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� ) - <br /> l <br /> CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> e ) y SAN JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> :s <br /> 1810 E. HAZELTON AVENUE, STOCKTON CA 95205 <br /> ;.r BUSINESS PHONE: (209) 468-3124 <br /> s BUSINESS HOURS: 8:A.M. TO 5:00 P.M MONDAY THROUGH FRIDAY (EXCLUDING HOLIDAYS) <br /> Permit No.: 10 00 1 (OS I APN:6 SS - I1 o • 4 D Contractor: <br /> Job-Site Address: 11012, fJ . W e5 T L A J L= Use of Structure: tDI Jlj6 UAL-L_ <br /> Lp p i G�L Planning Application No: CA o 4 00 -LG S <br /> OWNER NAME AND ADDRESS <br /> Name: �)A21jAIZ DC,5UML:5VA <br /> Address: 0 1 (GSA L_A.3e <br /> City: State: Zip: 9S z 4 0 Telephone:(Zo'l z9 51415 <br /> STRUCTURE REQUIREMENTS <br /> Occupancy Group: A ?j Occupancy Load: sa 9 <br /> Type of Construction: N1. t2;> Square Feet: 4-, 1 q-L <br /> Zoning O Fire Sprinklers: egNo YLAS <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 /> 6L, C�l��� l 7- W-z<� 1p <br /> DE TMENT PUBLI WORKS <br /> z_l fLy, 8 -:;>-o/v <br /> NVIRON ENTAL EALTH <br /> COUNTY FIRE WARDEN <br /> FIRE CHIEF <br /> LOCAL FIRE DISTRICT: <br /> 171 <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:\BUILDINGIHANDOUTSIHANDOUT 072 C of O.tlac(Revle d 0&30-09) Page 1 of 2 Comm. Dev.59 (07/09) <br />