The URL can be used to link to this page

690310.pdf1. .4 . C, BUILDING DEPARTMENT PERMIT APPLICATION 4C _S 7—E �S S, L Applicant Fill Inside Heavy Lines XXILMG ADDREIRS 6 / c/ —1 e 7--�- A CITY ' - TELEPHONE NUMBER /��4ioluos I pie �K _816Z_6 1D ON KROLL MAP NO.: PERMIT I NUMBER, " q T's YARD SETBACK STREET 13ETBACK I c>26 I ZON9— LOT AREA I (_ I /S I 13 YES C:3 UMBER "DRESS IM STREET R/W EX38TING STREET R/W ............ FT. DEFICIENCY THIS PROPERTY COMP. PLAN ST. R/W ............ FT. ............ CITY TELEPHONE NUMBER NAME ADDRESS IQ CHECKED BY CITY TELEPHONE NU �ER METE SIZE CLEARANCE CHECKED BY STATE LICENSE NUMBER CITY LICENSE NU—MBER REMARKS Legal Description of Property (Show Below or Attach Four Copies) TYPE CONNECTION VERIFIED BY ed PERC. TEST PERMIT NUMBER REMARKS I= ZONE TYPE OF CONSTRUCTION STREET IMPROVED EJ NEW 11 __ 0 ALTER DREPAIR I M GABE RESIDENTIAL LIN NON-RESIDENTIAL I M I(,,, RETAINING DEMOLISH WALL EXCAVATE FENCE —1 OR FILL FPRE -MOVE SWIM _1 INSP. POOL DWELLING UNITS t N I I hereby acknowledge that I have read this application; that the In- formation given is 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 Workmen*a Compensation Insurance. NOTE: Permit Umit One Your (Except DEMOLITIONS which shall be completed In ninety days; )OVED-IN BUILDINGS shall be com- '116 NOTE: Applicant Subject to Plan Check Fee TWo Permit coven work to be done on prITMe ProperlY ONLY. A" construction aim the pubtle dornaln (carbms sldew&Wg driverwaysq marquees, ate.) will require separate permission. [3 YES C] NO Plan Check No ............ BUILDING PLUMBING HEAT & GAS LINE FENCE SIGN RETAINING WALL SWIMMING POOL DEMOLITION PRE -MOVE INSPECTION EXCAVATION OR FILL TOTAL AMOUNT DUE ATTENTION THIS PERbUT AUTHORIZES ONLY THE WORK NOTED INSPECTION DEPARTMENT CITY OF EDMONDS PR 6-1107 [3 YES E3 No Valuation Fee 60 No. I C;� 0 0 I(SA16 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- Imowledged in space provided. ,0 APPLICATH�A & WORK PERMIT Application No. CITY OF EDMONDS Building Department Permit Limit, One Year Nis he . reby made for a permit to construct the following work, In accordance with the accompanying plans N ew/Adda. .... New Residence .......... . ...................................... ......................... . ............... Btorie& . ....... Ground Axea. ................................... NO- ... We J. McLain Frame Height .. 301� ................. Const. Type, ....................................... ............ . . . .... ................... ....... 3 Address... . .. ... . ... . ........ ... .............. . ...... . .. .................... Use Zone ....... Fire Zone.... View Manor Sewered ................... Add'n ....... . ......... . ..................... ....... ....................... . . ................... Sewerage ... . .......................... 67k120 6 ................ ..... Width. ........ + 1+ min. Bldg. Setbacks, Front and Rear ......... ............... Sides. ...... ...... ..... . .... 20114 - 83rd We, Edmonds PR 8-4740 We J. McLain Address... Phone ...... . ........... . ........................... . ....... . .......... ......... Phone . ...... .. ........................... . 46(ldress. ...... . . .... ......................................... ....... .............. ............. It Phone 'by ........................ . .. . ................... AddresL ....... . .......... . ........... ................. . ....... . ....... ................... . . ........ .. �_ . .. ...... . ... Ad&ez&..-.. . ......... . .............. . ...... . ......... . ... . .. . ....... Phone ............. . . ... . . ....... �Plbjr.�L by ................ ...... . ................ ................................... I H� by ............ . ............................................................... Address. .. ... ........... ................................................ Phone ..................... . . ....... Phone Elect. by� ......... . ... . ............. . .. . .......... . . . ... . ........... Axldress.._ ............... ......................... ........... . ....... .................. ........... . .. .. ....... . Remarks. ...... ........... ................................................. ................... ..................... . . . . . . . . . . . . . . . . . . . . . ................................................... ............. . . . . . . . . . . . . . . . . . . . . . ...................... . ...... ....... . . . . . . . . . . . . . . . . ... . . . . . .... . .. . .. . . . . . . . . . ... . . . . .. . . . . . . . . . . . . . . .. . . . . . . . . . . . . . . . . . .. . . . . .. . . . . . .. . . .. . . . . . . . . . . . . . . . . . .. . .. . .. . .. . .. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .. .. .. . . . . . .. . . . . . . . .. . . .. The above to a correct statement and I agree .. . . . . . . . . . . . . . . . . .. . . .. . . .. .. .. . . .. . . . ..... . .. . . . . . . . ... .. . . . .. . . .... . . .. . . . . . .. . . . . . . . . . . .. .. . . . . . . .. . . .. .. .... . . . . .. .. ... . .. . . . .. . . . . . . . . . to comply with all applicable Codes and State Laws nVdating the Work.L signed: Owner/Agent.� Address ... . ...... As ... Ab.ove ........................................... Date ...... 3/ - 28/63.. ..... ....... f 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. VALUATION PE&Mr FEIDS �7- ................... Bldg. ....................... APPROVED: Date... ........................................... BUILDING DEPARTMENT Plbg. . . . . Heat.... ....... . ............ 9__� Elect..... ......... . . ....................... Others . . ._$ ......... :� ............... TOTAL FEE S1 ............................. I V NOTES: No work requiring Building Department or City Eneneer'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 83 curbs, paving, driveways, sewer, water and street connections.