HomeMy WebLinkAboutF2021-0314 - Permit Application• ••••��NNuaaLion
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Please print 3 copies V �-
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Associated Building Permit # �/'
XZ01 �_- y 13 (� r Fire Sprinkler rj Fire Alarm IJ Fire Misc
71.Project Address (Not mailing address)
L_l- -► ('IG7�Q F^ Suite No
Tenant Name c 'y "�
(Le I �t`t�a✓1 #Units
2. Description of Work
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Extg Sq Ft q Ft Total Sq Ft New/Added S Valuation $ ,
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17
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New r Add Alter r Demo # Stories �'
Check Appropriate Box for Applicant/Notification III __
r 3. Owner's Name Last {{'' �-
1�%�Z-Z. _ ._1 FirstFMiC, Nell
Owner's adriro�. _.....__ ___.. _
F 5. Engineer's Name
Last First
Engineer's Address
City
State
f- 6. Contractor's Name
Lic. No.
Engineer's E-mail Address
Zip Telephone ...__ -...-_ -...
Last p b i First Lic. No. AT3 bpl
Contractor's Address 1 ���
17763, f tr Ave.
CityState
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OFFICE USE ONLY
TYPE OF CONSTRUCTION
OCCUPANCY - GROUP
Contractor's E-mail Address
SfDC_0057WKP0,,@Gne•caa
zip gp25�_1 Telephone310ifiird^ tjj 7
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PERMIT NO.
PLAN CHECK NO.
PLAN CHECK FEE $