690113.pdfUSE PERMIT
BUILDING DEPARTMENT Applicant FIB ZONE NUMBER
Inside Heavy Lines joB
PERMIT APPLICATION ADDRESS
NA�At�R NAM OF BUSINESS) C/
PERMISSIBLE % ACTUAL
LOT COVERAGE LOT COV
AILING ADDRESS
PERMISSIBLE HEIGHT PROPOSE
01
11
Ell
Z
0
FELEPHONE NUMBER
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774- t�299 Z-
6) Z<..) Aj
or Attac
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REAR
-27-
!0
101
REAR
/6
EXISTING(KTREET R/W ............ FT. v DEFICIENCY THIS PROPERTY
COUP. PLAN ST. R/W ............ FT. ............ FT.
REMARKS
IWO& -
A// Of
NIC
TYPE OF CONST ION
7"_CT ;j
GAS YES WO
NEW RESIDENTIAL LINE VPLAN CHECKED BY
NON-RESIDENTIAL
SIGN
ADD RETAINING REMARKS
DEMOLISH El WALL
F] ALTER EXCAVATE PENCE
OR FILL ( .......... x .......... Ft.)
REPAIR PRE -MOVE swim
INSP. POOL
NUMBER OF
DWELLING
UNITS
WAKTURE OF WORK TO BE DONE
_4�_r6r"o A4—n16 Co vz_vt� Plan Check No .....................
9 y / '2, BUILDING
.4&2e- A-7r%rAc4&v
PLUMBING
N
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION On FILL
TOTAL AMOUNT DUE
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 author-
Ized agent of the owner. I agree to comply with city and state laws regu-
ATTENTION
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
THIS PERMIT
relating to Workmen's Compensation Insurance,
AUTHORIZES
NOTE: Permit Limit One Your (Except DEMOLITIONS which
ONLY THE
WORK NOTED
shall be completad In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
IIGN47qRE (OWNER OR A
DATE ION
INSPECTION
DEPARTMENT
.7E
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
PH 6-1107
This Permit covers work to Im done an private property ONLY.
Any construction on the public domain (curbs, 0- alks, driveways,
nuLrquees, etc.) will require separate lesion.
YES [3 No
THIS SITE IS LOCATED IN THE CI
OF EDMONDS. LOCAL SALES T
SHOULD BE CODED 31.04.
Valuation I Fee
&.0
No.
ej
APPLICATION APPROVAL
This application Is not a pernilt until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
Imowledged in space provided.
DIR OR'S SICINATEr
DATE
FILE,
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