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Llt�.MAP N04, PER M I
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BUILDING DEPARIMINI
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10)7
6V
PERMIT APPLICATION
Ap pticant Fill
Inside lletwy Lfill,,
JOB ADDRESS
NAME (Olt NAME OF BUSINESS�
SIDE YARD SETBACK STREET SETS UK
REAK YAtlV'3ETHAqK
MA ILING ADDRE 85
USE SON E LOT A
VACANT
0
—CITY
WE —Nulumlt
......
, 2 1., ...
0-.iis. 0 NO
13UIL
HEIGHT DING AREA
V�Rlll NOE NU BER
NAME
-PLOT PLAN APPROVED.
ADDRESS
STIIF�.:T lt/W j.':'
EXISTING STREET RIW "t .FT. DEFICIENCY .-TY
CITY
1L1'1,,PIlONr I'll
77
p
I'TI .
COM P. PLAN ST.. /W ............ 1,
REMARKS
NAME
CHECKED BY.,
ADDIINUIS
METER SIZE SERVICE SIZE CLEARAIICEI
BE BY
A
CITY
NE N711
77
:jU
EMARKS
STATE LICENSE NUMBER
LICENSE NUMBEK
TYPE CONNECTION VERIFIED BY
Legal Description of Property (Show Below or Attach Fear Copies)
PERC, TEST PERIIIIT,NUMBER
SEMARKS
FIRE ZONE TYPE. 0 CONSTRUCTION
STREET IMPROVE�',
YES
5-iECIAL OCTOR R1139UIRED OC UPANCY GROUP
[I YES Ej-N6':
PLAN CHECKEC,BY
RESIDENTIAL
'-As
El
EINEW
El NON-RESIDENTIAL SIGN
�::A
ElRETAINING
WALL
DEMOLISH
ALTER EXCAVATE
OR FILL
PENCE
E] ( .
L_j
.......... ..........
FREPAIR [] PRE -MOVE
INSP.
swiAt
POOL
NUMBER OP-sTORIES NUMBE OF
DWELLING
UNITS
NATURE OF WORK TO DONE
V.I..tl.. Fee Receipt I�
Cl—k N.,_:: . ....
PROPOS USE
-VR-- ED
BUILDING
PLOT PLAN (Indicate Balldirg setbaclo, nblfttl�g la ... As)
PLUMBING
REAT & GAS LINE
PENCE
N
I
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE INSPECTION
EXCAVATION OR FILL
TOTAL A31OUNT DUE
I hereby acknowledge that I have rend this application; that ill, in.
form thin given Is correct; and that I not the owner, or the doll, author -
[zed agent of the owner, I agree,to cc ly With City and state laws reint.
Zack
ATTENTION
APPLICATION: APPROVAL
lilting construction: and in AOinj um authorized thereby, no person
Will be employed in violation of the Labor Code of the State of Washington
relating to Workmen's Compensation lesurance.
Tills I-ER311T
AUTHORIZES
This application Is not L permit until
�igned by the Building Official or his Dep-
NOTE: Permit Limit One Year (Except DEMOLITIO'.%H which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
sheall be completed In aptly days: MOTED-IN BUILDINGS ShAll he Core-
Ifflowledged in space provided.
pleted In six months.)
SIGNATURE (OWNE14 .?ENT) A H SIGNED—
INSPECTION
01RECTOR'S SIGNATURE,
DEPARTMENT
)ITY or
ISM HONDS
DAT
NOTE: Applicant Subject to Plan Check Fee
pit 6.1107
d
7—Thl. Pel con— work to be Onne no prl%mto preperty ONLY.
Any construction nil file Publ:r deal in (,mbs, mideivalks, driveways,
INSPECTOR bc�
marqn-1. sts.) WI ,q.R. selitiml,