680167.pdf.. ........ ------ �'7
7 � 7P
4,
jMII
4,
POSTED ON KROLL MA.? NO.: PERMIT
NUMBER
AnnIleant.Fill
BIJI:01NG:� DEPARTMENT
! . I I � I :
PERMIT, APPLIO kttdN
Inside Heavy Lines
I
( I - . — I -
—
JOB ADD E013
R
0 J
NAME (OR NAME OF, BUSINESS)
0-
SIDE YARD SETBACK
STREET SETBAU1%
SET
REAR YARD BA
_TA�CANTSITE
C4
14
MAILANG ADDRESS
r
bo.
USE ZONE
LOT AREA
YES in N 01
TELEPHONE NUMBER
HEIGHT
BUILDING AIMA
VARIANGN 14UMBER;
11
t
a 0j in Q I( -
A
or
I
DNEW
RESIDENTIAL
F1
GAS
LINE
E]
NON-RESIDENTIAL
F�
SIGN
r_1 ...
F]
DEMOLISH'
RETAINING
WALL
F
EXCAVATE
,NCE
FF
ALTER
OR FILL
US
0 REPAIR
PRE -MOVE
INSP.
SWIM
POOL
NUMBER OF STORIES
NUMBER OLP
DWELLING
UNITS
EXISTING STREET R/W ....... .... FT.
COUP. PLAN ST. R/W ............ ITT.
[I YES [] NO
Plan Check No ............. .......
BUILDING
It
N
PLUMBING
BEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have road this application; that the in.
formation given to correct; and that I am the owner, or�the duly 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 Compensation Insurance.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
AT=1 NTION
THIS PER311T
AUTHORIZES
ONLY THE
WORK NOTED
�T
DEFICIENCY THIS PROPERTY
CHECKED BY
a;
STREET IMPROVED
13 YES 13 NO
PANCY GROUP
Valuation
C;L
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep.
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
-8—IONATURS _(OWNER OR AGENT) DATE SIGNED INSPECTION DIRECT LIS 81
U
ENT
DEPARTM]
CITY OF DATE
EDIVIONDS
/,. (,_� , / 1"� I
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 (curbst shlownlksp driveways, INSPECTOR
marquees, etc.) will require separate permission.
4
Id
d
51 d
d I d
44
T t,
If t
4
A
dd
41
I f I+
f
1, 4
L%
4
k'
%
p
BLOM jTERMIT
I 1 1 4 1 1 1 1 1 1 1
I f
0 wit lfinit�
d 4
With
e follow�ng �works in acco' rdanoe
I d I r
.1. t
Sets'I sUb itted herewith for approvalt.'
1go,
Vin 'one am M1
gp ansi an icati 0
t 0 4 1 1 1 d
d r I Off& I
ItI PIA 11 1 1 1
�L ter
t
Par
MV V . . . . . . . . . . . . . .
�,f - - - - - W - - - -
a I . . . . . . . . .
pair ........ 7t
I P
t, Zone.;,.
... ire
Use zone., ..... ......
_1� 4 1
Constff type .....
................ .......
CUP
Add
f,' ......... .. .... . BIL .....
17A . . . . . . .. . . . . . . . . . . . . . . . . . . . Lot
I
Septic t�m
frontage .......... ......... I d
, fl,
k, A�d, I I - I - I I P
IIII % I r I P
�A; 'A Y.'
I I gr
'Side ........ L�side ............ ....... ...... rear ............. ............... l;ttr
L Y . � I I 1 1. r I I L r . rr P-
f"':"Bldgf set4xiCks ....... ... ...... r. 11
c/",
4 1 4 1
Address..:t.-l. . . ............
d
'Owner,-.,....
14'. . .. . . . . . . . " - - - - - - - - - - - - - - - - - - -
1 4
I I 1 11. 1
01 '4
.. Tel. ............................ I I.
.... Address ...... ............... ....... ...............
......................... ............. ...... -�i; Ir r,
It.
'd If
d
r r, No.;. I I I
d, I + I I
. . . . . . . . . .
. .. ... Tel,
............................. ............. .. Address
If
... k. ..................... r I
d
Mh .................... .............. ............... ........................
--.T1.nr-ntJ:4r%* lcoversw . .... 0. 1 .
- : ,, , 4
d d r III
P' ty .Uo be done
on privat
.d 11 . .,I o property OITLY
. . . . . . . . . 4 . . . . . . . . . . . . 0.4
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . I. . . . . . . . . . . . . . . . . . . . .
I
............. ql 4L
An
�,,,,,.ic domain
1 4
curbs side 0 1., ;1.` 1
11"s driveways marquees
. . . . . . . . . . It I.. . . .1 . . . . . . . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . r...
L I 'r I I k P
equ-ilre . . . se-Pa7rtEt . . . . . . . . 0-800 060004- 1 1 1 L L I . I L 11 1 P
, . m . . L
........ ....... . -V e permission,
It.
d
"I T
he:abotve is a correct statement and I agree to comply with A, applicable codes AM State 41 1 1 ".11 1.
1 4 1 'L I
4 d
4 �4 1 Date .. 4b
S & ed, ... . ... Address..., ........ ..............
owner/Agent ... ............... ................ .......... r I
I I d I I I
to lian
f.0 L jr,the 4 to the; above conditions, and ce with' the ip'itt
1 1. . . � I , .1 1 Il
;]bovjr work is hereby approved, subjeLt 4 L I 1 1 4 r. d I . ;I,,
PERM 14 � +1 .
theMXL I
I,
ding Department notations 4
a4-
roved
. . . . . . . . . . . . . . . . . . . . .
ait . . . . . . . . . . . .
...... .... Pern fee. . ........ ........ lo Recd
1 14
:P 7 1 . I . . .
_By. ....... ........... . .. ......... .... J.L
Biaildinio d 4 4
................
............... .......
Department
ddn 9
1+1 1
ancy
I
�
I P .
d I L I I 1 4 r L L
I I Pr I
LL d
r I r 114ti �r
r'.' r 'r This Perm I It d I "I �o I P1 bing, Sewer Electrical 1"Sta owl
Or
Oes not c Vey
d
d
I d I
I
d
d
d