700501.pdf.. ........ ..... .
BUILDING DEPARTMENT Applicant FIR
inside Heavy Lines
PERMIT APPLICATION
NAME (OR NAME OF BUSINESS)
r,r:.)nk Liefer
MAILING ADDRESS
810 12th ,we. 'Jo.
0 CITY TELEPHONE NUMBER
I Idinobids 776-4565
!� I Co.
Cd ADDRESS
7848 159th Fl. if- JE-
CITY
Z
Redmond
STATE LICENSE NUMBER
43599
Q
.4
or Attach Four
NEW
RESIDENTIAL
GAS
LINE
NON-RESIDENTIAL
SIGN
RETAINING
WALL
DEMOLISH
EXCAVATE
PENCE
ALTER
OR FILL
( X Ft.)
REPAIR
E]
PRE -MOVE
INSP.
El
.......... ..........
swim
POOL
;UMBER OF STORIES
NUMBER OF
DWELLING
UNITS
NO.: PERMIT
NUMBER
18821 — 89th P1. _-,,fest
0 YES E3 NO
EXISTING'STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT. ............ IV.
REMARKS
[] YES [3 NO
Mirylflrp
Plan Check No .....................
Z
0
PROPOSED USE
BUILDING
PLUMBING
PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT & GAS LINE
FENCE
SIGN
tRETAINING
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 to 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
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 PERIMIT
relating to Workmen's Compensation Insurance. AUTHORIZES
ONLY TILE
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In nix months.)
3IGjJATURE (OWNER OR,,tGENT) DATE 8 INSPECTION
DEPARTMENT
7d CITY OF
NOTE: Applicant Siibjcct in Plait ('lock Fce EDIVIONDS
PR 6-1107
This Permit coven %vork to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, drivewRys.
marqueesp etc,) will require separate permission.
Valuation
STREET
[:] YES
Fee
7.00
[3 NO
1 7 - 00 I(S I S-�
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-
Imowledged in space provided.
I