700213.pdfq
BUILDING DEPARTMENT
Applicant F111
PERMIT APPLICATION
Inside Heavy Lines
NAME (OR NAME OF BUSINESS
t9 R Z 9
MAILI a ADDRESS
2 3 0 71
�NUMBER
CITY
TEj;EFHONE
7 76 -J6 70
61TY
rv_ze IvZ, 5..
TELEPBONE NUMBER
)1,A11V
774 71g
STATE LICENSE NUMBER
Y ICENSE NUMBER
'13 —0/ 4, 334-
Legal Description Of Property (Show Below or Attach roar Copies)
sed P,09R le
Z
GAS
RESIDENTIAL El LINE
NEW
NON-RESIDENTIAL SIGN
ElADD
DEMOLISH
RETAINING
WALL
FV ALTER EXCAVATE FENCE
0 OR FILL ( .......... x .......... Ft.)
PRE -MOVE SWIM
REPAIR F-1 INSP. POOL
NUMBER OF STORIES NUL113ER OF
DWELLING
UNITS
NATUR,' OF WORK TO BE DONE
)' )(2 d FAUE,96-69'55 10h7hp Cay.FR
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Z
a
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I hereby acknowledge that I have read this application; that the In-
formation given 13 correct; and that I arn the owner, or the duly author -
[zed 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 Waahlngton
relating to Workmen's Compensation Insurance.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be completed In ninety days; BIOVED-1-4 BUILDINGS shall be com.
pleted In six months.) IGNED
IIGNATUILE WYNElt ult Au.� DATE S
I I
NOTE: Applicant SnAr(ect to Plan Check Fee
7jidspennit covers work to be done on private property ONLY.
Any construction on tile public domain (curbo, aldeWnlks, driveway$.
marquees, etc.) will require separate permission.
PERMIT
NUMBER 700213
7
,TBACK T �BTREET SETBACK
YES No
aVA
AREA
It IANCE NUAM,
rGHT BUILDING
L,OT EVAN P ROVED
//V yt
—
f_REET)1y/W/
XISTI*O STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT-
............
XMARKS
IIETER SIZE I SERVICE SIZE I CLEARANCE CHECKED BY
REMAIMS
11.W �n"W7.0-l"nN I VERIFIED BY
FIRE ZONE TYPE OF CONSTRUCTION I
[] YES 0 NO
SPECIAL INSPECTOR REQL NICY GROUP
0 YES NO
P7LACHE,9KEj0 BY
Plan Check No.
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDDIONDS
PR 0-1107
Valuation
Fee
M_
1 .3 00 1
No.
APPLICATION APPROVAL
This application is not a perralt until
Signed by the Building official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
_C__
I -90
FILE
I
I
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