HomeMy WebLinkAboutF2021-0504 - Permit Application (2)0 ' Worksheet for Fire Permit Application to
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Associated Building Permit # �(% p�% '� y� ° Fire11Spririnkller I F- Fire Alarm /F `Fire Misc
1. Project Address (Not
Tenant Name
2. Description of Work
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Extg Sq Ft I (f%/ New/Added Sq Ft r Total Sq Ft �w
F—, New rI Add Alter F_ Demo
Check Appropriate Box for Applicant/Notification
Floor Suite No
# Units
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Valuation $
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3. Owner's Name Last
Owner's Address
U Owner's E-mail Address
City *_
State /� ZIP 1 �l� Telephon4[J'�
tNo.
4. Architect/Designer's Name
Architect/Designer's
Last(First
IUI 1 Lic
�Architect/Designees
Address
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rE-mail Address
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State Zip Telephone I /1
5. Engineer's Name Last
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Engineer's Address
Engineer's E-mail Address
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State Zip / YJ Telephone
6. Cont'ractor's NameLast
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ic. No. Class
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Contractors
Address
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State Zip Telephone�,
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ONLY
PERMIT NO. : (f — O
ECES
ONSTRUCTION
PLAN CHECK NO.NCY-
GROUP
1 — J i PLAN CHECK FEE $