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u <br /> CITY OF STOCKTON <br /> pis FIRE PREVENTION DIVISION <br /> Telephone: (209) 944-8271 <br /> r ApPL CATION FOR PF.RHIT SPECIAL I SPECTTOif OR PLNN APPROVAL <br /> d <br /> " Application & Permit No. % <br /> Date: ' <br /> Application is hereby made for a permit/special inspection/plan <br /> V- approval as required by the Stockton Municipal Fire Code, <br /> tT, Articles) <br /> section(s) <br /> Fee(s) Required <br /> is <br /> This permit/special inspection/plan approval is to be used for the <br /> following Purpose(s) <br /> Location: <br /> a' occupant � . • �'� i�'�r-�. �. t• ,:-f <br /> Street .�....,i 7 -;C.( Telephone <br /> Zip Code <br /> Names of Additional Parties Involved (Contractor/Installer, Etc.) <br /> ,.:., Name �, v <br /> :• Street Y City <br /> Zip Code Telephone <br /> ;., I have read the above application and know the contents 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 — <br /> Inspected by: o r' <br /> Issued by.' of <br /> 0. ��7 <br /> Cade: <br /> Date: .�_ C�OF _ <br />