660229.pdfM
PERMIT APPLICATION Insid'e'lleavy Lines
NUMBER 0UUC_C_
JOB ADDRESS
(76th 244th S.W.)
04
0
NAME (OR NAME OF BUSINESS)
CITY EDMONDS
SIDE YARD SETBACK
STREET SETBACK
REAR YARD SETBACK
MCILINAED—DREStj
250 - 5th Ave, No.
USE ZONE
LOT AREA
VACANT SITE
YES 13 NO
UITY
Edmonds- Wash.
TELEPHONE NUMBER
HEIGHT
BUILDING AREA
VARIANCE NUMBER
NAME
PLOT PLAN APPROVED
ADDRESS
REMARKS
CITY
TELEPHONE NUMBER
NAME
REMARKS
rs
;4
1W
ADDRESS
METER SIZE SERVICE -SIZE CLEARANCE CHECK BY
V
CITY
TELEPHONE NUMBER
REMARKS
STATE LICENSE NUMBER
CITY LICENSE NUMBER
TYPE CONNECTION
VERIFIED BY
Legal Description of Property (Show Below or Attach Four Copies)
East 40 ft. of the So. 186 ft- pf F: 1301
PERC. TEST
PERMIT NUMBER
F
of Tract 10, Plat of Lake McAleer Five
Anrp T-rArtq. 5/48 Sno Ct
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
2 7 J
EXCEPT South 401 for road.
NEW
SIGN
NUMBER OF STORIES
ADD
FENC
90Q
0
ALTER
RESIDENTIAL
NUMBER OF
n REPAIR
I
F_� NON-RESIDENTIAL
DWELLING
UNITS
I hereby acknowledge that I have read this application; that the in.
formation given Is correct; and that I am the owner, or the duly author.
Ized agent of the owner. I agree to comply with city and state laws regu.
lating constructJon; arid in doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
relating to Workmen's Compensation Insurance.
IE,,,,, Demolitions which shall
NOTE: Permit Limit One Year be completed in ninety days.)
IC7-) If , , -, . I
Ir, 2!:�ZL �� I �' // /�,�
NOTE: Applicant Sitbject to Plan Check Fee
ThIm Per,olt coven work to be done on private property ONLY.
Any construction on the public domain (curbs. sidewalks, driveways,
marquees. etc.) will require separate permission.
[3 YES [] NO
BUILDING
I
VALUATION
BUILDING PERMIT
2
FEE
PLUMBING
3
PERMIT FEE
HEAT & GAS LINE
4
PERMIT FEE
SIGN PERMIT
FEE
DEMOLITION
6
PERMIT FEE
PLAN CHECK
7
FEB
81 AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDIVIONDS
11H 6-1107
0 YES [:] NO
APPLICATION APPROVAL
This application is not a permit until
signed by the Director of Building Inspec-
tion, or his deputy; and fW are paid, and
receipt is aclmowledgetl/oe�ppace provided.
4�-I- 6 C
FILE
Z
. ...... ..
POSTED ON KROLL MAP NO.:
13UILDING
B Jj I MING DEPARTMENT
PERMIT
'.0 .
......... Applicant Fin
NUMBER
,,,�,;f,ERMIT
"
N.10
Inside Heavy Lines
yr�'� APPLICA1
JOB ADDRESS
-7
16 �47ot; .4 W�. (76th � 244th S.w.)
OF BUSINESS)
SIDE YARD SETBACK
STREET SET13ACIK
HEAR YARD BET13ACK
R"
W NO ADDRES8
USE ZONE
LOT AREA
VACANT SITE
250 - 5th Avt,. No.
CITY
TELEPHONE NUMBh1R
0 YES 0 NO
kP
HEIGHT
BUILDING AREA
VARIANCE NUMBER
PLOT PLAN APPROVED
REUARKS
CITY
TELEPHONE NUMBER
NA.ME
REMARKS
ADDRESS
METER SIZE SERVICE SIZE CLEARANCE CHECKED BY
CITY
TELEPHONE NU MBER
REKARKS
STATE LICENSE NUMBER
CITY LICENSE NUMBER
I
TYPE CONNECTION
VERIFMUE BY
I
Legal Description of Property (Show Below or Attach Four copies)
Easje 40 ft,,, of flio 1116 PT, rif 1:��)
PERC. TEST
PERMIT NUMBER
of Tract 10,, Plat of LaRe llcAli�!ar 1'51.ve
Q /Ito f
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROV
EXCEPT SoLth 40' for road.
[] YES NO
SPECIAL INSPECTOR nEQuiRED___i
OCCUPANCY GROUP
. I 01� I S 0 YES [3 NO I I �
FRE
rim
BING
PERMIT FEE
BEAT & GAS LINE
4
PERMIT FEE
El
14EW
ADD
DEMEO]LISH
SIGN
FENCE
NUMBER OF STFIO—R—IES
0
2
5
5
—
SIGN PERMIT
FEE
DEMOLITION
PERMIT FEE
---
I
6
I
El ALTER
1
11 RESIDENTIAL
—
R OF
NU I
DIVEBELING
PLAN CHECK
ElREPAIR
1-1 NON-RESIDENTIAL
UNITS
7
FEE
I hereby acknowledge that I have read this application; that the in.
formation given is correct; and that I am the owner, or the duly author.
lzed dgent of the owner. I agree to comply with city and state laws regu-
lating construction; and in doing the work authorized thereby, no person
will be employed 1�. violation ' of thelLporigode of the State of Washington
relaUnfh% *Sr"cifs � Compensaitio.
IE,,,Pt Demolitions which shall
NOTE; Nermit Limit One Year be completed In ninety days.)
J0
�Zere-4-� � —,, --c-, 1 41'. A,
NOTE: AfIfilicant'. 1�vbject to Plan Check Fee
Thin pe7nit coyers work to be don�46AI`Iirivute property ONLY.
Any cofimtruction on the public dCqnalq,(fu!r,b.xj sidewalkm, drIvewaYN,
marqueenj 'et(;.�)iwlll4roqulri!�mdpatrnte perrultimlon.
81 AMOUNT DUE I I ---
ATTE, NTION APPLICATION APPROVAL
THIS PERMIT This application is not a permit until
AUTHORIZES signed by the Director of Building Inspec-
ONLY THE
WOBJ[ NOTED tion, or his deputy; and fees are paid, and
receipt is acknowledged, ifil�space provided.
INSPECTION
DEPARTMENT
CITY OF
EDAIONDS
PR 0-1107
INSPECTOR
i
t�k_ i
Date Passed
Foundation
Plumbing (Partial)
ougn)
Fra me,
Furnace &'Fu6 Lines
Final
t
A