740229.pdf�
BUILDING DEPARTMENT
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Appilcant MU I(L.S'(p` iilEimMUI ��(J�1rl
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PERMIT APPLICATION
I Inelde Heavy I►DeS A
ADDRESS
NAM lOR NAME OF BUS1N BB) /
PE Re1.VUR F. % ACTUAL //
LOT COVL'RAOE DLOT COVF.IYAOE
I: E8 � NO
SPECIAL INSPECTORREQUIREDOCCUPANCY
MA1LiN0 ADDHADDH a PERMISSIBLE HEIGHT PIt BED IIEIO
30 %�+Q,s�
��3 9 �zta•-: Ste` TOTAL BL
F
CITY,4_74 n PRON UMBER ACTUAL LOT A%�A� 1
%��
REQUIRED YA}LDS PROPOSE YARDS
REAR
'.i
RESIDENTIAL
GAS
LINE
NAME FRONT BIDE RF.Afl FRONT SIDE.
NON-REeIDENTIAL
El slaty
(t
LEO LOT VARIANCE OR CONDIT10NAL UBE
)
ADDRESS B PE MIT NUMBER
yyM
I,
ii
PLA O EP A PR L T.
1
DEMOLISH
FENC.x..........Ft.)
C•
CITY TE PHONE NUMBER
E E �D B
EXISTIN TREET R/ FT. DEFICIENCY T^^RIS PROPER
Id
J .C�
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NAME If COMP. PLAN ST. R/1��.�(....FT. .....I.l.FT.
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R"A"" Driveway slopes not to exceedthose
C
14
indicated on Standard Dwg. No. 103
U ADDRESS
C/iEQ Y
iL
w
NUMBER OF STORIES NUMBER OF
CITY I TELEPHONE NUMBER1q1DW e0 D I 1 III/I1V/i
ox METER SIZE SERVICE SIZECLEARANCE CH D BY
DWELLING
U
STATE 'LIICENSE NUMi^BER
CITY CENSE NUMBER
I /
I
t1
MARKS
NATURES OF WORK TO BE DONE
V
Fee Rceolpt No.
g
Leg¢I D(�—Ipllon of Properly (Show Below or Attach Four Copied)
!/ 9 7 a
Plan Check No .....................
IFI B
TYPE CONNECTION VERIFIE BY
da'1 /3 �Gtror,���p TION
-2
BUILDING
G
PERMI UMBER
(�
4 PROPOSED
PERC. TEST
y.
O
PLUMBING
�
I �
FIRE ZONE TYPE OF CONSTRUCTION IMPROVED
I
I: E8 � NO
SPECIAL INSPECTORREQUIREDOCCUPANCY
GROUP
(] YES
RESIDENTIAL
GAS
LINE
NEw
NON-REeIDENTIAL
El slaty
PLAN CH EC ED BY
THIS SITE 1 LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
ADD ❑ RETAINING
WALLI
MA
L/D Ili
_
DEMOLISH
FENC.x..........Ft.)
C•
�JCO.D�EyJD�3104
-S9HOU.
%!'O.C! 'ae; U�C
ALTER ❑ ORCFILL AVATE O
J .C�
�/J'-1
REPAIR ❑ PRE-SIVIM
INSP. Q POOL
,/p
�l/.V T?'/TCi/
�/Y ��/G��/y�/�C1'�✓f(l
NUMBER OF STORIES NUMBER OF
DWELLING
( UN1T8
NATURES OF WORK TO BE DONE
Valuation
Fee Rceolpt No.
/uy✓
Plan Check No .....................
BUILDING
G
/,
(�
4 PROPOSED
O
PLUMBING
nz 3 ,oa
PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT A GAS LINE
I (�
el
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
I
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this Applicatloe; that the In-
✓J
formation given Is correct; and that I am the owner, or the duly author-
Ixed agent of the owner. I agree to comply with city and elate laws regu-
ATTENTION
APPLICATION APPROVAL
'
,.u.. construction; and in doing the work authorized thereby, no person
will be employed 1. violation of the Labor Code of the State of Washington
TRIS PERMIT
This application is not a permit until
relating to Workmen's Compensation Iuaureace,
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
ntyi d fees are paid, and receipt is ac -
shall be completed In ninety days; MOVED -IN BDILDLNGS shall be w
tIn IS ged In space pr vlded.
pleted In six moolhs.)
SIO TlJltE LOW ER O AGENT) DATE eIONED
INSPECTION
DEPARTMENT
D RE OR'8 B TO
C+
CITY OF _..
EDMONDS
NOTE: Applicant Subject to Plan Check Fee _ Q 7
PR 6-1167
This Permit coven work to be done on private property ONLY.
Any conslructioo on the pubue domain (ewbe, sidewalks, driveways,FILE
marquees, etc.1 will require separate Wnd.slon. ,
.• i
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sM�ranrwaeetaawaR
EXCAVATION OR FILL
vr..�
BUILDING D E P A R T M E N Applicant Fill 'ZOO
UBEjar (� PERMIT
NUMBER
- ((J � e
i
PERMIT APPLICATION Inside Heavy LIDag
joil ADDRESS � OIL, G — �7Q.d �Cf -
ATTENTION
APPLICATION APPROVAL
NAM
NAMEOF BUSINESS)ACTUAL
PERMItlgIBLE % C1141LOT COVESYAOF, �.•�
1AT COVERAGE
-i
1,
will be employed In violation of the Labor Code of the State of Washington
pt
MAILING ADDRESS
1 I ' I1� c •�'
Pito E 1EI
PEit1•fltltllDLE HEI0i1T J� ���?t_ �1}; �r.r. 2 J
relating to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
O
O1TY .L!
BON MBLA
ACTUAL L07'�J��FGA� !1S 'COTAL Bl.Ua j? E
iii T
.hall be completed 1..1.ety days; MOVED -IN BUILDINGS shall be mm•
ImoWledged 1n space provided.
�,17
picked In els months.)
REQUIRED YARDS I ROPOtl1,D YARDS
-' it A
I1gNATU E (ONER' OR AGENT) / DATE SIGNED
W
-"
INSPECTION
DEPARTMENT
D ECTOR'S S °NATURE
R
�
FRONT HID' REAR FRONT/ SIU' REAR
(" `i
NAME .
1• 5 /O .}
Ypgi
Applicant Subject to Plan Check Fee
l.,
IK Olt CO
rL•IEXEnIJ!„ CIyOJ R PF. itMIT NUMBERNUITIONAL UBE
y
NOTE:
6-1107
y°I
ADDRESS
This Permit covers work to W done on private property ONLY.
'�
PLAN 6rUEP APPit� W. �. �� TEt F
��
Any conslructiou on the public domain (curbs, sidewalks, driveways,
i
INSPECTOR
m
marquees, ele.) will require separate per"..lon.
T BONE NUMBER
.�' ' 1
!
CITY
7
6TRLET Be !.)
EXIeT1N6TREET R/W —.t�...FT. DEFICIENCY THIS PROPERTY
O
I
`
1
NAMECOMP.
.... ........-SFT.
PLAN BT. R/W .FT.
M
REMARKS 1I'1vt1418y S O:JCS Il0 . -O 3::CCPC1' R051'
'
ADDRESS
]. 17 r1.'..Cu'i�n(i OR t'.3ilridl'tl il`ri f'. .10. 103
W
atl'E
E
F
CITY
I TELEPHONE NUMBER
����', �,I��� �l w�� ray.,, ,
Z
8
METPR SIZE SERVICE SIZE
CLEARANCE
C EOKED BY
gCtpTd .! (7 / UM E �
+a
C1T CENSE NUMBER
�C/ I l
I I
� G _�
4/ -
Pi
�!+
RE RHO
!_• i+
%I// ✓��(,G;` r � �;_/ ��� /F 74
Legal DpyurlpRt Properly (Show �r Attach Four Copies)
TYPE CONNECTION VERI1`FIE
O
PE C ( E IT UatIIER
y.
m
W
p
RE A B UuLf
FIRE -ZONE TYPE OF COPTRUCTIOlf STREET IMPROVED
NO
SPECIAL INSPECTOR REQUIRED OCCIn... ]°RO/UP
❑ NEW
RESIDENTIAL LINE
PLAN CHE KED IIY THIS SITE IS LOCATED IN THE CITY
( SALES TAX
NON-RESIDENTIAL
❑ ❑ BIaN"w'I'1•l
`Yf OF EDMONDS. LOCAL
LYy""` SHOULD BE CODED 31.04.
❑ ADD ❑ RETAINING
❑WALL
DEMOLISH
REMARKS
/
/��/� ( !'"/'il/ ��:iG �!✓.J ,' L'� ✓/J L /�%J
.
❑ ALTER ❑ EXCAVATE FENCE
OR FILL ❑ (....................Ft.)
❑ REPAIR ❑ PRE -MOVE ❑ SWIM
INSP. POOL
NUMBER OF BTQRIEB NUMBER OF
1 DWELLING
UNITS
NATURE, OF WORK T SE DON
i
Valuation
Fee RecelPl No.
Plan Check No....
p
5_L.-.•,. 1-.r-....�
BUILDING
"T t/ •'���
PROPOSED USE
pLUMBIN6
`-� •r%�
LINE
�rrLl
O
5
7
PLOT PLAN (Indicate Building setback., abutting streets)
HEAT A GAS
FENCE
RETAINING WALL
N
—
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
.• i
J
sM�ranrwaeetaawaR
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have rand this application: that the in -
formation given f. correct; and that I am the owner, or the duly author-
ized agent of Ne ovmer. I agree to comply with city and .tate lawn regu-
ATTENTION
APPLICATION APPROVAL
Intlu6 come ""tion; and In doing the work authorized thereby, no person
will be employed 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 Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit limit One Year (Except DEMOLITIONS whlch
ONLY THE
WORK NOTED
.and fees bre paid, and receipt 19 6C -
uty;. P
.hall be completed 1..1.ety days; MOVED -IN BUILDINGS shall be mm•
ImoWledged 1n space provided.
picked In els months.)
-' it A
I1gNATU E (ONER' OR AGENT) / DATE SIGNED
W
-"
INSPECTION
DEPARTMENT
D ECTOR'S S °NATURE
R
�
� j ;4 r �t•-��---,....1r..,.., �/',J;/. J1
(" `i
OITY OF
EDMONDSPR
DATE
Applicant Subject to Plan Check Fee
NOTE:
6-1107
This Permit covers work to W done on private property ONLY.
Any conslructiou on the public domain (curbs, sidewalks, driveways,
INSPECTOR
marquees, ele.) will require separate per"..lon.
.• i
J
sM�ranrwaeetaawaR
1
z
nl V,� � ) Nt'd�> ,in U1 P
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RECORD OF INSPECTI
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Furnace & Fuel Lines C.
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