. Use to request authorization for Department-directed jobs . Send completed permit application to: Email: Facilities Customer Fax: 756-6114 Attn: Facilities Help Center and Business Services Applicant’s Name: Today’s Date: (Applicant will be the primary contact for this project) Phone Number: Department: Alternate Phone Number: Email Address: Optional: Names and Phone numbers of other involved parties (Supervisor, Dean, Advisor etc.) Project Name: Bldg. Name: Bldg. #: Who is doing the work? Room #: (Check all that apply) Student Project Other Contractor (Explain) Department Labor Source of Funding: Estimated Cost/Budget: Description of Project: supporting documents such as scope, plans, specifications, location, etc. to: facilities-CBS@calpoly.edu and Mike Hogan at mhogan@calpoly.edu Status of Project: Proposal (We can only review the concept, not issue a permit) Ready to Review Under Construction (oops!) Approval Signature: Academic Departments Require Dean’s Signature (Please Print Name) (Non-Academic Departments Require Division or Department Head Signature) Facility Services Use Only Project SR_______________ Time Window: FAC-10A REV 9/14 Return Application Form to Facilities Customer and Business Services
Facilities Customer and Business Services Send completed permit application to: Email: Fax: 756-6114 Attn: Facilities Help Center Applicant’s Name: (Applicant will be the primary contact for this project) Today’s Date: Phone Number: Department: Alternate Phone Number: Email Address: Optional: Names and Phone numbers of other involved parties (Supervisor, Dean, Advisor etc.) Project Name: Bldg. Name: Bldg. #: Who is doing the work? (Check all that apply) Room #: Contractor Student Project Other (Explain) Department Labor Source of Funding: Estimated Cost/Budget: Description of Project: supporting documents such as scope, plans, specifications, location, etc. to: facilities-CBS@calpoly.edu and Mike Hogan at mhogan@calpoly.edu Status of Project: Proposal (We can only review the concept, not issue a permit) Ready to Review Under Construction (oops!) Approval Signature: Academic Departments Require Dean’s Signature (Non-Academic Departments Require Division or Department Head Signature) (Please Print Name) Facility Services Use Only Project SR_______________ Time Window: REV 9/14 FAC-10A Return Application Form to Facilities Customer and Business Services . Use to request authorization for Department-directed jobs .
building%20permit.docx