700385.pdfC
BUILDING DEPARTMENT
PERMIT APPLICATION I
Z
8
a.
0
or
Applicant FIR
Inside Ifeavy Lines
NEW
ALTER
RESIDENTIAL
NON-RESIDENTIAL j
DDEMOLISH
EXCAVATE
n OR FILL
0
AS
GLINE
SIGN
RETAINING
WALL
FENCE
( .......... x .......... Ft.)
REPAIR
1:1
PRE -MOVE
INSP.
swim
POOL
IUMBER OF STORIES
NUMBER OF
DWELLING
UNITS
A 0/
1E Y D
rj
S_
MAP NO.: PERMIT
NUMBER 700385
r" __7
L;K I STREET SET13ACK REjut YARD SETBACK
[] YES [3 NO
EXIS NG STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT. ............ I T.
REMARKB
FIRE
C] YES
L7l`A0JQ-_-AJr_ C)j
Plan Check No .....................
BUILDING
Z
PROPOSED USE
�Iwfyki_Ltl
PLUT PLAN (Inmcato
Building setbacks, abutting streets)
PLUMBING
GAS LINE!
HEAT & GAS LINE
FENC&
FENCE
gHEAT
SIGN
SIGN
LL
RETAINING WALL
RETAINING WA
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
_T
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledgo 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 stato laws regu-
ATT14CNTION
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
WOIUL NOTED
shall be completed in ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
3IGNATURE (OWNFIt Olt AGENT) DATE SIGNED
INSPECTION
DEPARTMENT
CITY OF
ED51ONDS
NOTE: Applicant Subject to Plan Check Fee
Pa 0-1107
This Pernilt coven work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
Valuation
G
[] YES
Fee I Reccillt No.
1 9. e) 5 Rs-b q�c)-
APPLICATION APPROVAL
This application Is not a permit until
vigned by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
FILE
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