700457.pdfBUILDING DEPARTMENT
PERMIT APPLICATION
POSTED ON KROLL MAP NO.: PERMIT [UU41 57
Applicant Fin /90 NUMBER
Inside Heavy Lines
JOB A EBB
NAME
MAILING "Jilmon
4:!i
CITY
TE—LEPHOND NUMBE
Qs,�I-Lv
S��-ZQ 7
�,V—
NAME
W
ADDRE88
9
CITY
TELE
SIDE YARD bh�k.�"AU
0
UMONE
"or AREA
VACANT SITE Z
a
I
ITNrl An -1
YES NO Z
ARIAIrCE NUMBER
I, EXIBTING STREET R/W-'D.Q. .. FT. DEFICIENCY T1118 PROPERTY
'-C--0M-P-.-P-,LAN ST. ... 0... ll. —
REMARKS
4 A, �+�A
NAME
Driveway slol.)e not
to exceeU
LLIOSe n
on Stiandard Drwing
#103.
4
DRESS
R,
CITY
Y LICENSE NUMBER— NIE'1'Ejt 81ZE SERVICE SIZE
CIT ILI ",
I CLEARANCE
C ED Y
HE
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Lx
STATE LACENSE NUMBER
ow or Attach Four copies)
FIRE ZoiNE TYPE OF CONSTRUCTION STREET IMPROVED
YES W<O
—j
SPECIAL INSPECTOR -13EQUIRED OCCUPANCY GROUP
GAS YES C-1--
LIN
E—RESIDENTIAL PLAN CHECKED BY
D NEW
NON-RESIDENTIAL SIGN
ElA1JLJ RETAINING REMAS3�W
DEMOLISH WALL
FENCE Permit issued subject to correctiorl letter
ALTER EXCAVATE
El OR FILL .......... x .......... Ft.)
REPAIR PRE -MOVE SWIM of September 15, 1970.
INSP. POOL
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE Valuation Fee Receipt No.
Plan Check No .....................
BUILDING
PROPO ED USE
PLUMBING
-PeT SeWacRs, abutting streets) HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
?oo41g
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read thin application; that the in- (�.09
formation given is correct; and that I am the owtmr, ,r the duly author-
ized 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
will be employed in violation of the Labor Code of the State of Washington THIS IIER511T This application is not a perrnit until
relating to Workmen's Compensation insurance. AUTHORIZES signed by the Building Official or his Dep-
ONLY THE
NOTE: Permit Limit One Year (Except DFMOLITIONS Which WORK NOTED uty; and fees are paid, and receipt is ac-
shall be completed in nicety days: MOVEB-IN BUILDINGS sluill be com. Imowledged in space provided.
pleted in six months.)
SIGNATURE (OWNER Olt ACIENT) —1 DA-IT' Iil0rTWff— INSPECTION DIRECTOR'S NAT
DEPARTMENT
CITY OF
DATW
I-',I)',%IONDS
NOTE: AP
pficant Subject to Plait Check I:ee Pit 0.1101
This Permit covers work to be doun on privult pris1wrly 0.4..W.
Any construction on the public domain (curb$, PhlewrOke, drl%a%%*Vb, FILE
marqures, etc.) will require separate per"IbIA1011.