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710046.pdfJ raYSSpo?faeea Pt®iWvlullrbYN�NNWuu, z1 1 IF BUILDING DEPARTMENT Applicant FM PERMIT APPLICATION Inside Ileavy Lines F NAME rc �A NO ADDREBB Or 11!31, CITY "w14a' �r3F.r0nld'r yynn; NAME itEBB o I.1 G7 Yx- O 111 .'E LICENSE NUMBER •z- t n I GAS RESIDENTIAL ❑ LINE NEW ❑ NON-RESIDENTIAL ❑ SIGIq ADD ❑ DEMOLISH RETAINING WALL ALTER ❑. EXCAVATE E ❑ ` PENCE ORFILL 5.......... Ft') El REPAIR ^ PRE -MOVE swim I I INSP. POOL DWELLING UNITS Y NOA 16 Oil. v ' [/; 1 710046 .;0IGiyE REAR YARD BETS VACANT BITE [3 YES i7 NO EXISTING STREET n/W ............FT, DEFICIENCY THIS PROPERTY COMP, PLAN ST. R/W ............FT. I ............FIT REMARKS CRECKED BY DETER SIZE SERVICE SIZE '•CLEARANCE CHECKED BY REMARKS TYPE CONNECTION I VERIFIED BY PERC. TEST I PERMIT NUMBER REMARKS FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVE] I0YES DNO SPECIAL INSPECTOR REQUIRED (OCCUPANCY GROUP, O YES NO PLAN CHECKED BY 0 IF Plan Check No, ........... ....... — 1 r _hue, PLUMBING HEAT R GAS LINE FENCE SIGN RETAINING WALL DEMOLITION PRE -MOVE INSPECTION EXCAVATION OR FILL Valuation I Fee 1 � l ♦ sM . f: , 1 1 r. I f � TOTAL AMOUNT DUE t �d �� SV� [NOTE9 hereby acknowledge that I have reed this application; that the In- V eCC r on given to correct; and that I am the owner, or the duly anlhor- ent of the owner. I agree to comply with city and state laws regu- ATTENTION APPLICATION APPROVAL construction; and In doing the work authorized thereby, no person employed In violation of the Labor Code of the Stale of Washington THIS PERMIT This application is not a permit until to workmen's Compensation Insurance. AUTHORIZES signed by the Building Official or his Dep- ONLY THE : Permit Limit One Year (Except DEMOLITIONS which WORK NOTED uty; and fees are paid, and receipt is ac- completed In ninety days; BIOVED-IN BUILDINGS Shall be com- knowledged in space provided, n SIX months.) URE (OWNER OR AGENT) DRAT I BIG ED INSPECTION D OR'B 810NATU$E ./ P DEPARTMENT P _ / ' IR Y;Ih 4 LCiu�x.th'tf/ CITY OF EDMOND$ DATE NOTE: Applicant Subject to Plan Check Fee Pa 6-1107 -� This Permit coven work to be done on private properly ONLY. Any construction on the public domain (curbs, sidewalks, drlvewsye, FILE marquees, etc.) will require Separate permlulon, 1 i n ... •1^s+.• •. .. �fLfle(x'icri tI' ps{., r' i�''a tr I •✓f li lr.`f 4. t , .t :r• ,k 6., y tlf a I i 1 t - _ ♦3 r:t.:'A 31 ry Sc r f."tit +..:a ..c �6 I' If i " y ♦~. r u „tl 1 �'A - i. , , • L, y'i r , 1, o-40% if rd4•AI,�. l,...,...r•�._�=\ ....,S:v,.......-).... ALLde.�.'.u...t r 7 t l'.4.� \ r . 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