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Igtr
t Prolect Appllcatlon ,'
1..Date... It'
Projeot Nam€:
Project Dosctiption:
Contact Person and Phone
Ownor, Addr€$ and Phon€:
Architect. Address and Phone:
Legal D€scription: Lot
Comments:
, Zone
-
Design Review Board
Date
Motion by:
Seconded by:
APPROVAL DISAPPROVAL
Summary:
+APPLICATION E:
DATE 0F DRB MEETIIIG, I /tZ,I
DRB APPLICATION
*****THJS APPLICATION hliLL NOT BE ACCEPTED UNTIL ALL INFORMATION IS SUBI{ITTED*****
I. PRE-APPLICATION MEETING:
A pre-application meeting with a planning staff member is strongly suggested to
determinb if any additjonal jnformation js needed. No application will be accepted
unless it is complete (must include all items reguired by the zoning administrator).It is the applicant's responsibility to make an appointment w'i th the staff to find
out about additional submittal requirements. Please note that a C0MPLETE applica-
tion wi'l I streamline the approval process for your project by decreasing the number
of conditions of approval that the DRB may st'ipulate. ALL condjtjons of approval must
be resolved before a building permit is issued.
A. PROJECT DESCRIPTiON:
a
DA]
B.LOCAT I ON
Addres s
OF PROPOSAL:
{\
o^^S-t - 5t"3
-L."{=' -&q44L,,"-ct < --
Lot Block " Filing
tel epho,re
f p l e nho np
E. NAriE 0F Or,rNrRS, ,_I^rol___4 -ir$-- llla\-----
Si gnature
Add ress
l-. DRB FtE: The fee tvill be paid at lhe tjme a bujldr'ng perinit is requested.
VAtUATlON rtrtr
Legal Description
Zoning
$o
5 10,c01
5 50,001
s150,001
$ 500 , 0015 0ver
$ 10,000$ 50,000$ 150,ooo$ 500,000
$1,ooo,ooo
$i,ooo,ooo
$ i0.00
$ 2s.00
$ 50.00
$1oo.oo
$2oo. oo
$300.00
r'ilE ili3:
c. NAI,1E 0F AppLrcANT: D ,.,.1 | i^d- lft.sL-
Address
NAI'1E OF APPLICANT'S RLPRESENTATIVE:
Add res s
tel ephone
Ili;,Ci?1,",i'lT ii0TICE RFCi-,r,DIliG At l- Sl,lilil-cSi0llS T0
oo
PO ,4{r"*{ qs a)b*' fl={, q;r'f-Lr- S'o-d'a
a--.-....-
- tloft,- lr'\* +.',tl-- '* 6 o"'sn'*)t
4,S11*y" d, <-we--
:==:l- P-UX
w&* ts-<)
e7v0 {1, '' \ ,t.
', s ,- d,,t.-if,Wr^Tro[ BFoPERMIT NUMBER OF PFOJECT
,o* u lu b,6 ,o"
READY FOR
LOCATION:
l- , t.-\-.
tr FOUNDATION / STEEL
PLUiIBING:
'tr UNDERGROUND
tr ROUGH / D.W.V.
ROOF & SHEER
PLYWOOD NAILING T] GAS PIPING
tr INSULATION
tr SHEETROCK
D POOL / H. TUB
tr FINAL tr FINAL
ELECTRICAL:
tr TEMP. POWER tr HEATING
ROUGH tr EXHAUST HOODS
CONDUIT tr SUPPLY AIR
tr FINAL
,F APPROVED
CORRECTIONS:
tr DISAPPROVED tr REINSPECTION REQUIRED
Best
coPY
Available
DATE INSPECTOR
-
r \\\\\ \ trF
\ i \\ ,,
PERMIT NUMBER OF PROJECT t^tttoN REouEsr
TOW$I OF VA|L r' /r--.,, \t
oor, \\--fN" JoB NAME
READY FOB
LOCATION:
'\
INSPECTIONh MON TUES WED THUR
i
FRI
CALLER '-''.i.. '1. \\
BUILDING:
O FOOTINGS / STEEL
PLUMBING:
ttr UNDERGROT.$ID
tr ROUGH / D.W.V.
tr ROUGH / WATER
tr FOUNDATION / STEEL...
tr FRAMING
|-1 ROOF & SHEER" PLYWOOD NAILING tr GAS PIPING
tr INSULATION O POOL / H. TUB
tr SHEETROCK NAIL o
trtr
D FINAL O FINAL
ELECTRICAL:
tr TEMP. POWER
MEGHANICAL:
tr HEATING
O ROUGH tr EXHAUST HOODS
tr CONDUIT tr SUPPLY AIR
tr
tr FINAL tr FINAL
tr APPROVED
CORRECTIONS:
tr DISAPPROVED D REINSPECTION REQUIRED
Besf
A,f,Wrc
DATE INSPECTOR