740330.pdfZ
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BUILDING DEPARTMENT Applicant Flll ZOO / • V. D <l�S D� PERMIT 740330
PERMIT APPLICATION Insldo Heavy Lines SGB 95/3 /r'lA/Ilf Si
ADDRESS
ESS)
N lOR NAGE OF BUSINESS)
/) /J PERMISSIBLE ? ACTUAL
LOT COVERAGES LOT COVEAOE
G w QL-R-
01 l Co -7o 0 1
ptio9 of Property (Show Below or
.L . _�
FRONT SIDE REAR FRONT
SIDE REAR
LEGAL LOT VARIANCE OR CONDITIONAL USE
YES NO PERMIT NUMBER
//
PLANNING DEPT. APPROVAL/LO /i L^
DATE:
STREET R/W
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT.
............FT.
REMARKS
flan Check No.... .................
SPECIAL INSPECTOR REQUIRED I OCCUPANCY GROUP
❑ YES VNO
ICHECKED BY
METERtll"LE SERVICE SIZE CLEARANCE
BY
a w
I I
ICHECKED
iia. ,cam 0M
1976
NA TU E OF WORK TO HE DONE
-Z
S -5 -
Valuation
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41.
FIRE ZONE '1'YYE ON OVitll'atuV YaV 1� nra:'a' ablrituvt
/ , YES NO
litt��i4IL��YF F
flan Check No.... .................
SPECIAL INSPECTOR REQUIRED I OCCUPANCY GROUP
❑ YES VNO
El
r
NEW
nnn
ALTER
REPAIR
10
❑
❑
RESIDENTIAL
NON-RESIDENTIAL
DEMOLISH
OR FILL
PRE-MOVEElPOOL
[:]LINE
1:1
❑
OAS
SIGN
RETAINING
WALL
FENC........... Ft.)•Z
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
SH EID 'DS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
REMARKS �7,L �+
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n//�t N//^//''^ {/�(/�/� /I� ,1 /TozJS
H p e e� - F-7
!UMBER OF STORIES
NUMBER OF
PROPOSED USE
PLUMBING
DWELLING
UNITS
J
PLOT PLAN (Indicate Building -thacks, abutting Streets)
HEAT & GAS LINE
NA TU E OF WORK TO HE DONE
-Z
S -5 -
Valuation
Fee Receipt No.
litt��i4IL��YF F
flan Check No.... .................
O
BUILDING
+++JJJ
PROPOSED USE
PLUMBING
J
PLOT PLAN (Indicate Building -thacks, abutting Streets)
HEAT & GAS LINE
N
�
I
FENCE
SIGN
RETAINING WALL
�
SWIDfMING POOL
'I
DEaIOLITION
_
PRE -MOVE INSPECTION
I
EXCAVATION OR FILL
I
— 1
b i�O
TOTAL AMOUNT DUE
I hereby acknowledge that I have reed this application; that the In-
formation given le correct; and that I am the owner, or the duly author-
Ized agent of the owner. 1 agree to comply with city and state law. regu.
ATTENTION
APPLICATION APPROVAL
lating con.tructlon; and In doing the Work authorized thereby, no person
will be employed In violation of the Labor Code of the Slate of Washington
THIS PERMIT
This application Is not a permit until
relating to Workmen's Compensation Insursnce.
AUTIIOmZEB
signed by the Building Official or his Dep -
�--- "-------,
NOTE: Permit limit One Year (E ... pt DEMOLITIONS w'hleh
ONLY THE
WORK NOTED
Dty; and fees are paid, and receipt is ac-
ahall be completed In ninety day.; g10VED-IN BUILDINGS ahall be com-
knowledged in space provided.
pleled In sib[ months.)
SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DIRECT '8 BIO U tE
DEPARTMENT
CITY OF
EDMONDS
DAT
NOTE: pplicant Subject to Pian Check Fee
6 S�� 7
775-2525
re on pr R'nte property ONLY.
Tkle Prrmll r ark Io be done
Al, rim •I rim!anti llfr pol�llr Aomnh. frnrua. nl�lrw'elk., drivew.y"
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