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P08'rED ON KROLL MAP NO.: � HM I� ��0�^�
BUILDING DEPARTMENT Appv(Iof,tFlu }V� �,;;
PERMIT APPLICATION Insldo Heavy Linos ,oB ADDREee l
NAME (OR N OF BUSINESS) r�3O� �i�yinP/C). � /61•✓,O,C� . �.�.... .
J� �� �- G ��A/� BIDE YARD BECHACK I STREET BHTDACK I REAR YARD BETBAOK 1
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C -/��� Lym �/� /E yt/ � � V BE ZONE LOT AREA I VAOANT BITE •!
TY TIEGEPiTON N MHEIt ��.� /�� I ❑ YEB ❑ NO'
�amONo s % % - �d' IOHT aUILDINO AREA VARIANOE NUMBER ,rFFil ,
xwME I I �
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PLOT PLAN APPROVED
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AD � G : I _.
tlTAEET B/{V 1 � � .
OITI T PRONE NUMB EXISTING STREET A/W ...».......PT. DF.P'IOI)$•10Y TAIB PROPERTY O
COMP. PLAN 8T. R/W ............Fr. ......•-...aT.
REMARKB .
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q �.7 LE'NM��E l.�Bii'=-4T/P(JCT/D/tI CIneCKED 8Y z •���
ADDRICBB \` / i7 I
OO S ^ � �� "' METER SIZE SERVICE afZE OLEARANCE CBE088D SY pJ c
ITY I B/ O� REMARKS I I I `y .
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a ATE LiOENSE NUMByE^R CITY OENBE NUMBER � Z .
�'�'-� � ' � U � TYPE CONNECTION VERD3YED SY �
Legal DeecrlDuoa of PropeHq (Show Below or Attach Four Copies) I j., �,
PERO. TEST PHRMIT NUMBER
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O Q � � / REMARKS I m
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A ' � FDA ZONID TYPE OF CONBTRVOTION STREET IMPROVED. �
�L/�T df� � E� /�C/�P S T �i I � I ❑ YEe �ro
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SPECIAL INSPECTOR REpUIRED I OCOUPANOY GROUP 1 "
❑ YEa l� � � l•
PLAN CHEOKED •(:*, -t r
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❑® RESIDENTIAL Q LINE /�� g , • 1 .� ��. � �
NEW i
❑Q NON-RESIDENTIAL Q BION 1 �� ` f
ADD ❑ RETAIIiIN6 "�. ,
®DEMOLISH Q wAT.T. ; : • ;
ALTER EXCAVATE FENCE 't .•-� , ,, ..
QOR FILL Q (.......s»........Ft.) � - ..
❑IPNR PMOVE POOL � � �.
REPAIR Q Q -
NU�IBER OF STORIES NUMBER OF
DWELLING / .
UNITS
N OF WOR$ TO SE ONE - j _'
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-- Vnluatlon Feo RecefDt No. � �� � � ^. �-'
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L1I!/�i ,��I�w�Z�y PUa Check No........-..»....... .: �. ;�.�
PROPO UBE
�, � _ /_ •�_ j HVILDINO ! � D d UG
.�ti.f.'G��vr ,LVL+ L .1
q PLOT PLAN (Indicate Building setbacks, abutting streets) PLVMBIN6
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� � HEAT h 6A8 LINE - 1 � } � ��
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FENCE - ��
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BION
RETAINING WALL
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awIMMIN6 POOL _ i J
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DEMOLITION - L.
PRE -MOVE INSPECTION ; � ��,,
EXCAVATION OR FILL
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TOTAL AMODNT DUE �� � r � � '
I herby acknowledge that I have read ibis aDPilcatlon; Wet the In- O V � '
fcrmaUoa given V correct; sad that I am the owner, or tha duly author- �
Iced agent of the owner. I agree to wmply with city nod elate laws re6v- ATTENTION APPLICATION APPROVAL `�
hung coastructlon; and to dolag the work authorlrad thereby, no Dorson � � i .. -
wlli bo emDloyed Ia Wolntloa o[ the Labor Code of the State of Wmhmgton TIDE PERMIT ! :�
relaUbg to workmen'■ Compemntloa Imuraace. 1711s application is not a permit until
• o rIIv � signed by the Bt111ding OPPicial or his Dep- i �
NOTE: Permit Limit One Year (Excevt nE�IOLITIoxB u•hlch wona xoTED uty; and fees are paid, and receipt is ae- � '' -
shall be completed Ia nlaety days; D(OVED-IN HUILDINOS dull bo com- Imowledged in apace provided. '
plated >n six months.) �
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BID TURF (OWNER O �AOEN ) DATE 8�(IN� INSPECTION DIRECTOR'S BIONATU � '
�j / DEPARTMENT �
9cC/ set/�i�71-�•�- I /D /3 �o CITY OF � � _ III °:1 i
EDhIOND$ D
NOTE: Ap�llcaat SBGject to Plan Check Fre ��`"`- •��
PR s-Ilov o —
This permit coven work to De done on ptivate property ONLY. _ � �
Ant ean■tractlon on the Dnblle domain (each■, ddewdlu, driveways, �� n � �
marquee■, ate.) will rogvlre ■eparate Permiulon. n
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