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V3/'Z f/ZVV6 VJ:4tt hxR LUJ466J Ib�' JJI_l Uldld_UtV 19 uu l/UV I <br /> L- w <br /> ho.y1.r CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> H SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> • �� 1810 E- HAZELTON AVENUE, STOCKTON CA 95205 <br /> BUSINESS PHONE: (209)468-3124 <br /> �4C Fol�� BUSINESS HOURS: 8.-A.M.TO 5:00 P.M MONDAY THROUGH FRIDAY (EXCLUDING HOLIDAYS) <br /> Permit No.:t�770�_-?j/ APN: - —.2_C Contractor: _ <br /> Job-Site Address: /09 = T. Use of Structure' <br /> Planning Application <br /> OWNER NAME AND ADDRESS <br /> Name: _,pr,P,47 <br /> Address: vX �,,PC <br /> City: State: Cif Zip�r TE!lephone:( ) <br /> STRUCTURE REd0 ME TN S <br /> Occupancy Group: c/ Occupancy Load: <br /> Type of Construction_ Square Feet: — <br /> Zoning : —�/o Fire Sprinklers: Yes/ <br /> Before a final inspection can be made by the Building Inspection Division, and prior 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 /> DE T Or PUBLIC WORKS <br /> ENVIRONMENTA HEAL <br /> .❑ <br /> COUNTY FIRE WAR <br /> FI HI <br /> CAL R DISTRICT AZ;(gC�-p <br /> D <br /> CALTRANS <br /> MOUNTAIN HOUSE CSD <br /> Q <br /> STOCKTON METRO AIRPORT(209)46"700 <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 /> FASUiLDINOHANDOUTSIHANDOUT 072 Col O.doe(RaviSad 2J25104) Page 1 of 2 <br />