BLD2020-0884+City_Application+8.20.2020_1.27.20_PMA e ° BUILDING PERMIT
C ° APPLICATION Rmma:
DevelopmeniseMcea
Bedding DMNon _ _
121 gM Ave N / Materials, WA 9=0
[. I8na I26.)A.0220 n Accesro Structure/ n Addition
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Job Site Address: »[IR Hl��P>�
Par[el:
Lot/Unit i1eN: 114 SubdiMalon:
Name
Mailing Addresa: SflGn �IEc.`Lw/ KH/A wra
CNsr%w lip: �Akq 'IReYI I.._e _roca
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Email: CA dais 4 c , 91 ,.farac—I [6yy.`
O W NER INSTAIIATON: 9f yn, read and sV^'
Will work be pertarmed bythe property owneri[:IyesmNo
I own, reside in, or will reside in she complete! structure. This
instillation Is belry made on pm"M that I own weleb Is not
intended for sale, lease, rent or earnings actordl ng to RICIN
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Owner SlgnIIure:
Name of Applicant: fdw,r V
Malang Addrew
city/state/zip: 9Bo 35
Phone p: c,f1 �--173-042
E-mail: �3s1✓S:fm S.L v L..., .11lvs_
General Own rMw:
Mellag ads, : /9/� � M1 `4
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E-mail:
STATE It A: a
CT' OF EOMONM BUSI NO S LICENSE R:
WA STATE CON TRAI L D I R: (CM) At UPIMTON DATS:
u Duration U Mechanical
New Ae Famlly/ouple, plumbing
Fire Sp!Met Remodel
n Newfnmmer[lal/Mhetl Ur nR, lard
u 71 I LiTank
nTeranLlmpmvmleM n Other
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