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I <br /> CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> -SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1810E HAZELTON AVENUE, STOCKTONCA95205 <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.: I: QZ Contractor , T,AyIO/Z g1/td <br /> Job-Site Address: 3934- Al. / lriTOrc/ /LD Use of Structure: 40" MOD. cir_rK�67, <br /> Planning Application No: <br /> 6WNER NAME AND ADDRESS <br /> Name: CC_ <br /> Address: . t�). *iOX 3'G?Z <br /> City:. LSlZkX- 7Z'A State: c�X Zip: z/S' Telephone:(661 ) 29{C-10 5/ <br /> STRUCTURE REQUIREMENTS <br /> Occupancy Group: ;6 Occupancy Load: / <br /> Type of Construction: //X/ fSquare Feet: ?a <br /> Zoning : / L Fire Sprinklers: Ye <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 /> DEPART NT OF PUBLIC WORKS <br /> ENVIRONMENTAL HEALTH <br /> COUNTY FIRE WARDEN <br /> FIRE CHIEF - <br /> LOCAL FIRE DISTRICT: <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:IaUILDING\HANDOUTS\HANDOUT 072 C of O.doc(Revised 2/25/04) Page 1 Of 2 <br />