660584.pdfPOSTED ON KROLL MAP NO.: I PERMIT L
60584
NUMBER U
BUILDING DEPARTh .02 A
RENT Applicant ]Fill //-6
Inside Heavy Lines _JOB ADDI
V
IEES
PERMIT APPLICATION A
NAME (OR NAME OF BUSINESS)
SIDE YA9 SETBACK STREET SETBACK RE YARD SETBACK
MMLLING A�DDRESS 4;2
-1561 USE ZOI LOT AREA VACANT SITrN
114-Z 5 0-y"Es [] NO
I TELEPHONE NUM
CITY
HEIGHT 13UILDING AREA. VARIANCJ5 14UM1314" ow
/o "'n
NAME
MIA
.j�
-FLIOT PLAN APPROVED
ADDRESS
STREET R/W
EXISTING STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
LEPRONE NUMB
CITY IT
............ FT.
1K, A COUP. PLAN ST. R/W ............ . M-
REMARKS
NAMID
BY
ICRECKED
j il METER SIZE SERVIC IiIZE CLEARANCE CHE
CITY
TELEPHONE NU
4 1 L 1
_314- -3yq"
C4
WT—ATELICENSE NUMBER
CITY LICENSE NUMBER
1Z 1Z _� .- 0 / — I �Z) 2�__
TYPE CONNECTION
VERIB
Legal Description Of Property (Show Below or Attach Four Copied)
PERC. TEST
PERMIT
REMARKS
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
YES 0-1 �o
SPECTA INSPECTon REQUIRJUD utivuFANCY GROUP
YES
PLAN CHECKED
GAS
ADD
ALTER
REPAIR
LIPJ RESIDENTIAL Li LINE
NON-RESIDENT SIGN
ElDEMOLISH
RETAINING
WALL
FEXCAVATE
0
PENCE
OR FILL
( .......... x .......... Ft.)
F-1
PRE -MOVE
INSP.
1:1
SWIM
POOL
ES NUMBER OF
DWELLING
UNITS
-WATURE TO BE DONE
Plan Check No ..................... .
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
N
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
I EXCAVATION OR FILL
Valuation I Fee
Receipt No.
I
TOTAL AMOUNT DUE
I
I hereby acknowledge that I have read this application; that the in-
formation given to 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-
-ITTIDN'TION
APPLICATION APPROVAL
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
THIS PERMIT
This application is not a permit until
tainting to Workmen's Compensation Insurance.
AUT"OnIZER
signed by the Building official or his Dep-
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
JVORK NOTED
uty; and fees are paid, and receipt is ac-
shall be Completed In ninety days; 31OVED-IN BUILDINGS she 11 be com-
knowledged in space provided.
pitted in six months.) -
INSPECTION
DEPARTMENT
DIRECTOR'S SIGNATURE
3IGNATURF,,,W% DATE IGN.ED
CITY OF
ED31ONDS
NOTE. 11APPlica"t SitbIct to Plan Check Fee
I
PR 6-1107
This Permit coven work to be done on private property
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
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