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1 - � <br /> til IRE DEPART,MM' CT 17Y 01 SIMIC10N <br /> WHITE COPY OFFICE <br /> FIRE PREVINrION BUREAU YELLOW COPY • FIRE CO. <br /> ' PINK COPY FINANCE <br /> CITY HALL <br /> 2 <br /> 3 944 -8271 <br /> APPLICATION FOR PERMIT SPECIAL INSPECTION OR PLAN APPROVAL <br /> Application & Permit No-_//73 Date <br /> Application is hereby made foraas required by the <br /> Stockton Municipal Fire Code , <br /> Article (s) 7 <br /> Section (s) 11 <br /> Rule <br /> Fee Schedule -Tee Requiredp <br /> THIS &AMnA417- _ _ IS TO BE USED FOR TIE FOLLOWING PURPOSECS) <br /> z 4k 0or-7 <br /> CATION WHERE Phi IS TO BE USED <br /> ' uCUPANT <br />' ADDRESS <br /> PIIONE <br /> NAME OF OTHER PERSONS INVOLVED (IDENTIFY CONTRACTOR, INSTALLER, ETC ) <br /> NAME /��_l�rar�r 2. 1 <br /> ADDRESS <br /> PHONE <br /> I have read the above application and know the contents thereof. the same is true .unci <br /> correct. I further state that I am familiar with accepted fire protection incl prcvcn <br /> tion practices as set forth in the City of Stockton Uniform fire Code , and the amend- <br /> ments thereof, and that the use of the permit being applied for will conform to these <br /> practices <br /> A pp i ant 1 c ' <br /> s <br /> Signature <br /> FINANCE DEPT- INSPECTED <br /> Pls collect from 1. — 7 <br /> dress 2 _ 7 <br /> e sumo dollars o on . <br /> finance Dept By <br /> Date :7 ISSUED BY <br /> DATE • "7--- <br /> F.D 5 fd-985 <br /> Revised 5/22/74 f <br />