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Permit Application
NAME OF BUSINESS)
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ADDRESS
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4de Heavy Lines
ONE NUMBJ_,;I1
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,_LEPHONE NUMBER
4
PERMIT
6403-70
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NUMBER
SET BACK
REAR YARD
USI! �;ONE
MAP NUMBER
VACANT SITE
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3UILDING AREA
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NOTE: TO EAVE LIN I' :-it � - C
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Encroachment Permit �'.'PERMI
Required
FI YES M NO
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TYPE,�
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PERC.
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I NEW NUMBER OF STORIE
F DEMOLISH
UMBER OF
ALTER RESIDENTIAL N
DWELLING
EjREPAIR NON-RESIDENTIAL UNITS
PROPOSED USE
I hereby acknowledge I e read this application; that. the in-
formation given Is correct: and that 1 am the owner. or the, duly author-
ized agent of the owner. I agree to comply with city and state laws regu-
lating construction; and in doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
relating to Workmen's Compensation Insurance.
NOTE: PERMIT U�AIT ONE YEAR
PLOT PLAN CI-IEC14: & APPROVED
FILE
CLEARANCE
1 C3 YES
CTOR REQUIRED OCCUPANCY GROUP
N 0
BUILDING
VALUATION
13UILDING PERMIT
FEE
PLUMBING
PERMIT FEE
HEAT & GAS LINE
4
PERMIT FEE
DEMOLITION
5
PrR-.%IIT FEE
61
AMOUNT DUE
I
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
IN'SPECTION
DEPARTMENT
CITY OF
ED-INIONDS
Pit 6-1107
NO* OF BLDG13, PERIBLDG.
41
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El NO
TOTAL FEE z
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APPLICATION APPROVAL
This application is not a permit until
signed by the Director of Building Inspec-
tion, or his deputy; and fees are paid, and
receipt is aclinowled.-ed in space provided.
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9
TIVAENT OF BUILDINGS
:J DEPAR71
"ER`9F9"ATE OF OCCUPA
UNIFORM BUILDING CODE, Sec. 306
At 290 25th Avenue South, Bl,lildil)g Perillit NL1n-jLL:r
Occupancy establislicd by this certificate-,
NURSING HOME
Fire Zone II
640370
N N
o. Stories One
Type Const. III—One—H�r. I Ba.wmellt None
Floor Load signs — in place
(per See. z-
.)o8 U.B.C.)
igns
— Capacity si
posted (per Sec. 3301 (1) U,B.C)
Floor load and rown rapacily signs, -when
I-L-quired, musl reinain
posled al all limes.
Qi ml�",
THE BUI-LDIING HAS BEEN INSPECTED AND APPIWVED AS COMPLYING WITH
PROVISIONS OF THE EDINIONDS BUILDING CODE AND NVITH UNIFORM BUILDING CODI:.S.
Issued t1j's 26th "larch 65
ay of
d, 9
CHIEF BUILDING OFFICIAL By
�4. J. Slahau'l
This certificate shall be posted in a conspicuous public area and shall not be removed, mutilated or obsetired and ,;hall 1.)L! main-
tained in legible condition at all times. Any chan.-e of occupancy requires a new certificate.
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