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' T-IRE DEPARTMENT CI N <br /> 01 SR)CICIDN <br /> C-1 .� f� FIRE PREY)STI'ION BiIR-AU <br /> CITY HALL <br /> 944-8271 <br /> APPLICATION FOR PERMIT SPECIAL INSPECTION OR PLAN APPROVAL <br /> Application & Peanut No. s'� <br /> Date• ?� <br /> Application is hereby made fora as required by the <br /> Stockton Municipal Fire Code, <br /> Article (s) I- <br /> Section (s) {b <br /> Mile <br /> Fee Schedule Fee e uire <br />' THIS IS TO BE USED FOR <br /> TIM FOLLOWING PURPOSE(S) <br /> rf3 r.4 t-a <br /> t <br /> T, it <br /> LOCATION MERE <br /> (' IS TO BE USED: _ <br /> PANT: e d§e r V ' <br /> LL <br /> ADDRESS: v r- <br /> PTTONE �q3_6 - <br /> NAME OF OTHER PERSONS INVOLVED. (IDENTIFY COMRACTOR, INSTALLER, ETC.) <br />' NAME. <br /> ADDRESS. <br />' PHONE- <br /> I have read the above application and know the contents thereof- the same is true and <br /> correct. I further state that I am fa.miluar with accepted fire protection and prevr-�n_ <br /> tion practices as set forth in the City of Stockton Uniform Fire Code, and the amcnrj- <br /> ments thereof, and that the use of the permit being applied for will conform to thc5c <br /> practices. <br /> Applicant's <br /> Signature: � % f <br /> { <br /> FIXANCE DEPT: <br /> INSPECTED BY: <br /> Pls collect from <br /> Address ,sum o ,r� dollars <br /> ante Dept. By- /� �� 3 <br /> Date. `' ; <br /> - ISSUED BY: J <br />' F.D.5 fd-985 HATE: 16 - 2 <br /> Revised 5/22/74 <br />