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PERMIT APPLICATION Inside Heavy Linos
NAME (OR NAME OF BUSINESS)
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NAME
ADDRESS
ADDRESS
PERMISSIBLE
LOT COVERAGE°
LOT COVERAGE
PERMISSIBLE HEIGHT
PROPOSED HEIGHT
ACTUAL LOT AREA
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TOTAL BLDG. AREA
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CITY TELEPHONE NUMBER
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EXIST 6 STREET R/W ............FT. DEFICIENCY TRIO PROPERTY
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CITY LICENSE NUMBER
REMARKS
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DEMOLISH WALL
❑ EXCAVATE ❑ FENCE
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p CHEC EU Y SITE IS LOCATED IN THE CITY
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REPAIR ❑ P-EINSP. t
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EXCAVATION OR FILL
NUMBER OF STORIES NUMBER OF
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DWELLING
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UNITS
NATURE OF WORK TO BE/DONE.
Valuation
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Receipt No.
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BUILDING
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4 PROPOSED USE
PLUMBING
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tRETAINING
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SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
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TOTAL AMOUNT DUE
I hereby acknowledge that I have rand this application; that the In-
formationm given Is correct; and that I athe owner, or the duly autbor-
Ixret agent of the owner. I agree to comply with city and .tate laws reg'-
ATTENTION
APPLICATION APPROVAL
lacing construction; and In doing the work authorised thereby, no parson
will be ...played to violation of the "bar Code of the State of Washington
THIS PERMIT
This application is not a permit until
relating to workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORKNOTED
uty; and fees are paid, and receipt Is ac.
.hall be completed In away days MOVED -IN BUILDINGS shall be com-
Imowledged in space provided.
In In six months.)
SON UR (ON EEJ� R G N_T) DATE SIONED
INSPECTION
D '0 GNA URE
L g� tr 1hArc{ 7*
DEPARTMENT
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CITY OF
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EDMONDS47
DATE
NOTE: Applicant Subject to Plan Check Fce
PR 9-1101
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This Permit coven work to be done an private property ONLY.
Any construction an the public domain (curb., sidewalks, driveways,
FILE
marque.., Ste.) .IB regmre ..paste P-.d..lon.
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REMARKS
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FI TYPE OF CONSTRUCTION STREET IMPROVED
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UBE PERMIT
BUILDING DEPARTMENT ZONE �,C PERMIT
Applicant FW
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PERMIT APPLICATION Illglda IlaaYy Lines G
ADDRESS ^ �_.�•
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THIS SITE IS LOCATED IN THE CITY
NAME (OR NAME OF BUSINESS) /L
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LOT COYERAOFc LOT COVERAGE
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SHOULD BE CODED 31.04.
MA11,116 A�D ESST ROPOdHEIGHT
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ACTUAL LOT AREA _OTZBG. AREA
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DWELLING
PLA O DEP AP R DATE•
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UNITS
NATUREJ,OF WORK TO BE
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CITY E PHONE NUMBER
Valuation Fee Receipt No.
tl REET /W
EXIST G BTREF.T R/N ..... ......F'r, UF.F'ICIENCY THIS PROPERTY
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NAM 3 I• COMP. PLAN ST. R/W ............FT.
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PLOT PLAN (Indlcatb Building setbacks, abutting etroet\a)
!/ (nl�A o S 248-2732 METER SIZE BEIiVICE SIZE CLEARANCE CHECKED BY
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FENCE
STATE LICENSE NUMBER
CITY CENSE NUMBER
SIGN
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RETAINING WALL
REMARHtl
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Legal Description of P,.porty (Show Below or Attach Four Copley) /
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DEMOLITION
O TYPE O �,7 IO VERIFIED BY
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EXCAVATION OR FILL
PERC. % I I E M F.R
TOTAL AMOUNT DUE
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REMARKS
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FI TYPE OF CONSTRUCTION STREET IMPROVED
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YES [3 NO
SPECIAL INSPECTOR REQUIREDOCCUPANCY GROUP
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RESIDENTIAL ❑
[3YES `6 NO
I F IS
LINE
NEW
PLAN CHECICEU Y
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THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL
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OF EDMONDS. LOCAL SALES TAX I
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SHOULD BE CODED 31.04.
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DEMOLISH'
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PRE -MOVE BWIM
REPAIR ❑ INSP. POOL..def
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NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
NATUREJ,OF WORK TO BE
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Valuation Fee Receipt No.
/DONE
lyri-1/O V 1•IC `A�VI�V W�t.V 'tel
Plbn Check N.....6 ................
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BUILDING
q PROPOSED USE
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PLUMBING
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PLOT PLAN (Indlcatb Building setbacks, abutting etroet\a)
HEAT &GAS LINE
FENCE
SIGN
i ^ O �•
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
-
EXCAVATION OR FILL
TOTAL AMOUNT DUE
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I hereby acknowledge that I have read this application: that the In-
/ rF -la
formation given le correct; and that I am the owner, or the duly author -
lied agent of the owner. I agree to comply with city and State laws reg.-
'doing
ATTENTION
APPLICATION APPROVAL
laths, co.ettuctlO.; sad In the, work authorized thereby, no person
will be employed In Violation of the Labor Code of the Stats of Washington
TIES PERMIT
This application is not a permit until''.
relating to Workmen's Compensatloa Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Ezeepl DEMOLITIONS which
ONLY TILE
WORK NOTED
uty; and fees are paid, and receipt is ac -
Shall be completed In bluely days; MOVED -IN BUILDINGS Shall be Com-
knowledged in space provided.
p)eTi In Sig ...the.)
.
_) ,. _
S 6�Ip URE (OtV ER Q 1 A4 rIF) DATE STONED
_' i� f•
INSPECTION
DEPARTMENT
DIRHCTOWS SIGNATURE .'
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f.. � t � r,
orrY of
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EDIIIOND$
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DATE .! ,_-._-._.-_
NOTE: Applicant Subject to Plain Check Fee
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This Permit covenwork to be done on private property ONLY.
PR 0-1107
,
Any construction oa the public domain (curbs, sidewalk.driveways,
INSPECTOR
marquees, etc.) willrequire Separate permloslon,