1221 CORONADO PL S.PDFIIIIIIIIIIIIII
10668
1221 CORONADO
PL S
ADDRESS:
TAX ACCOUNT/PARCEL NUMBER: U'D) ((D]] Q 22 U 0 0 O ?3D 0
BUILDING PERMIT (NEW STRUCTURE): ' "L 5 -I O DZ���)
COVENANTS (RECORDED)
CRITICAL AREAS: DETERMINATION: ❑ Conditional Waiver ❑ Study Required ❑ Waiver
DISCRETIONARY PERMIT #'S:
DRAINAGE PLAN DATED:
PARKING AGREEMENTS DATED:
EASEMENT(S) RECORDED FOR:
PERMITS (OTHER): Iqq D 5/ !? �-,,jui��� il�5��.hJ
PLANNING DATA CHECKLIST DA'
SCALED PLOT PLAN DATED:
SEWER LID FEE $:
LID #:
SHORT PLAT FILE: LOT: BLOCK:
SIDE SEWER AS BUILT DA
SIDE SEWER PERMIT(S) #:
GEOTECH REPORT DA
STREET USE / ENCROACHMENT PERMIT #:
FOR:
WATER METER TAP CARD DATED:
LATEMP\DSTs\Forms\,Street File Checklist.doc
APPLICATION
The Cityof Edmonds for
SIDE SEWER PERMIT EASEMENT No ...........................................
NEW CONSTRUCTION O REPAIRS
401-01000
OWNER........... Donald --- F....Burger-------------------------------------------------------- CONTRACTOR..........----------...........----............................................................... PERMIT No.......................
ADDRESS .......1221 Coronado P1aCe.............................................. LEGAL DESCRIPTION: LOT No. ................ .............................. BLOCK No. ............................................
•
NAMEOF ADDITION.........................................................................................................................................
•
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Dye Tested On Sewer 1972
Approved:
DATE................................................ By.............--.....................................................-
+%ram. \ .}, iI r �, •-• ' •. r t y 1 r � � � iXregii _ ,
77
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�A'PiJCA�'10�8 �9l�LEII�1� �ER�t'r � , APPI. No. —�
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CITY .ur EDMONDS Building Department Permit limit one year'
- l ei'iitr$;
iCAT1ON is hereby made for a permit to construct the following work, in accordance with, the accom I Wit' k t
.plane and specifications. Two sets are submitted herewith for approv
al
neov:� alter.
addn'lPb� ttpair:....---.._.._.._..__._.._.._.._..._ Parking _.._.._
......_...... ..........._.._.._.........._. d
—!� Fire zone-...__-_
.......... Usc zone....... 5,
COmSC. type...... .._.
_C� ........"`.`.:-ceq la.__: !..__ Blk-RGt/ .....YAddn.� �`-� +� 4t3 %i
S' 3 r
l......... Area_..___.._..—__—___........_ Septic tank....__.
loge..._..- _................. y •�f 3
Bldg. setkacka — from ...... r. side .............!.....-- 1. side-..... r` ..-. rear...--....-
i
_. _._
�. pq
tY Address.ara�/G ell. Tel. ....-.�......._ if
........-._... ........
cP�• 1.
lY L�---_._._. Tel. No._._.._...__._
Builder CJCl��h--_.__.. Address..
..._.._...__.._.-_......_.._... Tel. No.__.._.._.._.._
._ ....._...... �... Address
xNfAy The above is a correct statement, and I agree to comply with all applicable Codes and State lawn regulating this
r work'
7 c P .(C...(((((Ci' "ra36lG-H!�x_9%...Dau��—,�_ . .............Signed .. Address.._
. - . Signed Owner/Agent...........
subject to the above conditions, and to compliance with the apii'•+
PERMIT for the above work is hereby approved, j
proved plans and specifications, and Building Department notations thereon
Valuation .. by..._ .., _�..././._.._...._
.._.._........................... Pcrrtit fee......x.--......._.__. Recd. t a
Y.d _�
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Building Department, B - Date__ — ....%...._.....
..._........_............._.
y..-........_.._.............._. /'.
INSPECTION RECORDli;
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Final, OK..._.........._ .............._.. .' .: I �r
Fdn, OK Freese OK "
'his Permit does not cover Plumbing, Scwcr or Electrical installations.
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