670038.pdfBUILDING DEPARTMENT
PERMITAPPLICATION
Applicant F111
Inside Heavy Lines
POSTED ON KROLL MAP NO.: PERMIT 6,/Uujd
// 1, 1 NUMBER
JOB ADDRESS /
1�oe
4/ o .— / Q� (I I 1 0-
NAME (OR NAME OF BUOLNE83)
Te- m, let S r
SIDE YARD SETBACK
STREET SETBACK
REAR YARD SETBACK
_Zj
XAILING ADDRESS
//10 N 1.7,5- ZZ
USE ZONE
AREA
VACA.NT SITE
O-U-116 C3 No
CITY
TELEPHONE NUMBER
HEIG HT
AREA
VARIANCE NUMB
PLOT PLAN APPROVED
STREET X/rV
EMSMNG STREET R/W ... 4g?rr. DEFICWNCY.THIS PROPERTY
COMP. PLAN ST. R/W ............ FT.
TELEPHONE NUMBER
-f )740 9 1—
REMARKS
T-Woel
AD
CHMCKED BY
Z
N
A ./00�
METER SIZE SERVICE SIZIC CLEARANCE
C'7'1— 11
i..IrrATSLICZN81i
vz
RUREW
A01
TELEPHONE NUMBER
'5 S-9
CrrY LICENSE
A
TYPE CONNECTION BY
-FZRC.
Legal Description of Property.(Show Below or Attach Your I
TEST P!"BER
11
7 L4.000'ff r M
REMARKS
RESIDENTIAL
GAS
LINE
ElNON-RESIDENTLILL
SIG
ADD
ElDEMOLISH
RETAINING
WALL
ALTER
M
EXCAVATE
OR FILL
FENCE
( x In.)
REPAIR
E]
PRE -MOVE
INSP.
.......... . ........
swim
POOL
NUMBER OF STORIES
NUMBER OF
DWELLING
UNITS
13 YES E3 NO
[3 YES 13 NO
All construction to comply with the
Uniform Building Code.
Plan Ctwck .140 .. . ....... .......
PROPOSED USE
BUILDING
PLUMBING
PLOT PLAN (Indicate Building setbacks, ab streets)
ft
HEAT & GAS LINE
PENCE
SIGN
10
RETAINING WALL
_40
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTIO.-4
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
formation given Is correct; and that I &M the owner, or the duly author.
ized agent of the owner. I Lgr ee to comply with city and state laws regu.
ATTENTION
lating constmelion; and In doing the work authorized thereby, no person
will be employed In Violation of the Labor Code of the State of Washington
THIS PEILMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES,
N TE: Per Limit One Your (Except DEMOLITIONS which
014LY THE
WORK NOTED
N be complat in ninety days; MOVED -IN BUELDINGS shall be com-
et elz in 5.)
NITPRE, ;ER Oft AGENT)
DATE SIGNED
INSPECTION
DEPARTMENT
CITY OF
EDIVIONDS
NOTE: Applicant'Subject to Plan Clieck Fee
PH 6-1107
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curb@, sidewalks, driveways,
marquees, etc.) will re(tedrC separate permission.
APPLICATION APPROVAL
This application is not a perniit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt Is ac-
knowledged in space provided.
';OR'S SIGN[4`r�ME
DIR;C
ale...,2
DATE'
I�, �� �— ''� — I — - 1. � I � I;, I 1 '1`7 1 1 1 � .— -
I,, AI
v
1 Id
eI o'I I
19 L
Ip
fill
it
IIL V,
IN
i� tvin-�
44
It f,
'I t I r
It I I I
N1 I I , 't , I - N��
I I
I L kc I W,
41 1. ILI
IN I I I"N' I 'N I, I 1,' 1 4 It IS
1
C, It tij I 4�4 I t L it, 1.4 eA, w
It P,J, It I
I
1 11 IIIti
'%It k r I I;
If N.dkl
L t" P, I 1A F1
�LI C I d,L� I L�
L L Nt� j'
t L ILI N4I 1,,
-74
L,,4 1 41 Is
4 It
II,L Ii,�? f
It.
t
I I k I I It
".Ito
IN 9 1 1 1 , I
I
41 C
It
IN
I it I
1+f I
It
lto
r IN
It
It
7U,
r Ir. r rdd
I ?'tt"Ipt I, �,I I I I I q .1 IN.
j i �L L 1 9 1
I.tk
Al
LtI
It IN I
IIIIL, f� N
tt vz-� %% I IN
r it" �At
jt
It
el Is
. 4
gI. It
IL
It I. IN'
t.lk
I Ij
1 9 1
'LII
k A
r. t I
1 9
4 1
r I r r r, III RECORD OF INSPECTIONS It
rL I
:. I I . . � � I I I I I - I- - I I I . � I I I I L, , iff I I . . I I I I'NI I*, NIf"
I I I I I I r - r 1 1. , I I I. i L L T,
Ile N I t, . I r
r
+
NIIIIIIIIId
r Foundation
+ Plumbing (Partial) I I, If
*41 ;S "N" I.
.21 iii.4 I L I d I I I I
v
(Roug!Iii) L p
1 4 1
LI
0 +.-IormiiI
ILI
7�4 7 Frame L
L 1. L tL 3
I rI, , Furnace & Fuel Line
r 9, 1
LZ I I I I I I I I
k i I I . Final
ow
1 1 4
I 1 4 L I I , Ir., I I
ar.: I
p� I
I
NIIII'j 'j, '�WrI . I �II,N
0