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I&W DesoMpUan PropertY
iENT AppUcant Fill
DN inside lEfeavy unes
0
!901
4210
[1--RESIDENTIAL
J'LINE
LL-
ElRETAINING
No
El
SIGN
0 DEMOLISH
WALL
ALTER
EXCAVATE
D OR PILL
PENCE
( x Ft.)
.......... ..........
0 REPAIR
PRE -MOVE
INSP.
El
swim
POOL
NUII13ER or
DWELLING
UNITS
U)
0
STREET B/W
EXISTING. 13TREET R/W .Vl�
COMP. P LAN ST. R/W
(I
[:] YES
SAWO
Plan Check No ............. ... ...
PROPOSED USE
BUILDING
PLOT rl," (Indicate Building setbacks, abutting streets)
PLUMBING
/00
HEAT & GAS LINE
PENCE
t
SIGN
/I AR f
RETAINING WALL
SWITA NG POOL
DEMOLITION
A
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-
ATMNTION
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
THIS PERMIT
reWting to Workman's Compensation Insurance.
AUTHORIZES
ONLY THE
NOTE: Permit Limit One Your (Except DE3101JTIONS which
WORK NOTED
ohall be completed in ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six Months.)
FI-0—NA (OWNER AGENT) DATE SIGNED
N7
INSPECTION
DEPARTMENT
CXTY OF
xvMONDS
NOTE: Applicant Subject to Plan Cbeck Fee
PR 6-1107
This permit coven work to be done on private property ONLY.
Any construction an the public domain (curbs, sidewalks, driveways,
marquees, etc.) will reQuire separate permission.
to
PERMIT
NUMBER 6705±
�jd
r WE
C3 NO
ME NUMBER—
D15IC=CY THIS
YES 1:1
No.
J
�;A
W-Crp "011MMIE
APPLICATION APPRO AL
This application is not a pernit until,
signed by the Building Official or I Is Dep-
uty; and fees are paid, and receipt to ac-
knowledged in space provided.
.1
FILE
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