670047.pdfC
BUILDING DEPARTMENT I Applicant M
PERMIT APPLI Inside Heavy lAnes
NAME (OR NAME OF BUSINESS)
ARAI0 Y9 194-vail
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NAME
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ADDRESS
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—TELEPHONE NUMB
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M
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GAS
LINE
NON-RESI NTIAL
D
ml,
ElRETAINING
DEMOLISH
LIWALL
EXCAVATE
PENCE
ALTER
OR FILL
El
( x Ft.)
REPAIR
PRE -MOVE
INSP.
0
........ . ..........
swim
POOL
iUMBER OF STORIES
NUMBER OF
DWELLING
UNITS
C
-
-OSTED ON KROLL MAP NO-:
PERMIT
/P 4
NUMBER
OB ADDRESS
..A =3 / ) r7 —
#7
�IDE YARD SETBACK
STREET
SETBACK
USE ZONE
LOT AREA
0 ';�- � vr'
I
VACANT SrrIG
0-16- 13 NO
VARIANCE NUMBER
L�R W
XISWO /STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT. "Y4
t&CW_ eciocoz xc-r-fdfr (Z I
AS dP- rHt5 P.47-Gel-y
SERVICE SIZE CLEARANCE
13 YES
Plan Check No ................... .
PROPOSED UBE
BUILDING
F0—T_FL—AN(In4lcate
Building setbacks, abutting streets)
PLUMBING
BEAT & GAS LINE
PENCE
t
SIGN
N
RETAINING WALL
I
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby Acknowledge that I have read this application; that the in-
formation given to 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 construction; and in doing the work authorized thereby. no person
ATTENTION
will be employed In violation of the Labor Code of the State of Washington
THIS PERMIT
r@jzubg to Workmen-s Compensation Insurance.
AUTHORUES
NOTE: Permit Limit One Your (Except DEMOLITIONS which
#ban be completed in ninety days; MOVED -IN BUILDINGS shall be com-
ONLY THE
WORK NOTED
pleted In six months.)
INSPECTION
DEPARTMENT
IffGyeqRE (?WNER R
DATE 81GNED
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
PR 6-1107
This Permit coven work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
Marquees, etc.) Will require separate permission.
A.AU 6:1 '
0
3MON STREE
InyEs
No.
-47�2 0-0
I /� , 'If . ,5- -67 1
APPLICATION APPROVAL
This application is not a pern-tit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
/ eg Z__
-Tract D, &11 that portion of lot 4 in Block 2, Lake Ballinger Land Co,sl, Plat
'Subdivision No 11 described as follows, beginning at the Northwest eprner of said lot 4, thence
Southerly along the arc of a curve to the right having a radius of 350 ft., and following
the Easterly
continuing along
I
True Point of be
thence N 890251
Rdlght—of—way,,
140P81 ft, the
Subject to Eas
10 ft. thereof.
of Bradley Road,
for 146.,20 ft., to a point of
tangency, thence
e Easterly mamin
of Bradley Road, S 1302213011E,
17,30 ft. to the
0
ning of tract, thence continuing S13 2213011 E,
for 75 feet.,
E, for 121,53 ft.
to the Point of beginning, thence continuing N 890
MJpU9XK=XMXK
25,2111 E., for 121,53 ft. to
West margin of P.N.T. Co
�e North along S.D. West margin for 75.00 ft. thence S8902512111 E, for
South 72.00 ft. to the point of beginning.
for ingress, egress and utilities over the North 15 ft. of the West
71.1 -�
Rkdo . .......
RD OFANSPECTIONS--,
bate;
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i;66hdatlon.:
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Plurribing (Partial)
4'- qI,
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TkoN & WORK PERMIT
Application INO. I ... A ......................
OFEDMONDS Building Department Permit Limit, One Year
eby made for a permit to construct the following work, in accordance with the accompanying plans
........... ......... ............................ GroundiLrea. ................................... No. Stories ............
.................................................................. . ................. Const. Type ........................................ Height .......................
7.t�— zlr� Use Zone ..... C7. Fire Zone...
........................ .............................................................. . ........ .................
1.1/-Width. ........................... Min. Bldg. Setbacks, Front and
........... . ..................
ar ......... z ........ ..... Sides .........
Address ... ..... ... ....... Phone ..... ..f ...... .......
Address.......... ............................................................. Phone ....................... .......
Address........................................................................ Phone ................................
Address. ....................................................................... Phone ........................ .......
Address. ....................................................................... Phone ................................
Elect . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
.......................... Address ........................................................................ Phone .................... ............
Rernatke ................................ .......................................................................... . .......
................................................................................................ ....
............... . .................................................................................... ................... ......................................................................................................................
..................................................................................................................................................................................................................................................
................................................................................................................................................................................ ...............................................................
The above is a correct statement and I agree to comply with all applicable Codes and State Laws regulating the work.
Signed: owner/Agent-.&Ix4�—.�. ... ... 2A ... Address ............................................................................ Date .....
PERMIT for the above work Is hereby approved, subject to the above conditions, and to compliance with the approved plans
and specifications and Building Department notations thereon.
PERMIT FEES
VALUATION
$
APPROVED:
Date............ 4;;6 7e ....... ........................
BUILDING DEPARTMENT
Bldg. . . . . $ .... ........
Plbg . .... $ . ....... ...........
Heat .... $ ....... S ....... = ..............
Elect. . . . . $ ........................................
Others... $ ........................................
)TAL FEE .........
NOTES: No work requiring Building Depahment or City ffngineer's Inspection shall be covered before inspection and approval.
Twenty-four (24) hour notice requested. Contact the City Engineer prior to construction of all site utilities, such as
curbs, paving, driveways, sewer, water and street connections.
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APPLICAI(�,)N & WORK PERMITC
CITY OF EDMONDS Building Department
Ti . ON is hereby made for a permit to construct the following work, in accordance with the accompanying Plans
as ............
Ground Area ................................... NO- Stori
...............................................................
...................... Height. .......................
....... Const. Type .................
. .................................................................................... ..........
75 ..........
&V ..................................................... Use Zone ... N..A..R... Fire Zone...
CIL A- nu-1=14%gswerage .... ...
............
... 'Block. ................... Add'n.!.Eir�.. ... Mx;r..
..... Sides ..... 6.1k, ...........
.214?/Width ....................... .... Min. Bldg. Setbacks, Front and Rear ........
M.- .... i�=.714S-7>
........ Address,1194.z? 1:::i ... dod .... W ............ Phone
.. . .. . .
phone........................ .......
.......................
. .............. ................. Address ................................................................
. ............. .
Phone....................... . .......
... ..................................
........................... Address ................................... ...................
Phone ....................... . ..
Address .......................................................
g. by ....... . ...... . .
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
I
Address .......... . ............................................................
Phone .................. ..............
Aing by .............. ........... . ...........................................................
Phone................................
.........................................
liftect. by ........................................................................................... Address ...............................
....................................
................................................... .............................
..............................................................
Remarks ...............
A .....................................................................................
............... .........................................................................................
The above is a correct statement and I agree to comply with all applicable Codes and State Laws regulating the work.
. ........ .... ... .
s4a.2 kk-r� PeJ1JC.6Y6A9tf. "- Date..
8 1 Igned: -Owner/Agenj-z.Ai�t� ................................... Address ............................................................... * .........
tions, and to compliance with the approved plans
PERMIT for the above work is hereby approved, subject to the above condi
and specifications and Building Department notations thereon.
PER3= FEES
VALUATION
APPROVED:
Date..... ze:91.4a . ........ 6 ...............................
BUUMING DEPARTMENT
WM.J
4:!�, ON
Bldg. $ .... 7z4.....J-C_J ....
Plbg. .... $ .........................
Heat.... $ .......... . . ........................
Elect. ... .$ ........................................
Offiers... $ ........................................
r etor 9�01 LS-1 ion and approval.
NOTES: No work requiring Building Depar ent or City Engineer's inspection shall be covWe e inspect
4
r4 U site utilities, such as
Twenty-four (24) hour notice req&sted. Contact the City Engineer prior to construction of a
curbs, paving, driveways, sewer, water and street connections.
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