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Pa.UiN CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> SAN JOAQUiN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> " 1810 E. HAZELTON AVENUE, STOCKTON CA 95205 <br /> BUSINESS PHONE: (209)468-3124 <br /> • cR<iFn �'=P/ BUSINESS HOURS: 8:A.M. TO 5:00 P.M MONDAY THROUGH FRIDAY(EXCLUDING HOLIDAYS) <br /> Permit No.: Dq D — 03 Contractor: <br /> Job-Site Address: Use of Structure: -/ C,C�;Ops <br /> �-oD1 Planning Application No: LAP — 2 0 cog <br /> OWNER NAME AND ADDRESS <br /> Name: S tATE—=� � <br /> Address: r,0. p6?<- <br /> City: ST ¢ State: Gf� Zip: Telephone:{ ) Gj(a , 6 <br /> STRUCTUREREQUIREMENTS <br /> Occupancy Group: s_ Occupancy Load: p <br /> Type of Construction: 1 _14 <br /> Square Feet: <br /> Zoning : q,_ p Fire:Sprinklers: ( INo <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 /> D AR T OF PUBLIC WORKS <br /> ENVI ONMENTAL ALTH <br /> COUNTY FIRE WARDEN <br /> FIRE CHIEF <br /> LOCAL FIRE DISTRICT: <br /> CALTRANS <br /> El <br /> MOUNTAIN HOUSE CSD <br /> STOCKTON METRO AIRPORT(209)468-4700 <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 /> returned. <br /> FABUILDINGIHANDOUTS%HANDOUT 072 G of O.doc(Revised 2125104) Page 1 of 2 <br />