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'ity of Stockton <br />.-ire 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 />2=e <br />Permit. -Nd.. Date ZZ —17— <br />Application i . s ::h 1. erebymade for a permit/special inspection as required by the Stockton Municipal Code: <br />Fee(s) <br />Art.lSec(s)., Permit(s) <br />Comments:, <br />Total Fee: <br />Business. Nam <br />'.-Adclress.r= 1 Ste. Zip <br />Telephone— <br />Contact Person'!"-- Telephone <br />Business., . 0 <br />wner�� <br />Billing -AddM;7 <br />� C -L <br />City/Zip —Telephone <br />I have read the above- appUcation and know the contents thereof; the same is true and correct. I further state that <br />I am familiar with' acc&pted'fire protection and prevention practices as set forth in the City of Stockton Uniform Fire <br />Code, and the amendments thereof, and use of the permit being applied for will conform to these practices. <br />Code: 5$ Ck# ODApplicant's: Signatu'.­re'.,'.- <br />`J7 <br />Amt. <br />lnspected/1SSO'6d-by.1_. <br />Date 1ssuedr-i!V,,;­: <br />T:\FIREPREV.\F(DRMST-J,i ZITS .WPO , <br />E <br />.Fire Co-.' Goldenrod: Check Green: FPD, <br />e FIRE <br />