750199.pdf,A_
PER.. TEST
C _
W T/(L Lpz/ 'e'at=p,,z/�e4) %n f/(JL f0 U/—
REMARKS
r S
FI E TYPE OF STRUCTI STREET IMI
i
U n' //I' Yom(.' h /CAV /'s
eOn/.JS/S/.sw7' FT. Soni/� ae/L+—
•�� I
1
,:%a
_
L�vO/� /���� / J
SPECIAL INSPECTOR REQUIRED
❑ YES] NO
I OCCUPANCY OUP
CAB
ESIDENTIAL LINE
ONE NUMBER 750199
THIS SITE IS LOCATED IN THE
BUILDING DEPARTMENT
Applleant; Fill
OFEDMS. LOCAL SALES
slcN
n0D RETAINING
��_
SHOULD BE CODED 31.04.
REMARKS
A' , t•ro P—Y— Pim rli�'i /770
f{[•(� W C e ` V r `+
DEMOLISH
❑ EXCAVA E E] WALL
NCx..........Ft.)
PERMIT APPLICATION
Inside heavy Lines
aoB
SWIM
El
REP.IIR ❑ INSPh[OVE
❑ POOL
O
FENCE
NUA[BER OF STORIES NUMBER OF
ADDRESS I]()
0A) ^ DWELLING
P_ UNITS Otte
NAT E OF 111 TO HE DONE
,_: loiyEL 15� hl
NAME (OR NAME OF BUSINESS)
Valuation
Fee
BWIMMIN6 POOL
PERMISSIBLE UAL
�.
DEMOLITION
I
i
LOT COVERAGEq, COVERAGE
EXCAVATION OR FILL
MAILING ADDRESS i."R•r �
�: U /O O � �
36
PHEIGHT7881HLE HEIGHT PROPOSED HEI OHT
x
O /%`TELEP/HONNE
O� -
NUUMBER
ACTUAL LOT AREA TOTAL BLDG. AREA
z
l
formation given Is correct; and that I am the owner, or the duly author-
o -
(J'p'.S J
REQUIRED YARDS PROPOSED YARD!
p'
ized agent of the owner. f agree to comply with city and state law. reg.-
ATTENTION
APPLICATION APPROVAL
NAME
FRONT BIDE T BIDE REAR
REAR FRONT
WI II be employed In violation of the Labor Code of the Slate of Washington
+
ThiB application is not a permit until
F
AUTHORIZES
signed by the Building Official or his
NOTE: Permit Limit One Year (Except DEMOLITIONS which
I
LEGAL LOT VARIANCE OR CONDITIONAL USE
WADDRE88
F
YES NO PERMIT NUMBER
knowledged in space provided.
pletcd In el. m..the.)
PLANNING DEPT. APPROVAL - DATE:
INSPECTION
.I
DEPARTMENT
aCITY
NUMBER
_
r
-
1 • OZ9
CITY OF
(TELEPHONE
STREET R/LV
EXI8TIN6 STREET ft/W ............FT. DEFICIENCY THIS PROPERTY
EDMOND$
DATA
NOTE: At licant abject to Plan CGeck Fee
NAME
COMP. PLAN BT. R/W ............FT. ............FT.
yW
z+
�
775-2525
REMARKS
ADDRESS
C
k
'
(G
V See nn��
CHECKED BY
•i_ �, III r nitre. eennri... nrr„.l.einn
FCIT
YEL-E7PHOrNE NUMB/ER
J
I ,/
i
((
7 �%ib%%G! J
U
/ �d S -Y
METER SIZE BERVICE SIZE
CLEARANCE
CHECKED BY
STATE LICENSE NUMBER
CITY LICENSE NUMBER
I
I
I
y.
I
I
1 L-1 Dcacriniton of Pronerty (Show Below
or Attach Four Copies)
REMARKS �'•V� �/ / �.s�fv
/I AI t / \ lz�lIr
<
1
1
,A_
PER.. TEST
PERMIT NUMBER
W T/(L Lpz/ 'e'at=p,,z/�e4) %n f/(JL f0 U/—
REMARKS
r S
FI E TYPE OF STRUCTI STREET IMI
i
U n' //I' Yom(.' h /CAV /'s
eOn/.JS/S/.sw7' FT. Soni/� ae/L+—
•�� I
� YES
,:%a
_
L�vO/� /���� / J
SPECIAL INSPECTOR REQUIRED
❑ YES] NO
I OCCUPANCY OUP
CAB
ESIDENTIAL LINE
CHECK Y
PLAN D
THIS SITE IS LOCATED IN THE
xsty
NON-RESIDENTIAL
�°
OFEDMS. LOCAL SALES
slcN
n0D RETAINING
��_
SHOULD BE CODED 31.04.
REMARKS
A' , t•ro P—Y— Pim rli�'i /770
f{[•(� W C e ` V r `+
DEMOLISH
❑ EXCAVA E E] WALL
NCx..........Ft.)
ALTER
OR FILL (E
1
SWIM
El
REP.IIR ❑ INSPh[OVE
❑ POOL
O
FENCE
NUA[BER OF STORIES NUMBER OF
0A) ^ DWELLING
P_ UNITS Otte
NAT E OF 111 TO HE DONE
,_: loiyEL 15� hl
WALL
Valuation
Fee
'
Plan Check No .....................
i
BUILDING
PROPOSED UeE
'Q
PLUMBING /
l
• SO
PLOT PLAN (Indicate Building setback., abutting street.)
HEAT & GAB LINE
1
tl
I
O
FENCE
SIGN
tRETAINING
WALL
BWIMMIN6 POOL
�.
DEMOLITION
I
i
PRE -MOVE INSPECTION
EXCAVATION OR FILL
'
TOTAL AMOUNT DUE
I hereby ncknawtedgo that I haus rand this application; that the In-
formation given Is correct; and that I am the owner, or the duly author-
ized agent of the owner. f agree to comply with city and state law. reg.-
ATTENTION
APPLICATION APPROVAL
lat(ng aonstrucUcn; and In doing the work authorized thereby, no person
WI II be employed In violation of the Labor Code of the Slate of Washington
THIS PERMIT
ThiB application is not a permit until
relating to Workmen'. Compensation Insurance.
AUTHORIZES
signed by the Building Official or his
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTE
uty; and fees are paid, and receipt is Be
shut[ be completed In ninety days; MOVED -IN BUILDINGS shall be cam-
knowledged in space provided.
pletcd In el. m..the.)
SIGNATURE (OWNER AGENT) DAT1: STONED
INSPECTION
DIRECT 8 BSO URE
DEPARTMENT
_
r
1 • OZ9
CITY OF
EDMOND$
DATA
NOTE: At licant abject to Plan CGeck Fee
�.,
775-2525
This Perndt rovers Work to W done int private property ONLY.
Any rvnul ni O Wn on Il.• pnbllr .1 borne, sldewnik.� drlr ,:. ,
FILE
•i_ �, III r nitre. eennri... nrr„.l.einn