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BUILDING DEPARTMENT Applicant Fill
PERMIT APPLICAT101 Inside Heavy Lines
NAME (OR NAME OF BUSIN10311)
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PERMIT
NUMBER 670242
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VACANT SITE
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NUMBER 41
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ADDRESS
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CITY LICENSE NUMBER
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L09M Description of Property (Snow Below or Attach Four Copies)
"-ILGAS
El/ RESIDENTIAL INE
EE"'NEW
El NON-RESIDENTIAL SIGN
ADD RETAINING
FDEMOLISH F] WALL
DALTER EXCAVATE FENCE
M El
OR FILL ( .......... X .......... Ft.)
ED REPAIR PRE -MOVE swim
El INSP. 1:3 POOL
NUMBER OF STORIES
NUMBER OF
DWELLING
0j (_? 6A & f.
IV
zjwl�WK =,/ IV
EXISTING STREET R/W .526.1rT.
COMP. PLAN ST. R/W ............ FT.
YES
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Plan Check No .....................
BUILDING
PLUMBING
M
HEAT & GAS LINE
FENCE
t SIGN
N
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 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 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 Li ' 11&n� Year (Except DEMOLITIONS which
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shall be completed In Tnty d;jA,*, MOVED -IN BUILDINGS shall be com-
pleted In six rnonth;� .O�
NOTE: Applicant Subject to Plan YC;eck- Fee
This Permit Covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separnte permission.
ATTENTION
TMS PERMIT
AUTHORIZES
ONLY THE
AVORK NOTED
INSPECTION
DEPARTMENT
CITY OF
ED31ONDS
PR 6-1107
DZFICIENCY THIS PROPERTY
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CKED BY Z
$07 14
[] NO
Fee I Receipt No.
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APPLICATION APPROVAL
This application is not a perritit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt Is ac-
knowledged in space provided.
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