740233.pdfx
TOTAL AMOUNT DUI:
I hereby acknowledge that I have read this application; that the in-
formation given le correct; and that I sm the owner, or the duly author-
BUILDING
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G PROPOSED USE
ATTENTION
,¢ling construction; and In doing the work authorised thereby, no person
Will be employed In violation of the Labor Code of the State of Washington
PLUMBING
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BUILDING DEPARTMENT
Applicant FW
ZONE �'!S — /.0 NUMHEft
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shall be completed In ninety days; MOVED -IN BUILDINGS shall be com•
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PERMIT APPLICATION
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NAME ION NAME OF HUBINE88)
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NOTE: Applicant Subject to Plan Check Fee
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LOT VARI NCE CON UITIONAL V E
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EXIB'r 6/\V eTREET R/tti4.,yt::l..�.%T. aEFICIENCY THIS PROPERTY
NAME ���//
/ COMP. PLAN ST. R/V(�:f. ......(3...F"r.
REMARKeDriveway slopes not a#x to exceed
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SERVICE SIZE CLEARANCE
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FIRE ZO�IB TYPE OF=BTRUgTION STREET IMPROVE.a
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YES [] NO
eP CIALETINSPECTOR"REQUIRED OCCUPANCY ROUP
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NEW RESIDENTIAL ❑ LINE
Ln ElNON•REBIDENTiAL 9IGN
RETAINING
ADD ❑ WAIy
❑ DEMOLISH
ALTER EXCAVATE FENCE
❑ OR FILL .......... Ft.)
❑ YEB ] No
PLAN CHECKE ➢Y THIS SITE IS L CATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOl1LD BE CODED 31.04
REMARKS
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REPAIR ❑ IN MOVE
swim
❑ST, POOL
NUMBER OF STORIES NUMBER OF
�f DWELLING /
05 UNITS
Na.
NATURE OF WORK TTO� BE DON
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Recclpt
Pian Check No .....................
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jValuation
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TOTAL AMOUNT DUI:
I hereby acknowledge that I have read this application; that the in-
formation given le correct; and that I sm the owner, or the duly author-
BUILDING
�y
G PROPOSED USE
ATTENTION
,¢ling construction; and In doing the work authorised thereby, no person
Will be employed In violation of the Labor Code of the State of Washington
PLUMBING
V
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
PLOT PLAN (Indicate Building setbacks, abutting streets)
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com•
HEAT & GAS LINE
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i1GN RE (OtV ER A6 ) DATE 81ONED
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FENCE
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CITY OF
SIGN
EDhiONDB
NOTE: Applicant Subject to Plan Check Fee
RETAINING WALL
N
iSWIMMING
POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
This Permit coven work to be done on private property ONLY.
Any constructhm on the public domain (curbe. sidewalks, drlvewme,
marauces, etc.) w1U require separate permlWon.
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt Is ac-
knowledged in apace provided.
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FILE
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TOTAL AMOUNT DUI:
I hereby acknowledge that I have read this application; that the in-
formation given le correct; and that I sm the owner, or the duly author-
Ired agent of the owner. I agree to comply with city and state laws mgu-
ATTENTION
,¢ling construction; and In doing the work authorised thereby, no person
Will be employed In violation of the Labor Code of the State of Washington
THIS PERMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com•
pleted In six months.)
i1GN RE (OtV ER A6 ) DATE 81ONED
INSPECTION
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DEPARTMENT
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CITY OF
EDhiONDB
NOTE: Applicant Subject to Plan Check Fee
PR ti -1107
This Permit coven work to be done on private property ONLY.
Any constructhm on the public domain (curbe. sidewalks, drlvewme,
marauces, etc.) w1U require separate permlWon.
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt Is ac-
knowledged in apace provided.
S -1-7Y
FILE
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ZONE r� NUMBER
BU'iLDING DEPARTMENT Applicant Fill L' �' a
PERMIT APPLICATION Heavy Lines .Loa
/�J) / Oe/jfft, /HiiU/t%BnI`NrE•-eADDRESS
�g) V 6fN LOT COVERAG/ I J L'�E-iAOEBLE LOCVNAMEgYNME
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PERMISSIBLE HEIGHT L'
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_ PHONE NUIaHER ACTUAL` LOT ARE�fpr TOTAL BLDG. AREA .F
CITY / / r- L ? S/ ] �_ SOT E '�re7ln i
REQUIR D YARDS P OPOAED jAliO9
FRONT tlIDE REAR FRONT AI DI REAR
NAME rt'
TOW# ,,t0_0VR7 f %1- A)N %ooTS
LEGAL LOT � �VAItIANCt OR CONDITIONAL USS— 1
yt ADDREBH ?'EB ej O�-4ERh1IT NUMBER j
J O DE 'r74r, OV / / PATE' II i
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CITY TELE HONE NUMBER
EX eTITt� eTREET R/W �.'.'�/..r��r. EFICIENCY THIS PROPERTY
MO :#
NAME/ ..
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✓ S ley '
',lt 1vc: •ry s1o�.�e5 not It1is to ��:ccr�d
ADDRESS !
thr)se indicated an Ptandarr' 'i'wa. PC �.�'• w {
` C IHECKED BY
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CITY TELEPHONE NUMB1gR
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VMET� SALE I SERVICE SIZE I CLEARANCE I CHECHED BY
STATE LICENSE/%NUMBER [� CITY LICENSE NUMBER %�'�
C. 3 —`- `.. /o ] I REMAR/ItS 7 f
Legal Description of Property (Ahoy B.I.W or Attach Four Capt..) r/1
TYPE CONNECTION n VERIFIED BY !
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PERC, TEST PERMIT NUMBER
WREMARKS
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ICd - F1Rs: Z77O_NE" TYPE OF CONSTRUCTION STREET IMPROVED
SPECIAL INSPECTOR REQUIRED IOCCUPAfICYyI%UurP
RESIDENTIAL ❑ OA8 C] YEB �] NO
LINE PLAN CHECKED BY THIS SITE 15 LOCATED IN THE CITY
OF EDMONDS. 1; r NEW ❑ NON-RESIDENTIAL BION - _ SHOULD BE CODED 3104.SALES TAX
Tp ADD RETAINING Rf"r A /
DEMOLISH WALL
El ALTER
ElDEMOLISH
Ej FENCE � 1 J!
El OR FILL (...................Ft.) I
ElREPAIR ❑ PRE-MOVE SWIM
� V NUMBER OF BTOIifEe INAP. NPOOLUMBER OF-.'I
`1 DWELLING
S UN1TB
NATURE OF WORTO BE DON • i r) V.luntlon Fee Receipt No.
�r_.(ij,�) �,.c:•G.I%.—�l<.. Plan Check No..................... i(-i//{- 1i
j BUILDING - /t� ltlr,--t)i r//•(�J
PROPOSED UAE PLUMBING
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PLOT PLAN (Indicate Building setbacks, abutting street.) HEAT A CAS LINE
FENCE
SIGN !
RETAINING WALL
N -
BWIMMINO 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 le correct; and that I am the owner, or the duly author.
Ixedagent of the owner. I agree to comply with city sad stale laws "'u' ATTENTION APPLICATION APPROVAL
lttlas .....ruction; and In doing the work suthorlxed Nersby, no person
WI11 be employed In violation of the Labor Code of the State of Washington THIS PERMIT This application is not a permit until
relating to Workmen•. Compensation Insurance. AUTHORIZES signed by the Building Official or his Dep-
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS Which WORK NOTED uty; and fees are paid, and receipt is ac.
.hall be completed 1. ninety days; MOVED-IN BUILDINGS shall be win- knowledged in space provided. `
pleted In es months.)
SIONAT RE (OWNER p AGENT) DATE SIGNED INSPECTION DIRECTOR'S SIGNATURE
DEPARTMENT
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CITY OF
ED31ONDS DATE
NOTE: Applicant Applicant Subject to Plan Cbeck Fee
PR d-1107
This Permit coven work to be done .n private property ONLY. -
Any construction on the public domain (e.rbs, sidewalks, delvew►ys, INSPECTOR
mar0uus. ete.) Will re0.1. sepes.te per-1-don.
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Plumbing (Pr rtial)
Frame 9
70
Furnace &Fuel Lines
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