690121.pdfn
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BUILDING DEPARTMENT Applicant Fill
PERMIT APPLICATION ludde Heavy Unes
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IfAME LICENSE NUMBSIR r LJCMN
LAW Description or rroperty (Show Below Or Attach 701
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C)161. .
60
-------------
PERMIT
--LNUMBER 69012
=n..L ^ V""
SETBACK
DA VACANT ME
n TER -140
I)EFIcIENCY TWS PROPERTT
ISTREET R/W .... ....... FT.
PLAN ST. R/W ............ rr- .......... FT.
larger line than 2YO
13 YES
NEW E] RICKMENTIAL AS FL —AN
[3 !N
NON-RESMENTIAL BIG]:
Li RETAINING
DEMOLISH DWALL
F1 ALTE EXCAVATE FENCE
El OR FILL ( ........ . x .......... Ft.
REPAIR PRE -MOVE swim
El INSP. YKPOOL
Ell NUMBER OF
DwELLING
UNITS
(3 NO
Plan check
FR—OPOSED USE
BUMMING
PLUMBING
PLOT PLAN (Indicate Building vetbackm, abutting streetsY_
12
t
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
swrM311ING POOL
DEKOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; Mat the In.
formellion given is correct; and that I am the owner, or the dUlY Atlthor�
Ned agent Of the owner. I agree to comply with city and state laws regu-
ATTENTION
laiting nonAtruction; and in doing the work authorized thereby, no person
will be employed in violation of We Labor Code of the State Of WAshinjillon
TWO PzRblXT
relating 0 Workmens Compensation InguMOO1.
AU=OIMZES
ONLY T=
NOTE: Permit Limit One Your (Except DEMOLITIONS which
WORK NOTED
allH be completed In ninety days; MOVED-IIN BUELMINGS alual be com.
pietea in di months.)
:R 0 GENT) -DATE SIGNED INSPECTION
DEPARTMENT
CILTY OF
FADMONDS
Applicant Subject to Plan Check Fee PE 6-1107
This permN CoVers Work to be done on PtIVI" property ONLY.
Any oondrOCUSIM On the public domain (embs, sidewalks, driveways,
raiLl"Oes, etc.) will rNuIrs separate permission.
Valuation
M
13 YES C3 NO
APPLICATION APPROVAL
This application is not a permit until
sigmed by Ute Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
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