1985, 07-19 Permit App: 00006465 MHBUILDING 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)
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I Application Type
(Standard unless
otherwise Indicated)
❑ Fast Track
❑ Early Stan
DEPARTMENT APPROVALS
This is not a Permit
(Indicated approval$ required In either "release' or 'release with conditions -
space prior to permit Issuance.)
Environmental Health ❑ Commercial; ❑ Residential
W. 1101 College V New Construction; ❑ Bldg alteration/addition
Room 200 ❑ Additional structure;
APPLWATIONM S ezy
Condilona/Comments:
❑I Plan Exam
Fire Prov.
Conditional Comments:
Project Representative Telephone
Agencies Performing Special Inspection:
1.
2.
3. _
1 Indicate above or attach conditions relative to final ea built approval
2 Indicate above or attach reasons for hold
Release
Release w/condi
Hold
❑Frontage; �, i; '
❑use/zone;
fence;
C5 e*
❑I Plan Exam
Fire Prov.
Conditional Comments:
Project Representative Telephone
Agencies Performing Special Inspection:
1.
2.
3. _
1 Indicate above or attach conditions relative to final ea built approval
2 Indicate above or attach reasons for hold
Planning/Zoning:
N. 721 Jefferson
Conditions/Comments:
❑ Commercial; ❑ Cert. of Exemption;
❑ Setbacks; ❑lot w/d; 11 lot size;
,Q CU, variance, zone change; shoreline; ❑
❑ Other
-7i
❑Frontage; �, i; '
❑use/zone;
fence;
Engineers:
N. 811 Jefferson
CaWltions/Comments:
❑
❑
❑
_
Commercial; ❑ Residential;
drainage 0 newaccess/approach;
road Improvements
L�il�f� /.S --p
❑ Flood Plaln;
❑ fence;
Utilities:
N. 811 Jefferson
Conditions/ Comments:
Other:
❑I Plan Exam
Fire Prov.
Conditional Comments:
Project Representative Telephone
Agencies Performing Special Inspection:
1.
2.
3. _
1 Indicate above or attach conditions relative to final ea built approval
2 Indicate above or attach reasons for hold