18904 84TH PL WIIIIIIIIIIIIII
15411
18904 84TH PL W
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STREET FILE
0 F E D M 0 N D S
PUBLIC WORKS DEPARTMENT -
Routing of Ydildih-g Plat, or Subdivision. Applications
Proposed Property Address: 18904-- 84th Place West
DEPARTMENT.
COMMENTS
INITIAL
& DATE
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B U I L D I N G
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ADDITIONAL INFORMATION:
2
SE PERMIT
ZONE NUMBER
OJILDING DHARMINT Fill
�Applicant
side Heavy Lines
PERMIT APPLICATION
J013
ADDRESS
NAME (OR NAME OF BUSINESS
VARIANCE OR COND. USE NO.
ADB NO.
HEIGH T
W MAILING ADDRESS
z
PROPOSED YARDS
COVERAGE
0
FRONT SIDE R . EAR
JLOT
CITY
T ELEPHONE NUMBER
SIGN AREA —71RONMENTAL
REVIEW
z
e
ALLOWED PROPOSED
0 COMPLETE OEXEMPT
NAME
REMARKS
U
W ADDRESS
PLANNING DEPT. APPROVAL DATE
x
U
TELEPHONE NUMBER
LEGAL LOT
LOT
UBDIVISION NO.
j:1 YES 0 NO
NAME
e*?
STREET R/W
EXISTIN G STREET R/W FT, DEFICIEN . CY THIS PROPERTY
COMP. PLAN ST. R/W FT.. FT.
0 ADDRESS
U
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REMARKS
<
CITY
TELEPHONE NUMBER
z
7
0
z
CHECKED BY
U -!g'T-ATELICENSE NUMBER
CITY LICENSE NUMBER
22
W.
Z_
STREET AND/OR UTILITY WORK
R/W PERMIT REQUIRED
Legal Description of Property (Show Below or Attach Four Copies)
REQ'D. OyEs 0 No
0 YES 0 NO
93
77'�'
z
W
UNDERGROUND
WIRING REQ'D. 0 YES ONO
Z
71
TYPE.CONNECTION 0 YES IVERIFIED
SANITARY SEWER NO
B
U
SEPTIC SYSTEM
APPVD BY CITY ENG. YES
ERMIT*NUMBER
1P.
El NO
REMARKS
W
J
MET IZE
SERVICESiZE
CLEARANCE
CHECKED BY
REM`AAKS
N GAS
P--N EW R ES IDE1. TIAL E] LINE
FIRE ZONE
TYPE OF CONSTRUCTION
.
NON-RESIDENTIAL SIGN
TJ.A L
FJ
1CODE.
ADD . I
r I RETAINING
DEMOLISH
El 1:1
SPECIAL INSPEC TORJAREA
REQUI.RED
OCCUPANCY
GROUP
CCUPANT
LOAD
WALL
ALTER EXCAVATE
El o FENCE X
OR FILL'
0 YES 1:1 N 0
.10
W
PLAN CHECKED BY THIS SITF IS. LOCATED IN THE CITY+
PRE- OVE swim
EJINSPM
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.0 4.
REPAIR
POOL
El
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REMARKS 1
NUMBER OF STORIF;S7NUMBER
OF
DWELLING
D
U U NITS
NATURE OF WORK TO BE.DONF
PROPOSED USE
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�PLOT PLAN (INDICATE BUILDING SETBACKS,
m ABUTTING STREET S)
U
In
m
PLAN CHECK
NO.
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
VALUATION - I. ... FEE