670086.pdfef STREET R/W RlwY ....xr. DEFICIENCY THIS PROPEI;LTY
EXISTING STREET 0
COMP. PLAN ST. R/W ........... Fr- ..... ...
REMARKS
CHE000D BY Z
PRESS
CLEARANCE CHXCKXD BY
SIZE SERVICE SIZE
T LEPHONE NUMB
LICENSE NUMBER CITY LICENSE NUMBER
TYPE CONNECTION VERL7 �Blr
Legal Description of Property (Show Below or Attach Four Copies)
4P/ PERO. WEST PERIEV�N
'7ER
Z
REMARKS
T IMPROVED
I= ZONE TYPE OF CONSTRUCTION ISTREE
IVOA.77Y -767— 1:7 [3 YES
)T;Z:�' _1E. / 4
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
YES
0_110
PLAN CHECKEDBY
GAS
0 RESIDENTIAL LINE REMARKS
NEW 91 NON-RESIDENTIAL SIGN
0 RETAINING
DDEMOLISH F1 WALL
ElALTER EXCAVATE FENCE
0 OR FILL ( .......... x .......... Fn%
REPAIR PRE -MOVE swim
F-1 INSP. POOL
NUME R OF
DWELLING
UNITS
NgAT/U'R!�� WORK TO BE DONE
Valuation Fee Receipt No.
Plan Check No ............ . .......
W. �SUA�
-FROPIDS
ck No ........... . ......
BUILDING n 0
Q
N
-FL—OT ILAN (Indicate Building setbacks, abutting streets) PLUMBING
HEAT & GAS LINE
PENCE
tSIGN
N
RETAINING WALT
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR F71LL
4—s—o
I hereby acknowledge that I have read this application; that the In- TOTAL AMOUNT DUE
formation given In 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 re6u- ATMNTION 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 TIUS PERMIT This application is not a permit until
relating to WorkmerVa Compensation Insurance. AUTHORIZES signed by the Building Official or his Dep-
ONLY THE
NOTE: Permit Urnit One Year (Except DE.MOLITIONS which JVORK NOTED uty; and fees are paid, and receipt is ac-
shall be completed in ninety days; MOVED -IN BUILDINGS shall be com- knowledged in space provided.
pleted in six months.) INSPECTION
BIG WNEU UA vz�lp DATE,SIGNED D R, 3 SIGN
T IV 11
DEPARTMENT
-
3,/& 7 CITY OF rT
EDDIONDS DATE
APPlicant Subject to Plan Check Fee PR 6-1107
ThIs Permit co%en work to he done on private property ONLY.
Any construction on the public domain (curbs, oldewalks, driveways, FILE
marquees, etc.) will require separate permission.
T1
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