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i Before a final Inspection can be made by the Building Inspection Division, and prior to issuance of a Certificate of Occupancy by the Building Official, APPROVAL SIGNATURES must be obtained from the agencies indicated below. It is the applicant's responsibility to obtain all signatures and return this form to the Building Division. Please be aware that advanced notice and a field inspection time may be required by each agency prior to signature. If your project is in a flood zone, the Building Division must have the Elevation Certificate properly signed before approval can be granted. NOTE: PLEASE BRING YOUR APPROVED BUILDING PLANS WHEN OBTAINING SIGNATURES ON THE CERTIFICATE OF OCCUPANCY ROUTING FORM. APPROVAL REQUIRED: Z Z� 03 UBL1C WORKS DATE DEP ENT OF P r CERTIFICATE OF OCCUPANCY ROUTING FORM • • d• SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT „ ;p ftitloki� 1810 E. HAZELTON AVENUE, STOCKTON, CA 95205 BUSINESS PHONE (209) 458-3123 ,,� Permit No.: Q C O 008 APN: IQ� t�D— i ra Business License No.: Job -Site Address: 13'� Tpf4t Use of Structure: GO [-p Doing Business As m AA40 1 Gk Planning Application No.: r. OWNEFt:1AME ANO Al3DRESS CONTR4CTOR'NAMt AND ADQRE55 e COUNTY FIRE WARDEN Name: Name: P Q pz�t)G'� Address: P��, (C $a3S Address: 2t �� C.�� P� City: S-��G�-'�jr--i State: , City: ; ToH State: c"!� ZIP: 'Z ZIP: 5 PH:.g(o2 �. i -.... STfiUCTUR��I4EQUIREMENTS � . >r , Y Occupancy Load: cupant Grou Z ` pe of Construction: [Zkoe'a Square Feet: O2 ing: /4-b40Fire Sprinklers: fe ! No Separation Wall in Lieu of Sprinklers: Yes No Heated/Cooled: Ye 1 No i Before a final Inspection can be made by the Building Inspection Division, and prior to issuance of a Certificate of Occupancy by the Building Official, APPROVAL SIGNATURES must be obtained from the agencies indicated below. It is the applicant's responsibility to obtain all signatures and return this form to the Building Division. Please be aware that advanced notice and a field inspection time may be required by each agency prior to signature. If your project is in a flood zone, the Building Division must have the Elevation Certificate properly signed before approval can be granted. NOTE: PLEASE BRING YOUR APPROVED BUILDING PLANS WHEN OBTAINING SIGNATURES ON THE CERTIFICATE OF OCCUPANCY ROUTING FORM. APPROVAL REQUIRED: Z Z� 03 UBL1C WORKS DATE CALTRANS DATE _ OFFICE OF EMERGENCY SERVICES DATE +� COMMUNITY DEVELOPMENT THOMAS SWEESO 488-3184 DATE I , NOTE TODEPARTMENTS LISTED ABOV, E Your signature indicates that;yaur conditions have been met Use the reverse side of this form to netts corrtnierits or conditions or;to approve temporary occupancy ,, •,>, , F0112 e the required signatures are obtained, return this form to the Building Division. A final building inspection will be scheduled at your uest. A final inspection will not be made unless this completed form has been returned. 001 i � Page ! of 2 F:1Building\Handouts\Handout 72.doc (Revised 01-25-2001) DEP ENT OF P /jJ 1 ENVIRONMENT HEALTH DATE AIR POLLUTION CONTROL DISTRICT DATE COUNTY FIRE WARDEN DATE FIRE CHIEF DATE LOCAL FIRE DISTRICT: Lil'�DfGf'L " CITY OF STOCKTON FIRE DEPARTMENT DATE n CALTRANS DATE _ OFFICE OF EMERGENCY SERVICES DATE +� COMMUNITY DEVELOPMENT THOMAS SWEESO 488-3184 DATE I , NOTE TODEPARTMENTS LISTED ABOV, E Your signature indicates that;yaur conditions have been met Use the reverse side of this form to netts corrtnierits or conditions or;to approve temporary occupancy ,, •,>, , F0112 e the required signatures are obtained, return this form to the Building Division. A final building inspection will be scheduled at your uest. A final inspection will not be made unless this completed form has been returned. 001 i � Page ! of 2 F:1Building\Handouts\Handout 72.doc (Revised 01-25-2001)