750145.pdf-- - —-
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BUILDING DEPARTMENT ApplicelatFlu
WADDRESS
E
7
J
K Cl'fY I T
NAME
c7wi.a0M
C ADDRESS
6
C CITY T
F
O
0 STATE LICENSE NUMBER C
Legal Description of Property (Show Below or
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0
F'
U
W
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a
e
v
W
a
PERMIT
750145NUMBER
FRONT SIDE REAR FRONT BIDE REAR I
YES [] NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
STREET R/W
EXISTING STREET R/W... PT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
REMARKS
YES 0 NO
attached.
USE NE
PERMIT APPLICATION
I Inside Heavy Lines
JOB
ADDRESS
NAME 011
AME OF BUSINESS)
❑
LOT PERaCOVE
It
6.Y �t.1WS
M MAILING ADDRESS
oCITY `
NON-RESIDENTIALs3cN
TELEPHONE NUMBER
ACTUALS
E O PYt o to DS
I 7-74 S 59 (o
I
WADDRESS
E
7
J
K Cl'fY I T
NAME
c7wi.a0M
C ADDRESS
6
C CITY T
F
O
0 STATE LICENSE NUMBER C
Legal Description of Property (Show Below or
i
0
F'
U
W
O
a
e
v
W
a
PERMIT
750145NUMBER
FRONT SIDE REAR FRONT BIDE REAR I
YES [] NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
STREET R/W
EXISTING STREET R/W... PT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
REMARKS
YES 0 NO
Lj REPAIR ❑ PRE -MOVE❑ SWIM
INSP. POOL,
attached.
NUMBER OF STORSESI NUb1BER OF
❑RESIDENTIAL
NEW
DWELLING
❑
LINE
PPLANSCHECKED❑BYO THIS
SITE IS LOCATED IN THE CITY
UNITS
NON-RESIDENTIALs3cN
OF EDMONDS. LOCAL SALES TAX
ADD
Plan Cheek No .....................
RETAINING
REMARKS SHOULD BE CODED 31.04.
❑
DEMOLISH
WALL
ALTER
(O
4 PROPOSED
EXCAVATE
FE CE
Fence requirements -section 12.14.040
PLUMBING
OR FILL
U
(.....z.•�44tct.J
Lj REPAIR ❑ PRE -MOVE❑ SWIM
INSP. POOL,
attached.
NUMBER OF STORSESI NUb1BER OF
DWELLING
UNITS
NATURE OF RK TO BE DONE
Valuation Fee Receipt No.
Plan Cheek No .....................
BUILDING
(O
4 PROPOSED
UBE
PLUMBING
U
PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT & GAS LINE
11
�
7
FENCE
300cwt ll
?O4
BION
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I hereby echnowl.dge th¢t I have read this application; that the In-
TOTAL AMOUNT DUE
�J. , 0
formation glvOn Is correct; and that I am the owner, or the duly author.
Ired agent o[ the owner. I agree to comply with city and elate law. regu-
ATTENTION
APPLICATION APPROVAL
Milos construction; and In doing the work authorised thereby, no Dereon
will be employed In violation of the Labor Cade of the State or Washington
THIS PERATIT
This application is not a permit until
relating to Workmen's Compensation Insurance.
AUTHORIZESONL
signed by the Building OYY1C1a1 Or his Dep-
I -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
TILE
WORK YNOTED
uty: and fees are paid, and receipt is ac -
shall ompleled In ninety days; MOVED -IN BUILDINGS shall be cam-
Imowledged in space provided.
plcte I .1. month..)
OR AGENT DATE 836NED
INSPECTION
—
LR,EJVNER
DEPARTMENT
i.__�
�•n' I�r �,/.• f7%�
CITY OF
EDhYONDS
DATE
NOTE: Applicant Subject to Plan Check Fee
D s
775-2525
_
This Penult roves work to be done on private property ONLY.
Any cnnsl ructlnn nn Ihr nnLlle Amm�in (rarbs, mlAewalks, delvewaye,
,niii,r.. tits) „rel r,ynlr,• ern¢relr I,rr,ni..lnn,
_
PILE
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