700195.pdfPOSTED FN KROLL MAP NO-: PERMIT
VING DEPARTMENT
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Applicant Fill
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NUMBER700195
MIT APPLICATION
Sit
Inside HeELVY Lines
Its
JOB ADDRESS
(`OR �NE `WV BUSINESS)
fllo
SIDE YARD SETBACK
13TREET SETBACK REAR YARD SETH.
iI S (7 -f
9—
a ADDRESS
wo
17NIUMBER
USE ZONE
I —LOT AREA VACANT HITE
CLEP. uONX1
[3 YES (3 NO
U71(314T
I BUILDING AREA VARIANCE NUMBE
7
NEW
MADD
ALTER
E]
REPAIR
TELEPHONE NUMBER
ELEPHONN NUMBER
ra�
HER CITY LIC__ HER
W Below or Attach Pour Copies)
GAS
RESIDENTIAL 5
4 LINEN\
F-1 NON-RESIDENTIAL SIGN
RETAINING
DEMOLISH WALL
FEXCAVATE PENCE
OR FILL ( ......... A .......... F
FPRE -MOVE swim
-1 IN.P. POOL
STORIES NUMBER OF
DWELLING
UNITS I
100
STREET BIW
EXISTING STREET R/W ............ FT- DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT. ............
0
REMARKS
CRECICinn By
TE—TER SIZE I SERVICE SIZE CLEARANCE
CHECKED BY
_ff E_XARKS
TYPE CONNECTION
VERIFIED By
PERC. TEST PERMIT NUMBER
REMARKS
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
1 13 YES [3 NO
1
INSPECTOR REQUIRED
[3 YES [3 NO
OCCUPANCY GROUP
FEANCRECKED 33Y
REMARKS
Plan Ch66
Fee
Receipt No.
Z
BUILDING
PROPOSED USE
PLUMBING
BEAT & GAS LINE
av
PLOT PLAN (Indicate Building setbacks, abutting streets)
FENCE
SIGN
RETAINING WALL
t
SWIMMING POOL
DEMOLITION
PRE -MOVE IN13PECTION
MCCAVATION OR FILL
TOTAL AMOUNT DUE
ID
I hereby acknowledge that I have read this application; that the In.
APPLICATION APPROVAL
This application is not a permit until
formation given Is 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- ATMNTION
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 Workman's Compensation Insurance.
AUTHORIZES
signed by the Building official or his Dep-
NOTE: Permit Limit One Your (Except DEMOLITIONS which
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com.
ONLY THE
WORK NOTED
Uty; and fees are paid, and receipt is ae-
knowledged in space provided.
plated jaj4x months.)
I NER OR AGE DATE SPNED
NOTE: Applicant Subject to Plan Check Fee
INSPECTION
DEPARTMENT
CITY OF
EDDIONDS
PR 6-1107
—D71—RECTOWA SIGN AURF
JIM1:;��
_iTA_TX1
This Permit coven work to be done on private property ONLY.
Any construction on the public domain (curb@, sidewalks, driveways,
numquees, etc.) will require separate pern*Jsolon.
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