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.. � 4s ES'L..Cr �� ��b.D UIYS� ...�'� !•y.i� <br /> 41e Stockton Fire Department • Fire Prevention Division I <br /> 345 N. Et Dorado Street, Stockton, CA 95202 <br /> . a (209)937.8277 0 Fax(209)937.8893 i <br /> ` I <br /> INSPECTION APPLICATION <br /> Application is hereby made for a ins ection as re wired b the Stockton Munici aIC ode. <br /> - . 4• . - <br /> f .. � <br /> Application Date >' '� .y_ / Location: City.® County❑ <br /> Describe Type of Business/Services.. <br /> Business Name / Z�1,. , ? 1`�/�7 Business Owner <br /> Business Address_2. /2 -5 ,ry C .ce f. / '/ L3 I <br /> Suits Zip v-> �. y <br /> Mailing Address e Suite Zip J <br /> Business „ <br /> Tele hone ///+ f• ' 3 �T r r <br /> P � • � Contact Person I.,'t.-•:, /<�-l>f�� � <br /> E-Mail Address <br /> Inspection Type <br /> Check type of Inspection: <br /> ,.Special Inspection-City(charge per hour) <br /> ❑Special Inspection-County Contract Areas(charge per hour) <br /> ❑Permit and Code Compliance Inspection <br /> ❑Permit and Code Compliance Inspection after 2"d Inspection(charge per hour) <br /> El All other Field Inspections (charge per hour) <br /> Describe purpose of Inspection: �/)rn 4 • Tel."() rt tk'•r ,7 �,1 43 Z?_ X <br /> /'t' .£�s ',r•:+ Y.;7 tt r;Vit;:,1 h°;.1i _',:u.ti.0 ,J1_'rrs.,.•T t. ... /c C(. .�i,!r> <br /> k, J,J ofe? "",I <br /> �? ZlA'l •)' t tl•1� , •' f✓ - <br /> ', J <br /> APPLICANT SIGNATURE DATE <br /> PRINTNAME- (r2:1 •4r,=r J'('`�=+ / •L,"c f <br /> �¢aJir� /`n%orn G•^//^/.1 rn'.r �j^/5'^/•3 ---_- <br /> BELOW FOR OFFICE USE ONLY <br /> 195 <br /> y h. <br /> Cheek# / <br /> Special inspeetlan City pey Code)OC$/7C��i Q4fl 2s3t.382 $$0 i <br /> [a Speclallnapection Couply CphiractAreas Pay Code XX$ - i QQ8 268Q 3 2� 1 <br /> j} �)mltend CodQ Cgipp))once 10spgCtlpn pa Code XX <br /> Y — � o48x2C742 23 4o P a ',.f . <br /> ❑__PBlpiltandCntlaCompJittlti;elnspectlolt9tter2dlnsai <br /> pe00gp Pay GWg)O(V � Od��031 342.2��fD,� r <br /> �AllgtherFleld:ins pe¢flges't.)oaXCode ($ 04.663 '342, 1D <br /> INSPECTION RESULTS: <br />