750337.pdfUSE PERMIT
BUILDING DEPARTMENT I Applicant Fill ZONE S_, y NUMBER
PERMIT APPLICATION Inside Heavy Lines
NAME (OR NAME OF UUBINEBB)
ICA
m MAILING ADDRESS
l J?z Avg• rv.
U
qV'
td
F
x
8
rJ
Al
8/
JOB
ADDIMB 'O 7//
J' E
PERMISSIBLE 7
LOT COVERAGE
COPEUUAALL
ACTjCOVERAGE
LOT
PERMISSIBLE HEIGHT
PROPOSED HEIGHT
ACTUAL LOT AREA
TOTAL BLDG, AREA
REQUIRED YARDS
T
FRONHIDE
PROPOSED YARDS
REAR FRONT HIDE REAR
ORCFILL ( *..............Ft.)
I1F.OPq Lin NO PERMIT NUMBER VARIANCE OR CONDITIONAL USE
EXISTING STREET R/W ............Fr. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
REMARKS
NO
N"?
0 YES 0 NO
EDMONDS. LOCAL SALES 1
ULD BE CODED 31.04.
1399 7V0!
NATU�R/E�IOF WORK TO BE.fDONN
FIRE I
Valuation
SPECI,
Ej NEW RESIDENTIAL LINE
S
LAN
NON-RESIDENTIAL SIGN
ADD E] DEMOLISH ❑ RETAINING
AL L NINC
AVATE ❑ CE
ALTEREl
REMA:
ORCFILL ( *..............Ft.)
REPAIR INSP. El SWIM
POOL
_
iUMBEii OF STORIES NUMUEK OF
/ DWELLING
UNITS
NO
N"?
0 YES 0 NO
EDMONDS. LOCAL SALES 1
ULD BE CODED 31.04.
1399 7V0!
NATU�R/E�IOF WORK TO BE.fDONN
Valuation
Fee Receipt No.
,p ,C
L/��/-/-/1/U 7 QD/
�r�` /1
Pian Check No,
L/:�"4
BUILDING
1' f(/
L PROPOSED USE
CJ
J
PLUMBING
U
PLOT PLAN (Indicate Building setback., abutting street.)
HEAT A GAB LINE
5
FENCE
_
SIGN
.
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
AVO
I hereby acknowledge that I have read this application; that the In-
,.,motlon given iscorrect; and that I am the owner, or the duly author-
ised agent of the owner. I agree to comply with city and .late Is— re u.
ATTENTION
APPLICATION APPROVAL
lating construction; and in doing the work suthertzed thereby, no person
will be .replayed In violation of the Labor Code at the State of Was ilagton
THIS PERMIT
This application is not a permlt until
relating to Workmen'. Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TILE
WOER NOTED
uty; and fees are paid, and receipt is ac-
ehail be completed In ninety days; MOVED -IN BUILDINGS shall be com.me!O
edged In space provided.
plated In .lx months.)
SIGNATURE (OW(NER OR AGENT)
DATE SIONED
INSPECTION
DIRE S NATURE
'7 y /
�—%S
DEPARTMENT
CITY OF
I
ED11fOND8
ATE
NOTE: Applicant Subject to Flat: Check Fre
775-2525
Thl. Par it curers ..ark le W done on private properly ONLY.
Any c......climt no the publlc dnmein (curbs, .IdewWk., driveways,
FILE
marquee., air.) wllI r"care .e,Pseat. permission.