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1985, 05-15 Permit App: 00004988 MH-c a r BUILDING PERMIT APPLICATION WORKSHEET PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOU UNDERSTAND (Please return this original and your building plans to the Department of Building and Safety) 1 Owner's Name (first) (m) meat Only 1 CD/l /yps Q�1-y) F� . �� V Collins Comm 2 Prgea Address (not Mailing Address) or Road Name I Space` Zip N I I1�1 Bes3j a. .CligDI7, 3 City/Community l/� State l //��lr Subdivision/Plat Name 1iucten 11h U5t'cn1'1 /Ll4-i 4 Assessor Parcel No. I c;5 ) — Dgc, Lot Block t t * DEPARTMENT USE ONLY * * * 1 5 Sic Code Zone Act. 4 Zone' ( Cra Project No. C 0 ll.J/ 6 Daella No. of Buildings Sq Ft./Acre Depth 1 FrontageQQag� Com/ • 7 Sat Bppc-Front , (L)S-1 (RIS-2br Rear Census Tract Module No. Initials 2d` ii 16 Architect Firm Name I Street Address ' Zip Clty State Phone Conte Per Phone if different than above ( ) Contractor Firm Name al(Ite& 000-ire( 0fers Street C Address i (oa(/ 72". a.e.„14...), . Zip 9c 1(P City Slpokt)tvle. State Uk:. C:: Phone . ( ) `r a-)Da0 Contact Person rn I Ke, S{ /YK License No. Phone if different than above I ) 8 Owner/Agent (If different than 41 above) Business Address 9 Zip City State Phone ( I 12 Review Required Plan Check (Y/N) Other(Y/N) (SERA Exempt(Y/N) Date N -E; 15 Type Work 0 0 Bldg Fire 77 MH /❑ Demo ❑ New 0 Add/Alter 0 Replace 0 Move 0 Other 14 Describe Work M 11-4s SP ger S. : (z:r3cn,2-o.ti-2 (wx��. 10 Applicant Name �. ')CJYA€ (iS akve_. Street Address C aiRD6 toeIIcs/ecl -tI< 11 Zip 9 D 97 Clty_-(S c__� brc?klvr-05 n State LOCI, S CL— Phone Got,Tk 7L47 -7/I1 ( ) iigniii ci D L2 c1 / l , _.-- Lender Street Address Zip City State Phone Contact Person Phone if different than above Additional Information'REFl a•- te-Dna) qc5 -tt+E ( gC I e 4 -6C Application Type (Standard unless otherwise indicated) Fast Track Early Start DEPARTMENT APPROVALS This is not a Permit (Indicated approvals required in either "release" or "release with conditions" space prior to permit issuance.) Environmental Health • ❑/commercial; 0 Residential W. 1101 College ' New Construction; 0 Bldg alteration/addition Room 200 ' ' 0 Additional structure;(5---6:12 ' D APPLICATION p 3 Oc2 e2"5 -- Conditions/ Comments• 5Conditions)Comments n/2/kv7/U'DLC i11fi2/T./iI.-sj. 71/LE ✓0liL/,C-- Release Release w/cond 1 Hold 2 iza _.,LL.ril El Planning/Zoning: 0 Commercial; 0 Cert. of Exemption; 0 Frontage; N. 721 Jefferson 0 Setbacks; 0 lot w/d; 0 lot size; 0 use/zone; ❑ CU, variance, zone change; shoreline; 0 fence; ❑ Other Conditions/Comments' Engineers: 0 Commercial; 0 Residential; N. 811 Jefferson ❑ drainage 0 new access/approach; ❑ \road Improvements Conditions / Comments• ❑ Flood Plain; O fence; Utilities: N.811 Jefferson Conditions/Comments El Other: 0 Plan Exam Fire Prev. Conditions/Comments* Project Representative Telephone Agencies Performing Special Inspection: 1 2 3 1 Indicate above or attach conditions relative to final as built approval 2 Indicate above or attach reasons for hold e h I III11 o I' lillllili ° 11 -1 - EMI: == 3De� i i E IIOIL'I,IaUW�tOl 1111�t1W� `�- f = : i 4 f i. _ I 11111111 11111711 �� IIOlII� IIIilMilmiIOIOIIFIIIIIhh�IIIIIIIIIIIOI uiIIOI il�i u.J//9 111IPIPIU!ilIGNuItJt 6e=lEE•EeaSA�i�e�az%7Ce�ea''��iEi3111�'��■E.�'���'�A'eEEfti:C••'lu•• •• i•:�ji•• 11 R9•n. IfNlm uu•ug�u•. 1' Cp 1n - - :: --:: :•: •. n •"7• �. «i:•.•�....•i"i■ •sem--1 ire I : 1 ��- 11111 • . �S��We Np:I rm.. 4 IMPLIV B .o.® •�p,,�•:.g•-:,�I,:■.0 .. . •i•• u:: .■ Mil_ tl_��••■...n•. ...mrm -51 II nn.•1:n!w:.a ■ a• ■ ..1. NIINNINI 1Mai0•••I.l• ..os - -.:nMIMS MEM i NII{IIu • F.SW �u ftrnnfto•o-.w.••••= : MI mean=,.. . n . womMUMan 1afl, ai: II �NIIfNNNNNNNN ANNENNEIGNNBIras' •m an• ..::i• -a -ii .: in .i ■••••m:�wnilMIM:::-•:SII•:o1M1111= •••.sd GGlN6NiiN___NN_�.fl. flp 1BLii11•m�yi • �•••��1�� •.II �7............rag........naim'➢mm■ •' 6�i. •moi.�•�•�nwo�1111118IBINNIBIS �.n •m •nn i o mg ii . a n.iul pe,,,$puo•ta n •ut••s� NI ...iii' N=I'MOCS. ��. NN�I�1�NN .0 an••n a nusi� -oee •a. ■n onn■.n••n■■ m. Nampingte IMIRMI •� .R R..IIB_..I�i®1_� 111. Mme. IT .•. ..n B�m.nn .n..n �. • ••::o snno::O:::mm-n°.-nm�m•am• ••�-mi•m 11 ■il _•Spn■u..■..••a..nn • nn1'pn.■pnllnI. nnn amnn.ni �KI naan paa�a���apa� �.O.nn..a.mn� urn. In •: - : •.a =MOW MEM :m•" :::.•mGsv.. �Y.-rs�M.....MO..•n•nn �j--_� ®!®®1e1MLI! ISI '1N: u•.,am••an• 4.yIHI!RI.n. • OEM .n MINIM .nn .io NI -f%11 n•..■ uni. Ion _.'-_ SII 10111111.!!I! ....►�. � Y .■.■ .. . pp■.. ....... NINIi1 W1 Mpg T i imom•••••• ..ni :i.••: I.B 1A 6n1 i"••u•i:11iil . IINeil •r I �.:1- : i _ Ion-•I"•im:l'rn min �I�1iI1.1111� 1�tit ._ ... 1.1...■...:.:Ir.:E z„ n1 _ en•7. IFfi! L d/ g3rd