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A7-r- �� Z�166 s <br /> CITY OF STOCKTON <br /> FIRE PREVENTION DIVISION <br /> 345 North E1 Dorado Street <br /> Telephone: (209) 937-8271 <br /> APPLICATION FOR PERMIT AND SPECIAL INSPECTION <br /> Application & Permit No. _I fO 'c CJ Date: <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 -This permit and special inspection is to be used for the following purpose(s): <br /> &-1 L.-G'LL` l'171. : <br /> / — <br /> Business .r:. , i<=_1L , : is ,tl C.✓ ` � i Z`. <br /> Streety- <br /> Telephone <br /> Name(s) of Contract/Additional Parties Involved: <br /> Name t- <br /> Street �!) ✓� . �. <br /> City Telephone �4, y A <br /> I have read the above application and know the contents thereof; the same is true and correct. I further <br /> 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 Code: 5A t' <br /> Signature Q D <br /> Inspected/Issued By: D AUG — 1996 <br /> Date: <br /> FIRE PREVENTION DIVISION <br />