700172.pdfBUILDING DEPARTMENT Applicant Fill
PERMIT APPLICATION inside Heavy Lines
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REMARKS
TYPE CUNVI�UXIV"
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PERC. TEST PERMIT NUMBER
1,41
REMARKS
1
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FIRM ZONE TYPO OF C01411TRUCTION STREET IMPROVED
0
N
1 0 YES NO
GAS [] YES (3 NO
RESIDENTIAL LINE PLAN CHECKED BY
F] NEW NON-RESIDENTIAL SIGN
ADD RETAINING REMARKS
DEMOLISH WALL
ALTER EXCAVATE FENCE
OR FILL El ( .......... x .......... R.)
REPAIR PRE -MOVE swim
INSP. 1:1 POOL
4UMBER Or STORIES NUMBER OF
DWELLING
UNITS
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Plan Check No .....................
r a n C h e c k N o
IL D I N G
BUILDING
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PROPOSED USE
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PLUMBING
P L U M B N
PLOT PLAN (Indicate Building aetbacki, abutting streets)
LI N E
HEAT & GAS LINE
E A T G A 8
N C E
FENCE
E
ON
SIGN
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NINO WALL
RETAI�
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
0 VM INSP
P M�
E CAVAT FILL
XCAVATION OR FILL
TOTAL AMOUNT DUE
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 -
[zed 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
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
shell be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.) 1
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3 TURE (OWNER OR A9FNT) DAT IUNN
I SPECTION
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DEPARTMENT
CITY OF
0"�0�77
: Appfiea'�n�t Sublcl to Plart Chcch Fce
PH 6-1107
This Permit coven work to be done on private property ONLY.
Aar construction on the public domain (curbs, sidewalks, drivewaye,
marquees. etc.) will require separate permission.
�_ -or
Valuation
Fee I Receipt No.
rMir
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
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