750066.pdfUSE JL
PERMIT
771
PARTMENT Applicant Flu ZONE NUMBER 750066
LICATION I Inside Heavy Lime AU
ADDRESS • / O
BU81NE86) r
^ L POT ISSIBLE
COVERA7o ACTUAL'� � 0 � /C../= LOT COVERAGE LOT COVERAGE PERMISSIBLE HEIGHT PROPOSED HEIGHTl�l��Lor(G ti
O CITY t, TIDLEPHONID NUMBhR ACTUAL LOT AREA TOTAL BLDG. AREA ;
moi- I(�, (7 /•( b -S 7 S 2 �p 7 REQUIRED YARDS PROPOSED YARDS a
NAME FRONT SIDE REAR FRONT 8IDE REAR
fUi) ADDREtl6 LEGAL LOT ALLIANCE OR CONDITIONAL USE
E1 O YES 0 NO PERMIT NUMBER
JPLANNING DEPT. APPROVAL D E: �
C CITY I TELEPHONE NUMBER r �
STREET R/W a
EXISTING STREET R/W ............FI'. DEFICIENCY THIS PROPERTY I
NAME / IQ
O WG COMP. PLAN 9T. R/W ............FT. ............FT.
REMARKS 'C
tE ADDRESS x
W
ICHECKED BY I
M CITY TELEPHONE NUMBER N
J.
METER SIZE I SERVICE 612E I CLEARANCE ICHECKED BY
9TATE LICENSE NUMBER CITY LICENSE NUMBER WC
F
REMARKS a
Legal Description of Property (Show BeioW or Attach Four Copies)
L— O T $ (e i % TYPE CONNECTION I VERIFIED BY
A `
O �
! F I • 0 r / L-,> 7- 5- PERC. TEST PERMIT NUMBER
J\ n /J Lott- e7 JeC-C.LO (n6 �L• 4T- 'w
¢I REMARKS W
a /J/A
FILWE I TYPE OF NBTRUG•f10N I STREET IMPROVED
�• Ia.Ji [] YES 0 NO ;
SPECIAL INSPECTOR REQUIRED I OCCUPANCY9ROUP
I�yl� RESIDENTIAL 1
��•1 INE GAS 13 YES
CHECKED BY NEW L=
pf�� � THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL SIGN /AJ SH ULDEDMBE S. LOCAL SALES TAX
ADD ��WV SHOULD BE CODED 31.04.
DEMOLISH WALL NG REMARKS j� /j �/yy/�// (7�7
ALTER ❑
ORFILL
FENCE z .......... Ft.) �w fl{�O%L>� / �+/� I�'C �I�a /^�/ D i, I
El REPAIR❑ IN9P. 0 SWIM
POOL
PRE -MOVE •�
NUMBER Ob• BTOIl1E9 NUMBER OF /�� COKn [ !•
DWELLING
UNITS
NATURE OF WORK TO BE DONE Valuation Fee Receipt No.
I;
Plan Check No .....................
O BUILDING /�r Vim.
PROPOSED USE
`1y PLUMBING
O
PLOT PLAN (Indicate Rulldlng setbacks, abutting streets). 1 HEAT @ GAS LINE
21
FENCE
1�
r i�� Q6l-'r SIGN
r t RETAINING WALL
51 SWIMMING POOL -
�i( I— DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
1 hereby acknowledge that I hava read this application; that the In.
formation given Is correct; and that I am the owner• or the duly autltor-
Ired agent of the owner. I agree to comply with City and .tate laws regu- ATTENTION APPLICATION APPROVAL -
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 This application l9 not a permit until 1
relating to Workmen's Compennatlon Insursnes. AUTHORIZERsigned by the Building Official or his Dep -
NOTE:
ep- _
NOTE: Permit limit One Year (Except DEMOLITIONS which ONLY OTE WORK NOTED uty, find fees are paid, and receipt is ac -
shall be Completed In nlscly days; MOVED -IN DUILDINOR shall be cam• lillowledged in apace provided.
pleled In six months.)
SIGNATURE (OWNER OR AGENT) DATE SIGNED INSPECTION
B DIRECT ' O T RID
L l'
DEPARTMENT -
CITY OF DATE I
ED11fONDS
NOTE: Applicant SBGjre! t0 Plan Check Fee �
775.2525 �— �� ~ ,
TWs Permit ct cork to bo don. on private property ONLY.
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