690269.pdfPOSTED ON KROLL MAP 14U.;
BUILDING DEPARTMENT Applicant Fill
PERMIT APPLICATION
Inside Heavy Lines
JOB ADDRESS
NAME OF BUSINESS)
NAME (OR
LD F 4q
14 j+ c) r-
SIDE YARD SETBACK STREET 133
A RE
1SW
USE ZONE LOT AREA
CIT
rELEPHONIQ NUM13KR
V.
IIEIGIIT BUILDING
NAME
PLOT PLAN APPROVED
W
ADDRESS
STREET H/W
EXISTING STREET R/W ............
14
COMP. PLAN ST. R/W ............ 17T-
S
or
r=
j RESIDENTIA
C, AS
LINE
NEW
R
NON-RESIDE�NTIAL
IGN
RETAINING
WALL
F]
DEMOLISH
VIM
ALTER
E1
EXCAVATE
on FILL
F
FENCE
( .......... x .......... Ft.)
REPAIR
PRE -MOVE
INSP.
SWIM
POOL
,4UMBER r 13TORIES
NUM13ER OF
DWELLING
UNITS
ROPOSED USE
Pnop`��
PLOT PLAN (IndJ
C] YES
Plan Check No ................
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETKINING, WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the in.
formation given in correct; and that I tun 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 PEjt1.%lIT
relating to Workmen's Compensation Insurance. AUTHORIZES
ONLY THE
NOTE: Permit Limit One Year (Except D10,10LITIONS which WORIE NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be coin.
pleted In six months.) -1 INSPECTION
NATURE ((Jwri�lt uIL &f4l) UAIZ 01" DEPARTMENT
CITY OF
L
ED51ONDS
NOTE: Applicant Subject to Plats ChcckFcc PR 0-1107
This Permit coven work In be done on privets property ONLY.
Any construction on the public domain (curbs, shlewalliss drhoways,
maj�quccs. etc.) will require separate permission.
PERMIT
NUMBER
690269
ETBACK ILEAR YAR
VACANT SI
0 YES
Valuation
16 4
!:�� I I I - ____ i
<0
W
UMBER
r.
THIS PROPERTY
0
Z
9
[] YES 31,_�O
Fee I Receipt No.
EO
I < , � -2 C-) I
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-
Imowledged In space provided.
FILE