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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 SPECIAL INSPECTION APPLICATION <br /> n� City County O <br /> Permit No. Date <br /> Application is hereby made for a permit/special inspection as required by the Stockton Municipal Code: <br /> Art✓Sec(s) Permit(s) Feels) <br /> ` 1Cl 0-mud( akx r ylco , of 44)' �) of 1 1 <br /> «_.yyl <br /> Ou <br /> Comments: Total Fee: <br /> Business Name "�,t5ot <br /> Address Ste. Zip <br /> Telephone 4& <br /> Contact Person E< 1 ,�fCiL/ 'I ) Telephone 2 -3-,)& -6 <br /> Business Owner/C - STIX k�z n <br /> Address -A'.3.5 l/('.li'ci A/w)P Z3 <br /> City/ZipTelephone <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 thereof, and us oft7hnbeinapplied for will conform to these practices. <br /> Applicant's Signature: Ck#- tU �`' Amt.,;L—� <br /> Inspected/Issued by: Code: 54 (city) R6 ❑ (County) <br /> Date Issued: ��11 I�InII' <br /> ODMA%GRPW1 MCOS FD.FD Ub,.ry:3995.1 N ' 2O�L_ <br /> White: FPD File Goldenrod: Finan(e L7ePO is Pink: Customer <br /> FIRE FREVI-r:ti�r� uiYlSI6N <br />