660552.pdfPOSTED ON KROLL MAP NO.: PERMIT
t 660552
t RIMINI Applicant Fill NUMBE_rt
BUILDING DIP
PERMIT APPLI TI N Inside Heavy Lines JOB ADDRESS
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NAME (Olt NAME OF BUSINESS)
NFI—S M HE 0 1� III C
P9 MAILING ADDRESS
/4 W A v
CITY TH
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NAME
E YARD SETBACK
STREET SETBACK
REAR YARD SETBACK
USE ZONE
LOT AREA.
VACANT SITE
O'YEB
i nTnLnINa AREA
I VARIANCE NUMBRIK
EXISTING-STREEIT n/W ............ ITT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W J� ... FT. 20:3,,d ..�V_rr.
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4.( 1 %1.4 . (' I
Legal Description of Property (Show Below or j
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ZONE I TYPE OF
[] YES
XNEW
RESIDENTIAL
GAS
LINE
IN
NON-RESIDENTIAL 1
0
SIGN
RETAINING
17
DEMOLISH
WALL
DALTER
EXCAVATE
FENCE
0
OR FILL
( x Ft.)
REPAIR E3
PRE -MOVE
INSP.
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.......... ..........
swim
POOL
'NUMBER OF STORIES
—Nu—bLujun
OF
DWELLING
UNITS
Plan Check No .....................
PROPOSED USE
BUILDING
PLOT PLAN (Indicate Building setbacks, abutting streets)
PLUMBING
HEAT & GAS LINE
/Y
FENCE
t
SIGN
RETAINING WALL
SWIMMING POOL
'9%,<
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
(?
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application: that the In.
forniatlon given to correct; and that I am the owner, or the duly author-
ized agent of the owner. I agree to comply with city and state laws regu.
ATTENTION
lating construction; and in doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
THIS PERMIT
relating to WorkmerVa Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORR NOTED
shall be completed in ninety days: MOVED -IN BUILDINGS shall be com-
pleted In six months.)
SIGNATURE (OWNER OR AGENT)
DATE SIGNED
INSPECTION
DEPARTMENT
CITY OF
EDAIONDS
NOTE: Applicant Subjcct to Plan Check Fee
PR 6-1101
This Permit covers work to be done an private property ONLY.
Any construction an the public domain (curbs, sidewalks, drive%wo,
marquees, etc.) will require separate Pern'1581011.
Valuation
YES alileo
Fee
APPLICATION APPROVAL
3
L_
No.
This application Is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
FILE
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