640149.pdf- - - - - - - - - - - - - - - -
j
PLAN FILM NUMBER
F—Applicant FIR
Permit Application I inside Heavy Lines
PERMIT 640149
NUMBER
,jding
(OR N OF BUSINESS)
JOB ADDRESS
ADDRES13
SIDE YARD ISET BACK FARP
--x 2
urry
USE Z NE
MAP NUB113ER VIC-.TNT SITM__
YES 0 No
BUILDING AREA
LOT AREA VAIUANCI!; 14VAI,Ualt r
OTr
ass
HEIGHT
ALL BUILDING SETBACKS
NOTE: TO EAVE LINES
TELEPHONE NUMBER
REMARKS
v,
XAME
<
ADDRESS
neroakhment Ptimit
PERMIT NUMBER h RADE CHECK
Required
�O
rl YES �;T
CITY
TELEPHONE NUMBER
METER 8 SERVICE SIZE CLEARANCE D BY
I"a
Ci
Y4,
STATE LICENSE FUMBER
CITY LICENSE NU BER
RE�TARKS
LA iK TRACT
TYP CONNECTION
VERIFTDeY
4X f,
—2
-PERC./TEST
PIC
FIRE ZONE TYPE OF CONSTRUCTION 13TREET IMPROVED
I
I [] YES [3 NO
SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
[3 YES 0 NO
PLAN CHECKED 13Y
WORK TO BE DONE
NO. OF BLOO5.
PERIBLDO.
Z
BUILDING
VALUATION
��6 0
L/
2
BUILDING PERMIT
FEE
17,
NEW
DEMOLISH
NUMBER OF STORIE
PLUMBING
3
PERMIT FEE
ADD
HEAT & GAS LINE
ALTER
RESIDENTIAL
NUMBER OF
4
PERMIT FEE
DWELLING
UNITS
—
DEMOLITION
5
PERMIT FEE
6
AMOUNT DUE
Z- C)
I hereby acknowledge that I have read this application; that the In-
ATTENTION
APPLICATION APPROVAL
formation given is correct; and that I am the owner, or the duly author-
lzed agent of the owner. I agree to comply With city and state laws regu.
THIS PERMIT
This application Is not a permit until.
lating construction; and In doing the work authorized thereby, no person
AUTHORIZES
signed by the Director of Building Inspec-
will be employed In violation of the Labor Code of the State of Washington
ONLY THE
tion, or his deputy; and fees are paid, and
relating to Workmen's Compensation Insurance.
WORK NOTED
receipt Is acknowledged in space provided.
NOTE: PERMIT LIMIT ONE YEAR
SIGN OR OR AGENT) DATE IG
INSPECTION
7 7'
DEPARTMENT
OF
DIRECTTIGNATURE
,,-
44
CITY
ED31ONDS
DATE
PLOT -PLAN C]�Epjy& APPROVED
PR a -1107
FILE
0
m