690451.pdfNO.: PERMIT
POSTED ON KROLL
690451
NUMBER
BUILDING DEPARTMENT Applicant FIR
Diside Heavy Lines jon ADDRFsB
PERMIT APPLICATION 7
NAME (OR NAM OF BUMNNbb) YARD SETBACK
I STREET I, 13ACK RE
r7, SIDE YARD SETBACK
ADDRESS 4�
W3 �7 6
P1 Uj zoNn LOT AREA SITE Z
YES
I'D
G I TELEPUUN� LNUMBEI;t
F4_U_MBrR
ITY
B AREA VARIANCE
Z6 MO W bs� HEIGHT
�NAIAE
VED
PLOT PLAN AWRO
00,
�WDREPJB
NUMBER EXISTING STREET R/W .40 ... FT. DEFI-=ENCY THIS PROPERTY
TELEPHONE
COUP. PLAN ST. n/W.A!2..FT. ... r,-r.
0
MtE—MARKS
ILK,' Driveway slopes not to exceed.those
indicated on Standard Drawing #103.
LAJ CKED 13Y
ELEPHONE NUMBER
IZE SERVICE SIZE CLEARANCE IC ED BY
. . . . . . . . . . 7L7"- -Z-4310 METER s HECK
TATID-LICENSE NUMBER CITY IAU�VO� INUMBER Id
Sle?,
42 20 _�5 _06-
0 orlptloa of Property (show jjeiow or Attach Four Copies)
TYPE CONNECTION VERIFIED BY
.................
PERO. TEST PERMIT NUMBEIt
�,Sl
4,
N�
5"
7-Al ff
t� Z 72;
NEW
ADD
ALTER
E] REPAIR
to Sewers being installed under L.I.D. No. 164.
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVEL
5
RESIDENTIAL
Q
GAS
LINE
F-1 NON-RESIDENTIAL
El
SIGN
RETAINING
WALL
DEMOLISH
EXCAVATE
OR FILL
FENCE
( .......... x .......... Ft.)
PRE -MOVE
INSP.
E]
SWIM
POOL
JES
NUMBER OF
DWELLING
UNIT'S
— 1 -7 -V- S Ld
YES RrNo
UIRED CCUPANCY GROUP
(3 YES :2 —;r "/ -jr-- /
Plan Check No .....................
BUILDING
PLUMBING
-cets) HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
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
will be employed In violation of the Labor Code of the State of Washington
relating to Workmen's Compensation Insurance.
NOTE: Permit Li . One Y r (Except DEMOLITIONS which
ATTENT ON
THIS PERA T
AUTHORIZ 8
ONLY Tit
WORK NOT D
shall be completed I ety days; A VED-IN BUILDINGS $hall be com-
pleted In six mou�hg.
UGNATURE 01 R 0 L)AWN MUNNU
NSPECTION
I I
DEPARTMENT
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
PR 6-1107
This permit cov,�n work to 1. done on private property ONLY.
Any Construction ca the public domain (curbs, sidewalks, driverways,
m,nuets. etc.) will require Separate permission.
Valuation
M10
Fee
rAF
No.
/00
APPLICATION APPROVAL
This application Is not a permit until
signed by the Building Off Icial or his Dep-
uty; and fees are paid, and receipt Is ac-
Itnowledged in space provided.
DIRECTOR-S-_S N
DATW
_2 -/0
FILE
1 2
Yl.