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CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1810 E. HAZELTON AVENUE, STOCKTON CA 95205 <br /> BUSINESS PHONE. (209) 468-3124 <br /> BUSINESS HOURS: 8:A.M. TO 5:00 P.M MONDAY THROUGH FRIDAY (EXCLUDING HOLIDAYS) <br /> Permit No.: � APN: Q 07, - t Contractor: <br /> .fob-Site Address: S �� Use of Structure: <br /> -tL2 Planning Application No: -LOO <br /> C) <br /> NAME AND ADDRESS <br /> Name: $' tJ a�G{►� !�� <br /> Address: 4 fLr Q <br /> r <br /> City: Tip — AJ State: &A Zip t ti Telephone:( Z61 3 6 If 0 <br /> STRUCTURE REQUIREMENTS <br /> Occupancy Group: Occupancy Load: <br /> Type of Construction: /tA Ak r At- . Square Feet: <br /> Zoning A J • -2-ID Fire Sprinklers: Yes/No <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 /> xDEPARTMENT OF PUBLIC WORKS <br /> I .� 5 /v v <br /> ENVIRONMENTAL HEALTH <br /> COUNTY FIRE WARDEN <br /> FIRE CHIEF , <br /> p j �. A- d <br /> LOCAL FI Fj DI TF31 [;+ <br /> ❑ <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.IBUILDINGNANDOUTSIHANDOUT 072 C of 0 doc(Revised 06-30-09) Page 1 of 2 Comm Dev 59 (07109) <br />