660387.pdfZ
BUILDING DEPARTMENT I Applicant Fill,
PERMIT APPLICATION I inside Heavy Lines
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VALUATION
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BUILDING PERMIT
FEE
3
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PLUMBING
PERMIT FEE
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PERMIT FEE
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0 SIGN
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SIGN PERMIT
FEE
DEMOLITION
PERMIT FE=
ALTER
REPAIR
RESIDENTIAL
NON-RESIDENTIAL
NUMPER or
DWELLING
G
I UNITS
7
PLAN CHECK
FEE
8 1 AMOUNT DUE
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- ATT]SNTION
ized agent cf the owner. I agree to comply with city and state laws regu- THIS PERMIT
lating construction; and In doing the work authorized thereby, no person AUTHORIZES
will be employed In violation Of the Labor Code of the State of Washington ONLY THE
relating to Workmen's Compensation Insuranoe. WORK NOTED
IE,C*lt Demolitions which shall
NOTE: Permit Limit'One Year be completed In ninety days.) I
IIGNATURM (OWNMR OR AGENT) INSPECTION
DHPARTMENT
?Veti? /0 1 CITY OF
NOT . E: Applicant Subject to Plan ChecilFee EMIONDS
PR 0-1107
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbso sidewalks, driveways.
marquacs, etc.) will require separate PcITnINSIOn.
BUILDING
PERMIT
NUMBER 660387
xra PzeL r, e-
'REET SETBACK REAP. YARD BET13ACK
Xr AREA VACANT ITE
13 '40
JILDING AREA VARIANCE NUMBER
IZE CLEARANCE CHECKED BY
/I CAN
VERIFIED BY
024
PERMIT NUMtER
'ONSTRUCTION
STREET xxPRovED
1[3 YES
UIRED OCCUFANOY GROW
VALUATION TOTAL PIKE
APPLICATION APPROVAL
This application is not a pern-At until
signed by the Director of Building Inspec-
tion, or his deputy; and fees are paid, and
receipt is aclmowledged In space provided.
DIRECTOR'S SIGNATURE
DATm
FILE