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[3 YES El NO
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BUILDING DEPARTMENT Fill
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
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USE PERMIT 740326
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GAS
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NEW
Inside Heavy Lines
PERMIT APPLICATION
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THIS SITE IS LOCATED IN THE CITY
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NON•ItESIDENTIAL
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OF EDMONDS, LOCAL SALES TAX
BE CODED 31.04.
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NAME (OR NAME OF BUSINESS)
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FRONT BIDE REAR
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LEGAL LOT VARIANCE OR CONDITIONAL USE
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PLANNING DEPT. APPROVAL
DATE:
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TELEPHONE NUMBER
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DEFICIENCY THIS PROPERTY
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STATE LICENSE NUMBER
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PRE -MOVE INSPECTION
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REMARKS
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TYPE CONNECTION
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formation given 1- correct; and that I am the owner, or the duly nuthor-
Ized agent of the owner. I agree to comply with city and elate law. reg.-
PERO. TEST
PERMIT NUMBER
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laung construction; and In doing the work aulhcrized thereby, no person
will be employed fn violatlop of Na Labor Coda of the State of Washington
THIS PERMIT
This application is not a perinit until
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relatipg to Workmen's Compensation Insurance.
REMARKS
signed by the Building Official or his Dep -
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uty; and fees are paid, and receipt is ac -
.hall be completed In ninety day-: MOVED•IN BUILDINGS shall be ,am-
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FIRE ZONE TYPE OF CONSTRUCTION "1tEE't' ImrRuv Gu
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[3 YES El NO
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SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
El RESIDENTIAL
GAS
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[3 YES ❑ NO
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NEW
PLAN CHECKED BY
THIS SITE IS LOCATED IN THE CITY
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NON•ItESIDENTIAL
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OF EDMONDS, LOCAL SALES TAX
BE CODED 31.04.
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RETAINING
REMARKSDEMOLISH
SHOULD
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EXCAVATE FENCE
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REPAIR PRE -MOVE POOL
INSP. EDPOOL
attached.
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE
Valuation
Fee Recclpt No.
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4 PROPOSED USE
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SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
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PRE -MOVE INSPECTION
-
EXCAVATION OR FILL
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TOTAL AMOUNT DUE
I hereby acknowledge that I have reed this application; that the In-
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formation given 1- correct; and that I am the owner, or the duly nuthor-
Ized agent of the owner. I agree to comply with city and elate law. reg.-
ATTENTION
APPLICATION APPROVAL
laung construction; and In doing the work aulhcrized thereby, no person
will be employed fn violatlop of Na Labor Coda of the State of Washington
THIS PERMIT
This application is not a perinit until
relatipg to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TIIB
WORK NOTED
uty; and fees are paid, and receipt is ac -
.hall be completed In ninety day-: MOVED•IN BUILDINGS shall be ,am-
knowledged In space provided.
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tad In x mon a.) r C
S10 AT tE (OL E O AGENT)
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DATE BS NE-
INSPECTION
DIRECTO 'S 81 E
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DEPARTMENT
j-•�
CITY OF
EDMONDS
DATE
NOTE: Applicant Subjec to Plan Cheek Fre
775-2525
This Permit co—re cork to be dune on prism. properly ONLY.
Any construction an the public domain (curbs, sidewalks, driveways,
FILE
marquees, etc.) will require separate perntlselon.
I BUILDING DEPARTMENT .Applicant Fill ZONE�s- ��� NUMMBBER. 740326
rtK MIT APPLICATI®N I Inside heavy Lines
NAME (OR NAME OF BUSINESS)
MAILING ADDRESS
O CITY TELEPHONE NUMBER
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Lj RESIDENTIAL
ADDRESS
GAS
LINE
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ADD
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CITY
ICN
0
TOTAL BLDG. AREA
❑ DEMOLISH
NAME
WALLNiNC
PROPOSED USE
ALTER
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VARIANCE OR CONDITIONAL USE
PERMIT NUMBER
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❑ OR FILL
CITY
STATE LICENSE NUMDI
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REPAIR
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❑
Legal De.crlptlon of Prop
IUMHER OF STORIES NUMBER OF
HEAT & GAS LINE
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UNITS
FENCE
IATURE OF WORK TO DE DONE
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Lj RESIDENTIAL
PERMISSIBLEq
PERMISSIBLE—ACT
LOT COVERAOE
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❑
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TOTAL BLDG. AREA
❑ DEMOLISH
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WALLNiNC
PROPOSED USE
ALTER
EAVATE
VARIANCE OR CONDITIONAL USE
PERMIT NUMBER
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PLUMBING
❑ OR FILL
(ENC. .......... Ft.)
11
REPAIR
❑ PRE-INSP.
❑
POOL
IUMHER OF STORIES NUMBER OF
HEAT & GAS LINE
DWELLING
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UNITS
FENCE
IATURE OF WORK TO DE DONE
SIGN
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PERMISSIBLE—ACT
LOT COVERAOE
LOT COVERAGE
PERMISSIBLE HEIGHT
PROPOSED HEIGHT
ACTUAL LOT AREA
0
TOTAL BLDG. AREA
REQUIRED YARDS
FRONT BIDE REAR
PROPOSED YARDS
FRONT BIDE REAR
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PROPOSED USE
LEGAL LOT
0 YES (3 NO
VARIANCE OR CONDITIONAL USE
PERMIT NUMBER
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STREET R/W O
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY 0
COMP. PLAN ST. R/W ............FT. ............FT. pl
REMARKS (�j7
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CHECKED BY
METER BILE I SERVICE SIZE I CLEARANCECHECKED BY W
REMARKS
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TYPE CONNECTION VERIFIED BY
FERC. TESTI PERMIT NUMBER
REMARKS W
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FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
I0YES ONO
SPECIAL INSPECTOR REQUIRED 11 OCCUPANCY GROUP
YES NO
PLAN CHECKED DY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
REMARKS
SHOULD BE CODED 31.04.\
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Fence roqu i remcinTs - sec h I <gn 12. i 4 .0A(1
clll't3l:tleU.
_.II.hA 11 D n
Title Permit c or
wk Ill be be done on Private Property ONLY. i
Any canelrurtlan un the public domain (,.,be, .Idewnik., driveway., I
marquee., etc.) will require eeParnle Perml.elon. INSPECTOR
Plan Check Nn .....................
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HUILDINO
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PROPOSED USE
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PLUMBING
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PLOT PLAN (Indicate Bulitl 'bilt Ing t,Oct.)
HEAT & GAS LINE
FENCE
% 11
SIGN
RETAINING WALL
iSWIMMING
POOL
i
DEMOLITION
-
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I
TOTAL AMOUNT DUE
I heresy acknowledge that I have read [hie application; that the in.
torm¢t"n given Is correct; and that I ani the Owner, or the duly author-
lud agent tr cto owner. t ¢sten to comply with Illy and elate Inwa
toting conetructloa; and In doing the work authorized thereby, no
ATTENTION
APPLICATION APPROVAL
'
ernon
person
Will be employed In violation of the Labor Code or the State of Wmhnston
THIS PERMIT
This application is not a permit until
�
relating to Workmen's Compensation Imurance.
AUTHORIZES
NOTE: Permit Limit One Year
ONLY THE
signed by the Building Official or his Dep -
(ERC -Pt DEMOLITIONS Wldch
WORK NOTED
utyi and fees are paid, and receipt is ae-
.hall be completed In ninety days; MOVED -1N BUILDINGS shall be Com•
kllowledged in space provided.
"'DlCted In six month..)
'81ONATyv.a OR AGENT) 1 DATE 81 NED
�\ , I
INSPECTION
DEPARTMENT
DIRECTOR'S Bltll(AT RE _
( n / • .. /
• !
CITY OF
i -
NOTE: Ahhlicant Suhiecl to Plan Check Fee
EDIVIONDS
Title Permit c or
wk Ill be be done on Private Property ONLY. i
Any canelrurtlan un the public domain (,.,be, .Idewnik., driveway., I
marquee., etc.) will require eeParnle Perml.elon. INSPECTOR
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