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LEGAL LOT VARIANCE OR CONDITIONAL USE
N ADDREBB
7
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PLANNING DEPT. APPROVAL DATE:
CITY
NUMBER
DEPARTMENT
(TELEPHONE
PERMIT [�
NUMB EEL 7-T03•/L
..
Applicant Fill
UBEry
ZONEICS—�oC
07 ADDRESS
ITAPPLICATION
Inside Heavy Lines
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I CHECKED BY
F.aCITY
TELEPHONE NUMBER
7
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NAME OF BUSINESS)PERMISSIBLE17
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HEAT & GAS LINE
ACTUALQ
I CHECKED BY
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FENCE
REMARKS
FBLING
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LOT COVERAGELOT
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HEIGHT
PROPOSED HEIGHT
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DEMOLITION
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROV(
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ACTUAL LOT AREA
TOTAL BLDG. AREA
EXCAVATION OR FILL
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77`7e3REQUIRED
YARDS
PROPOSED YARDS
SPECIAL INSPECTOR REQUIRED I OCCUPANCY GROUP
❑ YES E] NO
TOTAL AMOUNT DUE
FRONT SIDE
REAR FRONf__ffIDE REAR
RESIDENTIAL
NON-RESIDENTIAL
❑
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LEGAL LOT VARIANCE OR CONDITIONAL USE
N ADDREBB
YESNO PERMIT NUMBER
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PLANNING DEPT. APPROVAL DATE:
CITY
NUMBER
A/W
(TELEPHONE
STREET
EXISTING STREET R/W ........ ... Fr. DEFICIENCY THIS PROPERTY
COMP. PLAN 0T. R/W ............FI'. ............FT.
NAME
n
REMARKS
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07 ADDRESS
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PLUMBING
I CHECKED BY
F.aCITY
TELEPHONE NUMBER
7
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HEAT & GAS LINE
METER SIZE I SERVICE SIZE I CLEARANCE
I CHECKED BY
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Plan Check No .....................
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PERC. TEBT
PERMIT NUMBER
BUILDING
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4 PROPOSED USE
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HEAT & GAS LINE
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FENCE
REMARKS
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SIGN
tRETAINING
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DEMOLITION
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROV(
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I Ej YES [3 NO
SPECIAL INSPECTOR REQUIRED I OCCUPANCY GROUP
❑ YES E] NO
TOTAL AMOUNT DUE
NEW
RESIDENTIAL
NON-RESIDENTIAL
❑
GAS
LINE
SIGN
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
REMARKS
r�
Fence requirements - section 12.14.040
FJ
El
ADD
ALTER
DEMOLISH
EXCAVATE
OR FILL
121
RETAINING
WALL
FENCE
laling construction; and In doing the work authorised thereby, no person
REPAIR
❑
TNSP.
❑
swim
attached.
NUMBER OF STORMS
NUMBER
ONLY THE
WORK NOTED
uty: and fees are paid, and receipt is ac -
shall be completed In nloety days; bIOVED-IN BUILDINGS shall be =in.
knowledged In Space provided.
pleted In six months.)
I
SIGNATURE (OWNER ORA ENT)
DATE SIGNED
INSPECTION
DIRECT SIGN TURF
UN ITS
DEPARTMENT
CITY OF
- F.• f r,
No.
Plan Check No .....................
Z
BUILDING
[O
4 PROPOSED USE
'fy
PLUMBING
U
PLOT PLAN (Indicate Building Setbacks, abutting Streets)
HEAT & GAS LINE
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FENCE
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SIGN
tRETAINING
WALL
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SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
[ hereby acknowledge that I have read this apPllcntlon; that the In.
_
formation given Is correct; and that I ara the owner, or the duly author.
Iced agent of the owner. I agree to comply with city and state lawn regu.
ATTENTION
APPLICATION APPROVAL
laling construction; and In doing the work authorised 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'. Compensation I¢surnnce.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
uty: and fees are paid, and receipt is ac -
shall be completed In nloety days; bIOVED-IN BUILDINGS shall be =in.
knowledged In Space provided.
pleted In six months.)
SIGNATURE (OWNER ORA ENT)
DATE SIGNED
INSPECTION
DIRECT SIGN TURF
�y ' /
DEPARTMENT
CITY OF
- F.• f r,
_
M.-_0nwxE
NOTE: Applicant Subject to Plan Check Fee
775-
This Permit coven stork to be done on private property ONLY.
Any rnnn'rurtlnn on the publle domain (curbs, sidew•Nks, drlrew'ays,
_ FILE
,rin.rr,, rl i.i .,Iii t,•�mire bePurut,• nrrml,nlon.