740294.pdfr
BUILDING DEPARTMENT Applicant Fill
USE
ZONE �S'O
�- PERMIT APPLICATION Inside Heavy Lines
IDB
NEW
ADDRESS
NAME (OR NAME OF BUSINESS
PF:ItM 1881BLE
57, N
LOT COVERAGE,
/
MAILING ADDRE6
/971 j�
pE1tM ISSIDLE HEIG
ACTUAL IAT AItE
O
CITY //� a TE EPHONID NUMD&R
FENCEII
PERMIT
NUMBER.740294
ACTUAL
LOT COVEIYAGE �✓
LE69 ❑ NO PERMIT NUMBER - TIO
LOTNAL USE
SEL 6 DEP' AP O ATE:
TELEPHONE NUMBER i
8REEy.
/WSTET
EXIST ORER/N ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
X.A.
CES [:I NO
SPECIAL INBPEC_TOORR RREQUIRED OCCUPANCY GROUP
C] YES I . — /
PLAN CHECKEp BY; THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TA)S(l'//Jt-.✓�.! !«!_-- ewnlll D RE CODED 31.04.
Valuation Fee
•
RESIDENTIAL
signed by the Building Official or his Dep -
LINE
NEW
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11
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knowledged in apace provided.
PROPOSED USE
PLUMBING
❑
NON-REeIDENTIAL
❑
SIGN
ADD
FENCEII
NINC
SIGN
❑
DEMOLISH
❑
µ.Aly
ALTER
❑
ORCTE FILL
❑
( x .......... Ft.)
REPAIR
❑
INSP. 7d0VE
O
SWI I
POOL
gUMBER OF STORIES
NUMBER OF
EXCAVATION OR FILL
DWELLING
I
7 0 ��6 r
4
APPLICATION
This application
UNITS
APPROVAL
is not a permit until
CES [:I NO
SPECIAL INBPEC_TOORR RREQUIRED OCCUPANCY GROUP
C] YES I . — /
PLAN CHECKEp BY; THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TA)S(l'//Jt-.✓�.! !«!_-- ewnlll D RE CODED 31.04.
Valuation Fee
•
I
signed by the Building Official or his Dep -
p BUILDING
G
I
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1
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11
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t-0 i0. r__ Pion Cheek No............_.......
AUTHORIZES
signed by the Building Official or his Dep -
p BUILDING
G
O
.hall be completed In ninety day.; MOVED -IN BUILDINGS shall be com-
knowledged in apace provided.
PROPOSED USE
PLUMBING
v
PLOT PLAN (Indicate Building setbacks, abutting streets) HEAT & GAS LINE
DATE SIGNED
INSPECTION
DEPARTMENT
FENCEII
CITY OF
SIGN
_
RETAINING WALL
EDMONDS
DATE
N
—
775.2525
SWIMMING POOL
Title Permit r n work to W done on private property ONLY.
DEMOLITION
I
FILEmarquees,
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this applicatlon; that the In-
7 0 ��6 r
4
APPLICATION
This application
formation given to correct; and that I am the owner, or the duly author-
Ized agent of the owner. I agree to comply with city and state laws regu- ATTENTION
lating construction; and In doing the work authorized thereby, no person
wilt be employed In violation of the Labor Cade of the State of Washington THIS PERMIT
APPROVAL
is not a permit until
relating to Workmen's Compensation Insurance.
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 ac -
.hall be completed In ninety day.; MOVED -IN BUILDINGS shall be com-
knowledged in apace provided.
pleted In six months.)
31ON11URE (ONNEH OB ENTI
�7
DATE SIGNED
INSPECTION
DEPARTMENT
ONA URi`
I
CITY OF
'✓/// _
EDMONDS
DATE
Ter
N E: Applicant Subject to Plan Check
775.2525
Title Permit r n work to W done on private property ONLY.
Any construction on the public domain (curb., aidew.Iks, drivewys,
FILEmarquees,
etc.) will require .epurgte permission.
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