680190.pdfI
POSTED ON KROLL MAP NO.: PERMIT
'IN - W NUMBER 680190
BUILDIN6 DEPARTMENT Applicant Fill
Inside Heavy Lines JOB ADDRESS
PERMIT APPLICATION
NAME (OP NAM OF BUSINESS) ?q kit
BIDE YARD SETBACK 1 8 mEET SETBACK nEAn YARD SETBACK
r-F1 T th. % I
ILING ADDRESS t,41)
USE ZONE LOT AlUjA
TELE ONE NUMBER 0 YES 13 No V.
RV, BUILDING AREA. 11
HEIGHT 161101111AWOM 'NUMBER 96
NAME
%T71 /Y PLOT PLAN APPROVED
STREET R/W
CITY UMBER EXISTING STREET R/W AQ...XV. DEFICIENCY THIS PROPERTY
YE—LEPHONE N
COMP. PLAN ST. R/W ........... XT. . ..... 0...
REMARKS
NAM Driveway slopes not to exceed those
R 15_�T -4 indicated on Standard Drawing #103. Pro
pe y
ADDRESS -tc— included in Sewer L.I.D. 161 proposef-for Z
I VACANT SIT111
0 0'_' ion in summerg 1968.
0 construct
CITY wzLEPRONE NO �ER
MEj,'ER SIZE I SERVICE SI
r� 0 ZE RED BY
8 fFT—ATE LICENSE NUMBER CITY LICENSE NUMBER CLEARANCE 6415C
A3-0 ( — —
':Z 144-3 7 1 WOMARKE;
Legal Description of Property (13now Below
TYPE CONNECTION VE D BY
Z
PERC. TEST PE
REMPfKS
FIRE Z2D�S- I TYPE OF Cl TIUCTI STREET IMPROVED
YES 0 NO
SPIMIAL INSPECTOR RE4elRED 11 OCCUPANCY GROUP
C] YES Z4JNO
RESIDENTIAL AS PLAN CHEC�MD BY-
ERNEW Ig
NON-RESIDENTIJAL SIGI:
1 1:1
ADD RETAINING REMARKS
11 DEMOLISH WALL
ALTER EXCAVATE PENCE
n OR FILL El ( .......... x .......... Ft.)
REPAIR PRE -MOVE SWIM
INSP. POOL
NUMBER OF
DWEL,LING
UNITS
NATURE OF WORK TO BE DONE
Aj /-- 1,41 R r_ C
-� -7
7
I hereby acknowledge that I have read this application; that the In.
formation given Is 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 Workmens Compensation Insurance.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be completed In ninety days; MOVED -IN BUILDINGS ahall be com-
pleted in six months.)
r/N "I _(OwNER OR AGENT) DATE SIGNED
LI
NOTE: Applicant Subject to Plan Check Fee
This Permit covers work to be done an private Property U14JUx-
Any construction on file public domain (carbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
Fee 1 Receipt
Plan Check No ........
BUILDING
PLUMBING
47 k
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIM31ING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
ITOTAL AMOUNT DUE
1*1
ATTFIMON
APPLICATION APPROVAL -
Tins PERMIT
This application Is not a perinit until
AUTHORIZES
signed by the Building official or his Dep-
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
INSPECTION
DEPARTMENT
aDO OR�� ATURE
CITY OF
MMONDS
PR 6-2107
FILE