740586.pdfe
USE
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MBRG
BUILDING DEPARTMENT
Applicant FW 740586
Al 4058U
Ildo Heavy Lines APPLICATION
ADDRESS �A
NAME (OR NAME OF BUSINESS) L- N'— w
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PEIfMItlBIBLE ne ACTUAL J
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mMAILING
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ADDRESS F'
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PERMISSIBLE HEIGHT PROPOSED HEIGHT
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CIPY TELEPHONE NUMBER ACrUAL L� A EA TOTAL B07'ZE
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KeBIKED YARDS POOBED YAR98
N ME FRONT' BIDE REAR FRONT BIDE REAR
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A DRESS LEA LOT VARIANCE OR CONDI I NAL USE
YEe NO PERMIT NUMBER /�
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PLANNING, T. PPR VAL F.:
Cl Y TELEPHONE NUMBER
STREET R/W
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EXISTING STREET R/W ............FT. DEFICIENCY TillB PROPERTY x
NAME
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COMP. PLAN ST. R/W ............FT. ............FT.
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CHECKED BY
C 'Y TELEPHONE —NUMBER
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METER BILb eEAV10E SIZE CLEARANCE
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CHECKED BY
8 ATE LICEN6E NUMHER IT
CY LICENSE NUMBER
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L gni Deecrlpllon o1 Properly (Show Bel— or Attach F.nr Coplee) ♦ r A
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TYPE CONNECTION VERIFIED
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BY
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PERC. TEST PERMIT NUMBER
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REMARKS W
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e1RE ZyDFE TYPE CONSTRUCTION STREET IMPROVED
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SPECIAL INSPECTOR REQUIRED GROUP
IOCCUPANCY
III �I LINE YDS NO
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1r JRESIDENTIAL
xlsw PLAN C.E.CKE DY THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL ❑ BICN OF EDMON DS. LOCAL SALES TAX
ADD SHOULD BE CODED 3104
DEMOLISH E]WALL MNG REMARKS
ALTER EXCAVATE FENCE S/CaLJ U IIJIOZN .- Sap P&W-1-1/'
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OR FILL L.........:.......... Fl.)
❑ SWIO
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REPAIR INBP. POOL
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NgbIHER OY STORIES NUMBER Oil
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DWELLING
UNITS
NATURE OF WORK TO BE DONE
nluatlon
Plan
Fee Receipt No.
Check Nil.. ...,
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BUILDING 0
P OPOBED UBE � � �G • Q
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PLUMBING
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OT PLAN (Indicate Building setback., abutting streets) HEAT & GAS LINE
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RETAINING WALL
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SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I heMby acknowledge that I have rend thle application; tTOTAL AMOUNT DUE
hat the In-
rorrttlntlon
elven 1. correct; and the I a n the owner, or the duly author-
Ized
agent or the owner. I agree to comply with Illy and elnle I¢we resu- ATTENTION APPLICATION APPROVAL
Lauri, oonetructlan; and In doing the work nutharized thereby, no Person
Sill Le employed In violation or the Labor Code of the Stale or Washington TIH8 PERMIT This application is not a permit Until
laths to Workmen'. Compensation In.uruces.
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AUTHORIZES
signed by the Building Official or his Dep-
ONLY THE
NOTe Perth} Lune(• Onedays Year (Except DEMOLITIONS which WORK NOTED Uty; and fees are paid, and receipt Is ac-
be completed In ninety days; MOVED -IN BUILDINGS Shall be com- knowled
plctc
plete�l
In six month..) god in space provided.
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TUItE (OWNER Olt AGENT) DATE SIGNED INSPECTION IR T R'S ION TUR
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SIGN
DEPARTMENT
1/-7
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CITY OF
EDIIIONDS ATE
NOTE: Applica))t Subject to Plan Check Fee
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Irl. !'rrmlt 1' s'rn work t¢ be done o 775.2525
On prh'nte property UNLV.
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A,y eo I ... Ip,n an the public damn.. (carbo, eldewalke, drhewaYs,
navquee.+ ole.) trill regmre eeparale permission. FILE
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BUILDING DEPARTMENT Applicant
USE PERMIT
/ NUMBER
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PERMIT APPLICATION IReldo IIeaYy Linos
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ADDREBB n r� .._,_ �1 / p ,y
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OF HUBINEBs)`-
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NAME (OR NAME
PEItMIdSIBLF- ro ACTUAL
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TI, j1, i • — / �,� r
LOT COVERAGE LOT COVESRAGE
MAILING ADDREtlB
PERMISSIBLE IIEIGIIT PROPOSED IIEIGHT l / !
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14- 14 D o YT r N�� .
TELEPHONE NUMBER
ACTUAL LOT' tF.A TOTAL BLDG, AREA
CITY
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REQUIRED YARDS PROPOSED YAROtl E
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NAME
FRONT HIDE REAR FRONT 81—DL REAR
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LEOLOT VARIANCE OR CONDI 1 NAL USE
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ADDRESS
M YES 0 NO PERMIT NUMBER J\ [)(Z / -7/�
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PLANNING D T-= VAL t�'JI.J
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CITY TELEPHONE NUMBER
R/W
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STREET
EXISTING STREET R/W ............FT. DEFICIENCY TH18 PROPERTY
NAME
COMP. PLAN BT. R/W ............FT. ........... FT.
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REMARKS
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ADDREBB
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CHECKED BY
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CITY
TELEPHONE NUMBER
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METER d1LE SERVICE SIZE CLEARANCE
CHECKED BY
STATE LICENSE NUMBER
CITY L10EN.E NUMBER
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1 /64-9
REMARK
Legal DeeerlPUon of Property tHM1OW HgloW or Atlnch Four Coplce)
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TYPE / T N
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VERIFIED BY
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PERC. TEST
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ULF77/777'1-�
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REMARKS u LSO
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FIRE EINE TY_y CONSTRUCTION6TREET IMPROVED
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NO
SPECIAL IN13PECTOR REQUIRED
OCCUPANCY GROUP
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YES NO
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RESIDENTIAL
❑ GA9
LINE
❑ .q
CHECKEDBY
IN THE CITY
NEW
JE:1
PLAN THIS SITE IS LOCATED
'�J`�'�"��
LOCAL SALES TAX
NON-RESIDENTIAL
❑ SIGN
C �•1! 5H ULDEDMBEDS.
SHOULD BE CODED 31.04.
Ann
RETAINING
REMARKS
E] DEMOLISH L WALT
K/ EXCAVATE FENCE
7 �l/Gf l L) /(•%L/L�(r.--�4'I"'• �L�` `t %
ALTER ❑
x.
OR FILL El (...................Ft.)
REPAIR PRE-MOVE swill
INSP. POOL
NUMBER OF STORIESI NUMBER ON
DWELLING
UNITS
NATURE OF WORK TO BE DONE.�,,�
count ion
Fee
Receipt No.
AI l' -.. 7i..: v.-.' o T
Pian Check No_,,:1.--+,......
BUILDING
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PROPOSED USE
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PLUMBING
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HEAT A GAB LINE
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PLOT PLAN (Indicate Building setbacks, abutting streets)
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FENCE
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TSIGN
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RETAINING WALL
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SWIMMING POOL
DEMOLITION'
PRE-MOVE INSPECTION
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EXCAVATION OR FILL
TOTAL AMOUNT DUE
2 hereby acknowledge that t have read this applicntlon; that the In.
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formation given Is correct; and that I am the owner, or the duly author.
Iced agent of the owner. I agree to comply with city and elate laws regu•
ATTENTION
APPLICATION APPROVAL
'
lath. construettan; and In doing the work authorized thereby, no person
will be employed fn violation of the Labor Code of the Stale of Washington
THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official Or his Dep-
i
NOTE: Permit Limit One Year (Except DEMOLITIONH which
ONLY TIE'
WORK NOTED
uty; and fees are paid, and receipt is ac: -
shnil be completed In .hely day.; MOVED-IN BUILDINGS shall be nom.
knowledged in space provided.
pleted In six months.)
SIGNATURE (OWNER Olt AGENT)
DA'Z'E SIGNED
INSPECTION
IREFTOR'8/SIONATURE
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DEPARTMENT
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CITY OF
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EDMONDS
DATE j•' /)
NOTE: Applicant Subject to Plan 77- Fee
775-2525
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This Permit r wen work in be done on private Property ONLY.
Any construction on the pubiic domain (curbs,sidewalks, driveways'
INSPECTOR
nuurquee., etc,) will require sep—te Pennlsslan,
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