750313.pdfUBE PERMIT
BUILDING DEPARTMENTZONE NUMBER
Applicant Fla -150313
PERMIT APPLICATION I Inside Heavy Lines JOB
ADDRESS
NA (OR NAME OF BUBI/NESS) / .(�+r�/C/.1���
<R �MONU /V / LOT COVERAGE
% ACTUAL
/ IAT COVERAGE LOT COVERAGE I
CA MAILING ADDREBBd7
PE1Lv11881IILE HEIGIIT PROPOSED HEIGHT
5 /Gb9 SP,&CE S1-
0 CITY ACTUAL LOT AREA TOTAL BLDG. AREA Z t
TELEPHONE/7NUM'7BbAR r!,!
IL) 77,f-0374- REQUIRED YARDS PROPOSED YARDS
NAME FRONT SIDE REAR FRONT BIDE REAR
WLEGAL LOT VARIANCE OR CONDITIONAL USE
ADDRESSy[+ YES [:I NO PERMIT NUMBER t
j PLA DEPT. APPROVA DATE:
- 74
CITY I TELEPHONE NUMBER :.
STREET R/W 11O f"
EXISTING STREET R/W ............FT. DEF4CIENCY THIS PROPERTY V.
V.
NAME
��'� E) / Y L C/•L S. „� Ivl-. LAN 8T. R/W ............FT. ............FT.
REMARKS W !' '•
CoF ADDRESS X
F CITY (G ThhELEPjHONE/7NUM/BER
A J -_L �'/1E / I . 6L, A5+1 I JS -71 / w" / METER SIZE SERVICE SIZE CLEARANCEY I
O
STATE LICENSE NUMBERECKEfy D
? J ('' I CITY LICE NUMBER I I I ^� •�.(/—/
I /LREMARKS �L•L�
Legal Description of Property (Show Below or Attach Four Copies) /V/)
TYPE CONNECTION VERIFIED BY
(+ PERC. TEST I RMITL UMBER
n+
;q
REMARKS
j)
O Al%T -
ki FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED i
SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
I'
® RESIDENTIAL
❑ B
I
l
❑ NEW
INE
PLAN ED�YO
THIS SITE 15 LOCATED IN THE CITY
NON-RESIDENTIAL
El SIGN
OF EDMONDS. LOCAL SALES TAX
ADD
:RETAININGA
MARKS
ULD BEC DED 31.04.
❑ DEMOLISH ❑
17
FENCE
/// --� ``
. n/I J I.t/L/C /7G
I - /f / z
rI/ �L=/(/ V 7/
ALTER EXCAVATE ❑
OR FILL (.....................Ft.)
_
❑ REPAIR ❑ PRE -MOVE O SWIM
INSPPOOL
lWj %
d /✓ 12VJX�'G17,)/�(
NUMBER OF STORIES NUMBER OF
DWELLING
I
UNITS
1
NATURE OF TO BE DONE
Valuation
Fee
Receipt
No.
CWORK
Plan Check Nn.
BUILDING
(O
G PROPOSED USE
PLUMBING
U
PLOT PLAN (Indicate Hulltlln6 9etb¢Cke, puultln6 Streets)
HEAT A GAS LINE
7
FENCE
I
SIGN
RETAINING WALL
—
9WIMMIN6 POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL A1110UNT DUE
I hereby acknowledge that I hove read this application; that the In.
formation given Is correct; and that I am the owner, or the duly author-
ized agent of the owner. I agree to comply with city and elate laws regu-
ATTENTION
APPLICATION APPROVAL
latlag conalrucllon; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Slate 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 DF.MOLITIONH whleh
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
ahall b completed In Naety days; MOVED -IN BUILDINGS shall be com.
Ifnowledged in space provided.
1
plete 1 els months.)
BIG AT RE (OWNS OH AGENT)
��ti i/
DATE SIGNED
INSPECTION
DEPARTMENT
RE BiGNATU
O
CLlC //'�', ClL-tv
J
CITY
EDhIONDB
DATE
NOTE: Applicant Subject to Plan Check Fee
775-2525
This Penultr ork to I. done on private property ONLY.
Any ran rt tart tars on II`r Publle domnln
FILE
rlr. „In rr,lu lr.srpnrnl„ l'r nde•Im