690311.pdfM
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POSTED ON KROLL MAP NO.:
PERMIT
690311
BUILDING DEPARTMENT
Applicant Fin
NUMBER
PERMIT APPLICATION
Inside Heavy Lines
JOB ADDRESS
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In �/_ n - / 2
NAM (OR NAME OF BUSINESS)
SIDE YARD SETBACK
STREET SETBACK REAR YARD SETHI
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MAILINU AJJI)kMbd
7 V�q_gE,
USE ZONE
LOT AREA
VACANT BITIS
0
P's — 0
YES [3 NO
CITY
WN"PHUNN 94UMBER
67��61
HEIGHT
BUILDING
AMEA VARIANCE NUMBEI
NAME
PLOT PLAN A L
PPRO
ADDRISUS
STRIWT R/W
EXISTING STREET R/W ............ FT.
DEFICIENCY THIS PROPERTY
CITY
TELEPHONE NUMBER
COUP. PLAN ST. R/W ............ FT.
............ FT.
9
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L4
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FIRE ZONE TYPE OF
NEW
ADD
R7
RESIDENTIA
NON-RESID32 �LTIAL
E] DEMOLISH
0
GAS
LINE
ION
RETAINING
WALL
[3 YES
PLAN
R4E
ElALTER
El
EXCAVATE
FENCE
OR FILL
( .......... x .......... Ft.)
REPAIR
PRE -MOVE
swim
POOL
INSP.
FUMBER OF STORIES
NUMBER OF
DWELLING
UNITS S�A&;J- E_F191n11-V1
' f XA446-
TO L IS 7-.1 H
Plan Check No .....................
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BUILDING
USE
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PLUMBING
HEAT & GAS L.ID;r
F (Indicate Btlilding setbacks, abutting streets)
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FENCE
SIGN
44
N
RETAINING WALL
SWIMMING POOL
DEMOLITION
X
L4
PRE -MOVE INSPECTION
EXCAVATION OR FILL
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AMOUNT DUE
I hereby acknowledge that I have read Life 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-
AT=NTION
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
TIUS PERMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit Otte Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
31GNATURE (OWNER,O DATE SIGNED
INSPECTION
0///4
DEPARTMENT
CITY OF
EDBIONDS
NOTE: Applicant Subject to Plan Check Fee
PH 0-1107
This Permit covers work to be done on Private Property ONLY.
Any construction on the public domain (eurbs, sidewalk*, driveways,
marquees, etc.) will require separate PerntI521011.
VERIFIED BY
Valuation
[3 YES &<
Fee
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W
No.
APPLICATION APPROVAL
This application is not a pernitt until
eigned by the Building Official or Ms Dep-
uty; and fees are paid, and receipt Is ac-
knowledged in space provided.
FILE
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It
RECORD OF INSPECTIONS
't
Date Passed
1k
Foundation
Plumbing (Partial)
(Rough)
Frame
Furnace & Fuel Line
Final
-4
RECORD -OF INS PECTIONS;
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Sewer
!.!"Parking
Landscaping.
Fire Dept.,
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