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} City of Stockton <br /> Fire Prevention Division <br /> TM 345 North El Dorado Street <br /> RE TIO Stockton, CA 95202 <br /> (209) 937-8271 <br /> FIRE PERMIT AND SPECIAL INSPECTION APPLICATION <br /> Application is hereby made for a permitispecial inspection as required by the Stockton 'Municipal Code: <br /> Date County Contract Area ❑ <br /> Permit No. P,-rmit Type Fee <br /> c [L� GPJ 0 <br /> Comments: Tota!Fee: -moo <br /> Business !Name �4,tv Cm <br /> Address i 1 7 �G�. Ao 5fc� -t ��n c.. Ste. Zip �2 v <br /> Telephone <br /> Contact Person C \,� Telephone SG 2- 92,1 s LZ <br /> Business OwnerJContractor Cc. <br /> Address_ bn(-,, 1 V. 5�'v �v a 1(' C� l� 1 <br /> CitylZip <br /> Telephone Clot)�00-0-7 <br /> I have read the above application and know the contents thereof;the same is true and correct. I further state that I <br /> am familiar with accepted fire protection and prevention practices as set forth in the city of Stockton Uniform Fire <br /> Code, and the amendments thereof, and use of the permit being applied for will conform to these practices. <br /> -11 <br /> ,Applicant's Signature' Ck# <br /> Inspected/issued by: Pay Code: 5A $ <br /> Date Issued: PZ <br /> R6 $ <br /> :3995.1 <br /> White: FPD File yellow: Customer <br />