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690129.pdf - LEGACYMIN, F., ­,4 F, IFO—STEDON KROLL MAP No.: T BV I L D.1 NG iDEPARTMENT NUMBER 6.97: Z9` Applle=ant FIR Inside Heavy Lines JOB ADDRESS i FI. PERMIT' APPLICATION NAM1n'(OR-NAM1n 0 X SIDE YARD SLT13ACK 15THNN'r SETBACK REAR YARD SETBACICI F BUSINESS) 0 L^J MAILING ADDRESS / t� �4- 0�46 / S --Tam _ZONE LOT AREA VACANT SITE o 0 TELEPHONE NUMBER YES 13 No, HEIGHT BUILDING AREA VARIANCE NUMBER ON el iF �,Vj S NAME PLOT PLAN APPROVED ADDRI STREET It/W THIS PROPERTY TELEPHONE NUMBER EXISTING STREET R/W ......... FF FT- DEFICIENCY CITY COMP. PLAN ST. R/W ........... PT. 0 IF NAME —All I ADDRESS k CXED BY CITY TELMEHO 19 VU ER 14 F, UETER SIZE SERVICE SIZE JCLEARANCN I CILECKED BY BE NUMBER CITY LICENSE NUMBER ,X F IF REMARKS vLagal Description of Property (Show Below or Attach Four Copies) TYPE CONNECTION VERIFIED By PERC. TEST PERMIT NUMBER to IF R -ARKS 14 rr FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED YES [3 No. SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP YES [3 N GAS 4.: RESIDENTIAL LINE PLAN CHECKED BY El NEW NONFIRESIDENTLALL SIGN 0 El _"1 .1, IF r AD" RETArNING REMARKS ElDEMOLISH WALL FI? PENCE ALTER EXCAVATE F� OR FILL REPAIR PRE -MOVE SWIM r� �_ 17 c�� IF/ LJ INSP. L_j POOL NUMBER OF NUMBER OF STORIES DWELLING UNITS NATURE OF WOR TO BE DONE PROPOSED USE I hereby acknowledge that I have read thin 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- 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 relating to WorkmeWs Compensation Insurance. NOTE: Permit Li mit One Year (Except DEMOLITIONS which shall be completed in ninety days; BIOVED-IN BUILDINGS shall be com. Plated In six months.) SIGNATU RE (OWNER OR AGENT) DATE SIGNED NOTE: Applicant Subject to Plan Check Fee This Permit covers work to be done on Private property ONLY. Any construction on the public domain (curbot oldeI driveways, marquess, etc.) will require separate permission. Plan Check No ............ BUILDING PLUMBING HE, AT & GAS LINE F19NCE SIGN RETAINING WALL SWIMMING POOL DEMOLITION PRE -MOVE INSPECTION EXCAVATION OR FILL TOTAL AMOUNT DUE ATTENTION THIS PERMIT AUTHORIZES ONLY THE WORK NOTED INSPECTION DEPARTMENT CITY OF EDIVIONDS PH 0-1107 Valuation 'I-) . 0 .,, Fee. Receipt No. /73- 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. INSPECTOR I 1 . I ""'Il - A %I I R APPLICATION & WO XWRMIT Application No.': ............................... CITY OF EDMONDS Building Department Permit Limit, One Year APPLICATION Is hereby made for a pern-tit to construct the following work, in accordance with the accompanying Plans and specifications: ........... Ground Area. ................................... No. Stories ............ WOItK,— New/Addn . ................ .................................................... . ...................... ...... Height ........................ Plans Submitted .......................................................................................................... Const. Type .................................. ............. . .............. . . ... ..... LOCATION — Address ......................................................... ...... ....... .......... use Zone.2 .... Fire Zone., ...... RecordedLot .................... Block . ........ Add'n ............................... .......................................... . ..................... Se\verage .................................... Lot Area ........................................ Width ............................ Min. Bldg. Setbacks, Front and Rear ................................ Sides .............................. Fz ii(_ -c,/b Address .............. ;L./ ..................................... Phon L. e� ............ ........ Owner ............................... .............................................................. Phone................... : Plans by ......... ................. Address ........................................................................ ............. ................................................................. Phone....................... ......... ... Address ................................................. ............... Bid by ........................................................................................ 9 rx" ...... Address ..................................................................... .. rnone�* rlFjg. by ...................................................................................... .................................... �Phone .................................. ........ Address ...................................... by ............................................................................... W, T,� ....... 'Phone. Address ............................. .......................................... ............................... Elect. by.l; .......................................................................................... -Remarks ........................................................................................................................................................................................................................ ...... V ......................................................................................................................................... ...................................................................................................... 1yo ,N ..................................... ............................................................................. I ....... ......... ............................................................................................................... . ................. I ........................................................................................................................................................... ........................................................ .......... ly with all applicable Codes and State Laws regulating the work. The above,is a correct statement and I agree to comp Signed: ner/Agent ..... ........... . . .1 ..... ........................................ Address ..... ................. ............. Date. Ow PERMIT for the abov"e work Is hereby approved, subject to the above conditions, and to compliance with theapproved plans ifications and Building Department notations thereon. and spec VALUATION PERMT F EES $ Bldg. . ............................... . . . ....................................... Plbg. . . . . $ ........................................ APPROVED: Heat . . . . $ ........................................ Elect. . $ ........................................ Date ............ ....... ..... ..... . ............... I ..... ................. BUILDING DEPARTMENT Others $ . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .: . . . . . . . . . . . . . . . . . . . . . . . . . . TOTAL FEE By...... NOTES: No work requiring Building Department QIrIcity 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.