12105 SW 92ND AVENUE --- 12105 SW 92ND AVENUE
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BUILDING PERMIT APPLICATION 1I Y TIGA'RCD ISI DATE 11`19-- is 36a
THE UNDERSIGNED HEREBY APPLIES FOR APEHMIT FOR THE WORK HEREIN INDICATED BUIk_DERP4rNE-
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNERPHONe"
LOT NO. -
OWNER • Ugbby JOB ADDRESS 14&" SCJ 92nd HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER VaMQ _ADDRESS DESIGNER
STRUCTURE ❑NEW C3 REMODEL s ADDITION _❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
(aRESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE L_SLAP. ❑FENCE
❑BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED_ ❑SIGNS
OCCUPANCY___ LAND USE ZONE— BLDG.TYPE_---.—._-FIRE ZONE_— PLAN CHECK BY —__ _ —_ HEAT_
UIKrw. LOAD --ELQQR-LQAU--- ----..__.HE1GHLN4.aCQR1�$----- - - AREiA.__.—_L�I�.@EJ�g491��__ VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAR I EFT SIDE RIGHT SIDE
Permit U•JIL) ------
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE" ZONING.
Plan Check REGULATIONS AND ALL APPLICABLE CODFS AND ORDINANCES, AND IT IS HEREBY AGREED THAT THC
WORK WILL BE DONE IN v..;CORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Subtotal ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
--- - RESTRICTIVE COVENAN rS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax •1a LICENSE. SEPARATE. PERMITS REOVIRED FOR SEWER, PLUMBING AND HEATING.
Total i.15
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APFLICANT OR AGENT
Approved. _ — ATO -- Rt�celpt No r y ,
04 DRESS -� p110NT — - --r
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DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No.
Rough-in
Fimure
Final
HEATING
_ Contractor _
Permit No.
Gas or Oil
Rough-in _
----- ---- Final
SEWER
-- Final
DRIVEWAY
Final
Storm Drainer
(Rain Drain) Final
Sidewalk
Curb&Street Final
A roach_
BLDG DEPT. FINAL TEMPORARY CERTIFICATE OCCUPANCY rival
CERTIFICATE OCCUPANCY —
Landscaping
\ Zoning F,nal
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Address ?�/D.S� 9`'. QiLi�Q Permit No.
Name of Occupant Permit charge
------- --__. Connection fee
-- — Paid by
- -- - -- _ - Date connected-- �'d"'f�
Type of Building-_ � _ Inspection fee__f n , 0 O
Service Rats Paid by _ 4 yj�n _Dats,.3 6O w U
Contractor. Assessment - -__ Paid --
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Size of connection --