750300.pdfUSE PERMIT -750300
Applicant Fill
BUILDING DEPARTMENT ZONE NUMBER
PERMIT APPLICATION Inside Heavy Lines
NAME (OR NAME OF BUSINESS)
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formation given le correct; and that I am the owner, or the duly author -
TOTAL BLDG, AREA
REQUIRED YARDS
FRONT SIDE REAR
PROPOSED YARDS
PRONT SIDE REAR
APPLICATION APPROVAL
I.R.g construction; and In doing the work authorized thereby, no person
LEGAL LOT
YES ❑ NO
VARIANCE OR CONDITIONAL USE
PERMIT NUMBER
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CITY TELEPHONE NUMBER i
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EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY 7
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REPAIR ❑ INSP. a POOL
LUMBER OF STORIES NUMBER OF
DWELLING
UNITS
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Plan Check No.......
BUILDING
PLUMBING
HEAT A: GAB LINE
FENCE
SIGN
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SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
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TOTAL OUNT DUE
I heresy acknowledge That I have rend this apPllcntlon; that the In-
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formation given le correct; and that I am the owner, or the duly author -
lied agent of tho owner. I agree to comply with city and state laws res..
ATTENTION
APPLICATION APPROVAL
I.R.g construction; and In doing the work authorized thereby, no person
Willbeemployed In viotntloP of the Labor Code of the State of WaeDlaglon
THIS PERMIT
This application Is not a perrldt until
relating to Workmen's Compenesticn Ineuranee.
AUTHORIZES
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-
ehall he cam feted In nlaely days; MOVED•IN BUILDINGS shall be Com,
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GNATURE (O NE 6E ) DATD SIGNED
INSPECTION
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DEPARTMENT
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CITY OF
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NOTE: Apant uhjecf io Plan Check Fee
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775-2525
This Permit toren rock !d done on private ONLY.
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Any construction on t e P Ile domgln (curbs, eldewdks, driveways,
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marquees, elc. will require separate perminlon.
Plan Check No..._..
BUILDING DEPARTMENT
PERMIT APPLICATION
Applicant Fill
Inside Heavy Lines
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NAME (OA NAME OF BUSINESS)
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REQUIRED YARDS PROPOSED YARDS d
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NAME
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REMARKS
LEGAL LOT VARIANCE OR CONDITIONAL USE
0 YES ❑ NO PERMIT NUMBER
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PLOT PLAN (Indicate Bul�g eCib a lulling streets)
HEAT ec GAS LINE
PLANNING DEPT. APPROVAL DATE:
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TELEPHONE NUMBER
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STATE LICENSE NUMBER
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SPECIAL INSPECTOR REQUIRED IOCCUPANCY GROUP
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PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
NEW
NON-RESIDENTIAL
0
SIGN
10HOl1LD
BE CODED 3104 SALES TAX
ADD
❑
DEMOLISH
DEMOLITION
WATI.AI.INING
REMARKS
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EXCAVATION OR FILL
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NUAIBER OF BTOIi1ES NUMBER OF
TOTAL AMOUNT DUE
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I hereby acknowledge that I have recd this aDPllc¢tlgn; that the in-
UNITS
formation given le correct; and that I not, the owner, or the duly nuthor.
(zed agent of the owner. I agree to comply with city and state laws roan-
I Valuation Fee Receipt
NATURE OF WORK TO RE DONE
No.
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Plan Check No..._..
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BUILDING
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PROPOSED USE
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PLUMBING
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PLOT PLAN (Indicate Bul�g eCib a lulling streets)
HEAT ec GAS LINE
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FENCE
SIGN
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N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
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TOTAL AMOUNT DUE
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I hereby acknowledge that I have recd this aDPllc¢tlgn; that the in-
formation given le correct; and that I not, the owner, or the duly nuthor.
(zed agent of the owner. I agree to comply with city and state laws roan-
ATTENTION
APPLICATION APPROVAL
(ming construction; and In doing the work authorized thereby, no person
will beemp1) In vIoi tic. of the Labor Code of the stale of Washington
THIS PERMIT
This application is not a permit until
reting to Workmen'. Compeneallo¢ IDsurance.
la
AUTHORIZES
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
.hall be completed In nmely day.; MOVED -IN BUILDINGS shall be corn.
knOWledged in space provided.
.-_pl<ted"Iri-ell
menthe,)
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ONATUISE (OWNS O_F{,�ACE T)DATE SIGNED
3NSPECTION
D3 CTOR's I¢NAT
DEPARTMENT
CITY OF
EDb10ND$
DATE
NOTE: Applicant Subject to Plan Check Fee
775-2525
This !'hall a ark to be done on private property ONLY.
Any construction on 1 e publtc demaln (curbs, sidewalks, driveways,
INSPECTOR
marquees, ate:) -will require separate permission.
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