700466.pdfApplicant Fill
inside Heavy Lines
BUILDING DEPARTMENT
ATION J
PERMIT APPLIC
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INNAS.I. 6_79- U .21 / a —
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IMP. 7.nr4E
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NO.: PERMIT
NUMBER
1 71
3TREET SETBACK
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700466
VACAD
[] YES
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STREET R/W
EXISTING STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/w ............ FT. ............
0
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TELEPHONE NUMBER
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REMARKS
tESS
iption of Property (Show Below or Attach Four
7- a_ 4Vt&L0WA!�'00V.'
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NON-RESIDENTIAL
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RETAINING
WALL
EJDEMOLISH
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EJALTER
EXCAVATE
FENCE
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on FILL
( .......... x Ft.)
..........
E] REPAIR
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PRF-TIOVE
INSP.
SWIM
POOL
;UMBER OF STORIES
NUMBER OF
DWELLING
UNITS
'IATURE OF WORK TO
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IF DONE
-./- 1
11
C] YES
TYPE OF
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[WIDIO)NOIC
0 YES 0 NO
Valuation I Fee
No.
L449LiQK 4p% %J r Zeennal- Plan Check No .....................
BUILDING
Ara-o� !?!i *&-s- -'�R
PROPOSED USE
PLUMBING
'01 Lir /V -
N (indicate Building setbacks, abutting streets) HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I hereby acknowledge that I have read this application; that the in- TOTAL AMOUNT DUE Jig
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. AT=- NTION 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 PERMIT This application is not a perinit until
relating to Workmen -a Compensation Insurance. AVTIIOIUZES Igned by the Building Official or his Dep-
ONLY THE a
NOTE: Permit Limit One Year (Except DEMOLITIONN which WORK NOTED uty; and fees are paid, and receipt is ac-
shall be completed In ninety days: IN BUILDINGS shall be com. knowledged in space provided.
pletcd In six months.) 77
DATE 81GNED INSPECTION DIRECTOR'S I N
L,1;2 3-- -70 DEPARTMENT
CITY OF DATE
ED51ONDS
Fee
NOTE: Applicant Subject to Plait Check I-B 0-1107
This rermn; covers work to bo done sit private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways, FILE
marquees, etc.) will require separate permission.
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