740081.pdfRESIDENTIAL F� NEW ❑ LiNE
NON-RESIDENTIAL ❑
SIGN
ADD ❑ DEMOLISH WALKING
LFJ
ALTER EAVAT❑ OR FILL E ❑ P'ENC........... Ft.)
REPAIR ❑ PRENa MOVE ❑ Pool,,
NUMBER OF STORIESDWELLNUMBER OF
CAI 4r-- I UNITS INC
NATURE OF WORK TO BE DONE
[[[zrrr
/V _#--,V- 1//1 oN/77LL �/,(��Zfir BUILDING
PROPOSED USE
PLUMBING
/l��si.b�nJC�
O PLOT PLAN (Indicate Building eett,"ke, abutting streets) HEAT d: GAS LINE
5
� FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
PERC. TEST PERA11'I' NUdInGR F,
3
REMARKS co
FIRE ZONE ITYPE OF CONSTRUCTION STREET IMPROVED
D YES ❑ NO
SPECIAL INSPECTOR REQUIRED IOCCUPANCY GROUP
E3 YES ❑ NO
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
Plan Check No...........
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
formatdo. given U correct; and that I am the owner, or the duty author-
ised agent of the owner. I agree to comply with city and state laws raga-
ATTENTION
Is Ing construction; and In doing the work authorised thereby, no parson
will be employed in violation of the Labor Code of the Elate of Washington
THIS PERMIT
relating to Workmen's Compensation Imuraaa.
AUTHORIZES
NOTE: Permit Limit One Year (Eieept DEMOLITIONS which
ONLY THE
WORE NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall a com-
pleted In sig mouth.,)
�-�- BUILDING DEPARTMENT Applicant Fill
USE PFRWT 7081
ONE NUMBER t ��
DEPARTMENT
Inside Heavy I.In°°
PERMIT APPLICATION I
ADDRESS
�%/
CITY OF
NAME (OR NAME OF BUBINEeg)
/7 6 `�/� /� —
�-' E
NOTE: Applicant t Su to Md. Check Fre
rn 8.1101
PERMIBeIBLE % ACTUAL
LOT COVERAGE LOT COVERAGE
j
AI O ADDRUSIS
SN
PERMISSIBLE HEIGHT PROPOSED HEIGHT
a
i
O
PHONE NUMBER
ACTUAL LOT AREA TOTAL BLDG. AREA
CITY
REQUIRED YARDSPROPOSED YARDS
REAR
t
i !
I
T
NAME FRONSIDE REAR FRONT BIDE
VARIANCE OR CONDITIONAL USE
I
ADDRESS
LEGAL LOT
0 YES 0 NO PERMIT NUMBER
i
M
CANNING DEPT. APPROVAL DATE:
i
CITY TELEPHONE NUMBER
STREET R/W
t9
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
j[dy
i
NAMMH%/,t�
C
COMP. PLAN °T. R/W ............FT. ............FT.
.tom
C 1 6 E-(C�,y -
RFIMARICB
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Id
ADDRESS _
CHECKED BY
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C TELEPHONE NUMBER
m9G
METER 01LE SERVICE SIZE CLEARANCE
CHECKED BY
°TATE LICENSE NUMBER CITY LICENSE NUMBER
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C
�
REMARKS
RESIDENTIAL F� NEW ❑ LiNE
NON-RESIDENTIAL ❑
SIGN
ADD ❑ DEMOLISH WALKING
LFJ
ALTER EAVAT❑ OR FILL E ❑ P'ENC........... Ft.)
REPAIR ❑ PRENa MOVE ❑ Pool,,
NUMBER OF STORIESDWELLNUMBER OF
CAI 4r-- I UNITS INC
NATURE OF WORK TO BE DONE
[[[zrrr
/V _#--,V- 1//1 oN/77LL �/,(��Zfir BUILDING
PROPOSED USE
PLUMBING
/l��si.b�nJC�
O PLOT PLAN (Indicate Building eett,"ke, abutting streets) HEAT d: GAS LINE
5
� FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
PERC. TEST PERA11'I' NUdInGR F,
3
REMARKS co
FIRE ZONE ITYPE OF CONSTRUCTION STREET IMPROVED
D YES ❑ NO
SPECIAL INSPECTOR REQUIRED IOCCUPANCY GROUP
E3 YES ❑ NO
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
Plan Check No...........
This PermR coven work to be done on "'Irate property ONLY.
Any anst.ctlon on the public cloned. (.tubs, eidawalks, driveways,
maeouees, eta.) will ream. separate peroWsla.
Valuation I Fee
1 3, g-0 176,
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 apace provided.
DIRT RIB SIONATURE
DAT
-aiTr 7V
FILE /
ad
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
formatdo. given U correct; and that I am the owner, or the duty author-
ised agent of the owner. I agree to comply with city and state laws raga-
ATTENTION
Is Ing construction; and In doing the work authorised thereby, no parson
will be employed in violation of the Labor Code of the Elate of Washington
THIS PERMIT
relating to Workmen's Compensation Imuraaa.
AUTHORIZES
NOTE: Permit Limit One Year (Eieept DEMOLITIONS which
ONLY THE
WORE NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall a com-
pleted In sig mouth.,)
SIGNATURE (OWNER OR AGENT DATE SIGNED
INSPECTION
DEPARTMENT
p 7
CITY OF
EDMONDS
NOTE: Applicant t Su to Md. Check Fre
rn 8.1101
This PermR coven work to be done on "'Irate property ONLY.
Any anst.ctlon on the public cloned. (.tubs, eidawalks, driveways,
maeouees, eta.) will ream. separate peroWsla.
Valuation I Fee
1 3, g-0 176,
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 apace provided.
DIRT RIB SIONATURE
DAT
-aiTr 7V
FILE /
ad
OAS ❑ YES
�RESIDENTIAL LINE
❑
PLAN CHECKED BY
THIS SITE IS LOCATED IN THE CITY
NEW
OF EDMONDS. LOCAL SALES TAX
..
NoN•RESIDENTIAL SIGN
SHOULD BE CODED 31.04.
'.
1
REMARKS
USE PERMIT
❑RETAINING
DEMOLISH
ALTER ❑ ORCFILL AVATE ❑ FENCEx.......... Ft.)
BUILDING DEPARTMENT Applicant Fill
ZOO Nu BSER`
swim
REPAIR ❑ ID SP. ❑ POOL
Lines
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PERMIT APPLICATION IDalda wavy
JOB
ADDRESS — / — 1•
DWELLING /
C1 Al C-- UNITS C� I' .r
t'
NATURE OF WORK TO BE DONE /
Valuation Fee Receipt No. ".
NAME (OR NAME OF BUSINESS)
PEHMI88IBLE % ACTUAL
I,OT COVEAOE
i
L 7 i (
1 ( _
LOI' COVERAGE
;
PROPOS2u UBE
PLUMBING
A1LIN0 E.AD REB
PERh1188IBLE HEIGHT BED HEIGHT
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7
•R
ACTUAL LOT AREA TOTAL BLDG. AREA
_
CITY
ON
REQUIRED YARDS PROPOSED YARDS
E(
{{
FENCE
I
REAR FRONT REAR
FRONT BIDF. d3DR''aV
SIGN
NAME
T
ftETAININ6 WALL
USE
E., S
N
q
LEGAL LOT VARIANCE OR CONDITIONAL
,
'
POOL
j
ADDRESS
❑ YEB ❑ NO PERMIT NUMBER
DEMOLITION
yOj
Ny
S
PLANNING DEPT. APPROVAL DATE:
)
,O. TELEPHONE NUMBER
CITY
EXCAVATION OR FILL
_
a
STREET 8/W
EXI8TIN6 STREET R/W ............FT. DEFICIENCY THIS PROPERTY
•� 5O i 4' 6
NAME
COMP. PLAN ST. R/W ............FT. ............FT.
ys
•+
formation given Is correct; and that I am the owner, or the duly author -
bed agent of the owner I agree to comply with city and state laws regu•
ATTENTION
APPLICATION APPROVAL,
W
THIS PERMIT
This application i9 not a permit until
d ADDRESS
C
will be employed In violation of the Labor
relating to WoMkmea's Compensation Indutmee.
AUTHORIZES
signed by the Building Official or his Dep -
Cj,TY
PHONE NUMBER
ONLY THE
uty; and fees are paid, and receipt is ac -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
be
WORK NOTED
/v
I
shall be completed In nicety days; MOVED•IN BUILDINGS .hall cone-
Tom. ))t —7y.�
/ ' �(J O ` C/'
METER SIZE BERVICE 81Z1 CLEARANCE
CHECKED BY
Din OR '8 1NAT ,
OTATE LICENS/tE HUMBER
CITY CENSE NUMBER
I I
FFB�
(/{'
/
cT-c•(9 � ll / •' '-1 1 Ip �
I
REMA1tKe
.
DATE
I --
—
Legal Description of Properly (Shaw Blow .r Attach Four Coplee)
NOTE: Applicant Subject to Plan Check Fee
_ PR g•uoI
'
TYPE CONNECTION VERIFIED BY
.y
INSPECTOR
Any db.slrutllem on the public domain iambs, sidewalk., driveways,
PE RMIT NUMBER
p;
Fy
D
j11i
'
•REM
n
R 8 I '
D
0
FIRE ZONE TYPE OF CONSTRUCTION BTR ROVED
7
I
❑YES [3 NO
SPECIAL INSPECTOR REQUIRED
GROUP'+''
NO
IOCCUPANCY
�RESIDENTIAL LINE
❑
PLAN CHECKED BY
THIS SITE IS LOCATED IN THE CITY
NEW
OF EDMONDS. LOCAL SALES TAX
..
NoN•RESIDENTIAL SIGN
SHOULD BE CODED 31.04.
'.
ADD
WALL
REMARKS
❑RETAINING
DEMOLISH
ALTER ❑ ORCFILL AVATE ❑ FENCEx.......... Ft.)
.
swim
REPAIR ❑ ID SP. ❑ POOL
NUMBER OF STORIES NUMBER OF7
DWELLING /
C1 Al C-- UNITS C� I' .r
NATURE OF WORK TO BE DONE /
Valuation Fee Receipt No. ".
I4
Plan Check NO ........ _........ ...
i
L 7 i (
BUILDING
PROPOS2u UBE
PLUMBING
()
1
I
7
W'
PLOT PLAN (Indicate Building setback., abutting street.)
BEAT d GAS LINE
32
FENCE
I
1
SIGN
T
ftETAININ6 WALL
N
ISWIMMING
POOL
j
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
•� 5O i 4' 6
TOTAL AMOUNT DUE
Ihereby acknowledge that I have read this application; that the In-
•+
formation given Is correct; and that I am the owner, or the duly author -
bed agent of the owner I agree to comply with city and state laws regu•
ATTENTION
APPLICATION APPROVAL,
is".. construction; and In doing the work authorised thereby, no pardon
Code of the Stale of Washington
THIS PERMIT
This application i9 not a permit until
will be employed In violation of the Labor
relating to WoMkmea's Compensation Indutmee.
AUTHORIZES
signed by the Building Official or his Dep -
ONLY THE
uty; and fees are paid, and receipt is ac -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
be
WORK NOTED
knoWledged in space provided.
shall be completed In nicety days; MOVED•IN BUILDINGS .hall cone-
pleted In elx moplhs.)
SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
Din OR '8 1NAT ,
-
DEPARTMENT
/
(/{'
,.-•- —i-: ,- �`
CITY OF
EDM OltiD3
DATE
I --
—
NOTE: Applicant Subject to Plan Check Fee
_ PR g•uoI
This Permit coven work to be done on private property ONLY.
INSPECTOR
Any db.slrutllem on the public domain iambs, sidewalk., driveways,
marquees, etc.) will require separate permledon.
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RECORD OF INSPECTIONS
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Date Passed
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Foundation
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Plumbing (Partial)
(Rough) !ZUS
Frame
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Furnace & Fuel Lines
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Final._.,
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