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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 />BUSINESNE: (209) 468-3124 <br />BUSINESS HOURS. 8:A.M. TO 5:00 P.M MONDAY THROUGH FRIDAY SEX OUDING HOLIDAYS) <br />Permit No.: Oq D Z3 1 APN: 2z-1 I Zi 0 c ti Contractor: <br />Job -Site Address: jJ5' Z U�nl M , r Use of Structure: <br />D �1 C _ <br />L4` ti 2L If 6A Planning Application No: PA C} `t C C, 41 <br />OWNER NAME AND ADDRESS <br />Name: IZ A J IL l a- C. l� ► r�1 ,G\ <br />Address: 2465 Lrjcc�(_-J <br />City: T2p, C -Y State: CQ Zip:14 37E. , ? •3 L Telephone:( LO ) 3Z - 4 -1-1 <br />STRUCTURE REQUIREMENTS <br />Occupancy Group: Occupancy Load: <br />Type of Construction: f Square Feet. 12 Z 5 S _ <br />Zoning ; ; . W Fire Sprinklers: Yes/No r4 0 <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: <br />DATE: <br />r. <br />DEP ARTM T OF PUBLIC WORK <br />' <br />/Azo/ d <br />ENVIRONMENTAL HEALTH <br />COUNTY FIRE WARDEN <br />FIRE CHIEF <br />LOCAL FIRE DISTRICT: <br />CALTRANS <br />El <br />MOUNTAIN HOUSE CSD <br />13 <br />STOCKTON METRO AIRPORT (209) 468-4700 <br />El <br />OTHER <br />11 <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 1BUILDINGIHANDOUTS%HANDOUT 072 C of 0 doc (Revised 06-30-09) Page 1 of 2 Comm Dev. 59 (07109) <br />