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--F—Applicant
BUILDING
PERMIT 640373
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NAME
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PERMIT NUMBEIt b1nZim, O.—DE CHEURid
ADDRESS
Required
IFGLE:::� ONE NUMBER
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MET W,131(110, SIZE
CITY
7
STATE LICENSE INUAIISXi" ICENSE NUMBER
RKS
LOT TRACT
100177
114
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TYPE CONNECTION
VERIFIED By
PERC. TEST
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FIRE ZONE TYPE OF CONSTRUC TION TREFTIMPROVED
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YES [3 No
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SPECIAL INSPECTOR ktEWUIRED OCCUPAN CY GROUP
0 YES 0 NO
—By
PLAN URECKED
WORK TO BE DONE
NO. OF BLDG5. PERIBLOG. TOTAL FEE
BUILDING
2_00
I VALUATION
13UILDING PERMIT 00
2
STOIRUIE FEE
DEMOLISH PLUMBING
NEW
LN ADD
3 PERMIT FEE
HEAT & GAS LINE
ALTER RESIDENTIAL NUMBER OF
4 PERMIT FEE
DWELLING
RREPAIR NON-RESIDENTIAL UNITS
DEMOLITION
5 PERMIT FEE
6 AMOUNT DUE
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-
I agree to comply with city and state laws regu-
THIS PERMIT
This 8,131) Ileation is not a perrnit until
Ized agent of the Owner.
lating construction; and in doing the work authorized thereby. no pers�"
AUTHORIZES
signed by the Director of Building Inspec-
I be employed In violation of the Labor Code of the State of Washington
ONLY THE
tion, or his deputy; and fees are paid, and
. Compensation Insurance.
rela ng to Workmen 8
WORK NOTED
receipt is aclmowledged In space provided.
N E: PERMIT LIMIT ONE YEAR
IG TURE (OWN ENT) A 8 GNED
INSPECTION
DEPARTMENT
DIRECTOJ�'S SIGNATURE
11 /
Dirk g. Official
CITY OF
�,n
EDATONDS
L.kN'CIIECK,'V#4- VED
OT TRO
PR 6-1107
FILE
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