740521.pdfBUILDING DEPARTMENT Applicant Flu �S- S� NUMBER 740521
PERMIT APPLICATION Inside heavy Lines
NAM • (OR N ME OF B e NEBB)
01viS(Dn
a MAILI O AD R_EB8
3 % OS C 4l —sa /�Cr
C1TY� LEPHONE NUMHNa
�v>1vn�bS 77c�S80
(-�NAME
M ADDRESS V 1
yN
T
Sl CITY I TELEPHONE NUMBER
ag
6
F
Z
0
G
dGB
RESIDENTIAL
ADDRE88 �/ �••—
LINE
Zo ✓ �/N
U sA
PEILM IBBIBLE r/e �f'I
LOT COVERAGE
ACT AL
�AOE
❑
❑
ElFENCz..........Ft.)
LOT C.VE
PERMISSIBLE HEIOItT
PROPOSED HEIGHT
DEMOLISH
E
EJREPAIR
ACTUAL LOT AREA
TOTAL BLDG. AREA
REQUIRED YARDS
PROPOSED YARDS
FRONT SIDE REAR
FRONT SIDE REAR
/a
t /`a ret
LE L LOT VARIANCE OR CONDITIONAL 8E
ES r] NO PERMIT NUMBER r/I(
/,A fJ!! O D VAL DATE:
STREET R/W
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
--/.c�^
`In NEW
RESIDENTIAL
Valuation
LINE
❑ YES
PLAN
I
T—
❑ ADD
El ALTER
11
NON-RESIDENTIAJ
❑
❑
ElFENCz..........Ft.)
BION
RETAINING
ALL NINE
A7
11
DEMOLISH
E
EJREPAIR
❑
El
ORCFILL
PN P-AIOVE
O
POOL
NUAIBER OF STORIESI
NUMBER OF
/
PLUMBING
DWELLINO
�^
Ir
UNITE
HEAT & 6A8 LINE
E] NO
I 'q "1
THIS SITE IS LOCATED IN THE CI
OF EDMONDS. LOCAL SALES T
--- - -- -- —l'
Valuation
Fee Rccelpt No.
Plan Check No.
;
[Oy
BUILDING
S
W PROPOBED U8E
/
PLUMBING
U
a
PLOT PLAN (Indicate Building Setbacks, abutting streets)
HEAT & 6A8 LINE
h
FENCE
//''``
j
BION
i/L��/
RETAINING WALL
i
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
J
j
i�
C�
TOTAL AMOUNT
I hereby acknowledge that I have rend this application; that the In-
larmatlon given is correct; and that I am the owner, ar the duty author.
Izcd agent of the owner. I agree to comply with city and stale laws ras..
ATTENTION
APPLICATION APPROVAL
letting construction; and in doing the work authorised thereby, no person
I
will be employed In violation of the Labor Cade of the State of Washington
THIS PERMIT
This application fa not a permit Until
relating to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep-
NOTE: Permit Limit One Year (Eaept DEMOLITIONS which
ONLY Tin:
WORK NOTED
uty; and fees are paid, and receipt is ac-
^
( —�
shall ble completed In ninety day,; MOVED -IN BUILDINGS shall be cam-
ged ace provided.
pleted In cis ...the.)
B10N D
B O TUBE ( V R OR AGENT) DAL:
INSPECTION
1REC '8 HfONA RE
g
DEPARTMENT
t
`v
CITY OF
I
EDMONDS
DATE
NOTE: Applicant Subject to Plan Cbech Fee
9
a�
This Permit rat'ere work to be done on private property ONLY.
775-2525
/
j
Any Bonet ruction on the public domain (autbe, emewallcs, drWewys,
n�nraurr., rt— n'Iil rrnnirr nrpnrntr prrmleelan.
FI LE