740594.pdf-. . _ _ ---- .
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BUILDING DEPARTMENT
ONE! NUMBE
R 740594
Applicant Flu
PERMIT APPLICATION Inside Heavy Lines
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ADDRESS
NAME (Oft NAME OF IIU81NE88)
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PERMISSIBLE ACTUAL
IAT COVERAGEo S �v LOT COVERAGE
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MAILING ADDREus
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PERMISSIBLE HEI`ly / PROPOSED'HF.IO�T
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CITY
TE'L7EPHONE NUMBERC/
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YARDS X PRROOPOSED YARDS
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NAME
FRONT SIDE REAR FRONT 81—DE REAR
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ADDRESS
EGAL LOT VARIANCE OR CONDITIONAL USE
�{ YES NO PERMIT NUMBER
PLANNI 6 D PROVA DA E:
CITY TELEPHONE NUMBER
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STREET R/W ��t
EXISTING STREET R/ttW . DEFICIENCY THIS PROPERTY
NAME
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COMP. PLAN BT. R/wL.�r .. .....V...FT.
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REMARKS
Driveway slopes es not to exceed those
ADDRF.BS
indicated on Standard Dwg. No. 103
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CHECKED���BBBY
CITY TELEPHONE NUMBER
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STATE LICENSE NUM R CITYYLLICENSE NUMBER
METER 81LE SER ICE 81ZE CLEARANCE Y
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Legal DcaCrlpllon of Property (Show 8cloty or Attach Feu[ Copies)
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TYPE CONNECTION ERIF BY
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REMARKS
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FIRE ZONE TYPE OF CONBTR CTION STREET IMPROVED
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SPECIAL INSPECTOR R$QUIRED OCCUPANCY GROUP
RESIDENTIAL
❑ YES O
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LINE
NEW
PLAN CHEC ED IIY THIS SITE IS LOCATED IN THE CITY
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NON-RESIDENTIAL
OF EDMONDS. LOCAL SALES TAX
sIGN,-
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SHOULD BE CODED 3104
nun RETAINING
❑ � WALL
EMARK/
DEMOLISH
ALTER ❑ EXCAVATE ❑ FENCE
OR FILL (.........
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REPAIR PRE -MOVE SWIM
INSP. POOL.j
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NUMBER OF STORIES NUMBER OF
DWELLING /
UNITS l
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NATURE OF WORK TO HE DONE
Valuation Fee Receipt No.
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Plan Check No ................ ....
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3, PROPOSED USE
SUILDINC
PLUMBING
a PLOT PLAN(Indicate Building setbacks, abutting etreete)
[TEAT k GAS LINE
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FENCE
SIGN
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RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I hereby ,knowledge that I have read this application; that the In-
TOTAL AMOUNT DUE /7 S•
f
-
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,.anal.'" given Is correct; and that I em its owner, or the duly author -
lied agent of the owner. I agree to Comply with city and state laws regll•
lating construction; and In doing the work authorized thereby, be person
ATTENTION APPLICATION APPROVAL
will be employed In violation of We Labor Code of the elate of Washington
THIS ZIER511T This application is not a permit until
relating to Workmen's Compeneallon Insurance.
AUTHORIZES Signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS Which
ONLY OTTIRE Ut and fees are aid, and receipt is Be-
lSOIUI NOTED yi P p
shall be eonepleled In ninety days; MOVED -IN BUILDINGS shall be cone-
wled ge space provided.
yleted I months.)
SIO ATUR WNER Olt AGEENN ' DATE SIGNED
INSPECTION DIR T 8 6 ON TUBE
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DEPARTMENT
-
CITY OF
NOTE: Applicant Subject to Plan Check Fee
EDMONDS DATE
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775-2525
This Penult covers cork to be, done on private properly ONLY.
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Any construction on the public domain (curhe, sidewalks, driveways,
ni arourrs, rtr., s,'ill r,q lrr erpnrnir I�rrmiselaa,
FILE
Foundation
Plumbing (Partial)
(Rough)
Frame
Furnace & Fuel Lines
Final