740195.pdfD
BUILDING DEPARTMENTUSEPERMIT
740195 '
Applicant Fill zoxE ash/ xuMHER
PERMIT APPLICATION Inside Heavy Idnea ,D F
ADDAF48�
NAME (OR NAME OF BUBINESSIPERMISSIBLE 7.
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LOT COVERAQE 7 I .OT COVESiAOE/
m AILING DRESS 7 7 D
[,7 PERh11d818LE HEIGHT PROPO ED HEIGHT 1
O CITY TELEPHONE UMBLA ACTUAL LO AR A TOTAL, BLDG/ A Z i 1
tet/ 7/3-.2 �-1— //�I �� a
—W—R YARDS PROP SED YARUB I
NAME FRONT HIDE REAR FRONT SIDE REAR i
LEGA VARIAN E OA CON ITIONAL 6
ADDRESS NO PE h[IT NUMBER
yF
U pL DE T. R AL je � DAT '
0.• CITY TELEPHONE NUMBER
STPE
EXISTING/ TREET A/tyY. DEFICIENCY THIS PROPERTY
NAME / ,, / n � y
1 COMP. PLAN BT. R/ Z) _(.J.....FT.
REMARKS Driveway slopes not to exceed those o
94Di ADDRESS indicated on Standard Dwg. No. 103
jZ
CHEC E BY ,
C1 �oTELEPHONE NUMBER
Z ME�� SIZE I SER4VICE SIZE CLEARANCEI C E ED BY
V e E LICENSE NUMBER"'
/ CITY LICENSE NUMBER p7
2 2. -3— Ct 1— O A •� I REMARKS v
Legal Description of Property (Show Below or Attach Four Copies)
TYPE CONNECTION VE IFIL•'
I
0y-• 'y
I VI ! /JS'S ���/ �/ sL6/ d O PERC. TEBT���Q PE MI U iH'R re
O REMARKS nMe
e Cf'T E �� w7yi 9� gS F Et
a
E FIRE ZONE I TYPE OF CONSTRUCTION 71BTAE T IMPROVED
E8 Q NO
r SPECIAL INSPECTOR REQUIRED IOCCUPANCY CROUP
RESIDENTIAL aPIANe
EJE
U YEe LL s. i J— 1� /
NEW
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
�
NON-RESIDENTIAL
❑
❑RET
01 IDMOND1 LOCAL SALES TAX
❑ ADD RETAIMNG
.a,, j��7"'`"'� 'QLDBE CODED 31.04.
IiWMARK '.
❑ DEMOLISH ❑ WALL
CAVAT FENCE
❑ ALTER EXE
❑
f�// �G�.iTI v/,r/c�(/ i�ft—MJ 6/,da-/97d
❑ OR FILL .......... .x .......... Ft.)'
❑PRE -MOVE SWIM
REPAIR ❑ INdP. POOL
NUMBER OF STORIES NUMBER OF
DWELLING
UNITE
NATURE O • WORK TO BE DON •
Veluatlon Fee Receipt Nov .1
'In z� �-
Plan Check No .....................
[0
(I
BUILDING o 3 0.3 aC
4
PROPOSED USE
PLUMBING /'S .S
J
U
HEAT do GAS LINE OO
Z
PLOT (Indicate Bn8ding Setbacks, abutting street.)
9
//PPL�LAN
//77r/UJ
FENCE
SIGN
a
.I�
RETAINING WALL j
N
1
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
1 hereby acknowledge that I have read thisapplication; that the In.
furation given Is correct: and that I ara the owner, or the duly author-
m
Ized agent of the nwnea. I agree to camD1Y with arty and state law. rogue
ATTENTION APPLICATION APPROVAL
toting Coca Mellon; and In doing the work authorized thereby, no per.-
will be employed In Wolatlo. of the Labor Code of the Stals of Washington
THIS PERMIT This application is not a permit until
retaung to Workm.n•$ Comp.nuticn In$ura.ee.
AUTHORIZES signed by the Building Official or his Dep- -----''
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED uty; and fees are paid, and receipt is so.
.hall be completed In .l.ety day$; MOVED -IN BUILDINGS .hall be corn-
Imowledged in space provided.
plated In at. mo.the.)
SIGNATURE (OWNER OR AGENT) DATE 6I1111E1)
INSPECTION REC R' S NATURILLE
$ �/DEPARTMENT
t
! �/
CITY OF
EDMONDS DATE
NOTE: Applicant Subject to Plan Check Fee
-
PR a-1107
This I•ermlt c ark to be done on private property ONLY.
Au wnetructlon oa the ,Ul lr dmneln (curb., sidewalk., drlvex'.Ia,
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