740240.pdfUSE
BUILDING DEPARTMENT Applicant Fill 4 A NUMBER 7402fi0
PERMIT APPLICATION I Inside Heavy Lines JOB r
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ADDRE88 9 3S —4PA40 V DS h1A1 *\ME (On NAME OF BUBINEB�) r o q
/ \ L T -r G� _A . CL A wt\ LOT COVERAGE LOTUCOVERAGE
1>15B 13 NO PERMIT NUMBER
'L N6 UE T. PROVAL
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IXIBT 6/STREET A/W. ...//. DEFICIENCY T}i18 I
COMP. PLAN ST. R/W ..../......FT. ..........FT.
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EST I PERMIT NUMBER
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O1TY ONE NUMHLR
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NAME
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ADDRESS
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TELEPHONE NUMBER
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NAME
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ADDRESIi�ELEPRONE
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CITY UMBER
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RETAINING
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FENCE
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El REPAIR E]NSP.
STATE LICENSE NUMBER CiTY HER
NUMBER OF
Legal Deeerlptlon of Propartyhow Below or Attach Four Copies)
DWELLING
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U
W
O
1>15B 13 NO PERMIT NUMBER
'L N6 UE T. PROVAL
W
IXIBT 6/STREET A/W. ...//. DEFICIENCY T}i18 I
COMP. PLAN ST. R/W ..../......FT. ..........FT.
[EMARKH i
$16x1 Slj�c� 111-fQ✓fC/1 Be✓6 0RSH/
EST I PERMIT NUMBER
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REAR
1 NIV nVj— — 7643=3 -t r - 1L—DI Plan Check No ..................... I i
BUILDING
�y �P'l�S,•1 �' l'��.�� 1 l�� �, e..+�•�+ ,
6,
PROPOSED UBE
pyq, PLUMBING
W
PLOT PLAN (Indicate Building setbacks, abulting ettcale) � HEAT d[ GAB LINE
FENCE
BION It , L
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL f
I hereby
AMOUNT DUE acknowledge that I have reed this application; that ins In- "`GGGJJJ ���000 00
formation given U corrMl; and that I am the owner, or the duly author.
Iced agent of the owner. I agree to comply with city and state laws regu- ATTENTION APPLICATION APPROVAL
kiting construction; and In doing the work authorised thereby, no person
Will be employed In violation of the Labor Code of the Btats of Washington THIS PERMIT This application is not a permit until
relating to Workmen's Compensation Inaurance. AUTHORIZE8 signed by the Building Official Or his Dep -
ONLY TH
NOTE: Permit limit One Year (Except DEMOLITIONS which WORK NOTED
uty; and fees are paid, and receipt is ac -
shall be completed In ninety days; MOVED -IN BUILDINGS shall be coin. knowledged in space provided.
pleled in six months.)
SIGNATURE (OWNER OR AGENT) DATE 810NED INSPECTION DIRECTO a BIG T E
—1 DEPARTMENT I�{y(/�' jJ�p�.
4 ` CITY OF /d" v`
EDMONDS
NOTE: Applicant Subject to Plan Check Fee 7 —�!
PR a-uar
This Permit [oven work to be done on private properly ONLY.
AnY canalroctinn an thn publle domain (-be, rld,walk., dri--ye, -
a FIIIF
r i 1 _ I -- RSd7\! 10 YES [3 NO
BE'EOIAinNSPEE`CCTT�OR REQUIRED
OCCUPANCY GROUP
❑RESIDENTIAL
NEW
NON-RESIDENTIAL
E]
❑
LINE
SIGN
❑PLAN
CHECK D RYO THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04El .
ADD
ALTER
DEMOLISH
AVATE
❑
RETAINING
WALL
FENCE
REMARKS
�AOL` SIZE'
l V
+' 1 1 /I` ', �►f
M' 0` IY U M ALLc 1�...)
❑ ORCFILL ........... Ft.)
PMOVE O Pswim OOL
El REPAIR E]NSP.
(UMBER OF STORIES
NUMBER OF
DWELLING
UNITS
1 NIV nVj— — 7643=3 -t r - 1L—DI Plan Check No ..................... I i
BUILDING
�y �P'l�S,•1 �' l'��.�� 1 l�� �, e..+�•�+ ,
6,
PROPOSED UBE
pyq, PLUMBING
W
PLOT PLAN (Indicate Building setbacks, abulting ettcale) � HEAT d[ GAB LINE
FENCE
BION It , L
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL f
I hereby
AMOUNT DUE acknowledge that I have reed this application; that ins In- "`GGGJJJ ���000 00
formation given U corrMl; and that I am the owner, or the duly author.
Iced agent of the owner. I agree to comply with city and state laws regu- ATTENTION APPLICATION APPROVAL
kiting construction; and In doing the work authorised thereby, no person
Will be employed In violation of the Labor Code of the Btats of Washington THIS PERMIT This application is not a permit until
relating to Workmen's Compensation Inaurance. AUTHORIZE8 signed by the Building Official Or his Dep -
ONLY TH
NOTE: Permit limit One Year (Except DEMOLITIONS which WORK NOTED
uty; and fees are paid, and receipt is ac -
shall be completed In ninety days; MOVED -IN BUILDINGS shall be coin. knowledged in space provided.
pleled in six months.)
SIGNATURE (OWNER OR AGENT) DATE 810NED INSPECTION DIRECTO a BIG T E
—1 DEPARTMENT I�{y(/�' jJ�p�.
4 ` CITY OF /d" v`
EDMONDS
NOTE: Applicant Subject to Plan Check Fee 7 —�!
PR a-uar
This Permit [oven work to be done on private properly ONLY.
AnY canalroctinn an thn publle domain (-be, rld,walk., dri--ye, -
a FIIIF