k & 6 2 <br /> Mailing Address P 0 EI)A 017 City/State LNTIIRCP Ck <br /> Phone Number Zip Code 9!All-i}000 <br /> 6 Occupant/Business Name Phone No <br />' Business Owners Name <br /> 7 Contractors Name SENCt Hiring Licensed Contractors (Y/N) 11 <br /> Mailing Address I217 iEVEIIIH 5TFEFT City/State ktiftSTI CA 15,41-0000 <br />' Phone Number 1-200-)N qr "t Cont St Lic <br /> 8 Project Manager's Name i-flIFB Phone No <br /> 9 Lender Name C70cc <br /> te <br /> 10 U 13 C Group U B C Type Load Stories Plan Nosh f <br />' 11 Census,Area, Value,Assessments Census No .+' Private Owners (Y/N) <br /> Cen#Census Number Description A/D/Y Per Bldg BVD Units No Sewer Water <br /> Sub Code Area'Value Code Per Bldg Tens Tens <br />' Code Or Cu Yrds Bldg of cfm of cfm <br /> Ir LLN1 1 'f I, 16 l i. 14.5 i'LP)a 3 ( , 1 'I. ! ! <br /> Total Area Total Value/Yards (,1 i,r p Zoning District . 11 <br />' THE FOLLOWING PRELIMINARY FEES ARE SUBJECT TO CHANGE BEFORE PERMIT ISSUANCE <br /> IFC -rl + rEL ,l' 3 <br /> 1h;4(r t_.. -' '1+I Ial} ".11)L,, l t �Et <br /> f�,Il i1F''i FFE; 0h,1L a L I.6 r r'_L <br /> r1,411 LLr( P0W tLrNir IIEa Is( 5ER'r11I'S 1 i tEl' <br /> a ffk PERMIT HES AvNlil (' F t!E <br /> FiTER PEPIIIT ti.Ea 11j11 '_+ tl 1' FF1 <br /> ,T#I I1,ST1ol ISP,, N1't I EL' 4 , 11)1 ILM tittS ? Ilfl 101, <br /> 3 k I P tCE3 U`1i1111.TRhf IVE <br /> fikOI+.,tF ED I'LANLlk LEES T01 L EEH C 11i <br /> HI Rt11 PLAl1 oAE1 k FFES 51111')111 P,Iu #= o) <br /> X11001. tflra 64L'Nr:L 'vft <br /> STfil'll Will i;F FEL <br />' Application Number 0075 Permit Number 1`� Activity Code { 1yS Ill <br /> Application Date q5 04 2? Issuance Date 5 f Activity Date <br /> Planning App No u <br /> ) <br /> OWNER/BUILDER/INFORMATION WORKERS'COMPENSATION <br /> f hereby elfum ilial i am licensed under provralona of Chapter 9(commenurq mull Secaan 7000)al Dmslon I Aereby a16"that I Dave a carblicalaof consent to pp61 1 F qr a,cenil,cale of Workars Compensation <br /> of WoBuswwsa and Profasarons Cada and my license is H iuu lona and allaG Insurance or a certified copy Ohereol(sec 3806 LaDM [I 2s(1L C <br /> i.iunaa0 P.,L,a Alq(ld: !taJ 1f campany- <br />