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77 <br /> 64 <br /> DEPARTMENT�• � -& S'1'(IM'ON <br /> �f <br /> f� <br /> FIRE <br /> i'REVI iNI'I C)N Bl1RI iAl1 �o <br /> CITY HALL <br /> 944-8271 , <br /> APPLICATION FOR PERMIT SPECIAL INSPECTION OR PLAN APPROVAL <br /> .Application & Permit No. � G / Date: <br /> .Application is hereby made fora as required by the <br /> Stockton Municipal Fire Code, <br /> Article (s)_7* -- -- <br /> Section (s) /',0 <br /> Rule <br /> Fee Schedule Fec Required: <br /> 'MIS IS TO BE USED FOR '111E FOLLOWING PURPOSE(S) <br /> -A1,1040 <br /> I <br /> Dm� <br /> LOCATION *EFMIS TO BE USED: 41 v&I <br /> OCCUPANT: <br /> ADDRESS: <br /> PHONE: <br /> : <br /> 'r V <br /> k NAME OF OTHER PERSONS INVOLVED. (IDENTIFY CONTRACTOR, INSTALLER, ETC.) <br /> u <br /> NAME <br /> ADDRESS: 46 2J <br /> PHONE: <br /> I have read the above application and know the contents thereof: the same is true and <br /> correct. I further state that I am familiar with accepted fire protection and prevcn - <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 /> Applicant's - <br /> Signature: <br /> FINANCE DEPT: INSPECTED <br /> Pls collect Tro . - C—r2 C 1. <br /> Address 2. <br /> The sumo 11ars ' y 3. <br /> Finance De t. - <br /> Date: /7 ISSUED BY:� <br /> 7 <br /> DATE: <br /> F.D.5 fd-985 <br /> t Revised 5/22/74 <br /> 4 <br />