Laserfiche WebLink
CERTIFItXTE OF OCCUPANCY ROUTING FORM <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1810 E.HAZELTON AVENUE,STOCKTON,CA 96246 <br /> 2 BUSINESS PHONE 209 4683123 <br /> FAddress: <br /> 1146 3'01-5 APN Z-�r -lyC7_ \-)4 Business License No.: <br /> dress: �.5 u l� .����.1� f Use of Structure:lW�j ir!C�+CXj:>Z <br /> ness As: Planning Application No.: <br /> OWNER NAME AND ADDRESS " <br /> "CONTRACTOR NAME AND ADDRESS': <br /> L t' L� ��?jy� 1� Name: <br /> �p�� \ll " �..) � Address: <br /> State: City: State: <br /> PH: �:5 Gam- oar}`-!1 21P: PH: <br /> { <br /> STRUCTURE.REQUIREMENTS i <br /> Occupancy Group: --� Occupancy Load: l 1 <br /> Type of Construction: Square Feet: <br /> Zoning. <br /> Fire Sprinklers: Yes ! No <br /> i <br /> Area Separation Wall in Lieu of Sprinklers: Yes T No HeatedlCooied: Yes <br /> Before a final inspection can be made by the Building Inspection Division,and prior to Issuance of a Certificate of Occupancy by the Building <br /> Official,APPROVAL SIGNATURES must be obtained from the agencies Indicated below. It Is the applicant's responsibility to obtain all I } <br /> signatures and return this form to the Building Division. Please be aware that advanced notice and a field Inspection time may be required by ! <br /> each agency prior to signature. If your project Is In a flood zone,the Building Division must have the Elevation Certificate properly signed F <br /> before approval can be granted. NOTE: PLEASE BRING YOUR APPROVED BUILDING PLANS WHEN OBTAINING SIGNATURES ON THE i <br /> CERTIFICATE OF OCCUPANCY ROUTING FORM. <br /> APPROVAL REQUIRED: <br /> a _3Z; <br /> DF ICRTMENT OF PUBLIC WORKS DATE <br /> 1//1 7i: I <br /> 1 <br /> ENVIRONMENT HEALTH DATE <br /> LO <br /> AIR POLLUTION CONTROL DISTRICT DATE <br /> L) <br /> COUNTY FIRE WARDEN DATE <br /> 1 <br /> ❑ { I <br /> FIRE CHIEF DATE <br /> i ! <br /> LOCAL FIRE DISTRICT: <br /> CITY OF STOCKTON FIRE DEPARTMENT DATE I <br /> i <br /> t <br /> CALTRANS DATE <br /> j <br /> OFFICE OF EMERGENCY SERVICES DATE <br /> NOTE TO DEPARTMENTS LISTED ABOVE: Your signature indicates that your;conditions have:been met. Use the reverse side of this form to } <br /> note catnrrients or conditions,or to approve tern#wraryoccupancy. <br /> t <br /> Once the required signatures are obtained,return this form to the Building Division. A final building inspection will be scheduled at your <br /> request. A final Inspection will not be made unless this completed form has been returned. I <br /> .07195 <br /> i. <br /> X <br /> ' k <br />