670359.pdfell
POS
BUILDING DEPARTMENT Applicant Fill
Inside Heavy Lines jOB A15
PERMIT APPLICATION Vy Lines
NAME (OR NAME OF BUSINN613)
7,;gm _;� SIDE
MAILING ADDRESS /0
USE
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0 CITY WELEF110144 147K
37- .7, y HEIGH
0
I KROLL MAP NO-: PERMIT
NUMBER 670359
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T AC! S
STREET SETB
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LOT AREA
STREET U/W
EXISTING STREET R/W :5.
COMP. PLAN ST. R/W ..... IT -
ADDRESS .4,
METIjR E
TELEPHONE NUMBER ir
2 / :;� _V_ �5 7 & r
8 STATE LICENSE NUMBER - ITY LICENSE NUMBER REMARK
3 TYPE CC
Legal Description of Property (Snow Below or Attach Four Copies)
PERC.
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REMARF
FIRE ZO
ECIAX
[j YES
PLAN C1
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[0-�-NEW D'�RESIDENTIAL M LINE -F-1 aAR3
1:1 NON-RESIDENTLAJL F"� SI...
ElRETAINING
1:1 DEMOLISH WALL
ALTER EXCAVATE PENCE
E] OR FILL ( .......... x .......... Ft.)
REPAIR PRE -MOVE swim
INSP. POOL
NUMBER OF STORIES NUMBER 61—P
DWELLING
UNITS
7
I hereby acknowledge that I have read this application: that the In-
formation given to correct: and that I am the owner, or the duly allthar-
Ized agent of the ovmer. I agree to comply with city and state laws regu-
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
relating to Workmen's Compensation Insurance.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be completed In ninety days: MOVED -IN BUILDINOS shall be COM-
pleted In six months.) I
� DATE/IGNSD
3IGNAT E (OWNER OR
NOTE: Applicant Subject to Plars Check, Fee
This permit coverg work to be done (in privitte property ONLY.
Any construction on the public domain (curbs. sidewalks, drivewayn,
marquees, etc.) Will reqWre separate permission.
4rf
4
Plan Check No .....................
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
s-'
VA —CANT BITE
[3 YES [3 NO
VARIANCE VUJAD� Ik
DEFICIENCY TnIS PROPERTY
..'e:IXT.
Valuation
;Z7 90
[:I YES eo9b
r�
Fee
15r]
TOTAL AIMOUNT DUE 0 0
ATTENTION APPLICATION APPROVAL
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W
TIUS PERMIT This application Is not a permit until
AUTHORKZES signed by the Building Official or his Dep-
ONLY TIIIE
WORIE NOTED uty; and fees are paid, and receipt is ac-
I knowledged in space provided. "If
INSPECTION
DEPARTMENT
CITY OF
EDAIONDS
PR 6-1107
FILE 1q, E.