740246.pdfBUILDING DEPARTMENT Applicant Fill z�NE rpiuMSETR
740246
�•.•r PERMIT APPLICATION
Inside Heavy Lines ADDRESS o R- _ � �_--
Ng;p NAME OF BUB1NE88)
PERMISSIBLE E A UAf L
PLOTER COVERAGE LOT COYERAOE
MMAILINGADDRESS
'� PEReIIBBIHLE HEIGHT PROPOSED HEIGHT
CITY C iX (T�E/LEPHONE UMHEft ACTUAL LOT AREA TOTAL BLDG. AREA
REQUIRED YARDS PROPOSED YARDS
NAME FRONT 81DE REAR FRONT HIDE REAR
LEGAL VARIA CE OR COy�7 ADDRESS 0 YES LOT NO PERMIT NUMBER
NDITIONAL U8E
PLANNING DEPT. APPROVAL DATE:
CITY
TELEPHONE NUMBER
STREET
EXIBTING STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
N E ._
JI -A,0777-1—
/, A.�_ /l /►� COMP. PLAN BT. R/W ............FT. ............FT.
/1 A,0 I l 17i�\ / REMARKS
—W/O
YES 0 NO
OA8
RESIDENTIAL LINE
❑ YES Cl NO
I
PLAN CHECKED BY
THIS SITE IS L
NEW
NON-RESIDENTIAL IE] SIGN
NUMBER 111
SHOULDEDM
BE C
SHOULD BE C(
REMARKS
pleted In els months.)
ADD ❑ DEMOLISH RETAINING
ElALTER E ❑
DWELLING
I
D TOR'8 BIONAT
:�VNER
(ENC. ... ....._Ft.)
❑ ORCFILL
REPAIR ❑ PRE -MOVE SWIM
INSP. POOL
signed by the Building Official or his Dep-
I
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED
i -
f
�3
1
{
NUMBER OF STORIES
REPAIR ❑ PRE -MOVE SWIM
INSP. POOL
signed by the Building Official or his Dep-
I
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED
Uty; and fees aro paid, and receipt Is ac -
NUMBER OF STORIES
NUMBER 111
knowledged in space provided.
i
pleted In els months.)
DWELLING
I
D TOR'8 BIONAT
:�VNER
UNITS
t '
DA E
_
775-2525
_
r
NATURE OF WORK TO BE DONE
Tills Pernu, l en work to be done on private property ONLY.
{
Valuation
Fee Receipt No.
t
marquee., etc., will r.quh. separate nenniedon.
Plan Check No .....................
BUILDING
0, PROPOSED UeE
PLUMBING
O
U
PLOT PLAN (Indicate —full—ding setbacks, abutting streets)
HEAT & GAB LINE
O
FENCE
SIGN
RETAINING WALL
�
N
f
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
i
EXCAVATION OR FILL
1
17
O
TOTAL AMOUNT DUE
1 hereby acknowledge that I have read this application; that the 1n-
r
uthor-
formation given le correct; and that I am the owner, or the duly author-
1
Ized agent et the owner. 1 agree to comply with city and state mire regu-
ago
ATTENTION
APPLICATION APPROVAL
,ating c...traction: and In doles the work authorized thereby, no person
will be employed In violatlen of the Labor Code of the State of Washington
THIS PER3IIIT
This application is not a permit lentil
relnlla to Workmen's Compensation Insurance
AUTHORIZES
i
g
ONLY THE
signed by the Building Official or his Dep-
I
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED
Uty; and fees aro paid, and receipt Is ac -
shall he completed In ninety day.; MOVED -IN BUILDINGS shall be cons-
knowledged in space provided.
i
pleted In els months.)
Olt AGENT DATE BI6 ED INSPECTION
DEPARTMENT
D TOR'8 BIONAT
:�VNER
CITYOF
CITY 3
NOTE: Applicant Subject to Plan Check Fee?
t '
DA E
_
775-2525
_
r
Tills Pernu, l en work to be done on private property ONLY.
{
Any construcllananthe public domain (cu+be..idewalk., d+hewn..
FILE
t
marquee., etc., will r.quh. separate nenniedon.