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CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> Q. SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> billy: t <br /> 1810 E. HAZELTON AVENUE, STOCKTON CA 95205 <br /> BUSINESS PHONE: (209)468-3124 <br /> 4�iFOR BUSINESS HOURS: 8-.A.M. TO 5:00 P.M MONDAY THROUGH FRIDAY (EXCLUDING HOLIDAYS) <br /> Permit No.: - APN: Contractor- <br /> Job-Site Address: _,., _ _fi Use of Structure: <br /> Planning Application No: <br /> OWNER NAME AND ADDRESS <br /> Name: <br /> Address: „ . • °, <br /> City: Zip: , .� F Telephone:(_ <br /> STRUCTURE REQUIREMENTS <br /> Occupancy Group: _ - Occupancy Load: <br /> Type of Construction: Square Feet: <br /> Zoning : Fire Sprinklers: Yes/Na <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 /> !VOTE: PLEASE BRING YOUR APPROVED BUILDING PLANS WHEN OBTAINING SIGNATURES ON THE CERTIFICATE OF <br /> OCCUPANCY ROUTING FORM. <br /> APPROVAL REQUIRED: DATE: <br /> El <br /> El DEPARTMENT OF PLIC WORKS <br /> ll l <br /> ANN?�T L HEALTH UB <br /> COUNTY FIRE WARDEN _ <br /> FIRE CHIEF <br /> LOCAL FIRE DISTRICT: <br /> El <br /> CALTRANS <br /> El <br /> MOUNTAIN HOUSE CSD <br /> STOCKTON METRO AIRPORT (209)468-4700 <br /> CSGmDllarzGe �t!! —/—C� TCo —/—G� ULZo —/—C-� <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 he scheduled at your request. A fins! inspection will not be scheduled until this form has be-- <br /> completed and returned, <br /> F\BUILDINGIHANDOUTS\HANDOUT 072 C of O.doc(Revised 2125104) Page 1 of 2 <br />