690039.pdf'N
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POSTED ON KROLL MAP NO.: PERMIT
BUILDONG DEPARIMENT
Applicant M
NUMBER
690039
PERMIT APPLICATION
Inside Hca7vyLines
J013 ADDRESS
NAM (OR NAME OF BUSINESS)
—
r<1 14
o /\/ i e s
SIDE YARD SETBACK STREET SETBACK
I r I I
REAR YARD SETBACK
-1 0
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M .
-all (14--t // F_ I
ITELEPHONE NUMBER
T_/)_�__/l VC/A
CLA - 41,
0 co 1-4 t-) i v
or
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10 �Y) J_'id . '--4 -a // . �4 / /
USE ZONE LOT A.REA VACANT SITE
13
rvARLANcE Nu UER
HEIGHT I BUILDING AREA
LU-
RESIDENTIAL
LIRE
NON-RESIDENTL4LL I
r
SIGN
RETAINING
ElDEMOLISH
WALL
EXCAVATE
PENCE
ALTER
1:1 OR FILL
( x Ft.)
PnE-MOVE
........ . ..........
SWIM
REPAIR
n INSP.
POOL
ES
NUMBER OF
DWELLING
UNITS
10�_n
RATURE OF WORK TO BE(7
5TnEEW 16/w "' Q
EXISTING STREET R/W ...FT. DEFICIENCY THIS PROPERTY
COUP. PLAN ST. R1Wv1..Q..jmr. 0
REMARKS
Driveway slopes not to exceed those
indicated on Standard Drawing #103.
Z
TYPE OF
i1j_- _Y�� I [j YES [j NO
SPECIAL INSACTOR RZQUIRED OCCUPANCY GROUP
[3 YES ')6NO T --f- l7T'
Plan Check No ............
PROPOSED USE
BUILDING
PLOT PLAN (Indicate Building setbacks. abutting streets)
PLUMBING
HEAT & G/is
_614-06-nVA
FENCE
t
SIGN
N
RETAINING WALL
SWIMM NG POOL
DEKOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this appliratton; that the In-
formation given In correct; and that I am the owner, or the duly author-
Ited agent of the owner. I agree to comply with city and state laws regu.
ATTENTION
lating construction; and In doing the work authorized thereby, no person
will he employed In violation of the Labor Code of the State of Washington
THIS PEIBUT
relating to Workmen's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit We Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
shall be completed in ninety days; MOVED -IN BUILDINGS shall be com-
plated in six months.) .
8:11ONTURE (OWNER/OR AG7T)
DATru lIIGNFD
INSPECTION
DEPARTMENT
J
CITY OF
ELYHONDS
NOTE: Applicant Subject to Plan Check Fee
PR 6-1107
This Permit coven work to be done on Private Property ONLY.
Any construction on the public domain (carbs, sidawalks, driveways,
marquess, etc.) will require separate permission.
Valuation I Fee
t;-W.01 6`2 "
V4 L3
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-
Ifflowledged in space provided.
DIRECTOR'S Q�XATr
I
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