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oh44!N, <br /> a••..,�c.i .oma <br /> r'' z <br /> CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1810 E.HAZELTON AVENUE, STOCKTON, CA 95205 <br /> BUSINESS PHONE (209) 468-3123 <br /> Permit No.: 9S 00 222 APN: l01 - 220-4'-5 Business License No.: 92- -j-7,0 <br /> Job-Site Address: -2 6 C OF, LA, Use of Structure: f7kJM IGAT101,4 G Ep- <br /> Doing Buslness As: C)-G A.cr-L"Cr Planning Application No.: fro <br /> OWNER NAME AND ADDRESS CONTRACTOR NAME AND ADDRESS <br /> Name: O-G �cl�u.!(�- Name: �TH Lt-iftF *\ C--N5-F, L-IC <br /> Address: Address: R6 zov, 56,5- <br /> City: <br /> 65City: I-,T6CJfT0" State: Com- City: Caa.Gi1 A -PlE�- State: (,A-JA <br /> ZIP: 9 l- 43 92 PH: Crl'ZL5 ZIP: 15 PH: — <br /> STRUCTURE REQUIREMENTS <br /> IAr <br /> ccupancy Group: - �j Occupancy Load: <br /> ype of Construction: -1J Square Feet: g24- <br /> oning: AU-2O Fire Sprinklers: Yes / <br /> ea Separation Wall In Lieu of Sprinklers: Yes / No Heated/Cooled: / No <br /> Before a final Inspection can be made by the Building Inspection Division,and prior to Issuance of a Certificate of Occupancy by the <br /> Building Official,APPROVAL SIGNATURES must be obtained from the agencies Indicated below. It Is the applicant's responsibility to <br /> obtain all signatures and return this form to the Building Division. Please be aware that advanced notice and a field Inspection time <br /> may be required by each agency prior to signature. H your project Is In a flood zone,the Building Division must have the Elevation <br /> Certificate properly signed before approval can be granted. NOTE: Please bring your approved Improvement Plan when obtaining <br /> signatures on the Certificate of Occupancy Routing Form. <br /> APPROVAL REQUIRED: <br /> hJ <br /> ARTMENt OF PUBLIC RKS D T6 <br /> ENVIRONMENTAL HEAUH DATE <br /> AIR POLLUTION CONTROL DISTRICT DATE <br /> XQIA� — - <br /> COUNTY FIRE WARDEN DATE <br /> FIRE CHIEF DATE <br /> LOCAL FIRE DISTRICT: <br /> CITY OF STOCKTON FIRE DEPARTMENT DATE <br /> NOTE TO DEPARTMENTS LISTED ABOVE: Your signature indicates that your conditions have been met. Use the reverse side of this <br /> form to note comments or conditions,or to approve temporary occupancy. <br /> Once the required signatures are obtained,return this form to the Building Division. A final building Inspection will be scheduled at <br /> your request. A flnal Inspection will not be made unless this completed form has bean returned. <br />