670146.pdf81.110ING DEPARTMENT
PERMIT APPLICATION
A 1'URW_!!Lt_N"M G! J!FB1n"9_X7<=.-lK
or
Applicant Fill
inside Heavy Lines
RESIDENTIAL
NEW
NON-RESIDENTIAI.,
Li
DEMOLISH
RETAINING
WALL
ALTER
M
EXCAVATE
PENCE
OR FILL
I .......... x .......... Ft.)
E] REPAIR
PRE -MOVE
INSP.
swim
POOL
NUMBER OF
DWELLING
UNITS
N
IOBTED ON KROLL MAP NO-: PERMIT
NUMBER 670146
[OB ADDRESS
'SETBACK
Jly,ARD SETBACK
BTREET 819WISAUM
REAR YAJ%F
I ly-)
Zs/ N I -a
Z,�� 0, o
0
1
'1
USE I z9f4m,
LAKE, AREA
VA 111TE
0 NO
1
DULL�LNG AREA
VARIAN
HEIGHT
PEor PLAN APPROVED 7
STBEET H/W 0 Cy THIS PROPERTY
EXISTING STREET R/W ............ Fr- DEFICIEN
COMP. PLAN ST. R/W ............ FT.
METER SIZE SERVICE SIZE CLEARANCE
CMCCKZD BY
TYPE CONNZCTIO
BY
PERO. TEST
PERMIT NUMBET —W,
REMARKS
4,
FIRE ZONIC TYPE OF CONSTRUCTION STREET IMPROVED
�o
YES
SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
0 YES
PLAN CHECKED BY
Plan Check No ............ . .......
BUILDING
PLUMBING
t
N
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
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. Z agree to comply with city and state laws regu-
ATTENTION
lating construction; and In doing the work authorized thereby, no person
Will be employed In violation Of the Labor Code of the State of Washington
THIS PERMIT
relating to Workman's Compensation Insurance.
AUMORIZES
NOTE: Permit Lilmit One Your (Except DENJOLITIONS which
ONLY THE
WORK NOTED
shall be completed in ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
SIGN TURE (OWNE—R, OR AG
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fce
PH 6-1107
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curft, sidewalks, driveways,
marquoes� etc.) will require separate permission.
Valuation Fee 6Recolp:1:No:
,/LIP
APPLICATION APPROVAL
This application Is not a periyAt until
,,, De
signed by the Building Official or a ep-
uty; and fees are paid, and receipt Is ac-
knowledged in space provided.
DMWC—To
66-111
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_7'
Appl. No. ...............
HKJOATIOk-I BUILM PREff C
CffY OF EDMONDS BuIWIng Department Permit limit, one year
:ATION is hereby made for a permit to construct the following work, in accordance with the acoom,
.phns and specifications. Two sets are submitted herewith for approval.
Off'st.
new alter kin . . ...................
............
repair ...... ........ . ...... .... ............................... Par g
Const. type ................................ Use zone .... x:::.s ......... Fire zone ...........................
Iot....... 2= ........ Blk ........................ Addn ............................ .. ..
P.- ... .............................. . . .....
.................................... Area .... 7.S.. Y .. f L.D .............. Septic tank ....... .. .........................
L
C
L
...............................................
r. side ............................. I. side .............................. rear ...............................
Addres&.I.�../ I Noe.1
........... Te. T::�
.............. Address. ............................... .................... Tel. No .............................
............... Address .................................................... Tel. No .............................
............................................................................
............................................................................................... ....................
ply %vith all applicable Codes and State laws regulating this
The above is a correct statement, and I agree to com
work.
I
Signed Owner/Agen ................... ............................... _ - ----- Address .........
Date..�.�r/=Az_
PERMff for the above work is hereby approved, subject to the above conditions, and to compliance with the ap-
proved plans and specifications, and Building Department notations therem.
CPO
Valuation ...............
. .................. permit fee ....... ;2 .................. Reed. by .... A .. .... �4 .... .......... .
Building Departments BY ........... A� ... /V ........................ . ................... Date ..... ..............................
NOTE This Permit does not cover Plumbing, sewer, or electrical installations, nor does it Permit any work to be
done in the Right of Way areas. Driveways and walkways must be planned to meet the official grades of streets
and allays, and Plans for future sidewalk develoPment-
I
K
I
Appl. No.
..... ............
CATIr" & BURAING' PERMIT
'�*F,WMCHDS Building Department Permit limit, one year
JW..hireby made for a permit to construct the following work, in accordance with the accotn-
ji6fications. Two sets are submitted herewith for approval.
. e:r Off -St.
. ...... ...... ... .................................................... Parking ......................
............ Const. type .............. ...........
.................. Use zone .... ..... 6.� Fire zone ....................
/I . . ......... ........... ...... ................
.... ........ Blk ............ ......
.... .. ........... 1,ot
.................. Area ........... 9LK.Zff.!� ....... Septic tank .... ... .............................. ..................
..........
LS
front....... :P-70 ............ r. side ........ ................. 1. side ............................. rear ........... ................
d Fle) .. ...... Tel. No .............................
A dresa/-'�/'P ................... ......
- _. - - . .. .........
Address............................. ...................... Tel. No .............................
........... ............................. ....................
...........
.. . . .... ................................................
....... Address .................................................... Tel. No ............
........................................................................................................................................................ ...... ...........
................................ ................
I .......................................................................................... ................ ..............................
........................................................
....................................................................................... .............................. .........
The above is a correct statement, and I agree to comply with all applicable Qodes and State laws regulating this
work.
Signed Owner/Agencle ... Address ............................................ Date..2:.:::� .............
PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance with the ap-
proved plans and specifications, and Building Department notations thereon.
41 b.0 wd.
Valuation .............. ... 4_0
........... Permit fee. ..... 5.-:!? ............... R4
Building Department, By .............................................. cte ........... Date ... 4
.. ...................................
This Permit does not cover Plumbing, Sewer or Electrical installations.
I
�777!
I
Wo
t BUILDING PERMIT Appl. No . . . ..... . ...............
VEDMONDS
Building Department Peri�'L .1nimit, one year.
CATION is hereby made for a permit to construct the following work, in an the accom,
g. plans and specifications. Two sets are submitted herewi for7a
t Off -St.
new. attley
............ ... .................................... Parking ......................
repau ...... ie-L-.4z .. ......
e ...... —.0 ............ Fire zone ...........................
... ............... Const. type ............................... Use zon ....
............ Lot ........ s?9 . ......... Blk .......................
.. ..........
....................... .......
................... AiailrM .... ............ Septic tank..
4-
r. e..... . .................... 1. side ......... ..................... rear .......................
es
. .... .. .... ..... . .... ... ddres&J.!7/.4..3.—..6S .. 6a ........... Tel. No.
ei;,
ddress............................. ...................... Tel. NO
........................ ...................
................... ) ..... ..... ddrem .................................................... Tel.' No ....................... U....
.11� ...............................
e
d
d
d
.................. ) ..... .... dd
........... .......... ..... ....................... ........ ...............
.................................... ......... ......... . ......................... . ........
.............................................
............ .. .... .. . . ...
.. ..... ..... ........ ......... ........ ........................... .
. ..........................
I ......................................................
..... ................. ... .....................
..................................................
o comply with all applicable Codes and State laws regulating, this
Ile above is a correct statement, and I agree t
work.
Signed Owner/Agent.67
Address .......................................... . Date.AA"/`***L
PERMIT for the above work is hereby approved, subject to the above conditions, and to complia= with the ap-
otations thereon.
proved plans and specificati=4 and Building Department n
Valuation ............. / .. ......... Permit fee ....... 5-5 ............. Recd. by..4CA-e4.-;� -
:;? . . ..........
C
Building Department, By ............................... ... .................... Date ......
This Permit does not cover Plumbing, Sewer or Electrical installations.
M