740556.pdft
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BUILDING DEPARTMENT USE PERMIT 740556
Applicant Flll ZONE NUMBER i
PERMIT APPLICATION Inaldo Heavy Linea ,O ,
ADDRESS +) / rf �����I•�wre-r/'�Y� �9 I ,I
NAME lOME OF Due E88L)��7.
LOT
LOT COVERAGEJ
ACT
LO OVE AOE
1 AIA ' EBB,(/ /�t�r-�'�� /✓/�'/)f PERMISSIBLE HEIGHT PROPOSED HEIGHT ((1yyyO
O 1 - Z �" 'TELEPHONE NM�JACTUAL LOT AREA TOTAL BLDG. AREA Z
REQUIRED YARD. PROPOSED YARDS
NAME FRONT BIDE REAR FRONT .IDE REAR
Vj
LEGAL LOT VARIANCE OR CO
Q ADDRESS NDITIONAL USE
H 0 YES I] NO PERMIT NUMBER
�. PLANNING DEPT. APPROVAL DATE:
t4 CITY I TELEPHONE NUMBER
STREET R/W O
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
NAME
COMP. PLAN 8T. R/W ............FT. ..........FT. W ,
REMARKS
z
[a Dnxasa �J �{rJ���vrr w
CHECKED BY
F CITY TELEPHONE NUMBER
z 6 zs-lor
O _METER 81'LE I SERVICE SIZE I CLEARANCE I CHECKED HY
Sq I
TATE LICENSE NUMBER CITY LICENSE NUMBEx
REMARKS )(IST '
Legal Description of Property (show Below Or Attach Four Copies) /�
TYPE CONNECTION VERIFIED BY
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PERC. TEST I PERMIT NUMBER 1
REMARK. WW '
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J
Fll!r I TYPE OF CONSTRUCTION STREET IMPROVED
0 YE. [:I NO
SPECIAL INSPECTOR REQUIRED I OCCUPANCY GROUP
❑ CA8 ❑YES E3 NO
RESIDENTIAL ❑ LINE PLAN CHECKED HY
NEW THIS SITE IS LOCATED IN THE CITY tl
NON•AE92DENTSAL SIGN OF EDMONDS. LOCAL SALES TAX
❑ ADD ❑ SHOULD BE CODED 31.04.
❑ DEMOLISH O WAIS KING REMARKS f
❑ PG�,srrc, Ag5 No7-nnir�z
ALTER ❑ ORCFILLTE ❑ (ENCs..........Ft.)
E �
❑ REPAIR ❑ I SPafOVE El POOL
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
NATURE U` WORK TO BE DONE
T,
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Vnivatlon
Fee Receipt Nu.
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Plan Check No .....................
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BUILDING
1
�O�yy
4 PROPOSED USE
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PLUMBING
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PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT k GAB LINE
PENCE
I ,
SIGN
1
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
1 hereby acknowledge that I have read this application: that the 1n•
! "
formation given le correct; and that I am the owner, or the duly author -
:sent
fled of the owner. I agree to comply with city and state laws regu-
ATTENTION
APPLICATION APPROVAL
lating conetructloo; and to doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Slate of Washington
THIS PER511T
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 TIRE
WORK NOTED
uty; and fees are paid, and receipt Is ac -
ii,�•�'`
shall be completed In ninety days; 31OVED-IN BUILDINGS shall be corn•
knowledged in space provided.
pleled In six months.)
BION URE (OWN t OR ENT)
INSPECTION
DIRECT Sf0 U
WHINED
��
DEPARTMENT
J
CITY OF
1
7VE: Applicant Subject to Plan Check Fee
ED51ONDS
DATE
775-2525
This Permit coven work to be done on private property ONLY.
-
Any mnetmctlnn on the, public domain (curbs, sldew Ik,. driveway.,
FILE
ar.......... el i'.i mill rc,alr,• .rtrnrnlr irrnd.el.n.