750114.pdfor g y
leed agent of the owner. I agree to comply with city and elate laws Ingo-
ATTENTION
e
,sting construction; nad to doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORE NOTED
utyi and fees are paid, and receipt is ac -
ZEE "°HI>rt 7501 14
i
knowledged in space provided.
pl lid In nix montos.)
BUILDING DEPARTMENT Applloallt Ftll
�-�
I TU " lt1tY Elt O lGENT) DATE SIGNED
,
INSPECTION
DIRECTO s S2G T E
Inside Heavy Linea
PERMIT APPLICATION
--
JOB
ADDRESS r-7 4 G
� �
DEPARTMENT
'�
E (OR NAME OF BUB EBB)
V ' � '✓ �_ a r/" .
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cITY or
i
EDMONDS
DAT
NOTE: Applicant Subject to Plat) Check Fee
PERb11SSI T ACTUAL l
3•-,`� - 6—
11
)
This I'ermlt rnrrn work to be done on private properly ONLY.
\/t --/vL�
LOT COVEItAOE ^D�LU LOT COVE'RAOE D �•
R
FILE
marquees, etc.) will require separate permisslon.
1
m
MAILING ADDRE88
PERMISSIBLE HEIGHG T PROPOSED HE16H /
QO2
—1 Q
CITY
NUMBER
ACTUAL LO AREA TOTAL BLDG AREA
�A'/t � t
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1
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1
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REQUIRED/YARDS /PR'O(PIOHEDYARDH
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NAM
FRONT HIDE REAR FRONT BIDE REAR
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4-T ' 17 S 'D' t 7 6,
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LEGAL LOT VARIANCE Oft CONDITIONAL USE
ADDRESS
YES 0 NO PERMIT NUMBER
.F.
i
PLANNINGUJ PT PPROVAL .y DATE:
t
CITY TELEPHONE NUMBER
• J
STREET R/{V
EXISTING STREET R/W ... .. FT, DEFICIENCY THIS PROPERTY
p
0
NAME
COMP. PLAN 8T. R/W ...�....FT.
.}�..FT.
REMARKS Driveway slopes not to exceed those
O
ADDRESS
indicated on Standard DWo. No. 103
tr,)
w
CHEMED BY
CITY
TELEPHONE NUMBER
F
I
METER SI'LE SERVICE SIZE
CLEARANCE
CHECKED BY��1
STATE LICENSE NUMBER
CITY LICENSE NUMBER
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I I
Z. Z S U I-- L pe ty
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1pa•,
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Legal Description of Property (show Below
or Attach Four Copies)
REMAJ
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/ J
V� C�t G �{ :. •.� •��-.•,
TYPE CON CTION IuS
VERIFIED BY
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PERC. TEST
FERMI UMBER
O{qE
•—•
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REMARKS
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ne
(�INDi�t6�,euN17 I�IIIKuJ4 �L-(�,fj-
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FIRE ZOC TYPE OF C NSSTRUCTION
STREET IMPROVED
J�fJ1�
YESL3 NO
SPECIAL INSPECTOR RECUIRED
OCCUPANCY
GIZ,OUP
E3 YES �NO
.Z /TJ/
RESIDEl ENTIAL
GAB
❑
® NEW
LINE
PLAN CHECKED Y THIS SITE IS LOCATED IN THE CITY
�i[v,J OF EDM0ND5. LOCAL SALES TAX
NON-RESIDENTIAL
SIGN
SHOULD B/fE CODED//31Q.0^4''.)
ADD RETAINING
DEMOLISH WALL
REM/�,ARK9%%
FENCE
El
et Gl.,d /r n V U.(J G ! 5
ALTER EXCAVATE
OR FILL � (..........x..........Ft.)
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❑ PISP. OVE RE-M
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REPAIR El EJ POOL
-�-"'
NUMBER OF STORIES NUMBER OF
DWELL
UNITS LING 1
NATURE OF WORK TO BE DONE
Valuation Fee Receipt No.
Pion Check No .....................
BUILDING
4
PROPC
IED USE
PLUMBING 10
MPLOT
LAN (Indicate Building setbacks,
butting streets)
HEAT @ GAS LINE
�{ U
J
D
i
FENCE
11
SIGN
'
RETAINING WALL
J
17, a
i'j.7
jl�
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
S
EXCAVATION OR FILL
J.
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
in mntlan Iven Ie correct: and that I am the owner r thedul author -
/'
/tea
or g y
leed agent of the owner. I agree to comply with city and elate laws Ingo-
ATTENTION
APPLICATION APPROVAL
,sting construction; nad to doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORE NOTED
utyi and fees are paid, and receipt is ac -
shall be completed la ninety days; MOVED -IN BUILDINGS shall be wm•
knowledged in space provided.
pl lid In nix montos.)
I TU " lt1tY Elt O lGENT) DATE SIGNED
INSPECTION
DIRECTO s S2G T E
_
I-/
DEPARTMENT
�1.�tt
cITY or
EDMONDS
DAT
NOTE: Applicant Subject to Plat) Check Fee
3•-,`� - 6—
775.2525
This I'ermlt rnrrn work to be done on private properly ONLY.
Any construction on the public domain (curbs, sidewalks, dil—aye,
FILE
marquees, etc.) will require separate permisslon.