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CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> Permit Number 40 S SCO Assessor Parcel No.- OI t p ~ <br /> (� <br /> Use of Structure : <br /> Address of Structure : <br /> Owner: O.S . ------_____.._____—v--- ---------_-_�___-__._-- <br /> _-� <br /> Contractor:ALC--L- <br /> ��—^- S <br /> C klK� Contact Phone No <br /> Occ. Group: Type of Construction: <br /> Zoning: <br /> Sprinklered : - on Wall in Lieu Occ. Load : Area Separati <br /> � Square Feet :-��-- of Sprinkler:_ <br /> Before a final. inspection can be made by the Building Inspection <br /> Division and prior to issuance of a Certificate of Occupancy by the <br /> Building Official , approval signatures must be obtained from each <br /> agency, listed below. It is the applicant ' s responsibility to obtain <br /> all signatures and return this form to the Building Division. Please <br /> be aware that advanced notice and field inspection time may be required <br /> i by each agency prior to signature . <br /> Public Works Department : <br /> Approval Signature-- <br /> -- Da Date <br /> HENRY �l . HIRATA, DIREC�'OR, PUBLIC WORKS DEPARMENT <br /> by Al. Blevins, Field Engineer <br /> Comments : _- a <br /> I <br /> San Joaquin Local Health D ' ict ; <br /> Z <br /> _ _�_ <br /> Approval. Signatur Date <br /> - --� -_ / -aZ - <br /> C. I,�; D HALL, ISI ECTOR _ - <br /> ENVIRONMENTAL HEALTH DIVISION <br /> Comments : -- t <br /> San Joaquin County Fire Warden or <br /> City of Stockton Fire Department : j <br /> Approval Signature Date <br /> STEVE THI -NES ----.---- - { <br /> COUNTY FIRE WARDEN <br /> Approval Signature - Date <br /> APPLICABLE FIRE CHIEF AND FIRE DISTRICT) <br /> Comments : <br /> ( 11/85 ) <br />