750044.pdfBUILDING DEPARTMENT Applicant Fin Zola NUMBIER 750044
PERMIT APPLICATION
Inside Heavy Lines ,DB ,
ADDRESS //
, rrA.I. iG NAME OS IIUe1NEB 12
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FRONT HIDE REAR FRONT 91 DE - REAR
LEGAL. LOT VARIANCE OR CONDITIONAL USE
0 YES 0 NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
TELEPHONE NUMHEA
SEET R/W
TF STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
�. • 1C, rjei i� �� Rc•r.Anlr
Se.,)[77 L P1 6W _r� I CHECKED BY
TELEPHONE NUMIIER
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n 7�LJ(J 2
BLF&. S;WPCV. PQZ UPC 1R'73 I'
Plan Check No .....................
BUILDING
PLUMBING .3
HEAT & GAS LINE
PENCE
SIGN
tRETAINING WALL
N
HNIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
1:1 RESIDENTIAL
MU]
TYPE Or'/ �iONSTRUCTION
J 1 1
STREET IMPROVI
THIS SITE IS LOCATED IN THE CITY
Yr �f
I
� YES ❑ NO
INSPECTOR
REQUIRED OCCUPANCY GROUP
will be employed In violation of the Labor Code of the Stale of Wnehinglon
F 2
Plan Check No .....................
BUILDING
PLUMBING .3
HEAT & GAS LINE
PENCE
SIGN
tRETAINING WALL
N
HNIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
1:1 RESIDENTIAL
I hereby acknowledge that I have read this application: that the In.
LINE
❑PLAN CYES H
ECKEDDYO1
THIS SITE IS LOCATED IN THE CITY
Ized agent of the owner. I agree to comply with city and etato laws regu-
NEW
Q
Iating conetructlou: and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Stale of Wnehinglon
THIS PERMIT
OFSHOULD EDMOND8ECOS. LOCAL SALES TAX
AUTHORIZES
NOTE: Permit Limit One Year (Except DE51OLITIONS which
NON-RESIDENTIAL
❑
SIGN
pleted In elz —the.)
DED 31.04.
116 TU32E lOtVNER OR AGENT)
nn0
RETAINING
WALL
REMARKS
DEMOLISH
CITY OF
L�LI t-�vJ 1pppC��'lu-L
EDMONDS
ALTER ❑
OR FILL AVATE
❑
FENCz..........Fl.)
Tide 1'ermlt rn work iu be done on F01.1. properly ONLY.
❑
Ana' ran.l nl rlinnro�ihc pnUllc d,�n�nln (rur1,,, nlAr.enllcn, drhewny$,
elr.l i.11l i fre eeparu perndeelon.
SWIM
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��� UPe C 1-73
REPAIR ❑
INSP.
❑
POOL
LUMBER OF STORIES
NUMIIER OS
/
DWELLING
I
UNITS
MATURE nr WORK TO BE DONE
IBJ/// au iI � e/ i• �_�
�iy -'ri/J.cC
Valuation
Fee
Receipt Na.
Plan Check No .....................
BUILDING
PLUMBING .3
HEAT & GAS LINE
PENCE
SIGN
tRETAINING WALL
N
HNIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
IAl. 5-ol
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
imowledged in space provided.
r
PILE
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application: that the In.
formation Elven is correct: and that I am the owner, or the duly author-
Ized agent of the owner. I agree to comply with city and etato laws regu-
ATTENTION
Iating conetructlou: and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Stale of Wnehinglon
THIS PERMIT
relating to Workmen'. Comp—a.u.n Imuran.
AUTHORIZES
NOTE: Permit Limit One Year (Except DE51OLITIONS which
ONLY THE
WORK NOTED
$hall be completed In ninety day.; MOVED -IN BUILDINGS shall be wen.
pleted In elz —the.)
116 TU32E lOtVNER OR AGENT)
DATE SIGNEDINSPECTION
DEPARTMENT
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
775-2525
Tide 1'ermlt rn work iu be done on F01.1. properly ONLY.
Ana' ran.l nl rlinnro�ihc pnUllc d,�n�nln (rur1,,, nlAr.enllcn, drhewny$,
elr.l i.11l i fre eeparu perndeelon.
IAl. 5-ol
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
imowledged in space provided.
r
PILE