HomeMy WebLinkAboutF2021-0608 - Permit ApplicationAssociated Building Permit # a -�ao ❑ Fire Sprinkler F,I Fire Alarm ❑ Fire Misc
1. Project Address (Not mailing address) Floor Suite No
3y`13 PB(Gl rc V,ew Dr 1oron� De filar �'/-1;l C. __ ! � �
—
Tenant Name I (favbw Units
Owner's Address
2. Description of Work
Owner's E-mail Address
city - — — - _ _ _ _State I
i
j
Zip-- Telephone
Two w t 67hl lit
—_
Architect/Designers Address
Extg Sq Ft j New/Added Sq Ft- Total Sq Ft
Valuation $t_;;
— I
—__ —
State
New ❑Add ❑Alter . [ Demo
# Stories IJJJJ
`J
Check Appropriate Box for Applicant/Notification
3. Owner's Name Last
—
— First �-
Owner's Address
Owner's E-mail Address
city - — — - _ _ _ _State I
i
j
Zip-- Telephone
j4. Architect/Designer's Name Last
U First Lic. No.
Architect/Designers Address
Architect/Designer's E-mail Address
City
State
Zip Telephone--
F-' 5. Engineer's Name LastF—,.
First
L, Lic.No.
Engineer's Address
Engineer's E-mail Address
City
— --I
State
Zip Telephone�—
6. Contractor's Name Last First A7gy .e ! Lic. No.
Contractor's Address
Contractor's E mail Address 9537'f9 4101371—
� )
4(a(o 5 got CAY w Ch. Sv Q_
60I_annie
�r nj
— -- -— --
City-NkwQ.._g.QAVh_-- -__—,'
State �—
/� /
71
Zip "I plOt�C�-- Telephone i -P a(fq
- - _-Fq q�
OFFICE USE ONLY
PERMIT NO. �J� ''bl %0z
TYPE OF CONSTRUCTION
PLAN CHECK NO.
OCCUPANCY - GROUP
lam` 1 61
; 7 PLAN CHECK FEE $
( t'r
i i�