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• i <br /> *DVrr, <br /> Stockton Fire Department • Fire Prevention Division <br /> 345 N. EI Dorado Street, Stockton, CA 95202 <br /> (209) 937-8271 • Fax (209) 937-8893 <br /> INSPECTION APPLICATION <br /> Annfication is herebv made for a ins ection as re uired bij the Stockton Munici al Code. <br /> completeApplicant both sections below <br /> Application Date: Location: City 0 County ❑ <br /> Describe Type of Business/Services: <br /> Business Name -) `-' „ 3 Business Owner <br /> Business Address l Suite Zip <br /> Mailing Address Suite Zip <br /> Business Telephone Contact Person <br /> E-Mail Address <br /> Inspection Type <br /> Ch <br /> - <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:__.__ <br /> BELOW FOR OFFICE USE ONLY <br /> Issued by: Date Issued: <br /> Check# <br /> El Special Inspection -City: Pay Code XX$ ' -':' 048-2631-342.23-00 <br /> ❑Special Inspection-County Contract 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 2nd Inspection: Pay Code XX$ 048-2631-342.2300 <br /> ❑All other Field Inspections: Pay Code XX$ 048-2631-342.2310 <br /> 7 -� i <br /> INSPECTION RESULTS: (Yl<p?6 +rCh Sck(-' <br /> rd <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 />