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740436.pdfBUILDING DEPARTMENT DBE PERMIT Applicant Filt ZONE �S--�j NUMBER PERMIT APPLICATION I Inside HGLVy Linea dos � ADDRESS 5 �� NADIE (O E OF BUp1NEbb) ACTUAL PERISSIBLE /_ /YiS w..O LOT ACOVERAOEe LOT COVERAGE Eb E FRONT BIDE nEAR FRONT BIDE REAR S 1 [] LE At, LOT VARIANCE: OR CONDITIONAL USE 0 YES NO PERMIT NUMBER NEW PLANNING DEPT. APPROVAL DATE: STREET R/LV PLUMBING EXISTING STREET R/W ...._......FT. DEFICIENCY THIS PROPERTY COMP. PLAN ST. R/W ............FT. ............FI'. REMARRB NON-RESIDENTIAL [ CHECKED HY � PLOT PLAN (Intlleate Building eetbaeke, abutting e[raete) METER BILE I BERVICfl SIZE I CLEARANCE CHECRED HY REMARKS N A ADD �6— /'J/A ❑ YES ❑ NO GROUP ICATED IN THE CITY LOCAL SALES TAX Plnn Cheek No ..................... DUILDIN6 ElRESIDENTIAL [] LINE ❑P NEW PLUMBING LANS ❑ NON-RESIDENTIAL [ � PLOT PLAN (Intlleate Building eetbaeke, abutting e[raete) HEAT & GAS LINE SIGN ® ADD ❑ Ej ylALL KING REltA] SIGN DEMOLISH TRETAINING WALL ALTER CTE ❑ PEN ❑ ORFIIL x..........Ft.) REPAIR ❑ PRE-INSP. El SWIM _ IUMBER OF STORIES NUMBER OF EXCAVATION OR FILL I DWELLING ❑ YES ❑ NO GROUP ICATED IN THE CITY LOCAL SALES TAX Plnn Cheek No ..................... DUILDIN6 E.Ei E PROPOSED UBE PLUMBING k � PLOT PLAN (Intlleate Building eetbaeke, abutting e[raete) HEAT & GAS LINE 21 FENCE SIGN TRETAINING WALL N SWIMMING POOL DEMOLITION PRE -MOVE INSPECTION EXCAVATION OR FILL TOTAL AMOUNT DUE 0 I hereby acknowledge that I have read this application; that the In- formation Riven Ie correct; and that I em the owner, or the duly author- ized agent of the owner. I agree to comply with city and stele law" regu- ATTENTION APPLICATION APPROVAL lating conetructlon; and In doing the work authorized thereby, no person trill be employed In violation of the Labor Cade of the State of Wmhington THIS PER5IIT This application 1s not a permit un reinting to Workmen's Carepeneatlon Ineurance. AUTHORIZES eigned by the Building Official Or his D( NOTE: Permit Limit One Year (Except DEMOLITIONS which ONLY THE WORK NOTED uty; and fees are paid, and receipt is t .11¢11 be completed In nl¢ety days; BIOVED-IN BUH,DINGS shall be co n- knowledged in space provided. pleted In eIx manth".) SIGNATURE (OWNER Olt AGENT) DATE SIGNED INSPECTION DIRE B S ♦ RE a9 DEPARTMENT •-� CITY OF EDMONDS DA•, l• NOTE: Applicant Subject to Plan Check Fee "~ 775.2525 fe Thle 1'lrnrlt !ar'enwork to be done an Private property ONLY. • Any construction on the public domaln (curbs, .Idewdk., driveway., FILE mnrqu!!.. etc.) will require elparate Perml..len.