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740067.pdfi l \ l • 'i BUILDING DEPARTMENT PERM 740067 + Applicant Fill ZONE NUMBER PERMIT APPLICATION I Inside Heavy Lines ,DB I i NAME, 1011 NAME BUSINESS) ADDRE08 1t1 1� / �/ lJ �O PERMIBBI R IAT COVERAGE 1 ACTUAL J LOT COVERAGE I. of MAILING ADDRESS t51,(,Isr Ave PERMISSIBLE HEIGHT PROPOSED HEIGHT O ! ; CITY TELEPHONE N BER ACTUAL LOT AREA TOTAL BLDG. AREA i• � j Oh a os Gr/q,r H 7 71-- Ya -G r 16 NAME REQUIRED YARDS FRONT SIDE PROPOSED YARDS REAR FRONT SIDE REAR ADDRESS .Ul Fy LEGAL LOT VARIANCE OR CONDITIONAL USE 0 YES E3 NO PERMIT NUMBER PLANNING DEPT. APPROVAL DATE: CITY TELEPHONE NUMBER STREET R/W � . NAME EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY 6 U E COMP. PLAN ST. R/N ............ F f. FT. µWp7I ADDRES8 RDMARKB y °z CHECKED HY W CITY NUMHEft qZ U (TELEPHONE METER SIZE I BLRVICE B1ZE CLEARANCE Cl1ECKED BY STATE LICENSE NUMBER CIT LICENSE NUMBER I I k(d� F Legal Dc.crlptlan o[ Property (Shaw Below or Attach Four Copies) REMARKS TYPE CONNECTION VERIFIED BY e ! I a FERC. TESTPERMIT NUMBER�• I i RE—MARKS m i v W .i FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED I 0 YES [] NO SPECIAL INSPECTOR ME—QUIRED1 OCCUPANCY GROUP RESIDENTIALE3GAB 0 YES NO E] NEW LINE PLAN CHECKED BY NON-RESIDENTIAL BION THIS SITE IS LOCATED IN THE CITY OF EDMONDS. LOCAL SALES TAX tH0 I D red ADD RETAINING REMARKS BE OD D 1 DEMOLISH WALL E ' ��7� ALTER ❑ .CAVATFILL ORILyC,i.��.Ft.) REPAIR ❑ I 8Ep-MOVE D POOL NUMBER OF BTORIE9 NUMBER OF DWELLING I UNITS NATURE OF WORK TO BE -FO R EDONE Valuation Foo Recclpt No. Plan Cheek No ..................... 7 BUILDING I O APLOT PROPOSED UeE PLUMBING PLAN (Indicate Building setbacks, abutting street.) HEAT & GAS LINE n FENCE nn ^^ SIGN RETAINING WALL SWIMMING POOL DEMOLITION PRE -MOVE INSPECTION EXCAVATION OR FILL , TOTAL AMOUNT DUE 6J. I hereby acknowledge that I have read this aDDllcatloo; that the tn. formation given le correct; and that I am the owner, or the duly author. s lzed agent of the ownLk er. I agree to Comply with city and elate law. regu. sang condricllon; and In doing the work authorl.ed thereby, no person ATTENTION APPLICATION APPROVAL will be employed in Wolntlon of the Labor Code of the Stale of W"bingtou Compensation Insurance. THI8 PERMIT Thies application is not a until pp ralatlag to Workmen's NOTE: Permit Limit One Year (]Except DEMOLITIONS AUTHORIZER ONLY THE permit signed by the Building Official or his Dep. which WORK NOTED uty; and fees are paid, and receipt is ac- .hall be completed In alnety days; MOVED -IN BUILDINGS xhall be _m.kllowled ed in e g pace pleted In six months.) provided. SIGNATURE (OWNER OR AGENT)DATE SIGNED INSPECTION D1R DEPARTMENT; OR•S d�NATU / A % 7 CITY OF ` %aim :.z�., EDMONDS DATE NOTE: Applicant Subject to Plan Check Fee ' Permit coven work b ldone privateprivateproperty ONLY, PR s-Iloy a Anyny <on.irncllpn on the public domain (c (turbo, sidewalks. &I—ay.,y treuct�, rlc.) wal "Q.1'. .'p-1. pinlln.lon. 1'If,l, YES [] NO res Plan Check No ............. ....... USE 740067 E] GASC] BUILDING DEPARTMENTAppucant Flu NUMBPERMIT ZONE NUMBER ZONE LINE L PLAN CHECKED BY THIS SITE IS L BUILDING PERMIT APPLICATION Inside Heavy Lines G ADDRESS / SIGN OFSHOULD EDMON DS. NAME (GAME O}� HUBINEeW ADD /F�/ � PLUMBING )4/I /Vsr� BE CC REMARKS LOTM 8IBL ACTUAL LOT COVERAGE LOT COVERAGE ❑�rty� MA LINO ADDRESSO PERal1BBIBLE HEIGHT YIiOYOBED HEIGHT HEAT A GAB LINE o CITY T ONN BLL ACTUAL TOTAL BLTG. AREA I(J� FEN E (}•;�, z.�r�..Fl.) DhauoGr/AfH � REPAIR ❑ RRO:U YARDS El NAME RETAINING WALL FRONT HIDE REAR FRONT HIDE REAR NUMBER OF ! [y t1 _ DWELLING LEGAL LOT VARIANCE OR CONDITIONAL USE ADDRESS DEMOLITION 0 YES ❑ NO PERMIT NUMBER UNITE .W1l V PLANNING DEPT. APPROVAL DATE' EXCAVATION OR FILL CITY TELEP ONE NUMBER STREET R/W O TOTAL AMOUNT I hereby acknowledge that I have read this application; that the In- formation Elven Is correct; and that I aa, the owner, or the duly author- EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY NAME ATTENTION COMP. PLAN ST. R/W ............FT. ............FT. N? t'4' toting coastruellon; and In doing the work authorized thereby, no person V W .11 F , REMARI(B TIDE PERMIT f ADDRESS AUTHORIZES signed by the Building Official or his Dep- O NOTE: Permit Limit One Your (Except DEMOLITIONS which ONLY TILE WORK NOTED uty; and fees are paid, and receipt is ac - shall be completed In ninety days; MOVED -IN EUILDINGS shall be nom- W knowledged In space provided. pleted In sig months.) (CHECKED BY SIGNATURE (OWNER OR AGENT) ! ! INSPECTION CITY TELEPHONE NUMDER F I DEPARTMENT r j, METER SIZE SERVICE SIZE CLEARANCE CHECKED BY CITY OF i STATE LICENSE NUMBER CITY 1,CENSE NUMBER EDMOND9 I NOTE: Applicant Subject to Plan Check Fee PR 6- 107 a - I , Any construction on the public domain (curbs, sidewalks, driveways, (iyr7. urouere, oto.) ,I11.,. Separate perndrelon. REMARKS !p Legal Deec I.M.n or Property (Shaw Below or Attach Four Copies) YES [] NO res Plan Check No ............. ....... RESIDENTIAL E] GASC] YES NO NEW LINE L PLAN CHECKED BY THIS SITE IS L BUILDING NON-RESIDENTIAL PROPOSED UBE SIGN OFSHOULD EDMON DS. ADD PLUMBING BE CC REMARKS O aPLOT ❑�rty� DEMOLISH WALiN/O HEAT A GAB LINE ALTER ❑ On FILL EXCAVATE I(J� FEN E (}•;�, z.�r�..Fl.) ^^ �. H� � REPAIR ❑ IN p. El swim POOL RETAINING WALL (UMBER OF STORIES NUMBER OF ! N _ DWELLING DEMOLITION UNITE PRE -MOVE INSPECTION YES [] NO res Plan Check No ............. ....... BUILDING PROPOSED UBE PLUMBING O aPLOT PLAN (Indicate Building setbacks, abutting streets) HEAT A GAB LINE E O FENCE ^^ �. H� � SIGN RETAINING WALL – — ! N _ SWIMMING POOL DEMOLITION PRE -MOVE INSPECTION EXCAVATION OR FILL TOTAL AMOUNT I hereby acknowledge that I have read this application; that the In- formation Elven Is correct; and that I aa, the owner, or the duly author- lred agent or the owner. I agree to comply with city and state laws ngu- ATTENTION APPLICATION APPROVAL toting coastruellon; and In doing the work authorized thereby, no person , Will be employed In violation or the Labor Code of the State or Washington TIDE PERMIT This application is not a permit until relating to Workmen -s Compensation Insurance. AUTHORIZES signed by the Building Official or his Dep- ----• NOTE: Permit Limit One Your (Except DEMOLITIONS which ONLY TILE WORK NOTED uty; and fees are paid, and receipt is ac - shall be completed In ninety days; MOVED -IN EUILDINGS shall be nom- knowledged In space provided. pleted In sig months.) SIGNATURE (OWNER OR AGENT) DATE SIGNED INSPECTION Dl OR•B BSNATU DEPARTMENT r j, CITY OF ! EDMOND9 DATE I NOTE: Applicant Subject to Plan Check Fee PR 6- 107 a - Tlds Permit coven work to be done oa DA -4. property ONLY. , Any construction on the public domain (curbs, sidewalks, driveways, FILE. urouere, oto.) ,I11.,. Separate perndrelon. !r PERMIT, APPLICATION I Inside Heavy Lines NAME (OR NAME OF BUSINESS) M/AIM. NO ADDR e d CITY TE PHONE NUMBER NAME y7 1113DIIE118 yl U OC CITY I TELEPHONE NUMBER NEW Lj RESIDENTIAL ❑ LINE NON-RESIDENTIAL ❑ SIGN ADD RETAINING E] DEMOLISH WALL ALTER ❑ ORFILLEl EXCAVATE © (.I NCx..l�.:..Ft.) REPAIR CI PRE -IN PMOVE SWINt POOL TN,HER OF STORIES I NUMBER OF DWELLING .IT. -1 "il`- 7 JOB ADDRESS NAME Fee ReeclPt No Plan Check No.. ................... PERMISSIBLE LOT COVERAGE. mqs� ADD11E88 PERMISSIBLE HEIGHT C CITY ACTUAL LOT AREA F Z TOTAL BLDG. AREA REQUIRED YARDS PROPOSED YARDS FRONT SIDE NEW Lj RESIDENTIAL ❑ LINE NON-RESIDENTIAL ❑ SIGN ADD RETAINING E] DEMOLISH WALL ALTER ❑ ORFILLEl EXCAVATE © (.I NCx..l�.:..Ft.) REPAIR CI PRE -IN PMOVE SWINt POOL TN,HER OF STORIES I NUMBER OF DWELLING .IT. -1 "il`- 7 JOB ADDRESS Valuation Fee ReeclPt No Plan Check No.. ................... PERMISSIBLE LOT COVERAGE. + / L //—�� LOT'COVERAGE PERMISSIBLE HEIGHT PROPOSED HEIGHT ACTUAL LOT AREA BUILDING TOTAL BLDG. AREA REQUIRED YARDS PROPOSED YARDS FRONT SIDE REAR FRONT SIDE REAR PLUMBING LEGAL LOT VARIANCE OR CONDITIONAL USE ❑ YES ❑ NO PERMIT NUMBER PLANNING DEPT. APPROVAL DATE: STREET R/W O EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY COMP. PLAN ST. R/W ............FT. ............FT. REMARKS & O P1 [] YES [] NO YES [] NO OF EDMONDS. LOCAL SALES TAX "'"---""- -` '•--'-- -" "` "�'"' Valuation Fee ReeclPt No Plan Check No.. ................... x BUILDING illus PROPOSED USE PLUMBING O a pt[getD�) PLOT PLAN (Indicate Building ectbackq si �[J(' HEAT & 6A9 LINE h \ JI O FENCE SIGN tRETAINING WALL N 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 Is correct; and that I am the owner, or the duly author- ized agent or the owner. I agree to camD1Y with city and state law. regu- ATTENTION APPLICATION APPROVAL lating Construction; and In doing the work authorised thereby, no person will be employed In violation of the Labor Code or the Biala or Waehlneton TINS PERMIT This application Is not a permit until relating to Workmen. Compensation Insurance. AUTHORIZES signed by the Building Official or his De P - NOTE: Permit Limit One Year (Except DEMOLITIONS which ONLY THE IL WORK NOTED Uty; and fees are paid, and receipt is ac - shall be completed In ninety days; MOVED -111 BUILDINGS shall be win- knowledged in space pleled In eta months.) provided. SIGNATURE (OWNER OR AGENT)DATE SIGNED INSPECTION DEPARTMENT DTRE R'e BIQNATU i 7, CITY OF EDMONDS DATID NOTE: Applicant Subject to Plan Check Fee PR d-1107 r7 TN. Permit coven work to be done on Private property ONLY. Any construction on the public domain (curbs, sidewalk., drlvew"s, INSPECTOR nr4�,r.,•,, He.) r,'lll rreolrr .Sporule p—ISO... ,. < �� r •�!� .v .a ..�.P.,...- '^��r:, f ���::., rrl "NiDl'. �I..'I:'�S^y(!i�l:yF•s•v►'•, n''}''i.K +.�H.,YTa '.'y7: �►`�.%2x`M"Ao�ilihla>'i � ..�i