740467.pdf0 YES I] NO
YES [] NO
OF EDMONDS. LOCAL SALES TAX
SHOULD eE CODED 31.04.
REMARKS
Fence requirements — section 12.14.040
attached.
Plan Check No
BUILDING
Valuation I Fee
PROPOSED USE
PLUMBING
ElRESIDENTIALF-108
LINE
HEAT & GAS LINE
NEW
❑
NON-RESIDENTIAL
FENCE
SIGN
❑
ADD
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DEMOLISH
BUILDING
PERMIT
DEPARTMENT
APPLICATION
Appueant FlU
Insldo Heavy Lines
USE E NUmel 740461
JOB
ADDRESS
�/ r
AVATE
1
N SE (OR NAME OF U.1 -88))y
ITRMISSIBLE ACTUAL
IAT COVERAGE LOT COVEIAGE
❑
OROFILL
►Mi A
11 d
El
REPAIR
PERMISSIBLE HEIGHT PROPOSED HEIGHT F
IN PMOVE
❑
O
TT—
IUMBER OF STORIES
TELEPHONE NUMBER
I
ACTUAL LOT AREA TOTAL BLDG. AREA 7
DWELLING
/ L4 ziO
REQUIRED YARDS PROPOSED YARDS
FRONT S_JD I: REAR FRONT SIDE. REAR
TOTAL AMOUNT DUE
i
''( I1
NAME
r7
t 1
,.,.all.. given Is correct; and that I = the owner, or the duly author-
`
lied agent of the owner. I agree to comply with city and .tate laws regu-
i
H
O
ADDRESS
LEGAL LOT VARIANCE CONDITIONAL USF.
0 yF.e ❑ NO PERMIT NUMM BER
PLANNING DEPT. APPROVAL DATE:
This application is not a permit until
relating to Workmen's Compensation Insurance.
'
i
C
CITY
ONLY TH'
Won. NOTED
TELEPHONE NUMBER
STREET R/1V
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
knowledged in space provided.
p2
COMP. PLAN ST. R/W ............FT. ............FT.
/ r I/h_f) A
REMARKS c
0 YES I] NO
YES [] NO
OF EDMONDS. LOCAL SALES TAX
SHOULD eE CODED 31.04.
REMARKS
Fence requirements — section 12.14.040
attached.
Plan Check No
BUILDING
Valuation I Fee
PROPOSED USE
PLUMBING
ElRESIDENTIALF-108
LINE
HEAT & GAS LINE
NEW
❑
NON-RESIDENTIAL
FENCE
SIGN
❑
ADD
❑
DEMOLISH
L]RETAINING
ALL
RETA114ING WALL
ALTER
AVATE
❑
OROFILL
(,,�....z�J.,3F•t.)
El
REPAIR
❑
IN PMOVE
❑
swill
POOL
IUMBER OF STORIES
NUMBER OF
EXCAVATION OR FILL
DWELLING
TOTAL AMOUNT DUE
UNITS
''( I1
I hereby acknowledge, that I have read this application; that the In-
0 YES I] NO
YES [] NO
OF EDMONDS. LOCAL SALES TAX
SHOULD eE CODED 31.04.
REMARKS
Fence requirements — section 12.14.040
attached.
Plan Check No
BUILDING
Valuation I Fee
PROPOSED USE
PLUMBING
PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT & GAS LINE
FENCE
. 0
, 0 0
SIGN
RETA114ING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
''( I1
I hereby acknowledge, that I have read this application; that the In-
r7
t 1
,.,.all.. given Is correct; and that I = the owner, or the duly author-
`
lied agent of the owner. I agree to comply with city and .tate 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 State of Washington
THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit limit One Year (Except DEMOLITIONS which
ONLY TH'
Won. NOTED
uty; and fees are paid, and receipt is ac -
shall be completed in nicety day.; MOVED -IN BUILDINGS shall be com-
knowledged in space provided.
pletcd In six months.)
UrNATURE (OWNER OR AGENT)
DATE SIGNED
INSPECTION
D We GNAT E
DEPARTMENT
r�
—
CITY OF
�/j'
` � cta,
EDMONDS
DATE -
NOTE: Applicant Su jcct to Pfau Check Fer
— a
775-2525
O
�
This 1'ennit raven work to he dune an Drlyate properly ONLY.
7
Any construction on the public doo�aln (curbs, Ila -1h., 1111 aY.,
FILE
mnrnueen, etc.) will rceulee separate nermledon.