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Plan Check No .....................
BUILDING
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PLUMBING
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BUILDING DEPARTMENT
Applicant FIR
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aPLOT PLAN (Indicate Building eetbacke, abutting streets)
PERMIT APPLICATION
Inside Heavy tines
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FENCE
ADDRESS
SIGN
NAME (OR NAME IN 8)
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PERMIHSIHLE a ACTUAL /
LOT COVERAGE %15 /G LOT COVESiAOE a</
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MAILING ADDRESS_
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DEMOLITION
PER1,118SIBLE HEIGHT / PROMD HEIGHT
PRE -MOVE INSPECTION
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CITYI�.
'I' NUMBER/
ACPUAlyLOf' O.REA� TOTAL HUD 6 AREA
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�PIHONE�•.�
(,rRE,QUIRE YAIt UB I''RO�yPO ED YARUH
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AMOUNT DUE
NAME
FRONT SIDE REA FRONT BIUE REAR
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formation given le correct; and that I am the owner, or the duly author-
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y
ADDRESS
LEGAL LOT VARIANCE Olt CONDITIONAL U E
AE NO PERAt1T NUbSBER
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will be employed In violation of the Labor Code of the State of
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N6 DEPT. Pilo' DATE:
This application is not a permit until
relating to Workmen's Compensation Insurance.
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CITY TELEPHONE NUMBER
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ONLY TIS
WORK NOTED
uty; and fees are paid, and receipt is ac -
shall be completed In ninety days; MOVED -IN BUILDINGS shall be cum-
knowledged inaco provided.
THEE /W
£XIS 6 STREET .. sx, I.1F.CY THIS PROPERTY
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ON R RE (O OR AGENT)DATE
NAME
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COMP. PLAN ST. R/ /7..... -FT. ....Q...FT.
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CITY or
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REMARKS Driveway slopes not to exceed those
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EDMONDS
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This Permit coven work to be done on private property ONLY.
CIIEC E BY
CITY TELEPHONE NUMBER
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STATE LICENSE NUMBER
CITY LICENSE NUMBER
METkka'.I rBILE I SERVIC SIZE CLEARANCE
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REMAARRKKS
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Legal Description of Property (Show Below or At soh o Copies)
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REMARKS
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FIRE ZONE TYPE OF CONSTRUCT;ON STREET IMPROVED
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... � YE9 n NO
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SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
REBiDENTIAL
GAB
LINE
❑ YES
® NEW
PLA -CHECK o n THIS SITE 15 LOCATED IN THE CITY
NON-RESIDENTIAL
aiaN
OF EDMONII.DS. LOCAL SALES TAX
ADD
RETAINING
RE ARK 9`'.
DEMOLISH WALL
ALTER EXCAVATE FENCE
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OR FILL (.......... ........... .'.)
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REPAIR ❑ swi
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NUMBER OF STORIES NUMBER OF
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Plan Check No .....................
BUILDING
(O
Y PROPOSED USE
O tyV
PLUMBING
HEAT & GAS LINE
y • on AV
aPLOT PLAN (Indicate Building eetbacke, abutting streets)
FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
AMOUNT DUE
/ 1
I hereby acknowledge that I have tend thiseDPlleatlo.; that the In.
formation given le correct; and that I am the owner, or the duly author-
Ized agent of the owner. I agree to Comply with city Gad state laws nail.
ATTENTION
APPLICATION APPROVAL
,at... construction; and in doing the work authorized thereby, no person
no
will be employed In violation of the Labor Code of the State of
THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation Insurance.
AUTHORIZER
signed by the Building Official or his Dep -
NOTE: Permit limit One Year (Except DEMOLITIONS which
ONLY TIS
WORK NOTED
uty; and fees are paid, and receipt is ac -
shall be completed In ninety days; MOVED -IN BUILDINGS shall be cum-
knowledged inaco provided.
pleled In six months.)
/Taco
ON R RE (O OR AGENT)DATE
SIGNED
INSPECTION
R C 'B 810 ATUHE
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DEPARTMENT
CITY or
EDMONDS
ATE
NOTE: Applicant Subject to Plan Check Fee
PR 6-1101
4-4--14
This Permit coven work to be done on private property ONLY.
Any ,...truffle. on the pebno dental. (curbs, .IdewslW, driveway.,
marquees, etc.) will require separate permission.
�� ,PERMIT
BUILDING DEPARTMENT
Applicant Fill
USE �l i � L� NUMBER
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PERMIT APPLICATION
Inside Heavy Ltneg
JOB
ADDRESS
NAME (OR NAME OF. BUSINESS)
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4/ ACTUAL /
LOTPE CO ERA �'� IAT COVE AOE
LOT COVERAGES
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MAI LIN6ADDRESS
PERa/lBBIBLE HEIGHT PRO�Q$E fIIvIOF(ITell
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ACPUAIA TOTAL B7D 1 AREA
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FIRE ZONT111 11 1011ET_RUON
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ONE NUMBER
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REQUI RED YARDS PROPOSED YARDS
N
I'�STREET
YES No
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FRONT BIDE REAP FRONT BI E REAR
SPECIAL INSPECTOR REQUIRED OCCUPANCY
NAME
1
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a7 ADDRESS
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SITE IS LOCATED IN THE CITY
LE¢AI, LOT VARIANCE OR CONDITIONAL U, E
NUMBER
v4]�YES• ❑ NOMI UMBER
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p RESIDENTIAL
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NEW
P N N6 DEPTH A�PRO/� PAT
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C CITY
rELEPHONE NUMBER
'STREET /LV ^� _
EXIS�NO STREET R/ F7. /bCiFtCIENCYTHIS PROPERTY
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NAME
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ST.
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COMP PLAN
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A \DRESS
DEMOLISH
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..CHEC Ery BY
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TEyLEP/HONH.��NJJUMBER
❑ ALTEREXCAVATE
❑ ORFILL
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CITY
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BERVlCE SIZE CLEARANCE
CHECKED BY
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8 �,;._,"\ •,'^
(,jCI?
METER SIZE
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OF
STATE LICENSE NUMBER
CITY CENSE NUMBER/',
2
WEL
IG
REMARRB ,
UNITS
Legal Description of Property ...w Below
'or Attach�Fo Copleel
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TYPE CONNECTION
VVERIF Y
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BUILDING
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PROPOSED USE
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FIRE ZONT111 11 1011ET_RUON
ILPROVED
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I'�STREET
YES No
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SPECIAL INSPECTOR REQUIRED OCCUPANCY
GROUP
❑ YES w
PLAN -CHECKED BY
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SITE IS LOCATED IN THE CITY
p RESIDENTIAL
OAS
❑ LINE
NEW
THIS
EDMNlLOCAL04. SALES TAX_
❑ NON-RESIDENT
AL ❑ BION
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SHOULD CB1E CC ODED 31
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❑ ADD❑ ❑
RETAINING
WALL
REMARKS
DEMOLISH
FE CE
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❑ ALTEREXCAVATE
❑ ORFILL
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❑ REPAIR ❑ FRE- OVE
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POOL
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NDUMNUhBER OBE
OF
WEL
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UNITS
NATURE OF WORK TO BE DONE
Valuation
" Fee Receipt No.
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Dlon Cheek No .....................
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BUILDING
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PROPOSED USE
PLUMBING
q
LINE
WWO PLOT PLAN (Intllcata Building ertbaeke,
abutting etraete)
HEAT A CAS
p
FENCE
SIGN
tRETAINING
WALL
N
-
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
'
N; ,;
EXCAVATION OR FILL
t;
'TOTAL AMOUNT DUE
/ 1 , .c� '7 -i 7
I hereby acknowledge that I have reW
this application; that the In-
'
formation given Ie correct; and that I ami
Ized agent of the owner. I -gree to comply
the owner, or the duly author-
with city end state I -We regu-
ATTENTION
APPLICATION APPROVAL
Ialing construction; and In doing the work
authorized thereby, no person
,
Will be employed 1. violation of the Labor
Code of the Stale of Washington
THIS PERMIT
This application is not a permit until
relating to Workmen's COmPea-Ut t Insu(ance,
AUTHORIZES
signed by the Building Official or his Dep-
NOTE: Permit Limit One Year
(Escapt DEMOLITIONS which
ONLYTHE
WORE NOTED
uty; and fees are paid, and receipt is ac -
.hall be completed In -lusty days; MOVE7
BUILDINGS than be com-
knowledged in space provided.
plated In .la mo -Ula.)
INSPECTION
DIRECTOR'S SIGNATURE
SIGNATURE (OWNER OR AGENT)
DATE SIGNED
_
71f
DEPARTMENT
1'
r /.
CITY OF
EDbLONDB
ATE
r�
LPH
NOTE: Applicant Subject
to Plan Check Fee
6-1107
�
This Permit coven Work to be done
Any co-etruetioa oa the public domain
on pHvate property ONLY.
(curbs, sidewalks, driveways,
INSPECTOR
marqueeeparate
permh;Z.
_
t!. ',. r.:..... �. -, .y, r ,-..�..•Ytr:... .e F-�4 'kG; n 'u: j,�.+i^ :.%�.� :'h':T �, .AA a -.IN . ��F-S^'��. ''r�5 '1;k° "�`
The south 70.00 feet of the north 210.00 feet of the west 95.00 feet of the
east 115.00 feet of the southwest quarter of the northwest quarter of the
southwest quarter of section 25, township 27 north, range 3 east, W.M.
Also subject to and together with an easement for the installation, operation
and maintenance of a drain line, over, under, across, through and upon the
west 10.00 feet of the east 40.00 feet and the south 10.00 feet of the north
75.00 feet of the west 38.00 feet of the east 78.00 feet, all in the north
210.00 feet of the east 115.00 feet of the southwest quarter of the northwest
quarter of the southwest quarter of section 25, township 27 north, range 3'
east, W.M. Also subject to and together with an access easement across south 4
10.00 of the south 70.00 of the north 210.00 feet of the west 95.00 feet of the
east 115.00 feet of the southwest quarter of the northwest quarter of the
southwest quarter of section 25, township 27 north, range 3 east. W.M. 1
Situated in Snohomish County, Washington
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