16750 SW QUEEN MARY AVE "__ ILS' .._.,«..,..,w-.u........,..:...........,....,. ,..._..,.,...........tw.._,,...£....,:,.:,.. .. _
BUILDING PERMIT APPLICATION TI ARD DAT .;�; , 19 V I�'o
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED
OR AS SHOWN AND Al'ROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
A.
OWNER ipag LGL 1110 de' ' ADDRESS /67 cb t_5( 9.GC.26w( /0BUILDER PHONE
q ENGINEER
BUILDER I� E%�%- \I! ARCHITECT DESIGNER
STRUCTURE I 1NEW 0 REMODEL0ADDITION REPAIR ❑RENEWAL LOIRE DAMAGE ❑DEMOLITION
ESIDENCE OCOMM ❑EDUCATIO--NAL DGOV'T ❑RELIGIOUS I:PATIO ❑CARPORT- ❑GARAGE ❑ STORAGE DSLAB ❑FENCE
DBOND ❑MOVING DCONDIT!ONALUSE El DESIGN REVIEW ❑COUNCIL APPROVED QSIGNS
OCCUPANCY LAND USE ZONE BLDG.TYPE FIRE ZONE, PLAN CHE f BYE HEAT ,
1„,c.,41,1 , f
OCC. LOAD FLOOR LOAD HEIGHT NO. STORIES AREA VALUE r/U , .ex)
I BUILDING DEP TMENT I SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
' Permit IT Tit 00 1 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 ,I ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTIIACTOR Ar. .JR CONTRACTORS TO HAVE CURRENT CITY BUSINESS
ill%StateI �7 I LICENSE. SEPARATE PERMITS REQUIRED FOR .BER, PLUMBING AND HEATING.
4{ .
Total ,i /I {1. �1 y I
It k- 41 ,0/z.. .._, ' �.
____56
Y if APPLICANT U4 ._isl AG
I Approved 111 I Receipt No.
ADDRESS PHONE