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CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT , <br /> N: Gi <br /> 1810 E. HAZELTON AVENUE, STOCKTON CA 95205 <br /> BUSINESS PHONE: (209)468-3124 <br /> BUSINESS HOURS: 8:A.M. TO 500 P.M MONDAY THROUGH FRIDAY(EXCLUDING HOLIDAYS) <br /> Permit No.: ^:�,f APN: j Ito-, Contractor. <br /> . .)r .• <br /> Jot;-Site Address: gip,% sd Use of Structure: ' ? <br /> Planning Application No: <br /> OWNER NAME AND ADDRESS <br /> Name: U Z id <br /> Address: f. r / <br /> City: :' State:,`', Zip: -; �} Telephone:(., <br /> Y STRUCTURE REQUIREMENTS <br /> Occupancy Group: r^; Occupancy Load: <br /> Type of Construction: i�l Square Feet: <br /> Zoning : r" r 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 /> DATE: <br /> APPROVAL REQUIRED: <br /> F �f <br /> ' DEPARTMENT OF PUB WORKS <br /> EN NMENTAL HEALTH <br /> COUNTY FIRE WARDEN <br /> I FIRE CHIEF <br /> LOCAL FIRE DISTRICT: r f <br /> CALTRANS <br /> I'I MOUNTAIN HOUSE CSD <br /> 4 ` <br /> ❑ STOCKTON METRO AIRPORT(209)468-4700 <br /> OTHER <br /> OTHER <br /> i <br /> NOTE TO DEPARTMENTS LISTED ABOVE: Your signature indicates that your conditions have been met and authorize <br /> the Communi!X Development Department to complete a final inspection, <br /> Once the required signatures above are obtained, return this form to the Community Development Department. A#anal <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:IBUILDINMHAI'r?,UTSIHANDOUT 072 C of O.doc(Revised 06-30-09) Page 1 of 2 Comm Dev.59 (07109) <br />