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CITY OF STOCKTON <br /> FIRF PRF,k'EN'TION DIVISION <br /> 345 North EI Dorado Street <br /> Telephone: (209) 937.8271 <br /> A—PPLI CATION FOR PER�i['I qNn— PECI.AL IN—sva,TION <br /> Application & Permit No, <br /> -- - Dare:------ / <br /> Applica;inr is herc;,y permitJspecial inspection as regwrr,l b� [!.r S:oc6ton Municipal Code. <br /> icle(s) section(s) Fee(s) <br /> Totai Fee Required__ c� <br /> This peri.il: i1 to be useu I-or rhe (ojjoAi'tg 11_r��i,.,;1�? <br /> Business__ It <br /> Street_- ---- _ <br /> Telephone <br /> 'rame(s) � i i'� n:rapt nudrt a:,.tl Parties lnvol%ed. <br /> Name�-- ��,— ) <br /> Citg-_— -- <br /> --- Telephon ____ _ <br /> I have read the above apPll,r,i»k the contents thereof: th,! — <br /> state that ] am familiar %k it!) accepted ilre protection and preventioniL: u, th,zr <br /> Stockton Uniform Pine code, and the amendments thereof, and use f the pen;�� �� lig <br /> n� 711�1 / <br /> CITY f <br /> conform ro 'hese practi�-.s. <br /> Applicant's —'- -- -- — - _Signature _ 1 (. c��f� AInspectedll.sued By, FIRE PREVE <br /> °'FIR ofPAR17� }vr f'f �:R�r APPUCAr 0!NEAR -V <br /> Date:--_---- <br /> - ON THE PART <br /> Mq iNT MAY PP-01T )i� Ani AQ 4W <br />