740156.pdfr
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BUILDING DEPARTMENT pppllcant Fut
ao�NE /�,5� 8y NUMBER 740156
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PERMIT APPLICATION Inside Healy Lines
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ADDRESS
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NAM/E///pJp�R AME F BU8INE88
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LOT OVER E '7o LOT CO %
IAT COVERAGE �/ LOT COVERAGE �
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MAILING ADDRESS
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PERMISSIBLE HEIGHT QQ It/IO.P.08gg(J/�//I�IEIOH�T/�
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CITE
T�,6AP UiP NE,NUMBER
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ACF'UAL LOT AREA TUTA BLD[G��jAI{EA
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REQUIRED YARDS PROPOS(,AROS
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FRONT SID' REAR FRONT SlI REAR
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LE6 LOT VARIANCE OIL CONDITIONAU8E.
B 9 — IffRMIT NUMBER
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P N6 A P O AL DA
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CITY T LEPBONE NU BER
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EXIST O STREET R/WN.. .... DEFICIENCY THIS PROPERTY
NAME
COMP. PLAN ST. R/W.�........
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REMARIIB
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ADD' B8�z.
Driveway slopes not to exceed those
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indicated on Standard Dwg. No. 103
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C1 T LEP80NE NU ER
METER SIZE SERVICE SIZE CLEARANCE
CHEC BY
ATE LICENSE NUMBER
CITY 'LICENSE i UMBER
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Legnt DeecrlDtlon Property
Attach Four
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of (Show Below or Caples)
TYPE CONNECTION
VERIFIE IIYYl
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PERC. TEST
PERhS1T MB R
REMARKS
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FIREZONETYPE OF CONSTR.U/CTION ETRE T IAtPROVED
NO
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SPECIAL INSPECTORE RUIRED(OCCUPANCY
GROUP
RESIDENTIAL
GAS,�
❑
� YES
IXI NEW
K-�
LINE
PLAN CHECKED H THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL
� SIGN
OF EDMONDS. LOCAL SALES TAX
/ �/ �(�{ SHO i D 8 DED 31 04
ADD RETAINING
WALL
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DEMOLISH
ALTER EXCAVATE FENCE
r=Jr%G///JJ �.f�r1 L'. i-�(Ji✓ �.:� L'/
❑ OR FILL f.........I%
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FIREPAIR PRE -MOVE SWIM
INSP. POOLI
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-56/i3 fh<C; I—V 0i(/
NUMBER OF STORIES NUMBER OF
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DWELLING /
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UNITS
NATURE OF WORK TO BE
Ili—of
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Valuallon
Fee Rtctlpt Na.
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Aa � _!'O&
Pian Check No .....................
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BUILDING
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PROPOSED USE
PLUMBING
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PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT &CAS LINE
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FENCE
SIGN
RETAINING WALL
SWIMMING POOL
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DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
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I hereby eck0awladge that i have read this application; that
the in-
formation given Is correct; and that I am the owner, or the du
y author-
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toedagent of the owner. I agree to Comply with city and stats
aces rogu-
'
intm6 constntctlon; and In doing the work authorised theroby,
no person
ATTENTION
APPLICATION APPROVAL
will be employed In violatten of the Labor Code of the Stale of Vyuhl'Eton
THIS PERMIT
This application Is not a permit until
'
relating to Workmen's Compe... U.. Insurance.
AUTHORIZES
signed by the Building Official or his Dep.
NOTE: Permit Limit One Year (E.Cept DEMOLITIONS
,htch
ONLY THE
WORE NOTED
uty; and fees are paid, and receipt is ac.
.hall be completed In ninety days; MOVED -IN BUILDINGS shall
be core-
knowledged In space provided.
pitted 1%.I. mouth..)
B (OWN R GENT) TE SI
NED �
INSPECTION
DI R' ATU..iDEPARTMENT
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CITY OF
ATE
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NOTE: Applicant Subject to Plan Che Fe
EDMOf'iD8
PR g-1107
This Permit coven work to be done on private property ONLY.
Any Construction Do thepublic domain (Corby, old.::., drNeways,
marquees, etc.) Will require separate prrmbeim.
FILE
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BUILDING DEPARTMENT Applicant Fill
USE ( PERMIT
ZONE Gs� NUMBER
PERMIT APPLICATION Inside Heavy Lines
ADD... l 0
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NAME (OR AME OF HUBINEBB) .�;
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f �' rt" / �'. .L <. (� f.• ./�:�(!/fir'..'•-L^%
PERMISSIBLE ^• , ACTUAL /
LAT COVERAOF.s �S � LOT COVAAOE
MAILING ADDRESS
I'EfiMISaIBLE HEIGHT �}{; ItUPos" HEIGHT
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C1TYI
tZEEPBUOREE-WUMBERACTUAL
LOT AREA TOTAL ULUO. AREA
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YLj•) - -^"�-
REQUIR D YARUH P POaEd YAyA RU
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NAMEI
FRONT BIDE! REAR FRONT SIDI IRF,AIt
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LEGAL, LOT VARIANCE OR CONDITIONAL URF -
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ADDRESS
[� O F RMIT NUMBER
�Y£8
DATE:
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CITY
TELEPHONE NUMBER'�
EXISTI 6 STREET A/W �FT. V DEFICIENCY THIS PROPERTY
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NAME
✓ ren .'>
LAN a /W ..:..FT. .. .
REMARKS f�.ri\Ir-,J?V `Oil c"'•- ��t to c: ).t�('t':! �.,:(i .'.
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ADDRESS
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GHECKE,D.{(BY
CITY
/
E PHONE NUMBS
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iJN II r-yj, 11� 1./ 6- r e.?CI
JI.F{ jV�K.�N
�tETER SIZE SERVICE/ SIZE
CLEARANCE
CHECKED BY
STATE LICENSE NUMBER
NUMBER I
CITY LICENSE
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as
2
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REMARKS
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Legal Description of Property (Show Below or Attach Four Copies)1
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TYPE CONNECTION
V RIFI'11 'Y,
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PE C T B
PERMIT`IYJIIMBER
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FIRE ZONE TYPE OF CONSTJU e M ROVED
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❑NO
SPECIAL INSPECTOR REQUIRED
OCCUPANCY
6A8
NEW -• RESIDENTIAL ❑ LINE
❑NON-RESIDENTIAL
❑ YES &74'
.1— ; _J _ /
I
,
PLAN CHECKED %Y THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
❑ BION
❑ ADD RETAINING
`J .J'y:.,�Ij � �;; ._.,�'' SHOULD BE CODED 31.04.
REMARKS)
❑ ❑ WALL
TE EXCAVAFENCE
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ALTER ❑
ALTER
OR FILL ❑ (.....................Ft.)
❑ REPAIR ❑ PRE-MOVE SWIM
INSP. El
"y /
.-i✓/� J�:�.:/ /(/ (!�/.: j /rlJl_ /.'✓S//'= ��;>•.'//./�
NUMBER OF STORIES NUMBER OF
..' DWELLING
I
UNITS
NATURE OF WORK TO HE
,
Valuation
Fee RecelPt No.
(DONE
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Plan Check N..... _...............
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BUILDING
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PROPOSED USE
PLUMHIN6=-
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APLOT
PLAN (Indicate Building eetbacka, abutting Street.)
HEAT & GAS LINE
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FENCE
.SIGN
tRETAINING
WALL
N
SWIMMING POOL
DEMOLITION
PRE-MOVE INSPECTION
EXCAVATION OR FILL
rLoe�6_7
TOTAL AMOUNT DUE
I hereby acknowledge that 1 have read Ni. application; that the 1n-
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 and state law, regu-
ATTENTION
APPLICATION APPROVAL
laung construction; and kq 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,
relating to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep-
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TILE
WORK NOTED
uty; and fees are paid, find receipt is so
.hall be completed In ninety day.; MOVED-IN BDILDINGS Shall be win-
knowledged in apace provided.
pitted In six months.)
SIGNATURE (OWNER OR,AGENT) DATE SIGNED
INSPECTION
DEPARTMENT
DI CTOR'Q -S ONATluftE /
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(•,,.•
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CITY OF
EDMONDS
DATE
NOTE: Applicant Subject to Plan Check Fee
PR d-1107
This Permit wren work to be done on private property ONLY.
Any construction on the public domain (curb., sidewalk., driveways,
INSPECTOR
marquees, etc.) will require separate permission.
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