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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: &A.M. TO 5:00 P.M MONDAY THROUGH FRIDAY (EXCLUDING HOLIDAYS) <br /> Permit No.: oG O Z SO APN: 0 Q> 7- o 7 5 Contractor: <br /> Job-Site Address: ?j 9 2 9 4AJ g&A FL p .Alegi& Use of Structure: Rt<L 1 6 1 0 JS A45 Eta L y <br /> -DAD STD 6I4�To^J CA Planning Application No: PA 010004J3. <br /> OWNER NAME AND ADDRESS <br /> Name-, 6"u Q Gl.-t OF GOD L✓&,-)7-" DA <br /> Address: 311-1 H u ae C3,&+LD 2.oA p <br /> City: 5 To C,1,4 T a,j State: C A Zip: 4.2 i Z- r vo 8 Telephone:(2 a 4 ) q5-5-- 06.316 <br /> STRUCTURE REQUIREMENTS <br /> Occupancy Group: A3 e Occupancy Load: S07— <br /> Type <br /> OZType of Construction: v PEI Square Feet: 2 1 CO <br /> Zoning : Le L_ 1 Fire Sprinklers: Yes/No N <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 /> APPROVAL REQUIRED: DATE: <br /> 9 <br /> DEPART OF PUBLIC WORKS <br /> ENVIRON NT L H TH <br /> COUNTY FIRE WARDEN <br /> FIRE CHIEF <br /> LOCAL FIRE DISTRICT: <br /> CALTRANS <br /> MOUNTAIN HOUSE CSD <br /> STOCKTON METRO AIRPORT (209)468-4700 <br /> OTHER <br /> El <br /> OTHER <br /> NOTE TO DEPARTMENTS LISTED ABOVE: Your signature indicates that your conditions have been met and authorize <br /> the Comm uni Develo ment 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%BUILDINGIHANDOUTSIHANDQUT 072 C of 0 doc(Revised 06-30-09) Pagel of 2 Comm Dev 59 (07109) <br />