740293.pdfNOTE: Permit Limit One Year ONLY THE
signed by the Building Official or his Dep
---� j
(Eac,pt DEMOLITIONS which {YORK NOTED
shall he completed In nicety days; MOVED -IN BUILDINGS shall
-
Uty; and fees are paid, and receipt Is AC-
BUILDING DEPARTMENT
be com-
pleted In ,Ig manth,.)
ZONE DM
PERMIT
d1GNATUItE (OWNER OR AGENT) DATE SIGNED INSPECTION
PERMIT APPLICATION
AppDennt FW
Inside Heavy Lines
I
/1 �
Loa
NUMBER
7��293
CITY OF
✓i
NAME (OR NAME OF BUSINESS)
EDMOND3
NOTE: APPlieant Subject to Plan Cbeek Fee
ADDRESS �l
This Permit c van work to bo done on private property ONLY. 775-2525
Any construction
s
p(
-
r
m.rquee,. Hc.) will require aeparale permission.
/��—�.�/1//!�./»i-•i-�V!'"7 -fin �'
C / " %1
LOTPFRMICOVERAGE7o 881HLE
ACTUAL
fS(
MAILING ADDREaB
LOT COVESYAOE
C,
PER11ISSIBLE HEICIIT
PROP08ED HEIGHT
CITY
1
TELEPHONE NUMBER
x
IYt
3
ACTUAL LOT AREA
TOTAL BLDG. AREA
e
I
S
NAME
YAHDB
PROPOSED YARDS
i
FRONT BIDE
REAR FRONT BIDE REAR
I.
I'
WADDI1Etl8
LEGAL LOT VARIANCE OR CONDITIONAL USE
E] YES NO PERMIT
NUMHER '
aj CITY TELEPHONE
cc
NUMBER
OVAL
PLANNING DEPT. DATE:
I
STREET R/W
li
..
-- NAME
EXISTING STREET R/W ,...........FT,
DEFICIENCY THIS PROPERTY
x
C, `� /
? Yr! - �� J ! J- ..SCI l�
COhfP. PLAN ST. R/W ............FT.
FT.
g
S'
ADDRESS
REMARKS
W
Z t
'
U n r
ZO
CITY
TELEPHONE
NUMBER
CHECKED BY
O cS-C !2 7r' f'I P-
7;' =� �I �—
STATE LICENSE NUDSBER CITY
LICENSE NUMBER
METERSIZE SERVICE SIZE
CLEARANCE CFf ED BY
I
n
I
Legal Description of Property ow Below or Attach Four Copies)
1EMARKtl
�y
i
TYPE CONNECTION
V: RIFIED —BY—
PDRC TEST
PERMIT NUMBER
I
REMARKS
p,)
se
O
FI'R�ETYPs. CONSTRU-CCTTI, STRE IMPROVED
rF
// �/ ES
I
[I NO
SPECIAL INdPECTOR R/EpUlRED O --y GROUP
NEW
RESIDENTIAL
rI GAS
LINE
C3 YES yid
I
NON-RESIDENTIAL
L„f
❑
PLAN CHECKED DY
THIS SITE IS LOCATED IN THE CITY
[EllADD
aIGN
OF EDMONDS. LOCAL SALES TAX
RETAINING
SHOULD BE CODED 31.04.
EX C
AVAT
ALTER ❑ OR FILL E PENCE(,
, g..........Ft.)
REPAIR
INBPAfOVE
NUMBER OF STOR)E8
DWELLING
UNITS
NATURE OF WORK TO BE DONE
'
tir_ev�re_� r� Kir6
Valuation
Fee Rcccipt N a'
Z
Plan Check N. .....................
:I
(o
L PROPOSED UeE
BUILDING
/ate QG
G
O
PLUMBING
PLOT PLAN (Indicate Balldl ng Be....it" abutting street-)
'
9
o �d
HEAT &GAS LINE
�I
FENCE
1
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I hereby acknowledge that I have read this &PlAlcallon; lhet the In -
given Is correct; and
TOTAL. AMOUNT DUE
ze alien that I am the owner, or the duly author.
, ed agent of the owner. I agree to
comply with city and state law, reg.-
luting construction; and In dotal, the work authorised thereby, no person
ATTENTION
APPLICATION
-
will be employed In vlolathm of the Labor Code of the State of Weablagton
APPROVAL
relating to Workmen's Carol, Go. Insurance,
THIS PERMIT
AUTI[
This application Is not a no it until
NOTE: Permit Limit One Year ONLY THE
signed by the Building Official or his Dep
---� j
(Eac,pt DEMOLITIONS which {YORK NOTED
shall he completed In nicety days; MOVED -IN BUILDINGS shall
-
Uty; and fees are paid, and receipt Is AC-
be com-
pleted In ,Ig manth,.)
kno ged in apace provided.
d1GNATUItE (OWNER OR AGENT) DATE SIGNED INSPECTION
DEPARTMENT
D E OR'B 8fGA U
CITY OF
✓i
EDMOND3
NOTE: APPlieant Subject to Plan Cbeek Fee
ATE
This Permit c van work to bo done on private property ONLY. 775-2525
Any construction
s
a the public domain (curbs, sidewalks, driveways.
m.rquee,. Hc.) will require aeparale permission.
FILE