740367.pdfI
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USE PERMIT A. ( ]
BUILDING DEPARTMENT Applicant Fill ZONE NUM➢ER 7.40:36
o /
PERMIT APPLICATION Ineldo Heavy Lines AD
ADDRESS
/I NAME (OR NAME OF ➢UBINEBB/') R tlf f• a L /�
A I b� S Jpxc%�, 17- LOT OOVERA0E LOTUCOVERAGE
FIRE ZONE I TYPE OF CONSTRUCTION I a'1I NZW IMPROV.
YES E] NO
SPECIAL INSPECTOR REQUIRED I OCCUPANCY GROUP
YES ❑ NO
PLAN CHECKED DY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
REMARKS
Valuation Fee Rome
-.fl'()(/(/
Plan Check No .....................
PERMISSIBLE HEIGHT PROPOSED HEIGHT
0 `
LINE
�t
AREA TOTAL BLDG. AREA
Z
TELEPHONE NUMBER ACTUAL LOT
❑
SIGN
REQUIRED YARD. PROPOSED YARDS
BIDE REAR
W
FRONT BIDE REAR FRONT
A,+•
/I�' /��+/�(f
LEGAL LOT VARIANCE OR CONDITIONAL USE
i
13 YES ❑ NO PERMIT NUMBER
UIC
/ /W
PL HIj' PT. A! ROVA DATE:
i
TELEPHONE NUMBER
L/'2 1
STREET R/\V
STREET
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
i
( .ENCx.......... Ft.)
ElREPAIR
COMP. PLAN ST. R/W ............FT. ............FTs
WWI
INSPa10VE
❑
REMARKS
;UMBER OF STORIES
N 111113 OF
I
O
FIRE ZONE I TYPE OF CONSTRUCTION I a'1I NZW IMPROV.
YES E] NO
SPECIAL INSPECTOR REQUIRED I OCCUPANCY GROUP
YES ❑ NO
PLAN CHECKED DY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
REMARKS
Valuation Fee Rome
-.fl'()(/(/
Plan Check No .....................
RESIDENTIAL
LINE
1
1
NEN
❑
NON-RESIDENTIAL
❑
SIGN
1
J
ADD
❑
DEMOLISH
❑
µEAT�A,IKING
1
ALTER
PLUMBING
EXCAVATE
❑
❑
ORFILL
( .ENCx.......... Ft.)
ElREPAIR
HEAT A GAS LINE
INSPa10VE
❑
POOL
;UMBER OF STORIES
N 111113 OF
I
O
FENCE
DWELLING
I
I
SIGN
UNITS
RETAINING WALL
FIRE ZONE I TYPE OF CONSTRUCTION I a'1I NZW IMPROV.
YES E] NO
SPECIAL INSPECTOR REQUIRED I OCCUPANCY GROUP
YES ❑ NO
PLAN CHECKED DY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
REMARKS
Valuation Fee Rome
-.fl'()(/(/
Plan Check No .....................
1
1
BUILDING
r
r� Off
1
J
F:
`=
1
Y PROPOSED USE
PLUMBING
PLOT PLAN (Indicate Bullding setback., abutting streets)
HEAT A GAS LINE
0
I
O
FENCE
I
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
1
TOTAL AMOUNT DUE
I hereby acknowledge that I haus rend this application; that the In.
formation given In correct; and that I a e the owner, or the duly author-
Ised agent of the owner. I agree to comply with city and state taws ragu-
ATTENTION
APPLICATION APPROVAL
laIIng coastructlon; and In doing the work authorised thereby, oo person
will be employed In violation of the Labor Code of the Stale of Washlogton
THIS PERMIT
This application is not a permit until
relating to Workmen'. Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep-
NOTE: Permit limit One Year (Except DEMOLITIONS which
ONLY TIL------
WORK NOTE"D
Uty; find fees are paid, and receipt is Be
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
knowledged in space provided.
pleted In six months.)
SIGNATU (OWNER O AGEN
DATE 816NED
INSPECTION
ONATURDEPARTMENTCITY
MIP"S
J
OF
EDMOND9
AT
NOTE: Applicant Subject to Plan Cbeck Fee
_
775-2525
This Per It nl work to be done on private property ONLY.
Any rnn.lrnrl Lon en the public domain (curb., sidewalks, driveways,
FILE
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