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CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> w 1810 E. HAZELTON AVENUE, STOCKTON CA 95205 <br /> _ BUSINESS PHONE: (209) 468-3124 <br /> BUSINESS HOURS: 8:A.M. TO 5:00 P.M MONDAY THROUGH FRIDAY (EXCLUDING HOLIDAYS) <br /> Permit No.: 04-0+-72APN: l-19-- !"t2- l5 Contractor: n%\/- Ug <br /> Job-Site Address: 4' t p !� S'j, {0= Use of Structure: C4T=gA,,4C, TpjcK rye. <br /> Planning Application No: F^ -030005Z. <br /> OWNER NAME AND ADDRESS <br /> Name: lY_,z,,R10 A,4`T6Ni C) 5�¢ za►.IO <br /> Address: <br /> City: C-KT64 State: zip: Telephone:( ) 2,45-- 41 -71 <br /> STRUCTURE REQUIREMENTS <br /> Occupancy Group: - 1 Occupancy Load: 115 <br /> Type of Construction: v Square Feet: <br /> Zoning : l r G Fire Sprinklers: Yes/0 <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 /> Af <br /> DEP TM OF PU WO <br /> y�, <br /> ENVIRONMENTAL HEALTH <br /> COUN F E R N <br /> l/12z j6 <br /> FIRE EHIfF <br /> LOCAL FIRE DISTRICT: <br /> CALTRANS <br /> El <br /> MOUNTAIN HOUSE CSD <br /> 171 <br /> STOCKTON METRO AIRPORT(209)468-4700 <br /> El <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 farm has been <br /> completed and returned. <br /> F 0UILDING\HAND0UT$1HAN1)0UT 072 C of O.doc(Revised 2125104) Page 1 of 2 <br />