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o � wr <br /> 'ROUTS i �0 �� <br /> IuATE OF OCCUPANCY R1% <br /> DEPARTM <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPh. ^KTON 95205 <br /> 1810 E. HAZELTON AVENUE,STG , <br /> BUSINESS PHONL;:_ ', 366-3123 <br /> Permit No.: ..:. APN: Business License No.: _T <br /> Job-Site Address: ;, ..f• i - Use of Structure: <br /> Doing Business As: Planning Application No.: <br /> OWNER NAME AND ADDRESS CONTRACTOR NAME AND ADDRESS <br /> Name: Name: , •.;;. . , . <br /> Address: Address: <br /> City: State: City: r I -;L1 State: <br /> ZIP: PH: ZIP: r 7 t PH: <br /> STRUCTURE REQUIREMENTS <br /> Occupancy Group: Occupancy Load: <br /> Type of Construction: Square Feet: <br /> Zoning: Fire Sprinklers: Yes ! No <br /> Area Separation Wall in Lieu of Sprinklers: Yes l No HeatedlCooled: Yes I No <br /> Before a final inspection Gan be made by the Building Inspection Division,and prior to issuance of a Certificate of Occupancy by the <br /> Building Off iciai,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 /> DEPARTMENT OF PUBLIC WORKS DATE <br /> LJ <br /> A:4 <br /> ENVIRONMENTAL HEALTH DATE <br /> AIR POLLUTION CONTROL DISTRICT DATE <br /> 0 <br /> COUNTY FIRE WARDEN DATE <br /> 0 <br /> FIRE CHIEF DATE <br /> LOCAL FIRE DISTRICT: <br /> CITY OF STOCKTON FIRE DEPARTMENT DATE <br /> 0 <br /> CALTRANS DATE <br /> 0 <br /> OFFICE OF EMERGENCY SERVICES DATE <br /> 0 <br /> STOCKTON METRO AIRPORT(209)468-4700 DATE <br /> NCTETO 4EPARTMENTS LISTED ABOVE: Your signature indicates that your conditions have been met. Use the reverse slde of this <br /> form to note comments or conditions,or to approve temporary occupancy. - <br /> Once the roquimtj 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 farm has been returned. <br /> i}112001 <br /> 1=:I8uildinglHandoutslHandout 72.doc(Revised 06-28-02) Paget . <br /> c. <br />