740324.pdfBUILDING DEPARTMENT Applicant Fill
USE f% �.2-/ NUMBER 740324
inside lienvy Lines
PERMIT APPLICATION
ADDRESS
NAME (Olt NAME OF BUSINESS)
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LOT CO8IBLE � LOT COVEIFAOE / I
LOT COVERAGE
PERMISSIBLE HEIGHT yo P POSED HEI¢HT (`
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TELEPHONE NUMBER
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REQUIRE YARDS P O OSCU ARUB
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NAME
FRONT BIDE REAR FRONT SID' REAR
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OT VARIANCE OR CONDITIONAL USE �!� C At/
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ADDRESH
PERMIT NUMBER
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CITY TELEPHONE NUM HER
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EXIS NG STREET R/14/�1 ...��j DEFICIENCY THIS PROPERTY
NAME
COMP. PLAN ST. R/9W'.�Y.:1e-I'.
REMARKS Driveway slopes not to exceed those
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"°DILE..indicated
on Standard Dwg. No. 103
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TELEPHONE NUMBERajj(YEZ6(ZX)UQ\N1QNG
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METEiiIZE SIZE
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CITY LICENSE NUMUZA
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REMARKS
Legal Description of P(pPerty (Show Below or Attach Four CODIcs)
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TYPE CONNECTION
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REMARKS
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
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P CIAL SNBPECTOR R QUIRED
OCCUPANCY GROUP
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RESIDENTIAL
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❑ LINE
❑ YES [ •10
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NEW
PLAN CH K BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
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❑ NON-RESIDENTIAL
❑ sloth
�, SHOULD eE CODED 31.04,
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❑ ADD RETAINING
❑ ❑ WAId,
EMA 9
DEMOLISIi
EXCAVATE FENCE-
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ALTER ❑
OR FSLL (..........z..........Ft.)
❑
PRE.
❑ REP,\1R ❑ N PMOVE El aw,POOL
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NUMBER OF STORIES NUMBER OF
DWELLING
UMTS
N�n-TrURE OF WORK TO HE DONE/
Vandalic.
Fee
Recelpl No.
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Man Check N............. ........
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BUILDING
PROPOSED USE
PLUMB1146
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HEAT A GAS LINE
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PLOT PLAN (Indicate Building .etbnek., abutting atreele)
al
FENCE
SIGN
tRETAINING
WALL
N
SWIMMING POOL
DFAIOLITION
PRE-MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
O O
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1 hereby acknowledge that I have rend t61e application; that the In-
formation Elven le correct: and that I am the owner, or the duly nuthor-
I.ed agent of the owner. I agree to comply with city and .tate law. regu-
ATTENTION
APPLICATION APPROVAL
noting coaetruetion; and In doing the work authorized thereby, no Dereon
w•111 beemployed In Violation of the Labor Cade of the Stale of Wmhington
THIS PERMIT
This application is not a permit until
renatlug to Workmen's Compen.atlon Imurance.
AUTIIORIZEs
signed by the Building Official or his Dep-
NOTE: Permit limit One Year (E."Pt DEMOLITIONS which
ONLY THE
{YORK NOTED
uty; and fees are paid, and receipt is ac
.hall be completed In nboty days: MOVER-IN BUILDINGS shall be a...
Imowledged in space provided.
l.let-In 7lj month..) .'
'atONATUI (] Ell Olt AG E T) / DATE 1GN U
INSPECTION
p3a;E OH�SIGNAT AF
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DEPARTMENT
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/
CITY OF
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EDMONDS
NOTE: Applicant Subject to Plan Check Fee
775-2525
Tld. 1'rnnit c.-. .,it to be done sn prlYole property ONLY.
Any conrtrucllsll on lite public domain (curb., emewalk., drleewnr.,
FILE
mored..., ele.l w1i1 reeulre ..parole perml.el it,
NATURE -OF WORR. TO BE DONE
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4 PROPOSED USE
a
PLOT PLAN (Indica o Wm t 9,-abutlin6 streets)
7
Pion Check No .....................
Valuation Fee Receipt No.
.
BUILDING
- )
PLUMBING
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HEAT A GAB LINE
•'(=,
FENCE
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SIGN
RETAINING WALL
PRE -MOVE INSPECTION
I'
j
EXCAVATION OR FILL
S
T
USE PERMIT / H/
UMBER
NUMBER—ENT
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
B A 1 L D I N G D E P A R T M E N Applicant Fiu
/.
I
formation given Is correct; and that I are, the owner, or the duly author -
the owner. I agree to comply with city and erste laws re
APPLICATION APPROVAL
Inside Heavy Lines
PERMIT APPLICATION I
OR , f• ,•
DDRESS / • %� �S^ .y,�
i
ATTENTION
TIUR PERMIT
This application is not a permit until
NAME (OR NAME OF BUSINESS)
-'
LOT COVERAGE ' ACT AL or
IAT COVERAGELOT COVESiAOE
AUTHORIZER
signed by the Building Official or his Dep -
AI ADnRES�
PERMISSIBLE IiEIOlIT PH POSED HEIGHT
7
shall be completed In nicely date; MOVED -IN BUILDINGS shall be nom-
•-• � % • r / LEPHONE NUMBER
ACTUAL LOT AREA ��rii 1. B DG. AREA
5
pitted In six months.)
SIGNATURE (O{VNER Olt AGENT) DATE SIGNED
INSPECTION
CITY
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DEPARTMENT
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EQUIREI) YARDS YAOPOSEU rcAttu
FRONT e1DE REAR
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NAME -
FRONT BIDE REAR
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Applicant Subject to Plan Cbeck Fee
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LE6•T, LOT VAR ANLL OR CONDITIONAL UeE •+ r 1 p �,
PERMIT NUMBER
775 -2525/r
Till Permit euvers work to be done on private property ONLY.
ai ADDRESS
p 1''VS f NO
Any conetrucUaa on the public domaino(cubs,ld-wrok.. driveways,
INSPECTOR
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�L�N NG'DEPT. APP VAL DA E;
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c CITY I
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TELEPHONE NUMBER
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STREET K/W I f- THIS PROPERTY
^FT. DEFICIENCY
STREET R/ti�!t...:.
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EXISTING
ST. R/W("I'4l(„FT,
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NAMECOMP
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PLAN
REMARKS ).i : • 1 (-'j!? i iiU'. �. l-: x(: (:
ei ADDRESS?03
W
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TELEPHONE NUMBER
V/
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MET" SIZE SERVICE SIZE
CLEARANCE ,
CHECKED BY
1
STATE LICENSE NUMBER
CITY LICENSE NUMBER
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Legal Description or Property ( row Below or Attach ..or Copies)
TYPE CONNECTION I VERIFIED
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PERC. TEST I PERMI'�I iN DSBER
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REMARKS
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FIRE ZONE
T � CONSTRUCTION STREET IMPROVED
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/ .: YEe ❑ NO
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SPE E Q/IRED GROUP
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RESIDENTIAL
ane
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(OCCUPANCY
H n SITE IS LOCATED IN THE CITY
NEW
P THIS
OF EDMONDS. LOCAL SALES TAX
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NON.RESIDENTIAL
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HOULD BE CODED 31.04.
❑ ADDEl/RKS
{
DEMOLISH
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ALTER ❑ EXCAVATE 1
OR FILL ',- ..... _ ..........Ie[.)
❑ REPAIR ❑ PRE -MOVE { IN
INSP. POOL
/ -, ' -i5-✓
NUMBER OFSTORlEB NUMBER
DNELLINa
NATURE -OF WORR. TO BE DONE
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4 PROPOSED USE
a
PLOT PLAN (Indica o Wm t 9,-abutlin6 streets)
7
Pion Check No .....................
Valuation Fee Receipt No.
.
BUILDING
- )
PLUMBING
! .n
HEAT A GAB LINE
•'(=,
FENCE
j
I
SIGN
RETAINING WALL
PRE -MOVE INSPECTION
�~� \ ISWIMMING
POOL
DEMOLITION
j
I
PRE -MOVE INSPECTION
I'
j
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
'
formation given Is correct; and that I are, the owner, or the duly author -
the owner. I agree to comply with city and erste laws re
APPLICATION APPROVAL
(zed agent of
lating construction; and In doing the work authorized thereby, no person
In violation of the Labor Code of the State of Washington
ATTENTION
TIUR PERMIT
This application is not a permit until
will be employed
relating to Workmen's Compere -Urn, Imurance,
AUTHORIZER
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS whirl,
IL
ONLY THE
WORK NOTED
Uty� and fees are paid, and receipt is Be
shall be completed In nicely date; MOVED -IN BUILDINGS shall be nom-
llnowledged in space provided.
pitted In six months.)
SIGNATURE (O{VNER Olt AGENT) DATE SIGNED
INSPECTION
O
DIRECTR'S SIGNATURE
^""- - -"" '
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DEPARTMENT
) t
'.•t , .. + J'._,
CITY OF
�
EDMONDS
Applicant Subject to Plan Cbeck Fee
-
NOTE:
775 -2525/r
Till Permit euvers work to be done on private property ONLY.
Any conetrucUaa on the public domaino(cubs,ld-wrok.. driveways,
INSPECTOR
masa.... etc.) w re separate
y