HomeMy WebLinkAboutEuclid E 12600 Walk in the Wild Solarium
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BUILDING PERMIT APPLICATION WORKSHEET
PLEASE PRINT ANO COMPLETE ONLY THOSE PARTS OF THE FORM YOD UNDERSTAND
(Ptease return thie original and rour builCing plans to the Department ot 8ullding and Safety)
t a Na~e (~1 (Nrsf) (m) OepertmeM tkeOnly
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2 Project Addreee (rtot Mafllnp AdOreae) or Road Pm% &pace Zip
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3 Cilyl nlly byat4~ BubdlvlelonlPlat Name
1 Aarcel No Lat Blodc
w•♦ QEPARTMENT U9E ONLY + t
5 Sia Cab ZoneAsf M Zane Proj9ct No
6 Oweil • No of Buildings Sq Fl/Azxe Oep1h FrontaQe
7 Set 8adc-Front (L)S-1 (R)S-2 Recir Ganaus Trect Module No Inttials
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* 18 Af+dllteci Flrnl Kefie Street Addreee •
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Phone if different Ifan eb0w
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8 Owner/AQsnt (11 different than Nt eDova) Busineae Address
9 Zip City 8tate Phone
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12 Rev!ew Rsqulrad Plan Checlt (Y!N) Oti ) SEPA EuemPt (Yf N) ~ p e
16 Type Wark 0 Bldg Q MH Naw O Rep18ce C,; pther
Ej Fife 17 Oemo C1 AddlAlw f'1 Move
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10 /lpptlcant Neme Stn9e! Addresa
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t1 21p City State Phone
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w lAnder Street Addrese - •
, Zfp City State Phone
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Contect Person Phone If differ+ent than above
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DEPARTMENT APPROVALS
This is not a Permit
Application Type
(Standard unless (Indlcated approvals reAulred in either "release' or'release with condltlons'
otherwlse In01ca1ed) space prlor to permlt Iseuence ) ~ .
Fast Track
C] Estly Stert Relesse
Rafesse w/cortd 1 Hold 2
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Envlronmental NeaNh p Commerclal ❑ Restdential
W 1101 Collsge p New Conetruction p Btdg alteratian/addltion
Room 200 ❑ Additlonal structure,
APPLICATION 0
Condltlons/Commente
Rlanning/Zon1n0 0 Commerciai, O CeA of Exemptlont O Frontage
N 721 Jefte►son O 8etbeclcs 0 lot w!d ❑ lot eize, O uselzone,
O CU varlance zone chenpe shorellne O tence
O Other '
Condltions/Commenta
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~ Engfneere O Commsrclal O Residenttal 0 Flood Ptain
N 811 Jefferaon O drafnaps O new eccesalapproach, O fence
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❑ road improvements
Conditlons/Comments
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0 UtlllUes
N 811 Jefferson
Oondltlons/Commente
0 Olher
❑ Plan Exam
Fire Pr9ev
Condltlons/Comments
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Project Representetive TelepAone
~ Agencfee Pertorming Speclal Inspection
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1 Indkate above or ettach eonditlona reletlve to tlnel es bullt epprovel
2 Indlcate ebove or etteah reaeons for hold
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