740288.pdfU I L D I N G DEPARTMENT I Applicant FiLL ZONENUMBETR 740288
PERMIT APPLICATION Inside heavy Linea JOB
LAME (OR NAME OF BUSINESS) ADDRESS
^..
NEW
u RESIDENTIALAs
FRONT SIDE REAR FRONT 81DE REAR
LINE
yADDRESS
PROPOSED USE
NON-RESIDENTIAL
❑
LEGAL LOT VARIANCE CONDITIONAL USE
PLAN (Indlaala Bnllcung setbacks, abutting streets)
ADD
ALTER
REPAIR
El DEMOLISH
❑CFL®2RIL
❑ PRE -MOVE:
INSP.❑
YES � NO PERMIT NUMBER
PLANNING DEPT.APPROVAL
U
<W CITY
UMBER
TELEPHONE NUMBER
DATE:
r; fr , rr+t-•r-r.r-r-.-.-+--r-,-rr-*rr-r+-.-t-r-•;-•--r-rrf
SIGN
I
STREET R/W
RETAINING WALL
-T...7
EXISTING STREET R/W.............FT. DEFICIENCY THIS PROPERTY
NAME
1! l�
\ e-11✓ Dp„U
Au
DEMOLITION
COMP. PLAN ST. R/W ............FT. ............FT.
1t ADDR— Etp -ter
e.
EXCAVATION OR FILL
REMARKS
L Z 0 / N r� 111t
r%
TOTAL AMOUNT DUE
formation given Is correct; And that I eat the owner, or the duly author-
CITY
ized agent of the owner, I agree to Comply with ally and state laws regu.
TELEPHONE NUMBER
I.Uag comtrualMa; and In doing the work authorized thereby, no
CHECKED BY
parson
Will beemployed In violation of the Labor Code of the State of Washington
I
THIS PERMIT
AUTRORIZP,8
NOTE: Permit limit One Year (Except
U Sea T r )e
DEMOLITIONS which
final] he Completed In Wetly day.; MOVED -IN BUILDINGS shall he cont.
6 S 6 8 yy
plated!n elx m.nlhfi.)
STATE LICENBE NUMBER
INSPECTION
.�
CITY LICENSE NUMBER
METER SIZE
SERVICE SIZE CLEARANCE
CHECKED BY
C 600 0 8 0 6 L/
7
I
77S -2S25
Any construct..- on the public dom.la (Curbs, nId-1111, driveway.,
REMARKS
Legal Deficrlpllon t Property (Show Below
or Attach Four Copies)
I 13 iQP ?7 R&Eo.3 n,r -f-)
0
FT ,F N L / r, V
w L T U 'rd Al 7b .30 Ot>E .3ot, Pi TPP, TW N 79 X1 9
fi.4& E_L-N Sn P,/t, --2-F7- 7-N S
ZONE
YES i7 NO
NEW
u RESIDENTIALAs
E
LINE
BUILDING
PROPOSED USE
NON-RESIDENTIAL
❑
SIGN
PLAN (Indlaala Bnllcung setbacks, abutting streets)
ADD
ALTER
REPAIR
El DEMOLISH
❑CFL®2RIL
❑ PRE -MOVE:
INSP.❑
RETAINING
WALL
(i sLL 60 .)
swil
POOL
UMBER
OF STORIES NUMBER OF
r; fr , rr+t-•r-r.r-r-.-.-+--r-,-rr-*rr-r+-.-t-r-•;-•--r-rrf
SIGN
N x
DWELLING
RETAINING WALL
-T...7
UNITS
SWIMMING POOL
ZONE
YES i7 NO
❑ YES i] NO
LOCAL
00
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
47
DATE
FILE
Plan Check No .....................
O
F
BUILDING
PROPOSED USE
O
aPLOT
PLUMBING
PLAN (Indlaala Bnllcung setbacks, abutting streets)
HEAT & GAS LINE
FENCE
5=7 tW i
r; fr , rr+t-•r-r.r-r-.-.-+--r-,-rr-*rr-r+-.-t-r-•;-•--r-rrf
SIGN
N x
RETAINING WALL
-T...7
, r
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
1 t., ...
r*r-.
I hereby acknowledge that I have read this application; that the In.
TOTAL AMOUNT DUE
formation given Is correct; And that I eat the owner, or the duly author-
ized agent of the owner, I agree to Comply with ally and state laws regu.
I.Uag comtrualMa; and In doing the work authorized thereby, no
ATTENTION
parson
Will beemployed In violation of the Labor Code of the State of Washington
relatlag to Workmen's Compensation Iaeureone.
THIS PERMIT
AUTRORIZP,8
NOTE: Permit limit One Year (Except
ONLY THE
DEMOLITIONS which
final] he Completed In Wetly day.; MOVED -IN BUILDINGS shall he cont.
WORK NOTED
plated!n elx m.nlhfi.)
BIG,ATUItE (OWNER OH ACENT) DATE 810NEU
INSPECTION
1 c
i I
DEPARTMENT
CITY OF
NOTE: Applicant Subject to Pian Check Fre
EDMONDS
This Perntlt cuven work to be done on private property ONLY.
77S -2S25
Any construct..- on the public dom.la (Curbs, nId-1111, driveway.,
n rearm. r".)u'10 rv'naro fieynrnlr nrrmLnl.n.
❑ YES i] NO
LOCAL
00
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
47
DATE
FILE