710126.pdfI
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BUILDING DEPARTMENT Ia
AppllntFill
PERMIT APPLICATION Inside Heavy Lines
NAME left-frremm-vl�vv - ff r/
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NAME
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C rr , TELEPHONL NUMBER
7-6/00
1-47 / S�q ✓/e N/ or
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0 RESIDENTIAL
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LAS
INE
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NING
ElDEMOLISH
El
WALL
ElALTER
EXAVAEl OROFILLTE
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(ENC.xFt.)
..........
REPAIR
I l PRE -MOVE
INSP.
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SWIM
POOL
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UNITS
`I KROL MAP NU.: PERMIT NUMBER lJ LCJ / I I 1 I )L
o A I
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`7 0 8 - l 810 �'
D SETBACKI STREET SETBACK REAR YARD SETBACK
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® I LOT AREA yV�AICANT SITE T.
1� I'AYES ❑ NO ITTTZ...
nnrr.nrxn AREA I VAIUA14UM NUMBER
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EYISTING STREET R/W .A,t—P.FT. DEFICIENCY THIS PROPERTY
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COMP. PLAN ST. R/W LO.FT. ... 0.... FT.
REMARKS
Driveway slopes not to exceed those
indicated on Standard Drawing #103.
3
TYPE OF
YES
[] YES
REMARKS
G,ddc._PoiL.-T- NoT 10CLUOW IAJ
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Plan Check No .....................
a ri a a i,'v tis
f�i - �-
BUILDING
�0
yqq PROPOSED USE -,�`-f
PLUMBING
W PLOT PLAN (Indlcata Building setbacks, abutting streets)
HEAT A 6A8 LINE
FENCE
SIGN
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RETAINING WALL
SWIMMING POOL
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DEMOLITION
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PRE -MOVE INSPECTION
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I
EXCAVATION OR FILL
......_
TOTAL AMOUNT DUE
I hereby acknowledge that I have read thin application; that the In-
formation given Is 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.
ATTENTION
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
relating to Workmen's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORT{ NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six mo
SIGNAT (OWV51Lyn A6 DjT) DATE S1GNE
INSPECTION
/ �/
DEPARTMENT
CITY OF
EDIVIONDB
NOTE: Applicant Subject to Platt Check Fee
PIL 6-1107
This Permit covers work to be done on private properly ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
Valuation I Fee
No.
/-/a.oa rs4�7_1
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.
FILE
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