Sprague E 10407 Warehouse - Storehouse (Arby's)
BUIIDING PERMIT APPLiCAT10M WORKSHEET
PLEASE PRINT AND COMPLETE ONLY THOSE PARTS OF THE FORM YOD UNDERSTAND
(Piease raturn thia original and yaur buliding plans to the Department ut Bu110ing and Safety)
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1 Owner a Nentie pa~si~ it~rst> (ml ~pvtment We Only ~
1 Ras Comm Loo~
2 Pp6Je6 Addre;s Iftot Medsi4g AdOress) a Nwo Name Spar-e Zio
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3 aql0ommunfcy stasb 8ubdivistonlPlet Neme
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yr~+ ~at 8t{71k
d Asaeesor No r OEPARTMENT USE ONLY w
5 Sk GbfJe ZCree Act M ZoRe ~ ProJecl No
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8 Owell / No of Buildfnga Sq Ft 1 A"d Oeptn ~ Fro1+tage ~
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7 Set Badc-Froni lL)&1 (R)&2 RaRa NtodWe No IniSiafe
~ 16 AnhIted Ftrtn Nam$ ' Sttw ILQdre3e ~
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Qbrttec! ParBOn Ptrone H dlRewt than above
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Contod Perwn ' 'UcenseHp ' Pl~one if dlltefent than aDove
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8 Owner/1Agent ptdiff tfltanMl above) BuelnesaAddtese
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9 Lp CMy Siste Ptione
12 Rttvtew Requlred ' Wert Ch9ck (YIN) f Othef (YlN) SEPA Exempt (YIN) ~ Date
15 Type Work )k'8tdg l~ C MH Q New 13 R6Dlae D Otteet
'C" Flre p Oems rt ANIANer Q Move
14 Oesctlbe Work ~
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10 Appllcant Nsme 8treet Addresa /
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11 Zip City Stete ~ Phone
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Contacl Femn Pnane i1 diHerent Ihen ebove
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DEPARTMENT APPROVALS
This is iint a Permit
Appllcatlon Type
(Stendard unlesa (Indlcated approval8 requlred in etther "release" or "release with conditions'
otherwlse Indicated) gpace prlor to permlt issuance )
❑ Fast Track '
p Early starc Re~ea~
Retease w/cond 1 Hold 2
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Enviranmenfsl Hsalth ~Pwew ommercial, p Residential
W 110/ College Conetructlon, 17 91dg alterationladdition
Room 200 1-1 Additionai struCture, ,
APPLICATION N
Condittons/Comments
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PlAnninp/Zonlnp. VCommercfal. CI Cert of Exemption, 0 Frontage,
N 721 Jetferson D Setbacks, 0 lot wld. Q lot afze, ❑ uee/zone, ,
0 CU, variance. =one change. 9horeline, C1 tence,
Other
Conditiona/Commen'}o~( ~e~,
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Enplnesn: "mme►clal. 0 Residential; 0 Flood Plain.
N 811 Jetterson O dralnage C'J new acxeaslapproach, ❑ fence.
O road improvements
Conditiona/Commenta
0 utiuties• ~ N 811 Jefferson
ConditionslComments
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Plan Ex*m
Flre Prsv
Condltlons/Comments
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Project Representative TelepAone
y Agencies Pertormtng Special Inapection
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1 Indkete above or attach conditlona relativs to 11na1 as bullt approvel
2 Indkata sbove or attsch rssaona for hold
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~ RM ARCHITECTS P. S. . ARBY,S REST'AURANT -6'g4~, ~
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sooonns e010? 5091469 3200 y~ ~ ~ gAeet NO
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