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CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> �.:• : -ter.--. ••� <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> > 1810 E. HAZELTON AVENUE, STOCKTON CA 95205 <br /> BUSINESS PHONE: (209) 468-3124 <br /> BUSINESS HOURS: 8:A.M. TO 5:00 P.M MONDAY THROUGH FRIDAY (EXCLUDING HOLIDAYS) <br /> Permit No.:Q- `' .{29 ar I :�Zg - U*_'5 Contractor: <br /> Job-Site Address: 1/6579 EE. Ilk 1141 A01�- Use of Structure: MAf.IU, FA c1,6 t)--( <br /> 5Planning Application No: PA--6 6036 <br /> OWNER NAME AND ADDRESS <br /> Name: ( �,, (W rmcp r J ire / <br /> Address: P. V , 13V795 <br /> - <br /> City: r0C)PEM State: Zip: 57Telephone:( j, )577-5 72-1 <br /> STRUCTURE REQUIREMENTS <br /> Occupancy Group: Occupancy Load: <br /> Type of Construction: Square Feet: "5'00 <br /> Zoning : Fire Sprinklers: ,e /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 /> DEPARTME F PUBLIC WORKS <br /> NV ONMENTAL HEALTH <br /> U <br /> COUNTY FIRE WARDEN <br /> FIRE CHIEF <br /> LOCAL FIRE DISTRICT: <br /> CALTRANS <br /> El <br /> MOUNTAIN HOUSE CSD <br /> El <br /> STOCKTON METRO AIRPORT(209)468-4700 <br /> El <br /> OTHER <br /> 171 <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 /> F\BUILDING\HANDOUTS\HANDOUT 072 C of O.doc(Revised 2/25/04) Page 1 Of 2 Comm Devel 59(06/08) <br />