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670382.pdfX11 BUILDING DEPARTMENT Applicant Fill v Inside Heavy Lines PERMIT APPLICATION NAME (OR NAME OF BUSINESS) Peter Salamonsen MAILING ADDRESS P. 0. Box 177 UMBE CITY TELEPHORE-l'INUMBER PERMIT 1 -70382 NUMBER 6 0 YES 13 NO Lynnwood PR 6-1256 HEIGHT NAME PL40T PLAN APPROVED j AD RESS STREET R/W EXISTING STREET R/W ............ FT. DEFICIENCY THIS PROPERTY CITY ONE NUMBER COMP. PLAN ST. R/W ............ FT. ....... .... Z REMARKS NAM Peter Salamonsen CHECKED BY Z —,O—DRESS P. 0. Box 177 METER SIZE SERVICE SIZE CLEARANCE CHECKED BY CITY TZLEPHONE NUMBER 94 PR 6- 1256 Lynnwood REMARKS 8 STATE LICENSE NUMBER CITY LICENSE NUMBER 223-01-5851 186 TYPE CONNECTION VERIFIED BY Legal Description of Property (Show Below or Attach Four Copies) I N 1 acre of the S 2 acres of IINI-12 PERO. TEST FEE T NUMBER Z of NWI- of NEI of NE..., of See. 30, 4 4 REMARKS T 27 Ni R4Ej W.M., EXCEPT road. Co. FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED of Snohomish YES No SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP 0 YES [3 NO PLAN CHEC D 33 GAS A." FRESIDENTIAL LINE NEW �KNON-RESIDENTIAL SIGN ADD RETAINING 1:1 DEMOLISH WALL 0 ALTER EXCAVATE PENCE F] OR FILL .......... x .......... Pt.) REPAIR PRE -MOVE swim INSP. POOL NUMBER OF DWELLING UNITS NATURE OF WO TO BE DONE /A e, b� a� Valuation Fee Receipt No. L/ Z Pod 7 Plan Check No ..................... 'OoiO.6 38 —/-5 BUILDING 5�3 73f ;UILP� W PLOT PLAN (Indicate Building setbacks, abutting streets) PLUM33ING HEAT & GAS LINE PENCE t 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 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 APPLICATION APPROVAL 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 PER311T This application is not a permit until relaUng to Workmen's Compensation Insurance. AUTHORIZES signed by the Building Official or his Dep- ONLY THE I NOTE: Permit Umit One Year (Except DEMOLITIO',S which WORK NOTED uty; and fees are paid, and receipt is ac- shall be completed In ninety days: 31OVED-l[N BUILDINGS shall be com- knowledged in space provided. pleted In six months.) (OWNER OR AGENT) DATE SIGNED INSPECTION DIRECTOR SIG DEPARTMENT CITY OF A2)t EDIMONDS NOTE: Applicant Subject to Plait Check Fee PR 6.1107 This remit covers work to be done on privnto property ONLY. Any construction on the public domain (curbst sidewalkal drivewayss FILE marquees, etc.) will require separate permission. ..... .... .. .......... . .. ..... .. APPLICATIC i & WORK PERMIT 3,) -Y Application No . ......... . ................ CITY OF EDMONDS Building Department Permit Limit, one Year APPLICATION Is hereby made for a permit to construct the following work, In accordance wIth the accompanying Plans and specifications- W — New/A Z�,.: .... C und Area .............................. .... NO. Stories ....... .... ORK d III n onst. Type.... .......... Height ............... . ...... Plans Submitted . . .. . ........... .... 7­41 .............................................................. Use Zone .................... Fire Zone .................... 7 .. ..... ATION — #ddress RecordeVIot.................... �lock .................. Add'n .......................................................................... . ..................... Sewerage ........................... . ... 30 .......... ... Width./ ......... :��U... Min, Bldg. Setbacks, Front and Rear ....................... . ....... Sides ..... ................ ....... Lot Area ..................... .... 0I Z IIIR Owner ........... ......... P.O.A, ... ee. .......... Address ..... 4� .... ....... ... ....... ell ....... Address ....................... . ......... . ................................... Phone ................... . ........... Plans by..... 05�e .. .. ...... ,V �V� Bldg. by ...... . . ...... ........................................................ Address ............... . ...... ..... .................. ....................... Phone ...... . ........................ PIbg. by .. 7-22 ................................... I ............. Address .................................... I ................................... Phone .................... Heatingby .......................... . .................... . .................................... Address ........................................................................ Phone ........ ........... Elect. by ........................................................................................... Address ........................................................................ Phone ................................ Remarks........................................................................................................................................................................................................................... ................................................................ The above Is a correct statement and I agree to comply with all applicable Codes and State Laws regulating the work. Signed: Owner/Agent ... .... �ddress ......................................................................... I... Date PERMIT fortheabove work is hereby approved, subject to the above conditions, and to compliance with the approved plans and specifications and Building Department notations thereon. VALUATION PERMIT IMES ..... <C?.. 00 Bldg. $ .... (�? Plbg. $ ....... ........ APPROVED: Heat .... $ ........................................ Date.......... 40/9 ............. 611 ........................ Elect. ........................................ BUILDING DEPARTMENT others ... $ ........................................ Will., Herber 41 TOTAL FEE I. . .... !�.o ... By.................................... �A� .............. NOTES: No work requiring Building Department or City Engineer'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.