660143.pdf..........
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POSTED ON KROLL MAP NO.: BUILDING
BUILDING DEPARTMENT PERMIT 660143
Applicant M NUMBER
Inside Heavy Lines JOB ADDRESS
PERMIT APPLICATION
NAME (OR NAME OF BUSINESS)
G ADDRESS
0,4/1)j
_/10
- 4svol_
NEW
1:1
1 n SIGN I
NUMBNH Uk'
I
ADD
DEMOLISH
10 PENCE
I
ALTER
RESIDENTIAL
ID, UMBER OF
WELLING
I
REPAIR
[ NON-RESIDENTIAL
UNITS
Z71
SIDE YARD SETBACK STREET SETB�CK REAR YARI) SETBACK
5� -71—�e?6
;u ZONE LOT AREA v . ACANT SITE
r� - 1 0 YES (J.NO
FIRE ZONE TYPE OF CU14Wi71tUUJ:1UN OKI�L A��vy
[] YES No
SPECIAL INSPECTOR REQUIRX OCCUPANCY GROUP
0 YES
I hereby acknowledge that I have read this application; that the In-
formation given In correct; and that I am the owner, or the duly author-
r-
ized agent of the owner. I agree to comply with city and state laws regu-
latlng construction: and in doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Wanhingt=]n
relating to Workmen's Compensation Insurance.
(Except Demolitions which shall
NOTE: Permit Limit One Year no completed In ninety days.)
SIGN iE (0 ER OR NT) DATE IGNE?
Wj
NOTE: Applicant Subject to Plan Check Fee
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, drivewaYs.
ntarquees, etc.) will require separate permission.
BUILDING
1
VALUATION
BUILDING PERMIT
2
FEE
PLUMBING
3
PERMIT FEE
HEAT & GAS LINE
4
PERMIT FEE
SIGN PERMIT
5
FEE
DEMOLITION
6
PERMIT FEE
PLAN CHECK
7
FEE
8
AMOUNT
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EILFIVIONDS
PR 6-1107
J.
APPLICATION APPROVAL
This application Is not a perndt until
signed by the Director of Building Inspec-
tion, or his deputy-, and fees are paid, and
receipt Is acknowledged in space provided.
FILE
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