690088.pdfT
UILDING DEPARTMENT Applicant Fill
PERMIT APPLICATION Inside Heavy Lines
4AMZ (OR NAME OF BUBXNEBS)
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Legal Description of Property (Bnow Iselow or Atumn k-our voYlow
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GAS [] YES
NEW RESIDENTLALL LINE PLAN
ENON-RESIDENTLILL SIGN
ADD RETAINING
1:1 DEMOLISH WALL
F1ALTER EXCAVATE FENCE
OR FILL El ( ........ . x . ....... Ft.
REPAIR o PRE -MOVE SWIM
INSP. POOL
OR or
DWELLING
UNITS I
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P No.:
I:k
PERMIT
NUMBER
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i;V- SETBACV
RE
3wr n/w 26EXT.
ST. R ..5-je.m.
s-I
C3 NO
DEFICIENCY 71316 PROPERTY
r slopes not to exceed those
�d on Standard Drawing #103.
4,-- c_
rm
Plan Check No ........
I G
BUILDING
B
G
PLUMUING
P h
7
HEAT 8(gLINE
H E A T
1 N
PENCE
M C E
t
IRETAINrNG
N
SIGN
0
G WALL
An qW WALL
W G POOL
S IMMIN
DEMOLITION
EM
PRE -MOVE INSPECMTION
EXCAVATION OR FILL
OTAL AMOUNT DUE
T TOT MOUNT DU
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 -
lost agent of the owner. I agree to comply with city and state laws regu. ATTENTION
lating construction; and In doing the work authoTtzed thereby, no person
will be employed in violation of the Labor Code of the State of Washington THIS PERMIT
relating to workmen's Compensation Insurance, AUTHORIZES
ONLY THE
NOTE: Permit Limit One Your (Except DEMOLITIONS which WORK NOTED
&hall be completed in ninety days; MOVED -IN BUILDINGS shoal be eom-
pleted In six monthm.) I
TURE VAT BIG ED INSPECTION
DEPARTMENT
77
CITY OF
11WIVIONDS
NOTE: Applicant Subject to Plan Cbeck Fee In 6-1107
This permit covers work to be done an private property ONLY.
Any construction an the public domain (curb$, sidewalks, drIvewaya,
marqueeta, GO.) Will rOQutrs se!Pst"e permission-
YES
Fee I Receipt No.
L10
APPLICATION APPROVAL
This application is not a perrait until
signed by the Building Official or Ids Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
pum
ct
0
NO.
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