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City of Stockton <br /> M1Fire Prevention Division <br /> 345 North El Dorado Street <br /> Stockton, CA 95202 <br /> (209) 937-8271 <br /> PERMIT AND SPECIAL INSPECTION APPLICATION <br /> City County ❑ <br /> Permit No. 97` 30 7 Date 11 - 6 `9 7 <br /> Application is hereby made for a permit/special inspection as required by the Stockton Municipal Code: <br /> Ari./Sec(s) Permit(s) Feels) <br /> e k�T6r -e- 260 00 e6u <br /> Comments: Tota/Fee: <br /> Business Name <br /> Address 1-43(') SI 51 06rOdO 147 Ste. Zip <br /> Telephone <br /> Contact Person Y / f Telephone LIA 7 f 0 iii <br /> Business Owner <br /> Billing Address <br /> City/Zip Telephone�Q9) 47."3 —29/0 <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 <br /> /'thereof, and use of the permit being applied for will conform to these practices. <br /> 1� applicant's Signature: W ) Code: 5A Ck# <br /> Amt. r �d <br /> Inspected/Issued by: <br /> Date Issued: <br /> T:\FIREPREVTORMSTERMITSMPD <br /> PD <br /> White: File Yellow: Fire Co. Goldenrod: Check Green: FPD Pink: Customer <br />