710507.pdf■
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BUILDING DEPARTMENT Applicant Fill
:11k PERMIT APPLICATION Inside Heavy Lines
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MAILING ADEIRFUS
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G CLTY - TELEPHONE NUMBER
NAME
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NAME i1 - -_
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POSTED ON KROLL MAP NO.: I PERMIT
NUMBER
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IDE. YARD SETBACK STREET SETBACK-
REAR YARD 8ETBACIC
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USE -ZONE LOT AREA
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VACANT SITE
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NUMBER
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IEIGHT BUILDING. AREA
VARIANCE
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?LOT PLAN APPROVED
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EXISTING STREET R/W 6.1/...��,,••�7 ...FT. DEFICIENCY THIS. PROPERTY -
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COMP. PLAN ST. R/W 6).UL..... FT.
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REMARKS
Dr1VeWay Slopes. not to
exceed those
Lndicated on Standard Drawing
103
14
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14 ADDRESS
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ry CZ07 METER SIZE SERVICE SIZE CLEARANCE CHh4ED BY
'�/• STATE LICENSE NUMBER - - CITY LICENSE NUMBER I I I
REMARKS
Legal Description of Property (Show BeloworAttach Four Copies) i I, '•
r r— Ct-- �Ci r TYPE CONNECTION VERIFIED BY
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PERC. TEST I PERMIT NUMBER C9
REMARKS - W
.OE7 FIRE ZO I TYPE OF CON CTION STREET IMPROVED
❑ YES ❑ NO
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SRXCIALINSPECTOR REQ IRED OCCUPANCY GROUP �-
_ ❑- ❑ GAS ❑ YES-7Q NO I - J�_ I
RESIDENTIAL LINE PLAN CHECKED BY
NEW _
❑ NON-RESIDENTIAL ❑. SIGN-
❑ ADD, E RETAINING.. RMARKS
DEMOLISH _ V..
❑ WALL
FENCE ALL, yib rzx_ Fes- L U9c N70El I
ALTER ❑ EXCAVATE OR FILL ❑ x..........Ft.)
REPAIR PRE -SWIM
❑ IN P. O POOL I
NUMBER OFJ STORIES NUMBER OF ,
/ I DWELLING
UNITS
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7s
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Plan Check No .....................
BUILDING
PLUMBING
HEAT A GAS LINE
FENCE
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SIGN
tRETAINING
WALL
S
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
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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-
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.
2TE: Permit Limit One Year (Except DEMOLITIONS which
be completed In ninety days; MOVED -IN BUILDINGS shall be mm-
1 ed In six months.)
NOTE: Applicant SubjeVt to Plan Check Fee
This Permit coven work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
TOTAL AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY TILE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDDIONDS
rR a-1107
Valuation I Fee
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
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FILE
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