740513.pdfBUILDING DEPARTMENT AppllcantP711
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NUMBR 740513IE
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PERMIT APPLICATION Inside Heavy Lines
ADDRESS
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NAME OR NAME OF BUB(NE..1
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PROPOtlED HEIGHT
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ACTUAL LOT AREA
TOTAL BLDG. AREA
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REQUIRED YARDS
PROPOSED YARDS
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FRONT BIDE
REAR FRONT SIDE REAR
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LEGAL LOT VA IANC k: Olt CONDITIONAL USE
0 YES' 0 NO PERMIT NUMBER
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PLANNING DEPT. APPROVAL DATE:
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CITY
TELEPHONE NUMBER
STREET R/WEXISTG
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EXISTING STREET R/W ............FT.
DEFICIENCY THIS PROPERTY
NAME \ - _
COMP. PLAN ST. R/W ............FT.
REMARKS
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CHECKED BY
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CITY TELEPHONE NUMBER
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METER SERVICE SIZE CLEARANCE
METER SIZE
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Legal Description Or Properly (Show Below or Attach Four
TYPE CONNECTION
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PEItC. TEST
PERMIT NUMBER
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REMARKS
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FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
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0 YES 0 NO
SPECIAL INSPECTOR REQUIRED
GROUP
1
6A8
RESIDENTIAL El LINE
NEW ❑
0 YES ❑ NO
IOCCUPANCY
PLAN CHECKED By
THIS SITE 15 LOCATED IN THE CITY
OP EDMONDS. LOCAL SALES TAX
NON-RESIDENTIAL ❑ 9IGN
SHOULD BE CODED 31.04.
ADD
El❑ WALL
REMARKS
DEMOLISH
DEMOLISHoLlex
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Fence requirements
-section 12.14.040
ALTER ❑ CFILLTE jy'��v� /yq
ORJ� tF-cx..J221.)
E] REPAIR PRE-MOVE El SWILL
INSP. POOL
attached.
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NUMBER OF STORIES NUMBER OF
DWELLING
I
UNITS
NATURE OF WORK TO BE DONE
Valuation
Fee Receipt No,
Plan Check Nn.....................
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BUILDING
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PROPOSED USE V
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PLUMBING
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PLOT PLAN (Indlcale Building setbacks, abutting elrccte)
HEAT !, GAS LINE
7
FENCE
SIGN
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RETAINING WALL
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1
SWIMMING POOL
DEMOLITION
PRE-MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I notchy acknowledge that I have rend this application; that the In.
formation given le correct: and that I ace the owner, or the duly author-
Ized ¢gent of the owner. i agree to comply with city ma State lawn regu-
ATTENTION
APPLICATION APPROVAL
lating construction; and In doing the work authorized thereby, no yore..
will be employed In vlole... or the Labor Code of the State of Washington
TIUR PERMIT
This application is not a permit until
iel.lmg to Workmen's Compensation Ihs r .
AUTHORIZES
signed by the Building Official or his Dep-
;
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
Dtyi and fees are paid, and receipt is ac-
.ball be completed In ninety day.; MOVED-IN BUILDINGS Shall be Som-
knowledged in space provided.
pletcd In six marine.)
SIGNATU{tE (OWNER OR AGENT) DATE SIGNED
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1. /
INSPECTION
DEPARTMENT
DIRExxc
Lrt rc� GL'
CITY OF
EDMONDS
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NOTE: Applicant Subject to Plan Check Fee
—
775-2525
This covers work be done private property ONLY.
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Any construction on the public domain
nstr c
SLE
ecurbs, P-11llu,
marquees, etc.) will regWre separate permis.lon,
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