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740050.pdfBUILDING DEPARTMENT Applicant °NE NUMBER PERMIT APPLICATION (Imide Heavy Lines jon ADDRESS NAME (OR NAME OF BU M88) A in �` �. i C` PERMISSIBLE u t' _�/ /C' C ✓� ��1 r �• LOT COVERAGE I MAILING ADDRE86 PEI(b1IS8IBLE HEIG}IT P C11�Y d TD PHONE UMHg:R ACTUAL LOT AREA 7 11 REQUIRED YARDS NAME METER 0I'LE FRONT SIDE REAR FRONT - BIDE REAR tADDRESS I CHECKED BY CONDITIONAL USE CIAL SNBPECTOR REQUIRED STATE LICENSE NUMBER CITY LICENSE NUMBER 0a-375� LEGAL LOT VARIANCE OR 0 YES 0 NO PERMIT NUMBER yH g RESIDENTIAL U ❑ YES [I NO PLANNING DEPT. APPROVAL C CITY TELEPHONE NUMBER VERIFIED BY NEW STREET R/W PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY] EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY NAME NON-RESIDENTIAL re- / �GGt.l�fi COMP. PLAN BT. R/W ............FT. ............FT. 21­e6 ;V4 rr�h REMARKS Iq ADDRESS C� � a l�� - /9G' //y ' �r�`� 7 CHECKED BY F CITY TELEPHONE NUMBER z/ /y X�- ��/ �'e yT{J�g p l.I.. 1'( METER 0I'LE I SERVICE SIZE I CLEARANCE I CHECKED BY al CIAL SNBPECTOR REQUIRED STATE LICENSE NUMBER CITY LICENSE NUMBER 0a-375� REMARKS g RESIDENTIAL ❑ YES [I NO Below or Attach Four Copies) Legal Description Property (Show Belo_ l4 IOCCUPANCY TYPE CONNECTION VERIFIED BY NEW LINEET PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY] NON-RESIDENTIAL SIGN AL SALES TAX PERC. TEST © ADD RETAINING L] WALL PERMIT NUMBER dy.1 3 ) W O OR FILL m REMARKS O REPAIR ❑ PRE -MOVE ❑ Swim- INSP. POOL NUMBER OF STORIES NUMBER OF ,�{///y'�' �!R UCTION I STREET IMPROVED R FIRE ZONE TYPE OFC�8T lY' I 10 YES ❑ NO CIAL SNBPECTOR REQUIRED GROUP RESIDENTIAL OAs ❑ YES [I NO IOCCUPANCY NEW LINEET PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY] NON-RESIDENTIAL SIGN AL SALES TAX © ADD RETAINING L] WALL REMARKS SOHOULD BE CODED ❑ DEMOLISH ALTER EXCAVATE ❑ FENCE ✓ O OR FILL REPAIR ❑ PRE -MOVE ❑ Swim- INSP. POOL NUMBER OF STORIES NUMBER OF IDWELLING UNITS I NATURE OF WORK TO BE DONE valuation Fee Receipt Na. ". Plan Check No ..................... L NG BUILDI I J [O a, 111 PROPOSED USE PLUMBING I PLOT PLAN (Indicate Building setbacks, abutting streets) HEAT A 6A8 LINE FENCE I I SIGN RETAINING WALL N SWIMMING POOL DEMOLITION PRE -MOVE INSPECTION EXCAVATION OR FILL �Z; 1-7 TOTAL AMOUNT DUE I hereby acknowledge that I have read this application; that the In. ---�� ,attention given 1. correct; and that I am the owner, or the duly anthor- Ired agent of the owner. I agree to comply with city and stats lawn Mint. ATTENTION APPLICATION APPROVAL IatmO construction; and In doing the work authorized thereby, noperson will be employed In violation of the Labor Code of the Slats of Washington TINS PERMIT This application is not a perfnit until relating to workmen. compensation Insurance. AUTHORIZES signed by the Building Official or his Dep - 1 l NOTE: Permit Limit One Year (Except DEMOLITIONS which ONLY THE WORK NOTED uty: and fees are paid, and receipt is ac - --1�-------" " shall be completed In ninety day.; MOVED -IN BUILDINGS shall be com- kpvledged in Space provided. Dleted In six months,) III (OWNER OR ENT ��L� DATE B10NED /'7 . INSPECTION DEPARTMENT IRE O 8 1 U E ' / CITY OF - EDMONDS DwT EF NOTE: pplicant Subject to Flan Check Fee PR 0.1107 Title Permit corers work to be done on petrels property ONLY. Any cenetructlon on the public domain (taros, sidewalks, driveway.. urpneee, etc.) till, reeolre separate permiseton. - FILE