740194.pdfBUILDING DEPARTMENT I AppncmtFl11 °NE
PERMIT APPLICATION Inside Heavy Lines
NAME (OR NAME OF BUb'NEBS)
WQ Z TE.0 �1', li,�W41 G
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I NAME
yADDRESS
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C CITY
PERMIT 740 94
NURSER
IGH /j
ADDREeB / r� / /!2
4 D . 1 � Q Or/ <r
(�) /�
PERM ISSIBLF. 70
LOT COVERAGE
- ACTUAL
LOT COVERAGE
PEIiMIBBIBLE HEIGHT
PROPOSED HEIGHT
ACTUAL LOT AREA
TOTAL BLDG. AREA
REQUIRED YARDS PROPOSED YARDS
FRONT SIDF. HEAR FRONT BIDF REAR
�AB
!4EOnL LOT_
o vn
VARIANCE Olt CONDITIONAL BE
PF.RMrr NUMBER
PLANNING DEPT. APPROVAL DATE:
STREET R/W
EXISTING STREET R/W... Fr. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ... _....... Fr. ............FT.
REMARKS
C ADDRESS iM
9ICHECKED BY
CITY TELEPHONE NUMBER
F
UMETER SIZE I SERVICE SIZE I CLEARANCE I CHECKED BY
STATE LICENSE NUMBER I C TYLICENSE NUMBER al
REMARKS
O
Plan Check No .....................
1
y
BUILDING
3Oa
�AB
PROPOSED USE
PERC. TEST
PERMIT NUMBER
U
PLUMBING
I
W
�
PLOT PLAN (Indicate Building setbacks, abutting el[cets)
w
(�
O
REMARKS
4
�
PENCE
I
-1
RETAINING WALL
V
tV
IN
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
BWIMMIN6 POOL
DEMOLITION
I
0 YES ONO
EXCAVATION OR FILL
SPECIAL INSPECTOR REQUIRED
GROUP
1
REBIDENTIAL
CAS
LINE
❑ El Y
IOCCUPANCY
NEW
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application: that the In-
PLAN O CHECKED
THIS SITE IS LOCATED IN THE CITY
NON•REBIDENTIAL
formation given Is correct; and that I am the owner, or the duly author-
SIGN
OF EDMONDS. LOCAL SALES TAX
ADD
ized agent of the owner. I agree to comply with City and .tate laws regu•
ATTENTION
NINE
REMARKS
SHOULDBE CODED 31.04
❑❑
DEMOLISH
will be employed In violation of the Labor Code of the State of Washington
WAL
This application is not a permit until
ALTER
AUTHORIZESi
CEFILL
❑
FENCE
ONLY WORK NOTED
uty; and fees are paid, and receipt is ac-
i—�-----
❑
knowledged in apace provided.
z .......... Ft.)
pleted In six months.)
REPAIR
❑
INSP.
DATE SIGNED
POOL
D3 OR'B B�aNATU YIEa
NUMBER OF STORIES
NUMBER OF
OF
CITY
EDMONDS
DWELL NO
NOTE: Applicant Subject to Plan Check Fee
PH a-I10I
rd
This Permit Covera work to be done on private property ONLY.
UNITS
Any tonrtrnctlnn on the public Cereal. (Curb., eldc.alk., dd-way.,
NATURE OF WORK TO BE DONE
ndaaI—
Valenti-
Fee Rceclpt No.
Plan Check No .....................
1
y
BUILDING
3Oa
�AB
PROPOSED USE
HV
PLUMBING
W
�
PLOT PLAN (Indicate Building setbacks, abutting el[cets)
HEAT @ 6A8 LINE
O
�
PENCE
I
SIGN
RETAINING WALL
IN
BWIMMIN6 POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
1
TOTAL AMOUNT DUE
I hereby acknowledge that I have 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 .tate laws regu•
ATTENTION
APPLICATION APPROVAL
-
lating conalmetlon; and in doing the work wthorlsed thereby, on person
will be employed In violation of the Labor Code of the State of Washington
TIDE PERMIT
This application is not a permit until
relating to Workmen -s Compensation Insurance.
AUTHORIZESi
-
signed by the BuildingOfficial or his DepTHE
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY WORK NOTED
uty; and fees are paid, and receipt is ac-
i—�-----
.hall be completed In ninety days; MovED-Ix 11173LDINaB shall be Sam•
knowledged in apace provided.
pleted In six months.)
H10NAT/URE <OWNE OR /.QENT)
,. ,!) / / J�
��
DATE SIGNED
INSPECTION
DEPARTMENT
D3 OR'B B�aNATU YIEa
`(✓ ✓//i/�c✓..rev
i% l!a%•r�� /!
OF
CITY
EDMONDS
DATE
NOTE: Applicant Subject to Plan Check Fee
PH a-I10I
rd
This Permit Covera work to be done on private property ONLY.
Any tonrtrnctlnn on the public Cereal. (Curb., eldc.alk., dd-way.,
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