740168.pdfLj DEMOLISH Lj WALL
ALTER EXCAVATE FENCE
�i
❑ OR FILL (.........s..........Ft.)
REPAIR ❑
INSP. POOL
NUMBER OF STORIES NUMBER OF
DWELLING /
�-�-_
C
_.
NATURE OF WORK TO BE DONE
BUILDING DEPARTMENT
RMIT
ZONE NU SEs
�
Fee
RecelPt No.
Applicant M
740168
.
/
��Y'fl.F��'-C-
PERMIT APPLICATION
Inside Heavy Lines
JG
o
/'• k/(�/(//�
!!��
PROPOSED USE
ADDRESS
O
PLUMBING
N E (OR NAME OF BUSINESS)
�/•_L
W
HEAT A OAS LINE
,�
a I
�y� ^
S� nV✓L
1,t ,�
_ J (/h/NU
PER MIBBIBLE ACTUAL q
IAT COVERAGE
FENCE
N
(�P
M IL[NG ADDRESS
LOT COVEHAGE
SIGN
RETAINING WALL
PERMISSIBLE HEIGHT PROPOSED HEIGHT
C
X
N
SWIMMING POOL
1
CITY welLeuragNm
UIM/B'ER
AL LOT AREA TOTAL BLDG. AREA
?'
!
PRE -MOVE INSPECTION
C ' I ,
N
11
EXCAVATION OR FILL
l W
—� / v
REQUIRED YARDS PAOPOBED YAHD9
a
I hereby acknowledge that I have read this applicallan; that the in.
�
d , %
/ / -/C
�/ t� J
NAME
FRONT BIDE REAR FRONT SIDE REAR
APPLICATION APPROVAL
I�
will be employed In violation of the Labor Code of the State of Waahlogton
relating to Workmen'. Compensation Insurance,
THIS PERMIT
is
This application is not a permit until
permitun
NOTE: Permit Limit One Year DEMOLITIONS
AUTHORIZES
ONLY TRE
signed the Building Official his
(Except which
shallbe completed In ninety days; MOVED -IN BUILDINGS .full be corn.
WORK NOTED
ULYi and fees are paid, and receipt Se ac-
ac-
ADDRESS
INSPECTION
NCE OR CONDITIONAL USE
LEGAL LOT VARIANUR
0 YES NO PERAtIT atBE
SIGNATURE (OWNER OR AGENT)
DATE BIONED
_
DEPARTMENT
OR
CITY OF
EDBiONDB
PR 6-1107
nATE
!fi /0�
V
CW
CITY
TELEPHONE NUMBER
PLANNING DEPT. APPROVAL )—J DATE:
marquees, etc.) willreemn separate permisalon.
FILE
STREET R/1Y
EXISTING STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
t7
�
NAME
'n
COMP, PLAN ST. R/W ............ Fr. ............FT.
Pi
REMARKS
ADDREB
x
:
CHECKEBY
D
W
E+
z
CITY
ELEPHONE NUMBER
I.r
J(�
o
U
METER 8125,
el•.ftV10E SIZE
CLEARANCE
CHECKED HY
STATE LICENSE NUMBER
CITY
LICENSE NUMBER
REMARKS
g
j
Legal Description of Property (Bbaw Eelow or Attach FOW Copies)
TYPE CONNECTION
VERIFIED BY
Z
i
s,
PERC. TEST
PERMIT NUMBER
d,
I
�
REMARKS
W
.7
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
YES C3 NO
SPECIAL INSPECTOR REQUIRED
GROUP
I
RESIDENTIAL
GAS❑
❑
YES NO
(OCCUPANCY
NEW
LINE
PLAN CHECILED DY THIS
SITE IS LOCATED IN THE
ADD
NON-RESIDENTIAL
SIGN
RETAINING
CITY
OFOEDD BNDS, DLOCAL 04SALES TAX
REMARKS
!
Lj DEMOLISH Lj WALL
ALTER EXCAVATE FENCE
�i
❑ OR FILL (.........s..........Ft.)
REPAIR ❑
INSP. POOL
NUMBER OF STORIES NUMBER OF
DWELLING /
UNITS
NATURE OF WORK TO BE DONE
Valuation
Fee
RecelPt No.
Plan Check NO .....................
.
/
��Y'fl.F��'-C-
BUILDING
o
/'• k/(�/(//�
!!��
PROPOSED USE
O
PLUMBING
HEAT A OAS LINE
a I
aPLOT
m
PLAN (Indicate Bulmtng eetbncke, abutting streete)
7
FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
1
DEMOLITION
PRE -MOVE INSPECTION
,
EXCAVATION OR FILL
I hereby acknowledge that I have read this applicallan; that the in.
TOTAL AMOUNT DUE
d , %
/ / -/C
�/ t� J
farmntlon given Ie correct; and that I am the owner, or the duly author-
ATTENTION
APPLICATION APPROVAL
lred agent of the owner. I agre `lo comply with city and .lata law. "In.
lating coaetructlon; bad to doing the wort( authorised thereby, no person
will be employed In violation of the Labor Code of the State of Waahlogton
relating to Workmen'. Compensation Insurance,
THIS PERMIT
is
This application is not a permit until
permitun
NOTE: Permit Limit One Year DEMOLITIONS
AUTHORIZES
ONLY TRE
signed the Building Official his
(Except which
shallbe completed In ninety days; MOVED -IN BUILDINGS .full be corn.
WORK NOTED
ULYi and fees are paid, and receipt Se ac-
ac-
Pleled In six months.)
INSPECTION
knowledged In apace provided.
DIRECT TUl
SIGNATURE (OWNER OR AGENT)
DATE BIONED
_
DEPARTMENT
OR
CITY OF
EDBiONDB
PR 6-1107
nATE
!fi /0�
NOTE: Applicant Subject to Plan Check Fee
Tide Permit coven work to be done oa private property ONLY.
Any construction on the public domala (curb., sidewalk. drivew..ys,
marquees, etc.) willreemn separate permisalon.
FILE
USE PERMIT I �`
BUILDING DEPARTMENT Applleant Fill ZOO NUMBER
I Inside Heavy Lines ADDRESS
PERMIT APPLICATION
N ME (OR NAME OF BUSINESS)
PERMIBSISLE ACTUAL
�i )� ! t '• �__� ( ii? �1UL.` LOT COVERAGE LOT COVESiAGE
MAILING ADDRESS PERMISSIBLE HEIGHT PROPOSED HEIGHT [
O Uhl , ll•.. (U_ __tel,(, .<.,' AREA Z }
PHONENUMBER ACTUAL LOT AREA TOTAL BLDG. A ! f
CITY , A
RFi I
PRO PORED YARDS
•�': {.alt C.-'}r,r- �, i ) 1 G REQUIRED YARDS
NAME FRONT BIDE REAR FRONT BIDE REAR
'Iv
Ityr i
1Uj ADDRESSLEGAL YES LOTS NO PERMIT NUMBERNDITIONAL USE '..j
PLANNING DEPT. APPROVAL DATE:
0 �G i
CITY TELEPHONE NUMBER
STREET R/W 17
EXISTING STREET R/W ............F -I'. DF,FICIENCY THIS PROPERTY
NAME
^ I COMP. PLAN ST. R/W ............F'T. ............FT.
REMARKS
41 Z tLADDRESS - +i � f
C / � CHECKED BY
FCITY NE I TELEPHONUMBER
Z {
$
METER SIZE I SERVICE 812E I CLEARANCE I CHECKED BY
L CENSE NUMBER
STATE LICENSE NUMBER CITY D7
REMARKS g
Legal Description or Property (Show, Below or Attach Four Copies)
TYPE CONNECTION � / I VERIFI • D I ! ,�J
F PERC. TES
PERMIT
�U2 /�
a
PROPOSED USE
PLUMBING
n REMARKS
'
HEAT h GAS LINE
�
L
i7 FIRE ZONE TYP
CONSTRUCTION
IMPROVED
.7
IBTREET
f
RESIDENTIAL LINE
El
NEN �
NON-RESIDENTIAL SIGN
ADD RETAINING
❑ DEMOLISH O WALL
ALTER ❑ EXCAVATE FENCE
OR FILL (.......... g .......... Ft.)
swim
REPAIR ❑ INSP. ❑ POOL
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE
`
�r'-kms QCT.
0 YES 0 NO
SPECIAV INSPECTOR REQUIRED OCCUPANCY GROUP
NO A
❑PLANBCHECKED BY THIS SITE IS LOCATED IN THE CITY
�
OF EDMONDS. LOCAL SALES TAX
REMARKS SHOULD BE CODED 31.04.
/Ll'Sla// ?7v
/ '-
, t
�f
t
j
Valuation Faa Reeaint No.
Plan Check No........ _........... I '
BUILDING 4
i
PROPOSED USE
PLUMBING
V
PLOT PLAN (Indicate Building setbacks, abutting .tree(.)
HEAT h GAS LINE
dD�
L
FENCE
SIGN
�
1
RETAINING WALL
I
N
—
I
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
.j, 77
I hereby nrhnowledge'that I have read this application; that the In-
�
� !
!
formation given Is correct; and that I am the owner, or the duly author.
-
!
Iced .,,atof the owner. I egn. to comply with city and slate law. rein-
ATTENTION
APPLICATION APPROVAL
{
lett.. construction; and m doing the work authorised thereby, no person
will noemployed In violation of the Labor Code of the State of Washington
TIDE PERMIT
This application is not a permit until
relating to Workmen's Compensation Immrance.
AUTHORIZES
signed by the Building Official Or his Dep -ONLY
'
NOTE: Permit Limit One Year (Egespt DEMOLITIONS which
TO
WORK NOTED
uty; and fees are paid, and receipt is Be
shall be completed In Nnaty days; MOVED•IN ]BUILDINGS shall be com-
knowledged In space.provlded.
plated In elk mouths.)
SIONATUItE (OWNER OR AGENT) DATE 811IN11D
INSPECTION
DIRECTOR'S SIONATFIRE
. ' - -
DEPARTMENT
- -
CITY OF
EDMONDS
DATE
NOTE: Applicant Subject to Plan Check Fee
PR 11-1107
This Permit coven work to be done .a private property ONLY.
I - Any const)prtioa oa the Dubuc domain (-'be, sidewalk-, drivnwg7s1
INSPECTOR
rttlMuaes. Co.) wUI reemre npuW parminlae.
.. .J%,-�...