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City of Stockton <br /> Fire Prevention Division <br /> 345 North EI Dorado Street <br /> Stockton, CA 95202 <br /> (209) 937-6271 <br />' FIRE PERMIT AND SPECIAL INSPECTION APPLICATION_ <br /> City ©, County ❑ <br /> Permit No.r, `�3 Date ' <br /> ' Application is hereby made for a permit/special Inspection as required by the Stockton Municipal Code <br /> ArtdSec(s) Permit(s) Fee(s) <br /> ' -Comments: Total Fee: <br /> Business Name' <br /> Address = Ste Zip <br /> Telephone <br /> Contact Person Telephone <br /> Business-Owner/Contractor.=_ ; 1 ', ° ` ( { <br /> Address .� �t 'a�-J, <br /> city/zip, �R', _ j - 4� i �� ` ; Telephone <br /> ' I have read the above application and know the contents thereof, the same is true and correct I further state that <br /> I am familiar with accepted fire protection and prevention practices as set forth In the City of Stockton Uniform Fire <br /> Code,and the amendments thereof, and use of the permit being applied for will conform to these practices <br /> ,Applicant's Signature ' ` '=y Ck# Amt. f <br /> Inspected/issued by Code SA 7_(cih+) R6 0 (county) <br /> Date Issued <br /> 0 1 <br /> ' ODMAIGRPWISEICOS FD FD—Library 3995 1 <br /> White FPD File Goldenrod Finance Yellow FPD Deposits Pink Customer <br /> r <br />