16705 SW QUEEN ANNE AVE cri-
BJILDING PERMIT APPLICATION FY Tr ARD DATE �`' ts �
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONF
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONF —
�� Pa-m&d:-.4. +�,) ( LOTNO.
RC( ZA. JOB ADDRESS / AO/ ✓W �-7'GGAar OME ADDRESS
ARCHITECT
��/�///'''���JJJ ENGINEER ADDRESSDESIGNER
JCTURE ONEW O REMODEL O ADDITION " REPAIR _____ ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
J'L-:ESIDENCE ❑COMM DEDUCATIONAL OGOV'T ❑RELIGIOUSDPATIO ❑CARPORT ❑GARAGE OSTORAGE DSLAB DFENCE
BOND ❑MOVING ❑CONDITIONAL USE ODLSIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
:.CUPANCY___ _LAND USE ZONE- BLDG.TYPE ._FIRE ZONE— "LAN CHECK BY HEAT
___ ______ A er-40-04
at
•
" ;C__LQAD FLOOR LOAD —_ HEIGHT NO. STORIES AREA NO.BEDROOMS V UE/ "
BUILDING DEPARTMENT SETBACKS FRONT REAR LEFT SIDE RIGHT SIDE
ermit /3�_
THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
i Plan Check REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
Subtotal
WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
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 6-6LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
By
APPLICANT OR AGENT
Approved Receipt No.
-- ADDRESS PHONE