06-101562Ciitof Federal WayR a
•
Community Development Services Buildio — Single Family Permi • 06 -101562 -00 -SIF
P.Q. Box 9718
Federal Way, WA 98063-9718
Ph: (252) 835-2607 Fax: (253) 835-2609 Inspection Request Line: (253) 835-3050
Project Name: NORTHLAKE RIDGE 4/30
Project Address: 33709 42ND CT S
Parcel Number: 618143 0300
Project Description: NEW - Construct a new 3592 sqft, 2 -story single-family residence with a 418 sqft attached
garage and 116 sqft covered porch, including plumbing & mechanical. No deck. *** 5
bedrooms, $316,900 sale price*** BASIC #05-100360 **7/31/06 Add 2nd HWT**
Owner
Applicant
Contractor
Lender
QUADRANT CORPORATION, THE
QUADRANT CORPORATION, THE
QUADRANT CORPORATION, THE
QUADRANT CORPORATION, THE
PO BOX 130
PO BOX 130
QUADRC*221 OF 9/10/07
PO BOX 130
BELLEVUE WA 98009
BELLEVUE WA 98009
PO BOX 130
BELLEVUE WA 98009
family)
BELLEVUE WA 98009
Zoning Designation ...............................................
Census Category: 101- New single family house, detached
Includes:
#1
#2 #3 #4
Occupancy Class:
R-3
U
Construction Type:
Type V- N
Type V- B
Occupancy Load:
4126
Occupancy #1 -Use ...............................................Residence
Floor Areas . ft.
3,592 1
418 1 0 1 0
New / Additional Sq. Feet - I st Floor....................1726
New Additional Sq. Feet - 2nd Floor ................... 1982
Occupancy #2 - Class ............................................
U
New / Additional Sq..Feet - Other.................:...
.0
Plumbing to be Included?......................................Yes
New / Additional Sq. Feet - Total..........................
4126
Occupancy #1 -Use ...............................................Residence
(1 or 2
Occupancy #2 - Use ...............................................
Private Garage
family)
Zoning Designation ...............................................
RS 9.6
New / Additional Sq. Feet - 3rd Floor ...................
0
Occupancy #1 - Area (Sq. Feet).............................3592
Occupancy #2 - Area (Sq. Feet) .............................
418
New / Additional Sq. Feet - Basement...................0
Basic Plan?...........................................................
No
Occupancy #2 - Construction Type ........................Type
V - B
New / Additional Sq. Feet - Deck ..........................
0
New / Additional Sq. Feet - Garage .......................418
Mechanical to be Included? ...................................
Yes
Occupancy #1 -Class ............................................R-3
Mechanical Fixtures
Air Handling Units ......................... 1.00 Fans................................................ 9.00 Furnaces......................................... 1.00
Gas Logs ........................................ 3.00 Gas Pipe Outlets............................. 9.00 Hot Water Tank............................. 1.00
Plumbing Fixtures
Bathtubs ......................................... 5.00 Dishwashers................................... 1.00 Laundry Washer Outlets................ 2.00
Lavatories ...................................... 7.00 Sinks.............................................. 3.00 Water Closets................................. 6.00
HoseBibbs..................................... 4.00
CONDITIONS:
This decision shall not waive compliance with future City of Federal Way codes, policies, or standards
relating to the subject proposal.
Special plat condition(s) apply.
PEVEXPIRES Monday, April 28,2008
t Issued on Friday, April 28, 2006
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington
` and the City of Federal Way.
Owner or agent: Date:
City of Federal Way
Certificate of Occupancy
This Certificate issued pursuant to the requirements of Section 110.2 of the International Building Code certifying that
at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building
construction or use. This certificate is valid ONLY when endorsed by City staff.
Tenant Name: NORTHLAKE RIDGE 4/30
Address: 33709 42ND CT S
Permit #: 06 -101562 -00 -SF
Includes:
#1
#2 #3 #4
Occupancy Class:
R-3
U
Construction Type:
Type V- N
Type V- B
Occupancy Load:
Floor Area (sq. ft.)
3,592
418 1 0 0
Owner Name: QUADRANT CORPORATION, THE
Owner Address: PO BOX 130
P__ BELLEVUE WA 98009
agamw:t,, Cao' (l
f
Building Official
The priority focus in the review and inspection made by the City prior to issuance of this Certificate was on those matters which
experience has shown most sevedy affect the health and safety of the general public. Although the City has made as complete a
review and inspection as is reasonably possible (within budgetary time and personnel limitations), the City neither guarantees nor
warrants to the owner/ occupant or to any other person that this Certificate evidences strict compliance with each and every
ordinance or regulation of the City or the State of Washington affecting the construction or use of said structure or the land upon
which it is situated. Such compliance is the responsibility of the owner and / or occupant of the premises.
City of Federal Way BuildA —
Community Development Services ll
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609
Single Family PermiA 06 -101562 -00 -SF
Inspection Request Line: (253) 835-3050
Project Name: NORTHLAKE RIDGE 4/30
Project Address: 33709 42ND CTS FILE Parcel Number: 618143 0300
Project Description: NEW - Construct a new 3592 sqft, 2 -story single-family residence with a 418 sqft attached
garage and 116 sqft covered porch, including plumbing & mechanical. No deck. *** 5
bedrooms, $316,900 sale price*** BASIC #05-100360 **7/31/06 Add 2nd HWT**
Owner
Applicant
Contractor
Lender
QUADRANT CORPORATION, THE
QUADRANT CORPORATION, THE
QUADRANT CORPORATION, THE
QUADRANT CORPORATION, THE
PO BOX 130
PO BOX 130
QUADRC*221OF 9/10/07
PO BOX 130
BELLEVUE WA 98009
BELLEVUE WA 98009
PO BOX 130
BELLEVUE WA 98009
New / Additional Sq. Feet - Garage .......................418
BELLEVUE WA 98009
Census Category: 101 - New single family house, detached
Includes:
#1
#2 #3 #4
Occupancy Class:
R-3
U
Construction Type:
Type V- N
Type V- B
C}eC Load:
Occupancy #1 - Area (Sq. Feet).............................3592
Floor Areas . ft.
3,592 1
418 1 0 1tk
New / Additional Sq. Feet - 1 st Floor....................1726
Occupancy #2 - Class ............................................ U
Plumbing to be Included?......................................Yes
Occupancy #1 - Use...............................................Residence
(1 or 2
family)
Zoning Designation ...............................................
RS 9.6
Occupancy #1 - Area (Sq. Feet).............................3592
New / Additional Sq. Feet - Basement...................0
Occupancy #2 - Construction Type ........................Type
V - B
New / Additional Sq. Feet - Garage .......................418
Occupancy #1 -Class .............................................R-3
iforilgimig 11 1kiff JJY jpmf
New / Additional Sq. Feet - 2nd Floor...................1982
New / Additional Sq. Feet - Other.:.....................0
New / Additional Sq. Feet - Total .......................... 4126
Occupancy #2 - Use...............................................Private Garage
New / Additional Sq. Feet - 3rd Floor...................0
Occupancy #2 - Area (Sq. Feet) ............................A18
BasicPlan?........................................................... No
New / Additional Sq. Feet - Deck..........................0
Mechanical to be Included?...................................Yes
Mechanical Fixtures
Air Handling Units ......................... 1.00 Fans................................................ 9.00 Furnaces......................................... 1.00
Gas Logs ........................................ 3.00 Gas Pipe Outlets............................. 9.00 Hot Water Tank............................. 1.00
Plumbing Fixtures
Bathtubs ......................................... 5.00 Dishwashers................................... 1.00 Laundry Washer Outlets................ 2.00
Lavatories ...................................... 7.00 Sinks.............................................. 3.00 Water Closets................................. 6.00
Hose Bibbs..................................... 4.00
CONDITIONS:
This decision shall not waive compliance with future City of Federal Way codes, policies, or standards
relating to the subject proposal.
Special plat condition(s) apply.
PERT EXPIRES Monday, April 28, 2008
it Issued on Friday, April 28, 2006 0
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington
./ and the City of Federal Way. _ n _
Owner or agent:
City of Federal Way
Certificate of Occupancy
Date: / -s/ - D (,
This Certificate issued pursuant to the requirements of Section 110.2 of the International Building Code certifying that
at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building
construction or use. This certificate is valid ONLY when endorsed by City staff.
Tenant Name: NORTHLAKE RIDGE 4/30
Address: 33709 42ND CT S
Permit #: 06 -101562 -00 -SF
Includes:
#1
#2 #3 #4
Occupancy Class:
R-3
U
Construction Type:
Type V- N
Type V- B
Occupancy Load:
Floor Area (sq. ft.) 1
3,592
418 0 0
Owner Name: QUADRANT CORPORATION, THE
Owner Address: PO BOX 130
BELLEVUE WA 98009
Building Official
Date
The priority focus in the review and inspection made by the City prior to issuance of this Certificate was on those matters which
experience has shown most severly affect the health and safety of the general public. Although the City has made as complete a
review and inspection as is reasonably possible (within budgetary time and personnel limitations), the City neither guarantees nor
warrants to the owner occupant or to any other person that this Certificate evidences strict compliance with each and every
ordinance or regulation of the City or the State of Washington affecting the construction or use of said structure or the land upon
which itis situated. Such compliance is the responsibility of the owner and / or occupant of the premises.
•�' , City of Federal Way gixild g - Ing a Family
Community Development Services
P.O. Box 9718
Federal Way, WA 98063-9718
Ph: (253) 835-2607 Fax: (253) 835-2609
Project Name: NORTHLAKE RIDGE 4/30
Project Address: 33709 42ND CT S
Permit #: 06 -101562r -00 -SF
Inspection Request Line: (253) 835-3050
Parcel Number: 618143 0300
Project Description: NEW - Construct a new 3592 sqft, 2 -story single-family residence with a 418 sqft attached
garage and 116 sqft covered porch, including plumbing & mechanical. No deck. *** 5
bedrooms, $316,900 sale price*** BASIC #05-100360
Owner
Applicant
Contractor
Lender
QUADRANT CORPORATION, THE
QUADRANT CORPORATION, THE
QUADRANT CORPORATION, THE
QUADRANT CORPORATION, THE
PO BOX 130
PO BOX 130
QUADRC*2210F 9/10/07
PO BOX 130
BELLEVUE WA 98009
BELLEVUE WA 98009
PO BOX 130
BELLEVUE WA 98009
New / Additional Sq. Feet - Garage .......................
BELLEVUE WA 98009
Mechanical to be Included?...................................Yes
Census Category: 101 - New single family house, detached
Includes:
#1
#2 #3 #4
Occupancy Class:
R-3
U
Construction Type:
Type V- N
Type V- B
Occupancy Load:
Basic Plan?...........................................................
Floor Areas . ft.
3,592•..
418 0 0
AdditiallM�errit Infonatian
New / Additional Sq. Feet - 1 st Floor....................1726
New / Additional Sq. Feet - loor..................
:1982
New / Additional Sq. Feet - 3rd Floor...................0
Occupancy #1 -Area (Sq. F
...............3592
Occupancy #2 - Area (Sq. Feet).............................418
New /Additional Sq. Feet - B ement...................0
Basic Plan?...........................................................
No
Occupancy #2 - Construction Type.......................Type
V - B
New / Additional Sq. Feet - Deck..........................0
New / Additional Sq. Feet - Garage .......................
418
Mechanical to be Included?...................................Yes
Occupancy #I - Class .............................................
R-3
Occupancy #2 - Class.............................................0
New / Additional Sq. Feet - Other .........................
0
Plumbing to be Included?......................................Yes
New / Additional Sq. Feet - Total.......................... 4126
Occupancy #1 -Use ...............................................Residence
(1 or 2
Occupancy #2 - Use ............................................... Private Garage
family)
Zoning Designation ............................................... RS 9.6
Mechanical Fixtures
Air Handling Units ......................... 1 Fans................................................ 9 Furnaces......................................... 1
Gas Logs ........................................ 3 Gas Pipe Outlets............................. 9 Hot Water Tank............................. 1
Plumbing Fixtures
Bathtubs ......................................... 5 Dishwashers................................... 1 Laundry Washer Outlets................ 2
Lavatories ...................................... 7 Sinks.............................................. 3 Water Closets................................. 6
Hose Bibbs..................................... 4
CONDITIONS:
This decision shall not waive compliance with future City of Federal Way codes, policies, or standards
relating to the subject proposal.
Special plat condition(s) apply.
i 0 1PIWIT EXPIRES Monday, April 28, 8 %'
-
—Permit Issued on Friday, April 28, 200 s
I hereby certify that the above information is correct and that the construction on the above described property and
the occupancy and the use will be in accordance with the laws, rules and regulations of the State of Washington
A A A A 9 and the Uity of Federal Way.
Owner or agent:
City of Federal Way
Certificate of Occupancy
Date: 4 -2,4b -6U-
This Certificate issued pursuant to the requirements of Section 110.2 of the International Building Code certifying that
at the time of issuance, this structure was in compliance with the various ordinances of the City regulating building
construction or use. This certificate is valid ONLY when endorsed by City staff.
Tenant Name: NORTHLAKE RIDGE 4/30
Address: 33709 42ND CT S
Permit #: 06 -101562 -00 -SF
Includes:
#1
#2 #3 #4
Occupancy Class:
R-3
U
Construction Type:
Type V- N
Type V- B
Occupancy Load:
Floor Area (sq. ft.)
3,592
1 418 1 0 0
Owner Name: QUADRANT CORPORATION, THE
Owner Address: PO BOX 130
BELLEVUE WA 98009
� Oho
oununIy VIIIUdi juate '
The priority focus in the review and inspection made by the City prior to issuance of this Certificate was on those matters which
experience has shown most severly affect the health and safety of the general public. Although the City has made as complete a
review and inspection as is reasonably possible (within budgetary time and personnel limitations), the City neither guarantees nor
warrants to the owner/ occupant or to any other person that this Certificate evidences strict compliance with each and every
ordinance or regulation of the City or the State of Washington affecting the construction or use of said structure or the land upon
which it is situated. Such compliance is the responsibility of the owner and / or occupant of the premises.
A
0 THIS CARD IS TOJMAIN ON-SITE
CITY of - Community Development Inspection Recor* d'
Federal Way IVR INSPECTION REQUEST PHONE # (253) 835-3050
PERMIT #: 06 -101562 -00 -SF
Owner: QUADRANT CORPORATION, THE
Address: 33709 42ND CT S
FEDERAL WAY, WA 98001
This card is part of your required inspection documents. Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD.
Inspections are listed as close to sequential order as possible (read left to right, top to bottom). Please schedule inspections as appropriate. Work must not
be covered until it is approved. Check with your inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections
are logged on the back of this card.
❑ Temp. Erosion Control (4365) ❑ Footings/Setback (4110) Foundation Wall (4115)
To be done prior to breaking ground Approved to place concrete Approved to place concrete
By GCj Date,<-aByDate -o�I By C Datepc
❑ Drainage/Downspout (4040)
Approved to backfill
By Date
❑ Underfloor Framing (4285)
Approved to sheath floor
By IJ4C Date , j Dk
❑ Roof Sheathing (4220)
Approved to install roofing
qxt 'S�
B}(1f� Date (.
❑ Gas Piping (4125)
Approved to release test
B ('_7 Date r - Z' _o
❑ Framing (4120)
Approved to insulate
BL=t t'- Date_ 27-0�
❑
Plumbing Groundwork (4190)
❑ Slab/Concrete Floor (4255)
Approved to cover
Approved to place concrete
By
Date
By Date
Q
Floor Sheathing (4105)
Shear Walls (4245)
Approved to install flooring
Approved to install siding
By
W,,j Date V _ 2�1_ p L
ByZ \A,,_� , Date 1,, -11—�
❑
Rough Plumbing (4230)
❑ Mechanical Rough -in (4165)
Approved
Approved
By
Date pfQ .15
B Date L
❑
Fire/Draft Stops (4095)
r to scheduling a Framing (4120)
Approved
ectrical, Plumbing & Mechanical
FRough-in
ire/Draft Stop inspections must be
By
Date _ 2,�,
pproved. IBC 1093.4/UBC 1085.4
❑
Insulation (4150)
❑ Gypsum Wallboard Nailing (4130)
Approved to install wallboard
Approved to install mud & tape
is Date -z7-U�
BL, Date -2 '
❑ Final - SWM (4375) ❑ Final - Mechanical (4065) ❑ Final - Plumbing (4075)
Approved Approved Approved
By Date By Date By Date
Final - Building (4050) []Temp. Erosion Maintenance (4370
Approved Approved
B Date By Date
arr. ,;1& RECEID
r-ecleml Way PERMIT
111 101 TY DEVELOPMENT SERVICES MAR 3 0 2 0 06
33325 D AVENUE SOUTH . 63 BOX 9718 � L I C AT I O N
FEDERAL, WAY, WA 98063-9718
253-835-2607• FA.Y 253-835-260`` (TY OF F E D
www.af'o deralwaucom BUILDING DEPT.
-& M14 I
ItFCOME LDEENFP
The ollowin is re wired information — an incoMnlete nonlication will not be acc ted. Please nrint le ibl in in or
PROPERTY•• •
SITE ADDRESS 33709 42nd Court So., Federal Way, WA 98001 SUITE/UNIT N N/A
ASSESSOR'S TAX/PARCEL # 6 1 8 1 4 3- 0 3 0 0 LOT SIZE (sfi 6,800
LEGAL DESCRIPTION (e.g. Acme Estates, Lot I) Northlake Ridge, Division 4, Lot #30
(Attach aWaratepage for lengthy legal des-phon)
TYPE OF PERMIT ♦ BUILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ELECTRICAL ❑ ENGINEERING ❑ FIRE PREVENTION SYSTEM
PROJECT DESCRIPTION (Provide detailed description of work included on this permit only)
Construction of Single Family Residence, Quadrant Homes Plan Number 3511 B.
Lot 30 of Northlake Ridge, Division 4
City of Federal Way Registered Basic Plan Number 05-100360-00.
PROJECT NAME (Name of Business or Owner Last Name) Quadrant Homes
PROPERTY
OWNER
APPLICANT
CONTACT
LENDER
NAME PRIMARY PHONE
Quadrant Homes ( 425) 455 - 2900
MAILING ADDRESS CITY, STATE, ZIP
PO Box 130 Bellevue, WA 98009
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
Quadrant Homes
Quadrant Homes
Quadrant Homes
( 425) 455 -
2900
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
( 425) 864 - 9771
PO Box 130
Bellevue, WA 98009
( 425) 864 -
9771
CITY OF FEDERAL WAY BUSINESS LICENSE NUMBER
EXPIRATION DATE
FAX NUMBER
1 9-9 0-1 0 1 9 1 4-B L
12 / 31 / 2005
( 425) 455 -
2900
CONTRACTOR'S REGISTRATION NUMBER (copy of card required with each application)
EXPIRATION DATE
Q U A D R C* 2 2 1 Q F
09 / 10
/ 2007
COMPANY NAME
APPLICANT NAME
OFFICE PHONE
Quadrant Homes
Quadrant Homes
( 425) 455 - 2900
MAILING ADDRESS
CITY, STATE, ZIP
CELL PHONE
PO Box 130
Bellevue, WA 98009
( 425) 864 - 9771
RELATIONSHIP TO PROJECT
FAX NUMBER
❑ Architect ❑ Tenant ♦ Agent ❑ Other (Describe),
( 425) 452 - 6535
NAME PRIMARY PHONE E-MAIL ADDRESS
Glen M. Lyons 425 646 - 8360 glen.lyons@quadranthomes.com
Per1tCW 19„27 095: Lender jArOrMat4M it ,:
NAME
rvngra&+ir)! tfproJect value ezceeQs.,,thoo; :
Quadrant Homes
MAILING ADDRESS
CITY, STATE, ZIP
PO Box 130
Bellevue, WA 98009
EXISTING USE N/A PROPOSED USE Single Family Residence
EXISTING ASSESSED/APPRAISED VALUE $ N/A VALUE OF PROPOSED WORK $ 132,904.00
SPRINKLERED BUILDING? ❑ YES ♦ NO FIRE SUPPRESSION SYSTEM PROPOSED/REQUIRED? ❑ YES ♦ NO
WATER SERVICE PROVIDER ♦ LAKEHAVEN ❑ HIGHLINE ❑ TACOMA ❑ PRIVATE (WELL)
SEWER SERVICE PROVIDER ♦ LAKEHAVEN ❑ HIGHLINE ❑ PRIVATE (SEPTIC)
AREA DESCRIPTION
EXISTING
PROPOSED
TOTAL
_ 0 BBQS
SQ. FT.
SQ. FT.
SQ. FT.
BASEMENT
0 FIREPLACE INSERTS
1 RANGES
0 MISC (Describe)
0 COMPRESSORS
0
0
0
FIRST
9 GAS PIPE OUTLETS
0 NO
NEW ADDRESS REQUIRED?
PLUMBING
0
1,610
1,6 -1 -0 -
610SECOND
SECOND
6 WATER CLOSETS (To,ieq
0 MISC (Describe)
1 DISHWASHERS
3 SINKS
0
1,982
1,982
THIRD
0 RAINWATER SYST
2 WASHING MACHINES
0 URINALS
0
0
0
FOURTH
O ELECTRIC WATER HEATERS
0
0
0
ADDITIONAL FLOORS (DESCRIBE)
0
0
0
DECK(COVERED?)
0
98
98
GARAGE ® CARPORT ❑
0
418
418
Ws77110
TxOt08ED
TOTAL
TOTAL:. S'i�C1V
TO?AL 11t4lO D#
iWruor
NUMBER OF FLOORS
0
2
2
0
4,108
4,108
�-*NEWHQMES ONLY** NUMBER OF BEDROOMS 5 ESTIMATED SELLING PRICE $ 383 400.00
number of each type of fixture to be installed or relocated as part of this project. Do not include existing fixtures to remain.
Value of Mechanical Work $ 5.926.80
1 AIR HANDLING UNITS
0 EVAPORATIVE COOLERS
3 GAS LOGS
0 REFRIG. SYSTEMS
_ 0 BBQS
9 FANS
0 HOODS (commeroul(
0 WOODSTOVES
0 BOILERS
0 FIREPLACE INSERTS
1 RANGES
0 MISC (Describe)
0 COMPRESSORS
1 FURNACES
1 GAS WATER HEATERS
_0 DUCTS
9 GAS PIPE OUTLETS
0 NO
NEW ADDRESS REQUIRED?
PLUMBING
UP/SEPA/SUP
0 YES
a NO
5 BATHTUBS (orTub/Shower combo( 0 SHOWERS
6 WATER CLOSETS (To,ieq
0 MISC (Describe)
1 DISHWASHERS
3 SINKS
0 DRINKING FOUNTAINS
0 GAS PIPE OUTLETS
0 SUMPS
0 RAINWATER SYST
2 WASHING MACHINES
0 URINALS
4 HOSE BIBBS
l_ LAVS (Bathroom Smka(
1 VACUUM BREAKERS
O ELECTRIC WATER HEATERS
I cert(& under penalty of perjury that the information furnished by me is true and correct to the best of my knowledge, and further, that I
am authorized by the owner of the above premises to perform the work for which the permit application is made. I further agree to hold
harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in the investigation and defense of
such claim), which may be made by any person, including the undersigned, and filed against the City of Federal Way, but only where such claim
arises out of the relianceo!f he city, jjtcluding its officers and employees, upon the accuracy of the information supplied to the city as a part of
this application. �/ , /
NAME/TITLE
RELATIONSHIP 10 PROJEJ` ❑ Owner ♦ Agent Cl Contractor
(Title)
❑ Architect ❑
DATE 3/29/2006
Bulletin #100 - August 19, 2004 Page 2 of 4 k\Handouts\Permit Application
o NEW o ADDITION
o ALTERATION
0 REPAIR o TENANT IMPROVEMENT
BUILDING SHELL ONLY?
0 YES 0 NO
BASIC PLAN?
0 YES
0 NO
ZONING DESIGNATION
CHANGE OF USE?
0 YES
0 NO
NEW ADDRESS REQUIRED?
0 YES a NO
UP/SEPA/SUP
0 YES
a NO
PLATTED LOT?
o YES 0 NO
DENO PERMIT REQUIRED?
Cl YES
ONO
Bulletin #100 - August 19, 2004 Page 2 of 4 k\Handouts\Permit Application
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