690259.pdf'OIITBD ON KI
BUILDING
DEPARTMENT
Applicant Fill I
PERMIT
APPLICA1
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P No.: PERMIT
I NUMBER 690259
PTBAC/K 4BTR(EET SE41C�: e� 15kieUt. YARD S:AEETBACIC
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LOT AREA VACILNT SITE
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KISTINCKTREET R/W ............ FT- DEFICIENCY THIS PROPERTY
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PRE -MOVE INSPECTION
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XCAVATION OR FILL
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TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
formation given Is correct; and that I am the owner, or the duly author-
lzed 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 Limit One Year (Except DE51OLITIONS which
WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
(0, '10
3IqNAWURn NPR OF, GENT)
DAWN SIGNED
INSPECTION
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DEPARTMENT
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CITY OF
NOTE: Applicant Subject to Plan Check Fee
PR 6-1107
This permit coven work to he done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
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APPLICATION APPROVAL
This application is not a permit until
eigned by the Building official or his Dep-
uty; and fees are paid, and receipt is ac- t
knowledged in space provided.
DIRECTOn'S HL
�DAAT
7-9-69
FILE
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