690131.pdfPOSTED ON KROLL, MAP No.: P
NUMBER
BUILDING DEPARTMENT Applicant M &r
lea
PFRUIT APPI If ATInN lindde HeavyLit JOB ADDRESS
NAME (OR NAME OF BUSINESS)
f7 0
AS
EET SETBACK REAR YARD ON
SIDE TAXI) SETBACK SIR SETBA
L� L� i Arm <
MAI ib
ADDRESS
a, 7h ;Z 5
LOT AREA VACANT SITE
P7 io
Yff MPHONE �NUMBOF [3 YES 0
'RT g 0 1
HEIGHT BUILDING AREA VARIANCM NUMBER aw
';q NAME
j,
PLOT PLAN APPROVED
ADDRESS
STREET R/W
f2 EN38TING STREET R/W ........... FT. DEFICIENCY THIS PROPERTY
TELEPHONE NUMBER
COUP. PLAN ST. R/W ... ....... 1". ...... _.j".
REAL41MIS
ADDRESS
A—
CKED BY
C)
—UT—Y TELEPHONE NUMBElt
&A
C-Z. "ac.; I I -;� _T�_
Legal Description of Pr6perty, (Show Below or Attach Four Cc
P7+. C�_7hf
NEW
RESIDENTIAL
GAS
LINE
ADD
NON-RE&IDENTL&L
SIGN
RETAINING
WALL
DEKOLJ13H
EXCAVATE
PENCE
ALTER
OR FILL
PRE -MOVE
( .. . .... A . ....... Ft.)
SVnM
REPAIR
INSP.
POOL
WS
NUMBER OF
rl-) t-v\ I
DWELLING
UNITS
I
56�rTtc TXQ%�.
13 YES E3 NO
13 YES
C1 aP 9- V I t W ke % L it. i %. Work K ^iL
ALL.. Wblt�L
05PEcTioQ
r1an Cheek No ............ .
PROPOSED utuo
BUILDING
PLOT PLAN (Indleallp Building setbacks, abutting streets)
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
krrAcu
(yo
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
IMCCAVATION OR PILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the in-
formation given to correct; and that I am the owner, or the duly author -
tied agent of the owner. I agree to comply with city and state laws regu-
ATTENMON
lating constrUetlon; and in doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
TW8 FZRBM
relating to workmen's compensation Insurance.
AUT130RUES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
shall be cogWated In ninety days; MOVED -IN BUILDINGS shall be com-
,pletokin sl� moahs.),.,
lIONAT It GENT) T SIGN
DA
INSPECTION
DEPARTMENT
I 7) q 7:9
CITY OF
I —
FIDMONDS
NOTE: Appfi"nt Subject to Plan ChIck Fee
PR 6-1107
This Penult coven work to be done on private property ONLY.
Any construction an the public domal, (curbs, sidewalks, driveways,
marquees� ek.) will require separate permission.
Valuation
10-0
I &f)
No.
I �'00 [#W
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.
knowledged in space provided.
I
I
0
4