740610.pdfI
BUILDING DEPARTMENT Applicant FIII i°NE NUMBER 740610
RMIT APPLICATION Inside Heavy Lines JOB
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DL' (UR NAME OF HI1J3IpFEa �ADDRESS � OcF• J rP .^c
/j'•/�- PETiM I`tlHFHLE "' ACTIn�L
REQUIRED YARDS
YARDS �'
FRONT BIDE REAR FRONT 8DDE REAR
I
LEGAL LOT VARIANCE OR CONDITIONAL USE
YES [J NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
STREET R/W 0
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ...........,FT. W
REMARKS
O
CHECKED BY W
METER SIZE I SERVICE SIZE I CLEARANCE I CHECKED BY
W
REMARKS m
FIRE ZONE I TYPE OF CONSTRUCTION I STREET IMPROVED I
0 YES E2 NO
r RESIDENTIAL a
LINE
mm1
M 1 ADDHE98
S
O
1
PLAN CHECKED BY
Y
TELEPHONE IQUMBER
NEN
NAME
tt
LOCL
OHOULD BE CODED 31.045ALE5 TAX
aUj
ADDRESS
F
7
ADD RETAINING
WALL
24
CITY
TELEPHONE NUMBER
NAM E
{`�•� pA� jC(�
04 G
ADDRESS
OR FILL (........_x..........Ft.)
o;
CITY
TELE; HONE NUMBER
1 c rT+(�/ y. r•� �,�-
I-/3 - 6
/ yl Z �
L_LS J 11�t1 TL%\Z
STATE LICENSE NUMBER
CITY LICENSE NUMBER
.223 -o'z- 3 �s3
NUMBER OF
of Property (tlho Below o! Aileen FOar Coplee)
NDe
DWELLING
x1111
REQUIRED YARDS
YARDS �'
FRONT BIDE REAR FRONT 8DDE REAR
I
LEGAL LOT VARIANCE OR CONDITIONAL USE
YES [J NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
STREET R/W 0
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ...........,FT. W
REMARKS
O
CHECKED BY W
METER SIZE I SERVICE SIZE I CLEARANCE I CHECKED BY
W
REMARKS m
FIRE ZONE I TYPE OF CONSTRUCTION I STREET IMPROVED I
0 YES E2 NO
r RESIDENTIAL a
LINE
❑ YES 0 NO
PLAN CHECKED BY
THIS SITE IS LOCATED IN THE CITY
NEN
NON-RESIDENTIAL ❑ SIGN
LOCL
OHOULD BE CODED 31.045ALE5 TAX
i
ADD RETAINING
WALL
REMARKS
IJV DEMOLISH
ALTER )~� EXCAVATE FENCE
{`�•� pA� jC(�
OR FILL (........_x..........Ft.)
1 c rT+(�/ y. r•� �,�-
REPAIR ❑
INSP.
SPhtOVE O POOL-ri—,
L_LS J 11�t1 TL%\Z
NUafDER OF` STORIES
NUMBER OF
DWELLING
UNITS
i
NATURE OF WORKTO HE DONE
Valuation
Fee Receipt No.
Plnn Check No .....................
i
[0,
BUILDING
4 PROPOSED USE
PLUMBING
i
aPLOT
PLAN (Indicate Building setbacks, abutting streets)
HEAT A GAB LINE
q
0
FENCE
aicx
I
tRETAINING
WALL
I
BWIMMIN6 POOL
DEMOLITION
'l a
r7C v V
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I hereby acknowledge that I have read this application; that the In.
TOTAL AMOUNT DUE
formation given is correct; and that I am the owner, or the duly nuthor-
Izetl agent of the owner. r ogres to comply with city and elate tnwe s
regu-
ATTENTION
APPLICATION APPROVAL
G
lating construction; and In doing the work authorized thereby, no perersonon
w•111 be employed In vlolallen or the Labor Code or the State of Washington
THIS PERMIT
This application Is not a permit until
relatlug to Workmen'. Compensation Insurance,
AUTHORIZES
signed by the Building Official or his Dep-
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TIE
uty; and fees are paid, and receipt is ac -
,1��,�_----
shall be completed In nicely days; MOVED -IN BUILDINGS shall be com•
WORK NOTEED
knowledged in space provided.
pleted In mix menthe.)
S1GN U (OWNER OR AGENT) DATE SIGNED--
INSPECTION
DIRECT 81 A U
l
DEPARTMENT
CITY OF
AA
IV' TE: Applicant Subject to Plan Check Fee
EDMONDS
DAT
775-2525
Title 1'ernut n>cen work to be done on private property ONLY.
'
Any construction on the public domain (curbs, sidewalk-, driveways,
ni.,rniirrn. rlr.1 alit rrn nirr nrpara tr prrn,i-cion.
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