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I hereby acknowledge that I have read, understand and answered these
questions accurately to the best of my ability.
u 1(,k f • 3- tT
signature date
Phone: 1St a days);784 44d evenings)
Project Name:
Project Address:
Notes:
1)If you have answered No on any of these questions you may be required to provide this information at
lie request of lie Building Official prior to beginning the plan review process. Delays in issuing the
permit are to he expected. Work may not proceed wi1hmit the issuance of the permit.
2)If you have answered "Not necessary for this project' on any of the questions and it is determined by the
Building Official that the information is necessary to review lie application and plans to determine
minimum compliance with the adopted codes, please expect the following:
A.The application may be placed behind more recent applications for building permits in the review
process and riot reviewed until required information has been provided and Itie application
rotates again to first position for review.
B.Delay in Issuance of the permit.
C.Delay in proceeding with construction.
3)If you answered "No" to this question the circumstances described in the queslion could result in a "Slop
Work Order" being issuecl or a "Certificate of Occupancy" not being issued -
PerApp02.95 Effective August 15, 1995
5