15935 SW QUEEN VICTORIA PL BLIP DINE PERMIT APPLICATION 1 s-.. AVEi E , 19 N2
GON 97223 ,
THE UNDERSIGNED HEREBY APPLIES FOR APEF MI I I-ORDTHE WORK HEREIN INDICATED
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONE
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OWNER t� C �i J�#�G%f 71C ADDRESS //7 jj jC�1 / 4..;.`�.a it BUILDER PHONE
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ENGINEER
9UILDER Cp 'fC` i L9 It li}it 1 `y( ty
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ARCHITECT '' (..ry/3-,...,e4. ' j/` G 1�,44.2vr; SIGNER
STRUCTURE DNEW I: REMODEL IC ADDITION REPAIR RENEWAL OFIRE DAMAGE DEMOLITION
C RESIDENCE D COMM EDUCATIONAL ['GOV'T ❑RELIGIOUS®PATIO ['CAR PORT ['GARAGE ®STORAGE CSLAB ❑FENCE
DBOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ['SIGNS
OCCUPANCY LAND USE ZONE BLDG.TYPE FIRE ZONE_ PLAN CHECK BY HEAT
l--r`7 .,7 7'O-r'' ,,r
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OCC. LOAD FLOOR LOAD HEIGHT NO.STORIES AREA VALUE L/` ,.�-�c,,',
r BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE //
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Permit I1
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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
,i WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording 1, ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
II RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
%State ll J C LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
II Total �l /et L - .
H j AP9LI,gANT OR AGENT
I Approved 1
1 j Receipt No.
ADDRESS PHONE