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-Pwjkl.„N..,..... ;:.,.,�... „„..,..�f. .rv,:yvy,� mar-0” <br /> Stockton Fire Department • Fire Prevention Uivision <br /> 345 N. EI Dorado Street, Stockton, CA 95202 <br /> (209) 937-8271 0 Fax (209) 937-8893 <br /> INSPECTION APPLICATION <br /> A@@Iication is herebV made for a insection as re uired bv the Stockton Municipal Code. <br /> plete both sections below <br /> Application Date: _ Location: City b�' County ❑ <br /> Describe Type of Business/Services: .' - p - <br /> Business Name ! f Business Owner , <br /> Business Address > Suite Zip <br /> Mailing Address Suite Zip <br /> Business Telephone ' "" , ' Contact Person ,%} r <br /> E-Mail Address <br /> Inspection Type <br /> Check type of Inspection: <br /> - Special Inspection-City (charge per hour) <br /> ❑ Special Inspection-County Contract Areas (charge per hour) <br /> ❑ Permit and Code Compliance Inspection <br /> ❑ Permit and Code Compliance Inspection after 2nd Inspection (charge per hour) <br /> ❑All other Field Inspections (charge per hour) <br /> Describe purpose of Inspection: �+ <br /> APPLICANT SIGNATURE DATE <br /> PRINT NAME E,... ..-•' <br /> BELOW FOR OFFICE USE ONLY <br /> Issued b •ter. x-i�-- Date Issued: Ay � <br /> Check# <br /> Special Inspection-City: Pay Code XX$ - -: 048-2831-342.23-00 <br /> ❑Special Inspection-CountyContract Areas: Pay Code XX,$ 048-2631-342.23-10 <br /> ❑Permit and Code Compliance Inspection: Pay Code XX$ 048-2631-342.23-00 <br /> ❑Permit and Code Compliance Inspection after tad Inspection:' Pay Code XX$ 048-2631-342.23-00 <br /> All other Field Inspections Pay Cade XX'$ 048-2631-342.23-10 <br /> INSPECTION RESULTS: <br /> INSPECTED BY: DATE <br /> 09/08/09 FPD FORM Inspection Application White: FPD File Yellow:Inspection Results to Customer Pink:Payment Copy to Customer <br />