740087.pdfU
W
F
pOH
NO
EXISTING(ATREET R/W ............FT. Dyr�iC1ENCY .THIS PROPERTY/
NAME (�
COMP. PLAN ST. R/W ............i'T. ............FT.
1- 7%2 t REMARKS
a7
ADD
AESe
�53 /, Ja �(J CHECKED BY
CITY TNE NUMBER
g�-7-79-377]
' 0 n �v N� s , W P - METER eI'LE I eERVICE SIZE I CLEARANCE ' CHECKED BY
LJRESIDENTIAL O LINE
NEW ❑ NON-RESIDENTIAL ® SIGN
ADD F_1 DEMOLISH WALL "TAIVINO
ALTER ❑ ORCE CE
FILL ❑ FEN. .......... Ft.)
REPAIR ❑ INSPSWI
. OYE POOL
fVafBER OF STORIES I NUMBER OF
DWELLING
UNITS
1ATURE OF WORK_ TO BE DONE
�� I �(XV
I-X YES � NO
SPECIAL INSPECTOR REQUIRED OCCUP�A`/NCY /GROUP
C] YES YNO I Vtl
PLAN CHECKED By THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
PlanCheck Na .....................
I
I
'
N.
_
BUILDING
BUILDING DEPARTMENT
Applicant Fill
ZONE (,
NUMBIER 740087
PERMIT APPLICATION
Inside Heavy Lines
I
A I
ADDRESS �� r�
Yi^l �; 1
—
NAME OF BUeINEBgB)
d
� (l �Wr/W
9
�NAME
�(on
t �)
f'/7/l �7%�'�S %/V/✓,%/t�ryN/� F �~�<O (,) Q�
LOT COVERAGE
LOT COVIAAOE
FENCE
N
MA1WN0 ADDRESS
.ION
}?F� I80IHL HEIGHT PROPOSED liEIOHT
RETAINING WALL
Cl Y
i� /� O G'2/✓7
LEP HONE (N+UMBERR
`J I 1 O
ACTUAL LOT AR
REQUIRED YARDS
TOT B AREA
PROPOSED YARDS
SWIMMING POOL
-
/ ��/J ,
NAME
RONT BSDE
FRONT SIDE_ REAR
PRE -MOVE INSPECTION
'REAR
l ,— _ " -
3-27— /T
U
W
F
pOH
NO
EXISTING(ATREET R/W ............FT. Dyr�iC1ENCY .THIS PROPERTY/
NAME (�
COMP. PLAN ST. R/W ............i'T. ............FT.
1- 7%2 t REMARKS
a7
ADD
AESe
�53 /, Ja �(J CHECKED BY
CITY TNE NUMBER
g�-7-79-377]
' 0 n �v N� s , W P - METER eI'LE I eERVICE SIZE I CLEARANCE ' CHECKED BY
LJRESIDENTIAL O LINE
NEW ❑ NON-RESIDENTIAL ® SIGN
ADD F_1 DEMOLISH WALL "TAIVINO
ALTER ❑ ORCE CE
FILL ❑ FEN. .......... Ft.)
REPAIR ❑ INSPSWI
. OYE POOL
fVafBER OF STORIES I NUMBER OF
DWELLING
UNITS
1ATURE OF WORK_ TO BE DONE
�� I �(XV
I-X YES � NO
SPECIAL INSPECTOR REQUIRED OCCUP�A`/NCY /GROUP
C] YES YNO I Vtl
PLAN CHECKED By THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
PlanCheck Na .....................
BUILDING
[[[rrr
PROPOSED UBE
PLUMBINO
—
PLOT PLAN (Indicate Building setback., abutting streets)
HEAT A CAS LINE
9
FENCE
.ION
RETAINING WALL
N
SWIMMING POOL
-
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
/-
I hereby acknowledge that I have read this application; that the In-
formation given Is correct; and that I am the owner, or the duty author-
Ired agent of the owner. I agree to comply with city sad state laws resin-
ATTENTION
APPLICATION APPROVAL
lating cenatrucllon; and In doing the work authorized thereby, no person
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 Insurance.
AUTHORIZER
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TIIE
WORK NOTED
uty; and fees are paid, and receipt is ac -
.hall be completed In ninety day.; MOVED -IN BUILDINGS shall be com-
knowledged in space provided.
plated In et% months.)
elONATUI OR ADEN ) DATE SIGNED—
INSPECTION
DIRECTO BI6 T
DEPARTMENT
," / 7 7
t
CITY OF
EDMONDS
DATE
NOTE: Applicant Subject to Plan Check Fee
PB 6-1107
This Penult coven work to be done on private property ONLY.
Any ronntroctlon on the public dnmaln (curb., nld-1k., drlvewnyr,
..w seewr.. u,.t. mss. l...— — _
® 111181
-
FILF
t
a. . ..... .......
..... . ....