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PERMIT APPLICATION Inside Heavy Lines joB A
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PERMIT 660295
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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-
laung construction; and In doing the work authorized thereby. no person
will be employed In violation of the Labor Code of the State of Washington
relating to Workmen's Compensation Insurance.
(Except Demolitions which shall
NOTE: Permit Limit One Year be completed In ninety days.)
NOTE: Applicant Subject to Plan Check Fee
This Permit covers work to m done off priflute property ONLY.
Any construction on life public domain (curbs, sidewalks, driveways,
marqt,"Fl, etc.) will require sobarate permissim.
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VALUATION
BUILDING PERMIT
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FEE
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PERMIT FEE
HEAT & GAS LINE
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FEE
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PERMIT FEE
PLAN CHECK
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FEE
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AMOUNT DuEk%
ATTENTION
THIS PERMIT
AUTHOIUZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
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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.
DIRECTOR"' SIGNATUAE
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