740181.pdfBUILDING DEPARTMENT APpH tFut
Nu UBE I> 7 0181
PERMIT APPLICATION
ride Heavy Lines
GH
G
ADDRESS O r'Z
1
NAME (OR NAME 08 BUSINESS)
C. - (r- I—At(5-0d
PER
LOT CO ERA % ACTUAL J
IAT COVERAGE LOT COVE AGE
j{
MAILING AD REBS�
' --r�
— 9-7". W
PERaS I881BLE HEIGHT PROPOSED HEIGHT Z
z1
O
2o�z I
CITY
Is NUMBER
A CI'VAL LOT AREA TOTAL BLDG. AREA y
,�
-1
EU/+tONUS
-77 6 — 027REQUIRED
YARDS PROPOSED YARDS
S
NAME
FRONT BIDE REAR FRONT BIDE REAR
ADDRESS
LEGAL LOT VARIANCE OH CON D3TIONAL USE
N
YES 0 NO PERMIT NUMBER
1
PLANNING EPT. APPROVAL DATE:
-I
CITY
TELJGPHONM-N UMBER
STREET R/W p
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
NAME
v `
COMP. PLAN 8T. R/W ............FT. ............FT.
REMARKS
1
ADDRESS
O
W
CHEC
CITY
TE PHONE NUMBER
l+
I
METER SIZE SERVICE SIZE CLEARANCE
HY
STATE LICENSE NUMBER
CITY LICENSE NUMBER
I I
ICHWCKED
F
REMARKS
Legal Description of Property (Show Below or Attach Four Copies)''//fIfI//e
A4)
SCE J't T—rfi CH 6--U
TYPE
VERIFIED BY
NNN
PERC. TEST
PERMIT NUAIHE a
REMARKS m
G
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
I
I YES O NO
8P CIAL INSPECTOR R QUIRED
YES O
OCCUPANCY GROUP
FLOC
❑ ❑ OAS
RESIDENTIAL LINE
NEW
11
[3
PLAN C CKED BY THIS SITE IS LOCATED IN THE CITY
LOCAL SALES TAX
NON-RESIDENTIALslat;OF
EDMONDS.
SHOULD BE CODED 3104
ADD RETAINING
DEMOLISH WALL
R '5fl&K
El EXCAVATE FENCE
9.1// �
,/H (/
ALTER
OR FILL (........ .......... Ell.)
PRE -MOVE SWIM
REPAIR O INSP. POOL
�(J✓, '�t/ I� O.1%-S�Tls'/NSPc;TGrT�O
I
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
NATURE OF/WORK BE DONE
Valuation
Fee
Receipt No.
�yTOO
4V�L-N iviTi' G�./
.'//J V/✓J
Plen Check No .....................
����IILytL/
PflOPOS 411' •75 U�c..J%c/6.
BUILDING
PLUMBING
V
PLOT PL/-A/{N (Indicate Building setbacks, abutting Streets)
HEAT k GAS LINE
FENCE
SIGN
1
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I
TOTAL AMOUNT DUE
I hereby acknowledge that I have read Ulla application: that the In.
/
formation given le Correct; and that I am the owner, or the duty wtbor-
Ized agent 11 the owner. I agree to eomDlY with ally and stab laws rogu-
ATTENTION
APPLICATION APPROVAL
letlOg Construction: sad In doing the work autborised thereby. no person
'
will be employed In violation of the Labor Code of the State of Wasbbgton
TIUB PERMIT
This application is not a permit until
relating to workmen's Compensation lasuranw.
AUTUORIZEB
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (EINpt DEMOLITIONS which
ONLY TE
WORK NOTED
utyi and fees are paid, and receipt is ac -
shelf be Compl@led In ntn days; MOVED -IN BUILDINGS shall be com.
knowledged In space provided.
plat the )
SIG TU (OWN AGENT)
DATE SIGNED
INSPECTION
IR T S SIO ATU E
DEPARTMENT
CITY OF
EDDIOND$
NOTE: Applicant Subject to Plan Check Fee
PR g-1107
�—
This Permit coven work to be done on private property ONLY.
Any conatructlon on the Dahlia domaln (curbs, sidewalks, driveways,
FILE
marquees, ate.) wW ropmro .0"ete Dermbelon.
-`
..
_�..^•�
'Y" ..: .. moi:+. V.. - ,3',..
_
i
.
i
ZONE
NU BE PERMIER `'
1
BUILDING DEPARTMENT
ApplpwntFlu
I Imide Heavy Lines
PERMIT APPLICATION
p
�•Q
'
NAME (OR NAME OF BUB1NE88)
"' '� ,
-
,
�E ) ,
(- C_AI'<%ON/
PERSIBLE
MIS
IAT COVERAGEJ
ATUCOVALESRAOE
LOCT
MAILINGADDRESS
PERMISSIBLE HEIGHT
PROPOSED HEIGHT
O
O
NER
ACTUAL LOT AREA
TOTAI. ULDO. AREA
CITY
r
(_ ()111("o fJJ
'7 �� - �f 1.:: /
PROPOSED YA RDB
i
REQUIRED YARDS
FRONT HIDE REAR FitONT HIUt: REAR
NAME
M
LEOAI. LOT VARIANCE Olt CONDITIONAL USE
NO PERMIT NUMBER
ADDRESS
YEB ❑
PLANNING EPT. APPROVAL - DATE:
I
CITY
T L P ONE NUMBER
/
-STREET R/W
EXISTING STREET R/W ............FT.
DEFICIENCY THIS PROPERTY
O
NAME
,p
1 tJ A) cit
COMP, PLAN ST. R/W ............FT. ............FT.
REMARKS
(!7 ,
lie'
07
ADDRESS
O
t!Ej
CHECKED BY
CITY
TELEPHONE NUMBER
I'
F
I
''//.; �`—
•.i`:_`—
O
V
METER SIZE SERVICE SIZE CLEARANCE
CHECKED BY
I
STATE LICENSE NUMBER
CITY LICENSE NUMBER
I
REMARKS
Legal Description of Property (Show Below or Attach Four Copies)
TYPE CONNECTION
VERIFIED BY
z
�
�!•I
PEC.
PF.RAi1T NUMBER.'
99i�U'•
✓I
W
REM 8
m I,
I
y
FIRE ZONE TYPE OF CONSTRUCTION T t ROVED-j
.W7
ITIi
[3 YES ❑ NO
SPECIAL INSPECTOR REQUIRED
OCCUPANCY OR UP
NEW 1 RESIDENTIAL LINE
❑S
IIO
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
PLANCHECKE Y
NON-RESIDENTIAL SIGN
ADD
---
REMARx9
SHOULD HE CODED 31.04.
❑RETAINING
DEMOLISH WALL
)
F] EXCAVATE '.' FENOE'
ALTER ❑
OR FILL (....................Fl.)
REPAIR PRE-MOVE El SWIM
INSP. POOL
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE
Valuation
Fee Receipt No.
'
Plon Check No.....................
Z
O
BUILDING
GPROPOSED
UBE
`yl
PLUMBING
O
Q
PLOT PLAN (Indicate Building e,,lack,, abutting street.)
HEAT A CAB LINE
FENCE
BION
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE-MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
formation given Is correct; and that I am the owner, or the duly author.
-
Ired agent of the owner. I afire. to comply with Oily and .tate law■ reg.-
ATTENTION
APPLICATION APPROVAL
letipg ...slructlon; ►ad in doing the work authorised thereby, no person
;
will be employed In violation of the Labor Code of the State of Waahington
THIS PERMIT
This application is not a permit until
relating to Workman's CculDensatlon Insuranee,
AUTHORIZES
Signed by the Building Official or his Dep-
NOTE: Permit Limit One Year (EZc.Pt DEMOLITIONS which
ONLY THE
WORK NOTED
utyi and fees are paid: and receipt is ac-
shall be completed In ninety days; MOVED-IN BUILDINGS ,hall be com-
knowledged in Space provided.
pleled In eI%
_months.)
SIGNATURE (OWNER OR AGENT)
DATE SIGNED
INSPECTION
DIRECT R'S SIGNATURE
- --
DEPARTMENT
.
CITY OF
EDHONDS
DATE...---
NOTE: Applicant Subject to Plan Check Fee
PR a -lino
/r
Thin Permit cogen work to be done on private property ONLY.
Any construction on the public domalo (curbs, sidewalks, driveways.
INSPECTOR
marquees, etc.) will require separate parmlseloo.
y
BtlltHtaeza�
/
_ -. ... ... . ...
.. _......_.......
.....
fi t 6 ..SI'.. n8i�. 9`bf'%f.L �. WC'2'<i6 Y T F.1l ttA'ii�'11k•k:Pf'14'
1 ,
WITU 914 MIN,
1 i «
i
b