750367.pdfEXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT,' ... _....... FT.
C/x -/
1ptlon or Propert:
00-9-
0 YES Ej NO
NEW jV. RESIDENTIAL ❑ OAS
LINE
Ej NON-RESIDENTIAL ❑ SIGN
EJADD DEMOLISH RETL XINC
ALTER ❑ ORFEXCAVATE ❑ FEN C x .......... Ft.)
SWI
REPAIR ❑ IN PMOL POOL
1UMBER OF STORIES I NUMBER OF
DWELLING
UNITS
I
ECKED BY
E
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III
ER
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STREET IMPROVED
0 YES NOIfll
ROUP
ii
I
Valuation
Fee Recolpt No.
Plan Check Na .....................
PROPOSED USE
O
BUILDING
4---
POSTED ON KROLL MAP NO.: PERMIT
750367
PLOT PLAN (Indicate Building estbUhs, abutting streets)
PLUMBING
BUILDING DEPARTMENT
AppJNUMBL.R
NUMBER
I
PERMIT APPLICATION
Inside,108
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rA�DOREtlB
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FENCE
NAM (OR NAME OF BU BS)
9IGN
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YARD SETBACK
STREET SETBACK
REAR YARD SETBACK
SWIMMING POOL
MAILING DRESS
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F
PRE -MOVE INSPECTION
USE ZONE
LOT AREA
VAOANT BITE
EXCAVATION OR FILL
C
CIT,
�iP 9NHEIGHT
1 BUILDING AREA
i VARIANCENUMBER
Q�
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT,' ... _....... FT.
C/x -/
1ptlon or Propert:
00-9-
0 YES Ej NO
NEW jV. RESIDENTIAL ❑ OAS
LINE
Ej NON-RESIDENTIAL ❑ SIGN
EJADD DEMOLISH RETL XINC
ALTER ❑ ORFEXCAVATE ❑ FEN C x .......... Ft.)
SWI
REPAIR ❑ IN PMOL POOL
1UMBER OF STORIES I NUMBER OF
DWELLING
UNITS
I
ECKED BY
E
I
III
ER
�i
STREET IMPROVED
0 YES NOIfll
ROUP
ii
I
Valuation
Fee Recolpt No.
Plan Check Na .....................
PROPOSED USE
O
BUILDING
PLOT PLAN (Indicate Building estbUhs, abutting streets)
PLUMBING
m
O
HEAT YQA9-I33t'E
FENCE
9IGN
—_
N
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
Q�
I hereby acknowladgo tont I have rand this application; that the la -
formation given Is cornet; and that I am the owner, or the duly author -
Ind agent of the owner. I agree to comply with city and elate Tawe K.-
ATTENTION
APPROVAL
conetructlon; and In doing the work authorized thereby, no peon
.APPLICATION
will be employed In Violation of the Labor Code of the State of Washington
THIS PERMIT
This application is not a permit until
ninths to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep-
Permit Limit One Year (Except DEMOLITIONS wmoh
0,TIM
WORK NOTED
uty; and fees are paid, and receipt is ac-
d In ety anya: MOVED -IN BUILDINGS shall be c
ehallbe completenin-
knowledged in space provided.
ptctsd In elx t tae.)
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BIG—NATU�' (OWN DATE IGNED
9
INSPECTION
DEPARTMENT
DI CTOR'S NAT E ! /{
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• �
CITY OF
NOTE: Applicant Subject to Play) Cbrck Fee
EDDfONDB
I'IL 6.1107
DATE
'fide Permit eavenvork Io be done on Private praperl,v ON I.Y.
Any co-tnellnnnn the public domain (curbs, sldercnllrs, dri—Is, n,
FILE
nuvquees, rlc.) will require separate per.alsslon.
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1
i
}•Od'PED ON KROLL, MAP NO.; PERMIT
BUILDING D E P A R T M E N T Applicant FIB
NUMBER
I
APPLICATIONI Inside Heavy Lines
JOH ADDRESS
NAME (OR NAME OF BUSINESS)
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SIVE YARD SETBACK
STREET SETBACKI
REAR YARD SETBACK
j
'Al ADDRESS
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NO
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USE ZONE
LOT AREA
VACANT SITE ri
'rlaja
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C
OITY,.....,.
TELEPHONE NUMBER
I
❑ YES [3 NO
( � �•� - r/'r
HElORT
BUILDING AREA
I VARIANCE NUMBER {y
�
NAME
I
i
PLOT PLAN APPROVED
I'
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ADDRESS,
•
STREET R/W
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EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
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CITY
TELEPHONE NUMBER
COMP. PLAN 8T. R/N ............FT. .........„.FT. 'C.5
.
REMARKS
NA/Mffi)J. /
�t%lI,✓ i
CHECKED BY z
Od
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ADDRESS
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METER SIZE SERVICE SIZE
CLEARANCE
CHECKED BY
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CITY, .'TELEPHONE
N//UMBER
I
/-:
STATE LICENSE NUMBER
C17Y LIOENSE NUMBEx
P.
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•'/ ,rr- % [./!
TY / E VERIFIED BY
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1
Legal Description of Property (Show Below
or Attach Four Coplce)
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REMARKS
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FIRE ZONE TYPE OF CONSTRUCTION STR PROVED
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YES El NO
SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
0 YES ❑ NO
PLAN CHECKED HY
RESIDENTIAL
El .E
NEW
REMARKS
•
El NON-RESIDENTIAL
❑ SIGN
I
ADD RETAINING
F]WALL
.
DEMOLISH
��.. ALTER ORCAVATFILL E ❑ FENCE'.... •Ft.)
REPAIR INSPMOVE ❑ POOL
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO H,_DONE �^
' 1
Valuation
Fee Receipt No.
�' L�•1 /.r �/✓i fes'•. Y: J � �f.�-
Plan Check :in .....................
PROPOSED USE
[}
BUILDING
PLOT PLAN (Indicate Building setbacks, abutting streets)
PLUMBING
tl
7
HEAT & GAS •LINE
FENCE
SIGN
N
RETAINING WALL
-
SWIMhIING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
n ��
I hereby acknowledge that I have rend tale application: that the In.
formation given Is correct; and that I am the owner, or the duly author-
Ired agent of the owner. I agree to comply with City and slats Incas m9U-
ATTENTION
APPLICATION APPROVAL
Iating conetructlem; and In doing Wo work authorimd thereby, no person
will bo employed In violation of the Labor Code of the Slate of Washington
THIN PERMIT
This application is not a permit until
relating to Workman's Compensation Insurance.
AUTIHMUZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
sIm11 be completed In ninety day.; MOVED -IN BUILDINGS shall be cam-
knowledged in space provided.
,.-_..-- --- - ---
pitted In six months.)
813NA7'1/1tE '(OIVNb1t OR AGEN P)- I VA/1. S16NEll
INSPECTION
DEPARTMENT
DIR TOR•e SIGrATU i `:--
CITY Or
DATE
---
NOrr:: Applinint Subject to Phin Check Fee
Fit (14107
This 1'ermll rayrrx n„rl; to le Annt nn priyllic pNlx•riy OXI.S'.
Any ranslrnrliml an Ikr I�nbke dnmlla (earls, sldrwolk.,,
INSPECTOR
amrnnees, rir.l will n'nllirr srpllrlllr perinisslou.
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