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Mar 17 09 12:32p <br />Elite Iv Contractors Inc <br />2094616342 <br />p.1 <br />DEPARTMENT OF PUBLIC WORKS <br />0 <br />• <br />boa <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.: y' eD [a -N: APN: �7 �y — �— � -1 Contractor: <br />.— <br />Job -Site Address: oZ4 32S j;.� , 5� 2; c� �{y'. r-?pp.Use of Structure: <br />�ircl4 ft Planning Application No: <br />_._ OWNER NAME AND ADDRESS <br />Name: r9 "•"-r *- A Cy .y vicSlht <br />v� <br />Address: �-`t'� LS jti - 6r,-- �-+ C %,A-; . F2 . j -_V9 . <br />City: AANl FO.. I State: r,A Zip: Telephono:(;MP,) <br />Occupancy Group: <br />Type of Construction: <br />Occupancy Load: <br />Square Feet: <br />f�Y <br />Zoning: /�� Fire Sprinklers: Yes/ to <br />Before a final inspection can be made by the Building Inspection Division, end 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 />'PROVAL REQUI ED: <br />DATE: <br />DEPARTMENT OF PUBLIC WORKS <br />ENVIRONMENTAL HEALTH <br />�ue <br />6 <br />l/doh <br />COUN'T'Y FIRE WARDEN <br />FIRE CHIEF <br />LOCAL FIRE DISTRICT: <br />CALTRANS• <br />MOUNTAIN HOUSE CSD <br />STOCKTON METRO AIRPORT (200) 468-4700 <br />OTHER <br />OTHER <br />_ <br />NOTE TO DEPARTMENTS LISTED ABOVE: Your signature indicates that your oondiliorts have been <br />the Communitv Develooment Department to complete a final insocction. ^ re <br />Once the required signalures above are obtained, return this form to the Community <br />building inspection will be scheduled at your request. A final inspection will not bt <br />completed and returned. <br />F:10UILDINGIHANDOUTSIMAN000J 072 C UI O,dUU (Rwi*Vd 2/25104) PaQe 1 of 2 <br />authorize <br />SAN„U: <br />EN'.'r.•_ •:tL <br />HEALTH Dhr:-tTMENT <br />k <br />