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CITY OF STOCKTON <br /> FIRE PREVENTION DIVISION <br /> 345 North El Dorado Street <br /> Telephone: (209) 937-8271 <br /> APPLICATION FOR PERMIT AND SPECIAL INSPECTION <br /> pplication & Permit No. �b /3 Date:—.///2G A <br /> pplication is hereby made for a permit/special inspection as required by the Stockton Municipal Code. <br /> Articles)/Section(s) Fee(s) <br /> ?91I. 3 foo <br /> Total Fee Required ACD <br /> This permit and special inspection is to be used for the following purpose(s): <br /> Business <br /> Street_ <br /> (r �� . L—Tu,) <br /> Telephone 7 " <br /> Name(s) of Contract/Additional Parties Involved: <br /> C / y <br /> Name <br /> Street <br /> Cityt3 L R A--y <br /> Telephone 037 <br /> I have read the above application and know the contents thereof; the same is true and correct. I further <br /> state that I am familiar with accepted fire protection and prevention practices as set forth in the City of <br /> Stockton Uniform Fire code, and the amendments thereof, and use of the permit being applied for will <br /> conform to these practices. <br /> Applicant's C/4 /f w7 <br /> Signature <br /> Inspected/Issued By: NOV 2.6 WSD <br /> Date: <br /> FIRE PREVENTION DIVISION <br />