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O.t''R uIN' C <br /> CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1810 E.HAZELTON AVENUE,STOCKTON,CA 9520 <br /> BUSINESS PHONE(209)468-3123 VV <br /> Permit No.: APNZ -120—17_ Business License No.: 06 -7 <br /> Job-Site Address: ,� 1• tI �� AQi Use of Structure: / �c/1?(1?.C4 <br /> NED <br /> Doing Business As: �, CQ}tirQ, t; Planning Application No.: �' (� V <br /> OWNER NAME AND ADDRESS CONTRACTOR NAME AND ADDRESS <br /> Name:_._' t ��("C�� Name: <br /> Address: Address: <br /> City:v ASA16- 1-�) State: � t 0, City: State: <br /> ZIP: L� PH: ZIP: PH: <br /> STRUCTURE REQUIREMENTS <br /> Occupancy Group: f'J Occupancy Load: <br /> Type of Construction: y�N Square Feet: <br /> Zoning: Fire Sprinklers: Yes /A'o <br /> Area Separation Walt in Lieu of Sprinklers: Yes Irl o) Heated/Cooled: e.Yes/ No <br /> F <br /> inal inspection can be made by[he Building Inspection Division,and prior to issuance of a Certificate of Occupancy by the <br /> fficial,APPROVAL SIGNATURES must be obtained from the agencies indicated below. It is the applicant's responsibility to <br /> signatures and return this form to the Building Division. Please be aware that advanced notice and a field inspection time may <br /> d by each agency prior to signature. If your project is in a flood zone,the Building Division must have the Elevation Certificate <br /> signed before approval can be granted. NOTE: PLEASE BRING YOUR APPROVED BUILDING PLANS WHEN OBTAINING <br /> RES ON THE CERTIFICATE OF OCCUPANCY ROUTING FORM. <br /> L REQUIRED: <br /> EPARTMENT PU �IC WORKS DAT <br /> -11� // 2 If U <br /> ENVIRONMENTAL HEALTH DATE <br /> 0 <br /> AIR POLLUTION CONTROL DISTRICT DATE <br /> 0 <br /> COUNTY FIRE WARDEN DATE <br /> FIRE CHIEF DATE <br /> // C r <br /> LOCAL FIRE DISTAICT:Jk.:iL I <br /> CITY OF STOCKTON FIRE DEPARTMENT DATE <br /> 0 <br /> CALTRANS DATE <br /> 0 <br /> OFFICE OF EMERGENCY SERVICES DATE <br /> 0 <br /> STOCKTON METRO AIRPORT(209)468-4700 DATE <br /> NOTE TO DEPARTMENTS LISTED ABOVE: Your signature indicates that your conditions have been met. Use the reverse side of this <br /> form to note comments or conditions,or to approve temporary occupancy. <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 /> 01/2001 <br /> F:\Buildingklnndoutb\Hmdout 72.duc(Revised 06-26-02) Page I Of 2 <br />