740289.pdfNATURE OF WOR TO EE D
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USE �Jdl�� NUMBER 740289
BUILDING DEPARTMENT Applicant Fill
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PERMIT APPLICATION Insldo Heavy LlnoeADDRESS �
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NAME (OR NAME OF BUSINESS) It - �—�
PERaIIStlIBLE r7 TUAL /�
LOT COVERAGES LOT COVERAGE
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MAILING ADDREBBU
PERMISSIBLE HEIGHT PROPOSED HEIGHT
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BUILDING
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T%EL�EPHONE NUMBE(%R ACTUAL LOT AREA TOTAL BLDG. AREA
/ �G O `- REQUIRED YARDS PROPOSED YARDS
PLUMBING
NAME FRONT SIDE FRONT SIDE REAR
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(y
JRREEAR
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PLOT PLAN (Indicate Building setbacks, abutting streets)
ADDRESS LEG LOT VARIANCE OR CONDITIONAL
B ❑ NO PERMIT NUMBER
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P G D PPI AL DAjE•
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CITY I TELEPHONE NUMBER
"TREE
EXIST O STREET R/W .�..FT DEFICIENCY THIS PROPERTY
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FENCE
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NAME
COMP. PLAN ST. R/4140.pl. ...�...FT.
R EMARKS
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SIGN
AD REtlB _ Driveway slopes not to exceed those
indicated on Standard Dwq. No. 103
SII K BY
1TY
CITY
TELEPHONE NUMBER
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METER SIZE SERVICE SIZE CLEARANCE
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C C ED ��
STATE ICENSE N MBER
a� �.%I •� ��.3
CITY LICENSE NUMBER
I I(EMARKB
LCgal Dcacrlptlon/�of/P�7[o�p/ejrly (8ho low or Attach Four Copies)
TYPE CONNECTION V F Y
PE32C, TEST
E Ml INIIiIHER
SWIMMING POOL
C
se
REMARKS
O.K. to connect into sanitary sewers
"1FIRE
—:5-ee� 1810,11 ell but with no larger line than 2 -inch.
ZONE TYPE OF CONSTRUCTION STREET IMPROVED
-7-0 .P /3/.1,' V
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PRE-1,10VE INSPECTION
Q YES [] NO
EXCAVATION OR FILL
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
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TOTAL AMOUNT DUE
❑ YES NO
RESIDENTIAL I
El
ElLINE PLAN CHECKED ➢Y
NEW THIS SITE IS LOCATED IN THE CITY
I hereby acknowledge that I have read this application; that the In-
NON- RESIDENTIALslaty 01 EDMONDS. LOCAL SALES TAX
El ADD RETAINING REMARKS SHOULD BE CODED 31.04.
1 DEMOLISH WALL
EJALTER EXCAVATE FENCE
formation m given Is correct; and that I athe owner, or the duly author-
OR FILL (..........x..........Ft.)
REPAIR PRE -MOVE SWIM
INSP, POOL
i
Ized agent of the owner. I agree to comply with City and et ate taws mgu-
lating In doing
ATTENTION
APPLICATION APPROVAL
NUMBER OF STONIER NUMBER OF
THIS PERMIT
D WELLING
I
relating to workmen's Comp .nesunit Insurance.
AUTHORIZES
UNITS
NATURE OF WOR TO EE D
Valuation
Fee Receipt No.
Pian Check
No .....................
G
�y
BUILDING
it
W PROPOSED USE
PLUMBING
PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT A GAB LINE
q
7
FENCE
i
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
I
PRE-1,10VE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
Q
I hereby acknowledge that I have read this application; that the In-
formation m given Is correct; and that I athe owner, or the duly author-
Ized agent of the owner. I agree to comply with City and et ate taws mgu-
lating In doing
ATTENTION
APPLICATION APPROVAL
conetructlon; and the work authorized thereby, no person
will he employed In violation of the Labor Code of the Stateof Washington
THIS PERMIT
This application Is not a permit until
relating to workmen's Comp .nesunit Insurance.
AUTHORIZES
ONLY THE
Signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
WORK NOTED
uty; and fees are paid, and receipt is ac -
shall be completed In ninety days; MOVED -IN BUILDINGS shell be cons-
knowledged in Space provided.
pleted In six months.)
SIGNATURE (OWNER OR AGENT) DATE SIGNED
/
INSPECTION
DEPARTMENT
I R' H1GN TU
4/
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/pip
V✓.
CITY OF
EDMONDS
DATE —
NOTE: Applicant Subject to Plan Check Fee
Ae
This Permit c l Work to 11. done no private properly ONLY.
775-2525
Any construcilonOn the public domain (club., sidewalk., driveways,
marquers, Sint will require separate permission.
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