690405.pdfPOSTED ON KROLL MAP NO.: D
BUILDING DEPARTMENT Applicant Fill
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14 '7 8 -
PERMIT APPLICATION Inside Ileavy Line JOB ADDRESS
NAM] Ro /F - 40 0
3ACK
ARD SETBACK
R
r f fieV] SErBACK STREET BETIJAUM REAK I
L SIDE YARD
Cd -4 0
UATIJNG ADDRESS 7 ;F1
USE ZON19 LOT AREA, VACA14T b1WE
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NUM13ER
*i;�_SKN_G_1sT,REL"r R/W ..&P..FT.
DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/w ... (kax-r.
C? ..... FT.
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REMARKS
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Driveway slopes not to
exceed those
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indicated on Standard
Drawing #103.
Cl- .
I CIIEC9F BY
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Legal Description Of k1roperty tonow Below or Attacm k�our uopica;
2- 1?7
1Z§
GAS
RrSIDENTIA LINE
P*A
NEW E] NON-RESIDE:,TIAL SIGN
DAVV RETAINING
ElDEMOLISH 0 WALL
ElALTER EXCAVATE FENCE
OR FILL ......... X .......... Ft.)
PRE -MOVE SWIM
REPAIR INSP. F� POOL
DWEI-I-I G
UNITS
':Z- 49 CV
j
A174
j;, /—=r to P-7 s;v-
0 YES 1% NO
Plan Check No ............
BUILDING
PLUM33ING
BEAT & GAS LINE
PENCE
SIGN
tRETAINING
WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I -
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the in.
formation given Is correct; and that I arn the owner, or the duty nuthor-
tzed 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 DEMOLITIONS which
WORK NOTED
aha completed Ila ninety days; MOVED -IN BUILDINGS $hall be com-
eted in sit months.)
IONA R7E AGENT) 7771 -DATE SIGNED
INSPECTION
�(06"ICLR
Z cf,-
DEPARTMENT
CITY OF
N cant Si ject to Plan Check Fee
PR B-1107
This Permit covers work to be done on private proPeztY ONLY -
Any construction an tile public docanin (curb@, sidewalks, driveways,
marquees, etc.) will require separate permission.
Valuation
[3 YES E3 NO
Y' UP /
b
APPLICATION APPROVAL
This application Is not a pernilt until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
lmowledged in space provided.
FILE
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