740335.pdfO
F PERC. TEST PERMIT NUMBER y.
is
U
41 REMARKS
.i
RESIDENTIAL
❑
LINE
ElNEW
NON-RESIDENTIAL
❑
SIGN
❑ ADD
ElDEMOLISH
BUILDING
❑
yALL NING
ElALTER
at
ZONNE 740335
❑
ENC
BUILDING DEPARTMENT
,ppu=t Flu
NUMHIER
( x .......... Ft.)
REPAIR
❑
PERMIT APPLICATION
Inside Ilcavy Lines
JOB
ADDRESS /A _
IUMBER OF STORIES
NUMBER OF
NAME OF 6U8 NE88)
SIGN
�I YJ ��
DWELLING
NAME (DR
1 /—
PERAIISeIBLECT CO
LOT COVERAGEOT VAAGE
UNITS
N
m MAI
LI ( ADDRESS
O O
PEItD11tl918LE HEIOifT PROPOSED ItElOHT
SG
O CITY
TELEPHONE NUMBER
ACTUAL LOT AREA TOTAL BLDG. AREA
N
f
DEMOLITION
REQUIRED YARDS PROPOSED YARDS
I'
NAME
FRONT SIDE REAR FRONT BIDE REAR{
'
EXCAVATION OR FILL
F ADDRESS
LEGAL LOT VARIANCE Olt CONDITIONAL USE
NUMBER
YES ❑ NO PERMIT
I�
II,
PLANNING DEPT. APPROVAL DATE:
TOTAL AMOUNT DUE
C CITY
TELEPHONE NUMBER
STREET R/W
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
I'
COMP. PLAN ST. R/W ............Fr. ............FT.
I"
Ised agent of the owner. I agree to comply with city and .tela law. reg.-
ATTENTION
APPLICATION APPROVAL
REMA..
x
1pC ADDRESS •(D.
will be employed In violation of the Labor Code of the State of Washington
OZ
This application is not a permit until
O 0/ S (/ V,cli
CHECKED BY
Permit Limit One Year (Except DEMOLITIONS which
ONLY
ONLY Tt[E
Y
TELEPHONE NUMBER
Shall be completed In ninety days; MOVED -IN BOILDIN09 Shall be cam-
WORK NOTED
ltnowledged in apace provided.
Pleted In six month..)
' I
4
METER SIZE I SERVICE SIZE CLEARANCE
I CHECKED BY
I DATE BIONED
INSPECTION
O
F PERC. TEST PERMIT NUMBER y.
is
U
41 REMARKS
.i
FIRE ZONE I TYPE OF CONSTRUCTION I STREET IMPROVED
YES [] NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
[3 YES L] NO
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS, LOCAL SALES TAX
.........0 ... ........ av au u..ac.
RESIDENTIAL
❑
LINE
ElNEW
NON-RESIDENTIAL
❑
SIGN
❑ ADD
ElDEMOLISH
BUILDING
❑
yALL NING
ElALTER
at
EXCAVATE
❑
ENC
❑
ORFILL
( x .......... Ft.)
REPAIR
❑
PRE -MOVE❑
SWIl
IUMBER OF STORIES
NUMBER OF
SIGN
DWELLING
RETAINING WALL
UNITS
N
FIRE ZONE I TYPE OF CONSTRUCTION I STREET IMPROVED
YES [] NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
[3 YES L] NO
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS, LOCAL SALES TAX
.........0 ... ........ av au u..ac.
Valuation
Fee ReCelpt No.
'-
F � V
Pion Check N
BUILDING
G PROPOSED UBE
PLUMBING
at
PLOT PLAN (Indlcrtla Building Setback., abutting streets)
HEAT & GAS LINE
9
FENCE
SIGN
II
RETAINING WALL
N
SWIMMING POOL
f
DEMOLITION
I'
PRE -MOVE INSPECTION
'
EXCAVATION OR FILL
ii
i
TOTAL AMOUNT DUE
that
I hereby acknowledge that 1 have read this appl"of"'; that the 1n-
formation given le correct; and that I — the owner, or the author-
I"
Ised agent of the owner. I agree to comply with city and .tela law. reg.-
ATTENTION
APPLICATION APPROVAL
`
lating construction; and In doing the work authorized thereby. no person
will be employed In violation of the Labor Code of the State of Washington
THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
Permit Limit One Year (Except DEMOLITIONS which
ONLY
ONLY Tt[E
uty; and fees are paid, and receipt is ac-
p
Shall be completed In ninety days; MOVED -IN BOILDIN09 Shall be cam-
WORK NOTED
ltnowledged in apace provided.
Pleted In six month..)
tl1GNATURE (OWNER OR GEN
I DATE BIONED
INSPECTION
DIR OR•S 8(,GNATU _ _
DEPARTMENT
_/•��
CITY OF%rI:ra:G(.1/'i"�r
(�'"V�i'L�LLG:•6
NOTE: Applicant Subject to Plan Check Fee
EDMONDS
DATB—
6, /
")
775-2525
This Permit eaten work to be done on prlt'rtle Property ONLY.
Any .nasi rnrlinn an thr Irnbtlere�inlri• dmm�ln (enrbn, nlden'Mitn, driveway.,ay.•
FILE
j
i•,•.• , .) r. in nrpn rate 1'1-ka,.
trynt
I