660426.pdfPOSTED ON KROLL MAP NO.: BUILDING
BUILDING DEPARTMENT
L DI NG DEPART11
PERMT
660426
cant Fin
Applicant Fin
NUMBER
PERMIT APPLICATION
P
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Inside Heavy Lines
y Lines
.3033 ADDRESS
NAME (OR NAAE OF BTSINESS)
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FLUE'
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SIDE YARD SETBACK
STREET SETBACK
RNAit YARD SETBACK
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M 11 J.;G a
AILING ADDRESS
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UBE ZONE
LOT AREA
VACANT SITE
G1WX I
wlu"rtiumu NU MBE�R
YES C3 NO 0
I
X
HEIGHT
BUILDING AREA
VARIANCE NUMBER
UNAME
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PLOT PLAN APPROVED
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0 ADDRESS
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iCITY TFILEFIAVIN
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1
FIRE ZONE TYPE Or CONSTRUCTION STREET IMPROVED
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[I YES [3 No
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67
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
YES [j NO
BY
PLAN
CHECKED
VALUATION
TOTAL 1199
BUILDING
VALUATION
0 (91 -0-'—
WORK TO BE DONE
2
3
:Z
BUILDING PERMIT
FEE
0 0
PLUMBING
PERMIT FEE
HEAT & GAS LINE
4
PERMIT FEE
EW
SIGN
NUMBKRI�5 �8� —
SIGN PERMIT
011
ADD
DE SH
MOLI
FENCE
5
—
FEE
DEMOLITION
PERMIT FEE
ALTER
REPAIR
1 1:1
RESIDENTIAL
NON-RESIDENTIALI
NUMBER OF 6
DWELLING —
UNITS 7
PLAN CHECK
FEE
PROPOSED USE
—
8
AMOUNT DUE
0
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-
ATTENTION
APPLICATION APPROVAL
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 Luber 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.)
THIS PER?inT
AUTHORIZES
ONLY THE
Wol[Ur NOTED
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.
019
SIGNATURE (OWNER OR AGENT) DATE SIGNED
44?
INSPECTION
DEPARTMENT
CITY OF
Lv.
DI 771 SIG]?K
.0
DATE
4
EDIVIONDS
NOTE: Applicant Sitliject to Plait Check Fee
Pit 0-1107
A_
FILE
This I -emit covers work to be done on Private property ONLY.
Any construction an the public domain (curbs, sidewalks, driveways,
marquees, etc.) will requirp separate permission.
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