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NON-RESIDENTIAL
❑ SIGN
BUILDING DEPARTMENT
Applicant Ful
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NUMBER 740559
ElAnn
RETAINING
REMARKSWALL
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PERMIT APPLICATION
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❑ REPAIR [:] INSP. RE -MOVE ❑ PSWIMOOL
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NUMBER OF HTIR1E0 NUMBER OF —'
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LOT COVERAGE /, 3
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NATURE OF WORK TO BE DONE
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TEyLEPH//ONE NUMBER
ACTUAL LOT pgSp
TOTAL BLUO. AREA
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PROPOSED YARDS
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FRONT BIDE
REAR BIDE REAR
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
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EXCAVATION OR FILL
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1 hereby acknowledge that I have reed this application ; that the In-
PLAN D AP OVAL
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CITY
TELEPHONE NUMBER
Iarmntion given le correct; and that I am the owner, or the duly author.
tzed agent of the owner. I agree to comply with city and elate laws raga•
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APPLICATION APPROVAL
STREET n/w
EXISTING STREET R/W ............FT.
DEFICIENCY THIS PROPERTY
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will be employed In violation of Ne Labor Code of the State of Washington
TRIS PERMIT
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NOTE: Permit Limit One Year (Except DEMOLITIONS which
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shall leled Inn ys; BUILDINGS shall be fleas•
REMARKS
kRowledged LR space provided.
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SIGNATURE (OW R OR AOE DATE BIG ED
INSPECTION
DIRECT B B10NATU
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DEPARTMENT
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CITY OF
EDMONDS
R TELEPHONE NUMDE
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(CHECKED BY
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This 1•ermit rovers work to be done on Private property ONLY.
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CITY
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Any constrn rtlon nn the public demnin (curbs• able -1k., drha
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STATE LICENSE NUMBER
CITY LICENSE NUMBER
METER SIZE I SERVICE SIZE I CLEARANCE
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CHECKED BY
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REMARKS
Legal Description of Property (Show Below
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PERO. TEST
PERMIT NUMBER
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SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROnUP
r
RESIDENTIAL
❑❑
GA8
LIN..
❑ NO
- Com -
❑ NEW
AN
PLAN CFIECK
IIy
`t THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL
❑ SIGN
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L, ) OF EDMONDS. LOCAL30SALES TAX
ElAnn
RETAINING
REMARKSWALL
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FENCE
JJ�J•s PC�• rJ / �oeCJ /N L �•/v'I�Iv
ALTER
❑OR FILL EXCAVATE ❑ (z Fl.)
.......... ..........
❑ REPAIR [:] INSP. RE -MOVE ❑ PSWIMOOL
�� I�l �/� %
V�CJ�/L ONL 7 . ALL IVd/_K_ PC
NUMBER OF HTIR1E0 NUMBER OF —'
DWELLING
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UNITS
NATURE OF WORK TO BE DONE
Valuation
Fee Receipt No.
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Plan Check No .....................
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HEAT & GAS LINE <
FENCE
B1GN
RETAINING WALL
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SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
1 hereby acknowledge that I have reed this application ; that the In-
Iarmntion given le correct; and that I am the owner, or the duly author.
tzed agent of the owner. I agree to comply with city and elate laws raga•
ATTENTION
APPLICATION APPROVAL
leting construction; and In doing the work authorized thereby, no person
will be employed In violation of Ne Labor Code of the State of Washington
TRIS PERMIT
This application Is not a permit until
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relating to Workmen's Compensation Insurance.
AVTDOBIZES
signed by the Building Official or his Dep-
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NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is aC-
shall leled Inn ys; BUILDINGS shall be fleas•
kRowledged LR space provided.
eted Ia six me
SIGNATURE (OW R OR AOE DATE BIG ED
INSPECTION
DIRECT B B10NATU
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DEPARTMENT
Check Fee
CITY OF
EDMONDS
-
DATE
TE: pplieast Subject to Pid
775-2525
This 1•ermit rovers work to be done on Private property ONLY.
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Any constrn rtlon nn the public demnin (curbs• able -1k., drha
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