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92-0828
Environmental Health - Public
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EHD Program Facility Records by Street Name
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MARSH
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5104
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4200/4300 - Liquid Waste/Water Well Permits
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92-0828
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Last modified
3/25/2020 10:08:02 PM
Creation date
12/3/2017 1:28:11 AM
Metadata
Fields
Template:
EHD - Public
ProgramCode
4200/4300 - Liquid Waste/Water Well Permits
RECORD_ID
92-0828
STREET_NUMBER
5104
Direction
E
STREET_NAME
MARSH
STREET_TYPE
ST
City
STOCKTON
SITE_LOCATION
5104 E MARSH ST
RECEIVED_DATE
04/20/1992
P_LOCATION
ELBA LEWIS
Supplemental fields
FilePath
\MIGRATIONS\M\MARSH\5104\92-0828.PDF
QuestysFileName
92-0828
QuestysRecordID
1845863
QuestysRecordType
12
Tags
EHD - Public
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AUTHORIZATION FOR APPLICATION FOR PERMIT(S) <br /> BY OTHER THAN OWNER OR LICENSED CONTRACTOR <br /> !E <br /> { <br /> r r ? <br /> TO: San Joaquin County I <br /> Department of Planning and <br /> Building Inspection <br /> { 1810 ,E. Hazelton Avenue <br /> Stockton,rICA 95205 <br /> Phone ( 209) 468-3123 <br /> 1 , as the owner of the 'property, understand or have been <br /> informs& 4U44 'ht* scat [,sn for a Aiaa;,ldk"Oo P srri i � <br /> Electrical Permit must be signed by the owner of the <br /> property, his jduly 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:Ijthe owner of the property .located at._ <br /> A"IPP I. '1 Stockton, CA <br /> address ) <br /> I do hereby authorize <br /> name <br /> to obtain a in my. name by affixing <br /> type of permit <br /> s <br /> my name followed by his or her signature on the application <br /> it <br /> y for' <br /> type of permit <br /> 'OWNER' S SIGNATURE <br /> OWNER' S. ADDRESS. <br /> DATE <br /> OWNER'S PHONE NUMBER C�c�' T ` <br />
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