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pqu[h <br /> r CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> • ��<iF6'n`�P• SAN JOACUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1810 E.HAZELTON AVENUE,STOCKTON,CA 95205 <br /> BUSINESS PHONE(209)4§8-3123 <br /> LAddress: <br /> Q 2�>� APN:Qj(-O j-05 Business License No.: b2 X64' <br /> ress: 82(S . �, [�I`E )2 Use of Structure: �Y(I-1 y 1j�,jO�j <br /> ss As: CSC Gff0L0 q(Li-1eP Planning Application No.: PA-O Z- 19 �- <br /> OWNER NAME AND ADDRESS CONTRACTOR NAME AND ADDRESS <br /> K,qy LD Name: cwtge�9--- &UiLL' <br /> g2(s [— 5'[ p--[� 2 Address: <br /> C) State:4C{�, City: State: <br /> �{p PH: /�j -271+ ZIP: PH: <br /> STRUCTURE REQUIREMENTS <br /> Occupancy Group: Occupancy Load: (d <br /> Type of Construction: v tq Square Feet: rocco - Csuw(4LI; -0O 0 CZUGMO0 <br /> Zoning: Fire Sprinklers: Yes I 0 <br /> Area Separation Wall in Lieu of Sprinklers: Yes I N� Heated/Cooled: ®e I No <br /> Before a final inspection can be made by the Building Inspection Division,and prior to issuance of a Certificate of Occupancy by the <br /> Building Official,APPROVAL SIGNATURES must be obtained from the agencies indicated below. It is the applicant's responsibility to <br /> obtain all signatures and return this form to the Building Division. Please be aware that advanced notice and a field inspection time may <br /> be required by each agency prior to signature. If your project is in a flood zone,the Building Division must have the Elevation Certificate <br /> properly signed before approval can be granted. NOTE: PLEASE BRING YOUR APPROVED BUILDING PLANS WHEN OBTAINING <br /> SIGNATURES ON THE CERTIFICATE OF OCCUPANCY ROUTING FORM. <br /> APPROVAL REQUIRED: <br /> DEPARTMENT 9F PUBLIC WORKS DATE <br /> OSS <br /> ENVIRONMENTAL HEALTH DATE <br /> AIR POLLUTION CONTROL DISTRICT DATE <br /> COUNTY FIRE WARDEN / A DATE <br /> P91forly71. 1-2, �GFiCKILI Mj4ilk iJ,frSrt✓l. 4 Z( D� <br /> FIRE CHIEF DATE <br /> LOCAL FIRE DISTRICT: MbkGj-'o DI.Sr <br /> 0 <br /> CITY OF STOCKTON FIRE DEPARTMENT DATE <br /> CALTRANS DATE <br /> OFFICE OF EMERGENCY SERVICES DATE <br /> STOCKTON Y2TRO AIRPORT(2W,t88-4;00. _ .^..iTE. . <br /> NOTE TO DEPARTMENTS LISTED ABOVE: Your signature indicates that your conditions have been met. Use the reverse side of this <br /> form to note comments or conditions,or to approve temporary occupancy. <br /> Once the required signatures are obtained,return this form to the Building Division. A final building Inspection will be scheduled at your <br /> request. A final inspection will not be made unless this completed form has been returned. <br /> 0112001 <br /> Cj r L-c. u <br /> F:\BuiIding\Hmdouts\Handour 72.dm(Revised 06-28-02) I_ �— Page 1 Of 2 <br />