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4 <br /> CITY OF STOCKTON . <br /> FIRE PREVENTION DIVISION <br /> .345 North El Dorado Street <br /> Telephone: (209) 937-8271 <br /> APPLICAT(,ION FOR PERMIT AND SPECIAL INSPECTION <br /> Application & Permit No. 7 6 ' ! Date: t <br /> Application is hereby made for a permit/special inspection as required by the Stockton Municipal Code. <br /> Articles)/Section(s) Fee(s) <br /> Total Fee Required 7,-CD <br /> This permit and special/inspection is to be used for the following purpose(s): <br /> 42 <br /> 21 <br /> Business [� e__ r- <br /> Street Z-t' '� �_� •�� ( =` <br /> Telephone 1 ` s <br /> Name(s) of Contract/Additional Parties Involved: <br /> Name �)L.� b . �•� � � �= c C _ t ' � .. -�._ <br /> Street <br /> City--L- -? ° Telephone <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 /> ji 17 C� <br /> Applicant's Code <br /> Signature 'IT w Q n <br /> II " i <br /> Inspected/Issued By: V`l NOV 2619% V <br /> Date: �,;1- - l7 /Z <br /> FIRE PRE'iE kIGii DIVISION i <br />