690266.pdfED ON 11
POSTED ON H
ARTMENT
BUILDING DEP Applicant Fil
PERMIT APPLICATION Inside Heavy Lines
'SS
—iLo)B `ADDRE55
NAMIa (OR NAME OF BUSINN")
SIDE YARD I
NO ADDREBB
0
USI-3-1-0-W-
%n11114M NUM33
"T
t
Z
or
I 4,.-re-0 No. s!�� ISAJO - Co , 6VA tA_
NEW
ry
WN RESIDENTIAL
GAB
LINE
NON-RESIDENTIAL
SIGN
09
ADD
RETAINING
WALL
DEMOLISFA
ALTER
EXCAVATE
OR FILL
FEL;(JE I
REPAIR
PRE_MOVn
INSP.
EJ
SWIM
POOL
NUMBER OF
DWELLING
UNITS
PERMIT
NUMBER
[] Yns
VARIANCE
4/' �p -
.1 ..
; STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
PLAN ST. R/W ............ FT. ............ IT.
FIRE Z I TYPE OF Cc
SPECIAL INSPECTOR LQU
YES ril No
yo'/
I
YES
ow
C9
NATURE -OF WORM TO 33E DONE
Valuation Fee Receipt No.
Plan Check No .....................
BUILDING
PROPOSED USE
PLUMBING
PLOT PLAN (Indic
I-JEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
/o �(rt) 4 i�
I hereby acknowledge that I have read thin application; that tile in-
formation given In 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
APPLICATION APPROVAL
lating construction; and in doing the work authorized thereby, no Vernon
In violation of the Labor Code of the State of Washington
TlIIH PERMIT
This application is not a permit until
will be employed
relating to Workmen 'a Compensation Insurance.
AUTlionizEs
signed by the Building Official or his Dep-
NOTE: Permit Limit one Year (Except DE151OLITIONS which
ONLY THE i
%VOIUE NOTED
uty; and fees are paid, and receipt is ac-
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
knowledged in space provided.
pleted In six months ) DATL
SJGNA (OW t AGENT)
INSPECTION
DEPARTMENT
DIRECTOR'S SIGNATURE 7
CITY OF
Fee
ED31ONDS
DATN'.
E: Applicant Subject io Plan Check
PR 6-1107
This Permit covers work to be done on private property ONLY.
on tile public domain (curbs, sidewalks, drlvo%v&Ys,
FILE
Any construction
marquees, etc.) will require separate permission.
a , ,