16135 SW QUEEN VICTORIA PL �� �} /y CITY OF
B :,. n1� '. PE1 ; 1 i AP!-`U ,,J -, ?O T6 �'t sw� DATE : 1g 77 N2
THE UNDERSIGNED HEREBY APPLIES FOR APERMIT FOR THE WORK HEREIN INDI—ATED
OR AS SHAWN AND APPROVED IN THE CCOMPANY!NG PLANS AND SPECIFICATIONS. OWNER PHONE
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OVJN�R ; ,� �t BUILDER PHONE
\ JENGINEER
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STRUCTURE ENEW r REMODEL ❑ADDITION `REPAIR ❑RENEWAL FIRE DAMAGE QDEMOLITION
rte, RESIDENCE 7COMM EEDUCATIONAL EGOV_T ❑RELIGIOUS EPATIO ❑CAR PORT ❑GARAGE ❑ STORAGEESLAB El FENCE
BOND L. MOVING ECONDITIONAL USE ❑DESIGN REVIEW OCOUNCIL APPROVED ESIGNS
OCCUPANCY LAND USE ZONE BLDG.TPP FIRE ZONE_ PLAN CHECK BY/�_ j f 'T .
` ` / `/ i y4z1 Atzfb' i ��.°, 74
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OCC. LOAD FLOOR LOAD HEIGHT NO.STORIES AREA VALUE
BUILDING DEPARTMENT 1 SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE F 7
Permit �'I IC) --- .
II l THIS PERMIT IS ISSUED SUBJECT TO THE REGULATIONS CONTAINED IN THE BUILDING CODE, ZONING
Plan Check i REGULATIONS AND ALL APPLICABLE CODES AND ORDINANCES, AND IT IS HEREBY AGREED THAT THE
l WORK WILL BE DONE IN ACCORDANCE WITH THE PLANS AND SPECIFICATIONS AND IN COMPLIANCE WITH
Recording ALL APPLICABLE CODES AND ORDINANCES. THE ISSUANCE OF THIS PERMIT DOES NOT WAIVE
Ii ,i RESTRICTIVE COVENANTS. CONTRACTOR A . .13 CONTRACTORS TO HAVE CURRENT CITY BUSINESS
."-1%State 1367 LICENSE. SEPARATE PERMITS REQUIRED FOR .'ER, PLUMBING AND HEATING.
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A L CAN I v°1 MCV
� Approved ! Receipt No. (6/3.1. �( � 6p • — ,
ADDRESS PHONE
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