740127.pdfBUILDING DEPARTMENT Appllmut FID us
NUMBIER 740 127
PERMIT APPLICATIONInside Heavy Lines aoB
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NAME IOR NAM F B EBB) !
PERMISSIHL 7 I ACTUAL
.. LOT COVERAGE LOT COVERAGE
MAILING REBS
76 b 7 � �� .-flu PERMISSIBLE HEIGHT PROPOSED HEIGHT
NEW
RESIDENTIAL
NON-RESIDENTIAL
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AS
LINE
SION,
ADD
ALTER
DEMOLISH
E
UNITS
RETAINING
WALL
FEN
C.
REPAIR
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ORCAVATFILL
INP.
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(UMBER OF STORIES
NUMBER OF
FCC Reaalpt No.
YES NO PERMIT NUMBER
PNOD P.
P'ROV
B BEET /W
EXI9T 6 BTREF.TR/ .//II�.�... DEFICIENCY THIN PROPERTY
COMP. PLAN ST. R/0�j..L, ' ...a.,FT,
REMARKS Driveway slopes not to exceed those
e-OONSTRUCTION STREET IMPROVED
YES I] NO
SPECIAL INSPECTOR ANWUIRED I OCCUPANCY GROUP
Q YES [3 NO
PLAN CHECKE7. THIS SITE IS LOCATED IN THE CITY
[/_ OF EDMONDS. LOCAL SALES TAX
L
DWELLING
UNITS
X ///;%'C Z" �/ t''..$ .
NATURE OF WOR({ TO 8 DONE_
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Valuation
FCC Reaalpt No.
Plan Checlt No .....................
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BUILDING
fII;
PROPOSED UeE
U
PLUMBING
I.
i
PLOT PLAN (IndiCate Building selhaek., abutting .t,C.t,)
HEAT @ GAS LINE
FENCE
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SIGN
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RETAINING WALL
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BRIMMING POOL
DEMOLITION
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PRE -MOVE INSPECTION
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EXCAVATION OR FILL
e g7ro
TOTAL AMOUNT DUE
I hereby sek0owledge
that I hove road this eppllealton; that the 111-
formation given le correct; and that I am file owner, or the duly author•
�
Ized agent of the owner. I agree to comply with City and atlawn regu-
(.ung conntMCtlon; grid In dal-Ifthe work authorised thereby►ts , no person
ATTENTION
APPLICATION APPROVAL
will be employed In Violation or the Labor Code of the State of Waablagton
TIDE PERMIT
This application is not a permit until
relating to workmen'. Compenaatfon Iaaurmos.
AUTHORIZES
Signed by the Building Official or his Dep-
_
NOTE: Permit Limit One Year (Except DEMOLITIONS whleh
ONLY OTETIRE
NOTED
ut find fees are aid, and receipt is ac.
Yi P
-
shall ad In nlriely dayn; MOVED -IN BUILDINGS ehall be mm•
elete 6I Completed
c
31noWledged In space provided.
pleled In six ionlhe.)
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SIGNATURE (OWNER OR AGENT)DATE
INSPECTION
Din R' SIONATU
/
DEPARTMENT
Y' 1,411
CITY OF
NOTE: Applicant Subject to Plan Check Fee
EDIIIONDB
DATE
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Tills 1'erndl Corers work to be done on private property ONLY.
PR 0-1107
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740
RECORD OF INSPECTIONS
Date'Passed;.
I,
Foundation -----
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Plumbing (Partial) —=--
(Rough)
Frame
Furnace & Fuel Lines
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