700302.pdfKROLL MAP NO.:
PERMIT
NUMBER 70
0302
q,13UILDING DEPARTMENT Applicant Fill
inside Heavy Lines JOB ADDRESS
PERMIT APPLICATION
NAME (okc riAblE OF BUSINESS) 0? /A)
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Rl,�! ILIN�2 DDRE4Z
.:,ttt ACANT SITE
UBE ZONE LOT AREA YES [3 NO Z
NUMBER
CITY RIANcE NUMBER
HEIGHT Bull, AREA VA
DING
PLOT PLAN APPROVED
STREET H/W
TELEPIIUNE NUMBER EXISTING STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT- ............ FT.
REMARKS
Z
CHEERED By
TELEPHONE NUMBER
METER SIZE SERVICE SIZE CLEARANCE CHECKED BY
BE NUMBER CITY LIC TIMBER
REMARKS
Four Copies)
Legal Description of �Property (Sh
Lake McAleer 5 Ac Tracts; th ptn TYPE CONNECTION VERIFIED BY
L ot 9, DAF: Beg 390' F of SE cor sd Lot;
PERO. TEST PERMIT NUMBER
th N 1251t th W 110'; th S 1251; th E
, :,,,�to POB, except E 301 for Co. Rd
REMARKS
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
YES 0 NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
0 YES 0 NO
GA I I
B
F] NEW RESIDENTIAL F LINE PLAN CHECKED BY
0 ADD
I L_j
NON-RESIDENTIAL
L_j
SIGN
RETAINING
r"M
D
WALL
I RI
DEMOLISH
F1ALTER
EXCAVATE
0
FENCE
OR FILL
( .......... x .......... Ft.)
E] REPAIR
PRE -MOVE
INSP.
F-1
swill
POOL
Z
DWELLING
UNITS
t
I hereby acknowledge that I have read thin 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 laws 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 DEMOLITION8 which
ahall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted lr.,,Btx montlis.)7
Valuation
Plan Check No ......
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
rlAzol
TOTAL AMOUNT DUE
ATMNTION APPLICATION APPROVAL
No.
THIS PERMIT This application is not a permit until
AUTHORIZES signed by the Building Official or his Dep-
ONLY THE
WORK NOTED uty; and fees are paid, and receipt is ac-
I Imowledged in space provided.
Of AG DATE SIGNED INSPECTION
DEPARTMENT
f) -6 -,70 CITY OF
ED51ONDS
NOTE: APPU to Plan Check Fee PH 6-1107
This Permit covers work to be done on private Property ONLY.
Any construction an the public domain (curbs. sidewalks, drivewaYs,
marquees, etc.) will require separate permission.
� /� - 12 0
FILE
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Sewer
Parking
Landscaping
Fire Dept,