740505.pdfSTATE LICENSE NUMBER
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U
yE NO ERMIT NUMB�y
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DEPARTMENT
PL jN0 D P V L DA
CITY I
TELEPHONE NUMBER
USE
NUMB1eTrt
1
BUILDING
Applicant Fill
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NAME
CDMP, PLAN BT. R/W ............F'r. - ............FT.
PERMIT APPLICATION
I Inside Heavy Lines
ion
ADDRESS
-
ADDRESS
NAME (OR NAME OF BUSINESS)
(CHECKED BY
TYPE CONNECTION
VERIFIED BY
Frank L. b Dorothy Brandt
PERMISSIBLE -I
LOT COVERAOE
ACTUA
LOT COVEWAGE
METER SIZE
MAILING ADDRE88
CLEARANCE
CHECKED BY
Acre Tracts. As described In attached
IE HEIGHT
PERDIISSB1.
PROPOSED HEIGHT
1336 - 205th Street
:tS
pERC.TE8T
NUMBER
O CITY
TELpEPHONE NUMBER
ACTUAL LOT AREA
TOTAL' LUG. AREA
Edmonds, Washington
770-6972
REQUIRED YARDS
I PROPOSED YARDS
Governor's Deed.
NAME
FRONT SIDE
REAR FRONT SIDE REAR
F
U
47
REMARKS
LEGAL LOT VARIANCE OR CO D U
STATE LICENSE NUMBER
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yE NO ERMIT NUMB�y
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PL jN0 D P V L DA
CITY I
TELEPHONE NUMBER
STREET
E%IBTI STREET R/W ............ DEFICIENCY THIS PROPE TY
1
REMARKS
1
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NAME
CDMP, PLAN BT. R/W ............F'r. - ............FT.
W
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REMARKS Driveway slopes not to exceed those
indicated on Standard Dmg. No. 103
ADDRESS
(CHECKED BY
TYPE CONNECTION
VERIFIED BY
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it
N CITY
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V
TELEPHONE NUMBER
METER SIZE
SERVICE SIZE
CLEARANCE
CHECKED BY
Acre Tracts. As described In attached
STATE LICENSE NUMBER
CITY LICENSE NUMBER
F
REMARKS
1
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'I
Legal Description of Property (Show Below or Attach Four Copies)
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Portion of Tract 13 Lake McAleer Five
TYPE CONNECTION
VERIFIED BY
(PERMIT
Acre Tracts. As described In attached
II
pERC.TE8T
NUMBER
'
2
I
i
Governor's Deed.
�
47
REMARKS
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FIRE ZON PE OF STREET IDSPROVED
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YES NO
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SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
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RESIDENTIAL
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❑ YES Q NO
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NEW
('INE
PLAN CHECKED BY
THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL
❑
OF EDMONDS. LOCAL SALES TAX
SIGN
SHOULD BE CODED 31.04.
ADD RETAINING
WALL
REMARKS
DEMOLISH
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ALTER EXCAVATE O FENCE
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OR FILL (......... .x .......... Ft.)
INSP. VE SWIM
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REPASR
INSP. � POOL
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NUMBER OF STORIES NUMBER OF
A Vr1<VFA
DWELLING
• J UMTS
NATURE OF WORK TO DE DONE
Valuation
Fee Receipt No.
Grading 6 Filling On Y
Plan Check Nn -
Y.
BUILDING
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[^
a, PROPOSED USE
!
PLUMBING
Future Commercial Site
PLOT PLAN (lndlcata Building Setbacks, abutting streets)
HEAT k GAB LINE
C
FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
—
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have rend ibis application; that the In-
10 _0 —0
farmatlnn 9111, la -71; and that I a n the owner, or the duly author.
(red agent of tho owner. I agree to comply with city and state laws regu.
ATTENTION
APPLICATION APPROVAL
laung construction; end In data, the work authorised thereby, no person
will be employed In Violation of the Labor Code of the State of WuhlDgton
THIS PERMIT
This application is not a permit until
relatingto Workmen's Compensation Insurance.
AOTHORIZF.B
Signed by the Building OIfICiHI Or his Dep-
NOTE: Permit limit One Year (Except DEMOLITIONS which
ONLY THE
WORE NOTED
uty; and fees are paid, and receipt is ac -
L_._�--"'--`
shall be completed In ninety days; MOVED -IN BUILDINGS shall be corn.
lDlowledged in space provided.
pleted In six months.)
jjDalATU1tE (OWNER Og7pGENT)
DATE SIGNED
INSPECTION
DIRE(. WS SIGNAT RE
//
DEPARTMENT
CITY OF
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EDMONDS
DATE
NOTE: Applicant Subject to Plan Check Fee
775-2525
This Permit Is— work to be done an private property ONLY.
Any t..Ilnlcl inn nn the public dmmain (enrbs, sidewalk., driveways,
rl r.l ulll rr�lulrr .epurnle prrrnleslnn.
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