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paR!n <br /> o c <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.: APN: -3-020-0-7 Business License No.: <br /> Job-Site Address: L��j'f'� 5 tvii e- Use of Structure: O P t LC R'%Ainot7-L <br /> Doing Business As: !>--I RPA CO. Planning Application No.: — <br /> OWNER NAME AND ADDRESS CONTRACTOR NAME AND ADDRESS <br /> Name: Name: <br /> Add ss: '� �'). Address: <br /> City: /Y�TEICA State: G& , City: LPH: <br /> ate: <br /> ZIP: �7j7j(o PH: /uZ-A9 ZIP: <br /> STRUCTURE REQUIREMENTS <br /> Occupancy Group: Pj Occupancy Load: 21 <br /> Type of Construction: VtA Square Feet: 22 SG <br /> Zoning: I L Fire Sprinklers: Yes / <br /> Area Separation Wall in Lieu of Sprinklers: Yes / o Heated/Cooled: es / No <br /> Boom <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 /> DEPART NT OF PUBLIC WORK DATE <br /> 2 � / :37 <br /> E VIRONMENTALHE LTH DATE <br /> 0 <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 /> CALTRANS DATE <br /> OFFICE OF EMERGENCY SERVICES DATE <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 /> 01/2001 <br /> FAI3uilding\Handcuts\Handout 72.doc(Revised 06-28-02) Page I of 2 <br />