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CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1810E. ON AVENUE, STOCKTON CA 95205 <br /> HAZELTBUSINESS PHONE: (209)468-3124 <br /> BUSINESS HOURS: &A.M. TO 5:00 P.M MONDAY THROUGH FRIDAY (EXCLUDING HOLIDAYS) <br /> Permit No.: b(p(} X89 APN:o2f7 -O-rv- Contractor: <br /> Job-Site Address: /Z gyp/ S. �j,/L%• 9q W r-A.0,tf7_ Use of Structure: W4-,ZWeOaa;7-,4 <br /> Planning Application No: Jam,¢ -06,00.52-/ <br /> OWNER NAME AND ADDRESS <br /> Name: <br /> Address: /200/ f/�y 99 S'• R- 1r-_ye6)AJ' f&F <br /> City: ,¢r(/ State: C=,4- Zip: �j�r'33C, Telephone:( 2 ) d'�' 3�peo <br /> STRUCTURE REQUIREMENTS <br /> Occupancy Group: Occupancy Load: /Z <br /> Type of Construction: Square Feet: <br /> Zoning : 0 Fire Sprinklers: e No <br /> Before a final inspection can be mad6 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 /> DE MENT OF PUBLIC �RKS <br /> ENVIR MENTAL HEALTH <br /> COUNTY FIR WAR-DEN - s���5 <br /> -� <br /> E CHIEF <br /> LOCAL FIRE DISTRICT: <br /> El <br /> CALTRANS <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 /> F:\BUILDING\HANDOUTS\HANDOUT 072 C of O.doc(Revised 2/25/04) Page 1 of 2 <br />