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750415.pdfu , W 0 PLUMBING W HEAT & GAS LINE — rAl FENCE it i t SIGN _ 1, '! BUILDING DEPARTMENT Applicant Fill USE Q PERMIT 'r-- .ZONE NUMBER I' PERMIT APPLICATION inside Heavy Lines JOB �01 ADDRESS �r7 i? Ny.�IE (OR NAME OF BUSINESS) 11 ��r I'�CL/Y S Gi"v LEGA1/,,LOT LDT AR A UBDIVISION NO. , formation given Is correct: and that I am the owner, or the duly author- JW l MAILING ADDRESS 1 liT YES ❑ NO OOH A°B NO. it lating construction; and In doing the wark authorleed person WIll be employed In violation of the Labor Code of the State of Wuhingtm THIS PERMIT i� J Z 'K' S_ � Ile_ � S_I y rl ` 1 VARIANCE OR COND. USE NO. AUTHORIZES signed by the Building Official or his Dep- NOTE: Permit Limit One Year (Except TIONS which ; 0 CITY /� �' TELEPHONE NUMBER O Z WORK NOTED knowledged In space provided. PROPOSED YARDS FRONT �' SIDE `Q , REARS' GH O� INSPECTION NAME ALLOWABLE PROPOSED _ SIGNTORE AGENT) J - DIR TO R'S NAT `�Y/ _•.` /r' /..._ter F SIGN AREA SIGN AREA CITY OF LG,t,'..�.-Irl.-1 c/•%. U W ADDRESS 41 L DATE NOTE: Applicant Subject to Plan Check Fee 775.2525 F = OTHER REQUIREMENTS IMI --S This Permit covers Work to be done on private roperty ONLY. on the domain tdurbs, sidewalks, driveways, ORIGINAL -File YELLOW -Inspector- U a; CITY TELEPHONE NUMBER —PINK - Ci:•. --:r GOLD. •'r Q PLANNING D T. APPROVAL � — DATE NAME L�7 E STREET R/W EXISTING STREET R/W FT. DEFICIENCY THIS PROPERTY Y p ADDRESSFT. F COMP. PLAN ST. R/W FT. €1 W CITY TELEPHONE NUMBER REMARKS t N W fz W p U STATE LICENSE NUMBER CITY LICENSE NUMBER CHECKED BY W ,. Z 1 Legal Description of Property (Show Below or Attach Four Copies) STREET AND/OR UTILITY ❑ YES ❑ W ' l WORK REQ'D NO 0CAI UNDERGROUND ❑ YES Z (\ \ I CG WIRING REWD ❑ NO BY 6 l VERIFIED TYPE CONNECTION uElYES agj 3 SEPTIC SYSTEM PERMIT NUMBER W O APPVD BY CITY ENG. ❑ NO W J O W '1 REMARKS (/ # E METER SIZE SERVICE SIZE CLEARANCE CHECKED BY 't REMARKS NEW 1§�RES....T.Al_ GS� LINE ❑NON-RESIDENTIAL •�I II FIRE Z � TYPE OF , U71N CODE N o- � ^ —73 U6 e�'/ ❑SIGN ® ADD ❑O RETAINING DEMOLISH WALL SPECIAL INSPECTOR REQUIRED AREA OCCUPANC GROUP OCCUPANT LOAD - F `: ❑ ALTER EXCAVATE FENCE [—]EXCAVATE OR FILL ❑ (_ X_FT) ❑ YES O PLAN CH CKE BY THIS SITE LOCATEDLfft I ALES TN THE AXOF p E]REPAIR❑PRE-MOVE SWIM INSP, POOL BIS SHOULD B 2 NUMBER OF STORIES NUMBER OF DWELLING I UNITS R MARKS t '0 1 in NAT `R�OF WORK TO BE DONE in I I j kr rJi�: Com,-t�0—�^--r•,cSl_ -4-- Y0"n-1 VALUATION FEE PROPOSED USES z , PLAN CHECK /U _CL/\�/ a PLOT PLANINDICATE BUILDING SETBACKS. - ABUTTING STREETS) BUILDING J u , W 0 PLUMBING W HEAT & GAS LINE — 0 FENCE it i SIGN _ 1, '! RETAINING WALL I' SWIMMING POOL oC I� �• TOTAL AMOUNT DUE pl I hereby acknoWledge, that I have read into application; at the In- formation given Is correct: and that I am the owner, or the duly author- Iced agent of the owner. I agree to comply with city and elate I.— go- thereby, no ATTENTION APPLICATION APPROVAL •;� lating construction; and In doing the wark authorleed person WIll be employed In violation of the Labor Code of the State of Wuhingtm THIS PERMIT This application is not a permit until 1 •� I' relating to Workmen's Compenealtan Inaunnce. AUTHORIZES signed by the Building Official or his Dep- NOTE: Permit Limit One Year (Except TIONS which ONLY THE nty; and fees are paid, and receipt is ac- DINGS shall he completed In Nnely days; atOVED-IN BUILDINGS ahali be Com- WORK NOTED knowledged In space provided. pleted In eIx monthe.> INSPECTION _ SIGNTORE AGENT) DATE SIGNED _ DEPARTMENT DIR TO R'S NAT `�Y/ _•.` /r' /..._ter �. J:• (• u CITY OF LG,t,'..�.-Irl.-1 c/•%. EDMONDS DATE NOTE: Applicant Subject to Plan Check Fee 775.2525 q This Permit covers Work to be done on private roperty ONLY. on the domain tdurbs, sidewalks, driveways, ORIGINAL -File YELLOW -Inspector- Any construction public �1� nmrquaes clr..l 11ill require.parate permission. _- _ - - —PINK - Ci:•. --:r GOLD. •'r