640340.pdf. .. . . . . . . . . .
BUILDING
PLAN FILE NUMBER
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In
Jnes =',`B`ER AAn.-�4n
Building Permit Application
-0
JOB ADDRESS
NAME (OR N E OF BUSINESS)
C. A A/ 'S
EAR YARD
_�LING ADDRESS SIDE YARD SET 33ACK
/71 0_� -;4- 12? 1 21---
A'Z�MNE 'NUMB" USE ZONE MAP NuAl"N'" VACANT SITE
CITY
ep.) YE - 8 - 0 NO 0
BUILDING AREA LOT AREA. VARIANCE NUMBER
NAME
IV'
ADDRESS HEIGHT ALL BUILDING SETRACKS
NOTE: TO EAVE LINES
PHONE NUMBER
y REMARKS
NAME
0 e
-PERMIT NUMBER �DE CHECKI
Encroachment Permit
R 94 )DRESS rZ
Required
YES
n NO
CITY TELEPHONE NUMBER METER SIZE BE CLEARANCE CHECKED By
BE NUMBER
--ffT—ATELaCENSE NUMBER REMARKS
CITY LICE
L T TRACT
0 ;11-
TYPE
J� VERIFI
PERO. TEST FEEMIKUMMBER
r= ZONE TYPE OF CONSTRUCTION STREET IMPROVED
YES NO
SPECIAL INSPECTOR REQUIRED OCCUPAN Y GROUP
0 YES a_1<0'
PLAN CHECKED BY
ca WORK TO BE DONE NO. OF SLOGS. PERIOLDG. TOTAL FZZ Z
BUILDING
VALUATION
BUILDING PERMIT
2 FEE
NUMBER OF STORIE
NEW F-1 DEMOLISH PLUMBING
ADD 3 PERMIT FEE
HEAT & GAS LINE
ALTER RESIDENTIAL NUMBER OF 4 PERMIT FEE
DWELLING DEMOLITION
REPAIR NON-RESIDENTIAL UNITS 5 PERMIT FEE
_FR_0POSEI> USE
6 AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
formation given is correct; and that I am the owner, or the duly nuthor- ATTENTION APPLICATION APPROVAL
lzed agent of the owner. I agree to comply with city and state laws regu- THIS rEn1%UT 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 aelmowledged in space proyided.
NOTE: PERMIT Ll - f4E YEAR
tDATE 81 NED INSPECTION DIRECT GNATU E
SIGN ItN to NER 0 GENT) DEPARTMENT
CITY OF
Ai. EDIVIONDS DATE
PL PLAN C CK APPROVED
PR
FILE
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