690208.pdf......... . ....
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FE PERMIT ___6W2U
FOS`r5D ON KROLL MAP NO.: NUMBER
//_16� 711)
BUILDING DEPARTMENT Applicant Fill
PERMIT APPLICATION I I Inside Heavy Lines
NAME (ult p4A=ju OF)JUSINJ9813)
S 4
MAlLJN0 "Ultmuu
CITY T-T-ZL—EPHONE NUMBM
6 - 2. 556
NAME
— EBB
Q XUD—R
CITY TELEPHONE KUMBER
14
9
or
I)DRE88
4K ?'?, 9� — / Ll
YARD SL"I'SACK STREET BET13ACK REAR Y.
ZONE LOT AREA VACANT
1? -4, / -2 1 1 0 YES
EXISTING STREET R/W ............ FT -
COMP. PLAN ST. RIW ............ FT -
ZONE I TYPE
RESIDENTIAL
GAS 0 YEE; 0 No
LINE BY
NEW
1
PLAN CHECKED
NoN.RESID ENTIAL
0
SIGN
El
21
n
RETAINING REMARKS
WALL
DEMOLISH CPZa
ALTER
n
EXCAVATE
OR FILL
PENCE
( ......... x ......... Ft.)
I
E] ItEPAIR
n
PRE -MOVE
INSP.
swim
POOL
FE
_81 ER or
DWELLING
UNITS
AS�
Plan Check No ............ . .......
Z
BUILDING
PROPOSED USE
PLUMIUNG
—abutting
& LINE
PLOT PLAN (Indicate Building setbacki, streets)
HEAT GAS
FENCE
SIGN
tRETAINING
WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge, that I havo read this npplication; 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-
ATTENTION
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
THIS PERMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
ONLY THE
NOTE: Permit Umit One Year (Except DEMOLITIONS which
WORK NOTED
shall be completed In ninety dayx;ypVED-IN BUILDINGS shall be corn -
plated In mix months.)
4
R VATN taun
INSPECTION
�ANT)
if,
DEPARTMENT
CITY OF
Jill
EDDIO
NOA.'Ap�plicant Subject to Plan Check Fee
PR 6-1107
This permit co . vers work to be done On Private property ONLY.
&ny construction on the pubtle domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate parrol$21011.
�1;
;0
MER
DEFICIENCY THIS PROPERTY
BY
[] YES 0 NO
7
it
Valuation Fee t Receipt No.
, g '9 Q—' 'T' 10 ID I
7%
I q -0--0 1 52W -�
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.
&VM
DATE
:5--
FILE
.N
Fire Dept.