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City of Stockton <br /> Fire Prevention Division <br /> �d 345 North El Dorado Street <br /> Stockton, CA 95202 <br /> (209) 937-8271 <br /> FIRE PERMIT AND SPECIAL INSPECTION APPLICATION <br /> City County O <br /> n <br /> Permit No. �'-1 � � Date 4 - I -JL� <br /> Application is hereby made for a permit/special inspection as required by the Stockton Municipal Code: <br /> Art./Sec(s) Permit(s) 1 Fee(s) <br /> —7� <br /> (�IuVS 71'�l k <br /> J <br /> Comments: (77 Total Fee: ?— <br /> Business Name I 1 C>1 CJTC`'I k cr) <br /> Address 4^ Ste. Zip <br /> Telephone <br /> Contact Person�( N LC�`��/ _Telephone <br /> /Contractor <br /> Address- <br /> City/Zips Telephone ( ) <br /> I have read the above application and know the contents thereof; the same is true and correct I further stats that <br /> I am familiar with accepted fire protection and prevention practices as set forth in the City of Stockton Uniform Fire <br /> Code, and the amendmen%theEptfl—, ind 'e of the ermit being applied for will conform to these practices. <br /> .Applicant's Signature: '// ` ' " Ck# <br /> Inspected/Issued y: l Code: 5A/)Z\J/(cay) R6 O (County) <br /> Date Issued: <br /> ::ODMA\GRPW IS E\COS.FD.FD_Ubmry:3995.1 <br /> White: FPD File Goldenrod: Finance Yellow: FPD Deposits Pink: Customer <br />