16420 SW KING CHARLES AVE •
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BUILDING PERMIT APPLICATION CITY of TIC RD DATE c7g t 7' No +
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONF
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONF
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• Ti: Ti: , � � _ �L / JOB ADDRESS . .., OME ADDRESS
ARCHITECT i
ENGINEER
, DER ADDRESS �� DESIGNER
t.1C {{++ TURE ONEW D REMODEL ❑ADDITION .C�•REPAIR ❑RENEWAL ['FIRE DAMAGE ['DEMOLITION •
;FSIDFNCE ❑COMM ['EDUCATIONAL DGOV•T DRELIGIOUS DPATIO OCAR PORT ['GARAGE ❑ STORAGE ❑SLAB ['FENCE
I .BOND 0 MOVING ❑CONDITIONAL USE 0 DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
L "_CU' • NCY_ LAND SE ZONE BLDG. TYPE FIRE ZONE PLA C, ECK BY HEAT
4 , - I `i r'I ir . a --9
pr:C LQAD FLOOR LOAD HEIGHT NO. STORIES AREA NO. BEDROOMS .
BUILDING DEPARTMENT p � ) , SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit ! p Ov I
I - THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES. AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE t,
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,/ RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
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State Tax g LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER. PLUMBING AND HEATING.
Total 1 iiD � j / • By ' I iI /. ,� iii - - J -�
• A'' ICAN 0 - GENT /
Approved Receipt No.
ADDRESS PHONE
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