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USE
BUILDING DEPARTMENT I ApplicantIlill ZONE
PERMIT APPLICATION Inside, Heavy Lines JOB
ADDS
NAASE lOR NAME OF BUB NE88)
L 6 W Pr:RNIiN
LOT
C AlWNO AD DREGS
PERM
e,7 C1f S/� �2S Y74 _....... �� 11
PERM
NUMBEER 740452
I%
FRONT SIDE REAR FRONT SIDE REAR
LEGAL LOT VARIANCE OR CONDITIONAL USE
i] YES [:INO PERMIT NUMBER
PLANNING DEPT. APPROVAL/ O 3 / (} DATE:
L / D c i7
STREET R/{V
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ........,...FT. ............FT.
REMARKS
730 3 17 CHECXED BY
M ' eIZ I SERVICE SIZE I CLEARANCE CHECKED BY
aeMARx
), , 7 303i 5
73d3/
TYPE OF CON�BfT'RUCTIO STREET IMPROVI
(-1 -/ Q YES PO
INSPECTOR REQUIRED OCCUPANCY GROUP
ECKE IIY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
' HOULD BE CODED 31.04.
J%J"eC
RESIDENTIAL
GAS
E]
(3 YES
NEN
LINE
BUILDING
1 i7 B 0
❑ NON-RESIDENTIAL
SIGN
r. PROPOSED USE
❑ ADD
❑ DEMOLISHO
RETAINING
WALL
RE ,
El ALTER
VATE
El PEN ...
❑ ORCFILL
.......... Ft.)
REPAIR
❑ PRE-NPTIOVE
SWIM
❑ POOL
p�
(UMBER OF STORIES NUMBER OF
O
DWELLING
UNITS
PENCE
IAT OF WORK TO BE DONE
_
I
_
F
l�-�I-lx
�. Or=
73d3/
TYPE OF CON�BfT'RUCTIO STREET IMPROVI
(-1 -/ Q YES PO
INSPECTOR REQUIRED OCCUPANCY GROUP
ECKE IIY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
' HOULD BE CODED 31.04.
J%J"eC
Plan Check Nn.
F
BUILDING
1 i7 B 0
QO
r. PROPOSED USE
`H1✓�T.
PLUMBING
��(,
O
aPLOT
PLAN (Indicate Building setbacks, abutting streets)
HEAT & GAS LINE
O
O
PENCE
_
I
SIGN
RETAINING WALL
N
SWIMMING POOL
_
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
i
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
formation given iscorrect; and that I am the owner, or the duly author-
_
(zed agent of the owner. I agree to comply with city and .late laws regu-
ATTENTION
APPLICATION APPROVAL
lating construction; and In doing the work authorized thereby, no person
will be employed In Violation of the Labor Code of the Slate of Washington
THIS PERMIT
This application Is not a permit until
relating to Workmen's Compensation In.ureau.
AUTHORIZES
signed by the Building Official Or his Dep-
i
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
---
3 -
shall be completed In ninety day.; MOVED -IN BUILDINGS shall be win-vledged
in space provided.
pleted In six months.)
SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DIR TOR•H Bl AT
DEPARTMENT
CITY OF
F.DRiONDB
ATE
NOTE: Applicant Subject io Plan Check Fee
775-2525
)-314-24
This 1•ermlt auvere work to be done on prlynte property ONLY.
Any construction on the public uomaln (curb.• sidewalks, drlceways,
i�i..rnii,•rr, rtr.l i, 111 rr�l nl rr �rinarnlr Irr,nlssien.
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