12060 SW 122ND COURT ALJ �L.1.1..�1 U, („,fv LJ ALJ C,.-3 ,0 -1
12060 SW 122ND COURT
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BUILDING PERMIT APPLICATION TIGA=:7 p
THE UNDERSIGNED HERESY APPLIES FGR A PERMIT FOR THE ViiORK HEREIN INDICATED BUILDER PHONE G q -j._�g
OR AS SHOMN AND APPROVED IN THE ACCON PANYING P�_ANS AND nSPECIFICATIONS. OWNER PHCti —_
/�.o hd( LOT NO. ill�7 —
0•.".ER 1. 0 LNC JOB ADDRESS 12(X00 '30 122-1 T.
Q "—+ ARCHITECT
BUILDER ✓G�y►1 Q� ADDRESS'k+- 3, t �8 ItsM DESII;NER Do, kI��_"
_STRUCTURE NEW ❑ REMODEL!_ ❑ AODIT!ON '_ REPAIR Cl RENEWAL ❑ FIRE DAMAGE C3 DEMOLITION
RESIDENCE C�COMM ❑ EDUCATIONAL =1 GOVT C! RELIGIOUS ❑ PATIO ❑ CAR PORT_❑ GARAGE ❑ STORAGE SLAP-177 FENCE
LaCGUFANCY IS' 7 LANO USE ZONE _ BLDG.TAPE FIRE ZONE .PLAN CHECK BY HEAT_
-- — —_ -- B r� - "_--
��� �M� Pry,�-�� s /e o -/ _ ._..•C�-) __ �__ __������s _
SEWER PERMIT#
OCC.LOAD _FLOOR LOAD HEIGHT L•j N0.STORIES — AREA/CD/7 NO.BEDROOMS VP.LUr�.��f00
BUILCING OFFPARTMENT SETBACKS FROR ,-S
NT 2D _REA 'f-✓� LEFICE
_ _ _ — g RIGHT SIDE_
P^rmit �G�a4 THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CGDE,ZON:N-
I REGULATIONS AND ALL APPLICABLE: CODES AND ORDINANCES, AND IT IS HERESY AG►+EED THAT THE
falnnCheck�M:' �5� � _ �g• O() WORK WILL BE DONE IN ACCORCANCE 'NITH THE PLANS AND SPECIFICATIONS AND IN CO!4PLIANCE
'WITH ALL APPLICABI CODES AND ORDINANCES. THE ISSUANCE OF THIS PERP:IIT DOES NOT WAIV'-
3u!}tc+tal RESTRICTIVE COVEN—TS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY EUSINF-SS
LICENSE.SEPARD fE PERMITS REQUIRED FOR SEWER,PLUM8040 AND HEATING.
_hate Tax • __ "' '��
SOC —
FOC# APPLICANT OR AGENT
By
�—
Approved Receipt No. _
ADDRESS PHONE
S0C
DC -• S T # /O� •
EWER CONNECTION 8 �2✓r_
.EWER INSPECTION S ?�_
EWER SURCHARGE S --'
1LI6V
0 CC R s
32 . G4
r/M, RIF
3660// r
BUILDING PERMIT APPLICATION TI(:ARD DATE_ __ _ -_ 19THE UNDERSiGNED HE_REE,Y APPLIES FOR A PERMIT FORTH E WORK HEREIN INDi,,A.TE.D BUILDER PHONE 647-5681
OR AS SHOWN AND APPROVED IN THE ACCOM" NYING PLANS AND SPECIFICATIONS nWNER~HONE: _ _ _
L01 NO. _- �d dE'
OWNER -'inco Homes, InC4013ADDRESS 12060 aLt 122nd_Court Uindmi.11
ARCHITECT
ENGINEER
<...
BUILDER _�aMkJ _ ADDRESS rtt• - Bax 448,Wi11sbD�IGNER __Oan Klover —
STRUCTURE 13 NEW ❑ REMODEL ❑ ADDITION ❑ REPAIR �❑ RENEWAL ❑ FIRE DkMAGE_ ❑ DEMOLITION
O(RESIDENCE t_.I Comm ❑ EDUCATIONAL ❑ GOV'T 0 RELIGIOUS ❑ PATIO ❑ CARPORT D GARAGE 0 STORAGE ❑ SLAB❑ FENCE
OCCUPANCY _ R-3 LAND USE ZONE R-7 BLDG.TYPE �N FIRE ZONE— PLAN CHECK BY E' 'EAT_.gab
Construct eitigla family duelling W/attached.9e_raya. 3 Bedrouu-: 1 bath.__-
fic-Issue of Permit x/36:.79 (119GU 511 122nd Court)
SEE: CORRECTION SHEIT ATTACHED
SEWERPERMIT# 2 3W3 Q.Qfl _ 4,�siTti.S,�B_ __tEiSl.� t�
OCC.LOAD FLOOR LOAD 40 HEIGHT 13 NO.STORIES 1 AREA 1017 NO.BEDROCM_S 3 VALU1642,aQU.
BUILDING DEPARTMENT_ SET RACKS FRONT_ 20 _ REAR �,y a _LEFT SIDE `) RIGHT SIDE
Permit $��'6•DO THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Plan Check 10.00 WORK WILL BE DONE IN ACCORDANCE WITH THE PLANE AND SPECIFICATIONS AND IN COMPLIANCE
WITH ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WA14E
Subtotal 176.00 RESTRICTIVE. COVENANTS. CONTRACTOR ANP SUB CONTRACTORS TO HAVE CL+RRENT CITY BUSINESS
LICENSE.SEPARATE PERMITS REQUIRED FOR SEWER,PLUMBING AND HEATIN%.
State Tax 4 6.64
Total_ $IU2.64 SDC- �4UO1 1,.OQ -- X110
PDCM 1 Sl OU-00 APPI ICANT OR A,FNT
1
By __._ __---�---- ti 13
Approved
dwh Receipt No. ADDRE8t3
1
i
DATE INSPP, TYPE INSPECTION REMARKS PL SING DATE
- Contractor
Permit No.
Rough-in
y-/ S• �' .fir.—i�..�� — -- —
Fixture
Final —_
HEATING
Contractor ��
-- _-- Permit No.
Gas or Oil U
--— Rough-in
Final
SEWER
--— Final
-- —�— V DRIVEWAY
�- -- Final
Storm Drainegr
(Rain Drain)Final
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT.FINAL TEMPORARY CERTIFICATE OC7_7
Y Final
CERTIFICATE OCCUPANCY /v_ _ —
O Landscaping
Zoning Final
i
i
VCY� • d Y/ !I M • • +amu w• v.� � .��• .�.. .. �.... —. ... � - .�
gave 1tt_:allation -.', Replace Relocation❑ Addition LJ Al!-ration 0 DATE: �—
HEATING Imperial Mech. c_;_nco Homes
CONTRACTOR p OWNER_
ADDRESS- PO Box 06327/97206 JOS` ADDRESS 12060 SW 122nd Ct.-PHONE — 777-3801 APPLICANT Cmpprial Mech. /,-_
Heat Input Ratiny(BTU per Hour) ___ 15. 5 RU Vent Size Flue Size
FUEL OIL GAS ❑ ELECT Qxx OTHER
ITEM FEE ITEM _ NO. FEE—
For Issuance of Permit SEE BELOW Each Air I-landlin9_Unit or Duct System 7.50
New up to & incl. 100,000 BTU 6.00 Commercial Hood System 7.50
Naw 100,000 BUT's & over _ 7.50_ _Other Equipment • Each _ 4.50
Woodburning Stove 4.50 1 Trip Inspection _ _4.50__
Wall-Floor- Suspended _6.00 Air Condition Compressor _ up to& incl.3 H.P. —6.00
Vent System w/Fan _— 4.b0 Air Condition Corn rressor•3.1 to 15. H.P. incl. 11.00_
6 00 A
CITY BUSINESS LICENSE REQUIRED BY ALL CONTRACTORS OR SUB-CONTRACTORS ! !
PERMIT ISSUANCE 10.00 Comments: —_— _____•_
FEES --_--
SUB—TTOTAL
% STATE - Issued By,---.—
TOTAL
y__--.—TOTALRFC. # __ -- Sinnatnrn of Annlirant --
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