670030.pdftoeJO&W -W
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POSTED ON FROLL MAP NO.: PERMIT
NUMBER
670030
BUILDING DEPARTMENT
Applicant Flu
PERMIT APPLICATION
Inside Heavy Lines
jog ADDRESS
NAME (OR NAME OF BUSINNUS)
n -) 4o
:�2 61" 13 4cL T
SIDE YARD SETBACK
sTREET/aETBACK
1
REAR YARD SETBACK
ALAIIAWG ADWIN05
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D/(2*
:
USE ZONE
LOT AREA
0
VACANT SITE
CITY ws;LAzrj:tONE
N:jUMB:ER
1
0 YES [3 NO
— b M a 4/'05'
i
HEIGHT
BUILDING AREA
VARIJOLNCE NUMBER
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ADDRESS
3 ci -k-
CITY Wial.BrIlUNE NUMBER
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0
EMST'ING'STREET R/W ....... . .. YT. DEFICIENCY T1338 PROPERTY
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YES [3 NO .1 ., 1. ;1
51 SPECIAI, INSPECTOR REQUIRED OCCUPANCY 6HOUP
[3 YES [3 NO
PLAN CHECKED BY
NEW RESIDENTIAL IGABE
REMARKS 7
rui NON-RESMENTZAL SIGN
LLkADD RET41NING
ElDEMOLISH El WALL
ALTER EXCAVATE PENCE q
El OR F11.1 El ( ........ _x ......... Ft.)
PRE -MOVE SWIM
REPAIR
El INSP. El POOL
NUMB R OF STORIES NUMBER OF
DVVELJ,ING
UNITS
NATURE OF WORK TO BE DONE
Valuation Fee Receipt No.
Plan Check No ............ ... . ...
AR-OPOSED USE
13UILDING 0"
00
PLOT PLAN (Indicate Building setbacks, abutting streets)
Q PLUMBING
0
ft HEAT & GAS LINE
PENCE
t SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL 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. j
lzed agent of the owner. I agree to comply, with city and state laws resu. i
lating construction; and In doing the work, authorized thereby, no person ATTENTION APPLICATION APPROVAL
will be employed in violation of the Labor Code of the State of Washington THISPERMIT Thief application is not a permit Until
relettlig to Workmens Compensation Insurance. AUTHORIZES
ONLY THE signed b,%f the Building Official or his Dep.-
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED Uty; and',fees are paid, and receipt is ac-
shall be completed in ninety days; MOVED -IN BUILDINnS shall be core. knowledged in space provided.
pleted in six Months.) I �
_81 TU OWNEA OR AGEVT) DATE SIGNED INSPECTION DIRECTORT SIGNATURE
DEPARTMENT
J
CITY OF DATE
EDIVIONDS
V NOTE: Applicant Subject'to Plan Check Fee Pyt 6-1107
This Permit covers work to be done on private property ONLY.
Any construction 00 the public domain (curbs. sidewalks, driveways, FILE
marquess, etc.) will require separate permission.
a