740122.pdfIUNITE /
NATURE 9F' WORK TO BE DONE
.-
Valuation Fait Receipt No.
,11
i
BUILDING
DEPARTMENT
BUILDING
ONE —6 USE NUMBER 740122
/O q d0
M PROPOSED USE
AppllcantFW
p
PLUMBING
PERMIT APPLICATION I Inside Heavy LI -11-
ADDRESS
NAME -10 O BUS1N B 2
PLOT PLAN (Indicate Building setback., abutting streets)
C e'tj�j
PE......BI WL'ACTUAL
LOT COVERAGE ���/ LOT COVE4FAOE (,
I
;
at
MAILING AD REBS
I ! � /i
�� (
PEIt\iISdIIILE HEIOIl'C PR SEU HEIO �1
✓ t7 // !(.vYi YiKN
C '
SIGN
ONENUMHER
^
AC !; LALOT ARTA TOTAL UL I ARE
A
N
Z'27
REQUICED YARDS PROPOSED YARDS
SWIMMING POOL
NAM
DEMOLITION
FR/JO,N�T BIIDDE REAR FRONT SIDE REAR
PRE -MOVE INSPECTION
EXCAVATION OR FILL
VARIANCE Olt CONDITIONAL UB
NLEGAL LOT
ADDRESS y0 NO PE ITN BER
yFr
PLAN D P V L DTE:
a
I
TOTAL AMOUNT DUE
y' CITY TELEPHONE NUMBER —
1 j
!
c
BT 'ET {V
p
ized agent of the owner. I agree to comply with city and state (awe ngu-
ATTENTION
]o'7(IBTI STREET R/ DEFICIENCY THIS PROPER TV
titling zin"c"tl'.; and la doing the work authorized thereby, no person
NAME
THIS PERMIT
This application is not a permit until
W
AUTHORIZES
signed by the Building Official Or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac.
COMP. PLAN BT. R/6pr. ....�.FT.
REMARK' Driveway to
thosew�
.
knowledged In space provided.
pleted In six month..)
�7 ADv EBB
SIGNATt1RE-(ONNER OR G T)
!'
slopes not exceed
indicated on Standard D• No- 1n3.
1 O B Sl ATU E
w
DEPARTMENT
'CITY
HONE NO
Al i
F
ATE
NOTE: Applicant S -4-t to Plan Cbeck Fee
SIZE SERVICE ZEOVLEARANC
This Permit coven week to be done on private property ONLY.
STATE LICENSE NUMBER ! CITY LICENSE NUMBER
METER B CHEC1 8
I / (� I I -
FILE
marquees, etc.) will require separate pernWalon.
REMA KS L
!P
L gal Dearrlpt11, o1 Properly Show Bslow or Attach Four Copies)
TYPE CONNECTION VERiF1ED�vB/Y�)
.S 1CFV LAK
� 7 �
1
t' L'
PERC. TEST
�I
A
REMARKS
W
I
V
W
J
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
_A/ NO
SPECIAL INSPECTOR REQUIREDOCCUPANCY ROUP
G
RESIDENTIAL
❑ OA8
C]_ YES I 7!
'
NEW LINE PLAN CHECKED B THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL
s1GN
1 - OF EDMONDS. LOCAL SALES TAX
ADD
El
❑ RETAIN—
WALL
/
(iti' SHOULD BE CODED 31,04,,
Ems' tARKB�
1
DALTER
DEMOLISH
EXCAVATE
FENCE
f-2// lliysi�GdGri'lc.i f�e-Z'/�,/,l3 Ci /y %D
❑ OR FILL
❑ (.....................Ft.)
REPAIR ❑ swim
IN PMOYE
El POOL
C. `/'V'a- G�'/ 7� G!/" j I/ C //✓1PGi7e�✓f
NUMBER OF STORIES NUMBER OF
DWELLING
IUNITE /
NATURE 9F' WORK TO BE DONE
.-
Valuation Fait Receipt No.
,11
Pian Check No .....................
[f)
BUILDING
/) /_t�
/O q d0
M PROPOSED USE
p
PLUMBING
oO
PLOT PLAN (Indicate Building setback., abutting streets)
HEAT d: GAB LINE
C e'tj�j
�=
FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
1 j
I hereby acknowledge that I have read this application; that the In-
/ J (. / !7
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 (awe ngu-
ATTENTION
APPLICATION APPROVAL
titling zin"c"tl'.; and la doing the work authorized thereby, no person
Will be employed In violation of the Labor Code Of the Stale of Washington
THIS PERMIT
This application is not a permit until
relating to Workman's Compensation Insurance.
AUTHORIZES
signed by the Building Official Or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac.
.bull be completed In mpety day.; MOVED -IN BUILDINOs Shall be corn-
knowledged In space provided.
pleted In six month..)
SIGNATt1RE-(ONNER OR G T)
DA E 810 ED
INSPECTION
1 O B Sl ATU E
J
DEPARTMENT
CITY OF
OND
EDMONTS
O
ATE
NOTE: Applicant S -4-t to Plan Cbeck Fee
PB 6-1107
This Permit coven week to be done on private property ONLY.
Any coaeiru.Him on the public domain (curbs, sidewalk., d lv—.Y..
FILE
marquees, etc.) will require separate pernWalon.
0&et_, Ind�ut
BUILDING DEPARTMENT Applicant Fill 2ONE ` — C PERMIT
UT BIER r
PERMIT APPLICATION InH,de Heavy Lmeg JOB
n
ADDRESS
NAME tORN / J " /" '
'-"FJ)' PEI(MIBtlfHLE ^ n / ACTUAL 1
LOT COVER
AGFa / LOT COVF-SYAGE 4=
PERMISSIBLE HEIOIITADDAE88 U' A��MAAREA�O T1'ORTO/A.B�LU�L,�I
lv,,Cl ONE U'YTRE/QUD
YARDS I'ROPOBED Y RUN
NAME FRONT HIDE REAR FRONT BIDE REAR
fD r / -';.It 2i' S' S•— iS 7L
LEGAL LOT VARIA C LONI)ITIONAL UH -
.H ADDRESS yE9' NO PE IT BER ;
U PL/AN {EP .
CITY 71ILEPHONE NUMBER
LT
E ET V p
EXIeT1NIi, ^REF.T R/Ld�.'..��r. DEFICIENCY THIS PROPERTV
NSE %':� �_ / COMP. PLAN BT. 2/K-..:/./`!�.`:F'r. ....\...�.FT.
\)_-/'t.�if �---v REMARKS Driveway slopes not to exceed those ,
AD indicated an Standard No. No 103. w
/ /+ l t' c CHIEC1K H �
`n F' TY BOND NUMB
UTE I� l- I) 1( � (I
LMiE1VTFSR SI'LE j SERVICD SIZECLEARANCE CHECKE HY
Gl STATE LICENSE NUMBER G, I CITY LICENSE NUMBER
REMARKS ! 1
Lygai Description of Property (HhaW Below or Attach Four Copies)
t (� f•,-/ -=-ei ,� TYPE CONNECTION VERIFI D 8
'r 7 /
o - i�
� PER a PE afIl TS ER C
R � � m
VIT Pi Li 5 n
Q i
j
FIRE ZONE TYPE OF CONSTRU TRH. DROVEDNO
I I
.rf f r
SPECIAL INSPECTOR REQUIRED IOCCUPANCY GROUP
RESIDENTIAL GAS ❑ YES ((j-IVO / _T__ / i
LINE PLAN, CHECKED II THIS SITE IS LOCATED IN THE CITY
NEW O ` /; OF EDMONDS. LOCAL SALES TAX
NON RESIDENTIAL SIGN may_ /,. SHOULD 8E CODED 31.04. oc _
ADD ❑ RETAINING RE ARKS
E]E3DEMOLISH WALL
ALTER ❑ EXCAVATE FENCE
.OR FILL (.......... x.......... Ft.)
❑
REPAIR PRE-MOVE swim
❑ INBP. POOL �i-'V-" / /!/ Ii/'/ _l i / L: /!'/-Y/-1-/�✓/'/S
NUMBER OF STORIES NUMBER OF
1 DWELLING /
UNITS
NATURE OF WORK TO BE DONE
`J Vuluallon Fee RecelPt No. i
Plan Check No—- ................ ,
I
((:(� BUILDING c�Il (;wV L/
of PROPOSED USE
a PLUMBING
ani
� PLOT PLAN (Indicate Building setbacks, abORfig etreete)�_ HEAT @GAB LINE
9
n FENCE �
SIGN
tRETAINING WALL
N
SWIMMING POOL
DEAfOLITION
PRE-MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE '�!J /its -
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 sego. ATTENTION APPLICATION APPROVAL
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 THIS PERMIT This application is not a permit until
re AU.9 to Workmen's Compensation Insurance. AUTHORIZES signed by the Building Official or his Dep-
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED Uty; and fees are paid, and receipt is ac-
shall be campteted In ninety days; MOVED-IN BUILDINGS shall be com- knowledged In space provided.
plated In six months.)
SIGNATURE (OWNER ORAGENT)DATE SIGNED INSPECTION DIRECTOIrB tlIONATU E
DEPARTMENT " %
CITY OFwT� E�
EDMONDS
NOTE: Applicant Subject io Plan Check Fee
rn 6-lip,
This Permit coven work to be done an private property ONLY.
Any construction on the public domain (..be, sId.watke, driveways, INSPECTOR
marquee., Ste.) w10 tall. separate p-mleelon.
.j