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CITY OF STOCKTON ' <br /> ►� FIRE PREVENTION DIVISION <br /> i Telephone: (209) 944-8271 <br /> k APPLICATION FOR PMTT SPECTAL IP---- — — PLAPi "PRO <br /> F` Application & Permit No. i !_1 pate: <br /> Application is hereby made for a per inspection/plan <br /> approval as required by the Stockton Municipal Fire Code, <br /> Article(s) <br /> Sections) <br /> Fee(s) Required <br /> This permit/special inspection/plan approval is to be used for the <br /> following purpose(s) <br /> [•a•.j L L! -.r ,. / � �.. E.-LLud-lam <br /> Location: <br /> occupantLL� "' <br /> Street <br /> Zip Code Telephone <br /> Names of Additional Parties Involved (Contractor/Installer, Etc.) <br /> Name w!, n�C -��l� •,. <br /> - ' Street is City . ! 'c i r• r <br /> Zip Code — Telephone i/, 1 ' e s <br /> I have read the above application and know the contsnts thereof; the <br /> same is true and correct. I further state that I am familiar with <br /> accepted fire protection and prevention practices as set forth in the <br /> City of Stockton Uniform Fire Code, and the amendments thereof, and <br /> use of the permit being applied for will conform to these practices. <br /> Applicant's <br /> Signature I� <br /> Inspected by: <br /> T'49"yP O� I <br /> Issued by: <br /> Date: Code: 5 _ <br /> .� 17 <br /> - <br /> z <br /> t a� F1ti��G <br />