740095.pdfI ..
BUILDING DEPARTMENT Appuestat FMZZOSNE �G NUMBIER 74009
PERMIT APPLICATION Inside Heavy LiDee ADDRESS
NAME (OR NAME OF BUSINESS) 7 11,244,
LOT rOVEfE _ LOT LOT COYERAOE LOT COVESi E
'�` E AILI O ADD /EJ88 //(J/� '
��II /^/'KI-'- !ie"'LL�)1/C/C� (�t �(��. 188IBL• EIQltT u�PROPO8ED 1f6,F01tTII
CITY �! /� ( 1'E P NE ...... ACTUAL LOT AREA\-","7_/^`�}-'.(, TOTAL ULDO. AREA t
/ IDN D /e 0 J, REQUIRED YARDS PROPOSED YARDS
NAME FRONT HIDE REAR FRONT HIDE REAR
ADDRESS LEGAL LOT VARIANCE Oft CONDITIONAL USE
M HIVES 0 NO PERMIT NUMBER
P 6 D PP O L a U
CITY ELEPHONE NUMUER 3 ^
8 REE /IV V,
EXIST 6 STREET R/W ............FT. DEFICIENCY THIS PROPERTY
NAME
C 111.
/��1 �
LAN T. R/W ............F1. ............T.�i, REMARKS .M.
DRESS
EE ADI S- G' H' �/' �i ��/7 �� •••tt( CHECKED BY W 1
' F CIT /J Al/� TELEPHONE NUMBER )/i(
Eo �I /, KZ_/3 0, I �y Z —/ �U C METER SIZE SERVICE SIZE CLEARANCE I CHECKED BY
U STATE LICENSE NUMBERCITY CENSE NU ER C
/-, �� I REMARKS
Legal De.crlption of Property (Show Below or Attach Four Copies) % g
n/f
TYPE CONNECTION VERIFIED BY
O
ly' PERC. TEST PERMIT NUMBER C
IJ
S
G REAfARKS pEc t
„WI FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
S/6N �YES NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY OUP
RESIDENTIAL ❑ OAS ❑ YES NO I F^ 2
NEW LINE PLAN CHE KED Y THIS SITE IS LOCATED IN THE CITY 1
ADD
❑' ALTER
REPAIR
®
E]
❑
❑
NON.RESIDENTIAL
DEMOLISH
ORE.CAI ".
PRE -MOVE
❑ATE
O
BIG,/
RETAINING
WALL
FENCE z..........Ft.)
wim
POOL
OF EDMONDS. LOCAL SALES TAX
MOW D BE CODED 31,04,
REMARKS
n %� 1/te 30 Nk -2
")c "k
, r � � -
-'y
,//
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,/7JV�tri/ P'
CD
NUAfBER OF STORIES
NUMBER
4 PROVOSEDrUSE
M
PLUMBING
U
OPLOT
W TeLING
I
HEAT A GAS LINE
^�"/T
FENCE
/
Pian Check No..... ................
—�
BUILDING
4 PROVOSEDrUSE
M
PLUMBING
U
OPLOT
PLAN (Indicate Bullding setbacks, abutting street.)
HEAT A GAS LINE
A
FENCE
�OO r
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
Ihereby atlmowted[e that I have read talo application; that the In.
TOTAL AMOUNT DUE
formation given I. correct; and that I am the owner, or the duly author.
trod ag.nt of Ne owner. I agree to comply with city and .tate laws resu-
ATTENTION
APPLICATION APPROVAL
latlog construction; and In doing the work authorised thereby, no person
will be 1.violation or the Labor Coda of the Blab or Washington
THIS PERMIT
This application is not a permlt until
to
relatlag to Workmen'. Compeasatlon Insuraaoe.
AUTHORIZES
signed by the Building Official or his Dep.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY WGItH TILE
NOTED
Uty' and fees 4[e paid, and receipt is ac -
shall be completed In ninety dayal MOVED -IN EHIUMINGs ■hall be mm-
knowledged In space provided.
pleted In els ...the.) _
SIGNAT(OWNER O/A ENT) DATE SIGNED
_/ 9 D
✓c-Lli '.LLJYt�
INSPECTION
DEPARTMENT
DIRE
CT U E
/
CITY OF
NOTE: Applicant Subject to Plan Check Fee
EDMONDS
PR g-1107
DATE V
_
This Perrnit coven work to bo done .n private property ONLY.
Any rnnstructlo. un the public domain (curb., sidewalk., drlvewa7e,
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RECORD OF INSPECTIONS I
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Date Passed " I�
.,.Foundation !. I
Plumbing (Partial)
(Rough) J;
Frame
Furnace & Fuel Lines-
ines
Final
Final ,
f;
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