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PERMITUSE
BUILDING DEPARTMENT Applicant ONE NUMBER 740291
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BUILDING
PERMIT APPLICATION Imide Heavy Lines JOB
4 PROPOSED USE
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ADDRESS
NAME (OR NAME OF BUSINESS)
PERMISBiBLE 7 A, ACTUAL q 1
C7 /�' LOT COVERAGE 2�(y� LOT COVERAGE
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a PLOT P AN (lndlcata Building elbacke, abutting street.)
HEAT & GAS LINE
MAILING ADDRESS
C L 3/� PEItDIIS818LE HEIGHT 36PR(JO,SEOD HEI6PHT
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CITY—'
TELEPHONE NUTGZ ACTUAL LOTAREATOTAL BL/�le A'
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FENCE
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NAME FFROONT SIDE REAR FRONT BID REAR
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SIGN
hi ADDRESS LEGSLOT VARIANCE OR CONDITIONAL USE
0 P MIT NUMBER
RETAINING WALL
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TELEPHONE NUMBER4
CITY
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I EXISTINR TREET R/A.;Ik,. DEFICIENCY THIS PROPERTY
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SWIMMING POOL
NAME /��-���t{{
COMP. PLAN ST. R/VM.:1.�.pT. ...Ll....FT.
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�{ REMARICB Driveway slopes not to exceed those
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CADDRE88
indicated on Standard Dwg. No. 103 v x 3 3 CH K D HY
PRE -MOVE INSPECTION
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TELEPHO/NE NUMBER
METER SIZEI SERVICE 812E CLEARANCE
EXCAVATION OR FILL
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STATELICENSE NUMBER
CITY LICENSE NUMBER
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TOTAL AMOUNT DUE.
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REMARKS
formation given le correct; and that I am the owner, or the duly nuthor-
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Ized agent of the owner. I agree to comply with city and state laws recu-
Legal De.crl it oI Properly (Show Below or Attach Four Coplee)
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/ -� D / 0 '•�- /Y )1 V /T G J TYPE CONNECTION V RIF ED BY
Mung c—tructlo.; and to datag the work authorized thereby, no parson
ATTENTION
APPLICATION APPROVAL
° L of l:' 2J�7Ff Lot , SLV��I2
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This application is not a permit until
relating to Workmen'. Compeneatlon Ieaurnnce.
AUTHORIZES
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f' J PERC. TEST
PERNUMBER
NOTE: Permit Limit One Year (Except DEMOLITIONS which
uty; and fees are paid, and receipt is ac -
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.hall be completed In ninety day.; MOVED -IN BUILDINGS .hall be com•
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]SII wledged in space provided.
a ltEunaxs
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pleted in .1. ...the.)
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at C U (OWNER GENT)
DATE SIGNED
k !/ 6TIRE ZONE TYPE OF CCO-NSTRUUCCl'ION STREET IMPROVED
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DEPARTMENT
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CITY OF
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SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
EDhiONDB
RESIDENTIAL ❑ GAS ❑ YES 441. /
NOTE: Applicant Subject to P/dB Check Fee
LINE PLAN CHECKED BY
IJV NEW / THIS SITE I LOCATED IN THE CITY
NON-RESIDENTIAL SALES TAX
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775-2525
SIGN �`,j� , _, ,, _ , OHOUEDMONDS.LD BE CODED 3LOCjL
E] ADD
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RETAINING RW41ARKS
DDE6fOLI8it WALL
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E] ALTER ❑ EXCAVATE ❑ FENCE /�/I. G 0/4 S�lJUCj r/CN ���j �a [lj / �O
OR FILL(..........z..........Ft.)
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REPAIR ❑ INap. O POOL _s?!/.O this L/ % rd ON sire,* iNlRr�i -
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NUMBER OF STORIES NUMBER OF
UNITS LING /
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I'Inn Check No .....................
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BUILDING
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4 PROPOSED USE
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PLUMBING
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a PLOT P AN (lndlcata Building elbacke, abutting street.)
HEAT & GAS LINE
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FENCE
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SIGN
RETAINING WALL
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SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
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I hereby acknowledge that I have reed 161. aDPllcatlon; that the In-
TOTAL AMOUNT DUE.
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formation given le correct; and that I am the owner, or the duly nuthor-
OY
Ized agent of the owner. I agree to comply with city and state laws recu-
Mung c—tructlo.; and to datag the work authorized thereby, no parson
ATTENTION
APPLICATION APPROVAL
will be employed In violation of the Labor Code of the Slate oI Washington
Tills PERMIT
This application is not a permit until
relating to Workmen'. Compeneatlon Ieaurnnce.
AUTHORIZES
signed by the Building Official or his Dep-
-------
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TUE
{SORK NOTED
uty; and fees are paid, and receipt is ac -
��
.hall be completed In ninety day.; MOVED -IN BUILDINGS .hall be com•
]SII wledged in space provided.
pleted in .1. ...the.)
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at C U (OWNER GENT)
DATE SIGNED
INSPECTION
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DEPARTMENT
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CITY OF
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EDhiONDB
NOTE: Applicant Subject to P/dB Check Fee
775-2525
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This Permit covers work to bo done on prN�ate property ONLY.
Anyrnn.t ntrtlnn an Ihr pnbllc danutin Irnrb, old—MR., drl)'eax>n.
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FILF.
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