680217.pdfI
BUILDIN6 DEPARTMENT
I PERMIT APPLICATION
NAMM (OR NAME OF BUSINESS)
S72LV
MAILING Ajojji�uo
or
Applicant FBI
Inside Heavy Lines
5�_ � 4S
�P,6-73,.:�i
RESIDENTIAL
o
GAS
LINE
NEW
E]
NON-RESIDENTIAL
SIGN
RETAINING
WALL
ALTER
DEMOLISH
EXCAVATE
PENCE
R
OR FILL
( .......... x .......... P
REPAIR
El
PRE -MOVE
INSP.
Ej
SWIM
POOL
NUMBER OF STORIES
NUMBER OF
DWELLING
NITS
PERMIT
NUMB bdL)2 I
7!
JOB ADDRESS
-P'
g( '04
ry 9, �Zr.
SIDE YARD surrisAcK
STREFr BETISArkL REAR XAnU SETBACK
USVCNE
LOT AREA VACANT SITE
12
13 YES 0 NO
HEIGHT
B UMZII N VARIANON NUX"hin
PLOT PJ
STREET R/W
EXISTING STREET R/W
............ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W
........... XT. ............
REMARKS
Z
CHECKED By
METER SIZE SERVICE
SIZE CLEARANCE
BY
I
ICHECKED
MMARKS
TYPE CONNECTION
VERIFIED BY
PERC. TE13T
PERMIT NUMBER
94
RZMARKS
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
0 YES [3 NO
SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
[I YES NO
PLAN CHECKED BY
Plan check NO ............ .... ...
PROPOSED USE BUILDING
41 PLOT PLAN (Indicate Building setbacks, abutting itreets) PLUMBING
4 HEAT & GAS LINE
FENCE
t SIGN
N
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the in-
formation given fir correct-, and that I am the owner. or the duty author-
lzed agent of the owner. I agree to comply with city and state laws regu- ATTENTION
lating construction; and In doing Lhe work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Wa-chingtm THIS PERMIT
relating to Workmen's Compensation Insurance. AUTHORIZES
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which 1VORI[ NOTED
shall be completed in ranety days; AIOVED-IN BUILDINGS shall be com-
pletei In six months.)
INSPECTION
SIONAT RE (OWNER OR A�GEr) DATE 9IGNED
6 DEPARTMENT
CITY OF
7 _T�
NOTE: Applicant Stibject to Plan Check Fee PR 6-IL107
This PermJt covarn work to be done unprivate property ONLY.
Any oonstraction on the public domain (curbs, xldownlks� drivewayst
marquees, etc.) will require separate permission.
Valuation
.0o
,)r70,0
APPLICATION APPROVAL
No.
This application Is not a pernait until
Signed by the Building Official or his Dep-
uty; and fees are paid, and receipt Is ac-
Imowledged In space provided.
.1
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