740167.pdfeI z/ -//Z-- a �-
CITY
C�•
61 TELEPHONE NUItBER
N � I
g iyo,✓ys, 7 7 `%
STATE LICENSENUMBER CITY CESL% NHE NUMBER
X23-0/-IZ64Z
1 Leaal Deecrfolio, of Properly Itlhow Selow Or Altaehl Four Copies)
Plon Chrek Noy ....................
... _......
00
LINE
❑ O
PLANNCHECKED❑BY
NEW
BUILDING
USE PERMIT
NUMBER
�–'"{
SIGN
BUILDING I L D I N G DEPARTMENT
ADD
///h//� ���"
A6 _ 740167
PLUMBING
SIGN
PERMIT APPLICATI®N
Heavy 'A"'
JD
FENCE
WAIL
❑
ADDRESS
�o /a
REPAIR
❑ MOVE
INSP.O
NA (OR N OF BUstN
SWIMMING POOL
PERMISSIBLE ^ ACTUAL
IAT COVERAGE. LOT COVEM
STORIES NUMBER OB
DWELLING
DEMOLITION
gAppll—tZONE
HEIOFIT YI ' EU IIEIOR7'CITY
PRE -MOVE INSPECTION
u/ I/ _/ fPERMIddIBLE
EXCAVATION Olt FILL
O
O REA TOT L%t��S
I �f II/ACTUAL
/�"fie/�
Q IR DYARDd 1' OPUNU�iY IIUH
J2
Ihereby acknowledge that 1 have read this application: that the in.
NAME
FRONT HIDF. REAR FRONT NIDI' REAR
I
formation given Ie correct; and that I am the owner, or the duly author-
[y
U
W ADDRESS
i f
ATTENTION
,
lellag u'ametl,u; and In dolog the work aulhorLLed thereby, no parson
LED OT ASIAN E Olt CONDITIONAL U�
E O PERMIT NUMBER
,F,��.
will be employed In violation of the Labor Code of the slats of Washington
TITIN PERMIT
..- ._
PLANNING YT APPROVAL HATE:
relatlug to Workmen's Compensation Insurance.
AUTHORIZES,
Signed by the Building Official or his Dep-
NOTE: Permit Limit One Your (Except DEMOLITIONS which
V
CITY
TELEPHONE NUMBER
shall be completed In muely days; MOVED -IN BUILDINGS shall be ram•kit
ledged in space provided.
plated In six moothe.)
,tI GNAT E N RE
STREET I
F%iBTIN I/WI STREET !3/- 3iy� .c... DEFICIENCY THIS Pltdl'F:It1'Y
RE HIO ATUR
NAM
COMP. PLAN ST. 1S)� ......... ..�.FT.
jpaw,l
CITY Or
��n) t �iw7.CT_
„ ,•
JL
REMARKS
Driveway slopes not to exceed those
o
EDMONDS
A
eI z/ -//Z-- a �-
CITY
C�•
61 TELEPHONE NUItBER
N � I
g iyo,✓ys, 7 7 `%
STATE LICENSENUMBER CITY CESL% NHE NUMBER
X23-0/-IZ64Z
1 Leaal Deecrfolio, of Properly Itlhow Selow Or Altaehl Four Copies)
Q YES 0 NO
GROUP
-ATED IN THE CITY
LOCAL SALES TAN
Valuntlen Fee R -11-t No.
1. d/.✓J//lLCLT �vu.l !mac✓c–•---•�v.Y
'
Plon Chrek Noy ....................
RESIDENTIAL
00
LINE
❑ O
PLANNCHECKED❑BY
NEW
BUILDING
NON-RESIDENTIAL
E-1
SIGN
ADD
❑WAI.IA'NINO
DEMOLISH
PLUMBING
SIGN
REMARKS
ALTER
ORCFII.L A
❑
FENCE
WAIL
❑
........... Ft.,
REPAIR
❑ MOVE
INSP.O
SWIM
POOL
SWIMMING POOL
NUMBER OF
STORIES NUMBER OB
DWELLING
DEMOLITION
/
UNITS
PRE -MOVE INSPECTION
Q YES 0 NO
GROUP
-ATED IN THE CITY
LOCAL SALES TAN
Valuntlen Fee R -11-t No.
1. d/.✓J//lLCLT �vu.l !mac✓c–•---•�v.Y
'
Plon Chrek Noy ....................
00
21
BUILDING
PENCE
FO,
0, PROPOSED USE
UaJ�Lc.i�(✓C�
PLUMBING
SIGN
'1 O
vC
tRETAINING
WAIL
PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT A GAS IANFI
00
21
PENCE
SIGN
tRETAINING
WAIL
1
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION Olt FILL
TOTAL AMOUNT DUE
J2
Ihereby acknowledge that 1 have read this application: that the in.
/ .J�
I
formation given Ie correct; and that I am the owner, or the duly author-
lxed agent of the owner. I agree to comply with city and .tate laws regu.
ATTENTION
APPLICATION APPROVAL
lellag u'ametl,u; and In dolog the work aulhorLLed thereby, no parson
will be employed In violation of the Labor Code of the slats of Washington
TITIN PERMIT
This application is not a permit until
relatlug to Workmen's Compensation Insurance.
AUTHORIZES,
Signed by the Building Official or his Dep-
NOTE: Permit Limit One Your (Except DEMOLITIONS which
ONI.Y TINE
WORK NOTED
uty; and fees are paid, and receipt is Be
shall be completed In muely days; MOVED -IN BUILDINGS shall be ram•kit
ledged in space provided.
plated In six moothe.)
,tI GNAT E N RE
A t N
INSPECTION
DEPARTMENT
RE HIO ATUR
3 1 %
CITY Or
EDMONDS
A
NOTE: Applicant Subject to Plan Check Fee
PR 6•II07
(� r
This Permitcoven work to Ib done Ga private property ONLY.
Any construction oo the poll,, domain ,.be, sidewalk,, driveways,
mount. .. Ne., wk, reemre separate W dael,n.
FILE
I
\ GAB
,�- RESIDENTIAL ❑ LINE
i
•
i
cu EDMONDS. LOCAL SALES TAX I
31.04.
❑ADD
❑ WA ANO
REMARKS
13
U 1 L D 1 N G DEPARTMENT AppllPBDL Flu
ZONE E� NUMBERi
PERMIT APPLICATION Inside Heavy Line"
JOB t 7
ADDRESS � � � 1� iC.�li.P.� r7"e-�C'i��� i
NA(OR NAME OF BUSINE�g� 1,
}
I l)/l�.l.: /, � ��C..
vV (T✓f•
ACTUAL t.
LOT C 8B18LE ^ f
LOT COVERAGES LOT COVESYAOE
`
r
L3SI7�
NUMBER O� STORIES NUMBER OF
DWELLING
ADDRE88 T/� )
`'S•1 ;�
90MAILING
PK O D HEiOHTs'
PERMI881BLE HEIGHT .a � /
OF WORK TO BE DONE
/NATURE
'\
-J
!%N
IyREA TOTAL LDO. A/BEA
•�T`c'('J �..� �1.F..��l ..l
Pian Check NO .....................
BUILDING
PLUMBING
C1Tg TE PHO�N/E NUMBI)UIR
ACIUALjASr
AR
[[[yyy
PROPOSED USE -
A
27T IZ/
a
OUIREDYAK.. P OPOSLDY RDi
PLOT PLAN (Indicate Building setbacks,, abutting street.)
HEAT & CAB LINE
FRONT SIDE REAR FRONT 91DE, REAR
ZL U§E
FENCE
Ol
ADDRE88
LEOALJ OT VARSAN EOR CONDITIONAL
YES(/I� �} ND PERMIT NUMBER
RETAINING WALL
,
DEPT --
N
it
PLANNINO
i
ELEPHONE NUMBER
CITY
STREET �1' ^^ O
EXI8TING ST STREET RJ.W):�...:'�FP. DEFICIENCY THIS PROPERTY
'
' K�!^�)
COMP PLAN ST. A/Vl;':::P'f. ...C_, !FT• _
REMARKS -
NAM 7 -V
nL.•'IN C.jn.�s % , ��(✓
EXCAVATION OR FILL
ed t o^-
Lriceoa'y slopes not to : : ew
c3
ADDRESS
,1,-r% •
/u/ tr�1
01
�oxlffcn-
- ED B1
I hereby acknowledge Chat I Gave rend this appllcatlon; that the In-
(4;()R? J)J^;iI '
formation given le correct; and that I am the owner, or the duly author-
CITY
TELEPHONE NUMB ER
H
O
Zc� .!�%",�'/✓�),5) -V�
7 -I ., I
METER SIZE SERVICE 8[ZE CLEARAN CHECKBD BY
STATE LICENSE NUMBER
.
C TY ICENSE NUMBER
U
I I I �) 7
I.J." to Workmen*. COMPenentlon Iasurmre.
AUTHORIZES
)
3 - (, l lj`_
NOTE: Permit limit One Year (Except DEMOLITION" which
REMARKS +�
Uty; and fees are paid, and Ieceipt is ac -
Legal D ... ciptlon of Property)(Show Below or Att/cri Your
knowledged in apace provided.
-
pleted In S% months.)
INSPECTION
,C`opies))
�; �- /(.-,•�-/ Ll !�(� (J(%!/L�t IC-�
TYPE CONNECTION V RIF D Y'
I
COINED
jUI f(O"ER
g
_ I \ rev ,� '�
`E$T
I
PERC PERMIT,. UMBER d.
TE
Dw- i
%/- r")
NOTE: Applicant Subject to Plan Check Fee
PR 0-1107
I o
Thls Permlt coven work to be done on private Property ONLY.
Any co.struetl.n on the p.bU. domain (curb., eldewalk., drlYear- S.,
LC
INSPECTOR
m¢rOutee, ale.) will require setaeate Parml.sion.
.7
E
D
W
.I
1
FIRE ZOND T`1PE OF CONSTRUCTIO T4&t2AC5VED
I
YES [3 NO
I
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
\ GAB
,�- RESIDENTIAL ❑ LINE
❑ YES I] NO
PLAN CHECKED ➢Y
THIS SITE IS LOCATED IN THE CITY i
NEW
❑NON-RESIDENTIAL ❑ elGx
cu EDMONDS. LOCAL SALES TAX I
31.04.
❑ADD
❑ WA ANO
REMARKS
SHOULD BE CODED
�
(ED] DEMOLISH
❑ ALTER II El FENCE
❑ OR FILL ......... Ft.)
❑ REPAIR ❑ PWIM
❑ INP. OOL
!
NUMBER O� STORIES NUMBER OF
DWELLING
UNITS
V.W.U.. Fec Reeclpt No.
OF WORK TO BE DONE
/NATURE
'\
-J
!%N
'
•�T`c'('J �..� �1.F..��l ..l
Pian Check NO .....................
BUILDING
PLUMBING
[[[yyy
PROPOSED USE -
A
PLOT PLAN (Indicate Building setbacks,, abutting street.)
HEAT & CAB LINE
FENCE
SIGN
RETAINING WALL
N
-
SWIMMING,POOL. -
DEMOLITION
'
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DDE
/ r'J �r�•l '� r(
I hereby acknowledge Chat I Gave rend this appllcatlon; that the In-
formation given le correct; and that I am the owner, or the duly author-
'-
Iced agent of the owner. I agree to comply with City and state laws requ-
ATTENTION
APPLICATION APPROVAL
lating whet- Rod; sod In doing the work authorised thereby, no person
will be employed In NOlatlOR of the Labor Code Of the State Of Washington
THIS PERMIT
This application is not a permit until
I.J." to Workmen*. COMPenentlon Iasurmre.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit limit One Year (Except DEMOLITION" which
ONLY TILE
WORK NOTED
Uty; and fees are paid, and Ieceipt is ac -
e
shall be completed 1. ninety day.; MOVED -IN BUILDINGS .hall bcore-
knowledged in apace provided.
-
pleted In S% months.)
INSPECTION
I; r
DIREOTOR'S SIGNATURE
81GNATUR01, AGENT)
COINED
jUI f(O"ER
DEPARTMENT
�
CITY OF
EDMONDS
TE
Dw- i
%/- r")
NOTE: Applicant Subject to Plan Check Fee
PR 0-1107
I o
Thls Permlt coven work to be done on private Property ONLY.
Any co.struetl.n on the p.bU. domain (curb., eldewalk., drlYear- S.,
INSPECTOR
m¢rOutee, ale.) will require setaeate Parml.sion.
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