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4' <br /> CITY OF STOCKTON <br /> FIRE PREVENTION DIVISION <br /> Telephone: (269) 944-8271. <br /> L Y ?j FOR P T SP C r NSPECT ON OR AP OVA3� <br /> Application & Permit No. <br /> Date: <br /> ppp1:cation is hereby made for a permit/special inspection/;flan <br /> e Stockton Municipal Fire Code, <br /> approval as required by th <br /> Article(s) i <br /> sections) <br /> Fee(s) Required � <br /> This permit/special inspection/plan approval is to be used for the <br /> following purplse(s) r <br /> -- <br /> Location: <br /> occupant <br /> street /� '�1 �c•�- ��u.14 i,E�City_ _�f-s -� r�- <br /> Zip Code_ t. Telephone <br /> Names of Additional Parties Involved (Contractor/Installer, Etc.) <br /> Name '(- C ty - <br /> Street 7 <br /> Zip Code Telephone � / 1 <br /> I have read the above application and know the contents thereof; the <br /> same is true and correct. I further state that I am familiar with <br /> accepted fire protection and prevention practices as set forth in the <br /> City of Stockton Uniform Fire Code, and the amendments thereof, and <br /> use of the permit being applied for will conform to these practices. <br /> Applicant's i <br /> Signature <br /> Inspected by: -- <br /> -+:)i- <br /> "d \ <br /> Issued by: �d � <br /> fid' �• <br /> 7 <br /> ----- <br /> Code: .. 5A <br /> _........................ <br /> Date: <br /> o.ae <br /> ,• OP FIN <br /> r%_79 3 <br />