740523.pdfPERMIT
BUILDING DEPARTMENT Appncant FIB ZONE NUMBER 74052.3
PERMIT APPLICATION IHuldo Heavy Linos p
ADDRESS
NAME (Oft NAM OF BUSINESS)
A L '� o - LOT CO BIBLE T / ACTUAL
7J11 IAT COVERAGE ( LOT COVELGE ly
ALONG ADDRESS p !�
PEAAIIdBIHLE HEIGHT PROPOBDD HEIGHT x
1117
O T ` TELEPHONE NUMHB;R ACTUAL LOT AREA TOTAL BLDG. AREA x ,I
n f 1, rAA/w
U
F
12-
FRONT HIDE REAR FRONT BIDE REAR
LEGAL LOT VARIANCE OR CONDITIONAL USE
YES NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
STREET R/W
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
REMARKS
FIRE ZONE I TYPE
SPECIAL INSPECTOR
[] YES [ NO
YES ❑ NO
Valuation I Fee
AX
1_ •-
t'lan Check N
RESIDENTIAL
❑
GAS
Ou
NEW
W PROPOSED USE
LIN
LINE
'
yy
NON-RESIDENTIAL
F_1
SIGN
ADD
El
DEMOLISH
ElWALL
KING
FENCE
ALTER
i
E
❑
I, I
❑
On FILL
j
( x .......... Im
REPAIR
PNP-T1SOVE
SWIMMING POOL
PI.
❑
OOL
;UMBER OF STORIESNUMDER
OF
EXCAVATION OR FILL
DWELLING
s
UNITS
I hereby ,knowledge that I have rend this application; that the In.
formation Elven Is correct; and that I ant the owner, or the duly author.
FRONT HIDE REAR FRONT BIDE REAR
LEGAL LOT VARIANCE OR CONDITIONAL USE
YES NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
STREET R/W
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
REMARKS
FIRE ZONE I TYPE
SPECIAL INSPECTOR
[] YES [ NO
YES ❑ NO
Valuation I Fee
AX
1_ •-
t'lan Check N
i
BUILDING
W PROPOSED USE
'
yy
PLUMBING
HEAT a: GAS LINE
PLOT PLAN (Indicate Building setbacks, abuttin6 .tresis)
FENCE
i
SIGN
I, I
RETAINING WALL
j
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
s
TOTAL AMOUNT DUE
I hereby ,knowledge that I have rend this application; that the In.
formation Elven Is correct; and that I ant the owner, or the duly author.
_
Ized agent of the owner. I agree to comply with city and elate law. regu•
ATT);NTION
APPLICATION APPROVAL
lating cunetruttIon; and In doing the work authorized thereby, no Person
Will be employed In violation or the Labor Code of the Stale of Washington
THISPERMIT
This application is not a perinit until
relating to Workmen's Comp.nentlon Insurance.
AUTHORIZES
signed by the Building Official or his Dep-
I
NOTE: mit Limit One Year (Except DEMOLITIONS which
ONLY TILE
wORE NOTED
uty and fees are paid, and receipt is ac-
__
ho ompl ted 1n nloety days; aIOVED•IN BUILDINGS shall be cam•
knowledged In space provided.
�letI alz m ntha.)
rt
I
dl A' RE ( WNER OR AGENT)
DATE ONED
INSPECTION
INSPECTION
DIR 0
Lr
DEPARTMENT
.l`}L,:e1%t�/'
L
CITY OF
EDMUNDS
DAT
NOTE: Applicant Subject to Plan Check Fee
775-2525
This Penult toren Work to be done on DIR'ala property ONLY.
Any tonslruellon on it,. public domain (curbs, sidewalks, drivoway.,
FILE
n,nr a„ vi r.l ,rill rrn,rlrr nrpnrnir Prn,denlon.