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BUILDING DEPARTMENT Applicant Fut
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NUMBEER 740066
I hereby acknowledge that I have rend this aDPllcattoP; that We 1n-
Inside Heavy Lines PERMIT APPLICATION
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formation given 1s correct: and that I am We owner, or the duty author.
NAME (OR NAME OF HUSTNE88)
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REQUIRED YARDS PROPOSED YARDS
ATTENTION
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ACTUAL
construction; and m doing the work authorised thereby, no person
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COVERA
LOT COVERAGE
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will he employed In violation of the Labor Code of the State or Washington
MAILING ADDREBe
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PERMISSIBLEkiEIGRT
PROPOSED HESOHT
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ACTUAL LOT AREA TOTAL BLDG. AREA
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TOTAL AMOUNT DUE
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formation given 1s correct: and that I am We owner, or the duty author.
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REQUIRED YARDS PROPOSED YARDS
ATTENTION
APPLICATION APPROVAL
construction; and m doing the work authorised thereby, no person
NAME
FRONT RIDE REAR FRONT HIDE BEAR
will he employed In violation of the Labor Code of the State or Washington
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This application is not a permit until
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ADDRESS
Signed by the Building Official or his Dop-
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NOTE: Permit Limit One Year (Except DEMOLITIONS which
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LEGAL LOT VAR ANCE OR CONDITIONAL USE
YES NO PERAlIT NUMBER
shall be completed In ninety day.; MOVED -IN BUILDINGS .hall be com-
knowledged in space provided.
PLANNING DEPT. APPROVAL DATE:
pleted In six months.)
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NUMBER
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DATE
NOTE: Applicant Subject io Plan Check Fee
PR a-1101
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EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
TN. Permit coven work to be done on private property ONLY.
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COMP. PLAN 8T. R/W ............FT. ............FT.
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PERMIT NUMBER
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FIRE ZONE TYPE OF CONBTRUCT/ION E IMPROVED
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SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
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NEW
PL N-ctrryC ED Y THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL
OF EDMONDS. LOCAL SALES TAX
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NUMBER OF STORIES NUMBER OF
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NATURE OF WORK TO HE DONE
Valuation
Fee Receipt -7.
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Plan Check No .....................
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BUILDING
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PROPOSED USE
PLUMBING
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PLOT PLAN (Indicate Building setback., abutting
streets)
HEAT & GAS LINE
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FENCE
SIGN
RETAINING WALL
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SWIMMING POOL
DEMOLITION
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PRE -MOVE INSPECTION
EXCAVATION OR FILL
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TOTAL AMOUNT DUE
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I hereby acknowledge that I have rend this aDPllcattoP; that We 1n-
formation given 1s correct: and that I am We owner, or the duty author.
Ixed agent of the owner. I agree to comply with city and state laws ratio-
ATTENTION
APPLICATION APPROVAL
construction; and m doing the work authorised thereby, no person
'
will he employed In violation of the Labor Code of the State or Washington
THIS PERMIT
This application is not a permit until
retail. g to Workman's Compensation Insurance.
AUTHORIZES
Signed by the Building Official or his Dop-
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NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORE NOTED
uty: and fees are paid, and receipt is ac -
shall be completed In ninety day.; MOVED -IN BUILDINGS .hall be com-
knowledged in space provided.
pleted In six months.)
SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DEPARTMENT
C7,'OR' QNATU
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CITY OF
ED11fOND3
DATE
NOTE: Applicant Subject io Plan Check Fee
PR a-1101
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TN. Permit coven work to be done on private property ONLY.
Any construction on thepnblio d omalP (caro., sidewalks, dtivewoys,
FILE
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mora.... etc.) will ma"'n separate permission.
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BUILDING DEPARTMENTPERMIT
NUMBER
Applicant Fill 1 J
PERMIT APPLICATION Inelde Heavy Linea
NAME (OR
(O.,R NA�M�Ed oe,BUSINESs)
11 MAILTNO'�flRffiHS' �O _
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ADDRESS
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Pt.Hel OVER An
LOT COYEROE
C LAL/
LOT COVEtiAGE
PERMISSIBLE HEIGHT
PROPOSED HEIGHT
ACTUAL LOT AREA
TOTAL BLDG. AREA
REVUIRED YARDS PROPOeEU YAIiUH
FRONT HIDE REAR FRONT HIUE REAR
STREET R/W
LEGAL LOT
.a n NO
VARIANCE OR CONDITIONAL USE
PERMIT NVI,SBER
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NOTE: APplicant Subject to Plan Check Fee PH a -last �� -- �7J�•
This Penult coven work to be done on private property ONLY. f
Any construction an the public domain (cmbe, sidewalks, driveways, INSPECTOR
marquees, ata.) will require separate pamlealm. J
PLANNING DEPT. APPROVAL DATE:
I1TY
TELEPHONE NUMBER
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STREET R/W
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EXISTING STREET R/W ............FT.
DEFICIENCY THIS PROPERTY
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COMP. PLAN 9T. R/W ............FT.
............FT.
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REMARKS
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CHECKED BY 1
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TELEPHONE NUMBER
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METER SIZE SERVICE SIZE
CLEARANCE
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C31R ICENSE NUMBER
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Legal Description of Property (Show Below or Attach Four COpies)
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TYPE C64dNAION
VERIFIED BY
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FIRE ZO E TYPE OF C-O7NSTRUC/TION STREET IMPROVED
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[j.YF,s [3 NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
RESIDENTIAL
LINE
❑PLANHCHECKEI']i'BYO
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❑ NEW
THIS SITE IS LOCATED IN THE CITY
❑
EDMONDS. LOCAL SALES TAX
NON-RESIDENTIAL
SIGN
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SHOULD BE CODED 31.04.
SH
ElADD❑ ❑ RETAINING
WAIT'
REi� 9�T
DEMOLISH
ALTER ❑ EXCAVATE FENCE
OR FILL (.....................Ft.)
El REPAIR PRE -MOVE El swill
INSP. POOL
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NUMBER OF STORIESI NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO HE DONE
Valuation
Fee
Receipt No.
Plan Check No .....................
-
BUILDING
PROPOSED USE
PLUMBING
PLOT PLAN (Indicate Building eetbackU.JJk—
HEAT k GAS LINE
FENCE
SIGN
RETAINING WALL
IN
—
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the m-
-
formaHon given Is correct; and that I an, the owner, or the duly author -
Iced agent oI the owner. I agree to comply with city and state lows regu-
ATTENTION
APPLICATION APPROVAL
latlag con. Mellon; and In doing the work authorised thereby, no person
Will beemployed In violation of the Labor Code of the State of Washington
TIU8 PERMIT
This application is not a permit until
remttog to Workmen's Compemltim Ioslrones.
AUTHORIZES
Signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Eieept DEMOLITIONS which
NOTE:
WORB NOTED
uty; and fees are paid, and receipt Is ac -
shall be completed In Watts, days; MOVED -IN BUILDINGS shall be com•
knowledged In space provided.
pleted In Sts months.)
RGNATURE (OWNER OR AGENT)
DATE 111GNED
INSPECTION
DIRECTOR'S SIGNATURE
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DEPARTMENT\
CITY OF
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NOTE: APplicant Subject to Plan Check Fee PH a -last �� -- �7J�•
This Penult coven work to be done on private property ONLY. f
Any construction an the public domain (cmbe, sidewalks, driveways, INSPECTOR
marquees, ata.) will require separate pamlealm. J
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