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- oq`gN(ty• a r.. <br /> �'-- CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> N: < <br /> 1810 E. HAZELTON AVENUE, STOCKTON CA 95205 <br /> BUSINESS PHONE: (209)468-3124 <br /> cqc%FOR��P BUSINESS HOURS: &A.M. TO 5:00 P.M MONDAY THROUGH FRIDAY (EXCLUDING HOLIDAYS) <br /> Permit No.:,'') QQ2_�`; APN:=& -030-6s Contractor: <br /> Job-Site Address: // t471 E. PALftl Use of Structure: - i-)rv- <br /> MMa „� Planning Application No: 4 <br /> / OWNER NAME AND ADDRESS <br /> Name: <br /> Address: <br /> City: State: Zip: Telephone:(? 57 <br /> STRUCTURE REQUIREMENTS <br /> Occupancy Group: Occupancy Load: 2t? <br /> Type of Construction: Square Feet: SSC 0 <br /> Zoning : I A Fire Sprinklers:;--Yes/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 /> DEPAR NT OF PIJ5LIC WORKS <br /> E IRONMENTAL HEALTH <br /> COUNTY FIRE WARDEN <br /> FIRE CHIEF <br /> LOCAL FIRE DISTRICT: <br /> El <br /> CALTRANS <br /> El <br /> MOUNTAIN HOUSE CSD <br /> El <br /> STOCKTON METRO AIRPORT(209)468-4700 <br /> El <br /> OTHER <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 /> FABUILDING\HANDOUTS\HANDOUT 072 C of O.doc(Revised 2/25/04) Page 1 of 2 Comm.Devel.59(08/08) <br />