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740341.pdfUSE PERMIT til.!
ONE ^ •J NUMBER
BUILDING DEPARTMENT I AppU..tM _
'
UNITS
PERMIT APPLICATION 1ne1de Heavy Lines JOB
NAME (OR NAME OF BUSINESS)
PERMISSIBLE ^ ACTUAL
1( �J' Y T7-'Y7('"'r if Po LOT COVERAGES �/ LOT COVESYAOE
i '
' 1
I
M1 n
SM_AILIYNO,iADD jWB / ��/�� PERMISSIBLE HEIGHPT'`'✓,e— OPOBED 11 HTT
_7 t`�"� T
Fee o.
ZO�'i-O `fl l.0 ACi'VAL LOT AREA TOTAL 6LPET. AREA
CITY PHONE NUMBER
•P7,
Q- REQUIRED YARDS PROPOSED YARDS
I
NAME FRON Sipe' REAR FRONT SIDE REAR
BUILDING
y
I; �I�TRIGk M ITc Ni:L(r LEGAL LOT VARIANCE OR CONFIT
ADDREe8 8 [] NO PER IT NUMBE
PLUMBING
U 2.40-cz5-/ E 4 2. -v.f� -/ 1 1 PL DE T. PRO
Cl
CITY TEjL�EPHONE M7BER
It /NSU
?1icLLV1JS f✓ �` ` "�a 7� EXIBTI STREET R/W ............FT. FI CIENCY TIHB PROPERTY
i
MO.,Yt/IN
�
NAME
COMP. PLAN ST. R/W ............F1'. W
�
K Or Q coli, c-rloLU REMARKS Driveway slopes not to exceed those Z
C
BION
m
ADDRESS indicated On Stanrlwrrl awn _ Nn
RETAINING WALL
CHECKFcD BY
i
CITY NUMBER
I
z
e
ITELEPHONE Tp;4'uIW(,rl(
METER SIZE SERVICE SIZE CLEARANCE C11EC ED BY
SWIMMING POOL
U
SATIATE LICENSE NUM/BBE�R7' CITY LICENSE NUMBER
[t+
REMARKS
Legal Deeerlptlon oL ProDarty (Shaw Below or Attach Four Copies) Si3f::fA /�A �Paem rr
DEMOLITION
l.1IW�E .ill
E. 280.0 ft Of the S. 2I7.0 ft Of the SE TYPE CONNECTION VERIFIED BY
0
1/4, NE 1/4 of Section 19 Township 27, 54� 59WErZ—
Range d Fact except a 30°for road and the FERC. TEST PERM NUMBER tG
EXCAVATION OR FILL
east 200.0 ft of tract 182 Wiliowdale `-
WQardangD
�
#1 REMARKS 1 m
UNt1i:1lGP-oi'N'D wiKil�� l:t�D. SEiiMFNd�/WD
FIRE 7$,pDDDFFES TYPE OF CONSTRUCTION STREET IMPROVED
.W7
YES [j NO
TOTAL AMOUNT DUE
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
❑ GA. YES ❑ NO g -� Z
ElRESIDENTIALLINE
PLAN CHECKED BY E] NEW THIS SITE IS LOCATED IN THE CITY
.
formation Elven Ie correct; and that I am the owner, or the duly author-
NON-RESIDENTIAL ❑ SIGN -PP0T jA-" OF EDM IE DS. LOCAL SALES TAX
01 EDD BE CODED 31I
Ized agent of the owner. I agree to comply with city and state Isws ragu-
ADD RETAINING REMARKS I
❑ DEMO❑ WALL (iQ7�{\
APPLICATION APPROVAL
lating Conetructlon; and In dolt. the work authorized thereby, no person
i20� jD
11-G iNPRtwEMw
FENCE boor) IG•�L�f'C.U`
.
wl4 be employed In violation of the Labor Code of the State of Wsahmgton
❑ ALTER EXCAVATE ❑
❑ OR FILL (-.........x .......... Ft.)
This application is not a permit until
relating to Workmen's Compensation Itsuranes.
❑ REPAIR ❑ PRE -NSP. ❑ swim
POOL
Signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS whlch
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac -
NUMBER OF STORIESNUMBER OF
DWELLING
'
UNITS
NATURE OF WORK TTO.{B.�E� D/ONE`J
Valuation
Fee o.
N ✓'+'(/t% J e�K� 7 V T� T �Tlt-�./� 17/
Pion Check N..J,_ .7
u r�celpt
/6 S'. oG.J / � e
Z
O r,0_-AA`�;,
BUILDING
a PROPOSED USE
PLUMBING
+'r
PLOT PLAN (Indlcate Building setbacks, abutting Streets)
HEAT k GAS LINE
q
�
FENCE
BION
RETAINING WALL
N
SWIMMING POOL
-
DEMOLITION
l.1IW�E .ill
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I hava read this application; that the In -
formation Elven Ie correct; and that I am the owner, or the duly author-
Ized agent of the owner. I agree to comply with city and state Isws ragu-
ATTENTION
APPLICATION APPROVAL
lating Conetructlon; and In dolt. the work authorized thereby, no person
wl4 be employed In violation of the Labor Code of the State of Wsahmgton
THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation Itsuranes.
AUTHORIZES
Signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS whlch
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac -
shall be Completed In Nasty days; MOVED -IN BUILDINGS shall be corn-
knowledged in space provided.
plate,, in nix months.)
16 (OWN OR AGENT) DATE SI NED
INSPECTION
DEPARTMENT
DIRECTOR'S N R
' 7
CITY OF
EDMONDS
DATE
NOTE: Applicant Subject to Plan Check Fee
PH 6.1107
This Permit coven work to be done on p'i'ste progeny ONLY.
Any construction on the public domain (Curbs, sidewalks, driveway..
FILE
murauece. e1..) x111 reymrn separate perminlon.
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