16580 SW QUEEN MARY AVE BUILDING PERMIT APPLICATION KING CITY DATE , 19
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONF
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS JD SPLf•IFICATIANS -
t.oi NO
OWNER JOB ADDRESS *teen HOME ADDRESS
ARCHITECT
ENGINEER
BUILDER
ADDRESS DESIGNER
STRUCTURE ❑NEW 0 REMODEL ❑ADDITION ❑REPAIR ❑RENEWAL ❑FIRE DAMAGE ❑DEMOLITION
❑ RESIDENCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CAR PORT ❑GARAGE ❑STORAGE❑SLAB ❑FENCE
Els OND El MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW ❑COUNCIL APPROVED ❑SIGNS
OCCUPANCY LAND USE ZONE BLDG.TYPE FIRE ZONE PLAN CHECK BY HEAT
OCC. LOAD FLOOR LOAD HEIGHT NO.STORIES AREA NO. BEDROOMS VALUE
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
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
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 LICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
Total
By
APPLICANT OR AGENT
Approved Receipt No.
ADDRESS PHONE
DATE INSP. TYPE INSPECTION REMARKS PLUMBING DATE
Contractor
Permit No.
111 Rough-in
Fixture
Final
HEATING
-' I Contractor
IPermit No.
Gas or Oil
Rough-in
Final
SEWER
Final
DRIVEWAY
Final
Storm Drainage
•
(Rain Drain) Final
Sidewalk
Curb&Street Final
Approach
BLDG. DEPT.FINAL Te'MPORARY CERTIFICATE OCCUPANCY I Final
CERTIFICATE OCCUPANCY
Landscaping
Zoning Final