670165.pdf� 7�1
POSTED ON KROLL MAP NO.: PERMIT
NUMBER
BUILDING DEPARTMENT Ipplicaill 1 14 V E 1 670165
PERMIT APPLICATION Inside Heavy Lines —roB A,)DRESS
7' ;,Y-
NAME (OR NAME OF BUSINESS)
SIDE YA3TD SETBACK STREET SETBACK REAXL YARD SETBACK
94 MAILING ADDRESS 7 / e, M /,Jv �2,5` 2 5-, r-yl I N a
3 4`11,�f7- 04- k2P� A/ USE ZONE LOT AREA VACANT _41TE
1 TELEPHONE NUMBER (10 / -;� — I
CITY #To
3�er '7— 7- L 4-
I-V / 2- 54 o 70 HEIGHT BUILDING �_�_A VARIANCE NUMBER N
NAME
PLOT PLAN,4,PF ED
ADDRESS
STM /W
CITY TELEMPHONE NUMBER EXINrG STREET R/W 2 ....... FT. DEFICIMCY THIS PROPERTY
COMP. PLAN ST. R/W !;-40 ... FT- ... (9 ... FT.
REMARKS
NAME
519111,6 CHECKED BY
ADDRESS
/?.
METER SIZE SERVICE SIZE CLEARANCE CFVKED BY
CITY TELEPHONE NUMBER
STATE LICENSE NUMBER CITY LICENSE NUMBER 19EMARKS
ITYPE CONNF
Legal Description of Property (Show Below or Attach Four Copies) jMON
A 0 T :2 5Z42 /- R ItW 7-4el?P c,�
PERC. TEfT PERM17ER
D i v. )3 T- Pi fc. V o Im -1 REMARKS
0 F P�, /9 7,50 2- 'V
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
1?)�C6XP5 51VO110IY15-H COUIV7—Y &�,
/-I,/- de 48' A!
SPECULL INSPECTOR��
QUIRED OCCUPANCY GROUP
[3 YES a -NO'
J
PLAN CHECKED
An�GAB
NEW RESIDENTIAL LINE REMAfKS
NON-RESIDENTIAL SIGN ZeXr4l
DRETAINING
ElDEMOLISH WALL
ALTER EXCAVATE FENCE
1:1 OR FILL (_ ....... x . ........ Ft.)
REPAIR PRE -MOVE SWIM
1:1 INSP. POOL
NUMBER OF STORIES NUMBER OF
DWELLING
,2 UNITS
NATURE _0F WORK TO 33E DONE
Valuation Fee Receipt No.
Z
0 ipe5_ Plan Check No ....... ............
PROPOSED USE
BUILDING _7
U
Q PLOT PLAN (Indicate Building setb abutting streets) PLLTU33ING 4� 2PLO
HEAT & GAS LINE 490
PENCE
SIGN
N
RETAINING WALL
19 SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
7 EXCAVATION OR FILL
I hereby acknowledge that I havei read thin application; that the in. TOTAL AMOUNT DUE 690 a I 12S
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- ATMNTION APPLICATION APPROVAL
lating construction; and in doing the wor;[ authorized thereby. no person
will be employed in violation of the Labor Code of the State of Washington THIS PERMIT TWs application is not a permit until
relating to Workman's Compensation Insurance. AUTHORIZES
ONLY 1111E signed by the Building Official or his Dep-
NOTE: Permit Limit One Your (Except DEMOLITIONS which WORK 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.)
BIG TURE (OWNER OR AGENT) DATE SIGNED INSPECTION DIRECTOR'S IS ATU
A;7 DEPARTMENT
CITY OF
1 EDATONDS DATE
NOTE: Applicant Subject to Plan Check Fee PR 0.1107
This rermit covers work to be done on Private property ONLY.
Any construction on the public domain (curb&, sidewalks, driveways, FILE
marquees, etc*) will require separate permission,
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