740072.pdfLegal Deacrlpllon of Property (Snow, uetow or Amen eeur
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PERMIT APPLICATION
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ADDRESS �- rA —I
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NA��,''FF (OR NAME OF DUe1NEetl)
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PRE -MOVE INSPECTION
DION
01 EDMONDS.
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LOT COVERAOEe LOT COVE AOJ
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EXCAVATION Oft FILL
ADD
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CITY
TELEPHONE NUMBbR
ACTUAL LOT AREA TOTA UO. ARE�tA .l
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.NAME
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REQUIRED YARO9 PR::O YARDS
FRONT BIDE REAR FRONT BI➢E REAR
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NAME
I hereby acknowledge that I have read this application; that the I.
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LEO$L LOT VARIANCE 0[i CON➢ITIONAL Ue
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ized agent of the owner. I agree to comply with city and elate Iowa regu-
ADDRESS
❑
NO PERMIT NUMBER
.Ft
will be employed In viola[.- of the Labor Code of lhs Stab o1 Waahington
TITIN PEIIM.T
At VAL ATE'
El
REPAIR
TELEPItONE NUMBER CITY
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ONLY Tur,
WORK NOTED
POOL
POOL
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ST lVS- TREET R/N ............ • DEFICIENCY THIS PROPERTY
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(UMBER OF STORIES
NAME
NUMBER OF
COMP. PLAN ST. R/W ...Q•..FC.
INSPECTION
DEPARTMENT
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REMARKS Driveway slopes not to exceed those
CITY OF
EDMONDS
Q ADDREtltl
DWELLING
I
indicated on Standard Dwg PIo 103
Legal Deacrlpllon of Property (Snow, uetow or Amen eeur
TYPE CONNECTION I VEAtFIED $Y -
0 W Wd a p, UD 0
F C�. W:pp,..4�Gaq• I PERMIT NUMBEit
Cotltl�t7w�% GNAlee
47 REISARR9
v 12e
/ i/jC %R-- 1
.D7 F.. ZONE TYPE OF CONSTRUCTION STREET IMPROV'
Vnluatinn Fee Receipt No,
Plan Cheek No .....................
r I
BUILDING
2 yes-`_ ��
PLUMBING
HEAT & GAB LINE
FENCE --
SIGN
1
RETAINING WALL
RESIDENTIAL
E]LINE
'A'
[YES 151`6
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NEW
awl MING
PLA CK Y
THIS SITE 15 LOCATED
IN THE CITY
TAX
NON-RESIDENTIAL
PRE -MOVE INSPECTION
DION
01 EDMONDS.
SHO
LOCAL SALES
3104
EXCAVATION Oft FILL
ADD
RETAINING
MAR
--
0
DEMOLISH
L
WAIT'
I hereby acknowledge that I have read this application; that the I.
EXCAVATE
FENCE
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ized agent of the owner. I agree to comply with city and elate Iowa regu-
ALTER
❑
OElR FILL
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will be employed In viola[.- of the Labor Code of lhs Stab o1 Waahington
TITIN PEIIM.T
This application Is not a permit until
El
REPAIR
❑
PRE -MOVE❑
INSP.
ONLY Tur,
WORK NOTED
POOL
POOL
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(UMBER OF STORIES
NUMBER OF
IIONATU (OWNER OR ASI NT) DATE tl10NEU
INSPECTION
DEPARTMENT
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CITY OF
EDMONDS
ATE
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DWELLING
I
lift 4.1107
Thin Permit coven York to be done on private property ONLY,
Any e,matructlon oa the publle, domain (curbs, aldewalks, drhewya'
a
FILE
mn+gbeen, ete.) will require separate permlulon.
UNITS
/
Vnluatinn Fee Receipt No,
Plan Cheek No .....................
r I
BUILDING
2 yes-`_ ��
PLUMBING
HEAT & GAB LINE
FENCE --
SIGN
1
RETAINING WALL
awl MING
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION Oft FILL
POOL
--
Vnluatinn Fee Receipt No,
Plan Cheek No .....................
r I
BUILDING
2 yes-`_ ��
PLUMBING
HEAT & GAB LINE
FENCE --
SIGN
1
RETAINING WALL
awl MING
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION Oft FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the I.
formation given In correct; and that I am the owner, or the duly author-
ized agent of the owner. I agree to comply with city and elate Iowa regu-
ATTENTION
APPLICATION APPROVAL
,.ting eonetructlon; and In doing the work authorised thereby, ne Deno.
will be employed In viola[.- of the Labor Code of lhs Stab o1 Waahington
TITIN PEIIM.T
This application Is not a permit until
relating to Workmen's Compenaslton Itrauranee.
AUTIIOItIZEN
signed by the Building Official or hill Dep -
NOTE: Permit Limit One Year (Except IIEMOLITIONN whlch
ONLY Tur,
WORK NOTED
uty; and fees are paid, and receipt is ae-
ahall be cam et't¢ In ninety a; h10VED-IN BOILUINOg shall be wilt
�pWl Sed In apnea provided.
plated Irt ei the.)
IIONATU (OWNER OR ASI NT) DATE tl10NEU
INSPECTION
DEPARTMENT
t C it'll tll HA'f ItE
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CITY OF
EDMONDS
ATE
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NOTE: Applicant Subject to Plan Check Fee
lift 4.1107
Thin Permit coven York to be done on private property ONLY,
Any e,matructlon oa the publle, domain (curbs, aldewalks, drhewya'
FILE
mn+gbeen, ete.) will require separate permlulon.
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NUMBER OF TORIES NUMBER OF
PERMIT
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DWELLING
NUMBER
BUILDING DEPARTMENT Appl.111111tFM ZONE /Z, _� -;-v UMI !
Inside heavy JIKHou Joe
PERMIT APPLICATION ADDRESS
UNITE
NAME (OR NA.&IN CE DUB----'
ACTUAL
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LOT COVERAGE? LOT COVJAGE
's
NATURE OF WORK TO BE DONE
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MAILING ADDRESS PERMISSIBLE HEIGHU Pt SMD I_W,
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Valuation
Fee Receipt No.
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AREA
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ACTUAL LOT AREA
CITY ._MPH�ONEN BER
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PROMISED
_SIVE
FRONT 87 UF: RF.Alt. PRO jr REAR
NAME
_PROPOSED USE
LEGAL LOT VARLAN 011 CONDITIONAL US
ADDREBB 0 No )PERMIT NUMBER
PLUMBING
CITY TELEPHONE NUMBER -RNu;EW1It - /IV
PROPEBTY
E T R/W.50 I;�' DEFICIENCY THIS PROPERTY
EXISTING STREET THIS
41 PLOT PLAN (indicate Building solutions, abutting streets)
NAME ST. R/W PT. 'r.
COMP. PLAN I
p9
a( REMwnics [wivouay slopes not to exceed tho e
94
ADDRESS Z
int!i-.at(;d on
FENCE
D BY
CRF C J? BY
CITY TELEPHONE
A
I
SIZE V CHECKED by
METER ICE SIZE CLOARANCE
STATE LICENSE NUMBER CITY LIC .... .....
REMARKU
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Legal Description of Property (Show Below or Attach Four Capt..) /)//
7Y—PECON CONNECTION
5AO Sl�,JC 01) 115
'ERC. EBT PERMIT NUMBER
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L
REMARKS
PRE -MOVE INSPECTION
STREET -
FIRE ZONE TYPE OF CONITRU71ON E IMPROVED i
I
, i 1 !
O.No
SPECIAL -1 SPECTOR REQUIRED OCCUPANCY GROUP
RESIDENTIAL E] IGANS YES I
E ❑PLAN
CHECKED By THIS SITE IS LOCATED IN THE CITY
M NEW SALES TAX
TOTAL AD IOUNT DUE
NON-RESIDENTIALit
SIGN OF EDMONDS. LOCAL
SHOULD BE CODED 31.04.
I hereby acknowledge that I have read this application: that the In.
ADD REMARKS)
❑RETAINING
❑DEMOLISH WALL
formationgiven Is correct; and that I Bra the owner, or the duly author-
❑PENCE
EXCAVATE /x S'/ 4- J
ized agent 11 the owner. I agree to ...]ply with City and State laws "g"'
ALTER ❑
OR FILL El ( .......... x .......... Ft.)
APPLICATION APPROVAL
0
REPAIR E] PRE*11 VE
INSP. POOL
ivI
NUMBER OF TORIES NUMBER OF
DWELLING
UNITE
NATURE OF WORK TO BE DONE
Valuation
Fee Receipt No.
Plan Cheek No .....................
BUILDING
_PROPOSED USE
PLUMBING
41 PLOT PLAN (indicate Building solutions, abutting streets)
HEAT & GAS LINEiia
7
0
FENCE
SIGN
RETAININGit
WALL
N
.-.MM.-:. POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AD IOUNT DUE
I hereby acknowledge that I have read this application: that the In.
formationgiven Is correct; and that I Bra the owner, or the duly author-
ized agent 11 the owner. I agree to ...]ply with City and State laws "g"'
ATTENTION
APPLICATION APPROVAL
l.u.. construction; and In doing the work authorized thereby, no person
will I'. employed In vi.I.U.. or .. Labor Code of the State of Washington
THIS PERMIT
This application Is not a permit until
relatingtin. to workmen's ComPen.Mloc, Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (E.C.Pt DEMOLITIONS which
NOTE:
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
ba completed In aloaty days; MOVED -IN BUILDINGS shall be -in.
knowlLdged in space provided.
plet1d In .1. --the.)INSPECTION
; - I
SIGNED
SIPNATU (OWNER OR AGENT)
rURE i, /
17T
DEPARTMENT
CITY OF
EDMONDS
DATE
"It
72 --'1 —1�;
-------- ---
NOTE: Applicant Subject to Plan Check Fee
PH 6-1107
This P.—It C.v,n work to 1re do.. an Private P-P-Ily ONLY.
Any Construction an the public doonal. (.-be, iildid,-Ilai, driveways,
INSPECTOR
onarquee., etc.) will require sepsonste ine,onsidect.
.,Fmme .
Lines
\ �:mmucearue/
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