740564.pdfBUILDING DEPARTMENT Applicant Fin ZONE /3/,)"� sr 740564
PERMIT APPLICATION Inside Heavy Lines 1G
ADDRESS / 0 .. � C / ,// _ //
NAME OR(,NAME OF BUB3N B) (���/ � (j!/}�•`J,,,�1Vy
AV LOT COVERAOE LOT COVERAGE
m MA1LiN0 ADDRESS
PER.11188IHLE HElaHT PROPOSED HEIGHT C
�o ao6 Enr��ni�os
GUTTY ryl /7 TELEPHONE N�U7MBER ACTUAL LOT AREA TOTAL BIRO. AREA
L�j1/ �S1
REQUIRED YARDS PAOPOBED YARDS ^
NAME FRONT SIDE REAR FRONT SIDE REAR
ADDRESS LEAL LT ARIANOR CONDITIONAL USE
F, YGE8 ❑ NO PERMIT NUCE CONDITIONAL
PLANNING DEPT. APPROVAL DATE:
4 CITY TELEPHONE NUMBER
t STREET R/W 0
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
NAME /J ' //'`
/ L Gt'I%7�1 C� COMP. PLAN BT. R/W ............FT. FT.
L S/j(//(/ayao p7
REMARKS
rC ADDRESS
/30.;2
3Q.;2—y�-lvcZ�,r�olaG9.
CHECKED BY
CITY TELEPHONE; NUMBER 4
%y/-061� METER SIZ, SERVICE SIZE CLEARANCE CHECKED BY
STATE LICENSE: NUMBER CITY LICENSE NUMBER
OWk�,7
ct••
REMARKS is
Legal Description of Property (Shaw Below or Attach Four Copies) El�(S"•'fes !;
TYPE CONNECTION I VERIFIED BY
0. PERC. TEST PERMIT NUMBER �.
� REMARK9 m i
.c Cx�S% it
..3 FIREZ TYPE OF CONSTRUCTION
STREET IMPROVED
1
YES
C3 NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
RESIDENTIAL GAB ❑YEB NO �-2— I'..
NEtV LINE PLAN CHECKED BY�•
THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL B3aN OF EDMONDS. LOCAL SALES TAX
F-11ADD RETAINING REMARKS SHOULD BE CODED 31.04.i.
ElDEMOLISH E3 WALL C ,
ALTER EXCAVATE FENCE 2C57ACr,,dNT `�/ry•"" VI•_�+J
OR FILL (..........X......•...Ft.)
REPAIR E] PRE -MOVE POOL ``J�f.
NUMBCR 01•' STORIF:e NU11LLI OF co r/," / G t ff19—
1 DWELLING 4 O J II'
UNITS
`I I
NATURE OF WORK TO BE DONE
_ Valuation Fee Recelpt No.
/l��vt 3 Gamow,-Evr si ix� /iJ�/F Plan Check No..., ..........
3
ly F",�E�L ACIT>�,quinrQ�,{/t• A�JlJ I,%� ✓.[/koBUILDING
L PROPOSED U E
I t PLUMHING /
PLOT PLAN (Indicate Bulidl s setbeeks, abutting streets) HEAT A GAS LINE
FENCE
I I
SIGN
1
tRETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
(�
TOTAL AMOUNT DUE
2 hereby acknowledge that I have read this application; that e 1n-
W
tormatlon given Is correct; and that I am the owner, or the duty aethor-
Ized agent a! the owner. 1 agree to comply with city and state laws rage.
lating contraction; and In doing
ATTENTION
APPLICATION APPROVAL
the work authorized thereby, no person
will be employed In vlolnlloo of the Labor Cade of the elate or Washington
THIS PERMIT
This application le not a permit until
relating to Workmen'. Compenaatlon Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (E—Pt DEMOLITIONS
ONLY TILE
signed by the Building Official or his Dep-
which
bo
WORK NOTED
uty; and fees are paid, and receipt Is Be -
Shall completed a-n)mq-da 11lOVED-IN BUILDINGS shall be com-
Imowledged in space provided.
Dm n-elx-m na.)
11GNATURF (O V Eli OR AGENT DATEpB.16NyED
INSPECTION
DIRECTO 8 B
1/
DEPARTMENT
/
CITY OF
/
EDMOND3
DATE
OTE: Applicant Subject to Plan Check Fee
775-2525
This Pe bill covework to be done on Private Droptlly ONLY.
Any construction on the pub le domain (curbs, sidewalks, driveways,
nii�raurrvI Mc.I „'ill rrnolrr "paretr prOnl.ninn,
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