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750204.pdf7._...... _ ...._.-2 _... r UBE PERMIT BUILDING DEPARTMENT Applicant Fill ZOO Nun1HER ,- r f1 ,1 PERMIT APPLICATION Inside Heavy Linea I GH .( / �. /J� w� —I - ADDRESS J ©O"'�' NAME (OR NAME OF BUSINE B) � RAOEe LOT COVESYAOE IAT COVERAGE LOT I j I l MAII.IN6 ADDREGl PEIIeeIHLE XEIGIIT PROPOSED IiI:l ial py I O�. TOTAL BLD°. AREA 7. O CITY ACTUALOHT MWPHONE NUMBER LOT AREA / REQUIRED YAHOB PROPOSED YA—H FRONT HIDE REAR c i FRONT HIDE REAR NAME I LEGAL LOTROR CONDITIONAL USE 11 ADDRESS 0 YES� NO PEERMITMIT NUMBER yN yl O PLANNING DEPT. APPROVAL DATE: CITY I TELEPHONE NUMBER STREETR/W EXISTINGSTREET A/W ............F1'. DEFSCIENCY THIS PROPERTY ST 0 � NAME ,...........FT. COMP. PLAN 8T. R/W ............Fr.+ 41 I // ��// l R EMARKH RAA��� "' CHECKED BY /h- CITYv9 fir/ �L TELEPHONE NUMBER I -� METER SIZE SERVICE SIZE CLEARANCE CHECKED BY I {0: F STATE LICENSE NUMBER CITY LICENSE NUMBER I I I REMARKS I Lcgnl Doec[Ip[lon of Yrope[ty lehow Below ar Attach Four Copies) TYPE CONNECTION VERIFIED BY PERC. TEST PERMIT NUMBER fG � I � WREMARKS m� I I 1 I O a V � j FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED. I I YES NO I l E] 13 SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP 6AB RESIDENTIAL LINE E] YE8 C3NO I ❑ NEW PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY NON-RESIDENTIAL slcx OF EDM0ND5. LOCAL SALES TAX BE CODED 31.04, I ADDElRETAINING SHOULD REMARKS DEMOLISH WALS' F NCE Fence requirements -section 12.14.040 ALTER EXCAVATE ,,// OR FILL yLi.4S...�f:..Fl.) swim attached. ❑ REPAIR ❑ PRE -MOVE 0 POOL INtlP. I NUMBER OF STORIES NUMBER OF DWELLING I UNITS No, NATURE OF WORK TO BE DONE Vnlaalinn Fee Receipt Plan Check No ......... ........... I [7 BUILDING 4 PROPOSED USE 4 PLUMBING . PLOT PLAN (Indicate Building setback., abotIFI; street.) HEAT A GAB LINE H 7 FENCE O�^ O p� Q o ! ,-C SIGN RETAINING WALL N SWIMMING POOL DEMOLITION PRE -MOVE INSPECTION EXCAVATION OR FILL TOTAL AMOUNT DUE J� Q D I hereby acknowledge that I have read this appllc¢tlon; that the In. formatlon given Ie correct; and that I am the owner, or the duly author- Ired agent of the owner. I agree to comply with city and state law. regu- ATTENTION APPLICATION APPROVAL lating construction; and In doing the work authorized thereby, no person , will be employed In vlolnllon of the Labor Code of the State of Washington TIUS PERMIT This application is not a permit until relalleig to Workmen's Compensation Insurance. AUTHORIZES signed by the Building Official or his Dep - NOTE: Permit Limit One Year (Except DE31OLITIONS which ONLY THE {YORK NOTED Uty, and fees are paid, and receipt is ac- ehnll be completed In ninety days; MOVED -IN BUILDINGS shall be Coin- knowledged in space provided. rifled In s1. months.) SIGNATURE (OWNER Olt AGENT) DATE SIGNED INSPECTION D1R OR -8 H(�iNATU 7S_ DEPARTMENT - (, �:. .!� .)/..•,.'.%j Fee CITY OF EDDIONDB pl:(it:{-h,� DAT—� 7577 _ ----- NOTE: AQhlicant SRkjccl to Plan Cherk 775.2525 This PrI nil c two work W IM done on privnl. property ONLY. Any construction on the public domain (curbs, .Idfwulk., driveways, FILE marquees, etc.) will require re Varale permisslon. 4