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3 City of Stockton <br /> Fire Prevention Division <br /> r 345 North E/Dorado Street <br /> Stockton, CA 95202 <br /> (209) 937-8271 <br /> PERMIT AND SPECIAL INSPECTION APPLICATION <br /> tl Permit No. '1 -7 Date /' 4�� ` /- <br /> Application is hereby made for a permit/special inspection as required by the Stockton Municipal Code: <br /> Article/Section(s): o/ r >) Fee(s): '(<' Cc •�� <br /> Total Fee Required: ' <br /> It <br /> Business Name <br /> Address <br /> Telephone T/7 <br /> Business. Owner_ <br /> /Contact <br /> Address �S / i< ft /lrt f•__. i:. r, . d, . <br /> City/ZIP t' <�S � f� Telephone ") G '`r • f / '�5� <br /> I have read the above application and know the contents thereof; the same is true and correct. I further state <br /> that I am familiar with accepted fire protection and prevention practices as set forth in the City of Stockton <br /> Uniform Fire Code, and the amendments thereof, and use of the permit being applied for will conform to these <br /> practices. <br /> J46Applicant's Signature: ` ._...Code: 5A Ck# <br /> Amt. <br /> Inspected/Issued by: <br /> Date Issued: D <br /> SEP 2 41997 <br /> White: File Yellow: Fire Co. Pink: C s <br /> � �REVENT IVIS 0 ck Green: FPD <br />