700395.pdfI
i—MILDING. DEPARTMENT
PERMIT APPLICATION
NAME (Vrv�AWETw
MAILING "131110111
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Applicant FIR
Inside Heavy Lines
NO.:
I
V
PERMIT
NUMBER 700395
JLW AV"IMUM
6 '�le — / 4± J. &J.
SIDE YARD SETBACK STREET 139TBACK HEAR, YARD SETBACK
UBE ZONE LOT AREA
0 YES
1h WNO
A— __
EXISTING STREET R/W ............ FT -
COMP. PLAN ST. R/W ............ rr-
DEFICIENCY THIS PROPERTY
Z
Legal Description of Property (Show Below or AtLacn &our uoyien)
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TYPE CONNECTION
VERIFIED BY
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PERC. TEST
PERMIT NUMBER 99
&4197-
GO
REMARKS
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
I
E] YES [3 NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
GAS
2-RESIDENTIA INE
L
C] YES NO
NEW
PLAN CHECKED BY
NON-RESIDE�NTIAL ION
ErADD RETAINING
FJ WALL
REMARKS
ElDEMOLISH
ALTER EXCAVATE FENCE
D OR FILL 1:3 ( .......... x .......... Ft.)
PRE -MOVE swim
REPAIR INSP. POOL
1:3
NUMBER OF
DWELLING
UNITS
NATURE OF WO!FKTO BE DONE
Valuation Fee
Plan Check No .....................
BUILDING
0
PROPOSED USE
PLUMBING
0
PLOT PLAN (Indicate Building setbacks, abutting streets)
BEAT & GAS LINE
FENCE
SIGN
t
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read thin application; that the in-
formation given In correct; and that I am the owner, or the duly author.
lzed agent of the owner. I agree to comply with city and state laws regu-
ATTENTION
APPLICATION APPROVAL
lating construction; and In doing the work authorized thereby, no person
vill be employed In violation of the Labor Code of the State of Washington
THIS PERBUT
This application is not a permit until
relating to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Off Icial or his Dep-
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TILE
WORK NOTED
uty; and fees are paid, and receipt is ac-
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
lmowledged in space provided.
pleted In six months.) DATE SIGNED
INSPECTION
DIRECTOR'S SIGRX;�O�/
Ate(AA-"
DEPARTMENT
IfIcA 0 749
CITY OF
NOTE: Applicint Sitbject to Plan Check Fee
3S
00000�
PR 0-1107
Thla remit coven work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, drivowaysi
marquees, etc.) will require separate permission.
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