16165 SW ROYALTY PKWY DUILDiNG PERMIT APPLICATION COF TIC „` . DATE 19 72 N
HE UNDERSIGNED HERESY APPLIES FOR APERMIT FOR THE WORK HEREIN INDICATED BUILDER PHONF __.
OR AS SHOWN AND APPROVED IN THE ACCOMPANYING PLANS AND SPECIFICATIONS. OWNER PHONF
RJ ~? ,�pA'� / L `/'�/ ` LOT NO ,
2' �v` r e JOB ADDRESS �6-/lv J J w i' .d • HOME ADDRESS �(?g,"--- '
ARCHITECT
��/ /� y/ . ENGINEER
:DER / / 1A ••••RESS DESIGNER
UCTURE DNEW DREMO�L DADDITION REPAIR DRENEWAL DFIRE DAMAGE DDEMOLITION
-FSIDENCE DCOMM DEDUCATIONAL DGOV'T DRELIGIOUSDPATIO DCAR PORT DGARAGE DSTORAGEDSLAB DFENCE
' POND 0MOVING El CONDITIONAL USE 0 DESIGN REVIEW DCOUNCIL APPROVED DSIGNS
Cl PANCY._ –_LAND USE ZONE_ BLDG.TYPE FIRE Z,NE PLAN CHH K BY HEAT
_ — - _....e.4.,_ I 21-' �� iL� moi.[✓,.,_�"iI
7 .
____ ,
,; OAD FLOOR LOAD HEIGHT NO.STORIES AREA NO.BEDROOMS VALUE,id
BUILDING DEPARTMENT SET BACKS FRONT REAR LEFT SIDE RIGHT SIDE
''ermit
7g2
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 ANP 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 3C. LICENSE. SEPARATE PERMITS REOUIRED FOR SEWER, PLUMBING AND HEATING.
Total g9 2G
By �jI1 / de' /��e/
A P• (CANT OR AG NT .....
Approved �_ ^ Receipt No. / '/. � a z)./� ,
ADDRESS
6� � PHO
//- ICING-CITY-STRUCCTIJR.AL..CHANGE-REQUEST
Memberk_ 4?1QDate I�/r/r�
Address ./ /65-5 4,/, lit yGV/y et/14)Y Phone ‘20 - 0V_5-3—
TYPE
20 0V_5-3—TYPE OF CHANGE
(Patio Cover, Room, Fence, etc.)
PLAN: DIMENSIONAL AND MATERIAL DETAILS
4'1v72,41-a6442/h., -1,-f/,
p fra
3. 4 -
Note:
1) Adjacent property owners will be informed of the requested change.
2) If there is an objection, the objection, but not the name of the objector, will
be given to the member asking for the change.
3) The Board of Directors of the Civic Association will review the plans and property
for approval or disapproval and compliance with the stated restrictions.
L ) A building permit must be obtained from the city for all improvements costing over
3500.00
Date Notified /2,W77 KCCA Board of Directors
President
Date to be Completed ;`pproved Vice President
Final Inspection Disallowed (Reasons)