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Permit No.� <br />arty of Stockton <br />Fire Prevention Division <br />345 North El Dorado Street <br />Stockton, CA 95202 <br />(2091937-8271 <br />Y <br />PERMIT AND SPECIAL INSPECTION APPLICATION <br />City ❑ County 0 -- <br />Date is _ 319_ <br />Application is hereby made for a permit/special inspection as required by the Stockton Municipal Code: <br />Art./Sec(s) Permits) <br />Fee(s) <br />Comments: <br />Total Fee: E6—,07�_ <br />Business <br />Address _ <br />Telephone <br />Contact PI <br />Telephone <br />Ste. Zip <br />:�137U <br />Business Owner <br />Billing Address <br />City/Zip <br />Te ephone <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 then f, and use of the permit being applied for will conform to these practices. <br />— ODApplicant's Signature: Code: 5A Ck11 <br />Amt. °5,Z)D <br />o <br />— Inspected/Issued by: Q _ <br />Date Issued: <br />TAFIREPREVIFOWM ,I tRMITS.WPD <br />DEC — 4. IRoA I I <br />I i <br />White: File Yellow: Fire Co. Goldenrod: CheckFIFE - I <br />Green: FPDihlE`_C_tistori eri_iI'i! i <br />