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0 <br />City of Stockton <br />Fire Prevention Division <br />345 North kl Dorado Street <br />Stockton, CA 95202 <br />(209) 937.6271 <br />FIRE PERMIT AND <br />City <br />PECIAL INSPECTION APPLICATION <br />County 0 <br />Permit No. bate <br />Application is hereby made for a permit/spacial inspection as required by the Stockton Municipal Code: <br />Permits Fee(s) Art✓Sec(s) Permit(s) <br />— --_t* <br />`� 0 <br />/f 0. n O — <br />Total Fee.�"'— <br />Comments: I ' <br />Business Name 0�.. - <br />1:11 .� Ste. Zip <br />.� <br />Address—j-.- <br />Telephone _ <br />Contact Person <br />Business*wnfflContractor_� <br />Address O n <br />City/Zip s C11 c ele one ( i <br />I have read the above application and know the contents thereof; the s true and correct r state that I <br />I fur <br />Uniform Fire <br />am familiar with accepted firprotection and prevention practices as set forth in the City S <br />e <br />the rmit being applied for will confer ractices- <br />Code, and the amendments thereof, a� ejw pe <br />Ck# rt Amt. ZOO`S <br />,@Applicant's Signature: t� vLi,y.c— <br />Inspected/Issued by:. - Code: 5, ary) R6 ❑ (county) <br />Date Issued: D... t <br />U <br />::ODMA\GRPIMSE\COS.FD.FD_Lbiary:3985.1 _ AUG Z O M�I <br />White: FPD File Goldenrod: Finance <br />II'��f/LORI <br />Pink: Customer <br />