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Stockton Fire Department,O'Fire Prevention Division <br />t 345 N. EI Dorado Street, Stockton, CA 95202 <br />(209) 937-8271 9 Fax (209) 937-8893 <br />INSPECTION APPLICATION <br />Application Date: <br />Describe Type of Business/Services:l/��ii <br />Business Name %�.% l� _ /� W!� � <br />\Business Address <br />Mailing Address_ <br />Business ielephoi <br />E -Mail Address ,, <br />cation: CitA County ❑ <br />/( /Zfoyr? L <br />'susiness Owner�X %r 1), <br />.z Suite Zip <br />suite .zip.! <br />/ 6onttactPerson IVfr;�-- <br />Check type of Inspection: <br />\\\ ! <br />Special Inspection -City (charge per hour) <br />Special Inspection - County Contract Areas.(( arge per -hour) <br />❑ Permit and Code Compliance Inspection ' <br />❑ Permit and Code Compliance Inspection aiEer 2nd InsWeetion (charge per hour) <br />❑ All other Field Inspections (charge per hour) <br />Describe purpose of Inspection: <br />APPLICANT SIGNATURE ! ��_ DATE 13 ` <br />PRINT NAME• rlei 'C <br />BELOW FOR OFFICE USE ONLY <br />Issued: <br />heck # <br />Special Inspection City. Pay Code XX $ 048-2631-342.23-00 <br />❑ Speclal Inspection - County Contract Areas: Pay Code XX $ 048-2631-342.23-10 <br />❑ Permit and Code Compliance Inspection: Pay CodQ.XX $ �' 048-2631-342.23-00 <br />❑ Permit and Code Compliance Inspection after 2hd Inspection: Pay Code XX $ 048-2631-342.23-00 <br />❑ Ail other Field Inspections: Pay Code XX $ 048-2631-342.23-10 <br />1) <br />