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°AQP!" CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> y { SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1810 E. HAZELTON AVENUE, STOCKTON CA 95205 <br /> .. BUSINESS PHONE: (209) 468-3124 <br /> 9�/FOR��P BUSINESS HOURS: 8:A.M. TO 5:00 P.M MONDAY THROUGH FRIDAY (EXCLUDING HOLIDAYS) <br /> Permit No.: Contractor- <br /> Job-Site Address: �7� ��; . / "' 1,, Use of Structure: <br /> Planning Application No: <br /> OWNER NAME AND ADDRESS <br /> Name: .5 ,�t� 9'9l /H - <br /> Address: 73 0J • 7u R t-*K P-4,-ND <br /> City: State -C-4,17Zip: Z Telephone:(Z(711 ) — MC) <br /> STRUCTURE REQUIREMENTS <br /> Occupancy Group: •------ Occupancy Load: <br /> Type of Construction: evj Square Feet: <br /> Zoning : - Fire Sprinklers: <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 N O PUBLIC W RKS <br /> ENVIRONMENTAL HEALTH <br /> El <br /> COUNTY FIRE WARDEN <br /> FIRE CHIEF <br /> LOCAL FIRE DISTRICT: <br /> CALTRANS <br /> El <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 /> FABUILDING\HANDOUTS\HANDOUT 072 C of O.doc(Revised 2/25/04) Page 1 of 2 <br />