700120.pdf. . . . . . . . . . ......
POSTED ON KROLL MAP NO.: PERMIT
NUMBER
I
7
1 20
UILDING DEPARTMENT
Applicant Fin
too
PERMIT A PD LICATION
Inside neavy Lines JOB
ADDRESS
,
0
4A.ME1 (OR NAME OF BUSINESS)
SIDE YARD SETBACK STREET SETBACK
HEAR YARD SETBACK
LOT AREA
C.—
VACANT SITE
MAVANG ADDRESS
41"
USE ZONE
—NUMBER
0 YES
TMLEPHORM
HEIGHT B LDING AREA
VARIANCE NUMBER
04
Fin -
PLOT PLAN APPROVED
—TELEPHONE
STREET R/W
EXISTING STREET R/W ............ FT- DEFICIENCY THIS PROPERTY
NUMBER
COMP. PLAN ST. R/W ............ FT.
............ FT.
REMARKS
�AJDDRESB
Q
LU
CHECKED By
TELEPHONE NUMBER
F> Cl-�'030T
METER SIZE SERVICE SIZE CLEARANCE
ICHECKED BY
ITA'1111 LICENSE NUMBER CITY LICENSE NUMBER
FAT
'A'A 3 - L) 3 6
REMARKS
Legal Description of Property (Show lisle r Attach Four Copies)
LEE tA KIE Rk&( U I c; 1; 1- o
TYPE CONNECTION VERIFIED
BY
kln Lj 0- ge. �r 4.) U-)
PERO. TEST PERMIT
NUMBER
A REMARKS
C�
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
(S' C) 0 YES 13 NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
GAS C] YES 0 NO
RESIDENTIAL LINE PLAN CHECKED BY
NEW
NON-RESIDENTIAL
I N SIGN
F] ADD RETAINING REMARKS
F] ALTER
Lj
0
DEMOLISH
EXCAVATE
OR FILL
WALL
PENCE
I .......... x .......... Ft.)
EjPRE
REPAIR
F-1
-MOVE
INSP.
SWIM
POOL
DWELLING
I
UNITS
.
NATURE OF WORK TO BE DONE
Valuation
Fee
—Receipt No.
? I J ZttlA 4'. C f1 11-1
Plan Check No .....................
Z
BUILDING
PROPOSED USE
PLUM13ING
PLOT PLAN (indicate Building setbacks, abutting streets)
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
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 Is correct; amd that I am, the owner, or the duly author-
Ized agent of the owner. I agree to comply with city and state laws ragu-
ATTENTION
APPLICATION APPROVAL
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
TWs application is not a permit until
relating to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep-
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
shall be completed In ninety days; MOVEB�IN BUILDINGS shall be com-
knowledged in space provided.
pleted In six months.)
IGNAT HE (owrqNR OR AGENT) DAT SIGNED
INSPECTION
DIRECTOR'S SIGN4&T
AT
DEPARTMENT
7a 'Z
CITY OF
Plan Check Fee
EDDIONDS
NOTE: Applicant Subject to
PH 6-IL107
This perrAlt covers work to be done an private Propertif ONLY.
Any construction an the public domain (curbs, sidewalks, driveways,
FILE
msu�quees, etc.) will require separate pern-Assion.
I Is