750016.pdfe
BUILDING DEPARTMENT
AppHeantFiII
Z , � "UMBO 7�OOIb
PERMIT APPLICATION
Inside Heavy Lines
IOD
ADDRESS
NAME (OR NAME OF BUSINESS)
A
�L
Nnn i `L,
Qt` 1 W00 Q 1--I Mg-- I' `e� r
PERMISSIBLE ACTUAL J
IAT COVERAGE t-i /} LOT COVERAGE D ,
�1
MAILING ADDRESS
,r O� �� '^
`(['
`� fl '
PERMI88IH E HEFT PROPOSED H OHT
O
CITY
TELEPHONE NUMBER
ACfU/VtVj EA TOTAL yLLLO.�,ARE
�J`A' r1 �LlF`iVn
�`� ^�
E& I )LE �9A, ►� /
�!�16-6y��
jtll/
REQUIRED YARD. PROPOSE YARDS
a
NAME
FRONT BIDE REAR FRONT BIDE REAR
L UeE
OR
U
ADDRESS
LEGAL LOT VARrANCE CONDITIONAL
P1 YES 0 NO PERMIT NUMBER
.E.+r
U
-
CITY TELEPHONE NUMBER
PLANNING D P ROVAL ATE:
!�
EXISTING STREET R/ .FT. DEFICIENCY THIS PROPERTY
NAME
..
J1A�I
(`' I V n3 0 w �� e'-^
COMP. PLAN BT. R/W)'i� ... ....O...FT.e5lq
REMARKS
�
0
Driveway slopes not to exceed those
p
ADDRESS
indicated on Standard Dwg, No. 103
W
HY
!
C
CITY
TELEPHONE NUMBER
•CLEARANCE
V
MET SIZE .ERVICE 822E
CHEC D BY
1
STATE LICENSE NUMBER
_0 -
6
CITY LICENSE NUMBER
I �r
/ C7
REMARKS
CY
L
Legal DescriptionofProperty�(Show orA�)ttaah Four Copies)
�0 �I�`Btell/otyw
'J� C�- l\` r I VTYPE
CONNECTION VERT IED BY
PERC. TEST PERM U ER
C
X
I
¢AI
REMARKS
se
O
FIRE ZONE TYPE CONST FON .TREE lPROVED
%OFF
_ ( ❑ NO
YES SPECIAL IN.PECTORO QUIRED I OCC CY GROUP
j
GAS
RESIDENTIALLINE
NEW
C]
4 yr
PLAN CHEC D Y THIS SITE IS LOCATED IN THE CITY
OFEDMONDS. LOCAL SALES TAX
I
NON-RESIDENTIAL BION
SHOULD CODED 31.04.
ADD RETAINING
BE
ARTS
❑ DEMOLISH ❑
ALTER EXCAVATE FENCE
'/ / /J
�O.V L- k C:. ,/ 11
OR FILL (.....................Ft.)
PRE-SWI
REPAIR ❑ INSPMOVE O POOL
"�,r 7-�' �!may ,l,, �J✓
��/rc.ry �Zr Z/•&J
NUDI'li
l-L R OF
j
D WELLING
WELL
;
L�.FTOiti
GV
NATUREOF WORK TO BE DONE
Valuation
Fee
Receipt No.
NEW
W RC1 i!C 1 1 l_ QoNSTCLVCTID
I
rinn Check Na.
F
BUILDING
6,
PROPOSED USEy
[� Apt JI /� � /•
• i I Vl+�..l. 1 t 11 1 i�� Ili/r%rl�.l-� 1 `alJ
PLUMBING
(yl
o2/iV t�
PLOT (frallc¢�to BuuuIlding setbacks, abutting streets)
HEAT A GAS LINE
V(/ /IA
�
�
/PLAN
FENCE
SIGN
RETAINING WALL
f
N
SWIMMING POOL
�I
DEMOLITION
1
-
PRE-MOVE INSPECTION
I
EXCAVATION OR FILL
I
1
I
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this appllcs.11oh; that the In-
J7 �a
formation given le correct; and that I = the owner, or the duly author-
Ized agent of the owner. I agree to comply with city And elate laws regu.
ATTENTION
APPLICATION APPROVAL
lating construction; and In doing the work authorized thereby, no person
will be employed 1. vlolatlan of the "bar Code of the State of Washington
THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation Imurance.
AUTRORIZESI
ONLY THE
signed by the Building Official or his Dep'
NOTE: Permit limit One Year (Except DEMOLITIONS which
WORK NOTED
uty; and fees are paid, and receipt is
ac-
ehcompleted In ninety days; MOVED-IN BUILDINGS shalt be com-
knowledged in space provided.
le In z months.)
SIGNAT - (ONN OR FG NT DATE SIGNED
INSPECTION
F R. ION TORE
7
DEPARTMENT
j
CITY OF
EDMONDS
DATEUl
/
NOTE: licant Subject to Plan Check Fee
775-2525
Thle Permit r rrro work to tH• done an prlYnte ptaMrly ONLY.
A- cn n.lrnconn , the 1,11, r dnnmin (cnrbr. rklra'ntke, drirnwaye'
FILE
d
PL 110'
ti
4o' .
750016
i
i
EA
z book o {
m 4' Cantilever o
a 11.
2' Cantilev r 3Z I �
I
000,
P S�Pr�ch11
2�
cf� ��
.,1�
•�'o. try, e , �. �
PLOT PLAN LEGAL DESCRIPTION ! .
- I
S. 11 :1 1" 20' Lot 31, Emerald Hills, I
W,, toc : W Snohomish County,
Edmonds, Washington
Sew,: S NORTHWOOD HOMES, INC.
Powers F P. 0. Box 7058
ADDRESS Seattle, Wa. 98133
1100 Emerald Hills Drive 546-6480 A
Edmonds, Washington 98020 s
RECEIVED I
0 E C 2 197•4 '
CITY0 @ IAON09
YY
I
i