740620.pdfr
BUILDING DEPARTMENT APIU—t Fill
PERMIT APPLICATION Inside Heavy Lines
NAME (OR NAME OF BUSINESS)
The Danmore Company
MAILING ADDRESS
400 -108th Avenue N.E.
O CITY TLEPRO E NUMBER
Bellevue Washln ton
NAME
WADDRESS
F
* CITY TE EPHONE NUMBER
NAME
Henrichsents Sodding & Landscaping
X G ADIIRE88
G 6927 Johnson Ad. Id. 1., Tacoma 981122
F CITY also faailinE address I TELEPHONE NUMBER
g n n 977 - i•ri lion 9 3511 922-8515
X BTA E LICENBfl NUa1 R CITY LICENBL NUMBER
223 02 8297
Legal Description of Properly temow Below or Attach Four Copies)
FO,
GAS
Y
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4
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RESIDENTIAL ❑ LINE
NEW ® NON-RESIDENTIAL SION
ADD ❑ DEMOLISH ❑ WAI�NINC
ALTER ❑ EXCAVATE FENCE
OR FILL (........ ........... Ft.)
REPAIR ❑ PRE-INSP. El swim
POOL
NUMBER OF STORIES NlJMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE
Lawn Sprinkler system
tt1'FJ
y PROPOSED USE
O
aPLOT PLAN (Indicate Building setback., abutting street.)
b
O
N
I hereby acknowledge that I have read this application; that the In.
formation given 1. correct; and that I am the oweer, or the duly author-
ized agent of the owner, i agree to comply With city and elate law. "gu-
lating construction; and In doing the work authorized thereby, no person
will be employed in violation of the Labor Code of the State of Washington
relating to Workmen's Compensation Iasurance.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be completed In ninety days; MOVED -IN BUILDINGS shell be com-
pleted In six months.)
HIGNAT RE EIi OR AGENT) I DATE SIGNED
o� Igr1L
ZONE NUMBEPERMITR / dO6G.O
JOB
ADDRESS 21400 -72nd Avenue West,
PEliM ltltlIDLE J
ACTAL �p
LOT COVERAGE, LOT COVERAGE
PERMISSIBLE HEIGHT PROPOSED HEIGHT
ACTUAL LOT AREA TOTAL BLDG. AREA
REQUIRED YARDS PROPOSED YARDS
FRONT 81DF: REAR FRONT SIDE REAR
LEGAL. LOT VARIANCE Olt CONDITIONAL USE
YEH I] NO PERMIT NUMBER '.
i
PLA NN IN— O D1iPT. APPROVAL DATE.
1
STREET R/W zM 1
C
EXI8TIN0 STREET R/W ............FT. DEFICIENCY TF(I8 PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT. W
REMARKS W'Z
c
w
ECKED BY
/� I On
METER SIZE I BERVICE SIZE I CLEARANCE I CHECKED BY
REMARKS
TYPE CONNECTION YI VERIFIED BY
PERC. TEST PERMIT NUMBER tE
I
pl
REMARKS m
FIRE y.DDFS TYPE OF, C�ONN'ST�R{�U.�CTIONSTREET IMPROVED I`
SP��L SYST YES ❑ NO
SPECIAL INSPECTOR REQUIRED (OCCUPANCY GROUP I
❑ YES ❑ NO
PLAN CHECKED II�Y THIS SITE 15 LOCATED IN THE CITY
J1 OFSHOULD EDMONDS.
BECODED LOCAL31.04. SALES TAX
REMARKS
ALL_ C O tls`�R�.3c T1 A r�3�ri
UPC— 1-^f-73
Vnluatloa Fee Receipt No.
Plan Check No .....................
BUILDING
PLUMBING 4.00
HEAT A GAS LINE
FENCE j
SIGN 1
RETAINING WALL I
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE 4 c QO 96 7�
ATTENTION APPLICATION APPROVAL
THIS PERMIT This application Is not a permit until
AUTHORIZES Signed by the Building Official or his Dep-
ONLOR
K NOTED THE
WORK uty; and fees are paid, and receipt Is ac-
knowledged in space provided.
INSPECTION DIRECTOR' 810 A R
DEPARTMENT
CITY OF DATE
EDDIOND9
NOTE: 'Applicant Subject to Plan Check Fee 775-2525 �`— 47 _ Li
Tills Per alt ....n work to be done an private property ONLY.
Any construetlon on the Public domain (curbs, sidewalks, driveways. FILM
marquees, etc.) will require separate perml.slon.
i