114 4TH AVE S.PDF114 4TH AVE 5
STREET FILE Side Sewer Drawing
The City of EdmoMi EASEMENT NO- ---------------- ---------- ----------------
NEW CONSTRUCTION ❑ REPAIRS El LID NO- ------------------ - ASMT. NO. ------------------
OWNER LAJAJ C,!�--- - ----- CONTRACTOR --------------------------- -------------- -- -------------------------------------- PERMIT NO. --------------------
-c Fe --------- --------------
JOB ADDRESS ------
-------------- LEGAL DESCRIPTION: LOT NO. ------ - ------------- ............ BLOCK NO. ----- C .......... ..............
...........
..................... ............................................... I ---- P - ... S. -
NAMEOF ADDITION ........................................... -------- -- ----------------------------------- ..................
� ECfpt 1:z - I � I 0-,Vc� W - (z 4, �ercop
S+t KAL
6-
e ,s: �,C, d,
-bvuo (-
L e�4
vk6
33.&C �e 1 ec�
. Ese /0 Approved:
PWW-0001-1 1175 (REV. 11/78) 42-4q-
DATE ... .... T 1----------- I- By ----- -------------- ---------------------------------
USE
BUILDING DIVISION' ZONE tE IVMBER
Applicant Fill
PEST APPLICATION inside Heavy Lines
r NAME OR NAME Of' p[ 55 t
9h . �.. i1 .f'f/ �f LEGAL DESCRIPTION SUBDIVISION SNOY2T
ty MAIL) ADDRESS 1 '4
F.
U
h ADDRESS
I
U
a CITY dTELEPNONE NUMBER
t 1
NAME _--�
O ADDRESS E!
a CITYA TELEPHONE N MBER
i�'_,�
USTATE LICENSE UMBER CITY LICENSE NUMBE
Legal Description of Property (Show Below or Attach Four Copie
U It
Ord 1
W �1
E i
W
J
PUB LI - Y PER OFFICIAL STREET MAP
EXISTING
PROPOSED
DEFICIENCY OF RIGHT OF WAY
PUBLIC IMPROVEMENTS REQUIRED
❑
rc
DRAINAGE IMPROVEMENTS REQUIRED
❑
O
y
DRAINAGE PLAN REQUIRED
❑
U
UNDERGROUND WIRING REQUIRED
❑
m
CONNECTION TO SANITARY SEWER
❑
6
SEPTIC TANK PERMIT REQ'O ❑ NO.
ELEVATION OF PROPERTY CORNERS
❑
Q FOOTINGS REQ'D
SEE ENGINEERING MEMO DATED
CHECKED BY -
METER SIZE
BUILDING SUPPLY SIZE
fz
W
REMARKS
+'
3
SIGN AREA
ALLOWED I PROPOSED
REMARKS
VARIANCE OR CU
YARDS
FRONT
aNEW
[0
RESIDENTIAL
n LINE
FIRE ZONE
NON-RESIDENTIAL
® SIGN
r
D
ADD
DEMOLISH
RETAINING
SPECIAL INSPECTOR
REQUIRED
DWALL
ALTER
0OXRc
EXCAVATE
FENCE ---�
❑ YES ❑ NO
DREPAIR
®
PRE-WIM
INSP.
Q POOL
CHECKED BY
Z MUMMER OF STORIES
tVUMeER OF
EMARKS
O
DWELLING
I;,
UNITS
[PLAN
NATURE OF WORK TO Be: DONE
a
U
W
Y a
rry
LAN CHECK FEE
1l �q
BUILDING
PLUMBING
STREET FILE FENCENICAL
uNi "Applicant. on behalf of his or her spouse, heirs, assigns and SIGN
J successors in interest, agrees to indemnify, defend and hold harmless
f the City of Edmonds, Washington, its ofr"icials, employees, and RETAINING WALL
a agents from any and all clai^ns for darmages of whatever nature,
i arising directly or indirectly from the issuance of this permit. lssu- SWIMMING POOL
ENV. REVIEW ADS NO.
IPLETEI EXEMPT
PLANNING REVIEW BY DATE
LOT COVERAGE
SIDE REA
OF
L SALES TAX
VALUATION I FEE
o�
ance of this permit shall not be deemed to modify, waive or reduce
,0, any requirement of any city ordinance not Ilmit in arty way the
-�� Ave, � o -
M
DATE':
MEMO TO: BUilding Division
Community Development'Department
FROM; Engineering Division
Public Works Department
SUBJECT:
After review of the subject b I uilding permit application, we have
the following comments:
P40