680161.pdfA�
POSTED ON KROLL MAP NO-: PERMIT
680161
BUILDING DEPARTMENT
A ppHeant Fill
NUMBER
fv
PERMIT APPLICATION
Inside Heavy I[Anes
ion ADDRESS
SINESS
NAMM (OR NAME 0
SIDE -YARD sE7rBACK STREET SETBACK REAR YARD BET13ACK
MAILING JCDI7HZ38
7 77
d/z, -X_ 0 -�_ — —
U)
USE ZONE LOT AREA VACANT SITE
�t
CITY TELEPHONE
NUMBER
0 YES NO
HEIGHT BUILDING AREA VARIAN CA NUM13MR
NAME
PL40T PLAN APPROVED
ADDR288
STREET R/W
CITY TELEPHONE
NUMBER
EXISTING STREET R/W ........... FT. DEFICIENCY THIS PROPERTY
COUP. PLAN ST.
REMARKS
NAME
ADDRESS
CHECKED BY
CITY TELEPHONE NUMBER
Z
i
201
i
&5e�o LINE
NEW R P .
11:1 NON -RE AC; SIGN
ADD RETAJINING
R DEMOLISH WALL
E] ALTER EXCAVATE PENCE
OR PILL ( ........ x .......... Ft.)
PRE -MOVE emu
REPAIR INSP. POOL
NUMBER OF STORIES NUMBER OF
DWEIALING
UNITS I
I hereby acknowledge Mat I have read this application; Mat 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-
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 Workman's Compensation Insurance.
NOTE: Permit Umit One Your (Except DEMOLITIONS which
shall be completed in ninety days; MOVED -IN BUILDINGS shall be oom-
plated In six Months.)
9IGNATURUE ( WNER 08 ATT) DATE HIONEL)
NOTE: Applicant Subject to Plan Check Fee
This Permit seven work to be done an private Property ONLY -
Any oonsgmction on the public domain (curbs, sidewalks, driveways,
me own, etc.) will require separate permission.
[I YES
[3 NO
Plan Check No....
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
OLITION
PRE -MOVE INSPECTION
EXCAVATION OR PILL
TOTAL AMOUNT DUE
ATTENTION
THIS PERMT
AUTBOlFtIZ
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
FMMONDS
PR 6-1107
13 YES Cl NO
Vaauatlon I Fee
APPLICATION APPROVAL
I
No.
This application is not a pernilt until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
FILM