750268.pdffolk ooa Q-ol- W 13S F4,
a
a
ti
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'PE OF CONSTRUCTION STREET IM PROVI
1ETAlIJ1 tJC1I- WALL I] YES )6 NO
'OR REQUIRED I OCCUPANCY GROUP
RESIDENTIAL ❑ GAS ❑ YES NO j � 4-
NEN LINE PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL F B1GN OF EDMONDS. LOCAL SALES TAX
ElADD
ALTER
DEMOLISH
CAVAT E
RETAINING
WALL
FENCEJgJL�G->`
BUILDING DEPARTMENT
Applicant FIR
UE PERMIT
ZONE RS -1 Z NUMBER 750263
REPAIR❑
❑
PERMIT APPLICATION
Inside Heavy Lines
IGH
IUb1BER
O3• STORIES
ADDRESS
NAD (O
j�
NAME OF H BIN •
I \ h
j� C
VX
PE.....SBIBLE J
V
h l I✓ I
LOT COVERAGE! LOT COVERAGE
MAILI.Q A DREOe�
PI,RelItlB1IILE HEIGHT
UNITS
Ic U(d
PROPOSED HEIGHT
C
CIT
T LEPHONE I VMIaER
S
ACTUAL LOT AREA TOTAL BLDG. AREA
{.�l,rr-" • r
REpUiRED YARDS PROPOSED YARDS
NAME
FRONT SIDE REAR FRONT SIDE REAR
tUjADDRE8B
LF.GAI, LOT VARIANCE OR CONDITIONAL USE
E.
� YE9 � NO PERMIT NUMBER
tj
PLANNING DEPT. APPROVAL DATE:
al
CITY TELEPHONE NUMBER
cc
STREET R/W `/
EXISTING STREET R/V"....FT. DEFICIENCY THIS PROPERTY
NAME
hS
COMP. PLAN ST. R/V�iD�.FT, 5�.....FT.
REMARIGI
It
ADOREtl
U
c
F
CITY
TELEPHONE NUMBER
CHECKED BY
1,A
in
rOj
METER SIZE I BERVICE SIZE I CLEARANCE
I CHE -D Ity
folk ooa Q-ol- W 13S F4,
a
a
ti
a
'PE OF CONSTRUCTION STREET IM PROVI
1ETAlIJ1 tJC1I- WALL I] YES )6 NO
'OR REQUIRED I OCCUPANCY GROUP
RESIDENTIAL ❑ GAS ❑ YES NO j � 4-
NEN LINE PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL F B1GN OF EDMONDS. LOCAL SALES TAX
ElADD
ALTER
DEMOLISH
CAVAT E
RETAINING
WALL
FENCEJgJL�G->`
REMARKS
SHOULD BE
REPAIR❑
❑
ORFILL
INSP
❑
(....... .............. PY. )
POOL
IUb1BER
O3• STORIES
NUMBER OF
DWELLING
I
UNITS
^�
' Plan Ch -ft No ..................... (I/ 1 L•
O BUILDING
PROPOSED UBE
O
PLUMBING
PLOT PLAN (Indlcnle Bmldlns eetbncke, abuttlns elrccte) HEAT & GAS LINE
E I
' FENCE
G 1
a1 SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
1 —7— EXCAVATION OR FILL
W
TOTAL AMOUNT DUE --
I hereby acknowledge that I have read this aPPilcatlon; that the In-
formation given le correct; and that I am the owner, or the duly author-
Ized agent o[ cto owner. i agree to comply withaut city and state eby Inwe eesu• ATTENTION APPLICATION APPROVAL
Inting mnetruclloa; and In doing the work aulhorized therapy, no parson
will be employed In violation of the Labor Code of the State of Washington THIN PERMIT
relating to Workmen's Compensation lutirmee. AUTHORIZES This application is not a permit until
ONLY THE signed by the Building Official or his Dep -
NOTE: Permit LM
t One Year (Except DF.\IOLITIONS which WORK NOTED uty; and fees are paid, and receipt Is ac -
eh be completed Inly days: IIOVED-IN BUILDINGS shall be com• knowledged In space provided.
PI t d I elx on ❑ :)
SI AT LE (OW R O ADEN DAT SIGNED INSPECTION DIRECTO 'H BION E
A DEPARTMENT
CITY OF _ /1.
ED51ONDS DATE' /
NOTE: Applicant Srlbject to Plan Cleck Fee 6 _ p 7 S
This 11CIt r. work to be donee 775-2525
n Private property ONLY.
Any <enetrurtinurnn the Pubile Aemnln (enrl,e, sldru'alks. drly .Yx.
„., .......
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