740607.pdfd
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BUILDING DEPARTMENT
Applicant Fill
USE
ZONE
lV
PERMIT
NDMBFR 740607
APPLICATION
Inside heavy Lines
,OB
' f
PERMIT
ADDRESS
`
NAME (Oft NAME OF BUSINESS)
-
/
eI/4 L7/P 00 ALC
PERMISSIBLE
LOT COVERAGE
ACTUAL %
LOT COVAAGE
1
0'
/l
MAILING ADD Etl8
V
1
PERMISSIBLE HEIGHT
PROPOSED HEIGHT
31Y—r-" So
V
CITY//
111011E NUMBER
ACTUAL LOT AREA
TOTAL BLDG. AREA
A-w",-A.)
/ O
REQUIRED YARDSPROPOSED YARDS
i
I -
NAME
FRONT BIDE
REAR FRONT SIDE REAR
1
!
LEGAL LOT VARIANCE OR CONDITIO"A USE
[3 YES I] NO PERMIT NUMBER A
ADDRESS
.H.y
D T. APP
IJF»� DAT
Irj
CITY
TELEPHONE NUMBER
L
-
cc
I
STREET R/W
EXISTING STREET R/W ............FT.
DEFICIENCY THI PROPERTY
Q
I
NAME
%
NO 2S f< ` 0 A, i%
COMP. PLAN ST. R' W ............F'f.
.....FT.
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REMARKS
ADDRESSI
M
tC
'!•r
—
(O S
CHECKED BY
67
OLTY TELEPHONE NUMBER
N
I
I
O
1
I
METER 13111E
SERVICE SIZE
CLEARANCE
CKECKED DY
STATE LICENSE NUMBERCITY LICENSE NUMBER
I
I
I
.2f 4/ l6 T- 9 6
I[,0��
REMARKS
Le�eacrip Ion of Properly (Show Bclow or Attach Four Cople9)
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C/y .5 4- �/� Q LJ f- �'L�
TYPE CONNECTION
VERIFIED BY
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A•N D Z-2�. � .i- I �' /J/ CIG /Z 0
PERO. TEST
PERMIT NUMBER
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REMARKS
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a
FIRE ZGNE TYPE OF
CONSTRUCTION STREET IMPROVED
.�
YES ❑ NO
SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
O YES '�Q NO
I F 7_
1
GAS
RESIDENTIAL ❑ LINE
NEW
PLAN CISECI[ D BY
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
® NON-RESIDENTIAL Ej SIGN
SHOULD BE CODED 3104
nnn RETAINING
REMARKS
QDEMOLISH WAIT'
El ALTER EXCAVATE FENCE
C r
RT �YOS
IO
OR FILL (..........x..........Ft.)
❑ ❑
REPAIR F]INSPPRE-MOVE ❑ PSWIM OOL
rC
�`? �O `
/���y,,�(^�
I� C�y ` •" - �cl M
N UAIHER OF 6TORl EH NUMBER OF
L
LOT
�i DWELLING
UNITS
NATURE OF WORK TO BE DONE
Valunllon _
Fee
Receipt Not
j
exfeg//fee.xs,.rs
Plan Cheek No .....................
111
O
BUILDING
5-0 Q p_—
�• a 01
PROPOSED USE
'ly
PLUMBING
U
PLOT PLAN (Indicate Building eetbaeka, emitting streets)
HEAT & GAS LINE
FENCE
i
BION
1
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE-MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby -knowledge that I have reed this aDPllcntlon; that the In.
formation glven le correct; and that 1 an the owner, or the duly mathor-
Ized agent of the owner. 1 agree to comply with city and elate law. regu.
ATTENTION
APPLICATION APPROVAL
failing construction; and In doing the work authorized thereby, no I)....
will be employed In vlolallon of the Labor Code of the elate of Washl.gton
THIS PERMIT
This application Is not a permlt until
I
ralaXi, to Workmen's Cumpem itlon Insurance.
AUTHORIZES
ONLY TILE
Signed by the Building OfflC181 Or hisDep-
f
NOTE: Permit Limit One Year (Except DEMOLITIONK which
WORK NOTED
uty; and fees are paid, and receipt Is ac-
shell be completed In ninety days; MOVED-IN BUILDINGS shall be morn-
knowledged in space provided.
plcted In .1. ...in..)
SLGNATURE(OWNER Olt -GENT)
�j
IGEll
DATE eN
INSPECTION
DEPARTMENT
DIRECTO ■ Bf RE
,
_7
elr/
CITY OF
NOTE: AQplkant Subject to Plan Check Fee
EDMONDS
DATE
I' Z8 —7(/
j
1
775•2525
i
This Permit coven work to be done on pri-t. Droluerly O.YLY.
Any rand ra ellen air the public dnntaln (rarbn, nidrreniks. drlrmrayn,
FILE
ct�.) i�111 �••tn lrc