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'QyIN <br /> z CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> ��(�FONeP SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1810 E.HAZELTON AVENUE,STOCKTON,CA 95205 <br /> BUSINESS PHONE(209)468-3123 <br /> Permit No.: APN: Business License No.: <br /> Job-Site Address: t c. Use of Structure: }"r <br /> Doing Business As: Planning Application No.: <br /> OWNER NAME AND ADDRESS CONTRACTOR NAME AND ADDRESS <br /> Name: Name: <br /> Address: r^� Address: <br /> City: State: City: State: <br /> ZIP: PH: ZIP: PH: <br /> STRUCTURE REQUIREMENTS <br /> [Zoning: <br /> cupancy Group: I' Occupancy Load: <br /> pe of Construction: Square Feet: <br /> _t " , Fire Sprinklers: Yes /No <br /> Area Separation Wall In Lieu of Sprinklers: Yes k No Heated/Cooled: r Yes,/ No <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 /> D TMENTU IC WORKS DAT <br /> 0 �j Tl�7 <br /> ENVIRONMENTAL HEALTH DATE <br /> 0 <br /> AIR POLLUTION CONTROL DISTRICT DATE <br /> 0 <br /> COUNTY FIRE WARDEN DATE /J <br /> ms s/ <br /> r7`���� <br /> FIR CE HIEF( DATE <br /> LOCAL FIRE DISTRICT: <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 forth 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 /> -`ndouls\Handout 72.doe(Revised 06-28-02) Pagel of 2 <br />