740614.pdfPERMIT APPLICATION I Inside HeaVy Lines
NAME (OR NAME OF HUHINEBB)
w
p' MALL O ADDRE.. L
'ADDRESS
BIZ
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C CITYy/�
{U{ ADDRESS
C CITY
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O
STATE LICENSE NUMBER
—7Z3 -o> - J a — z_o 3
JOB
ADDRESS t?:,
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PERMISSIBLE
ACTUAL
LOT COVERAGE.
LOT COYE�AGE lC
PERMISSIBLE HEIGII /
PROPOSED HEIGR'j'�, /
S
ACTUAL LO A
TOTAL BLDG. AREA
BION
REQ [RED YARDS
PRO OSED YARDS
FRONT BIDE REAR
FRONT SIDE REAR
CC
d
❑ DEMOLISH
LEGAL LqT VARIANCE OR CONDITIO A USE
(ej YES [3 NO PERMIT NUMBER *-7-7
g -
PLANNING} DEP�'.�PPROVAL �; /I9E
TE -ONE NUMBER (�J� [��
TEL/E � EXISTI RST
iiJl� EXISTING STREET R/W ......FT. DEFICIENCY THIS PROPERTY
(O.!$.) 1< CtT GL�n.e �.''J"� COMP. PLAN ST. R/W ............Fr. 5 ....FT,
IREMARICs
Driveway elopes not to exceed those
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:. TEST PERMIT NUMBER
ARKS
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TYPE OF CONSTRUCT�I) STREET IMPROV[
/t/
)(1 -Es [3 NO
,SAL INSPECTOR REQUIRED I OCCUPANCY ROUP
y CHF�CKED BY THIS SITE IS LOCATED IN THE CITY
tt�i`J� OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
ARKS
ND TPLsQD GPIX- S► ir IMP(ZWeHEK
Valuation Fa. Recelpt No.
flan Check Na .....................
BUILDING
PROPSE��DUdd
RESIDENTIAL
El
.1
NEW
_J
LINCASE
i, .
LJ1 X NON-RESIDENTIAL
❑
BION
ADD
a P T PLAN (Intllenle HUllding setbacks, abutting streets)
VAIsKING
❑ DEMOLISH
9
ALTER
❑
l
RCFILLE
❑ OR
(ENC. .......... Ft.)
❑
REPAIR ❑ NSP3fOVE
❑
swill
NUMBER OF STORIES NUa[DER OF
SIGN
DWELLING
RETAINING WALL
UNITS
NATURE OF {YORK TO S DONE
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v
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:. TEST PERMIT NUMBER
ARKS
WI9►a6 ro gc- uAJ00T6V0UA1y
TYPE OF CONSTRUCT�I) STREET IMPROV[
/t/
)(1 -Es [3 NO
,SAL INSPECTOR REQUIRED I OCCUPANCY ROUP
y CHF�CKED BY THIS SITE IS LOCATED IN THE CITY
tt�i`J� OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
ARKS
ND TPLsQD GPIX- S► ir IMP(ZWeHEK
Valuation Fa. Recelpt No.
flan Check Na .....................
BUILDING
PROPSE��DUdd
I /crC + OO
.1
PLUMBING �e
i, .
a P T PLAN (Intllenle HUllding setbacks, abutting streets)
HEAT do GAS LINE
9
l
PENCE
SIGN
i
RETAINING WALL
N
SWIMMING POOL
_
DEMOLITION
I
PRE -MOVE INSPECTION
EXCAVATION OR FILL
F,SD
TOTAL AMOUNT DUE
1 hereby acknowledge that 1 have read this application; that the In-
i
formation given le correct; and that I amt the owner, or the duly author.
Led igen{ of the owner, :agree to eomply with elty and elate Inwe ergo-
ATTENTION
APPLICATION APPROVAL
toting construction; end In doing the work authorized thereby, no Hereon
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be employed In violation of the Labor Cade of the Slate of Washington
THIS PERMIT
This application is not a permit until
rrlatlag to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep-
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TILE
WORK NOTED
uty; and fees are paid, and receipt Is ac-
bo c tpicted In nicety days; MOVED -1N BUILDINGS shall be ram•
Imowledged In space provided.
I
plctr
Plcled Ix mo+ he.)
1
SL URE 1 72 ORA T,�
DATE B}GNED
S
INSPECTION
DEPARTMENT
DIRECTOR'S SIGN FIF
CITY OF
NOTE: Applicant Subject to Plan Check Fee
EDbIONDS
DATE ^7
11 — 22 — / C�
775-2525
/
This Permit cove"work to be done an Private property ONLY.
Any marl rnctlnn an the Pnblle Aomnin Irnrba, slArtenike, drlren'aye.
.lu .,.. rl r,, .+ul +nin• sennrntr ncrod.elan,
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