750006.pdfT
u
USE PERMIT
�_I..,
BUILDING DEPARTMENT Applicant Fin JJ
FRONT SIDE REAR FRONT SIDE REAR
I'.
F
yU
Ir
.'j
ZONE NUMBER � OJJb
.2s' /-7 , ' s 05 4/' a54
NAME (ZgS•��%O h�✓•iJ
FRONT SIDE REAR FRONT SIDE REAR
I'.
F
yU
Ir
.'j
ZONE NUMBER � OJJb
.2s' /-7 , ' s 05 4/' a54
PERMIT APPLICATION I Inside Heavy Lines
soH
_.
g
NAME (OR NAME OF BUSINESS)
ADDRESS S3 0,,A
d
L-
DONIiL-b. I.r STEP I -i FtJSO�I%
M
PERMI881HLE ane ACTUAL
LOTC'O RAOE LOT COVEAGE
20'pt, O
'y(
••, ADDRESS
PERMISSIBLE HEIOIi PROPOSED
STREET R'tv GG;; /�
EXISTING STREET R,V;2 .F:_�FT. DEFICIENCY THIS PROPERTY
rr,,..�t rr--p�
COMP. PLAN ST. R/tK`.l16PI-r. J...FT.
�MrAILING
�C 3 ! VS I rT ti wRY s LJ
O
�
ul
Aft RESS
CITY
CITY
TELEPHONE NUMBER
ACTUAL`LJT )A T I' TOTAL By3.'4�
STATE LICENSE NUMBER
CITY LICENSE NUMBER
ER
MET E¢ S''!•. I SERV CE/ SIZE CLEARANCE
3
EDM Otil AS QO2 C%
7 I S _ IU Ij
R UIRED YARDS PROPOSED YARDS
Z
NAME (ZgS•��%O h�✓•iJ
FRONT SIDE REAR FRONT SIDE REAR
I'.
F
yU
Ir
.'j
OCCUPANCY GROUP
.2s' /-7 , ' s 05 4/' a54
ADDRESS
LEGAL LOT VARIANCE OR CONDITIONAL USE
LR YES NO PERMIT NUMBER
PLANNING DEP A ROVA DATE:
CITY
TELEPHONE NUMBER
k
cc
NON-RESIDENTIAL1
LI
LINE
El
,7�V
a
W
[�
w
a
STREET R'tv GG;; /�
EXISTING STREET R,V;2 .F:_�FT. DEFICIENCY THIS PROPERTY
rr,,..�t rr--p�
COMP. PLAN ST. R/tK`.l16PI-r. J...FT.
m
F<
O
O
NAME
UWNC2
AEMA"'Driveway slopes not to exceed those
indicated on Standard Dwg. No. 103
Aft RESS
CITY
TELEPHONE NUMBER
ORE 0)
STATE LICENSE NUMBER
CITY LICENSE NUMBER
ER
MET E¢ S''!•. I SERV CE/ SIZE CLEARANCE
3
CHECtf D BY
'
e
�
—
C
U
n
Legal Description of Property (Show Below or Attach Four Copies)
L0 -T / Lr %9L3UT ISAiQj�
REMARKS
p/
��� • �� ,
C'<
DMONAS ltJJi
TYPE CONNECTION
PL•RC. TESTP'
I VERItl Yn
Ml U BER
I
NUMBER OF STORIES NUMBER OF
h
REMARKS
f
.1
V
r@I{
j
UNITS
W
.1
FIRE ZOaLE � TYPm nr r•nu.mvrrrvnrnv i o ............. ...............
❑ YES �,NO
I'.
CIA
SPEL INSPECTOR REQUIRED
OCCUPANCY GROUP
irg
RESIDENTIAL
[3 YES NO
T1L
k
® NEWLEE]
NON-RESIDENTIAL1
LI
LINE
El
AW
PLA�CH�jCKED BY
e�(N
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
n +
ADD
SIGN
SHOULD BE CODED 31.04.j
DEMOLISH ❑ WALL NING
REMA�R7K ;
1
ALTER EXCAVATE FENCE
I (i D 1yvL-way cyLVIMT R�GtD
❑ OR FILL n.)
..........
REP.IIR SWI 1(*�
F-1PRE-MOVE
❑ POOL
I _ 9 �- t )//�`n
' ���
I
NUMBER OF STORIES NUMBER OF
f
DWELLING
Tw0 0�
r@I{
j
UNITS
NATURE OF WORK TO HE DONE
!
I� C- S I p EItJ l E
Valuation
Fee
Receipt No.
gt
}
Pian Check No ........ _... ........
N ii
,
1
O
USE
BUILDING
•�1 �/ �1 2 QO
!�I f-
/ I% Ji`�
p( G/
aPROPOSED
ES1 DcNc�
PLUMBING
2 0 0
PLOT PLAN (indicate Building eetbucka, abutting etrocle/
HEAT k GAS LINES
.77r
Q O
O
FENCE
f
SIGN
1
RETAINING WALL
SWIMMING POOL
I
DEMOLITION
PRE -MOVE INSPECTION
1
EXCAVATION OR FILL
I
/I
J
I
TOTAL AMOUNT DUE
hereby acknowledge that I have read tale application; that the In-
formation Riven incorrect; and that I am the owner, or the duly author.
I
Izetl agent or the owner. I agree to comply with city and elate ]awe regu•
lull.. conetrs
ruetloa; and In doing the work authorized thereby, no peon
ATTENTION
APPLICATION APPROVAL
will be employed In violation of the Labor Code Of the State of Washington
relating to Workman's Comp enentloa ]nluranu.
THIS PERMIT
This application is not a permit until
AUTHORIZES
signed by the BUildln Official Or his DO
g p"
--I
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TIIE
WORK NOTED
uty; and fees are paid, and receipt is aC-
L•���--'—
Bann be cpie d In Ias e; MOVED -IN BUILDINGS 111.11 be cone.
knowledged in
p lel n 1 )
space provided.
81G R
OW OR AGE T) DATE SIGNED
INSPECTION
DIRECTO 'S BI T HE
/
DEPARTMENT
1 A,l^' %
CITY OF
l
NOTE: hQlicant Subject to Plan Check Fee
EDMONDS
DATE
Thle Permit coeers work to be done on pi,.,. property ONLY.
7752525
Any c.nsDuctlOn nn the public dom.ln (enrbe, eldew.lks, drl-weye,
o...ro io•ra, ,t.1
r.) xlll ,,,mire nrinruir peril
-
PILE
e
rlt�rem