700029 (2).pdfBUILDING DEPARTMENT
PERMIT APPLICATION
NAM"= NJLM,?�F BUSI�"B) .
Applicant Fill
Inside Heavy Lines
C.z CO.
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'ITY TELEPHONE NUMB01
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TAME
ILDDRESS
DITY TELEP14ONL NUMBff
NAME
ADD 1_2
HESS
0 7-7
TELEPHONE NUMBE
P P_ X_ 94PIf
Legal Description of Property (Show Below or Attach Four Copies)
0 NEW
El ---
ALTER
REPAIR
RESIDENTIAL
NON-RESIDENTIAL
EJDEMOLISH
EXCAVATE
R OR FILL
R PRE -MOVE
INSP.
El
GAS
LINE
SIGN
RETAINING
WALL
FENCE
( .......... x .......... Ft.)
swim
POOL
DWELLING
UNITS
NE
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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.
ized agent of the owner. I agree to comply with city and state lawn regu-
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
relating to Workmen's Compensation Insurance.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be completed In ninety days: MOVED -IN BUILDINGS shall be com-
pleted in six months.)
NOTE: Applicant Subject to PIAICheck Fee
Thin Permit coven work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
POSTFD ON KROLL MAP NO.: PERMIT
I NUMBER
7-
-1 7 0002q
WAR YARD SFFDACK
I 1 0
USE ZONE LOT AREA VACANT SITS
I I (J YES ;r
HEIGHT I BUIUD—ING AREA I VARIANCE
PLOT PLAN APPROVED
STREET R/W
EXISTING STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT. ............ . FT.
REMARKS
P41
CHECKED BY
METER SIZE SERVICE SIZE I CLEARANCE ICHECKED BY
REMARKS
TYPE CONNECTION VERIFIED BY
REMARKS
OF
[I YES E-] NO
[] YES [] 140
PLAN CHECKED BY —
REMARKS
Plan Check No .....................
Valuation
Fee
BUILDING
PLUM13ING
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVAT:ON OR FILL
TOTAL AMOUNT DUE I I -V— O�O
No.
AT= NTION APPLICATION APPROVAL
THIS PERMIT This application Is not a permit until
AUTHORIZES
ONLY THE signed by the Building Official or his Dep.
WOIUL NOTED uty; and fees are paid, and receipt Is ac-
luiowledged in space provided.
INSPECTION DIRECTOR'S ION
DEPARTMENT
CITY OF �,4
EDAIONDS DATEIV
PH 6-1107 cOcl- 7o
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