650128.pdf. ..........
PLAW FILE -NUMBER I ULL&UNG
A111111 1111
Building Permit Application nside Heavy Lines
PERMIT
NUMBER 650128
NAME (OR NAME Uk' BUSINESS)
P/
JOB ADDRESS
/.Va',d-y -
MAILING ADDREEJ13
SIDE YARD SET BACK REAR YARD
2- / / - A lier
ZA TELEPHONE NUMBER
rTY
USE ZONE MAe 94UM V�� SITE
r,46,9 '1-1,41
1 [] YES NO a
NAME
BUILDING AREA VARIANCE NUAID�
ADDRESS
HEIGNT_
ALL BUILDING SETBACKS
NOTE:i
TO EAVE LINES
CITY TELEFRUNN INUM��
REMARKS
NAM
ADDRESS
Encroachment Permit r4ku�'x �U�Mxl STREET GRADE CRECKI
7- We
Required rl NO
[] YES
dZ,
CITY TEMP -HONE NUMBER
UETER SIZE SERVICE SIZE. CLEARANCE CHECKED By
X_ f
Lp
STATE LICENSE NUMBER
Urrx JILUZ�0� �Um"�n
REMARKS
LOT BLOCK TRACT
dr,� se r. 5m %/jv IV-T-,d$ d0rdt 1/� t-
Qe ,,, /L
/.,p re 1* -K "741 f;;Fe - 74 -
'�9&1
Al- 4F 3 7
� A�-Af�� ti";l J" N - �c I- 5�4 �-e. -ele"e� -3 7'W
TYPE CONNECTION
VERIFIED BY
4 3.,7;L Ak. 5 -,( S' 3 .3 7 "H/ Y'o e- d'A
6 :5 4 7 " W I V e 0 -
PERC. TEST
PERMIT NUMBER
I
die!�5 - 210 pr;df 0 0 Ile, 5 -.4,d� e 0 / !;A;Q1 Ae-4416
FIRE ZONE TYPE OF CONSTRUC TION STREET IMPROVED
[3 YES [3 NO
VPW 14 v
SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
'Pod
[] YES NO
U
PLAN CHECKED 13Y
WORK TO BE DONE
NO. OF OLOGS.-
PERIBLOG.
TOTAL FIE
Z
BUILDING
S 5
I
VALUATION
2
BUILDING PERMIT
Poe,r,e- 3
FEE
NEW
DEMOLISH
TORIE
PLUMBING
3
PERMIT FEE
0—d
El ADD
HEAT & GAS LINE
EaALTER
RESIDENTIAL
NUMBER. OF
4
PERMIT FEE
5
DEMOLITION
PERMIT FEE
REPAIR
NON-RE13IDENTIAL
DWELLING
UNITS
]FR—OPOSED USE
PW e / /
6
AMOUNT DUE
I hereby acknowledge that I have read this application; that the In. ATTENTION
APPLICATION APPROVAL
formation given In correct; and that I ELM 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 Wasbington 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.
NOTEPERMIT LIMIT ONE YEAR
,7
BIG OR AGENT) DATE SIGNED INSPECTION
NA,TURE (OW1429kc
11 DEPARTMENT
D rURE
OF
/,�JRE
�!/TORI
CITY
ATE
EDIVIONDS
PLOT PLAN CHECK & APPROVED
d�,
PR U-1107
FILE
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