670477.pdfk
POSTED ON KROLL MAP NO.: IT
BUILDING DEPARTMENT ApplIcalit MU NUMBER 670477
_I PER
Inside Heavy Lines
PERMIT APPLICATION JOB ADDREUS
NAM (OR NAME OF BUSINESS) ter -
YdL e t SIDE YARD SETBACK a EET SETBACK REAR YTRD SETIJACK
MAILING ADDRESS
7 �_ rq 0 r4 Z
'7731 19 y A USE ZONE JU'X AREA VACANT SITE
TELEPHONE NUMBER TER 13NO
CITY
HEIGHT A-BG AREA VARIANCE NUMBER PW
NAME
PLOT PLAN APPROVED
ADDRESS
STREET R1W
EXISTING STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
CITY TELEPHONE NUMBER COMP. PLAN ST. R/W ............ FT. ....... ...
REMARKS
NAME
CHECKED BY
04� C Z
ADI N
& P N METER SIZE SERVICE SIZE CLEARANCE CHEOMW BY
CITY TELEPHONE Num"Mat
PC, 6. � h IX e r4 � _q REMARKS
STATE LICENSE NUMBER CITY LICEA�SNKUBER
14Qo13 01 s- TYPE CONNECTION VERIFIED BY
Legal Description of Property (Show Below or Attach Four Copies)
Intl 4-4 7 /Ilac k Ph i-LAU&J, r, &I PERC. TEST PERMIT NUMBER
X Uj & 0 11- d f— Set 1'4 4 A Alf &I C f j'29 -2 7' REMARKS
AF I I ;,rt" At k e e 4 0
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
uo�A 1 [3 YES [3 NO
SPECIAL INSPECTOR REQUIRED JOCCUPANCT GROUP
TA 41 14 h -0 Ic S'U iz e, ry, iq C YES N
PLAN CHECKED BY
a-t 67 o)%f) ke f F,44t., /-j )IJ, 0 Z; Po 9
RESIDENTU I GAS
DNEW 'L LINE REMARKS
1 1:1 NON-RESIDI."NTIAL SIGN
Ef�� RETAINING
1:1 DEMOLISH F1 WALL
ALTER EXCAVATE PENCE
El OR F71LL .......... x .......... Ft.)
REPAIR PRE -MOVE swim
INSP. POOL
NUMBER OF STORIES NUMBER OF
DWELI2NQ
UNITS
NATURE OF WORK TO BE DONE
Bt,,dl desl ea Bad 1?, c&,,j Re C,
Valuation Fee Receipt No.
Z
R" A ]Plan Check No ............ . .......
I-PROPOSED USE
Do / 0 0 0
BUILDING 31 0 0 — ----------
PIOT PLA�43?ndfcate Building setbacks, abutting streets) PLUMBING
14
HEAT & GAS LINE
PENCE
SIGN
r r RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
the In -
I hereby acknowledge that I have read this application; that
formation given in 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 APPLICATION APPROVAL
lating eonstructlon; 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 This application is not a permit until
relating to Workmen's Compensation InsuMnee. AUTHORIZES signed by the Building Official or his Dep-
ONLY THE
NOTE: Permit Umit One Year (Except DE31OLITIONS which WORK NOTED uty; and fees are paid, and receipt is ac-
shall be completed In ninety days: MOVED -IN BUILDINGS shall be com- Imowledged in space provided.
pleted In six months.)
SIGR_,PLTI:RE (OWNER OR AGENT) DATESIGNED INSPECTION DIRECT R'S 810 7qu PE
DEPARTMENT
CITY OF
EDMONDS DATE
NOTE: Applicant Subject to Plan Check- Fee PR 6-1107
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (Curb*, sidewalks, drivewnys, FILE
marquees. etc.) will require separate Perrnifialon.
0