710165.pdfL
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:.L MAP NO.: PERMIT
NUMBER _
OACK I STREET SETBACK II
QZ) CPA4�
-71016
An YARD SETBAI
/S- I
,CANT SITES Dr
YES D NO
STREET R/W
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............ 1-T.
REMARKS
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✓ V�j 10 YES O NO
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NEW ' K� RESIDENTIAL GAS LINE O PLXES NO I r�
AN CHECKE BX� 'I
NON-RESIDENTIAL ❑ SIGN I
j� ADD ❑ DEMOLISH VALL REMARKS
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i Jti ALTER ❑ ORCFILL E ❑ FENC.7c..........Ft.) WD(f..R.+ V� D
7TE] REPAIR ❑ INSPMOVE O SVn 1
NUMBER OF STORIES NUMBER OF
DWELLING ,
UNITS
NATURE OF WORK TO BE DONE
A Valuation Fee Receipt No.
�dtSe r�Li ron rx/ �itl (�AY Ptan Check No..
rdoym above— Qal"C%i[:e BUILDING
PROPOSED USE
PLUMBING
13E'er'.! i'`i�0 VIP I i
LOT PLAN (Indlcato Building setbacks, abutting streets) HEAT & GAS LINE
FENCE I
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SIGN j
tRETAINING WALL 4
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SWIMMING POOL tt
DEMOLITION.t
,I.
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DOE oo
I hereby acknowledge that I have read this application; that the In- i�
formation given to correct; and that I am the owner, or the duly author-
lzed agent of the owner. I agree to comply with city and state lawn regu- ATTENTION APPLICATION APPROVAL
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 This application is not a permit until ?
relating to Workmen's Compensation Insurance. AUTHORIZES signed by the Building Official or his Dep- ,
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED uty; and fees are paid, and receipt is ae- 4
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com- knowledged in apace provided. 1
pleted In six months.) /
IIGNATURE (OWNER OR AGENT) DATE SIGN 'D INSPECTION
DIRECT '8 S16NA RE iii
c�'�/ DEPARTMENT
' CITY OF
EUhfONDS DATE
NOTE: Applicant Subject to Plan Check Fee
PR 0-1107
This Permit covers work to be done on prlvute property ONLY. ,
Any construction on the public domain (curbs, sidewalks, driveways, i
marquees, etc.) will require separate permission. FILE f
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RECORD OF INSPECTIONS
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Date Passed i
Foundation
'."Plumbing (Partial)
r (Rough)
( ;Frame
Furnace & Fuel Lines {
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RECORD OF INSPECTIONS
Date Passed
Drainage'
Sewer ,-
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Parking
( 1 Landscaping
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i Fire .Dept.
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