660570.pdft
'%� POSTED ON KROLL MAP NO.:
DUILUIMU ucriAnIMLMI I ApplicantFiii
PERMIT APPLICATION Inside Heavy Lines
7i. 'f
I
e 0
GAS
LTRESIDENTIAL 0 LINE
NON-RESIDENTIAL
I0 El SIGN
0 �" RETAINING
ElDEMOLISH WALL
EXCAVATE PENCE
ALTER
M OR FILL ( x Ft.)
.......... ..........
REPAIR PRE -MOVE SWIM
1:1 INSP. El POOL
NUMBER OF STORIES
NUMR R OF
DWELLING
UNITS
NATURE OF WORK TT7B_E —DONE
Z
PROPOSED USE
PLOT PLAN (Indicate Building setbacks, abuttin rects)
�Ls`o
6140
&AjCLCv er r
t
N
7Z
.< i
I hereby acknowledge that I have read this application; that the In-
formation given is correct; and that I am the owner, or the duty 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 of the Labor Code of the State of Washington
relating to Workmen's Compensation Insurance.
NOTE: Permit Limit One Year (Except DF)IOLITIO-,S which
shall be completed In ninety days: MOVED -IN BUILDINGS shall be com-
pleted In six months.) 17.
// -.50 -- e d
NOTE: Applicant Sub�cct to Plan Check Fcc
This p milt covers work to be done an Private Property ONLY.
Any construction on the public domain (curbst sidewalkst drlvewa3�ss
marquees, etc.) will require separate Permission.
A :A 4- 1 1� -
EMS77NG STREET R/W ............ FT.
COMP. PLAN ST. R/W ........ ... FT.
IE CONNECTION
. .. . ......
PERMIT
NUMBER
66051:0
ACK
REAR YARD SETBACK
IS-0
VACANT
8 [] NO
EA
VARIANCE NU W.R
DEFICIENCY THIS PROPERTY
YES 0
11�
SPECL&L INSPECTOR REQUIRED OCCUPANCY GROUP
I [] YES 9 f -go— 1 _7
Plan Check No ..........
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATMISMON
TIUS PERMIT
AUTHORIZES
ONLY 77EE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
ED51ONDS
PR 6-1107
91�:
Fee
APPLICATION APPROVAL
No.
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
FILE
6