730108.pdfBUILDING DEPARTMENT Applicant ZZOSNE NUMBER
30108
PERMIT APPLICATION Inside Heavy Linos o / J.f f�
ADDRESS ��E L' NAME (OR NAME OF BUSINESS) n�// ,
LOT COVERAGffia LOT COVERAGE
MAILMG ADDRESS /' PERMISSIBLE HEIGHT PROPOSED HEIGHT O
00L yn, Pi Ui cw
CITY TELEPHONE ER ACTUAL LOT AREA TOTAL BLDG. AREA
'; / "-;'•, - /i/h D sJ OS REQUIRED YARDS PROPOSED YARDS
NAME FRONT SIDE REAR FRONT SIDE REAR
pADDRESS LEGAL LOT VARIANCE OR CONDITIONAL USE
[+ ❑ YES ❑ NO PERMIT NUMBER
PLA EPT, PR TE:
1� 03 CITY TELEPHONE NUMBER
a • . ! STREET F
o6Wt7
EXISTIN STREET R/W ............FT. EFICIENCY THIS PROPERTY
NAMECOMP, PLAN ST. R/W ............FT. ....... .... FT.
1 �w� REhIwRKB
tt � � ADDRESS
/ I CHE ED HY
a CITY TELEPHONE NUMBER'
z
METER SIZE SERVICE SIZE CLEARANCE CXED BY
s STATE LICENSE NUMBER I CITY LICENSE NUMBER
REMARKS
Legal Description of Property (Show Below or Attaacchh�JFoour Copies) �X l
t �. O� /�Cd % 02. /!//�PL� TYPE CONNECTION I VERIFIED BY
• �i ��rQQl ���/� i " lT, GGr// E/I"S [= r%7JV PERC. TEST PERMIT NUMBER
. �, %D/l r\ •GfJ. �G{ /��O.SFS DIYL �. REMARKS I 60
, q �
l7
FIRE ZO E TYPE OF CONSTRN STREET IMPROVED
2 D I D F Gl^ /.Pew C' . P� A T OF LU I I❑ YES ro
SPECIAL INSPECTORREQUIREDOCCUPANCY GROUP
RESIDENTIAL GAS ❑ YES 0<0 I �w
LINE PLAN CHECKED Y
Nffiw0THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL ❑ .SIGN F EDMONDS. LOCAL SALES TAX
SHOULD BE
ADD RETAINING
11 DEMOLISH F1 WALL /n�
ALTER ❑ EXCAVATE ❑ FENCE �/ V G'�(/.T/�/(�Lj✓ 4�F/ �4XI (/ drgr / 9/�d
OR FILL (....... ..x ......... Ft.) REPAIR PRE-O MOVE SWIM
P L
S�`:� 7J P&—CeTjD
_ NUMBER O STORIES NUMBER OF
DWELLING
UNITS
NAT OF WORK TO HE DONE
Valuation Fee Receipt No.
/��t2 H NC �/Y)C-IVT JN7�Xi D2
� Plan Check No....»..»..»..»...
0
svILDlxa 16470 6c,
D
PROPOSED USE —
PLUMBING /�' �'v.
a PLOT PLAN (Indicate Building setbacks, abutting streets) HEAT h OAS LINE -
5
FENCE
SIGN
tRETAINING WALL
N
1 SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE ij�- (10 t
I hereby acknowledge that I have read this application; that the in. OS V J
formation given to correct: and that I am the owner, or the duly author.
ized agent of the owner. I agree to comply with city and state laws regu- ATTENTION APPLICATION APPRO!/AL
lating construction; and In doing the work authorized thereby, no parson
will be employed In violation of the Labor Code of the State of Washington THIS PERMIT This application is not a permit until
relating to Workmen's Compensation Ineura ioe. AUTHORIZES Algned by the Building Official or h1H Dep- i
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED uty; and fees are paid, and receipt is ac-
shall be Completed In ninety days; MOVED -IN BUILDINGS shall be com- Imo lodged in space provided. '
plated In six months.)
SIONATFRE (('Q%-/WGE
�NER OR AGENT) DATE: SIGNED INSPECTION RE R' Sl '
DEPARTMENT ,
- a QITY OF
EDAfONDS wTE
NOTE: Applicant Subject to Plan Check Fee
PR 6-1107 l
This Permit coven work to be done on private property ONLY.
Any construction on the public domain (curbs, s'- walks, drlvews7o,
marquees, etc.) will regmre separate lsoton.
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