740212.pdf1
BUILDING DEPARTMENT Applicant Ful
°� NUMBER 740212
RESIDENTIAL
PERMIT APPLICATION
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ADDRESS //_ �O 5 �- //_ri �//
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NAME (OR NAME OF BUSINESS)
a
(P ,A V" e
❑
,pACTUAL
CO.{i•M�\`a 1•`C•t-e�+S
PERMISSIBLE
LOT LOT COVERAGE
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MAILING ADDRESS
X903 Evece Ae
❑
PERMISSIBLE HEIGHT PROPOSED HEIGHT
❑
O LEONENMBRCITY
ACTUAL LOT AREA TOTAL BLDG. AREA
❑
Ev
REQUIRED YARDS PROPOSED YARDS
DEMOLISH
OR FILL
NAME
FRONT SIDE REAR FRONT SIDE REAR
•
p
G
pi ADDRESS
LEGAL LOT VARIANE Olt CONDITIONAL USE
T UMBER
0 YES 0 NO PERMICN
PLAN (Indicate Building setbncka, abutting Streets)
HEAT A GAS LINE
)'LAN O D . P;A
/r 3A'�E•y�
07 CITY TELEPHONE NUMBER
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!c
❑
BT ET /{V
NUMBER OF STORIES
NUMBER OF
EXISTI STREET R/W ../.. FT. DEFICIENCYTR B PROPERTY
NAME
COMP. PLAN ST. R/W ..(.......FT, ... ......FT.
RETAINING WALL
1
0 W hts l
_
REMARKS
N
ADDREdS �
'�L
1m
reed
CHECKED BY
UNITS
CITY
TELEPHONE NUER
MB
DEMOLITION
I
7
I
PRE -MOVE INSPECTION
A/N•L-
EXCAVATION OR FILL
METER SIZE I SERVICE SIZE I CLEARANCE
I CHECKED BY
LA4 $J
;eT
0 YES 0 NO
1
YES ❑ NO
Valuation
RESIDENTIAL
As
LINE
Plan check N. .....................
NEW
a
NON-RESIDENTIAL
❑
SIGN
ADD
❑
❑
NI
NG
WALL
❑
ALTER
a
DEMOLISH
OR FILL
❑VATE
FENC z..........
•
17(I
PLAN (Indicate Building setbncka, abutting Streets)
HEAT A GAS LINE
Ft.)
Q
REPAIR
O
INSP.PRE-
❑
swim
POOL
NUMBER OF STORIES
NUMBER OF
SIGN
i
RETAINING WALL
DWELLING
N
1
SWIMMING POOL
UNITS
;eT
0 YES 0 NO
1
YES ❑ NO
This remit coven work to be done on private property ONLY.
Any construction on the public domain (cub., sidewalks, driveways,
ntNqutes. Ste.) will require separate peredlWon.
FILE
Valuation
Fee Receipt No.
3 d A/Ki o u v� •
Plan check N. .....................
r.
BUILDING
ttlO
g PROPOSED USE
a
PLUMBING
V
aPLOT
PLAN (Indicate Building setbncka, abutting Streets)
HEAT A GAS LINE
Q
FENCE
i
SIGN
i
RETAINING WALL
N
1
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have road this application; that the In-
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formation given Is correct; and that I — the owner, or the duly author-
tred agent of the owner. I agree to comply with city and elate laws regu-
ATTENTION
APPLICATION APPROVAL
lating construction; and In doing the work authorised thereby, no person
will be employed In violation of the Labor Code of the State of Washington
T1118 PERMIT
This application is not a permlt until
relating to Workmen's Compensation In.urance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
uty; and fees are paid, and receipt is ac -
,hall be completed In ninety day.; MOVED -IN BUILDINGS shall be com-
WORE NOTED
edge 6Ce provided.
pleted In six months.)
SIGNATURE (OWNER OR AGENT)DATE SIGNED
INSPECTION
I C 'B Bl ATU
/
4
DEPARTMENT
/
CITY OF
1
EDIIONDS
AT
NOTE: Applicant Subject to Plan Check Fee
rn g-uqy
This remit coven work to be done on private property ONLY.
Any construction on the public domain (cub., sidewalks, driveways,
ntNqutes. Ste.) will require separate peredlWon.
FILE
( ow"x
lE ADDRESS T
,Vd
M CITY I TELEPHONE NUMBER
A
8 STATE LICENSE NUMBER I CITY LICENSE NUMBER
Legal Description of Property (Show Below or All.ft Four Copies)
et�
W
a
EXISTINO STREET R/W .L"/.,rT. DEFICIENCY TRIS PROPER
COMP PLAN ST R/W (.......FT. .. FT. _
REMARKS
g I PERMIT NUMBER
0 NO
GAS RESIDENTIAL ElLINE❑
E ❑ O
BY
IN THE CITY
NEW
PLANCHECKED
I'
❑ NON-RESIDENTIAL ❑ SIGN
BUILDING D77]
llcantFW
ZONE /(_ NUMBIETR 71' �.` I
/
REMARKS _
PERMIT APHeavy
Lines
JO
ADDRESS
WIM
REPAIR ❑ INSP. O POOL
NAME
(OR NAME OF
NUMBER OF STORIES NUMBER OF
! I !
DWELLING
I
PERMISSIBLE m ACTUAL
LOTCOVERAOFn LOT COV AAGE
MAIINO ADDREBB\
PERMISSIBLE HEIOIiT PI20PO8ED IIEIGHT OENeA�-
Fee Receipt No.
�y�
Y �
�
CITY
TELEPHONE NUMBER
ACTUAL LOT AREA TOTAL BLDG. AREA
PLUMBING
C l `K` `� �� 1�5\,
✓ .� <1 �C
REQUIRED��ARDS 1'ROPUSEUYARDS
REAR FRONT SIUF REAR
AD
HEAT & GAB LINE
FENCE
LEGAL LOT VARIANCE Olt CONDITIONAL USE
YES NO PERMIT NUMBER
ADDRESS
F
N
PL`r! 7NO-DEPT/.P PROVA f �_• _-/�/
f i/.0 V',I /t IT
_
SWIMMING POOL
Di
E
CITY I
TELEPHONE NUMBER
STREETR/W
DEMOLITION
( ow"x
lE ADDRESS T
,Vd
M CITY I TELEPHONE NUMBER
A
8 STATE LICENSE NUMBER I CITY LICENSE NUMBER
Legal Description of Property (Show Below or All.ft Four Copies)
et�
W
a
EXISTINO STREET R/W .L"/.,rT. DEFICIENCY TRIS PROPER
COMP PLAN ST R/W (.......FT. .. FT. _
REMARKS
g I PERMIT NUMBER
0 NO
GAS RESIDENTIAL ElLINE❑
E ❑ O
BY
IN THE CITY
NEW
PLANCHECKED
THIS SITE 15 LOCATED
LOCAL SALES TA):
❑ NON-RESIDENTIAL ❑ SIGN
SH EDMONDS.
SHOULD BE CODED 31 04.
ADD ❑ RETAINING
ElDEMOLISH
REMARKS _
E] ALTER EXCAVATE FENCE
OR FILL (..........%.......... Ft.)
WIM
REPAIR ❑ INSP. O POOL
NUMBER OF STORIES NUMBER OF
DWELLING
I
UNITS
NATURE OF WORK1 T,OA BE DONE( Ar ,�
V¢luntlon
Fee Receipt No.
BUILDING
PROPOSED USE
PLUMBING
`
aPLOT PLAN (Indicate BuildingSetbacKa; u nE atFecte)
HEAT & GAB LINE
FENCE
SIGN
RETAINING WALL
N
_
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
L
- (�� .tt�F•
I hereby acknowledge that I have read this application; that the In-
formatlon given le correct; and that I am the owner, or the duty author-
izedagent or the owner. I agree to comply with city and state laws Ingo-
ATTENTION
APPLICATION APPROVAL
lilting eoentructloa; and In 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
relattag to Workmen's Compensation Insuranes.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE; Permit Limit One Year (Except DEMOLITIONS which
ONLY TILE
WORK NOTED
tit and fees are paid, and receipt SS 6C -
y' p
Shall be Completed In ninety days; MOVED -IN BUILDINGS Shall be wm•
knoWledged-in space provided.
pleled In el% monthe.)
•. ' / - ,
IRECTOR'S BLUNATURE
WONATURE (OWNER OR AGENT) DATE SIGNED INSPECTION
at (�j
DEPARTMENT
'.) .4
i,\�uClS.i
CITY OF
ATF,
1
EDMOND$
NOTE: Applicant Subject to Plan Check Fee
PR 6-1107
This Permit coven work to be done an prlvale property ONLY.
Any constructlan oil the nubile domala (curbs, aldewNW, drlvewa7a,
INSPECTOR
nuvquees, etc.) WIU require separate permlsslon.
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RECORD OF INSPECTIONS
Date Passed
Foundation a.
Plumbing (Partial)
(Rough)
I Li
Frame
Furnace & Fuel Lines
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