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o~9.V.!N..co <br />~'··~.···9c~:~~•...?:; <br />(I):1:-<·.·.·....... <br />~".,';' <br />&(:i;:(,.~:~~, <br />CERTIFICATE OF OCCUPANCY ROUTING FORM <br />SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br />1810 E.HAZELTON AVENUE,STOCKTON CA 95205 <br />BUSINESS PHONE:(209)468-3124 <br />BUSINESS HOURS:8:A.M.TO 5:00 P.M MONDAY THROUGH FRIDAY (EXCLUDING HOLIDAYS) <br />Permit No.:O~Li'Z.13 0 I APN:12S~L~v<\Contractor: <br />Job-Site Address:"';-4 Use of Structure:Cf.-I:"'""..IT\-'....'/..~,d ,~._.,)r:";.,.\C ("/'1,.,\./l4,0(1-~. <br />c t~,(f i...I c.,-..-\Planning Application No:r "V I I''","~v <br />.~)Lj L\c.J),l J .. <br />OWNER NAME AND ADDRESS <br />Name:'\I -\.1 c-(1'-,•,J L!", <br />Address:~(.(7 -j (u ILf «s>I \,...,( <br />City:.,~..(L T t .••••••.)I State:I \I Zip:(I c,2.,G 7 I Telephone:(), <br />STRUCTURE REQUIREMENTS <br />Occupancy Group:~').I /.:..4-Occupancy Load: <br />Type of Construction:f-~Square Feet:,I 'I..."7 /!AI.'()/1',,-oJ ) <br />, <br />Nc)Zoning:I ..\0"Fire Sprinklers:Yes/Nof <br />Before a final inspection can-be made by the Building Inspection Division,and prior to issuance of a Certificate of <br />Occupancy by the Building Official,APPROVAL SIGNATURES must be obtained from the agencies indicated below.It is <br />the applicant's responsibility to obtain all signatures and return this form to the Community Development Department. <br />Please be aware that advanced notice and a field inspection time may be required by each agency prior to signature. <br />NOTE:PLEASE BRING YOUR APPROVED BUILDING PLANS WHEN OBTAINING SIGNATURES ON THE CERTIFICATE OF <br />OCCUPANCY ROUTING FORM, <br />APPROVALREQ~~~DATE'l~h;J;:-~md 7 I~~(llENViRONMNTALHEALTH <br />0 <br />COUNTY FIRE WARDEN <br />C( <br />FIRE CHIEF <1 U(!~"'rl...0 f ,'\.>2LOCALFIREDISTRICT: <br />0 <br />CALTRANS <br />0 <br />MOUNTAIN HOUSE CSD <br />0 <br />STOCKTON METRO AIRPORT (209)468-4700 <br />0 <br />OTHER <br />0 <br />OTHER <br />NOTE TO DEPARTMENTS LISTED ABOVE:Your signature indicates that your conditions have been met and authorize <br />the Community Development Department to complete a final inspection. <br />Once the required signatures above are obtained,return this form to the Community Development Department.A final <br />building inspection will be scheduled at your request.A final inspection will not be scheduled until this form has been <br />completed and returned. <br />F:\BUILDING\HANDOUTS\HANDOUT 072 C of O.doc (Revised Oe-30-09)Page 1 of 2 Comm.Dev.59 (07/09)