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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) 468-3124 <br /> BUSINESS HOURS: &A.M. TO 5:00 P.M MONDAY THROUGH FRIDAY(EXCLUDING HOLIDAYS) <br /> Permit No . APN: O- Contractor: jc / <br /> ,lob-Site Address: r 2 T #y Use of Structure: <br /> Planning Application No: .— 3 <br /> OWNER NAME AND ADDRESS <br /> Name: <br /> Address: Q ' <br /> City: D State: ,Q Zip. Telephone:( ) <br /> STRUCTURE REQUIREMENTS <br /> Occupancy Group: 571Occupancy Load: 2 <br /> Type of Construction: Square Feet: <br /> Zoning : Q Fire Sprinklers: Yes o <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_ R UIRED: DATE- <br /> D <br /> ATE: <br /> ACOUN <br /> MENT F PUBLICWORKS <br /> NTAL HEALTk L�) <br /> FIRE WARDEN <br /> FIRE CHIEF <br /> LOCAL FIRE DISTRICT: j <br /> tyRANS <br /> I MOUNTAIN HOUSE CSD <br /> N ❑ <br /> STOCKTON METRO AIRPORT(209)468-4700 <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 /> F FABUILDINGIHANDOUMHANDOUT 072 C of O.doo(Revised 06-30-09) Page 'I of 2 Comm.Dev.59 (07109) <br />