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City of Stockton - <br /> Fire Prevention Division <br /> rn� 345 North El Dorado Street <br /> Stockton, CA 95202 <br /> 0 (2031937-8271 <br /> bAVE3 LIVES <br /> PERMIT AND SPECIAL. INSPEQTIQN APPLICATIO-N <br /> City'&( County-n <br /> ❑ /J�, , <br /> Permit No. <br /> Application is hereby made for a permit/special inspection as required by the Stockton Municipal Code <br /> Art /Sec(s) Permit(s) Fee(s) <br /> Comments Total Fee• <br /> Business Name l <br /> AddressL�� Ste Zip <br /> Telephone <br /> �1 L <br /> Contact Person_ _I k's - �C �t _Telephone /// <br /> Business Owner s <br /> r � <br /> Billing Address -- , <br /> CrtylZIp <br /> c - - ` ---Telephone (- k) <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 use of the permit being applied for will conform to these practices <br /> ODAppllcant's Signature ' t^ I ��`�- f � Code 5, Ck# <br /> Alit. <br /> Inspected/issued by <br /> APR <br /> Date Issued 6 2coG , <br /> T 1FSREPREVFORMSWERMITS WPQ , <br /> FIRE PREVENTION DIVISION, ' <br /> - � rnr+ O..1. fi.ctnrriP► <br />