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CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> y: < <br /> 1810 E. HAZELTON AVENUE, STOCKTON CA 95205 <br /> BUSINESS PHONE: (209) 468-3124 <br /> catiFOR��P BUSINESS HOURS: 8:A.M. TO 5:00 P.M MONDAY THROUGH FRIDAY (EXCLUDING HOLIDAYS) <br /> Permit No.:) ),5 I APN: Contractor: <br /> Job-Site Address: j `+ P14,L)" ALIS , Use of Structure: ' <br /> MAt-'Ir Planning Application No: <br /> t� OWNER NAME AND ADDRESS <br /> Name: r�d rvi <br /> Address: P.(0. 61x 79 <br /> City: ,SIG PFFD State: (h Zip: ` � Telephone:( :A)9 ) 6V-572. <br /> STRUCTURE REQUIREMENTS <br /> Occupancy Group: F-1 Occupancy Load: c) <br /> Type of Construction: V8 Square Feet 1)'195_0 <br /> Zoning : --W Fire Sprinklers: es/No <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 /> DEP RTME F PUB WORKS <br /> _ /7 <br /> ENVIRONMENTAL HEArTH <br /> COUNTY FIRE WARDEN <br /> FIRE CHIEF <br /> LOCAL FIRE DISTRICT: <br /> El <br /> CALTRANS <br /> El <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 Communitx 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 /> FABUILDING\HANDOUTS\HANDOUT 072 C of O.doc(Revised 2/25/04) Page 1 of 2 Comm.Devel.59(08/08) <br />