750024.pdfPERMIT APPLICATION I Inside Heavy Lines
NAME R NAME OF BUSINF d)
sl MIiILIN6 ADDRE
� IMBE
CITY NE NUMBER
ADDRE88 '
7O y-
I99
PERMISSIBLE %
ACTUAL
LOT COVERAGE(
LOT COVEKADE
PERMISSIBLE HEIGH ]6-1
PROPOSED HEIGHT
ACTUAL LOT ARE
TOT/ B EA
/
REIII D ftD0
PR POSED YARDS
FRONT81 REAR
FR/IONJT SIDE REAR
AA
El
LE AI LOT VARIANCE OR CON TIONAL USE
GI YES rl NO PERMIT NUMBER
NEWLOCL
EXISTING STREET R/W'.:...,.'.:.`�.S r. DEFICIENCY^^THIS PROPERTY
COMP. PLAN ST. R/W'DD� . .F/.....Fr.
REMARKB Driveway slopes not to exceed those
indicated on Standard Dwg. No. 103
CCKEED BY
Aft WIlid kotf ALDE[ulboD ta-rm Dlsf. I CHEim-
or Attach Four Copies)
i/N��Iw FOU✓Q Wi�iK I'r-r CUKUP
TYPE CONNECTION `� VERIFIEjI RY
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5A0 5'Ewis1C �FUIV, ! CA//(
FERC. TEBi—y i
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PERMIT
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YE9 NO
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Plan Check N
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YE9 NO
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BUILDING
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SPECIAL INSPECTOR REQUIREDOCCUPANCY GROUP
RESIDENTIAL
El
GAS
[3 YES NO I F— Z
NEWLOCL
H.-./) ty
/7—
LINE
PLAN CH 'CBE
THIS SITE IS LOCATED IN THE CITY
-11d159
NON-RESIDENTIAL
SIGN
II
/" 0SLUED SALES TAX
ADD
PLOT PLAN (Indicate -
10 Setbacks, abutting streets)
HEAT do GAS LINE
BE CODED 31.04
'
❑DEMOLISH
ElVATI.AI.INING//R/K9
ALTER
EOR
PENCE
A/LLL
A)0/24lny�PM v/l3C � 97�/'3fj
❑
PILLXCAVATE
❑
x..........Fl.)
SIGN
REPAIR
❑
SPRE-AtOVE
❑
POOL SwII
f`"''
/� )� T
sem'_`' T W�s¢/� ' "1L PLAW li
YUAIBER Ob' STORIES
NUMBER OF
�
yf
/�
�,•M
DWELLING
I UNITS
u �
Plan Check N
%1 ,/ (JU
.
F0
BUILDING
/ y ` - 1
G� a///���
L
aPLUMBING
PROPOSED USE
H.-./) ty
/7—
-11d159
II
PLOT PLAN (Indicate -
10 Setbacks, abutting streets)
HEAT do GAS LINE
II
21
FENCE
I
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
O
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
formation given in correct; and that 1 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
leting construction; and In doing the work authorized thereby, no person
will be employed In Violation of the Labor Code of the Stale of Washington
TIUS PERMIT
This application Is not a permit until
ml¢ting to workmen's Compensation Insurance.
AUTHORIZES
eigned by the Building Official or his Dep -
NOTE: Permit Limit One Year (E—pt DE51OLITIONS which
TILE
uty; and fees are paid, and receipt is ac -
shall be completed In ninety days; MOVED -IN BUILDINGS shall be wm.
WORK NOTED
knowledged in space provided.
pleted In six months.)
SIGN TUBE (0%NER OR AGENT) DATE SIGNED
INSPECTION
DIRE OR'
Q p
DEPARTMENT
CITY OF
NOTE: Applicant Subject to Plan Check Fee
EDhIONDB
DATE /
775-2525
This 1'er.alf. r work I. be done on Private properly ONLY.
Any tot. ortloo an the Pnlilic tNmnln (rnrbs, slAeu'nll<s, drice.rnys,
ryui a .l ..III rennlrr ee,m I, p'' n.l•.Inn.
FILE
111
CITY OF EDMOND
DEPARTMENT OF BUILDINGS
CERTIFICATE OF OCCUPANCY
UNIFORM BUILDING CODE, Sec. 306
At 21108 HIGHWAY 99 Building Permit Number #750024
i .
Occupancy established by this certificate:
Fire Zone 11 No, Stories 1
F-2
Type Const. V—N Basement NO
Floor Load signs in place (per Sec, ajoB U.B.C.) — Capacity signs posted (per Sec, 3301 (i) U.B.C.)
Floor load and root capacity signs, when required, nrnst remain Hosted at all times.
THE RFAIITY SI40P HAS BEEN INSPECTED AND APPROVED AS COMPLYING WITH
PROVISIONS OF THE EDMONDS BUILDING CODE AND WITH UNIFORM BUILDING CODES.
Issued this 4th day of November 1975
i
CHIEF BUILDING OFFICIAL By t
This certificate shall be posted in a conspicuous public area and shall not be removed, mutilated or obscured and shall be main-
tained in legible condition at all times. Any change of occupancy requires a new certificate.