750156.pdfO
s
ti,;
r
PROPOSED USE
° PERMIT
u s �5U�5U
BUILDING
DEPARTMENT
Applicant Fill
'
Legal Description Of Property (Show Below or Attach Four Copies)
m
PERMIT APPLICATION
Inside Heavy Lines
JOB
ADDRESS
of
TYPE CONNECTION
VERIFIED BY
I
645 Maple Street
SIGN
NAME (OR NAME OF BUSINESS)
PERMISSIBLE 7e AMA
Lot 27,
Olvmnus Mortgag Orn.
N
LOT COVERAGE LOT COVERAGE
M
MAIWNO �D�REBS
SWIMMING POOL
O
PERMISSIBLE HEIGHT PROPOSED HEIGHT
O
CITY 22617 -76th Ave W
TELEPHONE NUMBER
ACTUAL LOT AREA TOTAL BLDG. AREA
REMARKS
775-1526
REQUIRED YARDS PROPOSED YARDS £
EXCAVATION OR FILL
Fdmonds Wa-hingtoo
a
FRONT BIDE REAR FRONT SIDE REAR
25.00
NAME
C
25.00 I 'Ij
to
W
'
LEGAL I.OT VARIANCE OR CONDITIONAL USE
I
YES [] NO
ADDRESS
� YES ❑ NO PERMIT NUMBER
ATTENTION
APPLICATION APPROVAL
OCCUPANCY GROUP
PLANNING DEPT. APPROVAL DATE:
SPECIAL INSPECTOR REQUIRED
0
will be employed in violation or the Labor Coda of the State of Washington
NUMBER
CITY
A.
LINE
(TELEPHONE
THIS SITE IS LOCATED IN THE CITY
STREET R/W O
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
NEW
El
NO ❑
glON
NAME............FT.
OF EDMONDS. LOCAL SALES TAX
COMP. PLAN ST. R/W ............FT.
ElADD
RETAINING
REMARKS
SHOULD BE CODED 31.04.
REMARKS94 d
❑ DEMOLISH [—]L
ADDRESS
O
W
Fl ALTER ❑ ORFILL❑
G
1•;
CHECKED HY
REPAIR ❑
P. El
tEC
F
CITY I
TELEPHONE NUsitu
I
IN
a.
CITY OF
EDMONDS
DATE i
METER SIZE SERVICE 812E CLEARANCE CHECKED BY
NUAiHER OF STORIES NUMBER OF
O
STATE LICENSE NUMBER
CITY LICENSE NUMBER
PROPOSED USE
I
REMARKS
'
Legal Description Of Property (Show Below or Attach Four Copies)
m
Th west 10 ft of Lot 25, all
of
TYPE CONNECTION
VERIFIED BY
I
SIGN
I
20 ft of
Lot 27,
N
lot 26 and the east
PERC, TEST
PERMIT NUMBER
SWIMMING POOL
DEMOLITION
Block 96 City of Edmonds.
REMARKS
a
EXCAVATION OR FILL
a
COMP. INSP.
25.00
C
25.00 I 'Ij
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROV]
'
I
YES [] NO
i
Ind agent of the owner. I agree to comply with city and state laws mgu-
ATTENTION
APPLICATION APPROVAL
OCCUPANCY GROUP
SPECIAL INSPECTOR REQUIRED
will be employed in violation or the Labor Coda of the State of Washington
® RESIDENTIAL
A.
LINE
YES
OPLAN CHECKED❑BYO
THIS SITE IS LOCATED IN THE CITY
AUTHORIZES
NEW
El
NO ❑
glON
NOTE: Permit limit One Year (Except DEMOLITIONS which
OF EDMONDS. LOCAL SALES TAX
uty; and fees are paid, and receipt is ac -
ElADD
RETAINING
REMARKS
SHOULD BE CODED 31.04.
❑ DEMOLISH [—]L
SIGNATURE (OWNER OR AGENT) DATE SIGNED
Fl ALTER ❑ ORFILL❑
FENCE ...Ft.)
DEPAflTMENT
REPAIR ❑
P. El
SWIM
Olympus Mortgage Col . 4-15-75
Y PP
IN
Fee
CITY OF
EDMONDS
DATE i
NUAiHER OF STORIES NUMBER OF
775.2525
This Permit euvem work to ha done on private property ONLY.
DWELLING
I
`
1
Any const rnetinn nn the public domain (curbs, .Iden'Nk., driveways,
UNITS
®1®®Ylel®elm
oi:.rloers, ,.l r., „III r,ilulre srlotrule I,er ndselou.
a� �
w e,l„e,�a.rrate�
NATURE OF WORK TO BE DONE
Valuation
Fee Rcce
SPECTION
O
COMPLA I NCE N
Plan Cheek N. .....................
BUILDING
PROPOSED USE
PLUMBING
U
'
aPLOT PLAN (Indicate Building setback., abutting street.) HEAT A GAS LINE
m
�
FENCE
I
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
COMP. INSP.
25.00
TOTAL AMOUNT DUE
25.00 I 'Ij
I hereby acknowledge that I have read this application; that the In-
'
formation Riven Is correct; and that I am the owner, or the duly author-
i
Ind agent of the owner. I agree to comply with city and state laws mgu-
ATTENTION
APPLICATION APPROVAL
)sting construction; and In doing the work authorized thereby, no person
will be employed in violation or the Labor Coda 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
WORK NOTED
uty; and fees are paid, and receipt is ac -
shall be completed In ninety days; MOVED -IN BUILDINGS shall be cone-
ImoWledged in space provided.
plated In I I menthe.)
SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
Di TOR'S SIONATU
4
DEPAflTMENT
r i(�r
Olympus Mortgage Col . 4-15-75
Y PP
Fee
CITY OF
EDMONDS
DATE i
NOTE: Applicant Subject to Plan Check
775.2525
This Permit euvem work to ha done on private property ONLY.
`
1
Any const rnetinn nn the public domain (curbs, .Iden'Nk., driveways,
FILE
®1®®Ylel®elm
oi:.rloers, ,.l r., „III r,ilulre srlotrule I,er ndselou.
a� �
w e,l„e,�a.rrate�