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21317 76TH AVE W (4).pdfVe ( d IMPORTANT! Press Firmly While Writing Application! M) F, DATE�'7 TIME a `^�.Il Applicant Fill (- 3 OD p M l NUMBER 111,'A1 / Building Relocation Peewit Inside Heavy Lmos NEW SITE AUD1111 S.n •rACHLEGALOESCRIPPION SNAMk; OF NEW RU1LDtCyf�y St'PE _� IV,5 f-F'ST� SiX'PfTSNo�t'CLI^�i j0f2' �{� Q MAILING AD`7DRE89'L+ ¢G rkn, E IMONDSNSPECTION PRE -MOVE too., ` tt�� n INSPECTION �l/.U. (WI lVl •.� a PERMIT NO. 3rd I ✓ S'CA'CF. `E I/n'� BLDG. PERMIT NO. CA IS'RV(7 EQM OM/yS - C) 37r�' Z NE / • FORORK r lira A � u /% � T� u3r� �� Ve Movl 4 co:FAIN_ (� /A, MOVE CONTRACTOR'S INSURANCE COVERAGE L U NAME OF SURETY/) ••��'' STREET ADDRE88 PROVIDTNo P.L.& /'%L�e1�T�!''!✓ L/✓SL(/j /Q'✓� �� ���'� ��^ �� �� to I♦ P.D. COVERAGE Z f •' yy STREET /AnyDD�REgS pulce� meye � CITY TEL, NO. PO_ /.-I/X I30 -7-7 ,-7— ¢ STATE. UI r\ r\ > �� 1 �N 3853 C Y, ZONE &�rSTATE m CON A TOWS - -'('���./i yv,, �/,,) �(�J ERCP " /V STATLICENO. �J { 1(-)(A k-� C)SVI �) VwLID I��RA��NCE L3CY CH����SY: DATE —{ -il SITE DESCRIPTION�1 Z �% �' _ om ADD%RF.ES OF PRESENT BU(I/LADING SI'CF-A7TACti I.F.GAI. DESCfttI"i'fON gUILDiNG DESCRIPTION 1Cll0 �•—/� / �`� '� �" DESCRIBE HAe11C C BTRUCTION �Ry)BENT USE OF BUILDING: -40 r EOF OWNER /��fl�/iIrj) 'Wim O �y z M A RESS J PNpONE�r ;�' FT. m ( 1 06 Edn on/ �' J �i % OVERALL LENGTH OF BUILDING: A HEIGHT A8 LOADED R'IDTB A8 LOADED BLDG. AREA C Z MOVING ROUTE E,I, L� gQ• p.I., r 6 A wsoutti W 9 s��frtio��9 Fr. 1 DATE -1 ���POLICE DEPT. APPROVAL OF G ROUTE 0 (jl /- BY:�✓ /-2oS7 6 �� 5/10/,(1//'(° (17YI11-1IT5 Tone 3e Cm,e,ee MevIng: 9?3G0 ©C¢ m m ' Ti— to Finish Ttovine:......................... �.�............................... FIRE DEPARTMENT CLEARANCE OS ROUTING DATE 00 M to (12_gg1 % I a cco By: CLEARED RY: ENOINEL'RIN AFiANCE DATE 9 Z SNOHOMISH COUNTY 6V1ye1U /� �'1'-frdi/` a �Z1 KING COUNTY �l - RELOCATION RECEIPT NO.•'� 2 Power Company PERMIT /OO 0 O Z . FEE $ Telephone Company -" 1 ATTENTION: PERMIT APPROVAL = oT 6x � "T�G1 %ZQ'0�4&0yb0,1� '~��� THIS PERMIT THIS PERMIT DOES NOT BECOME Z ^oskd �`2 AUTHORIZES VALID UNTIL SIGNED BY THE �� O 1f ONLY THE BUILDING OFFICIAL AI HIS DEPU- RELOCATION Ty. THE FEES ARE PAID, AND RE- m I hereby acknowledge that I have read this application; that CEIPT IS ACKNOWLEDGED IN THE the information given is correct; and that I am the owner, a OF THE SPACE PROVIDED duly licensed moving contractor, or the authorized agent of one BUILDING of these. I agree to comply with city and state laws regulating NOTED A a�l'1building relocation; and in doing this work, no person will be Byemployed In violation of the Labor Code, State of Washington ---- --- relating t0 Workm, pensation I surance. Hvxamg Gtr mPe sigpet e CDwneT - BUILDING tnr, ODEPARTMENT Date.......... Authorized Agent ............... I ._.. .... ...... .... ..._.... �.....:.. L.... ......... i. 1l - �- Phone -7 C , ' -1., J CITY OF Signer's )O' "I'. J_1....,, .....1..--:�.-`�J• Address 'S'21.--'•-•-•-`-" NoEDMONDS DISTRIBUTION OF COPIES _ l t .J Y lel.0?L?.�1..__.................. State t&)A ............. 771-�21i2 WHITE — File ,Bldg. city 1 YELLOW —Move Inspector ozzo. GREEN — Assessor Date .....................�. CX:t�..`.t.............................................................. GOLDENROD — Police Dept. PINK — Moving Contractor ) 76 TO-- DATE TO: PERMIT COORDINATOR, BUILDING DIVISION FROM: FIRE DEPARTMENT DATE X ENGINEERING DIVISION DATE PLANNING DIVISION DATE OWNER SC/RvV1Co ADDRESS 1311- 76, 1� GCo urn 74 f, 9 PERMIT # M�_ 9 7 ADB# INSPECTED ON z o A field inspection was conducted to determine compliance with approved plans. Final approval 0 m denotes there are no objections to the granting of: _i T rn -4 Occupancy for the building Performance Bonds may be released o m in 0 Maintenance Bonds may be released is approved --� o C q jLaandscaping / /—� W p z_ Other inspected t 1 O l t.� 1 t O 11 C t �Gl J 1 4111PAS ED IRST INSPECTION - CONDITIONS NOTED 1q7 CD . n FAILED INSPECTION - OUTSTANDING REQUIREMENTS - RECALL FOR m INSPECTION in 0 1. 0 m 9C 2 zr 3. A z D 4 z 2 OCCUPANCY OR FINAL APPROVAL DATE BY z 0 RE -INSPECTED - APPROVED DATE BY 0 m RE INSPECTED - FAILED DATE BY 1. 2. RE -INSPECTED APPROVED DATE BY /OCCAPRVLI2l96 I