690073.pdfBUILDING DEPARTMENT
Applicant M
PERMIT APPLIC)
Inside Heavy Lines -TO7
NAME (OR NAME OF 151.15LI-416US)
INE
S arkman. - McLean
mxp -
gG ADDREU5
2515 Fourth Avenue _U I
CITY —
WELEPHONE NUMBER
MA 4-5300
-,,Seattle
NAME
Harvey Dodd & Associates
ADDRESS
704 Third Avenue ST
EN
CITY
TELEPHONE NUMBER
Seattle
IMA 2-5235
NAME
Gall -Landau & Braund, Inc,
ADDRESS
1916 Eastlake Ave. East
CITY
M�MONE NUMBER
Z
8
Seattle
EA 4-0914
STATE LICENSE NUMBER
CITY LICENSE NUMBER
G-L 223 01 6207
IA-rniinrl Ino 29
Legal Description Of I-roperty (Show Below or Attach Four Copies)
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M 2AS
RESIDENTIAL INE T
ElNEW
NON-RESIDENTIAL El ION
SI
ADD RETAINING
F-1 El WALL
DEMOLISH
ALTER EXCAVATE FENCE
El
1:1 OR FILL ...... ... Ft.
REPAIR PRE -MOVE SWIM
INSP. 0 POOL
NUMBER OF STORIES
NUMBER or
DWELLING
UNITS
NATURE OF WORK TO BE DONE
Sidewalk Repair
PROPOSED USE
streets)
PLOT PLAN (Indicate Building setbaclo,_ abutting
I hereby acknowledge that I have read this application; that the in-
formation given In 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 Workman's Compensation Insurance.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be completed to ninety days; UoVED_I[N BUILDINGS shall be com.
plated in six months.) '___\
SIONATU RE towr4nin yn NT)
DATE SIGNED
3/10/69 J
/0
NOTE: APPficant Subject to Plan Check Fee
This permit covers work to be done an PrIVA" PPOPOKY ONLY -
Any construction an the public donaaln (curbs, al4awallce, driveway$,
AmMusco, etc.) will require sePAmtO permission-
F _ZoNE
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LE&T
!OMP. PLAN ST.
0; 4: 4'/,*) a a
YES
Ian Check No ...........
7, 7
P NO.: 'N"Un 1
6WID73:'�
Mt' BZE R
STREET SETBACK
RE AR Y::
LOT AREA,
VACANT bar"
E3 YES NO
BUILDING AREA
MBER
VARLALNOM UMBER
04
_.J".
iUrLDXNG
ILUWBING
IMAT & GAS LINE
PENCE
lIGN
IETAINING WALL
3WIA NG POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATMNTION
TWS PEIMIT
AUTUORIZES
ONLY TIM
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
WITIONDS
PR 6.1101
PROPERTY
E3 NO
Fee
I—
I F)
NO.
APPLICATION APPROVAL
This application is not a pemlit until
signed by the Building official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
4
APPLICATION APPROVAL
This application is not a pemlit until
signed by the Building official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
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