740261.pdf1 I 1
BUILDING DEPARTMENT Applicant Fill °� NUn'n 740261
PERMIT APPLICATION I Inside Heavy Linea
NAaIE R NAME OF BUSINE
MAILING DREee _
O CITY �- TELEPHONE WUL/BER
NAME
ADDRESS
JOB
ADDRESS
DATE:
pt;n......BLE ^
LOT COVERAGE^
ACT AL JJ
LOT COVERAGE
PERMtSHIBLE HEIGHT
PROPOSED HEIGHT
ACTUAL LOT AREA
TOTAL BLDG. AREA
REQUIRED YARDS PROPOSED YARDS
FRONT HIDE REAit FRONT SIDE REAR
1
LEGAL LOT
YEe NO
VARIANCE OR CONDITIONAL USE
PERMIT NUMBER
DATE:
i
CITY
I
PLANNING DEPT. APPROVAL
1
STREET R/W
O
S
EXISTING STREET R/W ............FT.
DEFICIENCY THIS PROPERTY
9
I
Wa
COMP. PLAN 8T. R/W ............FT. ............FT. �7
AEMARtIB "•
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44 AD BDII
DATE:
CITY
TELEPHONE NUMBER
PLANNING DEPT. APPROVAL
1
STREET R/W
O
EXISTING STREET R/W ............FT.
DEFICIENCY THIS PROPERTY
NAME n
,j/D_
Wa
COMP. PLAN 8T. R/W ............FT. ............FT. �7
AEMARtIB "•
44 AD BDII
1
W
U
TELEPHONE NUMDER
Cl Y
CHECKED BY
Fr
O
I
METER S1ZE
SERVICE SIZE CLEARANCE
CHECKED BY
O e TE L[CENBE NUM ER
CITY LICENSE NUMBER
I
I
al
I
I
REMARKS
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Legal Description o1 Property (Show Below or Attach Four Copies)
TYPE CONNECTION
VERIFIED BY
O
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ly
PERC. TEST
PERMIT NUMBER y�.t
�
1
3
m
M
REMARKS
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FIRM ZONE TYPE OF CONSTRUCTION STREET IhfPROVED
I
(:] YES NO
I
SPECIAL INSPECTOR REQUIREDOCCUPANCY GROUP
RESIDENTIAL
F GAB
LINE
❑ YES NO
O NEW
PLAN CHECKED BY
THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL
SIGN
OF EDMONDS. LOCAL SALES TAX
.
ADD
RETAINING
REMARKS
SHOULD BE CODED 31.04.
DEMOLISH WAIT'
ALTER EXCAVATE FENCE
❑
ORFILLPRE-MOVE
'.
SWIMx..........Ft.)
REPAIR ❑ INSP. POOL
NUMBER OF STORIESI NUMDER OF
DWELLING
UNITE
NATURE OF O K TO HE DON o
Valuation
Fee Receipt No.
•
Plan Check No .....................
Z
BUILDING
PROPOSED USE
i
PLUMBING
/t
O
V
PLOT PLAN (Indicate Building Setbacks, abutting streets)
HEAT & OAS LINE
s1
D
FENCE
'
SIGN
J
tRETAINING
WALL
9WILiMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE,
I hereby acknowledge that I have read this application; that the In-
/ 1
formation given le correct; and that I am the owner, or the duly author-
ized agent of the owner. I agree to comply with city and state law. regu.
ATTENTION
APPLICATION APPROVAL
Iatmg co illruction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Slate of Washington
TIUS PERMIT
This application is not a permit until
relating to Workmen's Compensation Inaurance.
AUTHORIZES
signed by the Building Official Or his Dep -
NOTE: Permit limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
uty: and fees are paid, and recelyt is ac -
shall be completed in ninety day.; MOVED -IN BUILDINGS shall he nom•
knowledged In space provided.
pleted In six months.)
SIGN 1E (OIVNEI OR AGENT
DATE B10NED
INSPECTION
DEPARTMENT
D1R •OR'S BfONATU �df{/, =__
`
CITY OFZ'
EDIIIONDS
DATE
._
NOTE: Applicant Subject 10 Plan Check Fee
_—
775-2525
/
Pertait.,... r cork be dans private.,Sid Property UNLY.
Ally Public (c d
Any eunNrucllua an the public domain (curbs, eldewdks, drRewy.,
marquees, etc.) will require separate pernds.lon.
FILE
t
IIAel�Al111A111�15l1®Allo AAIa/raw�i
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BUILDING DEPARTMENT Applicant Flu E°"E PE
I°TR l' •. i
PERMIT APPLICATION I Inside Heavy Lines JOB
ADDRESS 't / I �J ��_ `, L/ `•`•I,J �//
NAME (QR NAME OF BUSINb.Se)
Tt.__... PERMISSIBLE ra LOT
CO(5OYESRAGE
1
LOT COVERAGE L
MAILING ADDRESS , . •.
�..
/� PERMISSIBLE HEIGHT 'ROPOtlED I4EIGIiT� f
OTELE ONE NUMBER ACTUAL LOT AREA 'COTAL BLbO. AREA
CITY � A /
l/_i r�•}�-f},^t i- (;I,i/1/' REQUIRED YARDS i'ROPONED YAIIDB i
NAME FRONT BIDE REAR FRONT 8-1 REAR
�j LEGAL LOT VARIANCE Olt CONDITIONAL UBE I :
pI ADDRESS YEB ❑ NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE: I j
fE CITY __. ....................�.
NAME /
1 r
AD
CITY
' F ^
STREET R/W
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ..........,.FT. ............FT.
REMARKS
T
YES ❑ NO
el — 5--s^74 0,
ION STREET IMPROVED
YES ❑ NO
LOCAL SALES T
Fee
Plan Check Na .....................
GAS
NEW
❑
NON-RESIDENTIALBION
BUILDING
ADD
�Oy
4 PROPOSED USE
a
PLUMBING
ALL NINC
IC) 0
El
DEMOLISH
H
ALTER
PLOT PLAN (Indltitt��ln a backs, abutting streets)
\
❑
F
ORFILLEXCAVATE
. z..........Ft.)
O
FENCE
swlm
REPAIR❑
INSPMOVE
ED
POOL
(UMBER OF STORIES
NUa1BER OF
RETAINING WALL
DWELLING
UNITS
'j
tATURE OF WORK TO BE DONE n
9WIMMIN6 POOL
STREET R/W
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ..........,.FT. ............FT.
REMARKS
T
YES ❑ NO
el — 5--s^74 0,
ION STREET IMPROVED
YES ❑ NO
LOCAL SALES T
Fee
NOTE: Applicant Subject to Plan Check Fee l
775-2525
This,1'ermit em,ere work to by done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways. INSPECTOR
marquee., etc.) will require separate permission.
Plan Check Na .....................
I
t_
BUILDING
�Oy
4 PROPOSED USE
a
PLUMBING
IC) 0
PLOT PLAN (Indltitt��ln a backs, abutting streets)
\
HEAT & GAS LINE
O
FENCE
SIGN
RETAINING WALL
9WIMMIN6 POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I
I .
(M
I r'17;_y
TOTAL AMOUNT DUE
f hereby acknowledge that I haus recd this application; that the In-
f�� /
\ /
formation given Is correct; and that I am the owner, or the duly author -
lied agent of the owner. I agree to comply with city and state laws regu-
ATTENTION
APPLICATION APPROVAL
bating conetructlon; 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
relating to Workmen'. Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORE NOTED
uty; and fees are paid, and receipt is ac-
j
ehall be completed In ninety days; MOVED -IN BUILDINGS shall be cam•
knowledged in apace provided.
plated In six month..)
SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DEPARTMENT
DIR /OR'8 8 ATU
I
CITY OF
ED51ONDS
DATE —
NOTE: Applicant Subject to Plan Check Fee l
775-2525
This,1'ermit em,ere work to by done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways. INSPECTOR
marquee., etc.) will require separate permission.