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PERMIT APPLICATION
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Valuation
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REMARKS
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FIRE ZO� I TYPE F
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YES NO
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,J t�0A8 0YE8 �NO
NEN REeIDENTIAL ❑ LINE PLAN CHECKE THIS SITE IS LOCATED IN THE CITY
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BUILDING
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q PROPOSED UBE
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PLUMBING
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HEAT A GAS LINE
a
FENCE
SION
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this aDDlle¢llon; that the fn-
formation glVen le correct; and that I am the owner, or the duly author-
Ized agent of the owner. I agree to comply with city and stale laws regu-
ATTENTION
APPLICATION APPROVAL
leting construction; and In doing the work authorized thereby, no person
x•111 be employed In violation of the Labor Code of the State of Washington
THIS PERDHT
This application is not a permit until
relating to Workman'. Compeneatlon Imuran".
AUTHORIZES
signed by the Building Official or his Dep.
NOTE: Permit li nit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac -
an be comDletcd In sty day.' MOVED -IN BUILDINGS .hall be in.
knowledged in space provided.
Ictc at montlte.)
tll N LE (ONNER O AQE )
DATE B NED
INSPECTION
I R' SION4LTUR
DEPARTMENT
CITY OF
EDMONDS
wTe
NOTE: Applicant Subject to Plan Check Fee
PR 6.11x7
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Tins Permit rove. work to be done on private property ONLY.
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FILE
marquee., etc.) will require .eparat. permission.
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This Permit coven Work to I. done on private property ONLY.
Any construction an the public domain (curbs, sidewalk, drlvewys.
marquees, els.) will reaulre separate permission.
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TYPE CONNECTION VERIFIED BY..apq
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SE NUMBER� 24-7
BUILDING D E P A R•T M E N T APPU.t FM
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PERMIT APPLICATION
ADDRESS
1 11
NAME (OR NAME OF BUWNESB/
PER ^ AAL
1•. � w 1.��\1 t l,( k. ( _,��,
L
OELOT COVERAOOT COVE
SAI NO ADDRIDBB
PERMISSIBLE HEIGHT PROPOSED HEIGHT
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CITY
P(( ID NUJWER
ACTUAL LOT AREA TOTAL BLDG. AREA 7.
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REQUIRED YARDS PROPOSED YARDS
NAME
FRONT SLREAR FRONT TI—DE REAR
UE
AL LOT0 VARIANCE Olt NUITIONAL USE
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ADDRESS
IL-.ILyES NO PERMIT NUMBER
11V+I
CyP'-**LA O DEP AP Q AL DATE:
C
CITY
TELEPHONE NUMBER
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S ET/W '' O
EXISTI O STREET R/W ............FT. DEFICIENCY THIS PROPER
NAME
COMP. PLAN ST. R/W ............F'I'. ............I -T. 14
REMARKS
°y
ADDRESS
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CHECKED BY
OCCUPANCY GROUP
CITY
TELEPHONE NUMBER
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6A8
❑ LINE
❑ YES -UNO
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METER SIZE SERVICE SIZE CLEARANCE
CHECKED BY
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STATE LICENSE NUMBER
CITY LICENSE NUMBER
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ADD RETAINING
WALL
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DEMOLISH
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K�LsJ 1 �F^�i 1 y- l.�r 1 Ct�1_' 1
REMARKS
1
Legal Description o[ Property (Show Below or Attach Four Copies)
.1
This Permit coven Work to I. done on private property ONLY.
Any construction an the public domain (curbs, sidewalk, drlvewys.
marquees, els.) will reaulre separate permission.
-7n_y_ G
TYPE CONNECTION VERIFIED BY..apq
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FIRE ZON TYPE,_,,OFF CONSTRUCTION STREET IMPROVED
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1�,-� YES ❑ NO
� fes.
SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
RESIDENTIAL
6A8
❑ LINE
❑ YES -UNO
NEW
PLAN CHECKED BY THIS SITE IS LOCATEDINTHE CITY
,NON-RESIDENTIAL
BIGx
! \jitJ1 CHOUED TAX
ADD RETAINING
WALL
BE CMON ODED 3AOQSALES
REMARKS -1
1 1'7� �J 1--fj ! T'
DEMOLISH
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K�LsJ 1 �F^�i 1 y- l.�r 1 Ct�1_' 1
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E] REPAIR PRE -MOVE SWIM
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INSP. POOL
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NUMBER OF BTORIE9 NuxB
DWELLING
.f
7
j
UNITB
NATURE OF TO BE DONE
Valuation
Fae
Recclpt No.
^WORK
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Plan Cheek Nn .....................
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BUILDING
PROPOSED USE
PLUMBING
PLOT PLAN (Indl-to Building eetbncks, abutting streets)
HEAT A GAS LINE
5
O
- . �. .....:. .. ..
FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
._..- _
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that 1 have read this application; that the In-
\)
,
formation given Is correct; and that I ami the owner, or the duly author-
Izrd agent of the owner. I agree to comply with city aad elate laws relic.
ATTENTION
APPLICATION APPROVAL
lacing construction; end m doing the work authorized thereby, no person
Will be employed In vtolallaa of the Labor Code of the Stale of Washington
THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation Insurance.
AUTIIOIUZES
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 ac -
shall be completed In hloety days; MOVED -IN BUILDINGS shall be cam-
knowledged In space provided.
pieted In six months.);'
..
Bl NATURE (OWNER !OAGENT)DATE SIGNED
INSPECTION
DIRE T01VO SIONATUI
I
DEPARTMENT
I
CITY OF
MAZONDS
DATE
NOTE: Applicant Subject to Plan Check Fee
PR d-1107
This Permit coven Work to I. done on private property ONLY.
Any construction an the public domain (curbs, sidewalk, drlvewys.
marquees, els.) will reaulre separate permission.