710268.pdfn
C.
G DEPARTMENT
APPLICATIONInside
Applicant FLU
Heavy Lines
POSTED ON KROLL MAP NO.:
PERMIT
I NUMBER
71026
JOB ADDRESS
FENAME
SIDE YARDBACK
STREET SETBBACK
HEAR YR SET]
DREGS�/1"USE
J // C7 C•CTELEPBONE
ZONE
_—
LOT AREA
VACANT SITE
Q YESN(
NUMBER
HEIGHT
BUILDING AREA
I VA_ $IA E7 MIR
O C /, ^�
ADDRESS 6� /�� Y/��Ito Tati
F STREET R/W /*
EXISTING STREET R/W 60..FT. DEFICIENCY THIS PROPERTY
Q CITY TELEPHONE NUMBER ��++
COMP. PLAN ST. R/W ....�Q....FT. .1.,eJ....FT.
NAME
REMARKbriveway slopes not to exceed those in-
h/.� A? 7Zo2s dicated on Standard Drawing # 103
et ADDRESS
Fj 9 :a O CHE��`C(((K���ED BY
F CITY TELEPHONE NUMBER �{I�
METER SIZE I SERVICE SIZE I CLEARANCE I CHEC BY
$ STATE LICENSE NUMBER I CITY LICENSE NUMBER
REMARKS
Legal Description of Property (show Below or Attach
Four Copies)
�;�
j j TYPE CONNECTION I VERIFIED BY
O�
�+ PERC. TEST (PERMIT NUMBER
U
p) REMARKS
67 - FIRE Z TYPE OF NSTRUCTION STREET IMPROVED
117 YES ❑ No. —
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
OAS ❑ YES Y NO I J '_ /
RESIDENTIAL LINE PLAN CHECKS B
❑ NEW ❑Paj THIS SITE IS LOCATED IN THE
❑ NON-RESIDENTIAL ❑ SIGN CITY OF EDMONDS. LOCAL SALE
❑ ADD DEMOLISH El DEMOLISH
REMARKS TAX SHOULD BE CODED 31.04.
❑
ALTER CE
❑ OR (.
EXCAVATE
E ❑ EN,c..........Ft.)
❑ REPAIRPRE-MOVE SWIM
❑ INSP. ❑ POOL
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE L Valuation Fee Receipt
Finn Check No ........ ............
a 7
0 BUILDING / o 0 —
apIIIi PROPOSED USE
q PLUMBING
W
a PLOT PLAN (Indlcata Building setbacks, abutting streets) HEAT A GAB LINE
5
FENCE
SIGN
RETAINING WALL
ISWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL _
I hereby acknowledge that I have read this application; that the In.
formation given Is correct; and that I am the owner, or the duly author-
Ired agent of the owner. I agree to comply with city and slate laws regu-
lating construction; and in doing the work authorised 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 Limit One Your (Except DEMOLITIONS which
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
TOTAL AMOUNT DUE I I /
ATTENTION APPLICATION APPROVAL
THIS PERMIT This application is not a permit until
AUTHORIZES signed by the Building Official or his Dep-
ONt.Y THE ut and fees are paid and receipt is ac-
knowledged in space provided.
VA� (O NER OR AGENT) DATE SIGNED INSPECTION
DEPARTMENT
CITY OF
EDhfONDS
NOTE: Applicant Subject to Plan Check Fee
PR 0.110T
This Permit coven work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
nmrquees, etc.) will require separate permission.
6 � L
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