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740439.pdf
T, I ONE NUMBER 7x 0439 BUILDING DEPARTMENT Applicant Fill _ PERMIT APPLICATION Inside Heavy Lines I ,OB ADDRESSE- !+ NAME (OR NAME OF BUSINESS) • .rte ``,� —` K 0 � G• • LOT COVERAGE LOT CO ERA �F LOTUAL ry lAT COVERAGE .� - I fir( `�( 1 MAILIN6�D EBB 7 1 . IO Si W PROPOSED HEIGHT O x 1 PERMISSIBLE HEIGHT O CITY TELEPHONE NUMBER ACTUAL LOT AREA TOTAL BLDG. AREA Z ' I �{Ii (v r (0` O 1 Q REQUIRED YARDS PROPOSED YARDS .1..1 NAME FRONT SIDE REAR FRGNT BIDE REAR ') [� U ADDRESS LEGAL LOT VARIANCEOR CONDITIONAL USE 0 YES 0 NO PERMIT NUMBER I yE+ S PLANNING DEPT. APPROVAL DATE: i p0'TELEPHONE CITY NUMBER STREET R/W EXISTING STREET R/W ............FT. DEFICIENCY THIO PROPERTY p NAME COMP. PLAN ST. R/W ............FT. ............FT. w I 0 REMARKS w to ADDRESS Z ni I CHECKED BY CITY TELEPHONE NUMBER t I O O METER SIZE SERVICE SIZE CLEARANCE CHECKED BY STATE LICENSE NUMBER CITY LICENSE NUMBER Lugol Description of Property (Skald Below or Attach Sour Copies) REMARKS TYPE CONNECTION VERIFIED BY PERC. TEST PERMIT NUMBER C tY hal' O REMARKS Ce ' < I FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED j 0 YES 0 NO i I SPECIAL INSPECTOR REQUIREDOCCUPANCY GROUP fl ❑ RESIDENTIAL GAS ❑ NEW ❑ LINE 0 YE8 0 NO I ! 1 PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY OF E. LOCAL SALES TAX ❑ NON-RESIDENTIAL ❑ emN SHOULD BE CODED 31.04. 1 ❑ ADD M.ntN....G�n REMARKS 1 ❑ DEMOLISH ❑ vA ❑ ALTER r�1i{ ❑ OROFILL D ® (.E-r.`.z.c:N,t/Fl.) ❑ REPAIR ❑ INBPb10VE EJPOOL NUMBER OF STORIES NUMBER OF I I DWELLING UNITS NATURE OF WORK TO BE DONE Valuation Fee Receipt No. Plan Cheek No ..................... Ox BUILDING ly 4 PROPOSED USE I 7n, PLUMBING O QPLOT PLAN (Indicate Building setbacks, abutting streets) HEAT & GAS LINE c O FENCE / /] /] ©o 6�_Ls � • Q � � i j SIGN T! e RETAINING WALL N SWIMMING POOL DEMOLITfON ' PRE -MOVE INSPECTION EXCAVATION OR FILL TOTAL AMOUNT DUE I Hereby acknowledge that I have read this application; that The fn - formation Klvvn Is correct; and that I am the owner, or the duly author - I agof the owner. I agree to comply with ally and erste laws regu• ATTENTION APPLICATION APPROVAL ati motion; Iating constction; and In doing the work authorised thereby, no person will be employed In violation of the Labor Code of the Stale of Washington TINS PERMIT This application is not a permit until relating to Workmen's Compensation Imurance. AUTHORIZES signed by the Building Official or his Dep - NOTE: Permit limit One Year (Except DEMOLITIONS which ONLY TILE WORK NOTED Uty; and fees are paid, and receipt is ac - shall be completed In nlnely days; MOVED -IN BUILDINGS shall be cam- knowledged in space provided. Pleted In elk months.) SIGNATURE (UIVNER OR AGENT) DATE SIGNED INSPECTION DI 0R'S lONAT E �{ DEPARTMENT ` /•�- l(/ / t`•(. 1 1 CITY of / �' 2U EDMOND$ DATE ,�-`^----- NOTE: Applicant Subject to Plan Check Fee 7—J 775-2525 Thin Permit C C. cork to be done on Private Properly ONLY. Any construction on the Public domain (curbs, sidewalks, driveways, mmquces, Me.) will require sCpar.te Dermisslon. FILE