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04/;�1/1008 15:33 FAX 20946831 SJC_COMM_DEV IA 002/002 <br /> ""CERTIFICATE OF OCC ►NICY ROUTING FORIIII <br /> { S�41N,IOAQIAN'CQUNTY CQMMUNiTY DEVELOPIUIENT DEpgRrps4ENT <br /> -181OE. HAZELTON AVENUE, STOCKTON CA 95206 <br /> BUSINESS PHONE: (209)468-3124 <br /> BUSINESS HOURS: 8:A.M. TO-5:00 P.M MONDAY THROUGH FRIDAY(EXCLUDING HOLIDAYS) <br /> Kermit Na ARN: - �� Contractor" <br /> Job-Site Address: •~:, r� Use of Structure: '' a <br /> Planning Application NO: � <br /> AOWNEF NAME AND ADDRESS <br /> :.Name: '' �. <br /> Address: �. lv' ft <br /> Al I VAI 14 <br /> City; t-' Sta#e: Zip: Telephone: <br /> STRUCTURE REQUIREMENTSef <br /> ` <br /> Occupancy Croup: Occupancy toad: <br /> Type of Construction: Square Feet: <br /> Zoning : a ''I F=ire Sprinklers: Yes/ <br /> Before a final inspection can be made by the Eluldlng Inspection Division, and prior to issuance of a Certificate of <br /> Occupancy by the Building Official, APPROVAL,SIGNATURES roust be obtained from the agencies indicated below, It is <br /> th&AVptic�&Tbsponsibillty'to obt6k al�-,signatums and return this form to the Community Development Department- <br /> Please be avipre that advanced notice and a field Inspection time may be required by each agency prior to signature. <br /> NOTE: PLE %RING YOUR APPOt WED @U&DING.I!LA415 WHEN OBTAINING SIGNATURES ON THE CERTIFICATE OF <br /> OCCUPANCY ROUTING FORM. <br /> APPROVAL REQUIRED: DATE: <br /> DEPAR T OIPU8LlC VMRKS <br /> CN RONME AI..HEALTH <br /> C NTY FIRE W1ARDEN <br /> FlR CIES . d+t GCT�XIN <br /> LOCA IRE DISTRICT:. <br /> ❑ <br /> CALTRANS <br /> . <br /> MOUNTAIN HOUSE CSD <br /> STOCKTON METRO AIRPORT(209) 46"700 <br /> t <br /> OTHER-- <br /> El <br /> THER —❑ <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 com lets a final inspection- <br /> Once the required signatures,above are obtained, return this form to the Community Development Department. A final <br /> buildirig inspection will be scheduled at your request. A final inspection will not be scheduled until this form has_ban <br /> gM&Gted and returned. <br /> F,ABUILDINGIHMDOUTSIHANDOUT 071 G of O.dve(Revland 2126104) Pagg 1 of 2 <br />