HomeMy WebLinkAboutForm - Application for Alteration Permit (fillable)DEPARTMENT OF LIQUOR CONTROL COUNTY OF HAWAI‘I
Hilo Lagoon Centre, 101 Aupuni St., Unit 230, Hilo, Hawai‘i 96720 * Phone: (808)961-8218 * Fax: (808)961-8684 E-Mail: cohdlc@hawaiicounty.gov
APPLICATION FOR ALTERATION PERMIT
INSTRUCTIONS: Complete Section I and take this form and a copy of your plans to the County of
Hawai‘i Department of Public Works, Building Division, for their response.
Section I. TO: Liquor Commission, County of Hawai‘i Pursuant to Rule 3-2-D-1, Rules and Regulations of the Liquor Commission of the County of Hawai‘i, a request is hereby made for a proposed alteration to the licensed premises, which details are described as
follows (include square footage & TMK):
Licensee:
dba: By:
(Signature)
Name: Title:
Date:
Phone No.: E-Mail:
Section II. TO: Department of Public Works, Building Division The licensee is requesting a review of the proposed change or alteration to their premises. Does your
review indicate that a building permit is required?
Yes. Applicant to complete Section III.
No. Applicant to complete Section IV.
DPW By
(Signature)
Name:
Date:
Section III. To be completed if answer to Section II is “Yes.” Submit for Liquor Commission approval:
1. Application for Alteration Permit. 2. One set of building plans.
3. Copy of building permit.
Section IV. To be completed if answer to Section II is “No.” Submit to Department of Liquor Control:
1. Application for an Alteration Permit. 2. One set of building plans.
PERMIT
Your request for an alteration permit is approved effective . A final inspection by the Department of Liquor Control is required prior to use of the altered area.
By Director, Department of Liquor Control
Date: Ratified by the Liquor Commission on:
Date:
Hawai‘i County is an Equal Opportunity Provider and Employer