660429.pdfPOSTED ON KROLL MAP NO.:
BUILDING
PERMIT
-
660429
BUILDING DEPARTMENT
AppU=t Fill
I
NUMBER
PERMIT APPLICATION
Inside Heavy Lines
813
;2 -7
N OR NAME 0 BUS SS)
SIDE YARD 136TISALM STREET SETBACK
REAR YARD SETBACK
ADDRES
31
i A-REA
USE ONE
T SITE
IN SITE
1
TELEP ONE NUMBI!�R
0 YES 0 NO
0
HEIGHT I BUILDING
AREA
NAME
PLOT PLAN APPROVED
ADDRESS
REMA
CITY
MBER
NAME
REMARKS
ADORE as
METER SIZE SERVICE SIZE
CITY
TELE ONE NUMBER
REMARKS
STATE LICENSE NUM13ER
CITY LACE1031D
I
TYPE CONNECTION
VNkLIDVAN
BY
j
Legi$DqjrIptIon or vroperty k
---------- -- —C eel
PERC. T
ER
U0
Z
0
FIRE ZONE TYP E OF -CONSTRUCTION
IMPROVED
YES ITO
SPECIAL INSPECTOR REQUffND
OCCUPANCY URUUr
wa
F
YES 0 NO
UT.AW (I.RRCKED BY
BUILDING
VALUATION
Z
WORK TO BE DONE
I
BUILDING PERMIT
0
FEE
PLUMBING
3
PERMIT FEE
HEAT & GAS LINE
4
PERMIT FEE
1
NUMBER OF STORIES
SIGN PERMIT
Q
NEW
D
SION
5
FEE
F_j
FENCE
ADD
DEMOLISH
DEMOLITION
PERMIT FEE
0
ALTER
RESIDENTIAL
NUM13ER OF
6
—
REPAIR
NON-RESIDENTIAL
DWELLING
UNITS
7
PLAN CHECK
FEE
81
AMOUNT DUE
I hereby acknowledge that I have read this application; that the In- ATTENTION APPLICATION APPROVAL
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- TIHS PER311T This application is not a permit until
lating coUstructi0n; and in doing the work authorized thereby, no person AUTHORIZES signed by the Director of Building Inspec-
will be employed In violation of the Labor Code of the State of Washington ONLY THE tion, or his deputy; and fees are paid, and
relating to Workmen's Compensation Insurance. JVORK NOTED
(JE:xcept Demolitions which shall receipt Is acknowledged In space provided.
NOTE: Permit Limit one Year be completed In ninety days.) INSPECTION URE
CTO��!��
;IG;JATYRE (OWI�EA OR nENT) DATE SIGNED kl"7
I DEPARTMENT
CITY OF
NOTE: Applicant Snbject to Plan Check Fee PR 6.1107
Thim I-emlit covem work I, be dolle on private p",perty OINIA.
Any construction oil III, public domain (curbs. HideWilik", drIvewnYs,
marquees, etc.) will require eparate permission.
FILE