Laserfiche WebLink
IT] 7J 0 CL <br /> N Q- <br /> Z3 cD O (D Q <br /> ONrn <br /> W On Fire Department • Fire Prevention Division <br /> U1 <br /> Z3345 N . EI Dorado Street , Stockton , CA 95202 � � -P�6 <br /> N (209) 937 -8271 • Fax ( 209) 937-8893 O O <br /> O <br /> (D Z <br /> -p INSPECTION APPLICATION m <br /> M <br /> Www�Ajojojicajion is hereby made for a insecfion as re wired b the Stockton Municipal Code. ~ 0 <br /> vii O <br /> v <br /> Application Date ; 10 � �-( It (a • , - - r • - • ' � NIMM (p Q <br /> Describe T Location: City (a- Count 0 O <br /> Type of Business/Services: �'o..� „A �� � y ❑ 5yD A) 4rPA <br /> Business Name Cr — SrOcz�Af l � ELc>!' s" W <br /> SQA i I4 c T),,, sl <br /> Business Addre Business Owner S. AM (ted <br /> ss 1y34 7(, ' 1 S4at ^ 1 t (D <br /> Suite D / /q � A � (D <br /> Mailing Address� 3 — = ZIP 9_ � <br /> Suite Ain., .. Zip Gj y W <br /> Business Telephone 07 — $ / Z L —$ "-� / O <br /> E-Mail Address - � � Contact Person ZVi �( /Uf)� (7 (7 <br /> A <br /> O <br /> i4�^J sz/ S <br /> Check type of InspecTion : D <br /> Special Inspection - City (charge per hour) <br /> LqgoDptit. ft-- <br /> ❑ Special Inspection - County Contract Areas (charge per hour) <br /> ❑ Permit and Code Compliance Inspection <br /> ❑ Permit and Code Compliance Inspection after 20d Inspection (charge per hour) <br /> ❑ All other Field Inspections (charge per hour) <br /> Describe purpose of Inspection : U Sr <br /> APPLICANT SIGNATURE 1 <br /> PRINT NAME : 1 1 , <br /> [ b [ � U DATE_ <br /> ! l(f7n <br /> 1� 1 -' t10 r - 1 C 0 (o <br /> BELOW FOR OFFICE USE ONLY <br /> Issued b : V/ Date Issued: <br /> Check # <br /> Q ecial Inspection - City: Pay Code XX SF �FTP Ste- C.0 <br /> ❑ Special Inspection - County Contract Areas: Pay Code XX $ per/ <br /> 048-2631 -342 .23-10 5 � / <br /> ❑ Permit and Code Compliance Inspection. Pay Code XX $ 048-2631 -342 .23.00 r `' — <br /> ❑ <br /> Permit and Code Compliance Inspection after 2^d Inspection: Pay Code XX $ 048-2631 -342 .23.00 <br /> ❑ All other Field Inspections : Pay Code XX $ 048-2631 - 342 .23-10 <br /> INSPECTION DATE/TIME ' f\ lAhrt� �J *It <br /> INSPECTION RESULTS : 4�fZlLr <br /> I--,—tQ,A- f 74 ,4 it J 1J %rt!/l/ <br /> �/J I 76PjL< S St2 L 'MI ._ R Ejm 14 ( PLO f_� �-/l n lL C"kjro ,Pdq r t tTz -- <br /> y 5'Z tJ D - �TT47VS 1% a.i !&/ ing t.=fC _rjVzC-p oN TY4N k - — <br /> o (D <br /> C ^/l� j 114 r7 GN if 7v ' + %7� j iMJK- R�rt'k� _ � I L � -- o <br /> y <br /> Z / N6 -- 0 <br /> 1 o <br /> INSPECTED BY: C DATE - Zk� IT _ j W <br /> -- - o <br /> o <br /> N 02/12/16 FPD FOR14Inspection App(ica0on While: FPD File Yellow: Inspection Results to Customer Pink: Paymont Copy to Cuslomor 3 cci1 <br /> (O O 00 <br /> O N Uri <br /> .1 - <br /> (-I� <br /> O <br /> --h <br /> N <br />