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BUILDING DEPARTMENT I Applicant FIB Z°ITE 1� S V NUMBEn
PERMIT APPLICATION Inslde Heavy Lines JOB
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FRONT SIDE REAR FRONT SIDE REAR
LEGAL LOT VARIANCE OR CONDITIONAL USE
YES (] NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
STREET R/W
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
REMARKS
CHECKED BY
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—AV ter`- TYPE CONNECTION I VF..
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3TRUC'�INNON '[l;REET IMPROVI
YES ❑ NO
RESIDENTIAL
GAS
❑
❑ YES >0 NO
11 NEW
LINE
PLAN CHECKED BYS
THIS SITE IS LOCATED IN THE CITY
-
NON-RESIDENTIAL
OF EDMON DS. LOCAL SALES TAX
.['�I
SIGN
SHO�ULyD) BE CODED 31.04.
�7�1 ADD RETAINING
T-' ❑ DEMOLISH El WALL
REMARKS
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p� ham'
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C..1_- 1 \ ATS
J/yGVI��y�/ IVV
1 Qv Ci7� 7oM /"p'G V C
11 ALTER ❑ E ❑ ( z..........Ft.)
ORFAVATILL
PRE -MOVE
0 REPAIR ❑
P. POOL
I
NUMBER OF STORIES NUMBER OF
13
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1
DWELLING
tJ
UNITS 1
NATU(R[E. ,OF WORK TO BE DONE
I LO 2-j
Valuation
Fee Rreclpt No.
ir
O
Plan Check No..
BUILDING
( F,[xJ,
PROPOSED USE
a
PLUMBING
'
,, PLOT P AN _(Indlcal. Building setback., abutting at Mete)
HEAT &CAS LINE
FENCE
(N�CW.
f-�I�v.
1/K
SIGN
RETAINING WALLI
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\
SWIMMING POOL
1yJ'Lr
1y-
1J
DEMOLITION
�-
PRE -MOVE INSPECTION
1
EXCAVATION OR FILL
L AUtZt tELL5
TOTAL AMOUNT DUE
FlWi
I hereby acknowledge that I have Mad this applies tl.n; tact the In-
,.,motion given le 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•
ATTENTION
APPLICATION APPROVAL
lating construction; and In doing the work authorised thereby. no parson
will be employed In violation of the Labor Code of the Stale of Washington
THIS PERMIT
This application is not a perinit until
relating to Workmen's Compeneatlon Ine—c .
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 -
shall be completed In ninety days; MOVED -IN BUILDINGS shall be win.
knowledged In space provided.
pleted In six month..)
SIGN URE IOWNERLaDATE SIGNED
9DEPARTMENT�'L
INSPECTION
DIRECT O$$$ 8 S! AT E
CITY OF
IIIIII t�WWIJ
ED11fOND8
DATE"
NOT Applicant Subject !o Plan Cheek Fee
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el
775-2525
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Thi.Permit corers work to be done on private property ONLY.
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