HomeMy WebLinkAboutF2022-0003 - Permit ApplicationPlease print.3 copies
Associated Building Permit #
F_ Fire Sprinkler Fire Alarm f— FireMisc
1. Project Address (Not mailing address)
CJ/n31W Lltnt?
Floor Suite No
t t 7a,- J jAn
t. !($t
# Units F3-
Tenant Name
2. Description of Work
/
Use F
F -F7,.
C
f fir&)ef- { s tyyy� drdi arl", �AAWI
Valuation $ L� 3,�
Extg Sq Ft
Tot
New/Added Sq Ft Total Sq Ft
-
New (— Add
Alter r Demo
#Stories
c
Check Appropriate Box for ApplicanVNotification
3. Owner's Name Last First
Owner's Address Owner's E-mail Address
L5 Dove Sf tcity A� �% e Zip J/ / Telephone
r 4. Architect/Designer's Name Last First F— Lic. No.
Architect/Designees Address Architect/Designers-E-mail Address
City State F Zip Telephone
5. Engineer's Name Last First
-etdoza
r'b 5~1 Lic. No.
�—
Engineer's Address A Engineer's E-mail Address
q516 E_ to PO)"- .'", *.W I
city `M State (,k Zip l M-7 Telephone ?19- �q5 _1104
r
6. Contractor's Name Last First /%!'H'l Lic. No. 83 Class I a)
Contractor's Address Contractor's E-mail Address
18735
City O State K1� Zip eJQ � Telephone lc Q760
'FFICE USE ONLY PERMIT NO. F ZU v� _t✓� ='
'PE OF CONSTRUCTION PLAN CHECK NO. O
CUPANCY -GROUP _3,Z,; )-Z 0 _ C) "�� PLAN CHECK FEE $