740068.pdffj
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U I L D I N G DEPARTMENT Applicant Fill ONE s_ �? , NUMBER 7-10068
PERMIT APPLICATION I Inside Heavy Lines ,GB -
ADDRESS (I.,IZ y+ALy{9 'Lt) ITII�S {'1v
YAME NAME OF BUSINESS) Z' Y� V
Y PERMlSSISLE
/ //'��/I �JL// A LOT COVERAGE iJ C� LOT COVEAOE t
yADDRESS
yF
a5
CITY
NAME
! ADD
e7 CITY
z
U
STATE LICENSE NUMBER
�crlptlon f Properly (how II Properly (Show I
_Xt--435-
a
J,
O
O
;Ref 1891BLE HEIGHT
PROPOSED H I�r UIIT /J �7c
%UAL LOOT AREA TOTAL BLI/• EA iz4
REq IRED 'ARDS ARDS
FRONT SIDE REAR FnONT BIDE REAR
30, /a y� ' // �6
LOT VARIANCE OR CON ITIONAL U8
ELI P RMI NU BER
N L I
'REE /W O
CIH O STREET RI'lLi I DEFICIENCY THIS PROPERTY YqC
COMP. PLAN ST. R/)P'� .4.17 .. ..... Q.FT.
'MARKS Driveway slopes not to exceed those o
iicated on Stndard Dwa. No,103w
�1(II,TC �Q •3 -R(L ,..zO/ CHECKED BY
IIQ U_(47AI ll(�1Ai121l I,- T�^ 1r
ITj 81ZE 18ER )CA SIZE I CLEARAN E CH•C •1Y, Y
'�B7�g
'PE CONNECTION VERIFIE BY
It f
:RC. TJ—Ee,C 1+iIZtl- PEFE—giZT UdIBER
w
;MARKS
2 NEW
RESIDENTIAL
❑
LINE GAS
❑ YES
N
PLAN
'PLAN
ADD
ALTER
❑
NON•REBIDENTIAL
❑
O
❑
BION
RETAINING
R AI
❑
DEMTAR
O
EXCAVATE
REPAIR
❑
❑
RFILL
OR
PRE -MOVE
INSP.
O
`ENCz.......... Ft.)
SWIM
POOL
•SG�
UMBER OF STORIES
NUMBER OF
knowledged In space provided.
ix wont
pleted In elz months.)
/
DWELLING
UNITS
/
L
DIRECT tltON
- --
�I
fAOPeerp USE
PLOT PLAN (Indicate Building setbacks,
/-f�?irc��`c-J
TYPE OF CONSTRUCTION IMPROVE
TOTAL AMOUNT DUE
�BTREET
—'A//
EB [3 NO
CTOR REpU)RED
OCCUPANCY GROUP
Ized agent of the owner. I agree to comply with city and elate taws "go. ATTENTION
laung Construction; and In doing the work authorized thereby, no person
I _•t—
BY
THIS SITE IS LIOCATED IN THE CITY
TIHB PER6IIT
OF EDMONDS. LOCAL SALES TAX
SHOULD 8E CODED 31 04
�Bld'�I•ti�
u.✓ PL',& r/,�5 (5 /976'
s (?! �
ON S/ice iii/fly/TiuA
Plan Check No .....................
BUILDING
PLUMBING
HEAT A CAB LINE
FENCE
SIGN
fRETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION Olt FILL
I hereby acknowledge that I have read this application: that the In-
TOTAL AMOUNT DUE
formation given le correct; and that I am the owner, or the duty author-
APPLICATION APPROVAL
Ized agent of the owner. I agree to comply with city and elate taws "go. ATTENTION
laung Construction; and In doing the work authorized thereby, no person
will b0 employed In Wolatlon of the Latwr Code of lilt State a[ Wuhington
TIHB PER6IIT
This application is not a permit until
relating to Workmen'a Compensation Inallrence.
AUTHORIZER
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Ezcept DEMOLITIONS which
ONLY THE
WORK NOTED
Ut end fees RCC Bid, Lind receipt is ac -
y; P P
shall be completed In ninety days; MOVE0.IN BUILDINGS shall be wm•
knowledged In space provided.
ix wont
pleted In elz months.)
BIGNATUR ONNER R A T) DATE SIGNED
INSPECTION
DIRECT tltON
- --
DEPARTMENT
CITY OFhfK(/-
DATL
— 2 2—-7
EDMONDS
OTE: Applicant Subject to Plan Check Fee
Thinwort to be dans
This Permit on Private property ONLY.
PR 6-!107
on (c sid
Any construction on the nOb1lc domain ecurbn, nldnwNke, driven'►] n.
cl C.) will rc0ulra • mate
FILE
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