680065.pdfPOSTED ON KROLL MAP NO- PERMIT
'BUILDING DEPARTMENT Applicant Fill vY. NUMBER 680065
Inside Heavy Lines JOB ADDRESS
PERMIT APPLICATION I
NAME (OR NAME OF BUbINEES) 70
E� f/ C, li SIDE YARD SETBACK BTAENT SETBACK REAR xAr.D SETBACK
vit 1� )t1b � :25,1
-11111 ADDRESS C L;5
-2 / �- UBEZP LOT AREA VACANT S1W&J
0_0 NO Z
CilTy TELEPHONE NUM [3 YES 13
E,/ sk, I = I
III Nu
21 S'l 7 7 )z HEIGHT BUILDING AREA VARIANCE NUMB ER r.
NAME APPROVED I
PLOT PLAN
ADDRESS
STREET R1W
CITY ME EXISTING STREET R/M FT. DEFICIENCY THIS PROPERTY
Coup. PLAN ST. R/W_4_401". a
REMARKS
NAMM
ADDRESS Z
CHECKED 13�
CITY TELEPHONE NUMBER
STATE LICENSE NUMBER CITY LICENSE NUMBER METZ SIZE CLEARANCE OkWCICR 33Y
0
Legal Description of Property (Show Below jjr— Attach Four Copies)
TYPE CONNECTION Vill" BY
Z
--A
c 7- PERC. TEST PER It NUMBER
REMARKS
FIRE ZONE STEtR T IMPROVED
C, IL
TYPE OF CONSTRUCTION [:I YES 13 NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
GAS C] YE13 [:I N
NEW RESIDENTIAL LINE PLAN CHECKED By
NON-RESIDENTIAL El SIGN
ElADD RxEirAINING REMARKS
ElDEMnTITSH Li WALL
ALTER EXCAVATE FENCE
D OR FULL ( .......... x . ........ Ft.)
REPAIR PRE -MOVE swim
11 INSP. POOL
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
NATURE OF'[WORK TO BE DONE f
Valuation Fee Receipt No.
Plan Check No ..................
PROPOSED UBE
BUILDING
-10
7PLOT _FLAN (Indicate 1IUIIdtt1r-&etWWk4,ftbUtUU9ZRt=�- p ING
-40
BEAT & GAS LINE
"t; m 1/4 FENCE
SIGN
RETAINING WALL
/?JT
76� A Ipiq SWIMMING POOL
DEMOLITION
'4 PRE -MOVE INSPECTION
EXC
AVATION OR FILL
I hereby acknowledge that Ilhave read this applicationi that the in. TOTAL AMOUNT DUE
formation given Is correct; and that I am the owner, or the duly author.
Ited agent of the owner. I agree to comply with city and state laws regu- IMON APPLICATION APPROVAL
I&Ung Construction; and In doing the work authorized thereby, no person ATTE
will be limployed in violation of the Labor Code of the State of Washington THIS PERMIT This application is not a pernilt until
rel&Ung to Workman's Compensation Insurance. AUTHORIZES
ONLY THE signed by the Building Off lcial or his Dep-
NOTE: Permit Limit One Year (Except DE.MOIJTIONS which WORE 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 six months-) INSPECTION
SIGNATURE (OWNER OR AGENT) DATE RIGNE DIRECTOR 1�,BIGN
) DEPARTMENT
a �ti _t i
7� CITY OF
a
7 1
NOTE: APPlicant Subject to Plan Check Fee PH 6-1107
This Perml cov work to be done an private property ONLY.
Any construe I the public domain (curbs, sidewalks, driveways,
age.) Will require separate permission.
� I - , __ _ .-' i
RECORD OF INSPECTION
Date Passed
Foundation
Plumbing (Partial)
(Rough)
Frame
Furnace & Fuel Lin
Final P�7