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app <br /> CERTIFICATE OF OC <br /> CUP�®NAY ROUTING F®�IVI <br /> G <br /> N a� SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> k I I 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.: APN: CXZ$"-2,(V_ AZ Contractor: <br /> Job-Site Address: ��-r �. Use of Structure: <br /> Planning Application No: V_ p=roO g <br /> OWNER NAME AND ADDRESS <br /> Name: <br /> Address: <br /> City: e,�F& State: CA Zip: _Cy" Telephone:(Zpj) <br /> STRUCTURE REQUIREMENTS <br /> Occupancy Group: .$ Occupancy Load: <br /> f Type of Construction: Square Feet: 3 A <br /> Zoning : 40 Fire Sprinklers: Yes j <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 1 <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 j <br /> OCCUPANCY ROUTING FORM. i <br /> APPROVAL REQUIRED: DATE: <br /> DEPARTM T OF PUBLI WORKS <br /> ENVIRONMENTAL HEALTH <br /> COUNTY FIRE WARDEN <br /> ❑ i, <br /> FIRE CHIEF <br /> LOCAL FIRE DISTRICT: <br /> ❑ l <br /> CALTRANS <br /> .MOUNTAIN HOUSE CSD <br /> STOCKTON METRO AIRPORT(249)468-4700 <br /> OTHER <br /> ❑ 1 <br /> OTHER <br /> NOTE TO DEPARTMENTS LISTED ABOVE: Your signature indicates that your conditions have been met and authorize <br /> the Community Develo ment 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 /> i <br /> F\BUILDINGNANDOUTS%HANDOUT 072 C of O.doc(Revised 2125104) Page 1 of 2 } <br />