15960 SW QUEEN VICTORIA PL♦ ,
BUILDING PERMIT APPLICATION crTY TIC� _ DATE -4 f , 19 �� 1kin
0 O F —
THE UNDERSIGNED HEREBY APPLIES FOR A PERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONF
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS A D SPECIFICATIONS. OWNER PHONF
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__R_1:L1 C��' W�'\ JOB ADDRESS 15 �[/JV � (yJ ��!� � iOtAE ADDRESS50C,---v-s-,-42_,
ARCHITECT
ENGINEER
.' R ADDRESS DESIGNER
_
JCTURE DNEW 0 REMODEL ❑ADDITION 0EPAIR ❑RENEWAL DFIRE DAMAGE — DDEMOLITION
IDFNCE ❑COMM ❑EDUCATIONAL ❑GOV'T ❑RELIGIOUS❑PATIO ❑CARPORT DGARAGE 0 STORAGE DSLAB ❑FENCE
'.BOND ❑MOVING ❑CONDITIONAL USE ❑DESIGN REVIEW DCOUNCIL APPROVED ❑SIGNS
:'.CUPANCY.._.____ _LAND USE ZONE .____BLDG.TYPE_ __FIRE ZONE___ PLAN CHECK BY — HEAT
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1 . Air
c .OAD FLOOR LOAD ._. HEIGHT NO. STORIES_ AREA NO.BEDROOMS VALUES/J
_ BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
Permit I dC) — _ -
- 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 I ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
— RESTRICTIVE COVENANTS. CONTRACTOR AND SUB CONTRACTORS TO HAVE CURRENT CITY BUSINESS
`tate Tax
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41
Total
I idLICENSE. SEPARATE PERMITS REQUIRED FOR SEWER, PLUMBING AND HEATING.
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APPLICAGEIa
# Approved I _ Receipt No.
t ADDRESS PHONE
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