690234.pdf0
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POSTED ON KILO" MAP NO.: PERMIT
BUILDING DEPARTMENT Applicant Fin NUMBER 690234
PERMITAPPLICATION Inside Heavy Liner; JOB ADDRLUS
NAME (OR NAME OF BUSINESS) 7 '7 ;7—
SIDE YARD Sli�TBACK STREET BET13ACK REAR YARD SETBACK
'3 AILING ADDRESS
P600 i - Avi 4 S
77 -2— e 0 S 7UJ USE ZONE LOT AREA VACANT SITE
CITY TELEPHONE 9U—MBER [3 YES 0
)EJ HEIGHT BUILDING AREA VARIANCE NUMBER N
779-,5V 66
NAME PLOT PLAN APP VE
ADDRESS
STREET ft7W DEFICIENCY THIS PROPERTY
CITY TELEPHONE NUMBER EXIS77NO STREET R/W ............ FT.
COMP. PLAN ST. R/W ............ ITT. ............ PT. a
—REMARKS
NAME
/7
ADDRESS
CHECKED BY
CITY TELEPHONE NUMBER
STATE LICENSE NUMBER CITY LICENSE NUMBER METER SIZE SERVICE SIZE CLEARANCE CHECKED BY 04
REMARKS
Legal Description of Property (Show Below or Attach Four Copies)
P 7--77 /V e� 6�W -71.2,so "W4 55o.?y TYPE CONNECTION VERIFIED BY
(A
PERMIT NUMBER
W Llli? t17 /%/ PAI E LIV SC34C? Fot' PERO. TEST
1 141 134-611 't-11 6 PL-t- 5 REMARKS
0,K, to connect into sanitary sewers
A ,W F T It 3 il 44e 7T
EXC, with izwftan 211 line.
FIRE ZON TYPE OF CONSTRUCTION STREET IMPROVED
YES
SPECIAL INSPECTO��EQUIRED OCCUPANCY GROUP
GAS 0 YES Erg
ElNEW RESIDENTIAL El LINE PLAN CHECK'MD BY
NON-RESIDENTI&L SIGN
El--- RETAINING REMAPtSW
DEMOLISH WALL
ALTER EXCAVATE CE
OR FILL ......
E] REPAIR PRE -MOVE SWIM
13 INSP. POOL
NUM13ER OF STORIES NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO 13E DONE Valuation Fee —Receipt No.
4 'r / S10,1'f)7M,'f74 P001— Plan Check No .....................
)(A
Ile-, C, k- fil(17 14o�her Mode
2 &1 BUMDING
eeAt?yP_d
PROPOSED USE
PLUMWNG
PLOT PLAN (Indicate Building setbacks, abutting streets) HEAT & GAS LINE
PENCE
SIGN
tRETAINING WALL
N
SWIM3UNG POOL
DEMOLITION
PRE MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In- 5_63�
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-
lating construction; and in doing the work authorized thereby, no person ATI!ENTION APPLICATION APPROVAL
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 Workman's Compensation Insurance. AUTHORIZES
isigned by the Building Off Icial or his Dep-
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS 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.
pletcd In six months.)
SIGN ENT) DA GNED INSPECTION DIMECTOWS 'Tu
DEPARTIMENT
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee PH 6-1107
This Permit covars work to be done an private property ONLY.
Any construction an the public domain (curbs, eldewalksp drivewaysp PU
'N marquees, etc.) will require separate permissim.
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