690250.pdfr
POSTED ON KROLL BE" NO.: PERMIT
BUILDING DEPARTMENT
Applicant FLU
NUMBER 690250
PERMIT APPLICATION
Inside Heavy Lines
JOB ADDRESS
1A S.<
141DE YARD SFTJSAUA ,n,,r SETBACK HEAR YARD SETBACK
1,7.-Ar-,
NAMW (OR NAME OF BUSINESS)
S?65--tc
A
A
LING ADDRESS
7 Se-
USE ZONE
VQ (0
Evr AREA VACANT SITE
[3 YES [3 NO
CITY 'NJULEPHONE-RU—MBER
h7p In
IISIDHT
burMMNG AREA V ARIANCE NUMBER--
14AME
PLOT PLAN APPROVED
ADDRESS
STREET R/W
EXISTING STREET R/W ............ FT- D MCIENCY THIS PROPERTY
'T FT.
COMP. PLAN ST. R/W ............ F -
REMARKS
CITY
TELEPHONE NUMBER
NAME
kA I Sll� SA95�Vl r—e-5 . 11V C
CHECKED BY
Z
R
ADDRESS 01
Z
CITY
5 A;,9TT,4
METER SIZE SERVICE SIZE CLEARANCE
CHECKED BY
to
STATE —LICENSE NUMBER Grrx LICENSE NUMBER
7-!U
REMARKS
Legal Description of Property (anow, jjelow or Attaeh'Four Copies)
V05 77j" F / /2 6,7— 4 0 Z:;'l 7-1 �OU
TYPE CONNECTION
VERIFIED D
Z
PERC.TEST PERMIT NUMBER
REMARKS
FIRE ZONE TY RUCTION STREET IMPROVED
[j YES
SPECLALL INSPECTOR REQUIRED
OCCUPANCY GROUP
YES AKNO
GAS
RESIDENTIAL LINE
NEW
NON-RESIDENTIAL -1 SIGN
ADD RETAINING
DEMOLISH WALL
ALTER EXCAVATE FENCE
OR FILL ... . ... . x . ....... Ft.
�REPAIR
PLAN CHECKED BY
e
REMARKS r/7
PRE -MOVE SWIM
INSP. POOL
NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE
kfft:949 61;�c P,4,�114,9046 ELICIF e0efalIV41-
Plan Check No ......... ...... ....
Valuation
Fee
Recelpt No.
CO AfS a rl iA�
BUILDING
RR—OPOSWD USE
PLUMBING
HEAT & GAS LINE
PLOT PLAN (Indicate Building setbacks, abutting streets)
FENCE!
SIGN
RETAINING WALL
13WIMMNG POOL
DEMOLITION
PRE.MoVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read thin application; that the in-
ATIMI'MON
TIUS PERMIT
APPLICATION APPROVAL
%Us application is not a perTalt until
formation given In correct; and that I am the owner, or the duly author-
lzed 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
will be employed in violation of the Labor Code of the State of Washington
relating to Workmen's Compensation Insurance.
NOTE: Permit rimit One Your (Except DEMOLITIONS which
shall be completed in ninety days; MOVED -IN BUILDINGS shall be com.
AUTHOR11ZE8
ONLY THE
WORK NOTED
idgried by the Building Official or his Dep-
uty; and fees are paid, and receipt Is ac-
knowledged in space provided.
plated In mix months.)
INSPECTION
DEPARTMENT
)ITY OF
EDMONDS
PR 6-1141
_'BL_RECT0,W'1S SIGNA
=04
MDATJAC
-SIGNATURE (OWNER OR AGEN
DATE SIGNED
I //4K
NOTE: Applicant Subject to Plan Check- Fee
This Pe"Idt coven work to be done on prIT"a property ONLY.
Any 0onstraction an the public domnLin (curb@, iddawalka, driveways,
miarqueen, etc.) WW r6Qnlm NOP&mtO permission.
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RECORD OF INSPECTIONS
1 P
Date Passed
I I . . .
Foundation
..%.iPlumbing (Partial) -
I d 4
(Rough)
Frame
I I I d
" : % i :
I Furnace & Fuel Lines.
.."Final
t
I L L
.-J
I P L I
1 1+
RECORD OF. INSPECTIONS:*.
4.,� i.,.
Date.Passed
Drainage
Sqwer
Parking
Landscaping _P 4
Fire Dept,