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CITY OF ANAHEIM PLANNING DEPARTMENT BUILDING DIVISION 200 S. Anaheim Blvd., Suite 145, Anaheim, CA 92805 (714) 765-5153 Processing Fee $ Payment Verified By: CASE NUMBER REQUEST FOR MODIFICATION OF BUILDING STANDARDS (CBC SECTION 104.2.7) REQUEST FOR ALTERNATE MATERIAL OR METHODS OF CONSTRUCTION (CBC SECTION 104.2.8) For above requests, complete Section 1, 2, & 3 by Printing in ink or typing. 1. JOB ADDRESS Site Address: Owner: Address: Zip Daytime Phone ( ) Petitioner: Address: Zip Daytime Phone ( ) 2. REQUEST Submit plans if necessary to illustrate request. Additional sheets of data shall be attached. 3. PETITIONER’S JUSTIFICATION/EVIDENCE OF EQUIVALENCY CODE SECTIONS Petitioner’s Signature Title Date: FIRE DEPARTMENT ACTION: Concurrence from the Fire Marshal is required. Approved Disapproved Approved with Conditions By: Date: Conditions of Approval or Reasons for Denial: BUILDING DIVISION ACTION: The Request is Approved Disapproved Approved with Conditions Signature Position Date: Print Name Conditions of Approval or Reasons for Denial: Approval is applicable to this case only and is non-binding to any similar projects under construction or contemplated in the future. FOR STAFF USE ONLY Plan Check # # of Stories Occupancy Classification Construction Type Distribution: Owner File Petitioner Microfilm Fire Dept. SIGN