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PERMIT
ZONE 750082
BUILDING DEPARTMENT
Applicant Fill
NUMBER
6
PERMIT APPLICATION
Inside Heavy Linos
ADDRESS / �, / Q LFST.
NAI, .OR NA OF BUSINESS) e
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PERAIIddISLF. ^' ACTUAL
IAT COVERAGF. rr� LOT COVESRAOE((� (\
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AI N6 ADDRESS
PEI[M IBSIBLE HEIGiI PftOPOeHD FII:IOH1�
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COY TE/L�EnnPHO/N-E NUMBER
ACTUALeOT AREA TOTALLDO� A
�PRROP09ED
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RLL/EQUI�RED YAIiD9 YARDS
NAME
FRONT BIDE REAR FRONT BIDE REAR
/S 21' S' 4S
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LEGAL LOT VARIANCE OR CONDITIONAL UBE
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ADDREBd
Rl YES [:INO PERMIT NUMBER
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NUMBER
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EXISTING STREET R/W� .4, DEFICIENCY THIS PROPERTY
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NAME
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PLAN ST. R/WI?.•.!,0FT.
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COMM. ..5.,/....pT.
'Driveway slopes not to exceed those
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ADDRESSREbI
indicated on Standard Dwg. No. 103
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CHECKED BY
CITY
TELEPHONE NUMBER
METV SIZESERV1
E SIZE
CLEARANCE
CHECKS BY
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STATE LICENSE NUMBER
CITY LICENSE NUMBER
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REMARKS
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FIRERS Z — TYPE OF�T711; 1S[ STREET IMPROVED
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SPECIAL INSPECTOR REQUIRED (OCCUPAp�jylY G
RESIDENTIAL
❑ GAS
❑ YES NO .ii//+7+7 JJ��JJ
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NEW
LINE
PLAN CHEC BY aFl ES TAX
❑ ON
B1GN
EDMONDS OCALi SA
BE CODED 31.04.
ADD
RETAINING
,7f7 SHOULD
B MARK
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DEMOLISH � WALL
ALTER EXCAVATE FENCE
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OR FILL <..........x .......... Vt.)El
REPAIR ❑ WIM
PRE- El POOL
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//O'LY �' C�% iO V/✓
NUMBER 0111 9 OR1119 NUMBER OF
V� ��� DWELLING
UNITS(L.JJAN1
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NAT�U,R/E-�OF� ORI{ T/O BE DAO}NSE
V¢lunllorl
Fee
Receipt No.
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Plan Check No.
BUILDING
33/L6
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PROPOSED USE
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5/N7� F�n�t. �<S
PLUMBING
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PLOT PLAN (InUlcnlo Bulldln6 Setbacks, abutting streets)
HEAT & GAS LINE
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FENCE
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SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION Olt FILL
TOTAL AMOUNT DUE
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I hereby acknowledge that 3 h¢ve rend this application;that the In•
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formation glue" Is correct; and that I em the owner, or the duly author-
Ired agent of the owner. I agree to comply with city and state ]&We raga.
ATTENTION
APPLICATION APPROVAL
Inting construction; and In doing the work authorised thereby, no person
WillbeemVloyed In violation of the Labor Code of the Stale of Washington
T1118 PERMIT
This application is not a permit until
relating to Workmen's Compensation Insurance.
AUTHORIZES
Signed by the Building Official or his Dep-
NOTE: Permit limit One Year (F.gcept DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt Is ac -
shall be comP!eted In ninety days; MOVED -IN BUILDINGS shall be win.
knowledged In space provided.
ple •d la m37r—
SI TUitE (OWNSIt Ott A ENT)DATE GNED
INSPECTION
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DEPARTMENT
CITY OF
NOT'E: Applicant Subject to Pian Check Feel
EDMONDS
ATE -
775-2525
This Permit c ork In bo dmte on pr1-te property ONLY.
Any .........t ton..... Vnblle nlUrnnikn, drlreweye.
FILE
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RECORD OF INSPECTIONS
Date Passed
Foundation
Plumbing (Partial)
(Rough)
Frame
Furnace & Fuel Lines � -'�7.0 CIF-2—
Final
Final
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