740129.pdfUSE PERMIT
BUILDING DEPARTMENT AppH tFm ZONE NUMBER
PERMIT APPLICATION iD61de Heavy IrRe6 JOB
ADDRESS
NAME IOR NAME OF BUSINESS) 121 Edmonds Stn
P. MUS I and PERMISSIBLE 7 ACT
LOT COVERAGE LOT
MAILING ADDRE8B
PERMISSIBLE HEIGHT PROI
e 121 Edmonds Street — — - -
740129
FRONT HIDE REAR FRONT BIDE REAR
�(• �.
i)
AGE
IEIGHT
3. AREA
OPOSED YARDSIj
NAME
FRONT HIDE REAR FRONT BIDE REAR
DEMOLITION
�I
M ADDRESS
LEGAL LOT VARIANCE Oft CONDITIONAL USE
[3 YES ❑ NO PERMIT NUMBER
r
;I
�
PLANNING DEPT. APPROVAL DATE:
fd CITY
TELEPHONE NUMBER
STREET R/W
t7
25.00
'
TOTAL AMOUNT DUE
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
formatlo0 glven le cornet: and that I — the owner, or the duty author.
j i
NAME
COMP. PLAN ST. R/W ............FT.
ATTENTION
APPLICATION APPROVAL
Ialing Coaetruclloo; and to doing the work authorized thereby, no person
Z
REMaA
01 ADDRESS
This application is not a permit until
relatlpg to Workmen's Compensation Iosureaoe.
AUTHORIZES
signed by the Building Official or We Dep -
teEj
ONLY THE
WORK NOTED
CHECKED BY
.hall be Completed In nicety days: MOVED -IN DUELDINGS shall be com-
- I
CITY
NUMHICR
F
A
ITELEPHONE
SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DEPARTMENT
DIRE/C 011,11c'011,11SIONATUIjE n
AmFac Mortgage 3-25-74
'1`
METER SIZE
I SERVICE 8I2E I CLEARANCE
CHECKED BY
EDMONDs
STATE LICENSE NUMBER
CITY LICENSE NUMBER
i
Tris Permit coven work l0 be done oo private property ONLY.
PR 6.3107
111...M
e
Legal Description of Property (Show Below or Attach Four Copies)
REMARKS
FILE
TYPE CONNECTION
VERIFIED BY
[O[
I
PERC. TEST
I PERMIT NUMBER
U
m
1
al
REMARKS
a
!
O
M
„)
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
0 YES [3 NO
I
SPECIAL INSPECTOR REQUIRED
❑ YES � NO
OCCUPANCY GROUP
GAS
RESIDENTIAL ❑ LINE
NEW
I
PLAN CHECKED II1- THIS SITE IS LOCATED IN THE CITY
El NON-RESIDENTIAL SIGN
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 3104.
ElADD ❑ RETAINING
DEMOLISH WALL
REMARKS
ALTER AVATE ❑
'
❑ ORFULL( A .......... Ft.)
REPAIR PRE -MOVE swim
INSP. POOL
NUMBER OF STORIES NUMBER OF
DWELLING
I
UNITS
NATURE OF WORK TO HE DONE
Valuation Fee Receipt
No.
Compliance Inspection
Plan Check No .....................
z
[[[0 BUILDING —
q PROPOSED USE I
;caq� PLUMBING
P PLOT PLAN (Indicate Building setback., abutting streets) HEAT A GAS LINE
B
FENCE
SIGN
RETAINING WALL
N
1
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
Comp. Insp.
25.00
I hereby acknowledge that I have road iris application; that the In.
TOTAL AMOUNT DUE
25.00 I (7712)
formatlo0 glven le cornet: and that I — the owner, or the duty author.
Ire. agent of the owner. I arra to comply with city and state law. mgu•
ATTENTION
APPLICATION APPROVAL
Ialing Coaetruclloo; and to doing the work authorized thereby, no person
will be employed In Vlolatloo Of the Labor Code of the State of W"himgton
TIDS PERMIT
This application is not a permit until
relatlpg to Workmen's Compensation Iosureaoe.
AUTHORIZES
signed by the Building Official or We Dep -
NOTE: Permit Limit One Your (Except DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac -
.hall be Completed In nicety days: MOVED -IN DUELDINGS shall be com-
knowledged In space provided.
plated In six months.)
SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DEPARTMENT
DIRE/C 011,11c'011,11SIONATUIjE n
AmFac Mortgage 3-25-74
'1`
CITY OF
EDMONDs
DATIr
NOTE: Applicant Subject to Plan Check Fee
i
Tris Permit coven work l0 be done oo private property ONLY.
PR 6.3107
Any construction On the public domain (aurbs, sldewaiks, d,l,—"..
u,ruuvca etc.) r'W epara
rcaulra ate per I.don.
FILE
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