680257.pdfIC '�' I
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0 DEPARTMENT I Applicant Fill
APPLI, inside Heavy Lines
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plan
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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-
izod agent of the owner. I agree to comply with city and state laws ragu-
iauns 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'& Compensation IDsumncG-
NOTE: Permit Limit One Your (Except DEMOLITIONS which
shall be completed in ninety days; MOVED_][N BUELj)INGS shall be com-
pleted irk 9ft months.) i_19in
SIGNAW tvw�m� .. .,
Joe
NOTE: Applicant Subject to Plan Check Fee
This permit covers work to be done an private property ONLY.
Any construction on the public donuft (curbs, sidewalks, driveways,
nuLrQue", ate.) will require separate permission.
TOTAL
PERMIT
NUMBER 680257
eq'i '0, &a 4 —
13 YES 13 NO
R/W ........... FT. DEFICIENCY THIS PROPERTY
NO
WALL
POOL
INSPECTION
W OR FILL
DUNT DUE
PERMT
[ORIZES
V THE
: NOTZD
lw�i
6-1107
13 YES E3 NO
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-
lmowledged in space provided.