HomeMy WebLinkAboutCOM2005-00023 REVISION REQUEST - COM Application - 10/6/2006 Request To Revise An Approved Plan
Permit Number: 00 -
Parcel Number 12.6® t Name_T/ �f I LLf=Sij�3�
Phone Numberdaytime LD)
Project Addres i= k�r✓IEi�LL o—� Mailing Address
Please provide a complete,d, 1 .description of the roposed revisions to the approved plans:
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Are two sets of the revised plans or addendum indicating the changes included? Yes O N
Are the approved site plans included? o
11 No
Are the revisions clearly and accurately identified on the plans or addendum? Yes ❑ No
Does be Plan contain an engineer's or architect's lateral or vertical analysis? O Yes AM
If Yes,Has the engineer or architect approved this revision?
Is a stamped and signed ❑ Yes O No
gn approval included with this request? O Yes El No •
(Note:No structural changes to a"desi¢ned" Ian will be anoroved without the wntten consent of dig endneer and/or amhrtect of remrd
Does the proposed revision modify the footprint
If Yes,Is a revised site 1 with all new setback dimensions included ❑ Yes �No
. P.�'- luded with this request?
O Yes O No
Additional Information:
Applicant's signature o Dater
tlice use only
`' Received b e y: i
Date Sent Assigned To Approved by Date
B. Original Valuation:
` L_�`' 1 ! oZ -� Additional Valuation: $
P. •' r � Sq.Ft. x S
$E4
Sq.Ft. x
s $
E.H. Total New Valuation S
Additional Fees:
!0 N-O 11 Additional Planning Dept. $
New Setbacks: Front / r'/
Rear 15 Hk,/Additional Plan Review $
Side1 Additional Building Permit $
/ Side2 / Additional Plumbin 9 7z A141 C =
Additional Conditions/Comments: Additional Mechanical �s
Additional E.H.Dept. $
Other 5—�-" —
Total Amount Due: $
YU'Fd Amount To Be Paid Up-Front S
yak WW
J 1
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