740571.pdfI'Isn Check No . ....................
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LINE
[o BUILDING
NEW
�RESIDENTIAL
NON-RESIDENTIAL
1
❑
ADD
PLOT PLAN (Indicate Building setbacks, abutting streets)
BUILDING DEPARTMENT
Appum tFin
zuoNE
PENCE����
PERMIT APPLICATION
I Inside Heavy Lines
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ADDRESS
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NAME (OR NAME OF BUSINESS)
RETAINING WALL
❑
ORFILL
1
_FERMISBIR SIBLAI
LOT
gyp'
MAILING ADDRE..
❑
PRE-INSP.
PERMISSIBLE
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EXCAVATION OR FILL
❑
TELEPHONE NUMBER
ACTUAL LOT
NUMEER OF
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7 7 6- 3 4FS3
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REQ
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a
0
REAR
0 YES [3 NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
STREET R/W
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP, PLAN ST. R/W ............FT. ............FT.
REMARKS
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
YES [] NO
SPECIAL INSPECTOR REQUIRED I OCCUPANCY GROUP
YES r] NO
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
REMARKS
Fence requirements - section 12.14.040
attached.
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I'Isn Check No . ....................
1
I 1
LINE
[o BUILDING
NEW
�RESIDENTIAL
NON-RESIDENTIAL
SIGN
❑
ADD
PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT & GAS LINE
L]
RETAININGNINC
PENCE����
ALTER
DEMOLISH
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EXCAVATE
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RETAINING WALL
❑
ORFILL
SWIMMING POOL
REPAIR
❑
PRE-INSP.
PRE -MOVE INSPECTION
EXCAVATION OR FILL
❑
POOL
'Ua[IIER OF STORIES
NUMEER OF
I hereby acknowledge that I have road this appilcatlon; that the fn-
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formation given Is correct; and that I — the owner, or the duly author-
DWELLING
ized agent of the owner. I agree to comply with city and elate laws regu-
ATTENTION
APPLICATION APPROVAL
bating construction; and In doing the work authorised thereby, no person
UNITE
will be employed In violation of the Labor Code of the elate of Waahlagton
THUS PERMIT
REAR
0 YES [3 NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
STREET R/W
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP, PLAN ST. R/W ............FT. ............FT.
REMARKS
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
YES [] NO
SPECIAL INSPECTOR REQUIRED I OCCUPANCY GROUP
YES r] NO
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
REMARKS
Fence requirements - section 12.14.040
attached.
Z
I'Isn Check No . ....................
1
I 1
[o BUILDING
W PROPOSED USE
7q
PLUMBING
U
PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT & GAS LINE
O
PENCE����
I
r D
BION
—
RETAINING WALL
N
SWIMMING POOL
I.
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
�
TOTAL AMOUNT DUE
I hereby acknowledge that I have road this appilcatlon; that the fn-
O( '
formation given Is correct; and that I — the owner, or the duly author-
ized agent of the owner. I agree to comply with city and elate laws regu-
ATTENTION
APPLICATION APPROVAL
bating construction; and In doing the work authorised thereby, no person
will be employed In violation of the Labor Code of the elate of Waahlagton
THUS PERMIT
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 TILE
NOTED
ut and fees are paid, and receipt is ac -
y, p
shall
shell 6a completed In ninety days; MOVED -IN BUILDINGS shall be win•
knowledged in apace provided.
plated In six menthe.)
/ ,� r7 ,;.� _7
SIGNATURE (OWNER AGENT) DATE SIGNED
INSPECTION
/O�R�
DEPARTMENT
L �� �3 7
CITY OF
it
NOTE; Applicant Subject to Plan Check Fee
EDMONDS
DATE
— /
775-2525
coven cork to be done on Private,.01 properly ONLY.
AnyPermit
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