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c:ERTIFICATE OF OCCUP CY ROUTING FORM <br /> (16' SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1810 E. HAZELTON AVENUE, STOCKTON CA 95205 <br /> BUSINESS PHONE: (209)468-3124 <br /> ';j-F' BUSINESS HOUIRS: 8:A.M. TO 5:00 P.M MONDAY THROUGH FRIDAY (EXCLUDING HOLIDAYS) <br /> Permit No.:Ej 70 Z 05 7 APN: O/ o w— Contractor: <br /> Job-Site Address: Z Z11 " w/,�_co>c - Ap Use of Structure: 15 ,00-44— 61JLY <br /> Planning Application No: <br /> OWNER NAME AND ADDRESS <br /> Name: !S//Xo" rA A flt y 7'7L"s.7— <br /> Address: 0-W 95 . /C>E77"Ger-MAr" 1A)• <br /> City: Lob/ State: ex Zip: Telephone:(7.09 ) �� —92 Z�r <br /> STRUCTURE REQUIREMENTS <br /> Occupancy Group: Occupancy Load: S—/ <br /> Type of Construction: /j_ Al Square Feet: /SC 7Sl-- <br /> Zoning : ,T— !i 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 REQUIRED: DATE: <br /> DEPABTMENT OF PUBLIC WO S <br /> ENVI NMENTAL HEALTH <br /> COUNTY FIRE WARDENS�VAS_ 1444717X/ <br /> FIRE CHIEF <br /> LOCAL FIRE DISTRICT: <br /> CALTRANS <br /> El <br /> MOUNTAIN HOUSE CSD <br /> STOCKTON METRO AIRPORT(209)468-4700 <br /> El <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 /> FABUILDING\HANDOUTS\HANDOUT 072 C of O.doc(Revised 2/25/04) Page 1 of 2 <br />