670201.pdfBUILDING DEPARTMENT
PERMIT APPLICATION-
NANT (OR NAM OF BUSINESS)
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LING t"DREMS38
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Applicant Fill
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Inside Heavy Lines JOB ADDRr8'J -eek
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REET REAR yjLR:> SETBACK
SIDE YARD SETUAU� SETBACK
A IKE I K1
USE ZONE A VACANT SITE
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NUMBER �PA
�?�T.�TWM AW�!A I VARIANCE
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91
04
Z
0
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�Ax��. ../,. R/W ............ FT. DEFICIENCY THIS PROPERTY
EXISTING STREET 0
CITY TE COMP. PLAN ST. R/W ............ FT- ........ ... FT.
REMARKS
NAML
CKED BY 0
K. C Lk C_ 0 Z
ADDRESS
A) METER SIZE SERVICE SIZE CLEARANCE CHECXEDD BY
CITY IE.FHW41ll N
S REMARKS
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STATE LICENSE NUALbrin CITY LICIONUE Nu�z�
41;� -3 — 0 1 � - I TYPE CONNECTION VERIFIED BY
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Legal Description Of Property t8now M�Iuwl`7r Attach Four Copies)
rj-a,4, 44 17 PERC. TEST PERMIT NUMBER
0A REtIARKS
W
I= ZONE TYPE OF CONSTRUCTION STREET IMPROVED
YES NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
0 YES [] NO
PLAN CligCKED 'BY
GAS
RESIDENTIAL LINE
RE
0 NEW
NON-RESIDENTIA.L SIGN
ADD RETAINING
WALL
DEMOLISH
ALTER EXCAVATE FENCE
F1 OR FILL ( .......... x .......... Ft.)
REPAIR PRE -MOVE SWIM
INSP. POOL
NUMBER OF STOMEb
DWELLING
UNITS
NATURE OF WO TO BE DONE
c V> e-
Valuation Fee Receipt No.
Z
DAN( 16- 14r b�s
Plan Check No .....................
PROPOSED USE
BUILDING
PLOT PLAN (Indicate Building setbacks, abutting streetH;
PLUIMNG
_0'*
-All
HEAT & GAS LINE
FENCE
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SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL A51OUNT DUE
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1 hereby acknowledge that I have read this application; that the In-
formation given In correct; and that I am the owner, or the duly author -
zed agent of the owner. I agree to comply with city and state laws regu-
ATTENTION
APPLICATION APPROVAL
lating construction; and in doing the work authorized thereby, no person
of the Labor Code of the State of Washington
THIS PERMIT
This application is not a permit until
will be employed In violation
relating to Workmen'S Compensation Insurance.
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-
shail be completed in ninety days; I%JOVED-IN BUILDINGS shall be com-
knowledged in space provided.
pleted In Ix mon a.) AGENT DATE, SIGN
SIGNA (OWNE
INSPECTION
DEPARTMENT
DIR CT R'S SION7TU
;ig
CITY OF
DATF
EDMONDS
V
NOTE: APPlicant Subject to Plait Check FCC
PR 6-1107
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs. sidewall;s, driveways,
FILE tq.
marquees, etc.) will require separate permission.
7,1