740453.pdfPlan Check Na .....................
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D YES [I NO
PROPOSED USE
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SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
NEW
ADD
RESIDENTIAL
No
DEMOLISH
F]SGN
LINE
B
RETAINING
WALL
❑PLAN CHGCKEtODYO
REMARKS
PERMIT 740453
BUILDING
DEPARTMENT
Applicant Fill
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REPAIR
PERMIT
APPLICATION
Ineldo Heavy Linos
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(UMBER OF STORIES
NUMBER OF
BION
ADDRESS � _K/ IW
RETAINING WALL
DWELLING
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PERMISSIBLE 7 ACTUAL
LOT COVERAGE LOT COVERAGE
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Receipt 2
TELEPHONE NUMBER
ACTUAL LOT AREA TOTAL
EXCAVATION OR FILL
REQUIRED YARDS PROPOSED YARDS
NAME
FRONT e1DE REAR FRONT 3IIE REAR
TOTAL AMOUNT DUE
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I hereby acknowledge that I have rend this application; that the In.
LEGAL LOT VARIANCE OR CONDITIONAL USE
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ADDAEdB
YESNO PERMIT NUMBER
,zedagent of the owner. I agree to comply with city and state law. regu-
ATTENTION
APPLICATION APPROVAL
lating construction; and In doing the work authorized thereby, no Dereon
PLANNING DEPT. APPROVAL DATE:
x•111 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 Insurance.
CITY
signed by the Building Official or his Dep -
NUMBER
ONLY THE
WORK NOTED
and fees are paid, and receipt is ac -
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shall be completed In nloety days: MOVED -IN BUILDINGS shall be corn.
knOWledged in space provided.
plated In six months.)
(TELEPHONE
STREET li/IV
EXI8TIN6 STREET R/W ............FT. DEFICIENCY THIS PROPERTY
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DIRE TOR'S JIMNATU i. -':.'.-'-" '•
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DEPARTMENT
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COMP. PLAN ST. R/W ............FT. ............FT.
EDMONDS
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NOTE: Applicmti Subject to Plan Check Fee
REMARKS
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TELEPHONE NUMBER
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METER SIZE SERVICE SIZE CLEARANCE
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STATE LICENSE NUMIDER
CITY LICEN NUMBER
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REMARKS
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Legal Description 1 Property (ehow Below or Attach Four Copies)
TYPE ONNECTION
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PERC. TEST
PERMIT NUMBE
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FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
Plan Check Na .....................
1
Z �11 t %� — .� � +
D YES [I NO
PROPOSED USE
PLUMBING
SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
NEW
ADD
RESIDENTIAL
No
DEMOLISH
F]SGN
LINE
B
RETAINING
WALL
❑PLAN CHGCKEtODYO
REMARKS
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
EJ ALTER
❑
EXAVAT ORCI-ILL E
EliENC...........Ft.)
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REPAIR
❑
INSPMSOVE
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PWITA
OOL
(UMBER OF STORIES
NUMBER OF
BION
RETAINING WALL
DWELLING
N
UNITS
SWIMMING POOL
JATURE OF W
1
DE ONE
Valuation
Fee
Receipt 2
EXCAVATION OR FILL
Plan Check Na .....................
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BUILDING
PROPOSED USE
PLUMBING
O PLOT PLAN (Indicate 8ulltlmg eelbaeka, abutting elrccla)
BEAT A CAH LINE
O
PENCE
BION
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
C-Y�
I hereby acknowledge that I have rend this application; that the In.
�J
fonnnNm on given le correct; and that I athe owner, or the duly mthor.
,zedagent of the owner. I agree to comply with city and state law. regu-
ATTENTION
APPLICATION APPROVAL
lating construction; and In doing the work authorized thereby, no Dereon
x•111 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 Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIUNH which
ONLY THE
WORK NOTED
and fees are paid, and receipt is ac -
Dty; p
shall be completed In nloety days: MOVED -IN BUILDINGS shall be corn.
knOWledged in space provided.
plated In six months.)
SIGNATURE (OW NEII i AGENT) DATE SIGNED
INSPECTION
DIRE TOR'S JIMNATU i. -':.'.-'-" '•
( '
DEPARTMENT
CITY OF
EDMONDS
DATE
NOTE: Applicmti Subject to Plan Check Fee
—
ns-asas
This PernllLcoven work to be done on private property ONLY.
Any const rust i nn on the public domain (enrbn, old—Mlin, driveways.
FILE
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