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i <br /> r z CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> Edi ipcAi+�a SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1810 E.HAZELTON AVENUE,STOCKTON,CA 95205 <br /> BUSINESS PHONE(209)468-3123 <br /> Permit No.: 0107--772- APN: 3^6"a.,30 Business License No.: Z�- <br /> Job-Site Address: ] , ysr Use of Structure: S <br /> Doing Business As: Planning Application No.: � <br /> 63pW^�NEiR NJA�M!~ANfD ADdyRESS CONTRACTORNAMI AND ADDRE.S <br /> Name: .;� hL N 1t1 ► �. �f�I . Name: V�f� fF1 �� •S ""V . �i7�C. <br /> Address: �� � e Address:!� S, [, Lx J a <br /> City: (t� �11°l7 State: j City: C State:gC � <br /> ZIP: PH: Z •J�C�C�Q zip: � PH: / 2�' O <br /> i <br /> I <br /> STRUCTUREI3EQUIREMENTS <br /> Occupancy Group: S Occupancy Load: <br /> Type of Construction: Square Feet: 4r)s;o <br /> Zoning., Fire Sprinklers: Yes 1 <br /> Area Separation Wall in Lieu of Sprinklers: Yes !'N4 Heated/Cooled: Yes /(15 <br /> Before a final inspection can be made by the Building Inspection Division,and prior to issuance of a Certificate of Occupancy by the <br /> Building Official,APPROVAL SIGNATURES must be obtained from the agencies indicated below. It is the applicant's responsibility to <br /> obtain all signatures and return this form to the Building Division. Please be aware that advanced notice and a field inspection time may <br /> be required by each agency prior to signature. If your project Is In a flood zone,the Building Division must have the Elevation Certificate <br /> properly signed before approval can be granted. NOTE: PLEASE BRING YOUR APPROVED BUILDING PLANS WHEN OBTAINING <br /> SIGNATURES ON THE CERTIFICATE OF OCCUPANCY ROUTING FORM. <br /> APPROVAL REQUIRED: <br /> i <br /> E DEPARTMENT 9F PUBLIC WORKS DATE <br /> ENVIRONMENTAL HEALTH DATE ! <br /> 1{ <br /> r <br /> AIR POLLUTION CONTROL DISTRICT DATE <br /> COUNTY FIRE WARDEN DATE <br /> i <br /> FIRE CHIEF DATE <br /> LOCAL FIRE DISTRICT: <br /> CITY OF STOCKTON FIRE DEPARTMENT DATE <br /> CALTRANS DATE <br /> OFFICE OF EMERGENCY SERVICES DATE <br /> _ _ y'....e .�.1:•C'.w. ... r...T--'� 4 " --F.�..,�.r�yr�:---+..-t T _ =..—T�' n..��s.—.w"-�. ..... - - _ _ � _ <br /> COMMUNITY DEVELOPMENT THOMAS SWEESO 466-3164 DATE <br /> I <br /> NOTE TO DEPARTMENTS LISTEDABOVE :Your slgnature indicates that your conditions have`been met. Use the reverse side of this ; <br /> form to notecomments or conditions or tc'3a rove temporary occupancy ' <br /> pp <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. <br />! 0112001 <br /> t <br /> I <br /> F:1BuildinglHandoutslHandout 72.doe(Revised 01-25-2001) Pagel of 2 <br />