660022.pdfImp
POSTED ON KROLL MAP NO.: BUILDING
BUILDING DEPARTMENT Applicant FBI
PERMIT
NUMBER 660022
PERMIT APPLICATION Inside Heavy Lines
JOB ADDRESS
�7,;2
NAME (OR NAmli; oir BUSINESS)
SIDE YARD SETBACK
STREET SETBAUrL REAR YARD/SETBACK
NG ADDRESS
usp-)ZONE
LOT AREA VACANT SITE
206-
LEPHONE NUMB'
YES 13 NO
CITY
HEIGHT
B ING VARIANCE NUM
Z.
NAME
9k
PLOT PLAN APPRO V
D
ADDRESS
REMAP
CITY TE PHONE NUMBER
NAME
REMARKS
rs
Z
94 ADDRESS
9
METER SIZE SERVICE SIZE CLEARAN
CITY TELEPHONE NUMBER
—REMARKB
Q STATE LICENSE NUMBER
TYPE CONNECTION
VERIFIED By
Legal Description of Property (She low or Attach Four Copies)
PERC. TEST
Z
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
YES NO
qUIRED OCCUPANCY GROUP
--r—
YES 0
PLAN CHECKED 13Y
VALUATION OTAL FKZ
BUILDI G
WORK TO BE DONE
VALUATION
—.3 Z
BUILDING PERMIT
2
FEE
PLU ING
OW
In
3 PERMIT FEE
HEAT & GAS LINE
4 PERMIT I=-
TOIRUIES
NEW SIGN PERMIT
SIGN 5 FEE
ADD DEMOLI El FEN
F_j SH
DEMOLITION
ALTER H RESIDENTIAL NUMBER OF
LOU6.1
6 PERMIT FEE
—
DWELLING
UNITS
FREPAIR El
PLAN CHECK
7
NON-RESIDENTIAL
FEE
8 AMOUNT DUE
I hereby acknowledge that I have read thin application; that the in-
AT=NTION
APPLICATION APPROVAL
formation given in correct; and that I am the owner. or the duly author-
ized agent of the owner. I allee to comply with city and state laws rCgum
THIS PERMIT
This application is not a permit until
lating construction; mid in doing the work authorized thereby. no person
AUTHORIZES
signed by the Director of Building Inspec-
will be employed in violation of the Labor Code of the State of Wasbtl3gtOu
ONLY THE
tion, or his deputy; and fees are paid, and
relaUng to Workmen's Compensation Iftsursn0e-
WORK NOTED
receipt Is aelmowledged In space provided.
(Except Demolitions which shall
NOTE: Permit Limit One Year be completed In ninety days.)
81 A (OWNER AGENT) D SIGNYD
INSPECTION
M RTMENT
DEPA
IRECTOR'S ATURE
CITY OF
EDMONDS
TE,�
NOTE: Applicant Subject to Plan Checlz. Fee
7;z
PR 6-1107
This Peradt covers work to be done on private property ONLY.
FILE
Any construction an the public domain (curb&, sidewalks, driveways,
marquees, Cie.) will require separate permission.
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