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+ Stockton Fire Department• Fire Prevention Division <br /> 345 N.EI Dorado Street,Stockton,CA 95202 <br /> (209)937-8271 •Fax(209)937-8893 <br /> INSPECTION APPLICATION <br /> Application is hereby made for a ins tion as required b the Stockton Municipal Code. <br /> Application Date: Location: CityN County❑ <br /> Describe Type of Business/Services: U 1 r ' _1 <br /> Business Name—i �T_Ii�V\j <br /> � � 1 �' Business Owner � ( �'V YVI tBusiness Address } I I J^ Y `� N Suite zip�S1 b <br /> Mailing Address I I Suite 7jP <br /> BusinessTelephon.--(p ��- � contact rson 4 <br /> E-Mail Address f ' i f <br /> Inspection • <br /> Check type of Inspection- <br /> 0 Special Inspection-City(charge per hour) <br /> ❑Special Inspection-County Contract Areas(charge per hour) <br /> 0 Permit and Code Compliance Inspection <br /> El Permit and Code Compliance Inspection atter 2"a Inspection(charge per hour) <br /> 0 All other Field Inspections(charge per hour) <br /> Descr-igepu ose f In ection: ��. f �Vr �lr <br /> ... -y) 'r <br /> APPLICANT SIGNATURE ' 17ATE <br /> PRINT NAME: 6A, <br /> BELOW FOR OFFICE USE ONLY <br /> Issued Ea - Date Issued. <br /> Check 9 <br /> 0 special Inspection-City. Pay Code XX S 048-2631-342.23-00 <br /> 0 Special Inspection-County Contract Areas: Pay Code XX$ 045-2631-342-23-10 <br /> ❑Permit and Code Compliance Inspection:Pay Code XX$ 1148-2631-342.23400 <br /> 0 Permit and Code Compliance Inspection aftev V Inspection: Pay Code XX$ 048-2631-342.23.00 <br /> 0 All other Field Inspections: Pay Code XX$ 048-2631-342-2310 <br /> INSPECTION RESULTS: - <br /> INSPECTED BY: DATE <br /> 091OW9 FPD FORM Inspection Applicarien White.FPO File Yellcw Inspe(fUon ResuNslo Customer Pink:Payment COPY tri Customer <br /> 1 <br />