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CERTIFICATE OF OCCUPANCY ROUTING FORMA <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1810 E. HAZELTON AVENUE, STOCKTON CA 95205 <br /> R BUSINESS PHONE: (209) 468-3124 <br /> F'0 BUSINESS HOURS: 8:A.M. TO 5:00 P.M MONDAY THROUGH FRIDAY(EXCLUDING HOLIDAYS) <br /> Permit No.:6 02,+ _320,6 Contractor: <br /> Job-Site Address: ! ZOto Use of Structure: CE4:01M. C <br /> , Planning Application No: —Q,j''`j <br /> h, � A OWNER NAME AND ADDRESS <br /> Name: ��'t/� FT 7 �. <br /> Address: 5 <br /> City: State: Zip: Telephone:( 1C 361-3910 <br /> STRUCTURE RECJUIREMEATS <br /> i Occupancy Group: Occupancy Load: Q <br /> Type of Construction: V Square Feet: �Q j <br /> I <br /> Zoning : Fire Sprinklers: Yesno <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 /> k Please be aware that advanced notice and a field inspection time may be required by each agency prior to signature. <br /> o NOTE: PLEASE BRING YOUR APPROVED BUILDING PIANS WHEN OBTAINING SIGNATURES ON THE CERTIFICATE OF <br /> OCCUPANCY ROUTING FORM. <br /> APPROVAL REQUIRED: DATE: <br /> DEP TM T OF PUBLI WORKS <br /> VI O ENA H LTH <br /> COUNTY FIRE WARDEN <br /> ' FIRE CHIEF <br /> LOCAL FIRE DISTRICT: <br /> i ❑ <br /> CALTRANS <br /> MOUNTAIN HOUSE CSD <br /> STOCKTON METRO AIRPORT(209)4684700 <br /> El <br /> OTHER <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 /> k <br /> I <br /> .FABUILDING\RANDOUTSIHANDOUT 072 G of O.doc(Revised 2125104) Pagel of 2 <br /> I <br />