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CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> Q. �+ SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> R , 1810 E. HAZELTON AVENUE, STOCKTON CA 95205 <br /> BUSINESS PHONE: (209) 468-3124 <br /> �qC%FOR�`P BUSINESS HOURS: &A.M. TO 5:00 P.M MONDAY THROUGH FRIDAY (EXCLUDING HOLIDAYS) <br /> Permit No.: - )14 Z APN: f - Q {� Contractor: d��' -)g )�th14 <br /> Job-Site Address: s S C Use of Structure: ��--- <br /> / � Planning Application No: <br /> OWNER NAME AND ADDRESS <br /> Name: ro , <br /> Address: Q U <br /> City:` . State: ^ Zip: `� Telephone:( ) <br /> STRUCTURE REQUIREMENTS <br /> Occupancy Group: F1 Occupancy Load: <br /> Type of Construction: ff lY Square Feet: i! 6z 2CO <br /> Zoning : Fire Sprinklers: Yes/ � <br /> Before a final inspection can be made 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 /> DEP TME O PUBLIC WORKS <br /> N IRONMENTAL HEALTH 1I - <br /> o <br /> z �- <br /> COUNTY FIRE WARDEN <br /> FIRE CHIEF <br /> LOCAL FIRE DISTRICT: LP ! 14kte m t )-F, CP <br /> 71 <br /> CALTRANS <br /> El <br /> MOUNTAIN HOUSE CSD <br /> STOCKTON METRO AIRPORT <br /> �� (209)468-4700 PIT <br /> OTH R <br /> � 4 <br /> El <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 />