15695 SW QUEEN VICTORIA PL CITY 0I:
BUILDING PERMIT APPLICATION TI AI DATE 7— - , ,9 76 N2 09 ?)
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED /2a -// l
OR AS SHOWN AND
QAPPROVED IN THE ACCOMPANYING PLANS AAND SPECIFICATIONS.. OWNER PHONE
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OWNER ADDRESS � /V
6 e ENGINEER
BUILDER C IC 1 FF P- i ` [` ARCHITECT _--_ DESIGNER
STRUCTURE ❑NEW D REMODEL IDADDITION 'REPAIR ❑RENEWAL ❑FIRE DAMAGE DDEMOLITION
kRESIDENCE ❑-COMM ®EDUCATI--ONAL CIGOV'T ❑RELIGIOUS DPATIO ❑CAR PORT ❑GARAGE ❑STORAGE DSLAB ❑FENCE
�DBOND ❑MOVING LJCONDITIONAL USE ID DESIGN REVIEW ❑COUNCIL APPROVED EJSIGNS
OCCUPANCY_ LAND USE ZONE BLDG.TYPE_ FIRE ZONE_ PLAN CHECK BY HEAT
NnXi -- t" 07 Y e ---z'r At-7 a,---e--6-(-e,"-e-; >ze.dizr.,zai.e.)/0. ,
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OCC, LOAD FLOOR LOAD HEIGHT NO.STORIES AREA VALUE/149 i
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 4
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 ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS a
State LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
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By - if i APPLICANT OR AGENT re
I Approved /� Receipt No.
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ADDRESS PHONE
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