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ot,44!!!r <br /> v <br /> CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1810 E HAZELTON AVENUE,STOCKTON, CA 95205 <br /> BUSINESS PHbNE (209) 468-3123 <br /> [!-A; <br /> ` t�' rte. APN: i ;3- 1�i -i t Business License No.: <br /> dress: rc f }_ -v.r i r—i i Ci' v it) >. Use of Structure: {- <br /> ness As: Planning Application No.: <br /> OWNER NAME AND ADDRESS CONTRACTOR.NAME AND ADDRESS <br /> y ,s r ! J r,•�Fj..l( �i'Ji�'J �j - �:�rocklur.-1 Name: V. } <br /> j�:� j j 1.i►j!�)la !7T Address:_ �i r State: r City: � :jC�r .`} � j State:Lx <br /> 1_r�.. PH: ZIP: )��'? �� PH: <br /> STRUCTURE REQUIREMENTS <br /> Occupancy Group: A- Occupancy Load; <br /> Type of Construction: Square Feet: ��.?--= <br /> Zoning: (� Fire Sprinklers: Yes /(No) <br /> Area Separation Well In Lieu of Sprinklers: Yes /tfio Heated/Cooled: y / No <br /> Before a final inspection can be made by the Building Inspection Division,and prior to Issuance of a Certiflcate 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. If 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 /> *innrtw^oe nn th^rorrinu.*tA of Arcrinenr_v Routing Form. i <br /> 1 <br /> APPROVAL REQUIRED: <br /> r <br /> L G , C <br /> DEPARTMENT OF PUBLIC WORKS OAT <br /> Cd 3 r 5 <br /> ENVIRONMENTA H LTH BATE <br /> AIR POLLUTION CONTROL DISTRICT DATE <br /> COUNTY FIRE WARDEN DATE <br /> FIRE CHIEF l DATE <br /> LOCAL FIRE DISTRICT: <br /> a <br /> CITY OF STOCKTON FIRE DEPARTMENT DATE <br /> NOTE TO DEPARTMENTS LISTED ABOVE: Your signature Indicates that yaur conditions have been met. Use the reverse side of this <br /> form to note comments or conditions, or to approves 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 final Inspection will not be made unless this completed form has been returned. <br /> r I r <br />