710073.pdfBUILDING DEPARTMENT
PERMIT APPLICATION
NAME (OR-ff*WE-Or-BU0fNH09}—
Klauu Hann
MAILING ADDRESS
o 1023 188th S. We
pU
H
a�
Applicant Fill
Inside Heavy Lines
or
PERMIT
NUMBER
710073
i7 YES
,TBACK
t7
IHER
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ...........X-r. ............FT.
REMARKS
ZONE
NEW
❑ ADD
ALTER
REPAIR
RESIDENTIAL
NON-RESIDENTIAL
❑ DEMOLISH
FILL EXCAVATE
OR FILL
PRE -MOVE
0 INSP.
❑
❑
❑
GAS
LINE
SIGN
WALL
L
PENCE
(x..........Ft.)
swim
POOL
❑ YES ❑O
PLAN CHECKED BY
REMARKS
LUMBER OF STORIES
NUMBER OF
DWELLING
I
UNITS
OFF
"
Plan Check No .....................
BUILDING
G�
PROPOSED USE
PLUMHIN6
aPLOT
b
O
n
PLAN (Indicate Building setbacks, abutting streets)
tRETAINING
N
1
HEAT & GAS LINE
FENCE
SIGN
WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
UNT DUE
I hereby acknowledge that I have read this application; that the Iformation
given Is correct; and that I am the owner, or the duly authoized
agent of the owner. I agree to comply with city and state laws regNTION
lating construction; and In doing the work authorized thereby, no perso
will be employed In violation of the Labor Code of the State of WashingtERMIT
relating to Workmen's Compensation Insurance.
ORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS whi
THE
NOTED
rDEPARTMENT
shall be completed In ninety days; MOVED -IN BUILDINGS shall be aipleted
In six months.)
UGNAT (OWNER Olt AGENT) DATE SIGNEDCTION
/TMENT7iC
) `1 7
/ .2 - —
Y of
EDhIONDS
NOTE: (Applicant Subject to Plan Check Fee
PH a-IIo7
This Permit coven work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
al
3
❑ YES i] NO
Valuation I Fee
1 7e00 V'aI ty
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-
knowledged in space provided.
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=.! T
r RECORD OF INSPECTIONSIf I
Date Passed
_...
Foundation`
i Plumbing (Partial)
1 (R
_. ough)
_ ... Framm
e — 7 /
Furnac =& Fuel Line
_'
4 Final
I L I I
D
r: I 1 4 RECOR
;OF INSPECTION •
„ i • . Drainage Dat--- -- SSed
i ge .;
Sewer. _
..
Parking!
fI If
Landscaping _
Fire Dept.
--_-- ___
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