740131.pdfBUILDING DEPARTMENT Applicant Fill ZONE PERMIT
O BER 740131
PERMIT APPLICATION I Inside Heavy Lines ,GB—
ADDRESS
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N (OR NAME OF 8U83NE88) F-��. d /l.(/.. Lli
�- .PERMISSIBLE ACTUAL q
�•-� LOT COVERAGE' LOT COVERAGE -
MAILING ADDRESS V
�� �l IfL,j1t PERMIBtlIBLE HEIGHT PROI'OBED HEIGHT
O CITY TillI HONE Num
cER` ACTUAL LOT AREA TOTAL BLDG. AREA
1 _ Jl S REQUIRED YARDS PROSED YARD.
N�A_-MMEE mA-Ri µG FRONT SIDE REAR FRONTOPBIDE REAR
j; 1 P4� tilUt�ltv�S i� T• A .
y ADDRti B LEGAyLOT VARIANCE OR CONDITIONAL USE
H.� ISI S NO PERMIT NUMBER -
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CITYELEPHONE NUMBER I
l..C:r• '1 V� �Zq- q G STREET R/FT. DEFICIENCY THIS PROPERTY
NAMIg . IL 1 COMP. PLAN HT. R/ ..�'-I"I'. ...(,%...FT.
,Il -tel.- F FL -C-4— 1`VI'A-fl•t _r" REMARKS
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ADDRESS
p 1,u/�1 �1- Driveway slopes not to exceed those o
C6 12 1O� IT P&Lei,- � 7/auye.�.W,-a;,-..+.,a e+,.-.a..„.a n..,., u.. cxe x BY W
F CLTY TELE1P'S NUMBER t
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ATE LICENSE MBEftCITY LICENSE
NUMBER
223 0 2 16-11, I REMARKS
Legal De crIPRen of Property (Show Below or Attach Four Copies) , 1by •err, �+
TYPE CONNECTION VERIFIED BY
y PERC. TEST I PERMIT NUMBER d.
ID REMARKS m
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E FIRE ZONE TYPE CONSTRUCTION STREET IMPROVED
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YES [I NO i
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
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RESIDENTIAL
NEW {�• ON -RE IDENTIAL ❑ SIGN OLA'eC{IECK BYO OF. EDMOND5.IS 0 L01ALi SALES TN THE AX
ADD TY
E] H RETAINING REMARKS ) t t' J SHOULD ECODED 31 04 (�
DEMOLISH WALL�ST l.. t r`i 1 � 5! ✓ O �% yJ
ALTER ❑ ORCFILL AVATE O
FE .. W!'•'✓ 1
REPAIR El1Ne MSWI
OVE O POOL
NUMBER OF STORIES NUMBER OF
DWELL NO
�- UNITS T--”
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Valuation Fee Receipt No.
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Plsn Check N ....................
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BUILDING
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W PROPOSED USE
PLUMBING
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aPLOT
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PLAN (Indicate Building eetbaeks, abutting etreats)
HEAT A GAB LINE
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O VpAAN'-e 14A
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FENCE
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SIGN
RETAINING WALL
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SWIMMING POOL
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DEMOLITION
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PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
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I hereby acknowledge that I have read thlg application; that the In-
mrmatlen given la correct; and that I am the owner, or the duly author-
Iaed agent of the owner. I agree to comply with city and date law" regu-
ATTENTION
APPLICATION APPROVAL
laling CelgirdeUOn; and In doing the work authorized thereby, no panne
will he ..Played In vlolatlan or the Labor Coda of the State of Wuhington
THIS PSRMIT
This application is not a permit until
relating to Worltmen'" Compansation Inaurance,
AUTHORIZER
signed by the BuildingOfficial or his De p----�'�----
NAbecomitUmit One Year (Except DEMOLITIONS which
ONLY THE
{VORH NOTED
uty; and fees are paid, and receipt is ac -
sed Is idealr dor"; MOVED -IN BUILDINGS "hall be cont-
knowledged In space provided.
pBILL
ER OR T) DZ,,NE
INSPECTION
DIRE B O
DEPARTMENT
0
OITY OF
EDMONDS
DATE ` [�
NOTE: AQPli-Ilt Subject to Plan Check Fee
PR 6-1107
This Permit toren wort to be done on private property ONLY.
wnetrurtloo on the pubtic domain (curbs, eidewnlka, driveways,
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RECORD OF INSPECTIONS-S
Date Passed;
Foundation
Plumbing (Partial) n
(Rough)_=77-777 ��
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Furnace & Fuel Lines
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