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t w <br /> 1 <br /> FIRE DEPARTMENT (:1'1'Y OF 511)(XIDN . <br /> FIRE PREM iM'I ON BUREAU <br /> i CITY HALL <br /> j 94.4-8271 <br /> i <br /> , <br /> APPLICATION FOR PERMIT SPECIAL INSPECTION OR PLAN APPROVAL <br /> , <br /> Application F Permit No. ,!/ '-Date: <br /> fApplication is hereby made fora _ 4- �" as required by the <br /> Stockton ]Municipal Fire Code, <br /> Article (s) 7 <br /> Section (s)- <br /> Rule <br /> Fee Schedule <br /> —.�� � - -• —--- ee quire _-57�9�,4� <br /> THIS f , �: - IS TO BE USED FOR T1E FOLLOWING PURPOSE(S) <br /> _ —V, l � i , � iL I` I/ i fir _..' <br /> LOCATION WHERE 1-7711V , IS TO BE USED: ' <br /> 1 <br /> A[ OND�/D��REESS <br /> PHONE: '] ✓�./ c-+a @ "�I% h!'I,_r.1Lf`�v'{' f ✓i riv �` ..JO'C. I- iY' c ?'1 -f 5 , , <br /> I^ r <br /> NAME OF OTHER PERSONS INVOLVED. (IDENTIFY CONTRACTOR, INSTALLER, ETC:) : `. ' ; <br /> NAME: <br /> ADDRESS <br /> PHONE: - I ' <br /> I have read the above application and know the contents thereof: the 'same is true and <br /> correct. I further state that I am familiar with accepted fire protection and preven- <br /> tion practices as set forth in the City of Stockton Uniform Fire Code, and the .amenrl <br /> ments thereof, and that the use of the permit being applied for will conform to .th45c•.` <br /> practices. <br /> 'Applicant's - /J <br /> Signature: <br /> FINANCE DEPT: INSPECTED BY: <br /> PIS collect rom 1. <br /> Address ' <br /> 2. <br /> The sumo _ _ o11 v , <br /> Finance Dept. rJ�,;Date: )rl II 1 ISSUED BY: <br /> DATE: ` <br /> F.D.5 fd-985 <br /> Revised 5/22/74 <br />