740155.pdfPERMIT NUMBER7= 0155
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PERMIT APPLICATI®N Inside
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NAME (OA NAE 08 HUBtNEee)
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PERMIe IBLE HEIGHT
PROPOSED HEIGIIT
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ACTUAL LOT AREA
TOTAL OLD(;, AREA
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REQUIRED YARDS
PROP08ED YARUe
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FRONT BIDE
It FRONT HIDE. REAR
NAME
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LEGAL NDITIONAL USE
OT VARIANCE OA CO
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YES NO PERMIT NUMBER
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PLANNI 0 DEPT. APPROVAL DATE-
CITY
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XLEP ONE NUMBERI
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STBEE
EICIBTI O STREET R/W ............FT.
DEFICIENCY THIS PROPERTY
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NAME.....
COMP PLAN BT. R/W ............Fr.
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BY
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CHECKED
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METER SIZE
SERVICE SIZE
CLEARANCE
CHECKED BY
STATE LICENSE NUMBER I CITY L,IC118110 NUMBER
REMARKB
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Legal Description of Property (show Bela. or Attach Four Copies)
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TYPE CONNECTION
VERIFIED BY
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PERMIT NUMBER
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REMAR 8
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FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
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[] YES ❑ NO
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SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
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❑ RESIDENTIAL
OAS
❑ LINE
❑ YES NO
BY
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❑ NEW
PLAN NECKED
THIS SITE IS LOCATED IN THE CITY
❑ NON-RESIDENTIAL
❑ SIGN
EDMUNDS. LOCAL SALES TAX
SH OULD BE CODED 31,04,
❑ ADD ❑
❑ WALL NINE
REMA K8
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DEMOLISH
❑ ALTER EXCAVATE FENCE
❑ OR FILL D (........ .5 ......... Ft.)
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❑ REPAIR ❑ PRE -swim
IN pMOVE ❑ POOL
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NUMBER OF STORIES NUMBER OF
DWELLING
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1
UNITS
NA'//T}IJI{J,RE OF WORK TO BE DONNE '
Valuation
Fee Receipt No.
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Plan C eck N o .....................
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BUILDrO
PROPOSED UBE
PLUMI�IN6
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GAS LINE
aPLOT
PLAN (Indicate Building astbacks, abutting streets)
HEAT.
FENCE
BION
tRETA�NING
WALL
SWI+NO POOL
DEMOLITION
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PRE -MOVE INSPECTION
III
EXCAVATION On FILL
L AMOUNT DUE
TOTAI,
I hereby acknowledge that i have read this aDPlicatlon; that me In-
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-
tormatlon given 1e correct; and that I ami the owner, or the duly wthor-
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tied agent of the owner. I agree to Comply with Citymand state law. Mgu-
ATTENTION
APPLICATION APPROVAL
;
111log Cotruetion: and la doing the work authorised thereby, no Person
will be employed In VlolaUon of the Labor Code of the Stale of Washington
ISIS PERMIT
This application is not a permit Until
relating to workmen's Compeneatlon Iasursaee.
JAUTIIOIUZES
signed by the Building Official or his Dep -
NOT Permit Limit One Year (E...Pt DEMOLITIONS which
ONLY THE
•ORB NOTED
Utyi and fees are paid, and receipt is ac-
ehglI bee Dleled la .tasty days; MOVED -IN BUILDINGS shall be coin.
knowledged in space provided.
D led In moot
ONATU 10 NT) DATE BIO ED
E O AGE
INSPECTION
DEPARTMENT
DI OR'S QI/_11GNAT�_aw
It/� 7 i•__1,,
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CITY OF
D/� �i %%�fl�/"� (i� r' Lal
EDMONDS
Applicant Subject to Plan Check Fee
TE:
Pit e•1107y�—
ls Permit coven work to be, done oo Private property ONLY.
Any comtruetloo m the public domain (Curbs, sidewalks, drivewgs,
FILE
marquees, Na) will require eeDara's Permissloa.
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j USE PERMIT .1
BUILDING DEPARTMENT I Applicant Fill ZONE NUMBER 1
PERMIT APPI.ICATI®N Illgide Heavy "Anes ADDRESS , y/ �, - "1.:
NAME (OR NAMH OF HUSINKes)
PERMIa81DLE ACTUAL
A rl�e� LOT COYERAGe LOT COVESYAOE i 1
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21AILINP ADDRESS G
rig PERMISSIBLE HEIGHT i'ILOY09ED ILE76HT
BEa ACTUAL LOT AREA TOTAL BLUO. AREA 777j1
Rt:QUIn ED YAItUtl PILOPUtlEU YARUa ;
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NAME FRONT AIDE REAR FISOIiT RIDE REAR
i F .
U LEGAL LOT VARIANCE OR CONDITIONAL USE
ADDRESS 0 YES ❑ NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
CITY TELEPHONE NUMBER —STREET R/W
EXISTING STREET R/\V ............FT. DEF)CIENCY THIe PROPERTY
NAMEf
(.., P. PLAN ST. R/W ............FT. ............Fr.
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Cd ADDRESS °x
8"449 11. /E,�i �x / //LE Z'i_1
�J J I CHECKED BY
CITY T'Hy� P?ONE NUMBER
O((, , I /'"/J —� METER SIZE I SERVICE SIZI) I CLEARANCE CHECKED BY iI
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STATE LICENSE NUMBER I CITY LICENBE NUMBER !n
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REMARKS � 1
Legal Description of Property (Show Below or Attach Four Copies)
TYPE CONNECTION (VERIFIED BY i I
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I PERMIT NUMBER y. 1
In
O REMkR\ I In
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FIRE ZONE TYPE OF'ONS ft- ZI aSPROVED
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SPECIAL INSPECTOR REQUIRED OCCUPANC G /
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NEW 0 RESIDENTIAL ElLINE❑GAS PLAN IYESCHEC..G'.N
El THIS SITE IS LOCATED IN THE CITY i
NON-RESIDENTIAL slGx OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
ADD ❑ DEMOLISH WALL InNG REMARKS
ALTER Ej EXCAVATE FENCE
OR FILL ......... .s .......... Ft.)
REPAIR PRE -MOVE swim
INSP. POOL
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO HE DONE Valuation Fee Receipt No.
Plan Chock No ..................... �
[[[O 11 _ BUILDING ,
PROPOSED USE L
PLUMBING
0
PLOT PLAN (Indicate Building setbacks, abutting streets) HEAT A GAS LINE
b
� FENCE
SIGN
tRETAINING WALL
eWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
Ihereby acknowledge that I have read this application; that the /n-
tarmnlion given Is correct; and that I am or -
the owner, or the duly auth
(zed .gent of the owner. i agree to comply with city and state laws regu- ATTENTION APPLICATION( APPROVAL
iatl.g construction; and In doing the work authorized thereby, no person
will be to
In violation Of the Labor Code of the State of Washington THIS PERMIT This application is not a permit until '
relating to workmen'. compensation Imuran. AUTHONZES signed by the Building Official or his Dep -
ONLY TIIE
NOTE:, Permit Limit One Year (Except DEMOLITIONS which WORK NOTED uty, and fees are paid, and receipt is Be
.halt be completed In Wooly days; MOVED -IN BUILDINGS shall be once. knowledged In apace provided.
plated In slit ceoalhy.?
INSPECTION
SIGNATURE (OWNEROft AGENT_) DATE SIGNED DIRE R'9 S1 UR / (.
/ DEPARTMENT / A /`
- - CITY OF
EDhIONDB DATE , /
NOTE: Applicant Subject to Plan Check Fee / `/ I
PR 6-1101
This Permlt mucro work to be done on privet. property ONLY. 1 '
Any construction on the patello docud. (curbs, etdewaik*, drlvew.10. INSPECTOR
nu rquees, etc.) will raq.1r. separate parmis.lm.
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RECORD OF INSPECTIONS
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Date Passed
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Foundation
Plumbing (Partial)
(Rough) -0 -7�f
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Frame
Furnace & Fuel Lines -
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