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690285.pdfBUILDING DEPARTMENT PERMIT APPLICATION b t .4 Q a or Applicant Fill Inside Heavy Lines C F NO.: PERMIT bVU28b I 14UMBER SIDE YARD 71, -57 UPZONE S - k SETBACK - :L STREET SETBACK --Z� *' LOT AREA I BUILDING AREA ROAR YARD SETBACK 71�1 0 — ;F1 VACANT SITE P4 C3 YES ;05 or z 04 I VA—JUANCE NUMBER 11 I -STREET R/W ............ FT. DEFICIENCY THIS PROPERTY PLAN ST. R /W ............ FT. ........... FT. K. to connect into sani, no larzer line than 2"0 sewers, z N =zzl: 0413 0 No SPECIAU INSPECTOR REQUIRED OCCUPANCY GROUP GAS 0 YES 5.2 �O El NEW RESIDENTIAL LINE PLAN CjiECKED BY "�'" 1"' NON-RESIDENTZAL E] SIGN ;4_2 �- RETAINING REMARKS-' DEMOLISH WALL ALTER EXCAVATE PENCE El OR FILL ( ........ . x .......... Ft.) REPAIR PRE -MOVE swim 1:1 INSP. POOL ES NUMBER OF DWELLING UNITS NATURE OF WORK TO BE DONE Valuation Fee Receipt No. Plan Check BUILDING PROPOSED USE PLUMBING PLOT PLAN (Indicate Building setbacks, abutting stroets) HEAT & GAS LINE PENCE SIGN tRETAINING WALL N SWIMMING POOL 0 1�9 /0.106 DEMOLITION PRE -MOVE INSPECTION EXCAVATION OR FILL I hereby acknowledge that I have read this application; that the In- TOTAL AMOUNT DUE lo. Q 0 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 Vernon will be employed In violation of the Labor Code of the State of Washington TIUS PEIL511T This application is not a permit until relating to Workman's Compensation Insurance. AUTHORIZES signed by the Building Off Icial or his Dep- ONL E - Permit Limit One Year (Except DEMOLITIONS which WORK NOTED uty; and f Sell are paid, and receipt Is ac- a I completed in ninety days; MOVED -IN BUILDINGS shall be cam- knowledged in space provided. pi end in s x monthfi-n T) INSPECTION DATE SIGNED 11 N TURL (OWN t AGE JR—RECTOR'S SIGNATU DEPARTMENT 7_231 CITY OF A0, :1-L EDMONDS DATE 77�_077 Applicant Subject to Plan Check Fee Pl 6-1107 k_�Thjs Permit coven work to be done on private property ONLY. Any construction on the pubtla domain (curbs, sidewalks. driveways, FILE nuLrqueen; etc.) will require separate permission. IITItIIIIAIIAIIIIITIIII P. 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I IIIIIIIIIIIIIIitIIIIIt IIlIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIII I I I I 4L I IIIIIIIIIIIIIIIITIIIIIIIIIIIItIIIIIIIIIIIIIIItIII II" t ::'RECORD"OF"IPJSPECTIC I IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIr IIIIItIIIIIIITIII d ss. r- III I Datef Pa IIe IIIIIIII. I 4� IIIIIIIIIAId— %.rA 11 IIII4L I Drainage I I .1 P IIIIIII' IIIIIII I IIIII I 'I,' . . IIII I Sewer IIII I I I, I II _' I I ' 4 II Ie r"a P It I IIIIIItIIIIIIIIIIIIIIIIIIIIParki IIIIIIIIIIIIII 4, II I I I I I t I...... ILart I­q ds6aping, ITII4 IIIIIIIIIIIIFire Dept. IIII IIIIIII 4 II z ITII1 4 I I It Ij I IIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIN1. I It I1 IItIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIIAAIIII /0 APPLICATION BUILDING PERMIT Ap I . .................................... p 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 accom,, panying plans and specifications, Two sets are submitted herewith for approval. z Off -St. new alter epair . ................. Parking ...................... Work addn r ................................................................................ . . . . . . . . . . . . . . . . . . . . . . . . . . . Occupancy ................................ Const. type ............................... Use zone ... S- ......... ..... Fire zone. �"7 ............. Blk ... Zl.� ..... ......... Address Lot ........ Ad Area.- Septic tank ......... ...... ...... I ........... Lot frontage ....................................... ............ 1. side ... ;7 ...... ........ ............. front ....... r. side .... rear. Bldg. set backs a-0 Address. ............ ....... Owner...,(/ ............................ e.z;&t-X4._Tel. No.& ........................... I t ..... Address ................................................... Tel. No ............................. Builder .............................................................. Plans by .................... ..... ............... Address ..................................................... Tel. No ............................. ........................ Remarks ......... ......................... This.por,111t covers worl- to be done ... PrIvata ... pr`apexty .. UU .......................... ............... . .................. on A construction on the public ny ......................................................................................... .................. tau c.) et 'Me above is a correct statement, and I agree to comply with all applicable Codes and State, la g, this:i work. .. ............ ...... lelbatZ. ...................... Address/ Signed Owner/Agent.... .. ........ I.., PERMIT for the above work is.hereby approved subject to the above conditions, and to comi itli th Plianci Vn e tions th roved plans and. specifications, and Building Department nota ereon. p fee., ...... 54- 1 ............... Recd. .. . .. . ........... Valuation ........... i� 2 ....... Permit Z� ........................ Building Department, By ................................... .. . . ................... Date ..... .. .... This Permit does not cover Plumbing, Sewer or Electrical installations.