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a s City of Stockton <br /> Fire Prevention Division <br /> 345 North EI Dorado Street <br /> Stockton, CA 95202 <br /> (209) 937-8271 <br /> FIRE PERMIT AND P CIAL INSPECTION APPLICATION <br /> City County O h � ,, <br /> Permit No. Date oc�'�Y -0-131 <br /> Application is hereby made for a permittspecial inspection as required by the Stockton Municipal Code: <br /> Art✓Sec(s) Permit(s) Fee(s) <br /> a V ,yr,ruuft(J 1aa c lilryuv6I <br /> I 1 „17 <br /> Comments: Tota/Fee: GL n S <br /> Business Name Jkc I lDr'J ft& 71"aLS d f 'V - <br /> Address L anl?yl Ste. Zip CA <br /> Telephone <br /> Contact Person ia Telephone <br /> Business Owner/Contractor /f �lhUlf-�� �� 5y os- <br /> Address S <br /> City/Zip _ a dt /- Telephone (elY�) 7 S7 <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 ther bf, and use of the permit being applied for will conform to these practices. <br /> Applicant's Signature: Ck# Amt. <br /> Inspected/Issued by: Code: 54 (city) R6 U (County) <br /> Date Issued: <br /> ::ODMA\GRPW ISEICOS.FD.FD_tJbmry:3995.1 <br /> White: FPD File Goldenrod: Finance Yellow: FPD Deposits Pink: Customer <br />