HomeMy Public PortalAbout9034 RANCHO REAL RD_Building_7/3/1975_garage and addition to residence APPLICATIO FOR BUIL ING PERMIT
FOR APPLICANT TO FILL IN (Print or type only)
ADDRESS r.��p" �'� (��q(/jh BUILDING
CITY d/ �
ZIP LOCALIT �� Fla
NO.OF BLDGS. NEAREST
SIZE OF LOT 7 NOW ON LOT CROSS ST.
TRA Z BLOCK 'LOT NO ASSESSOR
+� MAP BOOK PAGE PARCEL
OWNERG� ` r ,NOLG � , DISTRICT GROUP TYPE FIRE P ESSED BY
// �.�QQ / CONS Z NE r
ADDRESS � e/4�l 1✓ C/ ff/O i O `
STATISTICAL CLASSIFICATION SEWER MAP
CITY e l ZIP y CLASS NO. y�_DWELL.UNITS � BK,�PG
ARCHENG NIEERT R I/ 1� h NO. Im
Z.F �W/g USE ZONE NO.,.
OP D/
ADDRESS y 3�=L,tsTit,ids D6i 1,e • � SPECIAL
TEL. `� V`��fv CONDITIONS
CONTRACTOR C C�/ �eVNp (O ROAD DEPARTMENT APPROVAL REQUIRED YES❑ NO❑
'l LIC. }
ADDRESS Gr'~ NO.LIC /
BLDG.SETBACK FRO
CITY'� `/ CLASS FRONT PROP.LINE O � (STREET).
HIGHWAY + YARD TOTAL SETBACK FROM TYPE OF EXISTING
NAMECONSAND BRANCH UCTI LENDER FRONT PROP. LINE HIGHWAY WIDTH
NAME A �fU/tt ,t
ADDRESOI.S a�Q CITY Q ' + /_5_ v
}
SQ. FT pp NO. OF g NO. OF CHECK BLD 'SETBACK FROM CD
CD
SIZE r/ STORIES FAMILIES ONE S PROP.LINE OF (STREET)
V
DESCRIPTION OF WORK NEW HIGHWAY + YARD = TOTAL SETBACK FROM TYPE OF EXISTING
SIDE PROP. LINE HIGHWAY WIDTH �
I/ 5� ADD ❑ + _ W
ALTER ❑ Z
EPAIR❑ CORNER CUTOFF YES ❑ NO ❑
USE OF
EXISTING BLDG. DEMOL ❑ IN OPEN SPACE YES ❑ NO ❑
AP PRIN T) I/A_.i NOTEL
IN COASTAL ZONE YES ❑ NO ❑
BY (SIGNATURE) ENVIRONMENTAL CATEGORICAL EXEMPTION YES❑ NO ❑
Q d B IMPACT EXEMPTION DECLARATION SIGNED (DATE)
VALUATION72 IMPACT REPORT PROCESSED (DATE)
I HEREBY ACKNOWL DGE THAT I HAVE READ THIS APPLICATION p
AND STATE THAT THE ABOVE 15 CORRECT AND AGREE TO COMPLY
WITH ALL ORDINANCES AND LAWS REGULATING BUILDING CON-
STRUCTION. IC
THAT IN DOING THE WORK AUTHORI D
HEREBY 1 WILL NOT EMPLOY ANY PERSON IN VIOLATIO OF HE f/L
LABOR CODE OF THE STAT OF C IFOR A IN RE AT TO
WORKMEN'S COMPENSATI SURA yJ, 7AI ] k- TD
SIGNATURE OF i/1) / INAL
JdY
PERMITTEE DATE ^ �"
ADDRESS "�� y e/ FEE /J FEE $ _
CITYZ?/n
l!-/� TEL.ZO(p I->? (J t/�
1 I
PLAN CHECK VALIDATI NCK. M.O. CASH PERMIT VALIDATION CK. M�.Oei CASH
�) 5 U c- 'Irl, (D c L J 7l) ,o 8 Y"� )
ds io 3 !J 2 -70. 4S
,2 :2 9.�JUL 3 1 0 4 5 0.7 5 ,4!18
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