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CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> ya SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> {� Nei ` 1810 E. HAZELTON AVENUE, STOCKTON CA 95205 <br /> BUSINESS PHONE: (209) 468-3124 <br /> • c¢(r oR�'`P• BUSINESS HOURS: 8:A.M. TO 5:00 P.M MONDAY THROUGH FRIDAY (EXCLUDING HOLIDAYS) <br /> Permit No.: AP L Contractor: <br /> Job-Site Address: l_, sr P Use of Structure:6JPPOH,){- TfOCK <br /> 5 0 � Planning Application No: -» wQ <br /> OOWnNER NAME AND ADDRESS <br /> Name: LQUtS ��ff1l �' / l� _._ <br /> Address: 2 ,�. H(,fJ P20 <br /> city.. State: Zip: Telephone:( ) Z <br /> STRUCTURE REQUIREMENTS x <br /> Occupancy Group: '^'-"" "' Occupancy Load: ----� <br /> Type of Construction: p.00K ACCESS,eL), #WKI Square Feet: <br /> Zoning : Q Fire Sprinklers: *esffto' �--� <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 /> 1 - <br /> DEA MENT OF PUBLIC WORKS <br /> XENVIRO M NTA HEALTH <br /> COUNTY FIRE WARDEN <br /> FIRE CHIEF <br /> LOCAL FIRE DISTRICT: <br /> r, <br /> L <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 Community Development 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 /> 9 <br /> ;F:IBUILOiNGIHANDQUTSIHANDOUT 072 C of O.doc(Revised 2125104) Page 1 of 2 <br />