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� CERTIFICATE OF OCC !PANCY ROUTING FORM <br />San Joaquin CountyCommunity Development Department <br />1810 E. Hazelton Ave, Stockton, Ca 95205 <br />Business Phone (209) 468-3121 <br />Permit No: BP -2003032 <br />APN: 055-160-23 <br />Contractor: <br />Job -Site Address: 5484 W ST RT 12 HY LODI <br />Use of Structure: Modular Office <br />Plannin A lication No: <br />OWNER NAME AND ADDRESS <br />Name: ALEGRE, ANTHONY J TR ETAL <br />Address: PO BOX 1508 LODI CA 95241 - <br />Tele hone: <br />STRUCTURE REQUIREMENTS <br />Occu anc Grou : B <br />Occu anc Load: 3 <br />T e of Construction: VB <br />S uare Feet: 320 <br />Zoning: I -T <br />Fire S rinklers: Provided: NO <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 <br />agencies indicated below. It <br />is the applicant's responsibility to obtain all signatures and return this form to the Community <br />Development Department. <br />Please be aware that advanced notice and a field inspection time may be required by each agency <br />prior to signature. <br />NOTE: PLEASE BRING YOUR APPROVED BUILDING PLANS WHEN OBTAINING SIGNATURES ON THE <br />CERTIFICATE OF OCCUPANCY ROUTING FORM. <br />APPROVAL RE <br />DATE: <br />�°w� <br />DE ME T F PUBLIC W RKS 209-468-3000 <br />/ <br />�� �C Z <br />/ <br />IRO M NTA EALTH 209-4�8� 420 <br />_� <br />� `� <br />COUNTY FIRE WARDEN 209-468-3166 <br />FIRE CHIEF -FIRE DISTRICT: WOODBRIDGE-D 209-369-1945 <br />CALTRANS 209-948-7543 <br />MOUNTAIN HOUSE CSD 209-468-0327 <br />STOCKTON METRO AIRPORT 209-468-4700 <br />OTHER: <br />NOTE TO DEPARTMENTS LISTED ABOVE: Your signature indicates that your conditions have been tnet and <br />authorize 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 />