670230.pdf:j
C.
BUILDING DEPARTMENT
PERMIT APPLICATION
NAME (OR NAME OF BUSINESS)
/, ��A F ,.214
AIAILING ADDRESS
13 c Y 3.�_ S-
ADWREN
& 0 x 3,P
CITY
/:_4D A4 0 ND-S
SWATE LIOMNSM _X`UM_dEr__
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Applicant F111
Inside Heavy Lines
POSTED ON KROLL MAP NO.: PEPMT
// 5� U/. I NUMBER 670230
JOB ADDRESS /
/.4.35 —_ q— 050e— &ZZ
SIDE YARD SETBACK
/6 j . )q
STREET SETBACK
25
REAR TARD SETBAC
.1s, Arl i ta
USE ZONE
OR A I 2�,
LOT AREK
VAG err"
[3 NO
; or —
BPHONE NUMBER
3 6 -7-j-
HEIGHT
I 33UILDING AREA
VARIANCE NUMBER
C_
PLOT P OVED
G
;8T4 A�Z:
,EPHONE NUMBER
STREET RIW4. JT. DEMCIMCY?� PROPERTr
COMP. PLAN AT R/W
REMARKS
/,0 -'.<140RA!r 270S,7eA17- (,cgs rxroe v /e
C. 3 ess
-0 -89
t ereo rec. in vol 12 of Plats Page
Ree. of Snoh. Co. Wash. Excep the So. 1
50 Irt. tnereor,
SUBJECT TO AND TOGETHERWITH an easement
'for ingress and egress and fqr utilies
over iind upon tFact of land.
9
13 YES
NEW
RESIDENTIAL
GAS
LINE
NON-RESIDENTIAL
.1 ...
RETAINING
DEMOLISH
WALL
DALTER
EXCAVATE
E
OR FILL
wc Ft.)
REPAIR
PRE -MOVE
;W31
INSP.
POOL
.4UMBER OF STORIES
NUMBER Or
DWELLING
UNITS
11
t I
—FR—OPOSIOD USIC
BUILDING
PLOT PLAN Indicate Building setbacKS. abutting streets) PLUMISING
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
Oa
3 Zat SWIMMING POOL
DEMOLITION
0
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the in-
formation given in 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- 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 PERMT
relating to Workmens Compensation Insurance. AUTHORIZES
ONLY THE
NOTE: Permit Limit One Your (Except DEMOLITIONS which WORK NOTED
shall be completed in ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
SIGNAPR5 (OWNER ON —AGENT) DATESIGNED INSPECTION
erp DEPARTMENT
CITY OF
EDMONDS
NOTWAPP Kcant Subject.to Plan Cbeck Fee PR 0-1107
This Permit covers work to be done an private Property ONLY.
Any construction on the public domain (curbs, sidewalks. drIv&ways,
in"Quees, etc.) will require separate permission.
Valuation
13 YES
Fee
FIKAO.".00 9.3rTA
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.
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PUPATION
71VF t EDMONDS
BUILDING PERMIT Appl. No. ..............
Building Department Permit limit, one year
is hereby made for a permit to construct the following work, in acoorda= with the accom-
Two sew are submitted herewith for approval.
.;iltpr Off'st.
..........
.1� ......................................................................... Parking ............
.2'J Fire zone ...............
...... Const. type ................................ Use zone ... ...... . .............
............. ... .......
"s,
.& .......... Lot ........................ Blk ........................ Addn ...................................
.................................................
..e4O ....................... Area ........................................... Septic tank .........
side ........... 1. side...
front .... .0.1f-5 ............... r. .............. rear ... ..........
A
9 P".IZX Address ... t.�?KOR .... . Tel. No =alx.eje�'
.15 ........ 5;;
7.74.!*
............. Address ............................ ....................... Tel. No .............................
');n
........... ........................................... Tel. No .............................
... Address .........
..........
..........................................
771 M-P"".Le
Rwar ........... ........................................................................................................................................................................
.................................................................
............................................................................................. ...............................
................. ............................................................................ ...............................................................................................
The above is a correct statement, and I agree to comply with all applicable Codes and State laws regulating this
work.
gigned Owner/Agent.A46 X25 �&& �..Address ............................. . . .. .....
PERMIT for the above work is hereby approved, subject to the above conditions pli with the ap-
proved piano and specifications, and Building Department notations thereon.
.... ......
Valuati. ............... Permit ...... Recd. b ... F...
Building Department, .. . . .. ......... Date ............. ................
This Permit does not cover Plumbing, Sewer or Electrical inst4ilati
APPLICATI(�:I & WORK PERMIT
CITY OF EDMONDS Building Department Permit Limit, One Year
—:1
it t,: t�
APPLICATION is hereby made for a permit to construct the following work, in accordance with the accompanying plans
an specifications:
d
,Y,
�WORX — New/Addn I ...... .. No. Stories ............
.'r ... .. .... .......................................................I Ground Area. ...................................
11; Plans SubmittAd ............................................... I .... ................................ Const. Type ........................................ Height .......................
IF
IF re Zone ....................
ZMATION — Address ..... ........... ................................... Use Zone....
Remarks
Lot................... Block. .................... iiinWA .. A*ox`� . ..... ........................................... . ..................... Sewerage ....................................
I. . ..... ............................. Width ... 126 ............ Min. Bldg. Setbacks, Front and Rea .... ...... Sides ..... 1.712.'
PhoneO.O" 0.::99.6F:?
...... ..... ....... Address./. ........................
................................................................................... Address ....................................................................... Phone ................................
...................................................... Address ........................................................................ Phone ................................
................................................................I Address ........................................................................ Phone ................................
11.1 9 by ....................................................................................... Address ........................................................................ Phone ....................... . .......
ebyi ........................................................................................... Address .......... . ............................................................ Phone ................................
CL
Remarks ap ... ma MR ... RT3 A-2. BARP on E. Ln Goyt Lot 4. 8%.& ... N ... .............
IF ....... ....... IF .. .. .... IF .. . .. I. .. IF IF .....
TPB th N ON SD E ... 7-10-3-1-t-W-9 ... T-H ... S-LY ... TO ... EST FENC LN PC 55566
ELY ALG SD FENCE..LN TAP 198.701 W of E LN GOVT LOT 4 T ... $ THJP .. ;k9.9.1.761
..................... t ........... ...... ....................... .................................................... a . IF ...... ......................
OPB TRF`.*
......................................................................................................................... ..................................... . .................................................................................
..................................................................................................................................................................................................................................................
ta Laws regulating the work.
The above is a correct statement and I agree to comply with all applicable Codes and S te
Signed: Owner/Agent ................................................................... 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.
VAT.TTAqff0?J PERMT FEES
................................
APPROVED:
Date....... ...................................
BUILDING DEPARTMENT
Bldg. $ ....... ......
...............
PIbg. . . . . * ........................................
Heat.... $ ........................................
Elect. ... I$ ........................................
Others... $ ........................................
TOTAL FEE $ ....... . ;2.1.6.�.
.................
NOTES: No work requiring Build)eg Department or"City Engineer's Inspection shall be covered before Inspection and approval.
Twenty-four (24) hour iotice requested. Contact the City Engineer prior to construction of all site utilities, such am
curbs, paving, driveways, sewer, water and street connections.
E