680135.pdf'j)��-1,9,,U.ILDJN0 DEPARTMENT
,"PEWIT APPLICATION
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W WA
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Applicant Fill
inside Heavy Lines
141"Va
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NEW
ALTER
ElREPAIR
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RESIDENTIAL
GAS
LINE
IsTON-RESIDENTIAL
SIGN
DEMOLISH
RETAINING
WALL
EXCAVATE
PENCE
on FILL
( ........ . x ...... ... Fit.)
PRE -MOVE
El
SWIM
INSP.
POOL
NUMBER OF
DWELLING
0'
UNITS
IJOAJ
I
P NO.:
9— ft.0 3
EXISTING STREET R/W ......... FT.
COMP. PLAN ST. R/W .......... FT.
A
PERMIT
NUMBER
680135
0 YES
NO
DEFICIENCY TE38 PROPERTY
—L I 'm -- I mr-i 113 YES _ [3 NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
(3 YES "�&NO F_ _?�
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MI POW )Asi
Plan Check No ........ ...........
PROPOSED U511
BUILDING
PLUBE31NG
PLOT PLAN (Indicate 11—ullding setbacks, abutting streets)
CA
1
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMNG POOL
V"
r
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
A iv e-
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the in-
formation given Is correct; and that I am the owner, or the duty author-
ized agent of the owner. I agree to comply with city and state laws regu-
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
relating to Workmen's Compansatlon Insurance.
NOTE: Permit Limit One Your (Except DR31OLITIONS which
ATMNTION
TIUS PERMIT
AUTHORIZE
ONLY THE
WORK NOTED
shall be completed in ninety days; MOVED -IN BUILDINGS shall be com.
n1a ix th )
INSPECTION
Ffu—RTURE (OWNER 0
—E101— DEPARTMENT
724 -, ",-Ce, 1�1,_ 6P orry OF
IL" MVIONDS
NOTE: APPficant Subject to Plan cbech Fee PH 6-1107
This permit coven work to be done On Prl%'LtO Property ONLY -
Any construction on the public domain (curbs, sidewalks, drivOWAY2,
manufts, etc.) will require sepxmte permission.
Fee
W!IM
DOI
I T. ab &.4c
APPLICATION APPROVAL
This application is not a permit until
eigned by the Building Official or his DeP-
uty; and fees are paid, and receipt is ac-
knowledged in Space provided.
FILE