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(OD <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.: 3 APN: 3 -ozo Z ^ S� <br /> Business License No.: <br /> Job-Site Address: 3 e ;2., L�.V Use of Structure: i <br /> ^ � ► I Doing Business As: 1 "pct' ,CS Planning Application No.: r <br /> f,c oDOWWNER�CNAMME AND ADDRESS CONTRACTOR NAME AND ADDRESS <br /> Name: .SI.C%f`-!`Z/ Name: �- <br /> Address: <br /> 3 Address: 20 4 <br /> C ,$ I State: <� l� City: C State: <br /> ZIP: .�Z� PH: 90Z - 9} 21P: Z� PH: 7[`'' <br /> 3 <br /> STRUCTURE REQUIREMENTS <br /> Occupancy Group: 5 0 e Occupancy Load: <br /> Type of Construction: Square Feet: 17 94Y 7 <br /> Zoning: — L Fire Sprinklers: Yes I o <br /> Area Separation Wallin Lieu of Sprinklers: Yes 1494- Heated/Cooled: Yes I <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 may <br /> be required by each agency prior to signature. If your project is in a flood zone,the Building Division must have the Elevation Certificate <br /> properly signed before approval can be granted. NOTE: PLEASE BRING YOUR APPROVED BUILDING PLANS WHEN OBTAINING <br /> SIGNATURES ON THE CERTIFICATE OF OCCUPANCY ROUTING FORM. <br /> APPROVAL REQUIRED: <br /> DEPARTMENTOF B IC WORKDATk&ZC)C� <br /> E IRONMENTAL HEALTH DATE <br /> AIR POLLUTION CONTROL DISTRICT DATE <br /> COUNTY FIRE WARDEN DATE <br /> 0 <br /> FIRE CHIEF DATE <br /> LOCAL FIRE DISTRICT: <br /> 0 <br /> CITY OF STOCKTON FIRE DEPARTMENT DATE <br /> 0 <br /> CALTRANS DATE <br /> 9 <br /> OFFICE OF EMERGENCY SERVICES DATE <br /> 0 <br /> STOCKTON METRO AIRPORT(209)4684700 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 your <br /> request. A final inspection will not be made unless this completed form has been returned. <br /> 0112001 <br /> F:\Building\Handouls\Handoul 72.doc(Revised 06-28-02) Page I of 2 <br />