750293.pdfUSE PERMIT� i
BUILDING D PARTMENT ZONE %S _ pj NUMBER 75�27�
Applicant FBI
�- - PERMIT AP LIGATION Inside heavy Lines JOB
ADDRESS
NAME (OR NAME OF BUSINESS) ! I
/-1I _ /nw/ POT C.E R 7u !7 ACTUAr D i j
���o l7 �- /`eQ/G�/1rd LOT
COVERAGE 2/' 1D LOT C VE GE
MAILING ADD1tEBS J i7 Pll P08ED
p�[�7 /� 0 f `. PEFtA71SSIBLE HEIGHT � �i1 '
O ACTUAL LOT ARE A /a gaQO 1 -
CITY T PHONE NUMBER t/' ,�] 7' 0.
tD62?d^/D 7 3 - Z9'f / REpU1RED ARDS PROPOSED ARUB
NAME FRONT BIDE HEAR FRONT 2WIDE— HEAR
VARANCE/OR CONDITIONAL US ' / t '
W
All"'E9 NO PERMIT NUMBER
U /, 7o N. NUMBER
P N N6 DE T. APP j
of CITY L/ 1' TfELF.PHONE '
cc 1FIg1Wa.t VS 7 13-z95�i / t�
STREET R t O
EXISTING 8 EET R/W ............F7'. DEFICIENCY THIS PROPERTY ,
NAME COMP, PLAN ST. R/W ............FT. ............FT• ! .
D L(/ /(�,� 2 REMARKS C
ADDRESS f
bi
ICHECKED BY
.1 CITY I TELEPHONE NUMDER
F
METER 812E I SERVICE SIZE I CLEARANCE ICHECKED BY
STATE LICENSE NtiMBERI CITY LICENSE NUMBER
REMARKS i
as DCacrlPtlon oL Property (Know Below /or Attach Four Copies) A
if le e-e-vu/H �%/L TYPE CONNECTION I VERIFIED BY
I
Lo7 3
N PER0. TEST PERMIT NUMBER Cd
Yy I
O
fd REMARKS
a
FIRE ZON TYPE OF ONSTRU 'ION STREET IMPROVED
I/ I A Ad 0 YES 0 NO
SPECIAL INSPECTOR REQUIRED OCCUPA)rr7CY GROUP
CAB
YES )(No�/
RESIDENTIAL ❑ LINE PLAN CHECKED BY 1 THIS SITE 15 LOCATED IN THE CITY
NEW �%,� / OF EDMONDS. LQCAL SALES TAX
NON-RESIDENTIAL El SIGN / v SHOULD BE CODED 31 M !
El ADD ❑
DEMOLISH ❑ RETA NING REMARH9
❑ ALTER ❑ ORCFILL FENCE
E (..........x..........Fl.) I
BWII
REPAIR ❑ PIRB MOVE ElPOOL
NUAIBEIi OF STOI IES NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO SE DONE Valuation rsacelpt No.
jpoG sfi�E� N
- Pian Check Nu..................... �r 1
[0 BUILDING n� Q 06
4 PROPOSED USE
PLUMBING
V
PLOT PLAN (Indicate Building eetbacke, abutting street.) HEAT k GAS LINE
I
FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION I
PRE-MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE 66 (/
I hereby eckmwlodgo that I have read this application; that the In-
formation given Is orrecl; and that I non the owner. or the duly author-
lied agent of tun o nen I agree to comply with city and stat. laws rogu- ATTENTION APPLICATION APPROVAL
lating eoaetruoUoa; end In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Slate of Washington THIS PERMIT This application is not a permit until
relating to Workm n's Compensation Insurance. AUTHORIZES signed by the Building Official or his Dep-
ONLY THE
uty; and Pees aro old, and receipt is ac-
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED p p
.hall be completed n rdesty day,; MOVED-IN BUILDINGS shall be Co.- knowledged In space provided.
meted In six month.)
SIIGG/NATU.,RE (OWN Ali OR OEN DATE B10NEU INSPECTION DIRECT B10 HE
DEPARTMENT j
. 6 -2,r— 71— CITY OF
EDMONDS DATE
NOTE: APplicdn Subject to Plan CGeck Fee 775-2525
This
1'ermlt c ork In Ua done on Private properly ONLY.
Any conslrucllaton the pub11C tlom.ln IeurUg, sidewalks. driveways, FILE
merge es, etc.) w01 require generate Permlgsl.n.
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