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' POSTED ON KROLL YAP NO.t pg�(�
BUILDING DEPARTMENT AppllcazltFlll NUMBER 710540
PERMIT APPLICATION Ineldo Heavy Ltnoe ,Ipg ADDAEnBB /' (��% ,N^K J1 1JJ^/) ..
NAP���Eyyy(OR NAPE OF BUBINffiBS) /� ✓ �p � �Li�l � / � � l �+ — F �' � '
Q � ���/ � BIDE YARD SETBACK I BTRE BETDACK I RH;AR YARD BffiTHACH j �
mm SAL O ADD BB ` d I ,
_ tTi ,.� � UBffi ZONE LOT AREA VAOANT B Tffi I 1
G OI P ON YB&'R I ❑ YEB ❑ NO
�- •-y
< REIOHT I DUILDIN6 AREA VARIANOffi NUMBER .
NAME �
t� PLOT PLAN APPROVED
.. 1�1 ADDRESS 5.
tM�pp� tlTHEET R/W j
��' at C TY P ONE NUMHER / ,.FT. CI .,. ,
." ` << EXISTING STREET R W ............FT. DEFIOIENOY• T1iIB PROPERTY ,
COMP PLAN ST. R/W ............FT. .... •.
REMARKS � .
t,/ Cv/ r�r� , �
A RE 8 � O
t
' �� O }^ `� S CHECKED SY ,: .
C/ITY " TE PHONE NUMBER 1
(� t //�>' �� (� Q � I 77� �_) � � METER BIZffi SERVICE BiZE CLEARANCE CHECKED BY {
FFFBT===A--- ICENBE NUMBER CITY LICENSE NUMH R � I I � �l '�
REYARKB
Legal Description of Property (Show Below or Attach Four CoDles) �
" TYPE CONNECTION I VERIFIED BY I
x 1 :.
,' o
� I
PERC. TEST I PERMIT NUMHER � ;
!yy� !
�'• w REMARKS
c 1•
F ffi I TYPE OF CO�UCTION I I STREET IMPROVED j,
SPECIAL INSPECTOR REpUIRED OCCUPANCY ORO P �", 'I
❑ RESIDENTIAL ❑ LINE ❑PLANBCHEC�HYO I �- � ... _ II
. ❑ NEW
NON-RESIDENTIAL ❑ BION THIS CITG (� ����.-.... _ _ � �
❑ ADD RETAINING REMARKS t � i.�
❑•DEMOLISH ❑ R'A� CITY OF EDf�4Cf':�5. LCCAL SALES
❑ ALTER ❑ EXCAVATE FENCE TAX 4NOLI�B S•- n••�-. .-.. ... �' ,� '.
OR FILL ❑ (..........z_........Ft.) / G�1T3�_ ...
. ❑ REPAIR PRE -MOVE SWIM 3O�C, � `r
'�' � ', , i
INSP. ❑ POOL
NUMBER OF 8TOR1E8 NUMBER OF 1 ��� �
' I DWELLING I �'
UNITS � „
NATURE OF WO TO BE DONE Valuation Fee Receipt No. -. i.
// ..+
S / �.� o- � c# � � �_ Plan Check No...._.._.._.._... .� lij I ".
(I (
BVILDIN6 ` ,
(((yyy is
PROPOSED UBE ��
PLUMBING � '� , t
G PLOT PLAN (Indicate Bullding setbacks, abutting streets) HEAT R OAS LINE !� �ii1
ffiJ
,e FENCE
BION }
RETAINING WALL � � ,
N
IHWIMMIN6 POOL i�� � �
DEMOLITION � -
i i
t
PRE -MOVE INSPECTION 1
EXCAVATION OR FILL
ry V V � � ���
TOTAL AMOIINT DOE Y s � � i.
I hereby nckaowledge that I have read this aDPllcntton; that the tn- -
formation given le correct; and that I am the owner, or the duly motor- }
tsea agent of the owner. I agree to comply with city and dnee laws rasa- ATTENTION APPLICATION APPROVAL ` '
latlbs construction; and la doing the work author):ed theroby, no Panan ! � -
wlll be employed In Wolatlob of ute Labor Coda of the 8tnte of Waahmgton TIII6 PERMIT ThIB applieatlon ie not a permit untll � - ��
rotating to Workmea'a Compeneatlon iwurmcs. AUTHORIz1CB B1gIled by the Bullding Official or h1B Dep- i ,; � t
ONLY THE
NOTE: Per - It �A8 YeGr (EaceDt DEMOLITIONS which WORN NOTED utyi and feeB are paid, slid receipt fa ac- , ,
1 be comb ea W aety days; MOVED -IN SDII.DINOB shalt be wm• knowledged in apace provided. j
p tad la da obthe. �
INSPECTION
T� (OWN OR AOENT) DA� NED DIRECTO S 810N U1
aDEPARTMENT
!/ OITY OF
EDMONDS DATE
NOTE: Ap(�ficant Subject to Plan Cbeck Fee pg e•IIo7 �/ •' ��
This Permit coven work to be dose on DHvate property ONLY.
Aay eonalruetlon oa the pubno domdo (curbs, sldewNks, drlvewgs, ,
marpuees, ate.) wW reQdm seDwte DerWselon.
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