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03/08/2004 08:27 91 2126 CHAMPION CONTRACTORS PAGE 02 <br /> ra tr <br /> CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> orb y� SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1010 E.HAZEL!ON AVENUE,STOCKTON.CA 96205 <br /> BUSINESS PHONE 1209).440-3123 <br /> Pertrlll No.: Q APN: a Ruslness License No.' -^Q3-�137. <br /> Jo4 Site Address: Use pf 3tructuw: <br /> Doing Business Ac: Planning Application No.: <br /> OWNER NAVI_AND ADDRESS CONTRACTOR NAME AND ADDRESS <br /> Name: 6 p� / - [. Name: ) j <br /> Address: Address: <br /> City: State: City: State: <br /> Yip: jr, PH: ZiP: PH: �- <br /> STRUM, Rt REQUIREMENTS <br /> F-* <br /> ncy Getup OcIvpaney 1 oad: <br /> f Construction: Square Fest 2. „ <br /> * �— Fin Sprinklers: Yes <br /> i <br /> Area eparstton Wall In Lieu of Sprinklers: Yes o HeateNGovlsd: a No <br /> 8etore a Final Inspection can be matte 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 applicanra responsibility to <br /> obtaln all signeturas and return ItNs 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. It your project Is In a Flood zone,the Building Division must have the Elevatlon Csrtifleate <br /> property signed before approvd can be granted. NOTE' l5l- �E BRING YOUR APPkOVF-U BUILDING PLANS WHEN OBTAINING <br /> SIGNATURES ON THE CFRTIFICATE OF OCCUPANCY ROUTING FORM. <br /> APPROVAL REQUIRED: <br /> a <br /> DEPARTMENT OF P BLIC WORKS DATE <br /> °NFeNT I�Ay DATE <br /> AIR POLLUTION CONTROL DISTRICT DOTE <br /> 0 <br /> COUNTY FIRE WARDEN DATE <br /> FIRE CHIEF DATE <br /> LOCAL FIRE OtSTRICT: <br /> CITY OF STOCKTON FIRE DEPARTMENT OATIw <br /> CALTRANS DATE <br /> 0 -- <br /> OFFICE OF EMERGENCY SERVICES T DATE <br /> IJ - <br /> STOCKTON METRO AIRPORT(209)4611.4700 DATE <br /> NOTE TO DEPARTMENTS USTED ABOVE: Your signature Indicates that your conditions have Doan met. Use the rr eree Olds df Fi <br /> form to note comments.or-conditions,or to approve temporary occupancy. <br /> Once the required algraturee are obtained,return this form to the Building Division. A Final bui)dine Inspection wiTI by Scheduled at your <br /> request. A 11nal Inspection will not be made unless this completed form has been returned. <br /> 41!2001 <br /> f^,F1rrlldingltiendnurclHaiTdout 72.dm(Rc-ised D649-021 page I of 2 <br />