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LE LOT ARIA NCE OR CON mT10NAL US
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PERMNUMBIh1R 140106
B 01 L D 1 RI O DEPARTMENT
AppLcant Fill
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PERMIT APPLICATION
Inside Heavy Lines —
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414r•a+ori nn ctanriard NO. No. 103
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NAME (OR NAME OF BUSINESS)
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PF.RMISeIHLE %
COVERAGE
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NAME
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V ADDRESI
A CITY
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Z U18 �xsO /750
YED ARDS
BUILDING
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FRONT SIDE 1 FRONT BIDE REAR
REAR
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LE LOT ARIA NCE OR CON mT10NAL US
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EXISTIN STREET R/w ....... DEFICIENCY THIS PROPERTY
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_ Plan Check No ................ _...
414r•a+ori nn ctanriard NO. No. 103
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RESIDENTIAL O LINE
NEW ❑NON-RESIDENTIAL BION
ADD ❑❑ WALL NINO
DEMOLISH
ALTER ❑ OREXCAVATE ❑ FENC...........
Ft.
REPAIR ❑ swim
IN PMOL POOL
NUMBER OF STORIES I NUMBER OF
Z DWELLING
UNITS
NATURE OF WORK TO BE DONE
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CHECKED HY
NC I CHE E HY
70
RI •I D
RM T N M ER Is
to
f
FIRE ZONE TYPE OF CONE RUCTION STREE IMPROVED
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BUILDING
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SPECIAL INSPECTOR R WIRED
...UP''ANCY GROUP
PLUMBING
HEAT A GAB LINE
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PLAN CHECK D THIS SITE IS LOCATED IN THE CITY
'� OF EDMONDS. CAL SALES TAX
SH.ULD BE CODEDLO31 04.
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Valuation Fcc Receipt No.
_ Plan Check No ................ _...
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BUILDING
PROPOSED USE
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3 g0t4G
.� PLOT PLAN (Indicate Building setbacks, abutting streets)
PLUMBING
HEAT A GAB LINE
eL
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O
O
FENCE
"ION
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
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1 hereby acknowledge that I have read this application; that the 1n-
formatmn given Is correct: and that I am the owner, or the duty author -
,.ed agent of the owns. I agree to comply with city and .tate law. regu-
eotruetlon; and in doing the work authorised thereby, to person
lating m
will be employed in violation of the labor Code of the "tate of Washington
ATTENTION
TIDE PERMIT
APPLICATION APPROVAL
This application is not a permit until
relating to workmen's Compensation Insurance.
AUTRORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITION" which
.hall be completed In ale days; MOVEDAN 13UELMINGS shall be aom-
ONLY THE
WORE NOTED
uty; and fee" are paid, and receipt Is Be
knowledged in space provided.
pl In months.)
S1QNAT WNER O AO ) DATE BION D
1
NOTE: Applicant Sub o P►an Cilrck Fee
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6•1101
IgE 'S SIONATUI
AT
FILE
This Permit ca re work to be dean oa private peeparly ONLY.
Any constructionroo the public domain 11-b*, sidewalks, driveways,
marquees, etc.) will require Separate permiWon.
s-- DENOTES EXIST. GRADE
1
— DENOTES FIN. GRADE
s-- DENOTES EXIST. GRADE
— DENOTES FIN. GRADE
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Sw0i4oM1G4l couNTY
DATE REVISION
ADDRESS
2o412 Soi. Ave.w.
PLOT PLAN
JOB NO.
3 •1' 4 1L�0-10
'5
SCALE— I 1U�
I
(TELEPHONE NUMBER
STREETR�vV !y,�
EXISTINt. STREETft/W .)/...'.�..: DEFICIENCY THIS PROPERTY
COMP. PLAN 8T. R�W!1./�... .._5.,...FT.
RFIDIARKH (11`j VCwal slopes not to r'XC@t?t'. thosc
indicitcrl On Standard Lin. No. 1('13
- HE KFjD-HY
(TELEPHONE NUMBER
MET7 8'2L•' I SERVICE f8KE
1ZE I CLEARANCE I CHECKED BY
CNSE NUMBER C[TY CENSE NUMBER lY
�'� 4__�� REMARKS
ptton of Property (Show Below or Attach Four
C7p_l I r1r// UL /�.f' �L �, •l- li // ��C!/ �i� / /�
IO WC)0WAI.� Q(D k TYPE CONNECTION VERI /�D �R
NO
NEW
F ADD
❑//
ALTER
r
❑
-
PLAN CHECKEI�BYYESO
;'• /•
��
� ;;l •-[-�--:-/
RW1SA0�
/ ,� ` ^
/ /l/`i .S.`f ��",-i
I ,� -'
OF EDMONDS.O LOCALED (N THE CITY
SALES TAX
SHOULD BE CODED 31.04.
iC/, •'I :�C--F.!/ J�'� 1�
-
❑
BUILDING DEPARTMENT
Applicant Fill
USE n _ NUMBIFTR
lC� �}• p I{(ate
BUILDING
/0 ;!U
PERMIT APPLICATION
I Inside Heavy Llne.
ADD RESS �4 n /�',% - rA� l�r�R �i)�.Y't '•
U X
PRE -MOVE
INSP.
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POOL
NAME (OR NAME OF BUSINESS)
A
T
-
C�- -I'a M� t I 1\
s
S (
!f f /! i i , / `�:= �'
PERM/ddIHLE ^ .y, D ACTUAL %
LOT COVERAGE' �� i O LOT COVE AGE
IUMDER OF STORIESNUMBER OF
2-
MAILING ADDRE88
fo
DWELLI NO
!{IGf\T9PO
PERMISSIBLE ki EIGRT O
SMITH`
O
RETAINING WALL
CITY
T PRONID NUMBER
ACTUAL LO _ARETOTAL )%
UNITS
SWIMMING POOL
II
I\,At2—ot8/
YARDS
REAR FRONT B-17UE AR
•P]•
PRE -MOVE INSPECTION
NAM81FRONT
NAME
�B7IDF
�
O
N
ADDRESS
I hereby acknowledge that I have reed this application; that the In-
LEDAL LOT T VARIANCE. OR CONDITIONAL U8
PERMIT NUMBER
.Y'
formation w
formation given to correct; and that I athe owner, or the duly author-
Ised agent of the owner. I agree to comply with City and elate law. regu-
PLA DE R V I. UA
APPLICATION APPROVAL
I
(TELEPHONE NUMBER
STREETR�vV !y,�
EXISTINt. STREETft/W .)/...'.�..: DEFICIENCY THIS PROPERTY
COMP. PLAN 8T. R�W!1./�... .._5.,...FT.
RFIDIARKH (11`j VCwal slopes not to r'XC@t?t'. thosc
indicitcrl On Standard Lin. No. 1('13
- HE KFjD-HY
(TELEPHONE NUMBER
MET7 8'2L•' I SERVICE f8KE
1ZE I CLEARANCE I CHECKED BY
CNSE NUMBER C[TY CENSE NUMBER lY
�'� 4__�� REMARKS
ptton of Property (Show Below or Attach Four
C7p_l I r1r// UL /�.f' �L �, •l- li // ��C!/ �i� / /�
IO WC)0WAI.� Q(D k TYPE CONNECTION VERI /�D �R
NO
NEW
F ADD
❑//
ALTER
RESIDENTIAL
NON-RESIDENTIAL
❑ DEMOLISH
EXCAVATE
❑
LINE
SIGN
RETAINING
WALL
FENCE
PLAN CHECKEI�BYYESO
;'• /•
��
� ;;l •-[-�--:-/
RW1SA0�
/ ,� ` ^
/ /l/`i .S.`f ��",-i
I ,� -'
OF EDMONDS.O LOCALED (N THE CITY
SALES TAX
SHOULD BE CODED 31.04.
iC/, •'I :�C--F.!/ J�'� 1�
-
❑
OR FILL
(......... :.......... Ft.)
BUILDING
/0 ;!U
1,1
E] REPAIR
❑
PRE -MOVE
INSP.
❑
swim
POOL
? G' i d /
s
S (
!f f /! i i , / `�:= �'
1 .
I
IUMDER OF STORIESNUMBER OF
2-
DWELLI NO
1
RETAINING WALL
-
N
UNITS
SWIMMING POOL
II
DEMOLITION
For Receipt No.
�
Plus Check No .....................
BUILDING
/0 ;!U
1,1
PROPOSED USE
PLUMBING
aim Gi U
! I0p l t_,
PLOT PLAN (Indicate Building setback., abutting streets)
HEAT d: OAS LINE
�•� L'_.`)
FENCE
SIGN
RETAINING WALL
-
N
_
SWIMMING POOL
II
DEMOLITION
PRE -MOVE INSPECTION
I
I
EXCAVATION OR FILL
TOTAL AMOUNT DUE
J. Lf �'. L.-_ .1/ •/ G ,A j
I hereby acknowledge that I have reed this application; that the In-
.Y'
formation w
formation given to correct; and that I athe owner, or the duly author-
Ised agent of the owner. I agree to comply with City and elate law. regu-
ATTENTION
APPLICATION APPROVAL
I'll,, construction; and In doing the work authorlsed thereby, no person
will be employed 11 A.111tlo¢ of the Labor Code of the .tate of Wa M.Ion
THIS PERMIT
This application is not a permit until
rsi.U.g to Workmeu'e Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit limit One Year (EXCept DEMOL1TIGN8 which
ONLY TILE
WORK NOTED
utyl and fees are paid, and receipt is ac -
shall be completed In bluely day.; MOVED -IN BUILDINGS shall be Som-
knowledged in space provided.
pleted,ln eta months.) !I 1,.
.. j
310NAT E (OWNER ORPAOE ) I ( I , DATE S16N, D 1
(
INSPECTION
DEPARTMENT
` O
DIRECTOR'S SIGNATURE
�...-�
CITY OF
NOTE: Applicant Subject fo Plan Check Fee
EDh
I
DATEIONDB �
PR a-LI07
-2
This Permit Coven work to be done on private property ONLY.
1
Any Construct, n on the public domain (curbs, sidewalk., driveway.,
INSPECTOR
nu>reuees, ele.I win rrgmre separate Permission.
9