650247.pdft
4,"
Z".
P-1
Applicant FIR
Inside Heavy Lit
6 G'b r e
_n
PRESS'.
TELEPHONE NUMBi
7 7
1, H
lo eend //
Required
r-I YES 1`11 NO
_? I
SPECIAL INSPECTO]
I [] YES M4
BUILDING
I VALUATION
BUILDING PEIU
MBER OF STORIES 2 FEE
NEW
DEMOLISH
—
PLUMBING
3
PERMIT FEE
ADD
4
HEAT & GAS LINE
PERMIT FEE
ALTER
rZ71
L/\j RESIDENTIAL
NUMBER OF
REPAIR
I
F-I NON-RESIDENTIAL
DWELLING
UNITS
5
DEMOLITION
PERMIT FEE
6
AMOUNT DUE
I hereby acknowledge that I have read thin application; that the in-
formation given is correct; and that I am the owner, or the duly author- ATTENTION
ized agent of the owner. I agree to comply with city and state laws regu- THIS PERMIT
lating construction: and in doing the work authorized thereby, no person AUTHORIIZES
will be employed In violation of the Labor Code of the State of WanhIngton ONLY THE
relating to Workmen's Compensation Insurance. WORH NOTED
NOTE: PERMIT LIMIT ONE YEAR INSPECTION
3IGNATURE (QwNvR OR GENT
DEPARTMENT
Aa A CITY OF
Ejo_T PLAN CAECK & APPROVED NIONDS
Z, / 7�� �P"R 6-1107
FILE
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 acknowledged in space provided.
MEN
" I