640404.pdfIdn"'g'..Permit Application I.. '"I"an'
side Heavy Lines
NAMIU - (08 NAME OF BUSINESS)
0 ADDRESS
TELEPHONE NUINISWR
W I NAMM
FILE NUMBER BUILDING
PERMIT
NUMBER 640404
�DDRESS
YARD SET BACK� REAR YA
4
�A YARI�
a:T
ZONE MAP NUMBER _t7v;A:& SI�g
YES NO
,131� LOT AREA VARIANCE NUMBER
z
IRT L BUILDING SETBACKS 061
NOTE: ATIO� EAVB LINES
ADDRESS
Encromliment Permit
Fig RIMIT NUMBER a ET GRADE CHECKI
Required
n YES 0 NO
CIT TELEPHO E NUMBER
METER SIZE SERVICE
SIZE CLEARANCE CHECKED BY
fill
STATE LICENSE NUMBER CITY LICEN134 N UMBER
REMARK9
LOT TRACT
7
TYPE CONNECTION
VERIFIED BY
eqv
I
PERC. TFR F.
_P��
— RMIT NUMBER rA
I
M
_7E
FIREPNE TYPE OF CONSTRUCTION STREET IMPROVED
I
0 YES
I [] NO
0
SPECIAL I NSPECTOR REQUIRED OCCUPANCY GROUP
[] YES NO
x
PLAN CHECKED 13X
WORK TO BE DONE
NO. OF MILD1213. PERISLOG. TOTAL FEE
BUILDING
1
VALUATION
4-
ITUILDING PERMaT
NUMBER OF STORIE
DEMOLISH
2 FEE
NEW
ELUMBING
;x
3 PERMIT FEE
ADD
H9AX_&-G*S-LrNE
_7:2
El ALTER RESIDENTIAL NUMBER OF
4 PERMIT FEE
DWELLING
UNITS
E]
DEMOLITION
REPAIR NON-RESIDENTIAL
5 PERMIT FEE
o AMOUNT DUE
C9
I hereby acknowledge that I.have read this application; that the In-
ATMNTION
APPLICATION APPROVAL
formation given Is correct; End that I am the owner, or the duly author.
Ized agent of the owner. I agree to comply with city and state laws regu-
THIS PERBUT
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 aclailowledged in space provided.
NOTE: PERMIT LIMIT ONEYE��
FER OR —AGE 11
BIG TU yi, 5x) tf�x DATE SIGNED
INSPECTION
DEPARTMENT
GTOlry BIG TURE
Bldg. Official
CITY OF
EDBIONDS
LOT CHECR,—&� �,Rovhw
PR 6.1107
FILE
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