670502.pdf-- --- ---------- - -
POSTED ON KRO LL MAP NO.:
PERMIT
BUILDING
DEPARTMENT Applicant F1
10�4
NUMBER
PERMIT
Inside Heavy 1,111813
JOB ADDRESS
-APPLICATION
BUSINESS)
17 11 NAME
OF
A/
SIDE A D BET13ACK
STREET SETBACK
BEAR YARD SETBACK
A/
MAILING ADDRESS
USE
ZONE
LOT ARE A
SITE
CON
YES NO
T LE ONE NU BER
HEIGHT
MILDING
VARIANCE NUMONM
PW
NAME
A
PLOT PLAN APPROVED
Lo
A4Z
AD�
STREET R/`W
EXISTING STREET R/W ............ FT.
CY THIS PROPE
DEFICIEN RTY
-CITY
TELEPHONE NUMBER
COMP. PLAN ST. R/W ............ FT-
............
99
REMARKS
S
%1 Z'
a
ED BY
Z
DRE55
Mli
METER SIZE SERVICE $IZE CLEARANCE
CHINKED BY
TRL—EPHONE NUMBER
It I �;
REMARKS
STATE LICENSE NUMBER
CITY LICENBE NUMBER
TYPE CONNECTION
VERI I'D BY j
Description
of Property (Show Below or Attach Four Copies)
L
PERM��MBER
A.S 7:
e r o
PERC. TEST
RMIARKS
ad
FIRE ZONE TYPE OF CONSTRUCTION
STREET IMPROVED
LL rkzc��l I-L,
YES NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
[] YES 0 NO
PLAN CHECKED BY
GAS
RESIDENTIAL D LINE REMARKS
N NEW
Ew NON-RESIDENTIAL SIGN
ElW RETAINING
DEMOLISH F-1 WALL
ElALTER EXCAVATE PENCE
1:1 OR FILL ( .......... x .......... Ft.)
El REPAIR PRE -MOVE swill
INSP. POOL
NUMBER OF STORIES NUMBElt OF
DWELLING
UNITS
NATUR;V,F WORK TO Be DONE
0 Al Valuation Fee Receipt No*
4 1
0 Plan Check No .....................
PROPOSED USE
BUILDING
U -
Ql
PLOT PLAN (Indicate W%_1_11_dIn'g i4�Xs,"aDSu=MgngRLrccts)
PLUMBING
HEAT & GAS LINE
d<
PENCE
SIGN
N
RETAINING WALL
Ne w
0 ` I
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 to 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-
ATTENTION
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 Workmen's Compensation Insurance.
AUTHOFUZES
signed by the Building official or his Dep-
NOTE: Permit Limit one Year (Except DEMOLITIONS Which
ONLY THE
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 IX Months.) ___ I � A A
DATE 81
NA U (OWNE AGEN[J,_.�[! GNED
INSPECTION
DEPARTMENT
DIRPCYOR-13 Sj,�G7�1��TRE
j
CITY
DATL�
EuMONDS
NOTE: Applicant Subject to Plan Check Fce
PR 6.1107
This Permit covers Work to be done on private property ONLY.
Ally construction on the public domain (curbs, sidewalks, driveways,
FILE
nuLrquees, etc.) will require separate permission.
IF
Furnace & Fuel Lines—Ea-C-W—
Final