740169.pdfSTATE LICENSE NUMBER CITY CENSE NUMBER
2-23-01 - 75-5^?
t d•' LO I
RESIDENTIAL
❑
GASLINE
ENEW
BY _
NON-RESIDENTIAL
❑
SIGN
ADD
❑
DEMOLISH
r I
WALL NINO
ALTER
m
OR FAI.TE
❑
FENCi..........Vt.)
ECIAL INSPECTOR RREEQUIRED
OCCUPANCY GROUP
I /
~
�•--
DEPARTMENT
PRE -MOVE
INSP.
ZOIE NUMBER 0169
SWIM
POOL
IUMBER OF STORIES
NUMBER OF
SHOU LD BE CODED 31,04.
S
BUILDING
Applicant Fill
DWELLING
FENCE
UNITS
PERMIT APPLICATION
I)(Ilglde Heavy Lines
D
RETAINING WALL
N
ADDRESS��
1
SWIMMING POOL
NAME (OR NAME OF BUeffIE88)
--
PRE -MOVE INSPECTION
EXCAVATION OR FILL
PERMISSIBLEGES �^ ACTUAL /
LOT COVERALOT COVE?AAGE
I
./
r
`^� Q tog, re y�
MAILING ADDRE88O
�—r7
S 3
y
_
PERMI88IDLE HEIGHT PROPOSED HEIGHT
w<s�
ACTUAL TOTAL BLDG
z
U iN
formation given Is correct; and that I am the owner, or the duty author.
O Y
fP LEI9iONE NUMDIYR
(zed agent of the owner. [agree to comply with city and .tate laws ngu•
ATTENTION
X3/3
REQUIRED YARDS POBEU YARDS
{
THIS PERMIT
This application is not a permit until
NAME
AUTHORIZES
FRONT BIDE REAR FRONT BIDE REAR
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TILE
µ•OAR NOTED
and fees are paid, and receipt is ac -
shall l be completed In ninety days; MOVED -IN BUILD[N08 .heli be nom•
O
plcted In eta month,.)
tlION TORE (OWNER OR AGENT
DATE SIGNED
INSPECTION
LEGAL LOT VARIANCE OR CONDITIONAL USE
ADDRE88
DEPARTMENT
yEe NO PERMIT NUMBER
!L
j
CITYOF
.�
U
TELEPHONE NUMBER
PLANNING DEPT. APPROVAL DATE:
�!
l
PR 8-1107
s 7�
CITY
STREET R/W
O
FILE
,EXISTING STREET R/W ............ DEFICIENCY THIS PROPERTY
NAME
•+
............ ...
COMP. PLAN 8T. R/W FT. .FT.
II--
17 a
'
RREMARKS......
�
ad
'
G q4l N.F.- 1531"' ,-
CHECKED BY
O
8
W
e
CITY
TELEPHONE NUMBER
F
�p j� �p I
r'
- , I l
'CKED
��� •
/ O IJ
METER SIZE
SERVICE SIZE CLEARANCE
C
STATE LICENSE NUMBER CITY CENSE NUMBER
2-23-01 - 75-5^?
t d•' LO I
I I I A
RESIDENTIAL
❑
GASLINE
ENEW
BY _
NON-RESIDENTIAL
❑
SIGN
ADD
❑
DEMOLISH
r I
WALL NINO
ALTER
m
OR FAI.TE
❑
FENCi..........Vt.)
ECIAL INSPECTOR RREEQUIRED
OCCUPANCY GROUP
I /
REPAIR
YES �.if�
PRE -MOVE
INSP.
SWIM
POOL
IUMBER OF STORIES
NUMBER OF
SHOU LD BE CODED 31,04.
S
DWELLING
FENCE
UNITS
BION
I I I A
MARKS
Fce Recelpt No.
PE CONNECTION (VERIFIED
BY _
,
RC. TEST
AL/���_�
PERMIT N HER
Plon CbeeI. No.
r I
BUILDING
m
MARKS
BE ZONE TYPE OF CONSTRIJOTION STREET.IMPROVED
/�X —/.1 E8 0 NO
ECIAL INSPECTOR RREEQUIRED
OCCUPANCY GROUP
I /
V
OPLOT
YES �.if�
_T__
AN CHECKED HY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOU LD BE CODED 31,04.
S
r Aauxr: va wuxn au as uur,s
Valuation
Fce Recelpt No.
j•
�h �.�✓er� CG,�/7n /O
CLOS-t. r7
Plon CbeeI. No.
SI H4L C 4 4 r G Q 'Y
BUILDING
G, PROPO D USE
PLUMBING
V
OPLOT
PLAN (Indicate Building setbacks, abutting lnets)
BEAT A GAB LINE
S
FENCE
BION
RETAINING WALL
N
1
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read trueappllcalton; that the 1n•
U iN
formation given Is correct; and that I am the owner, or the duty author.
(zed agent of the owner. [agree to comply with city and .tate laws ngu•
ATTENTION
APPLICATION APPROVAL
Inllbg const Mellon; and In doing the work wthorlsed thereby, no personwill
be employed In violation of the Labor Code of the Stale of Washington
THIS PERMIT
This application is not a permit until
relating to Workmeb'e Compensation Ibaurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TILE
µ•OAR NOTED
and fees are paid, and receipt is ac -
shall l be completed In ninety days; MOVED -IN BUILD[N08 .heli be nom•
kDOW apace provided,
plcted In eta month,.)
tlION TORE (OWNER OR AGENT
DATE SIGNED
INSPECTION
DEPARTMENT
!L
CITYOF
4ATi
EDMOND3
NOTE: Applicant Subject to Pias deck Fee
PR 8-1107
s 7�
This Permit coven work to be done on private property ONLY.
Any cobalructlpn an the pubao donuln (curbs, aldewalka, driveway.,
maraueeS. Ste.) .1. regmro Separate permission.
FILE
USE
PERMIT r
BUILDING
DEPARTMENT
Applicant FW
ZONE
NUMBER
L
PERMIT APPLICATION
Inside Heavy Lines
I
G
NAME (OR NAME OF BUSINESS)
ADDRESS
PERMISSIBLE ro
ACTUAL
/'
'•"-/Q 1 e
l
LOT COVERAGE
LOT COVERAGE
r
MAILING ADDRESSa
rye
PERMISSIBLE HEIGHT
pnupourD HEIGHT
I i
�ca�a9 — S3 c�.s
0
O
Imo'
C3rIY
HO B&R
ACTUAL LOT AREA
TOTAL BLDG. AREA
r� 313
REQVIRED YARDS PROPOSED YARDS
iy
It
AME
FRONT SIDE
REAR FRONT HIDE REAR
t(
LEGAL LOT VARIANCE OR CONDITIONAL USE
h�l
h
ADDRESS
C3 YES [3 NO PERMIT NUMBER
PLANNING DEPT. APPROVALDATE:
C
CITY T
LEPHONE NUMBER
-
j
STREET R/W
EXISTING STREET R/W ............FT.
DEFICIENCY THIS PROPERTY
NAME�,
-l)
COMP. PLAN ST. R/W ............FT,:;
"D n h I o S R FOC / e Tt—
REMARKS
At
A DREBe
G/, �Nr- �s3
y
CHECKED BY
CITY T
PONE NUMBER
LIDQ
_
rJ
6 - /11 l C'1
METER RAZE SERVICE SIZE CLEARANCECHECKED
BY
STATI'J LICENSE NUMBER CITY
7.5 5- 17
LICENSE NUMBER
I
_
i i' - -'-
!
REMARKS
Legal Description of Property (Show Below or Attach Four Copies)
:r/;
1
_ I 11 )
TYPE CONNECTION
VERIFIED
Q13)4G/C ono
_.
p TES
PERMIT NUMBER`
C
{
1j- 02 p� LG��
w
pl
�r�ll
E1 8:r
W
'tl
OF -CONST
FIRE ZONTYPEE
Fit -D
V.
_
i
El NO
SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
El RESIDENTIAL
OAS
O LINE
❑ YES m.NO�
.�J -• /
NEW
PLAN CHECKED, IIY
„
THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL
BIOx
j ,, -
/
OF EDMONDS. LOCAL SALES TAX
ADD
RETAINING
,l .%.,
EMARK�-
SHOULD BE CODED 31.04.
DEMOLISH WAIT'
El DEMOLISH
_j
FENCE
ALTER ❑EXCAVATE
OR FILL � (........ ..1[ .......... Ft.)
El❑PRE -MOVE O SWIM
REPAIR INSP. POOL
'i/- .-rL _., /:1
G'/,./ /, /', Jfj"✓ ��/!>.�
.
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO HE DONE
Valuation
Fee RccelPt No.
), Clo .0 died
Plan Cheek No .....................
i
[[(.O
Ine.4 '� C{ 4/`e 0 •E��,y `(�`�
JP08
BUILDING
� ✓ ii d:'
ICJ '-
PROD U8E
PLUMBING
O
PLOT PLAN (Indicate Building setback., abutting streets)
HEAT A GAS LINE
9
�
FENCE
BION
RETAINING WALL
N
SWIMMING POOL
j
DEMOLITION
I
PRE -MOVE INSPECTION
I
EXCAVATION OR FILL
'
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the in.
formation given In correct; and that I a t the owner, or the duly author-
lrsd agent of the owner. I agree to comply with city and state laws regu.
ATTENTION
APPLICATION APPROVAL
J
lating construction; and in doing the work authorlsed thereby, no person
will be employed in violation of the Labor Code of the State of Washington
THUS PERMIT
This application is not a permlt until
I
relating to Workman's Compensation Iusursues.
AUTHORIZER
signed by the Building Official or his Dep-
i
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TILE
WORN NOTED
uty;. and fees are paid, and receipt is ac -
.hall be Completed In Natty day., MOVED -IN BUILDINGS shall be coon.
knowledged In Space provided.
pitted In six m..the.)
li
SIGNATURE (OWNER OR AGENT)
DATE SIGNED
INSPECTION
IREC_T_OWS SIGNATURE
DEPARTMENT
/
�\ n
CITY OF1
E
EDMOND9
ATE
NOTE: Applicant Subject to Plan Check Fee
PR a-1107
This Permit coven work to be done on private property ONLY.
!
Any coaslrcetloo oa the public domain (curbs, sidewalk., drivewa7s,
INSPECTOR
marquees, etc.) will re0hire separate parml.doa.
07-
t
..:
... .... ... ... ..... .. _. _...__..._... .. .... ..«........... .y.
nK'r:—w .':�_ t - `+na a. tl f'• 1'.+p r3,,
pp ;
;31 fl C t si i {4i 4, 4
t
. _...-... ._._ ...
_a
t,
i'•
v ,
,
7.
I
1 u
i
T.i
. 7
r
st
i S' � llly
1
r
T
! 1
I
t
ez
.a
t
,
tz t
I.,
_
s RECORD OF INSPECTIONS',
'
'' Date Passed
'Foundation
;Plumbing (Partial)
_
(Rou,h)
Frame
Furnace & NO Lines
Final
:
,
A 5..... 3