750271.pdfBUILDING DEPARTMENTApplicant Fill
USE PERMIT
° PSS - NUMBER750271
PERMIT APPLICATION Inside Heavy Linea
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NAME (OR NAME OF BUSINESS)
ADDRESS
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PERMISSIBLE OTUAL L
LOT COVERAGE LOT COOE
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MAILING ADDRESS
PERMISSIBLE HEIGHT ^ / PROPOSED HEIGHT,
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TELEPHONE NUMBER
ACTU L L,/O'T� ArR{E�A TOTAL BLDG. AREryAt
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REQUIRED YARDS PROPOSED YARDS
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NAME/
FRONT REAR 816E REAR
/BIDE 2FRONf
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ADDRESS
LF -'VAI. LOT VAN A_rN OR DITIONAL USE
�I YE8 NO PERMIT NUMBER
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N NO D PT AP TE:
CITY
TELEPHONE NUMBER
STREET
EXISTING It/ EET R/40/9 9FT. DEFICIENCY THIS PROPERTY
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COMP. PLAN BT. R FT. D...,FT.
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REMARKS
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Driveway slopes not to: '.exceed those
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indicated on Standard Dw No. 103
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CITY
TELEPHONE —NUMBER
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CHECKED BY
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STATE LICENSE NUMBER
CIT LICENSE NUMBER
BILE BEliVICE SIZE
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CLEARANCE
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Legal Description of Properly (Show Below or Attach Four Caplan)
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PLAN CHECKED BY THIS SITE IS LOCATED( IN THE CITY
NON-RESIDENTIAL s1cN
gOULD BE CODED 31.04.SALES TAX
ADD RETAINING
DEMOLISH El WALL
REMARKS
ElALTER EXCAVATE FENCE
Olt FILL (..........It .......... M.)
f7REPAIR PIRE-MOVE SWINI
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❑ SP ❑ POOL
NUMBER ON STOlt1E8 NU OF
IMBER
DWELLING
/ UNITS
NATURE OF WORK TO BE DONE.
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PROPOSED USE
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PLOT PLAN (Indlenlo Building setbnclts, abutting Streets)
HEAT & GAS LINE
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RETAINING WALL
SWIMMING POOL
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DEAIOLITION
PRE -MOVE INSPECTION
EXCAVATION OR PILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In.
formallon given le correct; and that I sat the owner, or the duly author -
(red agent tr the owner. I agree to comply with city and State I.—ergo-
Inling construction; and In doing the work authorized Hereby, no person
ATTENTION
APPLICATION APPROVAL
will toemployed In violation of the Labor Code of the State of Washington
relaling to Workmen's Compensation Insurance,
THIS PERMIT
This application is not a permit until
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AUTHORIZES
signed by the Building Official or his Dep-
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NOTE: Permit Limit One Year (Except DE51OLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
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shall be completed In ninety day.; MOVED -IN BUILDINGS shall be arm-
knOWled ed 1n s
plated In six mon eJ
g pace provided,
81G TUBE (O E DATE SIGNED
INSPECTION
DIRECT R'B B URE
DEPARTMENT
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7_57
CITY OF
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EDMOND9
DATE!
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NOTE: Applicant Subject to Plan Check Fee
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This Permit --work to 1. done an peltate property. ONLY.
775-2525
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Any construction on the Quilt domain (curbs,.Idewelks, driveways,
nurrgnrrn. rir.) „ill n•mdrr nrparolr prnnlnninn.
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