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CITY OF
BUILDING PERMIT APPLICATION TIM ARD N° 0722
THE UNDERSIGNED HEREBY APPLIES FOR APFRMIT FOR TFIE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS ;SND SPECIFICATIONS. OWNER PHONE_
OWNER To Je Rive `men ADDRESS
_
ABCAR'S cNGINEER
=LDER A�iyhLL9—,T DESIGNER
STRUCTURE ❑NEW 08EA0DFL ❑ADDITION_^T IJ REPAIR DRENEWAL ❑FIRE DAMAGErr� 17DEMOL'-.ON
❑ RESIDENCE ❑COMM ❑EDUC.ATIONAL ❑GO','T ❑RELIGIOUSOPATIO LCARPORT nG,1RAGE ❑STORAGE CISLAB [,FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED OS!-,NS
OCCUPANCY LAND USE ZONE _BLDG.TYPE FIRE ZONE— PLAN CHECK BY _HEAT
Pe-roof oxisti,ng hL1unfi. Third riser, no mora, L'Ti[y-roofinq ailow-
QCC.LOAD FLOOR LOAD HEIGHT NO.STORIES AREA VALUE _
_BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit '.''�Q,�110
—�-' 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
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT (NAIVE
RFSTRICT;VE COVENANTS. CONTRACTOR AND SUU CONTRACTORS TO HAVE. CURRENT CITY BUSINESS
%State LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEALING.
Total
By _
---{ APPLICANT OR A-6FNT
Receipt [go
ADDRESS__.__
iL�il•1
Address Permit DTn,
Name of Occupant —�--_ Permit charge_
At
Paid by_
4..
------ ---- n Date connected �-
Type of Building d�Ci=�[ Inapection fes - --�
Service Rate__.--_- e) Paid by ___ Date
Contrrotor Assessment, paid _
Size of connection