15080 SW 79TH AVENUE #!' WIWAN m
SW 19TH AVENUE
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-GI I Y U►- IIl AHU Plumbing Permit
Building Department NO
Residential u 'Commercial ❑
New Installation ❑ Replace Lvj' Addition ❑ Alteration ❑ Date 1-26.1
Licensed
Plumoer ._ 7A} Q' _ G'
/Jd � ���•+ Owner ��-i-•.�,��
Address Qr{5...� _ � - 1� — Job Address _1=0 Cj
Phone -_— li Q / __-- U _ Applicant
CITY BUSINESS T'Ax REOUIRED FOR ALL CONTRACTORS.AN7,;UB-CONTRACTORS
ITEMNC. FEE TOTAL ITEM NO. FEE TOTAL
Fixtures-Trap, 7.50 Sewer:First 100 tt. 30.00
Dishwasher 7.50 _ Each Addit.10C ft. 15.00
Garbage Disposal _ 7.50 Ejector Pump 7.50
Water Heater 7.50 Water:First 10411_ 20.00
Backflow Preventer 7.50 Each Addit.200 h. 15.00
Storm 6 Rain Drain:First 1 BO It. 30.00
_
Ear.h Addit.200 ft. _ 15.00
MINIMUM ; EE $15,00 +4% Mobile Home Space 25.00
Other(Specify): Rain Drain-Single Fain.Dwelling 15.00
PERMI I FEE Comments: __ _—_—— --------.----—
STATE w, .gn Issued By:
p
TOTAL Receipt No.------, Applicant—
For
pplicant.- � ft
��. 0� Signature
For 91timbing Im:peclion Phone 639-4175
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BUILDING PERMIT APPLICATION CIT TIGARJ DA E Sept • 28 -, tg 76OF
THE UNDERSI3NED HEREBY APPLIES FCR APFRMIT FDR THE WORK HEREIN INDICATED BUILDER PHONE �.
OR AS SHOWN AND APPROVED IN THE ACCOMPANYII,IG PLANS AND SPECIFICATIONS. OWNERPHONE _—
LOT No
15086 S.W. 79t;; 255-041.5
^WNER JOB Ar"PRESS HOME ADDRESS
-- -- — ARCHITECT —�— ---
i -A J ( oast. ENGINEER
BUILDER ADDRESS DESIGNER
STRUCTURE ❑NEK ❑REMODEL OADDITION ❑REPAIR ❑RENEWAL (]FIRE DAMAGE ❑DEMOLITION
C3 RESIDENCE ❑CCOMM ❑EDUCATIONAL ❑GOV'T URELIGIOUSOPATIO ❑CARPORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
0_80:413QMOVING IJCONDITIONAL USE ❑DESIGN RFVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY_-I Ak"i.;"GE .UNC. BLDG.TYPE. _ FIRE ZONE_. PLAN CHECK BYHEAT—
Cuust. u�ikdit.(oi; of 18 x bedroom to exiating dwelling ------ --
OCC.LOAD FL.OGH LOgQNEI.�hi.LN4ySIQP �_--BBE.9_ L O.13lZAtS_ E VALU ---
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE 20 RIGHT SIDE
2
Permit REAR---
--"— 1000 REGULATIONS
PERMIT IS ISSUED SUBJECT TO THE REGULATION'; rONTKINED IN THE BUILDING CODE, ZONING
Plan Check. REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCE':, AND IT IS HEREBv1 AGREED THAT THE
WORK WILL FIE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total ALL APPLICABLE CI)DE:, AND ORnINANCES. THE ISSUANCE OF THIS PERMIT DOES NOf WAIVE
JL 14 RESTRICTIVE COVENANTS. CONTRACTOR AND SUR COI1!TRACTORS TO HAVE. CURRENT CITY °lUSINFSS
State Tax LICENSE. SfiPARATE PERMITS REQUIRED FOR SEWER, P1 UMBING AND HEATING.
Total 1.1. 14 --_
BV ---- ---- -- -----
_ 1� ^.ANT OR AGENT
Approved Receipt No. -' .../: ��) 'Y '.�- ( r 1• 41
16,j3176 c90 Ccr�.e�v
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