670120.pdfI �
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BUILDING DEPARTMENT Applicant Fill
PERMIT APPLICATION I Inside Heavy Lines
fi —
PERMIT
NUMBER
6 . . f
_rW�G 5MRESS -
P O!t Box 2488
U13E ZONE
LOT AREA VACA14T
13 YES 103 N 0
-1
TELEPHONE NUMBER
Mae Wash., 98902
248-u6
HEIGHT
BUILDING AREA VARIANCE NUMBER
Sato & Assoc,
PL40T PLAN APPROVED
1620 So. Jackson St.
STREET R/W CIENCY Tni
EXISTING STREET R/W ........... IrT. DEVI s PROPERTY
TELEPHONE N UMBER
COMP. PLAN ST. R/W ............ F'r.
REMARKS
-Wash Ek 5- 5363
-seattle.
NAAM
8 leshlRa Inc*
Z
CHECKED BY
IQ
ADDRESS
P.O. Box 2488
METER SIZE SERVICE SIZE C ARANCE
CHECKED BY
CITY TELEPHONE NUMBER
ash, 98902 248-ja
RE�8
-akim
WEr&_ NUMB= CITY Ll NU
E] YES 13 NO
GAS
NEW RESIDENTIAL LINE
I F] NON-RESIDENTIAL SIGN
ADD RETAINING
REMARKS
DEMOLISH WALL
ALTER EXCAVATE PENCE
Ro OR FILL ( .......... x ......... Ft.)
REPAIR PRE -MOVE swim
M INSP. 1:3 POOL
NUMBER OF STORIES
NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE
Plan Check No ............ . .......
Z
PROPOSED USE
BUILDING
PLUMBING
PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT & GAS LINE
PENCE
S
t
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL A31OUNT DUE
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 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
relating to Workman's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Your (Except DEMOLITIONS which
ONLY THE
WORK NOTED
shall be completed in ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
INSPECTION
ITI—ONATURE (OWNER OR A
DATE SIGNED
DEPARTMENT
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fce
PR 6-1107
Whim permit covers work to be done on private property ONLY.
Any constraction ou the Public domain (curbs, sidewalks, driveways,
nvarquees, etc.) will require separate permission.
13 YES 0 No
Fee
I �L - to 0 1 �
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or hill Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
Dl'�MR' SIGN
FILE
t
BUILUIMU DEPARI 9111 1 ApplicaUtM
PERMIT APPLICATION Inside Heavy Lines
Club
F,O. Box 2488
CITY
Yakliza, 'Wash.. , 9� _`9 0 2
NAMBL I
John Y. Sato 2, Assoc.
ADDRESS
16*210 So. Jackson St.
Seattle, Wasli.
NAME
W.—W. Net�tloship, Inc.
ADDRESS
P.O. Pox 2438
CITY
I
Yakiria, W'ash. , 98904"
STATE LICENSE NUMBER
223-01-2584
I
DNEW
RESIDENTI
ADD
DEMOLISH
ALTER
EXCAVATE
F] OR FILL
REPAIR
PRE -MOVE
F-1 INSP.
Kk
cry
lb,
toLL MAP NO.: PERMIT
NUMBER
�DDRESB
YARD SFTBAL;K OFR—EET SETBACK REAR YARD SETBACK
ZONE
1jull arm�
VACANT 131TE
NO
[3 YES 13 N
�VAARIANCENUKBER
IRT --IrR—TUTTLDING
AREA
I
�PLAN APPROVED
EN313TING STREET R/W ............ FT -
COMP. PLAN ST. R/W ............ FT.
DEFICIENCY THIS PROPERTY
............ FT.
I CHECKED BY z
N
LEGAL DESCRIPTION
ALL THAT PORTION OF THE SOUTH HALF OF THE SOUTHEAST QUARTER OF
TWr NORTHEAST QUARTER OF THE NORTHEAST QUARTER OF SECTION 26.
TOWNSHIP 27 NORTH, RANGE 3 EAST W,M, DESCRIBED AS FOLLOWS:
BEGINNING AT A POINT ON THE WEST LINE OF 5TH STREET SOUTH
WHICH IS 100 FEET SOUTH OF'THE SOUTHEAST CORNER OF BLOCK 29 CITY
PARK ADDITION TO EDMONDS9 ACCORDING TO PLAT THEREOF RECORDED
IN VOLUME 9 PLATS9 PAGE 1.0 RECORDS OF SNOHOMISH COUNTY,,
WASHINGTONt THENCE SOUTH ALONG THE WEST LINE OF 5TH STREET SOUTH
TO THE NORTH LINE OF PINE STREET AS PROJECTED EAST FROM CITY
PARKADDITTON NO. 2 TO EDMONDS ACCORDING TO PLAT THEREOF
RECORDED IN VOLUME 13 OF PLATS9 PACE 809 RECORDS OF SNOHOMISH
COUNTY9 WASHINGTONt THENCE NORTH 89'47#30" WEST TO A POINT
THAT IS 110 FEET EAST OF THE EAST LINE OF 4TH STREET SOUTHt
THENCE NORTH PARALLEL TO THE EAST LINE OF 4TH STREET SOUTH TO
THE SOUTHWEST CORNER OF TRACT CONVEYED TO WAYNE BRANSTETTEN
UNDER AUDITORIS FILE NO 1669341; THENCE EAST ALONG BRANSTETTEN
.,TRACT TO THE TRUE POJNT OF BEGINNING&
DWELLING
UNITS
L_J ( .......... x .......... Ft.)
Eswim
l POOL
t
N
I
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 Mgu-
toting construction; and 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,
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be completed in ninety days; MOVED -IN BUILDINGS shall be com-
pleted In mix months.)
3IGNATURE (OWNER OR AGENT) I DATE SIGNED
NOTE: Applicant Snbject to Plan Check Fee
This Permit covers work to be done on privale property ONLY.
Any construction on the public domain (curbst sidewalksp drivewaymp
marquees, etc.) will require separate Permission.
Plan Check No .....................
BUILDING
PLUMBING
HEAT & GAB LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
JVORK NOTED
INSPECTION
DEPARTMENT
CITY OF -
EDMONDS
Fn 0-1107
Valuation
Fee
I ;� - -0 C) I
APPLICATION APPROVAL
This application Is not a permit until
signed by the Building official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
S;Em
INSPECTOR.
a