HomeMy WebLinkAboutPermit 0523 - Johnson ResidenceJOE ADDRESS
13612 - 52nd Ave. So.
DATE
8/20/74
AL
1 DEBAR.
LOT NO.
T.L. 64
ELK
TRACT
ED „SHEET)
(EE ATTA
Steven Foster Dona ion C
OWNER MAIL ADDRESS ZIP PHONE
2 Leonard W. Johnson 13612 - 52nd Ave. So. Seattle, 98168 Ch. 2 -3335
CONTRACTOR MAIL ADDRESS PHONE LICENSE NO.
3 Owner
ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO.
4
ENGINEER MAIL ADDRESS PHONE LICENSE N0.
5
LENDER MAIL ADDRESS BRANCH
6
USE OF BUILDING
7
8 Class of work: ❑ NEW 0 ADDITION F3 ALTERATION • REPAIR • MOVE • REMOVE
9 Describe work: Single Flue Concrete Block with clay liner
10 Change of use from
Change of use to
11 Valuation of work: $ 125.00
PLAN CHECK FEE
PERMIT FEE 5. 00
SPECIAL CONDITIONS:
Typo of
Const.
Occupancy
Group
Division
Size of Bldg.
(Total) Sq. Ft.
No. of
Stories
Max,
Occ. Load
Fire
Zone
Use
Zone
Fire Sprinklers
Required • y NO
APPLICATION ACCEPTED BY:
PLANS CHECKED BY.
PP OVE FOR ISSUA
No. Dwelling of
Dwelling Units
OFFSTREET PARKING
Covered
SPACES:
Uncovered
NOTICE
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB-
ING, HEATING, VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS' COM•
MENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS
APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.
ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS
TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED
HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
CONSTRUCTION OR THE PER ORM NCB OF CONSTRUCTION.
� 'r ,',CA
Special Approvals
Required
Not Required
Approved
ZONING
HEALTH DEPT.
FIRE DEPT.
SOIL REPORT
OTHER (Specify)
FOUNDATION
FRAMING
FINAL
51 TU or OWNER (IF OWNER SUI E 1
SIGNATURE OR AUTHORIZED AGENT IRATE)
BOLDING PERMIT
Applicant to comp /ete numbered spaces only.
CIT( DF TUKWILA BUILDING PL .MIT
14475 - 59th Ave. So. / Tukwila, Washington 98067
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMI
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION
OCCUPANCY PERMIT REQUIRED
M.O.
BUILDING
PERMIT NO.
N 523
Joa 3:0!1 =.Si
/3 6 / .Z S /A V (sr So 5 L- R % (" c v c-0,41.9/,/
PATE
a-- a ° ^ 7
GAL
L %ai r.C.
:
ELK [ril ACT
-/ P 14%-a C3G.E.y.A.TTACH 34611)..
OWNER MAIL ADtIIES9 ZIP PHONE
2 4c a/ 'Ls Z c) h/NSCN /3 6/2 SZ AUG-So 5S- /G g 0//Z 3 33S --
CO•l?lAC T ^H MAIL ADDRESS PHONE LICENSE NO.
3
ARCH. •_CT JP DCJ. GNER MAIL ADORE59 PHONE LICENSE NO.
A
ENGINSCI1 MAIL ADDRESS PHONE LICENSE NO.
5
LENDER MAIL ADDRESS OHANCH
6 •
USE O7 BUILO:r.,
7 '
•
8 Class of work: • EIII EW ■.ADDITION ❑ ALTERATION • REPAIR • MOVE ❑ REMOVE
•
9 Describe work: S/ iv ? C G f Luc:: a D e. fr E r- - G 0
-
• iii ri4 c4et..y Li Ar zzZ
10 Change of use frorn
Change of use to
11 Valuation of work: $ rte• L S / • v 0
"
PLAN CHECK FEE
PERMIT FEE
SPECIAL CONDITIONS:
Type or
Cunst.
occupancy .
Group
Division
Size of Bldg. .
(Total) Sq.'Ft.
No. of
Stories
Max.
Occ. Load
Fire
Zone
Use
Zone • •
Fire Sprinklers I-y
"Required Dyes ❑ND
APPLICATION ACCEPTED BY:
•
PLANS CHECKED BY:
APPRO D F R ISSUANCE BY:
No of
Dwelling Units
OFFSTREET PARKING
Covered
SPACES:
[ Uncoverad
NOTICE
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB-
ING, HEATING, VENTILATING OR AIR CONDITIONING,
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED
I HL:I-FFBY CERTIFY THAT I HAVE RENO AND EXAMINED THIS
APPLICATION AND KNOW THE SAME TO I.IF. TRUE AND CORRECT.
ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS
TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED
HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT
PRESUME 'r0 GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PR0VItUONS OF ANY OTHER STATE_ 00 LOCAL LAW REGULATING
CONSTRUCTION OR TI•I PERFO• 'MAN • OF CONSTRUCTION.
C� � ! •.
Special Approvals
Required
Not Required
Approved
ZONING
FIEpIL7 DEPT.
FIRE DEPT.
•
SOIL- REPORT
OTHER (Specify)
FOUNDATION
FRAMING
S l arl A'; u RE o .f NEN llr O'NNEII OuILO a )
FINAL
H!G IATUr'E 011 AUTHORIZE0 AGENT IDATEI
PUILT,INO 'PERMIT
APPLICATION
CIT .. �F TUKWILA BUILDING DEPAR TN11T
6230 Southcenter Blvd.
Tukwila, Washington 98067
Phone: 242 -2177