740525.pdfUSE PERMIT .�
BUILDING DEPARTMENT Applicant Fin ZONE - I/� NUMBER
7_40525
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PERMIT APPLMAI M11 Inalde Ileavy Lines
NAME (OR NAME OF BUSINESS)
MAILING A EBB
O CI�Y I TELEPHONH NUMBER
NAME
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171 ADDRESS
JOB / D 4 V / N•+.�W^
ADDRESS
PERMISSIBLE %ACTUAL
LOT COVERAGE 2/ [� lir LOT COVELGE �-
PLItM78HIBLE?EI6k T /G PROPOSED RylyT,
ACTUAL LOT AREA TOTAL HL O. AREA
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REQUIRED YARDS PROPOSED YARDS
FRONT SIDE REAR FRONT SIDE REAR
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LEGAL LOT VARIANCE OR CONDITIONAL UBE
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YES NO PERMIT NUMBER
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PERV NUMBER
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REMARKS Driveway slopes not to those
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indimted on Standard Dwo. No. 103
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.TATE LICENSE NUMBERCITY
LICENSE NUMBER
9PLCIAL INSPECTOR REQUIRED OCCUPANCY GROUP
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RESIDENTIAL
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Legal Description of Property (Show Below or Attach Four Copies)
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9PLCIAL INSPECTOR REQUIRED OCCUPANCY GROUP
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LINE.
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PL CHEC3 Y
THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL ❑ SICN
OF EDMONDS. LOCAL SALES TAX
❑ADD RETAINING
HO LD BE CODED 31.04.
❑ DEMOLlBH ❑ WALL
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❑ ALTER EXCAVATE FENCE
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❑ REPAIR PRE -h OVE SWIM
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NUMBER 011 eTORllsB NUMBER OF
DWELLING
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UNITS
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NATURE OF WORK TO ➢E DONE
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Fee Recel pl No.
Plan,
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Check No .....................
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BUILDING
4 PROPOSED USE
PLUMBING
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PLAN (Indicate Dulldlng setbacks, abutting streets)
HEAT & GAS LINE
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DEMOLITION
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PRE -MOVE INSPECTION
EXCAVATION OR FILL
i hereby ne. that I hnva read tole application; that the In-
TOTAL AMOUNT DUE
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tormnUon given Is ca reel; and tont I am the owner, or the duly nuther-
orthe
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Ized agent o[ theowner. I agree to comply with city mtl state 16WI raga-
latmg conetMetlen; and In doing the work authorlsea thereby, no
ATTENTION
APPLICATION APPROVAL
J
Berson
will be employed in violation of the Lebot Code of the Slate of Washington
lag to workmen's Campene¢tloq
THIS PERMIT
This application 1s not R permit until
rate Iruurnau.
AUTIIORIZEB
NOTE: Permit Limit One Year IIEMOLITIONI
ONLY THE
signed by the BuildingOfficial Or his De p -
I
(Except which
WORK NOTED
uty; and fees are paid, and receipt is Be.
shall be completed In ninety days; MOVED -IN BUILDINGS shall be cone-
knOWledged in apace
pleted In six months.)
provided.
Sl \TUBI(OWNER OR AGENT) 1 UA E BIONEU
II�J,�
INSPECTION
DEPARTMENT
IR' TOW. B! AT
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CITY OF1
NOTE: Applicant Subject to Plan Check Fee
EDMONDS
ATE
This Permit --work to be done on prirute praptrtY ONLY.
775-2525
Any eanstrucHon an the public domain (curb., sidewalks, drlrewgs,
margates, etc.) x'111 reamre separals perntleslen.
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BUILDING DEPARTMENT
Appucunt Fin
USE PERMIT
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SIGN
yALL KING
ALTER
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PERMIT APPLICATION
1ne1do "�� Lines
AD Q (_ j�,;j
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❑ REPAIR
❑
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NAME (OR NAME OF BUSINESS)
HEAT & GAS LINE
PEIt.tIBSIBLE ' ACTUAL
NUMBER OF
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'y� LOT COVERAGE 0 4—
LOT COVERAGEv � U
FENCE
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MAILING A6 R S8 ,..
) UNITS
PERMISSIBLE HEIGHT PItOPOeED }IEI�H'f/
PERMISSIBLE
RETAINING WALL
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CITY - TELEPHONE NUMBER
ACTUAL LOT AREA TOTAL SLD .AREA
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REQUIRED YARDS PROPOSED YAa
DEMOLITION
FRONT SIDE REAR FRONT elUFlSs
PRE -MOVE INSPECTION
-
NAME
5a s'f
_
LEGAL LOT VARIANCE OR CONDITIONAL USE
TOTAL AMOUNT DUE
W ADDREtlB
I hereby acknowledge that I have read this application; that the In-
Cl YES 0 NO PERMIT NUMBER
,
n
PLAN IN6 DEP�'T.YROV!)j. -7.4.7
Ired agent of the owner. I agree to comply with city fund elate laws regu-
ATTENTION
APPLICATION APPROVAL
11 TELEPHONE NUMBER
STREET R/lY j
EXiBTINO eTREETriJ.!r_.�'r. DEFICIENCY THIS PROPERTY
COMP PLAN BT R/tilLi -PT. •••• •-FT•
Y'.A-11--1 Q: Y I 1i 11,. REMARKS l)i'1Veway slopes not to exceed dose
in:.lyatc-d on Standard Niq. Iqo. 103
STATE LICENSE NUDI➢EK I C Y L CENBL NUMBER
Legal Description L Property (Show Below or Attach Four Copies))
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. RESIDENTIAL
I."r❑ NON-RESIDENTIAL
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AS
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DEMOIS-
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SIGN
yALL KING
ALTER
❑
ORFILL
❑
(ENCx._.......Ft.)
❑ REPAIR
❑
IN MOVE
ElPOOLI
HEAT & GAS LINE
JUDIBER OF STOIti EB
NUMBER OF
40
DWELLING
FENCE
1-. ! r'
i .., y..
) UNITS
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SPECIAL INSPECTOR REpUIRED OCCUPANCY GROUP
7— _r
0 YES G] -NO 1
PL7AN oNEC{REtjtRY THIS SITE IS LOCATED IN THE CITY
/%�/(y-Q/ tom✓'/ SHOULD BE CODED 3A045ALE TAX
R MARK TI
Fee I I Receipt No.
Plan Chark Na .....................
BUILDING
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PROPOSED USE
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PLUMBING
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PLOT PLAN (Indlcalo Buildltlg setb eke, Abuttingstreets)
HEAT & GAS LINE
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40
FENCE
SIGN
RETAINING WALL
BNIMDSIN6 POOL
DEMOLITION
PRE -MOVE INSPECTION
-
EXCAVATION OR FILL
_
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
formation given le correct; and that I am the owner, or the duly uuthm-
Ired agent of the owner. I agree to comply with city fund elate laws regu-
ATTENTION
APPLICATION APPROVAL
lating construction; and In doing the work authorised thereby, no person
will be employed In vlolatloa of the Labor Code of the State of Washington
THIS PERMIT
This application is not aermit llRtil
relating to Workmen's Compensation Insurance•
AUTHORIZES
signed by the Building Offlciaor his Dep-
NOTE. Permit Limit One Year (Except DF,MOLITIONB which
ONLY TIRE
WORK NOTED
1
Kty; and fees are paid, and r eelpt is ac
.hall ba completed In ninety days; MOVED -IN BUILDINGS shall be com-
knowledged in space provided.
plated In six months.)1
SIGNATURE (OWNER OR AGENT) DATE BIGNEU
INSPECTION
DIRECTOR'S SIGNATURE �
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DEPARTMENT
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CITY OF
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Plan Check
EDAIONDS
ATE
N icaJt Subject to r
775-2525
his t'ermll +even work to W done on prhate property ONLY.
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Any co..t—llou an the public domain (curb., e,dawZks, drlvewsys,
INSPECTO
(7
marquees, etc.) will require separate permissloo.