670595.pdfPOSTED ON KROLL MAP NO.: PERMIT
NUMBER
BUILDING DEPART ENT Hcant Fill 1 670595
PERMITAPPLICATION 111111110 Heavy Lines
JOB ADDRESS
NAME OF BUSINESS)
72 09—
A 3 Z/
W
NAME (OR
-
4 1-08,4127, da.
SIDE YARD SETBACK
STREEF SETBACK
0 f
BEAR YARD SETBACK
01 t�
A5, n I &I--
/ S" M; 0
Q > If 2/ 4-Looeu V
USE ZONE
LOT AREA
VACANT SITE
- —
CITY TELEPHONE NUMBIaR
CIYES (3 NO
A-bA4,y Al nc ,A. -.Al 14�0 2 - I'll /V 9 7�_
GUT
BUILDING AREA
VARIA
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or
[ErNEW
RESIDENTIAL
GAS
LINE
ADD
1 1:1
NON-RESIDENTIAL
SIGN
nDEMOT.TRH
RETAINING
WALL
ALTER
EXCAVATE
OR FILL
PENCE
( x FQ
REPAIR
PRE -MOVE
........ . ..........
swim
POOL
INSP.
NUMBER OF STORIES
N MB R or
I)4U= G
UNITS
NATURE OF WORK TO BE DONE
A?^
1,0A_ 11 11
b
CISTING STREET R/W ... . ..... XT.
COMP. PLAN ST. R/W ........ .. XT.
[J YES
q
Plan Check No ..................
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
t
SIGN
N
RETAINING WALL
SWIM29NG 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 lawn regu- AT=NTION
lating construction; and in doing the work authorized thereby. no person
will be employed In violation of the Labor Coda of the State of Washington TIUS PERMIT
relaUng to Workmen's Compensation Insurance. AUTHORIZFS
ONLY THE
NOTE. Permit Limit One Year (Except DEMOLITIONS which WORK NOTED
shall be completed in ninety days; MOVED -IN BUILDINGS shall be com-
pleted in six months.) I
317ONURE ( �"R A INSPECTION
O%VZ "PENT) DATE SIGNED DEPARTMENT
"00
CITY OF
NDS
NOTE: Applicant Subject to Plan Check Fee PR 6-1107
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbao sidewalks, drive%vays,
mMuees, otc.) will require separate permission.
Valuation
W01
PROPERTY
T
MC BY
STREET I
13 YES 7NV016D
941
Fee
APPLICATION APPROVAL
This application is not a permit until
Signed by the Building Off Icial or his Dep-
uty; and fees are paid, and receipt is ac-
Itnowledged in space provided.
I