Laserfiche WebLink
Q„ctu!n - T <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.: f� / // ,/�[' L <br /> {C` APN(,�_y _ Business License No.: !i/ o ((7 <br /> Job-Site Address: �`� � N S-r f'T C$C�y Use of Structure: <br /> Doing Business As: CM - Planning Application No.: <br /> f OWNER NAME AND ADDRESS CONTRACTOR NAME AND ADDRESS <br /> Name: 9)ALG , )A)2/ �, t= Name: <br /> Address: L;'0 U r4L Address: <br /> City,:, to State: ����7'; City: <br /> State: <br /> ZIP: PH: —O} <br /> ZIP: PH: <br /> STRUCTURE REQUIREMENTS <br /> Occupancy Group: Occupancy Load: <br /> Type of Construction: Square Feet: <br /> Zoning: �-^ Fire Sprinklers; Yes !(!o T <br /> Area Separation Wall in Lieu of Sprinklers: Yes / <br /> Heated/Cooled: ! No <br /> Before a final inspection can be made by the Building Inspection Division,and prior to issuance of a Certificate of Occupancy by the <br /> Building Official,APPROVAL SIGNATURES must be obtained from the agencies indicated below. It is the applicant's responsibility to <br /> obtain all signatures and return this form to the Building Division. Please be aware that advanced notice and a field inspection time may <br /> be required by each agency prior to signature. If your project is in a flood zone,the Building Division must have the Elevation Certificate <br /> SIGNATURES OIJ THE CERTIFICATE OF OCCUPANCY ROUTING FORM.properly signed before approval can be granted. NOTE; PLEASE BRING YOUR APPROVED BUILDING PLANS WHEN OBTAINING <br /> APPROVAL REQUIRED: <br /> DEPARTMEN PUBLIC WORKS DATE <br /> I�+�f <br /> IRO ENTAL EALTH DATE----------------- <br /> liZ° <br /> AIR POLLUTION CONTROL DISTRICT DATE <br /> COUNTY FIRE WARDEN <br /> DATE <br /> 0 <br /> FIRE CHIEF <br /> LOCAL FIRE DISTRICT: DATE <br /> 0 <br /> CITY OF STOCKTON FIRE DEPARTMENT DATE <br /> 0 <br /> CALTRANS <br /> DATE <br /> OFFICE OF EMERGENCY SERVICES — <br /> DATE <br /> COMMUNITY DEVELOPMENT THOMAS$WEESO 460-31$4 DATE <br /> NOTE TO DEPARTMENTS LISTED ABOVE: Your signature indicates that your conditions have been met. Use the reversE side of this / <br /> Farm to note comments or conditions,or to approve temporary occupancy. <br /> i <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 complete <br /> 0112001 d form has been returned. <br /> i <br /> l-'1WuifditlgkUlandoutslflandoul 72.doc(Rcviscd 01-25-2001) I <br /> Page 1 of 2 I <br /> i <br /> 1 <br /> I <br />