690013.pdf. ...........
817 . 0
N KROLL MAP NO.:
PERMIT
BUILDING DEPARTMENT
Applicant Fill
/ /_S'- tj
NUMBER
PERMITAPPLICATION
Inside Heavy Lines
—JOB ADDRESS
�g A -z 0
(V
NAME (OR 14AM.W OF BUSINF688)
TSIDE
JJ
YARD BET13ACK REET SETBACK AR YARD SEWIJ
11 A__�
0
M GA.DDRE
q1USE
ZONE LOT AREA
VACANW kuria
CITY T LE HONE NUMB
[3 NO
P_:P/00
g-
HEIGHT UANUJ11 NUMMMJ
NAME
PLOT PLAN "PROVED
ADDRESS
�TELEPHONE
E
EXISTING STAW-f/C
THIS PROPERTY
NUMBER
CITY
11
COMP. PLAN ST.
REMARKS
NAME
Driveway slopes not to
exceed those
indicated on Standard
Drawing #103.
mom
4L 1 --1-4 C �.
PERO. TEST
KRESIDENTIAL
GAS (:I YES
LINE PLAN
lbNEW
[ 1:1
NON-RESIDENTIAL
SIGN
DADD
.—TAM*ZING REMAJ
WALL
ElDEMOLISH
ALTER
EXCAVATE
PENCE
Ft.)
I
OR FILL
( ......... x ..........
REPAIR El
PRE -MOVE
INSP.
swim
POOL
1�_Hl
NUMBER OF
DWELLING
I
UNITS
13 NO
or
Plan Check No ... . ............
BUILDING
FLUM33ING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE-MOVM INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application: that the In-
formation given Is correct; and that I ILM the owner. or the duly author-
ized agent of the owner. I agree to Comply with city and state laws regu-
ATTFMION
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
THIS PEIDUT
relating to Workman's Compensation InBumzce-
AUTHORIZES
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which
WORK NOTED
shall be completed in ninety days; MOVED.IN BUILDINGS shall be com-
pleted In six months.)
0 WN0rOR AGENT) DATE SIGNED
WN
INSPECTION
DEPARTMENT
My OF
NOTE: Applicant Subject to Plan Check Fee
PH 6.1107
This permit coven work to be does on vnv=a pmperty ONLY.
Any construction w the public donuiJn (curbs, sidewalks, drIv&wxYs,
m"quees, etc.) %will require separate PernIABB100-
Valuation
13 YES
Fee
Vice
I U4 00
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or Ills Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
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FILE