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740358.pdfSTATE LICENSE NUMBER CITY LICENSE NUMBER I I BUILDING DEPARTMENT nW ZONE NUMBE R 740358 Applicant Fill Inside Heavy Lines PERMIT APPLICATION A /• DDREae REMA (UCS NAME (OR NAME OF HUetN£88) � ?60 ttttN��y i Pt%ItMIBtl IILE ^e ACTUAL IALOT COVERAGE T COVERAOF tl MAILING ADD EBB Plslth11881BLF HFIOfiT IiOPOdED 1i EIGHT O !-1 /9603 &/Sa � 6,1 I CITY TERIMPRONS NUUMB11;R ACTUAL LOT AREA TOTAL BLDG. AREA a 4ml FC S 7760,791 / 9 RF.QUIRF.D YAIiDtl YnOPOBED YARDS NAME 9s— FRONT SIDK RF.." FRONT BIDE REAR O Lon e i✓ LOT VARIANCF, OR CONDITIONAL USE N ADDRESS LEGA YEBL C3 NO PERMIT NUMBER ....�� U YES [3 NO PLANNING DEPT. APPROVAL DATE: C CITY TELEPHONE NUMBER 1 GAB ❑ YES NO STREET It/W EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY PLAN CIIECXED BY NAME ' COhfP. PLAN BT. R/W ............FT. ............FT. © W n e r REMARKS OF EDMUNDS. LOCAL SALES TAX ADDRESS ADD RETAINING REMAR s BY F CITY TELEPHONE NUMBER ICRECKED z V ALTER EXCAVATE FENCE METER SIZE SERVICE SIZE CLEARANCE CHECKED BY STATE LICENSE NUMBER CITY LICENSE NUMBER I I I REMA (UCS ttttN��y i Legal Description of Properly (Show Below or Attach Four Copies) TYPE CONNECTION VERIFIED BY I /+/� T 10T qBlock lock I � 19L JRGR /t- / PERC. TEST I a 4ml PERMIT NUMBER a Q/31 C// C'Fa y IF AAQ/ 7-1 o REMARKS S f rP ?Lo r ea- 16, P6 9r o a a / 1,97_' ?E'Coe&W 1/V J%vON6fI0 FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED YES [3 NO l �C SPECIAL INSPECTOR REQUIRED (OCCUPANCY GROUP 1 GAB ❑ YES NO RESIDENTIAL LINE ❑ NEW PLAN CIIECXED BY THIS SITE IS LOCATED IN THE CITY NON-RESIDENTIAL SIGN OF EDMUNDS. LOCAL SALES TAX ADD RETAINING REMAR s H ULD BE CODED 31.04. DEMOLISH WALL ALTER EXCAVATE FENCE Q� f OR FILL (.....................Ft.) ❑ REPAIR ❑ O NSP,, POOL NUMBER OF STORIES NUMBER OF DWELLING UNITS NATURE OF WORK TO BE DONE Valuation Fee Receipt Na. Plan Check Na .... _...............'. O BUILDING W PROPOSED USE PLUMBING U aPLOT PLAN (Indicate IIunding a baback., abutting streets) HEAT Sr OAS LINE 21 PENCE SIGN — RETAINING WALL N SWIMMING POOL DEMOLITION 1 PRE -MOVE INSPECTION EXCAVATION OR FILL TOTAL AMOUNT DUE I hereby neknowledge that I have rend this application; that the fn- ate- form¢tlun given Is correct; and that I ant the owner, or the duly author- ized agent of theowner. I agree to comply with city and elate taws regu- ATTENTION APPLICATION APPROVAL 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 THL8 PEI BUT This application is not a permit until relating to Workmen's Compensation luxurtub". AUTHORIZES signed by the Building Official or his Dep - NOTE: Permit Limit One Year (Except DEMOLITIONS which ONLY THE WORK NOTED uty; and fees are paid, and receipt is ac - .hall be completed In el¢ely day.; AIOVED-1N BUILDINGS shell be in. knowledged in space provided. pfeted In .ix months.) SIGNATURE (OWNER OR AGENT) DATE SIGNED INSPECTION DEPARTMENT DI OR'S BtGNATU CITY OF EDIIIOND9 DATE NOTE: Applicant Subject to Plan Cbeck Fee 775-2525 v This Permit coven dark to he done on private property ONLY. Any construction on the public domain (curb.,sidewalk., drNVeways, .,.queen, .le.) will require separate perml.elon. FILM