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710143.pdfBUILDING DEPARTMENT POSTED ON KROLL MAP NO.: I � IIER Applicant Fill �7 I fl I PERMIT APPLICATION Inside Ifeavy Lines JOB ADDRESS NAME (OR 1 OF BUSINPBB) n^ ! t I t / C 7..- n, Im ti U 8 or ram k- D/9 L NEW u RESIDENTIAL GAS LINE ADD NON-RESIDENTIAL SIGN El DEMOLISH RETAINING L AVATE FENCE ALTER ❑ OR FILL El xFt.) PRE -MOVE .......... SWIM REPAIR 1:1 INSP. POOL NUMBER OF BTOR(EB NUMBER Or DWELLING UNITS YES EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY COMP. PLAN ST. R/W ............FT. .......... FT. 0 YES � r V _-�� I� o Plan Check No ..................... PROPOSED USE U BUILDING APLOT PLAN (Indicate Building setbacks, abutting streets) PLUMBING IQ F' O 's HEAT & GAS LINE FENCE t SIGN N 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 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 rogu. 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 WORK NOTED shall be completed In ninety days; MOVED -IN BUILDINGS shall be com- pleted In six months.) SIGNATURE (OWNER OR AGENT) DATE SIGNED INSPECTION DEPARTMENT CITY OF ED:VIONDS NOTE: Applicant Subject to Plait Check Fec PR 8-1307 This Permit covers work to be done on private property ONLY. Any construction on the public domain (curbs, sidewalks, driveways, marquees, etc.) will require separate permission. f;W_ ❑ YES NO Fee ,© I No. 1 �3 - &-' I Sr16 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. tatLw3l