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I <br /> CITY OF STOCKTON <br /> FIRE PREVENTION DIVISION <br /> 345 North EI Dorado Street <br /> Telephone: (209) 937-8271 <br /> APPLICATION FOR PERMIT AND SPECIAL INSPECTION <br /> Application & Permit No. Date: l <br /> Application is hereby made for a permit/special inspection as required by the Stockton Municipal Code. <br /> Article(s)/Section(s) Fee(s) <br /> Total Fee Required <br /> This permit and special inspection is to be used for the following purpose(s): <br /> r <br /> Business <br /> Street /''O/ lr.vrlrl/, . i%• lr <br /> Telephone <br /> Name(s) of Contract/Additional Parties Involved: <br /> Name /, l/i //,c <br /> Streer <br /> City Telephone <br /> I have read the above application and know the contents thereof; the same is true and correct. I further <br /> i state that I am familiar with accepted fire protection and prevention practices as set forth in the City of <br /> Stockton Uniform Fire code, and the amendments thereof, and use of the permit being applied for will <br /> conform to these practices. <br /> Applicant's i Code: 5A <br /> Signatuq <br /> Inspected/Issued By: <br /> JUN 2 1995 !J <br /> Date. _1 <br /> t FIRE PREVENTION DIVI`>syb'N <br />