750210.pdft
1
UBE PERMIT 750210
BUILDING DEPARTMENT Appllcaat Fill ZONE NUMBER
PERMIT APPLICATION I Inside Heavy Lines JGH
ADDRESS —(/A/
NAME (OR NAME OF BUSINESS)
NrA/-�7 n INCPERMISSIBLE � ACTUAL
UI` 1 OW000 0 ()M� , I 4 r LOT COVERAOE���1� LOT COVE�AOE �L
ppplll AILING ADDRE88 / /� C
p
RIO. Os ,S ^ �� PERDIIBBIHLE HEIGHT PROPO Ij.F�IElO" x
two 'C�^J '/fQ�7.6' �
CITY TELEPHONE NUMBER ACTU/� TOTS BLD��A e
seet % W { % - 6y S� 'CREEQUIRED4'YARD8 O ,PROPOSED YAKDB •p7
NAME FRONT SIDE REAR FRONT 8IDE REAR
aUj ADDRESS LEGAL LOT VARIANCE OR CON ITIONAL USE
tti IR YES Ej NO PERMIT NUMBER
PLANNING DE PAOV 4 A
O I TELEPHONE NUMBER'
E CITY
! STREET R/1V p�
EXISTING STREET R/4q44DEFICIENCY THIS PROPERTY ;ter
NAME ,w1,A� //�� �L
COMP. PLAN BT. R/ .. �1`M'1'. ...i.�...FT, �
No9,TH"oo REMARKB Dirveway slopes not to exceed those o
indicated on Standard Wig. No. 103
`O &X `-)0-8� CHECKED BY
C CITY
TEL
CITY NUMBER
I
��10 ` V O Ln
MEITES,B ZE SERVICE BIZ. CLEARANCE CH—Q! D Y
G LICENgOE; llLf� I CITY LICENSE NUMBER �j I / A , I '�
3 R•MARKS t I
Legal Description of Property (Show Below or Atlnch Four COPIas)
TYPE CONNECTION VERIFIED
I1) n HY
-
1' PERC. TE8
PERMa NUMBER 4.
U
pl
REMARKS W I
a
i
O
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
•e EjNO
SPECIAL INSPECTOR REQUIRED (OCCUPANCY lGROUP
It
GAS ❑YES 0.110NEW SIDENTIAL ❑ LINE PLAN CHECIfED Y THIS SITE IS LOCATED IN THE CITY
N -RESIDENTIAL /$ OEDMONDS.LOCAL SALES TAX
❑ SIGN ,�(, �%L.C�,� SHOULD BE CODED 31.04.
❑ ADD RETAINING MA I
❑ DEMOLISH ❑ WALT
r > ❑❑ FENCE i'ii Co��Sre c� er16r.✓ ��s,ei d.�6 i 9 73
ALTER F]EXCAVATE
❑ E]PRE MOVE El SWIM x..........Ft.)
REPAIR
INSP. POOL �/Sd'c C -T t1iL S�/ z,,. �N�P�G��L�i✓
NUMBER OF 6TORIEBI NUAfBER OF
DWELLING
UNITS
NAyT�U7RE� OF WORK/T/�Ol33EE DONE
`/ �/ Valuation Fee Receipt No.
NG W �� / Y 4 I t M1 <- / Plan Check No. ....................
A
O /'I'r�` BUILDING
[.r IIIPROPOSED USE
4'47 PLUMBING
APLOT PLAN (Indicate Building setback., abutting streets) BEAT k GAS LINE r�iil d U
m d
� PENCE
SIGN
RETAINING WALL
SWIMMING POOL I
DEhfOLITION
i
PRE -MOVE INSPECTION
EXCAVATION Olt FILL
TOTAL AMOUNT DUE2�
I hereby acknowledge that I have read this application; that the In- �//''� TY's
[ormnllan given Is correct; and that I am the owner, or the duly author-
lzed agent of the owner. I agree to comply with city and elate laws regu- ATTENTION APPLICATION APPROVAL
(ming construction; and In doing the work authorized thereby, no person
w'111 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 Inaurmce, AUTHORIZES Signed by the Building Official or his Dep -
ONLY TIRE
NOT ' Permit Limit One Year (E.copl DEMOLITIONS which WORK NOTED uty; and fees are paid, and receipt Is ac -
eh a co pleled In ninety days; MOVED -IN ILDINGB shall be wm• knowledged In apace provided.
.led in el% months.)
BIGNATU tVNER ENT DATE 11 Oil INSPECTION 1R iOjATUItE
A/0/ DEPARTMENT
, CITY OF
EDMONDS DATE
NOTE: Applr t Subject to Plan Check Fee
775-2525
This Permit c vers work to be done on private property ONLY.
Any rv,n.l ru rll,a,l nn I I, pu Dilc dmm�in IcurM1...Idew'nik., drlyew'ay.' FILE
ri,.• „III r i,dre ncl�nrnt,• prrml..lon. '