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t <br /> 'o�qu�N <br /> CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> . :r• SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1810 E.HAZELTON AVENUE,STOCKTON,CA 96265 <br /> r� BUSINESS PHONE 209 ""123 <br /> Permit No.: 600 17 AP''N1:G 3 `` 56 Business License No.: <br /> Job-Site Address: Z 1 0 . LIAi ,, Use of Structure: 4�f �f <br /> Doing Business As: � L Planning Application No.: <br /> OWNER NAME AND ADDRESS /I CONTRACTOR NAME AND ADDRESS <br /> Name: ! UH �SL. Name: �. ,1,J''4.11� m cc. <br /> Address: Address: G Z <br /> City: State: L j City: i � State: Cr'7L <br /> ZIP: PH: ZIP: L PH: 3�• �j9 <br /> STRUCTURE REQUIREMENTS <br /> Occupancy Group: /1� I' 4—I F Occupancy Load: !� 2 <br /> Type of Construction: yrs Square Feet: 7900 <br /> Zoning: �.G-}� Fire Sprinklers: Yes ! <br /> Area Separation Wall in Lieu of Sprinklers: Yes ! ® HeatedlCooled: Yes ! 1 <br /> Before a final inspection can be made by the Building Inspection Division,and prior to issuance of a Certificate of Occupancy by the Building <br /> Official,APPROVAL SIGNATURES must be obtained from the agencies Indicated below. It is the applicant's responsibility to obtain all <br /> signatures and return this form to the Building Division. Please be aware that advanced notice and a field Inspection time may be required by <br /> each agency prior to signature. If your project is in a flood zone,the Building Division must have the Elevation Certificate properly signed <br /> before approval can be granted. NOTE: PLEASE BRING YOUR APPROVED BUILDING PLANS WHEN OBTAINING SIGNATURES ON THE <br /> CERTIFICATE OF OCCUPANCY ROUTING FORM. <br /> APPROVAL REQUIRED: <br /> DEPARTMENT OF PUBLIC WORKS DATE <br /> �e ENVIRONMENTAL HEALTH DATE <br /> POLLUTION CONTROL DISTRICT DATE <br /> COUNTY FIRE WARDEN DATE <br /> FIRE CHIEF DATE <br /> LOCAL FIRE DISTRICT: <br /> El <br /> CITY OF STOCKTON FIRE DEPARTMENT DATE <br /> El <br /> CAL.TRANS DATE <br /> OFFICE OF EMERGENCY SERVICES DATE <br /> NOTE TO DEPARTMENTS LISTED ABOVE: Your signature indicates that your conditions have been met. Use the reverse side of this form to <br /> note comrrients of conditions,or to approve temporary occupancy. <br /> Frequest. <br /> ired signatures are obtained,return this form to the Building Division. A final building inspection will be scheduled at your <br /> al inspection willnot be made unless this completed form has been returned. <br />