680397.pdf_d
POSTED ON KROLL MAP NO.: FERMI
BUILDING DEPARTMENT Applicant M / �z NUMBER 680397
PERMIT APPLICATION Inside Heavy Lines JOB ADDRES9
B 77 APPUCant F111
nside Heavy Lines
NAM (OR NAME OF EUSINESS)
61— /A -,� SIDE YARD SETBACK STREET SETBACK REAR YARD SETBACK
MAILING ADDRESS 't, 0:?—Is /,s 1 0
UBE ZONE LOT AREA VACANT SITE
O'k
C17 NE NUMBER &198- NO
3 p
HEIGHT 13UILDING AREA VARIANCE NUMBER ;6,
r7o �P o -7
1 NAMh
Fl _7?
ADDRESS
CITY TELEPHONE NUMBER RX1146ING STREET R/W ..9!5!.FT. DEFICIENCY THIS PROPERTY
I I COMP. PLAN ST. R/W ......... .. FT.
��W� V
X-4 r1r — I indicated on Standard Drawing #103.
ENSE NUMBER CITY LICENSE NUMBER
CK;Z%I., 6(
% I ct� q "TS
Iption of Property (Show Below pr Attach Four Copies) REMARKS or
2 V7 � �BY
TYPE CONNECTION
A( 5z) PERC.TEST PERMIT%FiVMBER
&,,/A0 J S�4 - I
REMARKS 02
'7/
so., 4rj FIREZONIO. -TYPE OF CONSTRUCTION STREET IMPROVED
:.2z:: 1 1 [] YES W�ze�
SPECLALL INSPECTOR REQUIRED OCCUPANCY GROUP
GAS C]YES
NEW RESIDENTIAL LINE PLAN CHE.URN I�x;
NON-RE131DENTI j SIGN
ADD RETAIMNG REMAJ�W
DEMOLISH WALL
ElALTER EXCAVATE PENCE
OR FILL ( ......... x .......... Ft.)
0 REPAIR PRE -MOVE swim
INSP. POOL
NUMBER DF
DWELLIN I
UNITS
NATURE OF WORK TO BE DONE
C(_).VSfR-Uzf lj(2- t. /40SeL
Valuation Fee -Receipt No.
Plan Check No ......... ....... ...
PROPOBED Up BUILDING
J'J'S JO/
19 44t 4�
PLOT PLAN (Indicate Building setbacks, abutting streets) PLUMBING
03 /!z
1
HEAT & GAS LINE
PENCE
t SIGN
N
RETAINING WALL
SWIUMNG POOL
DEMOLITION
PRE-MOVIC INSPECTION
EXCAVATION OR FILL
I hereby acknowledge that I have read his application; that the In- TOTAL AMOUNT DUE (7
formation given Is correct; and that I am th) owner, or the duly author-
lzed agent of the owner. I agree to comply -with city and state laws regu- ATTENTION
lating construction; and In doing the work authorizad thereby, no person APPLICATION APPROVAL
will be employed In violation of the Labor Code of the State of Washington Tlus FERMIN This application is not a permit until
relating to Workmen's Compensation Insuraree. AUTHORIZES
ONLY THE signed by the Building Official or his Dep-
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laws
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NOTE: Permit Limit One Year (E cept DE31OLITIONIS which WORK NOTED uty; and fees are paid, and receipt Is ac-
shall be completed In ninety days: MOVED -I BUILDINGS shall jbecom- Imowledged in space provided.
pleted In aLc months.)
SIGNATURE (0 t A T) GNED
)A ;; . INSPECTION DIRECTOWS BIGNAMT
DEPARTMENT
e,
g�_ jjjj� CITY OF e_�
� ;�ffl" EDMONDS DATE,��
NOTE: Applicant Subject to Plan Check Fee PH 6-1107 X-
This Permit covers work to be done on private pmperty ONLY.
Any construction on the public domain (co�bs, sidewalks, drivewayso FILE
marquees, etc.) will require separate permission.
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