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750102.pdfE PERM BUILDING DEPARTMENT Applicant FW Z NNE �1 NUMBER 750102 PERMIT APPLICATION Inside Heavy Lines .GB L o ADDRESS 2 NAME (OR NAME OF BU81NEB8) of e5 n � I LOTPERCO ERA ? ACTUAL rYI d rri ` Oc. Pr LOT COVERAGE yq LOT COVENAOE rt�� MAILING ADDRESS 1 �r) S� r/ 4 SI f PER—rullBLL HEI T PROPOSED � �•� -AI W �`7/ , mmr avvnve. vrevvn•o ACTIIAi. S.OT w .e TOTAL BLDG. AR6EM ` �- • "-" NAME CLAFOA/ FRONT HIDE REAR FRONT BIDE REAR -;'' ? as0' ? ca.5' WADDRE88 14 ` �,() ( o 5 -14 �✓ • LEGAL LOT VARIANCE OR CONDITIONAL USE � YES NO PERMIT NUMBER PLANN NG P ROYAL -_3 PATE: Q' CITY TELEPHONE NUMBER R/{V G EXISTING eTREET R/ .. .I'• DEFICIENCY THIS PROPERTY EXISTING c , , 1MI"w D '774-k444 WtA NAME r �y .Ln - •S{b/FR' ............F'1'. COMP. PLAN BT. R/446A,- RDMARXB Driveway slopes not to exceed those p indicated r+r,Tct(a�ndard Dwg. No. 103 w C ADDRESS I�:N� Y/K..1� /tVIM V GY H CITY !, TELEPHONE NUMIIEA O METER SIZE SERVICE e1ZECLEARANCE HEAT & GAS LINE CREC D Y G7Cl I l I �t t{rCd !TATE LICENSE NUMBER CITY LICENSE NUMBEK Legal e--gppnl Description of Property (Show Below or Attach POLL. Copies) -BLOCK (:;00 •-L O 4 S nL/�� L7L �/ / C/ ! TYPE CONNECTION VERIFI • D Y 6 I f+ LOT ! 3 's PERC. TEST PERM�) � VUMBER I E1AI--4-ALn I"I i LI S REMARKS m aGDM�'dDS3 wi t7 „I FIRE E I TYPE OF CONSTRUCTION STREET IMPROVED .�—/✓ 4E9 0 NO SWIMMING POOL SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP I 30 ❑ YES NO I RESIDENTIAL CAS LINE © NEW NON-RESIDENTIAL SIGN El ADD RETAINING DEMOLISH 0 WA' ALTER EXCAVATE ❑ FENCE PLAN CHECKED Y THIS SITE IS LOCATED IN THE CITY (� I / OF EDMONDS. LOCAL SALES TAX iii.�t/ SHOULD BE CODED 31.04. R ARK W. �G�//f �[�Cll ✓ PG I/A� G / �J E]IT OR FILL I .......... x..........Ft.) ❑ REPAIRBWIDi ❑ PRE•TIOVE INBP. O POOL I NUMBER Oi' HTOIiIE! NUMIIER OF DEMOLITION DWELLING b�%e UNITS (V17e NATURE OF WI TBE DONE I PRE -MOVE INSPECTION Valuation Fee Reeelm No ` �- • "-" Plan Check N [,............. O BUILDING 3, PROPOSED USE PLUMBING pv '� PLOT PLAN (Indtento Building setbacks, ¢butting street.) HEAT & GAS LINE G7Cl 4 S.' -E P`.IMS FENCE 6 SIGN I RETAINING WALL SWIMMING POOL I 30 I 90l DEMOLITION PRE -MOVE INSPECTION ' L1 I EXCAVATION OR FILL I hereby acknowledge that I bays read this application;that Ute in. TOTAL AMOUNT DUE formation given B correct; mid that I am the owner, or the duly nulhor- ,zed agent of the owner. 1 agree to comply with city and state laws reg.- ATTENTION APPLICATION APPROVAL Iating construction; and In doing the work authorl..d thereby, no person will be employed In violation or the Labor Code of the State of Washington THIS PERMIT This application is not a permit until relating to Workmen's Compensation Insurance. AUTHORIZER signed by the Building Official or his Dep- :�____------ NOTE: Permit Limit One Year (Except DEMOLITIONS which ONLY THE WORK NOTED uty; and fees are paid, and receipt Is ae- shall be completed In ninety days; MOVED -IN BUILDINGS shall be com. Imowledged in space provided. paled In 11. month..) 1GNATURE OWNER ORA ENT)DATE SIGNED INSPECTION D RE T e IONATURD DEPARTMENT . 18 1q7 CITY OF EDMONDg ATE NOTE: Applicant Subject to Plan Cheek Fee This 1'enNt core. work to be done an private property ONLY. 775-2525 Any const ruetion on the public domain (.orbs, .Idrwnikn, driveway., , 1' ) 11111 rr�lnlrr nrpnrnl,� 1 ml+e.,l FILE •�