680398.pdfPOSTED ON KROLL MAP NO.: PERMIT 680398
BUILDING DEPARTMENT I NUMBER
] Applicant FRI IN
Liside Heavy Lines JOB ADDRESS
PERMIT APPLICATION
NANIE (OR NAME OF BUSINESS) 19 CF�L 4s;7 g7o tj
SIDE YARD SETBACK STFEET --SETBACK REAR T TRACK
V A �4 rz I
MAILING ADDRESS %1S, 1 1 0
LOT AREA _VT_
USE ZONE ACANT SITE
19 3-2- s- 30"-L LL)
CITY TECEPHONE NUMBER YES [3 NO
[it ri ppi_ -4 s-:� HEIGHT BUILDING AREA VARIANCE riuMBER
NAME
PLOT PLAN APPROVED
ADDRESS
STREET R/W
EXISTING STREET R/W ........... FT. DEFICIENCY THIS PROPERTY
CITY TELEPHONE NUMBER
COMP. PLAN ST. R/W ........ .. XT- .......... .
L REMARKS
NAME
L
ADDRESS Z
CHECKED BY
CITY TELEnuuriN NUMBER
METM SIZE SERVICE SIZE CLEARANCE CHECKED BY
STATE LICENSE NUMBER CITY LICENSE NUMBER C4
REMARKS
Legal Description of Property (Show Below or Attach Four Copies)
,�v'e - ter I es T", P_ & w Ftlr- 4 TYPE CONNECTION VERIFIED BY
Z
RE.39-13.L MR Rld _S�. SX, N %4�_ ,5c- PERC.TEST PERMIT NUMBER
5'j D E C OLI SY4 CaP, SD Sug I il .5 8!iQ ip' 2 REMARKS
E 14) i2 -S /-/V 127 "T-P R T14 C ew-jr S 6 9il� 6
122 / 71-1 IV 0 f4t�,�b V,/ kJL N _C� 1) FIRE TYPE OF CONSTRUCTI STREET IMPROVED
��3r 1 -�r 0, 113 YES No
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
GAO YES I.Pgyo
NEW RESIDENTIAL ziiiE PLAN CHECKED BY
NON-RESIDENTIAL
SIGN
R1 1 1:1 1�j
ADD RETAINING REMARKS
DEMOLISH WALL
0 ALTER EXCAVATE PENCE
n OR FILL ( .......... x .......... Pt.)
REPAIR PRE -MOVE SWIM
1:1 INSP. POOL
NUMBER OF STORIES -NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE
CA R-P I
Valuation Fee Receipt No.
Z
Plan Check No ..................
PROPOSED USE
BUILDING
PLOT PLAN (Indicate Building setbacks, abu PLUMBING
HEAT & GAS LINE
iQ
PENCE
SIGN
N
RETAINING WALL
SWIMIIING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR PILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this &PPIIc&tIon; that the in- (9 A0
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
Iating construction; and in doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington THIS PER1%U[T This application is not a permit until
relating to Workmen's Compensation Insurance. AUTHORIZES signed by the Building Off icial or his Dep-
ONLY THE
NOTE: Permit Limit One Year (Except DE51OLITIONS which WORK NOTED uty; and fees are paid, and receipt Is ac-
shall be completed in ninety days; MOVED -IN BUILDINGS shall be com- knowledged in space provided.
pleted In six months.)
OWNER ORAVENT) DATE71GNED INSPECTION
DEPARTMENT
,2
140, 7e, re CITY OF
EDMONDS
Applicant Subject to Plan Check FCC Pn 6-1101
This Perralt covers work to be done on Private Property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
FILE
marquees, etc.) will require separate permission.