660365.pdfP
)STED ON XROLL MAP NO.: BUILDING
PERMIT
BUILDING DEPARTMENT 0"'e
Applicant FIR NUMBER.
PERMITAPPLICATION Inside Heavy Lines JOB ADDRESS
NAME (OR NAME OF BUSINESS) r,
4
3-
91
T.,
USE ZONE
LOT
VACANT SITE
elf�
I
'D YES ub'NO
TELEPHONE NUMBER
I/ -
4- 9 0
HEIGHT
BUILDING.AREA
VARIANCE NUMBER
311"
ow
PLOT PLAN APPROVED
REMARKS
-- , C � I " - 1.� and Pa1'ti-4)a4."(.A
I - C� i
TELEPHONE NUMBER
X"
-td'ca"06
REMARKS
Dta
METER SIZE SERV ICE. SIZE
CLEARA; 4CE CHECKED BY
-5idg
I
1:4
TELEPHONE NUMBER
REMARKS
L i*__'i1:_1 r)0f,0d 011 TA.'111
NUMBER
CITY LICENSE NUMBER
TYPE CONNECTION
VERIFIED BY
If Property (Show Below or Attach Four Copies)
PERC. TEST
FERMI
F77Z !,N TkNE TRUCTION
STREET IMPROVED
YES NO
.Z
Z
NEW
SIGN
NUMBER OF STORIES
I
Q
r
ADD
DE MOLISH
El
PENCE
4
ALTER
REPAIR
RESIDENTIAL
NON-RESIDENTIAL
NUMBER OF
DWELLING
I UNITS
FI
9 1
I hereby =knowledge that I hw�e read this application; that the In.
formation given in 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, o!...tbe.,M
of the State of Washington
relating to�Wotkmen'h 'COMPepiiatkI asurance.
111,,pt Demolitions which shall
NOTbe completed In ninety days.)
,9:,,fq!mit Limit One Year
b ...
SIGNA.TURE (OWNER OR AGENT) DATE SIGNE]
N&TE: APPlicdnt,SIiibjrct to Plan Check Fee
ThIs FermIt covers work to Im dnne cm'lirM�lc property ONLY
Any construction on the public doTahs [�?r", qlqewalkn, drIveway;'
marquees. ctc.);;Ihill requirb separate permission.
�\YNt�
No
I F-2
?LAC,9ffFCKED
BY
A - 7
N'
VALUATION
TOTAL r9t
BUILDING
I
VALUATION
Z
BUILDING PERMIT
0
2
FEE
6
PLUMBING
14
3
PERMIT FEE
50.00
HEAT & GAS LINE
4
PERMIT FEE
25 50
5
FEE, V
;E)EMPTITION cvkadiit
f0v
0-n
6
PERIXITFEE
Ve
iJI-'41
PLAW'i5fiE6 ii3i'71Z)
7
F
V:�3 3 U
8
AMOUNT DUE
ATTENTION
-APPLICATION APPROVAL
THIS PERMIT
This application is not a permit until
AUTHORIZES
signed by the Director of Building Inspee-
ONLY THE
WORK NOTED
tion, or his deputy; and fees are paid, and
receipt Is acknowledged in space provided.
INSPECTION
DIRECTOR'S SIGNATURE
DEPARTMENT
CITY OF
DATE
ELITMONDS
PR 6-1107
.4 1 INSPECTOR
I
c7
jr
10
Ve, < /-5-'
I
-LE�CORD biF iN §PECTIONS
:Date Passed
FOUndation
PlUmbin' Vartial),
9
(Roug;l-)) A�- //1
Frame
Furnace & FUel
Final