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750070.pdfUSE PERMIT BUILDING DEPARTMENT Applicant FII( ZONE NUMBER PERMIT APPLICATION Inside Heavy Lines JOB ADDRESS K NAME (OR NAME OF BUSINESS) dl a rL'h! / LOT COVERAGE LOT MAILINNU S PERMISSIBLE HEI11 PRO) R ACTUAL LOT AREA TOT/ gip` /� //n �TjELEPEONE /NU2MB^�E REgUIRED YARDS Ll RESIDENTIAL FRONT BIDE REAR FRONT BIDE REAR NAME ❑ NON-RESIDENTIAL ❑ WLEGAL ADD :..� DEMOLISH LOT VARIANCE OR CONDITIONAL BE , USE PERMIT BUILDING DEPARTMENT Applicant FII( ZONE NUMBER PERMIT APPLICATION Inside Heavy Lines JOB ADDRESS K NAME (OR NAME OF BUSINESS) dl a rL'h! / LOT COVERAGE LOT MAILINNU S PERMISSIBLE HEI11 PRO) R ACTUAL LOT AREA TOT/ gip` /� //n �TjELEPEONE /NU2MB^�E REgUIRED YARDS C ADDREBB [O[y F CITY TELEPHONE NUMBER V I METI TYPE CONNECTION I VERIFIED BY o_ f' PE C. TEST PERMIT NUMBER k7 q REMARKS io O Ll RESIDENTIAL FRONT BIDE REAR FRONT BIDE REAR NAME ❑ NON-RESIDENTIAL ❑ WLEGAL ADD ❑ DEMOLISH LOT VARIANCE OR CONDITIONAL BE ADDRESS F 0 YES NO PERMIT NUMBER PLUMBING ❑ PLANNING DEPT. APPROVAL DATE: J C CITY REPAIR NUMBER PRE-MOVEO HEAT A GAS LINE swim (TELEPHONE STREET R/\V FENCE IUMBER OF STORIESNUMHER OF EXISTING STREET A/W ............FT. DEFICIENCY THIS PROPERTY NAME COMP. PLAN BT. R/W ... .........2''T. .........._ FT. ©`� REMARKS UNITE C ADDREBB [O[y F CITY TELEPHONE NUMBER V I METI TYPE CONNECTION I VERIFIED BY o_ f' PE C. TEST PERMIT NUMBER k7 q REMARKS io O 0 YES 0 NO SPECIAL INSPECTOR REQUIRED I OCCUPANCY GROUP 0 YES 0 NO PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY OF EDMONDS.-LOCAL SALES TAX SHOULD BE CODED 31.04. REMARKS Fence requirements - section 12.14+040 attached. Valuation Ll RESIDENTIAL GAS LINE NEW ❑ NON-RESIDENTIAL ❑ SIGN ADD ❑ DEMOLISH RETAINING ALTER UTE PLUMBING ❑ FULL OR L uq w REPAIR PRE-MOVEO HEAT A GAS LINE swim ❑ E FENCE IUMBER OF STORIESNUMHER OF SIGN DWELLING RETAINING WALL UNITE rATURE OF WORK TO BE DONE 1 0 YES 0 NO SPECIAL INSPECTOR REQUIRED I OCCUPANCY GROUP 0 YES 0 NO PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY OF EDMONDS.-LOCAL SALES TAX SHOULD BE CODED 31.04. REMARKS Fence requirements - section 12.14+040 attached. Valuation Plan Check No ..................... O �jrQ BUILDING PROPOSED USE PLUMBING uq w PLOT PLAN (Indicate Bullding setbacks, abutting street.) HEAT A GAS LINE E FENCE O O SIGN RETAINING WALL 1 SWIMMING POOL DEMOLITION I PRE -MOVE INSPECTION - - EXCAVATION OR FILL 1 ^ TOTAL AMOUNT DUE I hereby acknowledge tont i have read this application; that the In- t 0 V formation given Is correct; and that I an the owner, or the duly author- I ized agent of the owner. I agree to comply with city and state laws regu• ATTENTION APPLICATION APPROVAL laling construction; and In doing the work authorized thereby, no person - wlil be employed In violation of the Lobar Code of tha Slate of Wmhmgton THIS PERMIT This application is not a permit until relating to Workmen's Compen.aUon (murines. AUTHORIZES signed by the Building Official or his Dep -ONLY .) — NOTE: Permit Limit One Year (Ezeept DEMOLITIONS which WORK NOTED uty; and fees are paid, and receipt is ac- ?-- �— shall be completed In ninety days; LIOVED-IN BUILDINGS shall be coin- Imowledged in space provided. pleted 1 Is month..) SNA RE (OWNE]t OR AGENT) DATE SIGNED INSPECTION DIR OWS NATU +✓ r. DEPARTMENT J` f NOTE: Applicant Subject to Plan Check Fee CITY OF EDDIONDS DAT E -� 775-2525 This Per It corers work to be done on private Property ONLY. Any cnn.t rueNan an Illr' PubIIIlic domnln (sorb., nldnrnik., Jrirewars' PILE rr),I,..., , „rr,Inlre .ePnrul,• I nJ+cion.