16615 SW QUEEN MARY AVE BUILDING PERMIT APPLICATION KING CITY DATE , 19
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. OWNERPHONF
LOT NO.
OWNER JOB ADDRESS HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER ADDRESS DESIGNER
STRUCTURE ❑NEW ❑REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
QBOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY LAND USE ZONE BLDG.TYPE FIRE ZONE PLAN CHECK BY HEAT
OCC. LOAD FLOOR LOAD HEIGHT _ NO.STORIES AREA NO. BEDROOMS VALUE
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit
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
Sub-total ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
State Tax LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
By
APPLICANT OR AGENT
Approved Receipt No.
ADDRESS PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
-w-7[ F, Contractor
Permit No.
Rough-in
Fixture
Final
HEATING
Contractor
Permit No.
Gas or Oil
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Storni Drainage
(Rain Drain) Final
Sidewalk
Curb&Street Final
Approach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final