Loading...
The URL can be used to link to this page
Your browser does not support the video tag.
660284.pdf
Y'al +�?�. r,�t�',I�Y �4bar..,�..............�._..�+-.-..._........._:,..�..._._...._...�._...y._._....._.�....._r.___•____......:..,-+..�...+..++n.+ww�.`.aw.a,:,.am., ; ; POSTED ON KROLL MAP NO.: BUILDINGPERMI ' 'BUILD ! N G D E P A R T M E N T Applicant Fill I NVMBlBii 660284 t IIi 3�1PERMIT APPLICATION Inside Heavy Lines dD8 ADDRESS ' _ O � La5S 64'1 fir.✓ NAME (OR NAME OF HUBINE88) � - 'I.� F YARD SETBACK 8T TBACK REAR YARD SETBACK ; MAILING A 88 /f 1 91xiwaf` O/ N . USE ZONE LOT AREA VAOANT BITE t iA TY TELEPHONE NUMBER ❑ YES ❑ NO s M I HEIGHT I BUILDING AREA I VARIANCE NUMBER 't Iry I , NAME I c PLOT PLAN APPROVED ADDRESS S .. :r - _ REMARKS . +�'•CITY TELEPHONE NUMBER , NAME 1 s 1 �?- REMARKS I D 7 01 .ADDRESS i.. " ,y METER SIZE I SERVICE SIZE I CLEARANCE I CHECKED BY .� •; CITY I TELEPHONE NUMBER I( - k STATE LICENSE NUMBER CITY LICENSE NUMBER I If (; th TYPE CONNECTION I VERIFIED BY L N{ }t(tS I I P • ,r_ f Legal Description o[ Property (Show Below or Attmh Four Captes) - ` o q7 4 U r% PERC. TEST PERMIT NUMBER z 1 FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED >1s %t _ ❑YES ❑ NO 1 s Illddd s , SPECIAL INSPECTOR. REQUIRED I OCCVPANOY GROUP r ❑ YES ❑ NO ^' PLAN CHECKED BY If .VALUATION TOTAL FUR !{I BUILDING ) WORK TO BE DONE 1 VALUATION !s� ✓ L o D f OIf -4k . 3 FB�VILDING PERMIT O O a. y .o Y ... -•iF -.{~ PLUMBING to - ;t; 3 PERMIT FEE i - O BEAT h GAS LINE * PERMIT FEE NUMBER OF STORIES ❑ NEW SIGN SIGN PERMIT': ❑ li FEE q ❑ ADD DEMOLISH FENCE m DEMOLITION ❑ ALTER IN RESIDENTIAL NUMBER OF - �r REPAIR NON-RESIDENTIAL NITDLLIN6 I hereby acknowledge that I have read this application; that the In- formation given is correct; and that I am the owner, or the duly author- ized agent of the owner. I agree to comply with city and state laws regu- lating construction; and In doing the work authorized thereby, no person will be employed In violation of the Labor Code of the State of Washington III to workmen's Compensation Insurance. (Except Demolitions which shall NOTE: Permit Limit One Year be completed In ninety days.) NOTE: Applicant SsI to Plan Check Pee This Permit cavers work to be done on private Property ONLY. Any construction on the public domain (cwbs, sldawallis, driveways, nuuquees, etc.) will mqulre separate perndesion. e 8 1 AMOUNT DUE �© �- 0 0 ATTENTION APPLICATION APPROVAL THIS PERMIT This application is not a permit until AUTHORIZES signed by the Director of Building Inspec- THE WORKORH NOTED on, or tihis de and fees are aid and deputy; p' receipt is acknowledged in space provided. INSPECTION DIRE CTNATURI DEPARTMENT CITY OF DATE EDAZONDS PR 6-1167 y 1. I , t 1 {