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POSTED ON KROLL MAP NO.: pffi
' PERMIT:1UILDING DEPARTMENT Applicant Fill NUMBER ;00I3?
,PERMIT APPLICATION Inside Heavy Lines JOB ADDRESS
NAME OF BUSINESS) /!c`
OALr'4Zu ", BIDE YARD SETBACK STREET SETBACK REAR YARD SETBACK
-zz0 '
f� e.�.' / w /` S �. USE ZONE LOT AREA VACANT BITE
i maw TzI,10PHONE_N_UX9_E_R O YES E3 NO { -.
LSE' I\O8T I BUILDING AREA I VARIANOE NUMBER
PLOT PLAN APPROVED
,
G1rdl, 40 0
STREET R/W t
TELEPHONE NUMBERFttttttttI` EXISTING STREET R/W ..........FT. DEFICIENCY THIS PROPERTY 1
COMP. PLAN ST. R/W ............FT. ............FT. O
REMARKS
CHECKED HY '
TELEPHONE NUMBER
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METER SIZE I SERVICE SIZE I CLEARANCE I CHECKED BY CL10=011 NUMBER ITY LICENSE ENSE NUMBER
t,
REMARKS
pre of Property (Show Below or Attach Your Copies)
{
TYPE CONNECTION VERIFIED BY
PERC. TEST I PERMIT NUMBER .
j
REMARKS
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_ I FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROV
� SPECIAL INBPECTOft UIiiffiD I OCCUPANCY GROUP :
GAB YffiB O
�{ RESIDENTIAL LINE PLAN CH cc B
NEW
.. �
I
NON-RESIDENTIAL ❑ SIGN e
ADD RET❑ DEMOLISH ❑ WALL
AnHIN6
ALTER EXCAVATE FENCE -
OR FILL 4._.s_........ I t,) '
REPAIR ❑ PRE -IN P, PWIM
OOL
NUMBER OF STORIES NUMBER OF 1
DWELLING /
UNITS
NATURE OF WORK TO HE DONE Valuation Fee Receipt No.
/I/A'/ze UFO PAZF_ iiji/jUh m Pr9iYELS Od�/I GXrun ahWA Nu. ..............
x /�l..'¢sr�/r f3a.r+e"d-
° /�GY%vole &N j:&Wje ^ r/i4 GSE 04gr161.✓aj _ BUILDING
'PROPOSED USE
PLUMBING
Ci PLOT PLAN (Indicate BuShcng setbacks, abutting streets) HEAT. & GAB LINE
O
F81NCffi ,
SIGN i
RETAINING WALL
1 t 75 TF*LAC� W . I SWIMMING POOL
I\ /� DEMOLITION
PRE -MOVE INSPECTION
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i
EXCAVATION OR FILL
I :
a:rf lt/9.f is- /3EifcN 2o.f-,9 I
TOTAL AMOUNT DUE �A
I hereby acknowledge that I have read this application; that the in- (/
formation given is correct; and that I am the owner, or the duly author-
ised agent of the owner. I agree to comply with city and state laws regu- ATTENTION APPLICATION APPROVAL
laUng construction; and In doing the work authorised thereby, no person
will be employed in violation of the Labor Code of the State of Washington THIS PERMIT This application is not a permit until r
nuting to Workmen's Compensation Insurance. AUTHORIZER 1
signed by the Building Official or hie Dep- 1
THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which coos YxoTaD uty; and fees are paid, and receipt is ac- f
shall bjkkoomplated In ninety days; MOVED -IN BUILDINGS shall be oom- llnOWledged in Space providedt
pletpeO six months.).)
Bf RE (OWNER OR AG DATE SIGNED INSPECTION
r / DEPARTMENT DIRECTOR'S SIGN
OITY OF tae.614 i
MMONDS DAT
NOTE: Applicant Subject to P404 Check Fee I d j
PR g-1117
This Permit coven work to be done an private property ONLY. '�.�....,::~ •"
Any eonstrue"an on the public domain (curbs, eldewalks, driveways, F11 .
marqueelh ems) win require separate permission. !r!r
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