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AODRESS �'S6y PERMIT NO.
PERMIT CHARGE none
CONNECTION FEE (c,"- _
PAID BY
TYPE OF SUILCING � �' _ _ _ DATE COI;%;ECTEO
SERVICE RATE
INSPECTION FEE
CONTRACTOR PAID BY DATE
SIZE OF CO�J"J CTION SSESSMENT PAID
0 ,
BUILDING PERMIT APPLICATION `'o ������ DALE
THE UNDERSIGNED HEREBY APPLIES FOR Ar" RMIT FOR THE WORK HEREIN INDICATED BUILDER PHONE
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING FLANS AND SPECIFICATIONS. OWNER PIAONE
LOT NO.
OWNER s�1WFi211tE'� JOB ADDRESS_ Avun (,.uur L. HOME ADDRESS
- — ARCHITECT
BUILDER
r�-'�
--11 ENGINEER
STRUCTURE ONEW LJRFMODEL ADDRESS
❑REPAIR ❑RENEWALIGNE FIRE DAMAGE [:]DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO [:]CARPORT ❑GARAGE ❑STORAGE❑SL.AB ❑FENCE
_ ❑BOND ❑MOVING [:]CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED _❑SIGNS
OCCUPANCY LAND USE ZONE —7—BLDG.
7BLDG. TYPE_ FIRE ZONE PLAN CHECK BY HEAT—
instruct single family duallinV w/sttachsd aragH 3 bedruam Q !K 3 _^--
Qn-jes,js ,rl oarmit r,1662
pool
t.�unu ++ 411 — 1� 4t:s 400,
Qc
FL QR LOAD HEIGHT-__ —NO.S-TQRItq ARSB_ NO.BEDROOMS YALIA
BUILDING DEPARTMENT70
SETBACKS F+tnNT — ' rFr T SIDE , RIGHT SIDE
Permit 1ta4.(7U ---REAR
---
EAR-- --- ----- �_�
THIS PERMITIS ISSUED SUBJECT TO THE RFGUI.ATIONS CONTAINED IN THE BUILDING CODE, ZONING'
Plan Check 1NGO REGULATIONS AND ALL APPLICABLE CODES AND ORDINAN',ES, AND IT IS HEREBY AGREED THAT THE
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Sub-total 194.01-1 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 :, 7,3f, Ll',EENSE. SEPAFAkTA PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
4�, • IJ
Total %2U1.3b FtLlC �'t �ilOC7�t 1J
By P1
-.�_.�. APPL.ICANT ORA EN1 !
Approved • IS!!t " t► Receipt Nu I
vDATE INSP. TYPE INSPECTION REMARKS PLUMBING _ DATE
- Contractor
Rough-in
1/2-7Y -
Uf Fixture
Final - ---
�`� el HEATING
Contractor
Permit No. /� /—/.x,
Cies or Oi'
Rough-in
- —�
Final
— SEWER
Final y
DRIVEWAY
Final
Storlh Drainage
(Rain Drain)Final.
— Sidewalk
—� Curb&St-eet Final
Approach
BLDG.DEPT.FINAL TEMPORARY CERTIFICATE OCCUPANCY Final
CERTIFICATE OCCUPAt4CY S 9 q` _ � / Landscaping
Zoning Final