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CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1810 E.HAZELTON AVENUE,STOCKTON,CA 95205 <br /> BUSINESS PHONE(209)468-3123 <br /> EZIP:-- ? <br /> b <br /> a2 C) APN:(jd `� Business License No.: --- <br /> dress: . rs j �' Use of Structure: y J�� F0Z le <br /> ess As: Planning Application No.: <br /> < <br /> OWNER `NAME AND ADDRESS CONTRACTOR NAME AND ADDRESS <br /> J�lv �7 }� }•� Name:� 0 Gf Address: <br /> State: City: State: <br /> _, ZIP: PH: <br /> STRUCTURE REQUIREMENTS <br /> [Area <br /> cupancy Grou7Liuof <br /> Occupancy Load: - <br /> pe of ConstruSquare Feet: <br /> ning: Fire Sprinklers: Yes <br /> Separation ers: Yes / Heated/Cooled: Yes / <br /> Before a final inspection can be made by the Building Inspection Division,and prior to issuance of a Certificate of Occupancy by the <br /> Building Official,APPROVAL SIGNATURES must be obtained from the agencies indicated below. It is the applicant's responsibility to <br /> obtain all signatures and return this form to the Building Division. Please be aware that advanced notice and a field inspection time may <br /> be required by each agency prior to signature. If your project is in a flood zone,the Building Division must have the Elevation Certificate <br /> properly signed before approval can be granted. NOTE: PLEASE BRING YOUR APPROVED BUILDING PLANS WHEN OBTAINING <br /> SIGNATURES ON THE CERTIFICAT OF OC Y ROUTING FORM. <br /> APPROVAL REQUIRED: <br /> DEPARTMET'0A.PBLNUWO KS DATE <br /> NVIRONMENTAL HEALTH DATE <br /> 0 <br /> AIR POLLUTION CONTROL DISTRICT DATE <br /> 0 <br /> COUNTY FIRE WARDEN DATE <br /> 0 <br /> FIRE CHIEF DATE <br /> LOCAL FIRE DISTRICT: <br /> 0 <br /> CITY OF STOCKTON FIRE DEPARTMENT DATE <br /> 0 <br /> CALTRANS DATE <br /> 0 <br /> OFFICE OF EMERGENCY SERVICES DATE <br /> 0 <br /> STOCKTON METRO AIRPORT(209)468-4700 DATE <br /> NOTE TO DEPARTMENTS LISTED ABOVE: Your signature indicates that your conditions have been met. Ilse the reverse side of this <br /> fora to note comments or conditions,or to approve temporary occupancy. r <br /> Once the required signatures are obtained, return this form to the Building Division. A final building inspection will be scheduled at your <br /> request. A final inspection will not be made unless this completed form has been returned. <br /> 01/2001 <br /> F:\13uiIding\Handouts\Handout 72.doc(Rcviscd 06-28-02) Page 1 of 2 <br />