700317.pdf. .... ..... . .. ....
I DING DEPARTMENT Applicant FIR
Pa Inside Heavy Lines
ERMIT APPLICATION I
NAME (OR NAME OF BUSINESS)
�-d H AL M
M ILIN 8
A 0 ADDRES
t _XD C��
DRESS
CITY TELEPHONE NUMBER
11 ADDRESS
9 N
9 CITY TELEPHONE NUMBER
2
NEW
I
ry�r
RESIDENTIAL
o
-AS
LINE
NON-RESIDENTIAL JF�
SIGN
D---
RETAINING
DEMOLISH
0
WALL
ALTER
EXCAVATE
OR FILL
FENCE
( x Ft.)
REPAIR
1:1
PRE -MOVE
INSP.
El
........ . ..........
SWIM
POOL
4UMBER OF STORIES
NUM13ER OF
DWELLING
UNITS
POSTED ON KROLL MAP NO.:
I —
LD SETBACK STREET
E LOT ARE
PERMIT
NUMBER 700317
13 YES 13 NO
; t " 50
STREET n/w ............ FT. DEFICIENCY THIS PROPERTY
PLAN ST. R/W.. ... FT. FT.
Driveway slopes not to exceed those;
for
A .5 96f -JF P
X, V 57p-
j1p 1 113 YES )Q NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY ORO
[3 YES X-No
PLAN CHECKED BY
REMAR
C2 'P f 'of a 5, C'e
Plan Check No .....................
BUILDING
PROPOSED USE
PLUMBING
PLOT PLAN (Indicate Building setbacks, abutting streets)
IIEAT & GAS ZANE
PENCE
SIGN
RETAINING WALL
N
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 in 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-
ATTENTION
lating construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Coda of the State of Washington
THIS FE115UT
relating to Workmen'a Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
shall be completed In ninety days; MOVED -IN 13UILDINGS shall be com.
plated In six months.)
IIGNATURE (OWNER OR GENT)
DATE SIGNED
INSPECTION
DEPARTMENT
2r
-1
CITY OF
Njik
EDBIONDS
NOTE: Applicant Subject to Plan Check Fee
PR 6-1107
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
Valuation Fee Receipt No.
� '�w I ert
T _V
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-
knowledged in space provided.
— I e -A _.'
FILE
I