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/ ° �o CERTIFICATE OF OCCUPANCY ROUTING FORM <br /> 'a SAN.JOAQUIN COUNTY COMMUNITY DEVELOPMENT DEPARTMENT <br /> 1810 E. HAZELTON AVENUE, STOCKTON CA 95205 <br /> BUSINESS PHONE: (209)468-3124 <br /> c4<iFg %P BUSINESS HOURS: 8:A.M.TO 5:00 P.M MONDAY THROUGH FRIDAY(EXCLUDING HOLIDAYS) <br /> Permit No.: 09VZO 7 APN: 23 4 Q • Contractor: <br /> Job-Site Address: Use of Structure: p Fr—f y ,J <br /> 44 Planning Application No: <br /> OWNER NAME AND ADDRESS <br /> Name: IS I <br /> Address: v ,U 010r1 <br /> City: !� I� ,v State: rA I Zip: q6-Loj Telephone:(w ) 1 Co 14 <br /> j STRUCTURE REQUIREMENTS <br /> Occupancy Group: Occupancy Load: <br /> Type of Construction: Square Feet: 14-00 <br /> Zoning : Fire Sprinklers: Yes/No of d <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 BR YOUR APPROVED BUILDING PLANS WHEN OBTAINING SIGNATURES ON THE CERTIFICATE OF <br /> OCCUPANCYy26UTING FORM. <br /> APPROVAL R UIRE DATE. <br /> 77g111-2-- <br /> • Cf TMENT LIWORKS No1�� Feod �4-ec�t� <br /> ENVIRO E HEALTH <br /> x <br /> C¢hlIqTYFIREWARDEN <br /> CHIEF C a7r: •:�,_I <br /> 9 LOCAL FIRE DISTRICT• <br /> CALTRANS <br /> El <br /> MOUNTAIN HOUSE CSD <br /> El <br /> STOCKTON METRO AIRPORT(209)468-4700 <br /> El <br /> OTHER <br /> ❑ <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 /> I 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 schedr uled until this form has been <br /> completed and returned. e <br /> F:\BUILDING\HANDOUTS\HANDOUT 072 C of O.doc_(Revised 2/25104) Pagel of 2 <br /> tc <br />