700516.pdfBUILDING DEPARTME
PERMIT APPLIC
C"
NT Applicant Fill
inside Heavy Lines
P391221F.fm
— 66X
P 1 4.,
14.111,
PERMIT
NUMBER
C3 YES C3 NO
IADDRESS
STREET R/W DEFICIENCY THIS PROPERTY
CITY TELEPHONE NUMBER E213STING STREET R/W ... ........ FT. "T.
I I COMP. PLAN ST. R/W ............ FT. ............ I —
01 -KD—DRE08
6 ;7- W,( / Alt UMBER
iCITY PHONE N
X
4IN410EM LICE141SE NUMISNA CITY LICENSE 14UMBlUJM
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i LeffRi naseruntion of Fronerty (Show Below or Attach Four Copies)
PERO. TEST
PERMIT NUMBER
REMARKS
0
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
13 YES [3 NO
SPECIAL INSPECTOR REQUIRED
[:I YES [3 NO
OCCUPANCY GROUP
GAS
NEW RESIDENTIAL E] LINE
NON-RESIDENTIAL SIGN
RETAINING
E] DEMOLISH WALL
ALTER EXCAVATE PENCE
1:1 OR FILL ( ........ . X . ........ Ft.)
REPAIR PRE -MOVE swim
1:1 INSP. POOL_
PLAN CHECKED BY
REMARKS
o a q=rs--n
W
-WU—MBER OF STORIES
NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE
Plan Chock No .....................
Valuation
Fee
Receipt No.
X
0
BUILDING
PROPOSED USE
PLUMBING
HEAT & GAS LINE
PLOT PLAN (Indicate Building setbacks, abutting streets)
-5 NIK t
0 ID-1,
0 /� IOvle- fo7 R 7-/Vj
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cis /- os C-)
FENCE
SIGN
RETAINING WALL
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-
Ited agent of the owner. I agree to comply with city and state laws regu-
ATTENTION
lating construction; and In dotnx the work authorized thereby, no person
will be employed In violation Of the Labor Code of the Sta" of Washington
THIS PERMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
shall be completed in ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six mouths.)__
31ON R A DATE SIGNED
INSPECTION
DEPARTMENT
1,12.
CITY OF
RAMMONDS
N07% APPlicant Subject to Plan Check Fee
PH 6-1107
This Permit coven work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) wW require separate permission.
I 117n2 K09d
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.
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