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SAN JOAQUIN RIVER CLUB, INC. <br /> 30000 Kasson Road Tracy, CA 95304 <br /> Phone (209) 835-1969 • Email sjrcinc@gmaiLcom <br /> BUILDING PERMIT <br /> APPLICANT: ,_A � VQ \/A LG. � 0-MEMBER#: (o 'E SITE ADDRESS: <br /> MAILING ADDRESS: bC7 SS S c- 'L 'w Q - <br /> CONTRACTOR: <br /> Improvement Description (include materials, size and use): <br /> -k -LA <br /> COUNTY PERMIT IS REQUIREKYES NO (Member's Initials) <br /> CLUB AND COUNTY PERMITS EXPIRES 6 MONTHS FROM APPROVAL DATE <br /> SAN JOAQUIN RIVER CLUB, INC. WILL NOT BE RESPONSIBLE FOR SITE IMPROVEMENTS <br /> • Notice is hereby given that the San Joaquin River Club, Inc. a non-profit corporation of the State of California, is <br /> the owner of certain properties as recorded in the official book of records of the San Joaquin County. <br /> • The San Joaquin River Club, Inc. will not be responsible for construction of, and/or addition to, and/or alteration <br /> of said building, or for material or labor or professional services to be used thereon. The member/applicant <br /> assumes all responsibility. <br /> • Building permits may be required from San Joaquin County, 1810E Hazelton St Stockton CA Contact the <br /> County for a complete list of improvements that require permits. <br /> • Copy of initial County site permit must be returned to the SJRC prior to construction. Permit must be posted on <br /> site and a copy of the final County site permit must be returned to the SJRC for retention in the site file. <br /> • Refer to the SJRC Building Regulations for additional information. <br /> Fee Due:$25.00 for original or renewal permit. Alternate Fee:$100.00 if project was begun prior to permit approval <br /> - CTI 1 11 <br /> s <br /> or continued after permit expired. Amount Paid:_2.4,,­- , Date: )I �' Receipt#: <br /> 1 agree to comply with the Building Regulations of the San Joaquin River Club, Inc. and the County of San Joaquin, if <br /> applicable. I agree I will in no way hold the SJRC responsible for any property damage or physical injury related to this <br /> work. I further agree to maintain all improvements and my home site in GOOD CONDITION. <br /> 1JAPPLICATION SIGNATURE: i". PHONE#: <br /> CONTRACTOR SIGNATURE:_ ��_._ PHONE#: ^ 2-hZ.O <br /> BUILDING COMMITTEE APPROVAL , BOARD APPROVAL <br /> Na MCI <br /> i _ Vt� Date: ll- ]b <br /> -- APPROVED - DESIGN ONLY <br /> Nar SUBJECT TO COUNTY HEALTH <br /> Date: i 2 -7- �� AND BUILD Lr T NS��C( <br /> J SAN JOA E` C <br /> Name: Date: W-7- 1 5 BY 1 h q <br /> Board Approved 8/15/20 DATE <br />