740370.pdff
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BUILDING DEPARTMENT I A,PU.tFill UBE PERMIT 740 70
ZONE NUMBER / l IBJ / ll
PERMIT APPLICATION
inside Heavy Linea
IP, 141 13 — 4 off" //J lv 1-/W -
WM
JOB
ADDRESS �) d /� _
m
U �� // W.
(/
RESIDENTIAL I
R
LINE
PROPOSED HEIGHT
NEW
t(u—i
NON-RESIDENTIAL
❑
SIGN
LEGAL LOTVARIANCE OR CONDITIONAL USE
n vsc n NO PERMIT NUMBER
ADD
❑
[O
0. PROPOSED
ElWAIL
NIL
1
ALTER
PLUMBING
DEMOLISH
O
FENCE
❑
ORFILL
HEAT A GAB LINE
....... _Pt.)
J
REPAIR
Swill
FENCE
❑
INSP�fOVE
❑
POOL
IUb16ER OF STORIES
NUMBER OF
WALL
DWELLING
SWIMMING POOL
UNITS
DEMOLITION
JOB
ADDRESS �) d /� _
m
U �� // W.
(/
PKIINIUSIBLE
LOT COVERAGE'
ACTUA(L/(//(/.2
LOT COVERAGE
PERMISSIBLE HEIGHT
PROPOSED HEIGHT
ACTUAL LOT AREA
TOTAL BLDG. AREA
REQUIRED YARDS PROPOSED YARDH
FRONT BIDE REAR PRONT HIDE REAR
LEGAL LOTVARIANCE OR CONDITIONAL USE
n vsc n NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
STREET R/W
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
REMARKS
[] YES EJ NO
YES ri NO
OF EDMONDS. LOCAL SALES TAX
i�
No.
Plan Check N
BUILDING
[O
0. PROPOSED
1
USE
t7,
PLUMBING
O
• 0
PLOT PLAN (Indicate Building Setbacks, abutting streets)
HEAT A GAB LINE
J
21
O
FENCE
-
e
SIGN
I
tRETAINING
WALL
SWIMMING POOL
-
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
^
Ta'S
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
S ll/
rormntlon given Is correct: and that I am the owner• or the duly author-
ized agent of the owner. I agree to comply with ally and .late laws regu.
ATTENTION
APPLICATION APPROVAL
Ieting construction; and In doing the work authorised thereby, no person
will beemployed 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 Imuran.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except nEb10LITIONS which
ONLY T
WORKry( NOTILEED
llty; and fees are paid, and receipt is ac -
Shall be completed In nicely days; MOVED -IN BUILDINGS shall be Som.
knowledged In space provided.
pleted In elx months.)
tl UI(F. (OWNE OR AGENT) DATE ONE
INSPECTION
O'S 'fI(ONAT
DI lt
I
DEPARTMENT
.� I
CITY OF
EDhfOND$
DATE
4`
NOTE: J [Pplicdnt Subject to Plan Cbrck Fre
775-2525
This Permit colvers work to be done an private property ONLY.
Any construction on the public domain (nabs, eldewNke, till—nee,
marquees, ele.) will require separate permleHon.
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