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PERMIT APPLICATION Inside Heavy Lines
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BUILDING DEPARTMENT I AppllcaDt FW �oNE zo PERMIT NUMBER /J)WdJ
PERMIT APPLICATION Inside Heavy Lines
b (OR N OF BUB1NE88)
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PEI'blieeIBLE
LOT COVERAGE •7 L.2�
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LOT COVERAGE
PERMISSIBLE HEI�GII,1
PROPOSED
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ACTUAL L AREA
TOTAL H D AR A
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REQUIRED YARDS
PROPOSED YARDS
FRON;FRONTSIDE REAR2RONT
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LEGAL LOT VAKIA NCE,OR CON IONAL Ul1E
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PLANNING DEPT. AP AOV L TE:
CCITY TELEPHONE NUMBER -27
STREET R/lV
EXISTING STREET R/W ... .`.'FT. DEFICIENCY THIS PROPERTY
NAME
OUP
RESIDENTIAL CA8
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YES '�jNO
COMP. PLAN 9T. R/PFT. ..{,/.....FT.
PLAN CHECK D x
THIS SITE IS LOdAATED IN THE CITY
RDMARKS
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ADD RETAINING
DEMOLISH O WALL
Driveway slopes not to exceed those
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ALTER ENCE
EXCAVA E D
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STATE LICENSE NUMBER CITY LICENSE NUMBEK
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PLUMBING
REMARKS
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TYPE OOJL. NSSTRUCTION STREET IMPROVED
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SPECIAL INSPECTOR REQUIREDIOCCUPFA
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LINE
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PLAN CHECK D x
THIS SITE IS LOdAATED IN THE CITY
El NON-RESIDENTIAL SIGN
OP EDMONDS. LOCAL SALES TAX
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ADD RETAINING
DEMOLISH O WALL
REMARKa{
SHOULD BE CODED 31 04
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REPAIR RE-MOVEPSWIM
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N'UbiBER OF a ORIES NUbIBER OF
DWELLING
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NATURE UF(WORK TO HE DONE
Valuation Fee Receipt No.
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PLOT PLAN (Intlicntr Bulitlln6 9etbneke, abutting streets)
HEAT A GAS LINE
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PENCE
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SIGN
fRETAINING
WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
1 hereby acknowledge that I have rend this application; that the In-
TOTAL AMOUNT DUE
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formation given Is correct; and 'hat I nm the owner, or the duly author-
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lied agent of the owner. I agree to comply with city and erste Inwe ergo•
Inling
ATTENTION
APPLICATION APPROVAL
conelructloo; and In doing the work suthorired thereby, no parson
will be employed In violation of the Labor Coda of the State of Weshlogton
Tins PERMIT
This application is not a permit until
relating to Workman'. Cope.D. Insurance.
mm
AUTHORIZES
NOTE: Permit One Year (Except which
ONLY THE
WORK NOTED
signed by the Building Official or his Dep -
c-
Uty; and fees are paid, and receipt is ac-
cinst
be comp�rl6 In ninety days; MOVED -IN BUILDINGS shell be cam•
DINGS hall
knowledged In space provided.
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SI URW t0 VN L t Olt AG T) DATE SIGNIND
INSPECTION
DEPARTMENT
DIRE T 'S I TUR
Z'24. 75
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CITY OF
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NOTE: Applicant Subject to Plan CLeck Frees
EDMONDS
DATE \
775.2525
This I'ermlt c vete work to be dune on private property ONLY.
Any construct lob on the public domain (curbs, sldewalks, driveways,
mnrpnees, Me.) 11111 1e7u11a separate psrntlkl...
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