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SULLIVAN N 4424 Key Tronics Loading Dock c~ - ~ r - - r , (THIS IS NOT A PERMiT) BUILDING PERMIT APPLICATION WORKSHEET PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOD UNDERSTAND COMPLETE IN INK (Please return this original and your building plans to the Department of Building and Safety) _ SNADEO AREAS ARE FOFi DEPARTMENTAL USE Pra}oct Number I ~ QwnOr•sNam I.AST FIRST MI ~ ~.o rvI cs ~ppq Adares9 ~StreG1 Name & Number) ZiD ~ q,;2 1 V 2AV d kA V-k W 1. 1 Applicant ress ~ P4 Ct n~~l"..pr~f~~'✓ ~ ~y State 2op Pnone j - 8usiness Phone j _ OontractorlApent AOOres,s t ~ AJs o A1 4e c~ o,~ . ~-c ~3 s~Ne t C_~s ~ City State Zip~ Pnane ! t ~00 4 Ne W 6. ~ 9LoZ ~.3a~' ~ s 3S- 3~-~7 , ppntaW Lfcense Nurnber (RsQuired) Busirtess Ptone ~ ~ AncnftectlEnpineet Ads7ress ' . : Gty State Zip Pnpnn , ( 1 ~ Confacy Business PROrte i , • ( 1 lenaer Address ~ City StBte Zip Phone • ( 1 ' O~a~a1b6WOrIC Ras. ' COtTtm. ~ 'Ly~•ip~.~ia O~j'~y + ~ • ~ ~ ` s C. . ~ SubdtvtstonlP,f at,Nan+e1Stwrt p1,e1 Number_ ° - - , ~ - ~ - - . ~ ~~,~,q~.-;:•y~>>N;~,r~.-~~.=:aYQ;•-<: :r: ~~6 ~ . a ' ' . . ° - : j ~ F~. . 'A~ses9p~ Peroe) NutnD~ ~ = - _ . _ n , LOt - Binck . Piat Number ~~~o~~;t~!'~ y d ~gtY~ - 1- ~ ~ y(-~ - ~ " ~ Zone Comp. Pian , ~ ~ Census 7rast - : "~rz~"t ; '"~S=% " ' !Y'". ' ' , ; ~ _ , ~ e ~ _ c.N~uun~~b6f Y I~p ljnlte~t Number of Bulldinga ~ Lot Size (Sq. FI./Atre) Oapth FroMage ~ L`StLt~!~ - .z>'~.?~:,.\j~.,ct_~.~ i• y= „,ch= Rigt11S@~bask ~ , •J .I~ _ , Roar Setba~e...e' . a RIW 1lYfdtN . . .es. ~ ~r p~~CY~~~ ~ .~J~~ ~ '}F , d'S C.y n p. T, ~ " ' • . • , , ~ ' - ~_S i' ' . ~ . • . ~ • 1 ~l,.Cy[~~rb: T~~-~~:~`:"'~..-.y~ . •e.- - - ~ , . . t 'r . . , .AwaE J~ 1-V;r :S - d~l , ' _ ` ` ~ . ' ' • , r , ~ I ~ . ' _ s - '~er ~~y~~ , ~R ~d~1~y'~L ~a"Lt ~~,✓t y~~.r,r. . : . - " _ a-.;.~'svy\~~'?ij~:r.'rt"~ti -y,~' ~~^18.r.v+!!Qtlv C~.= WJ:' . !~~°r'_~ir•• ~7 :~I~~7i"'~~` ~ ~;`};/✓4~`' I t lr w~` ~ r~ , r ° : . . . _ , J L• _ _ _ _ • • Sr~ • "'p' ; . '5~.= a. ~ ~r f K~';`ti'•y: ~e;' ~ 'aG'~ s-~ ' 's• ~'c~~4.-S~So . ..r 4!. ldl~~ w'y~3i:~iF..,s~~' ~.'1:'•, . Q~Kl~-~ •A s , . '~o ao "c A - . v:`F" '.P ~ i-:t'~' 't s'TS,-~i-7 _ a°' ~~r~-~ - a'~J• i2P, ' ' ~ , ~ ~ ~i ~ , T, :r;+ ~ • . , - ~~`-`Rs *.~~'~r=''-L.~+f :~o ~.`1►~~ _ ~ 3~`., , r Y=. iO r•- . ~ ~ . _ ` ~.L ~ r ~ t~~~" ~~"t` , /v , G ~ , `a t~~l~~ ~!G~.F~IdI ~b~b3,.,ac i.,,.,. ,':rt._ ?..i _ ^.3. _ + A~ ~",J- ~ • P ' I . - - - - Z ~ M1 • a O '~G. ~'~V i '-=.i?34: f~ ~`~+~`C ~P~•}'~ _ - _ , _ , t. . . ~ r a r,. . t~,l _.~~y.~ ,?~~~'~~~~r ' ~.~:i. ~ = ,i~ : ~ r - ' ' - ~ ir-' a ~ - Q ~ a~-'`-~•'-.`~ ~ J- ~i'r' ~~-'1'R..~tS~.r - ~v~..w - t'` t:. ~ ~ ' . ~ T l~. . ' ' V Y~ _p` 1 • p 04 (y. ~ 'Y u.f~.- • : V . r . cr. , _ o r .t~ ~eY~~~f ~ ~~~y y F~~'+ ' ^ 'T ~a n ' ` ` - : ' . - • r ' ' . O ~ ~i• ' ~ ~ ~'~~6:'~: ~ ^a+ ' . ~ . Z i. ( ,7'~ '{~"_'~lq' ,i"'.,•;~ - ~ a r'-° ' _ - ° O . ` 1~"\-H~c~ ~~I _1~'✓ • rh~' J ' • ' ' ' • ~ ' Z ` ~ ~ ' • ~ w ' ~ ~ ~ ~ C". ~ 6 ' ' I o O ~ _ ' 5,~:~ q+1~v~:`'~{~ s-~.-.: a ~~r7~(~^~ _ _ , • , , , . J , r y~ ~ •'`''i~~y~y~~14 1 ~1 _~r 4 ~ - 0 ,5umber of Bo/rWrrV ~ ~ T~,• `.x _ o" ' „ ' . . 'q~g` 4- `"i~ J! v • a~` ~t~~i~~~4~_ 7.i ~ . r y ~ ,%'~►e~1~'„~~~=`.`~ v.F-' ~r~,o _ ~ , _ c, . 1 •i'l .~AYr~f~;.~ rr ~"1.~'d+ t_c- ' ' ~ - ♦ ~ii_ ~ . aa~~'.~, W' i b ~u t.~~ .:ab+. a~ . J✓ ~ l . 7^", GrOUp Typ~ _ , ~ . ~.J..:~a E~ ~3 ' _ - _ _ . t ~ . °P . . , _ , ' - j ' , , ° „ , DEPARTMENTAL REVIEW cond. Approve0, Approval Hold ' Environ,mental HeaHh Appllcatlon~N - ~ W:1101 College Roonn 200 • - ~ . , _ , . . . . , -Plannlng/Zoning N. 721.Jefferson - - - iEngineere - *G ~ N. 811 Jefieraon Utlllties ~ N. 811, Jefferson . , w Plan',Revlew/~Flre Prevontlon - ~ N, 8t 1 Jeffecson - - - - - - . . . , . . I Olher'(SEPA'/Critlcal Meterisl/etc.), - - - i: i Fa'st Tracbc%Speclai Inspectlon Intormatlon. - - - , ~ 'i: 'Project Representetlve Phone ' - 1 Address I certtf,y,,that: I*have,,examined thla applicatlon,and,.state that• the' int&matfon contalned in it~ and 'submitted , by..me,or, my agent•to compite sald'applicatlon is'true and correct. Sigriature- Date ~ ~ ~ • . . { ~ 1 • i ° ' ► „o o~ - • ~ • . ~ ° . ISu LLi YAN ROAD . 1 ° . 64 - -J 4 f ~I t v - . ~ ~ ~ C f ~ A, _ ► 7 . F,iPLOYGC f"K'tti ZJ 7C fAROp J w G r:, ~ ia ° r, Ct•'i , ~ N n ~-7 _.=L i. ' ' S+:r1`~Prrw • ~ r ' v ~ ' • _ ~ y . ~ _ . I~ ~ . , , ~ • , +i , _ ~ ~ ~ ; . L; t, . . ~ , y v ~ ► • , . a rJ e _ - - ~ ' ~ ~ ~ , ...v.. .~:.~~:..~'1 L~i 1 ' n+ ~ - . - ~ - ~ - I•. ' , ~ . _ _ ~ ~•r,, ~y - i , ~ ~j~~- ~ • 1 . ~ ► ° . ~ -00~ n' ' ~ C zs ~ ~ a . .!a •1, . ~ ♦ . o ~ ~ r • ~ ~ w (1 A . • ' ~ ~1 • 40 , _ .