750257.pdf-------
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BUILDING DEPARTMENT ZONENUMBER
Applicant FW zoNE �S` NUM1[DER 150 )� 7
75025-7
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PERMIT APPLICATION Inside Heavy Lines dDB
ADDRESS -7�dLANA
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NAME (OR NAME OF BUSiN S) OMLrnSE%
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PERMISSIBLEs ACTUAL / I O
LOT COVERAGE D %O LOT COYERADE %MA1L1N
ADDRESS `
PERMISSIBLE 11.005C'/ 1'ROPOeED HEIOHT14
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ACTUAL OT AR
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CITY T LEPHONE NUMBER? A r� ., TO AL BLDG. ARE
REQUIRED YARDS �- PROPOSED YAADB
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NAME '7�,� �;'-.- FRONT SIDE REAR FRONT BIDE REAR
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ADDRESS I�EG�/�i.'LOT VARIACICE OR CS-7 A
�Ee [3 NO PERMIT NUMBER $ 'Q
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NNIN6 EPT. VA
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CITY TF.SiFPHON PjJ�jER
`r�^� 7
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ii�,{. L-/J/I•!�' EXISTE L76 TREET R/ FT. DEFICIENCY THIS PROPERTY z
NAME C
.�> COMP. PLAFT.
�DsTy��{ri REMARKS
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ADDRESS Driveway slopes not to exceed those C
indicated on Standard Dw)?. No. 103 w
CHECKED 13YCITY R� {s'TIELE HONE NUMBER
METER SIZE BERM SIZE CLEARANCE CIIE K D BY
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STATE LICENSE NUA113ER CITY LICENSE NUMBER
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Legal Description o1 Property (Show Below or Attach Four Copies)
li J 1`ClY l
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TYPE CONNECTION VERIFIED Y
Loi 8 -;o Hep--TET
PERC. TEST P
W
T 8Eft to
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REMARKS 14
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A
FIRETY�F CONSTRUCTION STREET IMPROVED
QYES
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NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY ROUP
I r�i RESIDENTIAL ❑ OAS ❑ YES NO
NEWLINE PLAN CHECK nY THIS SITE IS LOCATED IN THE CITY
❑
i
NON-RESIDENTIAL ❑ SIGN /�,J OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 3104.
❑ ADD RETAINING REMARKS
❑ DEMOLISH WALL
❑
5��� I rf
❑ ALTER PENCEAL 1iJo2iC IL U CSG % 3
❑ FENC...........Ft.)
El OR FILL
❑ REPAIR PRE-MOVE swIM
❑ INSP. ❑ POOL
NUMBER OF STORIES NUhiDER OF
DWELLING
I
l
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UNITS
NATURE OF WORK TO BE DONE Valuation Fc Receipt No.
rlan Cheek No
.....................
BUILDING
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PROPOSED USE
aPLUMBING
O
PLOT PLAN (Indlcrtto Building setbacks, abutting streets) HEAT G GAS LINE V
PENCE
SIGN
RETAINING WALL
IN
SWIMMING POOL
DEMOLITION
PRE-MOVE INSPECTION
EXCAVATION OR FILL
/ Y S / 1
I Rtr,hy TOTAL AMOUNT DUE lJ
acknowledge that I have rend this application; that the In-
formation given Is correct; and m that I athe owner, or the duly author-
lied 11,11 of the owner. I agree to comply with city and elate laws regu- ATTENTION APPLICATION APPROVAL
tering construction; and In doing the work allthorized thereby, no person
1.111 beemployed in violation of the Labor Code of the Slate of Washington THIS PERMIT This application is not a permit until
-
r.huI.g to Workmen's Compensation Insurance. AUTHORIZES
by the Building Official or his Dep-
ONLY THEsigned
NOTE: Permit Limit One Year (Except DF.SIOLITION8 which WORK NOTED uty; and fees are paid, and receipt is ac-
shall be completed In ninety days; MOVED-IN BUILDINGS shall be com- knowledged in space provided.
pitted In six months.)
SIGNATU
L (OWNER Oil AGENT) DATE STONED INSPECTION DIRECTO7L/�, el r
�� DEPARTMENT
'^.��C(
�� CG
CITY OF J//
EDMONDS DATE
NOTE: Applicant Subject to Plan Check Fee G _ D� 7 j
775-2525
This t'ennle torerowork lu be done on prh�ate property ONLY.
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