650281.pdfApplicant Fill
Building Permit Applicationi inside Heavy Lines
NAME (OR NAME OF BUSINESS)
M V- (I, C-Coi
MAIT ING ADDRESS -.a
tA
PLAN FILE NUMBER
JOB ADDRESS
A
SIDE Y713
'70(—
AW650281
BUILDING
PERMIT -)281
5
NUMBER
BET BACK REAR YARD/
:2�=
77
01TY Wka"PRONIc NUM13ER
us ONE
MAP NUMBER VACANT SITE
E3 YES [3 NO
NAME
BUILDING AgA
tV=ARLkNCENIJMBER
HrTGHT ALL BUILDING SETBA�>
(0-T E:
TO EAVE LINE
CITY TELEPHONE NU �F.R
REMARKS
14AMM
fS ID LV VAC A\ �%SA-cv
ADDRESS
Encroachment Permit
PERMIT NUMBER STREET COME
Required
n- YES 0 NO
CITY TELEP21ONE NUMBER
METER SIZE SERVICE SIZE CLEARANCE CHECKE BY
13TATE LICENSE NUM(;PR CITY LICENSE NUMBED
REMARKS
LOT BLOCK TRA
2&
-,D
TYPE CONNECTION
VERIFIED BY
-PERC. TEO T
PERMIT NUMBER
\A) .2 tg 3 7,F
1/ 4
NON D"ROVED
FIREI ZONE TYPE STREET
0 YES [3 No
V
SPECIAJ, INSPECTOR REQUIRED OCCUPANCY GROUPL
0 YES Ej NO
PLAN CHECKED 13Y
1%
A r
WORK TO BE DONE
%A�c
No. OF 211.0091 PERIVIL.00. TOTAL FKK
CLo'w
BUILDING
Ave W 16
VALUATION
ci )6 x Ar
BUILDING PERMIT
- 1 1. 7n R
NEW '*DEMOLIM
2 FEE
PLUMBING
ADD
3 PERMIT FEE
1 0 F
r
BEAT & GA13 LINE
4 PERMIT FEE
ALTER RESIDENTIAL
L] =ELLING
REPAIR NON-RESIDENTIAL UNITS
]DEMOLITION
PERMIT FEE
6 AMOUNT DUE
I hereby Ack owledge that I have read this application; that th:bIn-
A7=NT]ION
APPLICATION APPROVAL
formation given In correct: And that I am the owner, or the duly au or-
lzed agent of the o%yner. I agree to comply with city and state laws regu.
THIS PERBUT
This application is not a pernlit. Until
lating construction; and in doing the work authorized thereby, no person
AUTHORIZER
signed by the Director of Building Inspec-
Will be employed In violation of the Labor Code of the State of Washington
ONLY THE
relating to Workmens Compensation Insurance.
JVORK NOTED
tion, or his deputy; and fees are paid, and
NOTE: PERMIT LIMIT ONE YEAR
receipt is acknowledged In space provided.
—871—GNATURE (OWNER OR AGENT) DATE SIGNED
IN13PECTION
DI R' I ATURE
MC
DEPARTMENT
CITY OF
�Z,-
ED14IDNDS
PLOT PLAN.,0111E If OVED
PR 6.1107
FILE
I
A I ..... .:T-.
A 1. Wd
I I I, pit I I i 0
N'�AI IT >A? It' j A,ij If Acii. t4k, t .. ..... lf,� I Il', y
1� 11, IT' .,I I I I I A
A' IV
IT, ` 1 4 1 1. 4
AN
Ft uri
A;�,
W-1 I TI4
'JIVAL I 1AAoil AA. kw Al4 It W
AiAIIlip: AT, IT.(.
L ifIfAIA;
Ill, IT TitATn�'Z '�4 itIllTTk- ItIIT- IIfIllTVVAf11.01 iIIlAit111 AtIIllI I 0'. 00
AIkL tVTh 6 -OTL-f At At AlitAP IT AI4- .1 L, A1 )1 1`41 IAA,A LI; L' L I I f- 14 0 AI IlL L rd AWo L AlP� .1, I11A'It d', M, it I I
IIt A 4 r tt
- y It L'
1,L .41 11 r II 'IT ... 1 L 4 4 L I10, 1 A:L AIAT1FF IL A
1. IIIIIIIIL 777 Ai- t;" tr AII I A I r I I11 t ",I kf I -.1 I1IAitIII4 P' f4 AIL 4 4, A I A
tL It, 4 4, j I I III I .,I I IVL 10 11 A 1 .1 .1 1 14" It AI; I I I I I I A4
TVIL
ittIt I
L L' I L k,7. Aix
L
0 L L' PAT All I L
f4 V., 14 d:
or IrA AIL
AA4 AI IllIItr IVIll14
L ...... Ali AIL IIIIFI r A I A4
Ar 0 A r iftit" All L I A4 I
AA
A'W' itr' L At P
AL IIITt
AITItL I A AAL
_TL
L
IT IfIIt A"dk.
Itilfel tt4: 1 1 A, L)
I-1. k' I r
IL 4 14 Ik IIkk
AtX, j
Ar I I I4 L
I r
It IIIIL I4 it: L 'P AlL
ififAit L P.. I AItA4 1 Ilr I 4P It r k d. ATL'4 r. L r' I I
I I ' I
t 4
I L L ..... AL IV4l IliitAL L It1IIIP A I 4 AA IIIAI111 L r Lt 1L r titII IIL Iif L 4 '3 tt r IIIfAAAIAl0 t
AA
IIV, P, t
IIIl4 I'T 1, L r IAAI I ITIII t I, I I 'r L r r
ItIr IA4 L TtI II AI4 It.Ip tVrC P
IfAitI I T IItI 4 1AIALL
L Ir Li IIt1k IIIAtIII1Ili P. 14 itt I L t-1 IL I .X, 1 1 3 r :'P. I . It t
4 I I . . . .
IIII
I11 1I 1. f
;,RECORDj:OF:-1 NbIfLU. I I U f4 L It r Itr 4
AL r r I IVIL r L I IP, I %
d' 4 IIIAL r AIt .11. _tf 14'� Ill Ip, I I,, r it, IT ki ITT M i I AIIVTVIIIATq itIVr f -"Ddtot�Pas§ed,
Yr, r
IIItitItIItAg IAA r, r I I . r P+
I4 4 L I
IAIT;4 L 1 At r fitTI 'd 'Pr A r r r r
ITir
AtLOT L 14 r IitAAL
jQ �4Z AI I ATr. Ir IIP L I4, IA7 1IIIItIItI I t% A ifI ItL t ItA4 L
I4 I AA ItItI Ar
r
L L I'
IAr. r r Ft a I IL I 'k L r4 r . I I . . I I rrr
4,V*
t I%% 14 F' IIr 1Ar % ITItAL 4 L L 1 jf,k r L. 1 .1 r r r L L
1 3 A A I
IA
TL 11 1 1
AP, L
P, AIAA P 4 111 1 'A Iir IIItIIVA.P A4
t
A4
V t
4 VAL to 1,
L
A r'
4
r
A
L
A