15615 SW QUEEN VICTORIA PL CITY
B JILDING PERMIT APPLICATION 0 '1 ,k,,RD DATE
7HE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDERPHONF 6v ?Y3 1_
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONF
(� 1' LOT NO-
- Q c `ile-, Lti - JOB ADDRESS l 1.5=5,"V .!/J� �HC?ME ADDRESS
I � ARCHITECT
e ENGINEER
^LR �'.RESS��I ' �^ �0 i DESIGNER
_CTURE DNEW 0 REM•DEL 0 ADDITION REPAIR PlIEI'ZIEWAI_ DF(RE DAMAGE DDEMOLITION
ESIDENCE DCOMM DEDUCATIONAL DGOV'T DRELIGIOUSDPATIO OCAR PORT DGARAGE DSTORAGE DSLAB DFENCE
q_c
'I1BOND 0MOVING UCONDITIONAL USE 0 DESIGN REVIEW DCOUNCIL APPROVED DSIGNS
. :.CUPANCY _LAND USE ZONE BLDG.TYPE_- FIRE ZONEPLAN CHECK BY HEAT
______ %.' --kr---tl-t-(11 4-4_40-'7
ii
";L LOAD _FLOOR LOAD HEIGHT NO. STORIES - AREA NO.BEDROOMS VALUE p-r
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit a_ Li Q 0
. 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
1 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 L/ ! - LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total .96
By 1
______ _-.— APPLICANT OR AGENT
Approved Receipt No.
— — ADDRESS PHONE
4Cf - P.--; 6 0 0 y,
o /t
0 6 da_ 2 L