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PERMIT APPLICATION Inside Ileavy Lines
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TELEPHONE NUMBER
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. PLANNING DEPTAPPROVAL DATE:
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TELEPHONE NUMBER
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STREET R/W ............FT. DEFICIENCY THIS PROPERTY
EXISTI H/S
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REMARKS
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CHECKED BY
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REMARKS
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Legal Description of PrePerly I.h.w Below or Attach Four Copies)
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SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
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RESIDENTIAL
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❑ LINE
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PLAN CHECKED DY
❑ NEW
THIS SITE IS LOCATED IN THE CITY
.
NON-RESIDENTIAL
slcx
OF EDMONDS. LOCAL SALES TAX
CODED 31.04.
ADD
RETAINING
SHOULD BE
REMARKS
DEM"'IS11 WAS'
EXCAVATE FENCE
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Fee
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Plot, Cheek No.....................
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BUILDING
PROPOSED USE
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PLOT PLAN (Indlenta Building eetbacke, abutting streets)
HEAT & 6A9 LINE
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FENCE
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SIGN
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SWIMMING POOL
DEMOLITION
PRE-MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
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In-
I hereby acknowledge that I have rend this application; that tha In-
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formation given in correct; and that I am the owner, or the duly author.
(zed agent of the owner. I agree to comply with city and elate laws ratio.
ATTENTION
APPLICATION APPROVAL
(Ming construction; and In doing the work authorized thereby, no peroon
will be employed In violation of We Labor Code of the State of Washington
THUS PERMIT
This application is not a permit until
relating to Workmen's Compensation Insurance.
AUTHORIZES
eigned by the Building Official or his Dep-
l
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TILE
{YORK NOTED
uty; and fees are paid, and receipt is ac-
.hall be completed In nicely days; MOVED-IN BUILDINGS shall be cam-
knowledged in space provided.
pleted Ina menthe.)
HIONAT t (OW It AGENT) DATE 810NE
INSPECTION
DEPARTMENT
DIRE B E
CITY OF
NOTE: Applicant Subject to Platt Check Fee
hh 1
ED51ONDS
775-2525
DAIW
This Permit -vers work to be done on private properly ONLY.
Any construction on the public domain (curb., sidewalks, drlvew•ays,
FILE
marquee., ele.l will require separate permission.
USE
PERM
�— BUILDING DEPARTMENT ZONE �.-{ � NUMBER
Applicant Fill t
PERMIT APPLICATION Inaldo Heavy Ltneg JOB
ADDRESS r-') / ��•'
NAME (OR NAME OF BUSINESS)'--
/ PE LOU u ACTUAL
V. �i ' - T COVERAGE LOT COVAAGE
M MA LING ADDRESS I /-, r'. PERMISSIBLE I(EIOIIT
PROPOSED HEIGHT
C CITY I TELEPHONE N MIIEH ACTUAL LOT AREA TOTAL BLDG. AREA '
�•i i ;`;i l•�
REQUIRED YARDS PROP.... YARDS
NAME FRONT at DE ,RFAH FRONT SIDE REAR
LEOAI. LO'r VARIANCE OIt' CON DLTIONAL USE
N ADDRESS [3 YES 0 NO PERMIT NUMBER
1 1
DATE;
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C1TY
NAME
TELEPHONE NUMBER
PLANNING DEPT. API ROVAI,
TT R/W
EXISTING STREET R/W ............FT.
COMP. PLAN ST. R/W ............FT.
REMARKS
(2-N
1 1 1C
DEFICIENCY THIS PROPERTY
............FT.
NEW
al
ADDRESS ,
lating construction: and In doing the work authorized thereby, no person
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
will be employed In violation of the Labor Code of the State of Washington
Q
:.�,I.t r (: (� %�.(.'- L'
SIGN
OF EDMONDS. LOCAL SALES TAX
31.04.
CHECKED BY
y" C
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21
CITY;J
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((.j/Lit .j l'G 1"
TELEPHONE NUMBER
1 C`
METER SIZE SERVICE SIZE CLEARANCE
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CHECKED BY
STATE LICENSE NUMBER
CITY LICENSE NUMBER
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CITY OF
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N�L.�K--Y-_.. 1" C �L. UPC �- 1 70
ElALTER
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REMARKS
This !'smut nm'rro work le be dans an Private property ONLY.
REPAIR
PRE -MOVE
INSP,
❑
SWIM
POOL
NUMBER OF STORIES NUMBER O
-
Legal Description of Properly (Show Below or Attach Four Copies)\�
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PERC. E lErr N BE I Cd
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REM8 W
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FIRE ZONE TYPE O_F1CONSTRUCTION
7 STREET
IMPROVED
YE9 0 NO
SPECIAL INSPECTOR REQUIRED, (OCCUPANCY GROUP
Z
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
D RESIDENTIAL
I hereby acknowledge that I have read this application; that the In-
LINE
a YES -
NEW
Ired agent of the owner. I agree to comply with city and state law. regu.
ATTENTION
lating construction: and In doing the work authorized thereby, no person
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
will be employed In violation of the Labor Code of the State of Washington
NON-RESIDENTIAL1:1
relating to Workmen'. Compensation Insurance.
SIGN
OF EDMONDS. LOCAL SALES TAX
31.04.
ElADD
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
RETAINING
REMARKS SHOULD BE CODED
IIGNATURE (OWNER OR AGENT) DATE 117ONEU
DEMOLISH
WAIT'
t�
G`i
CITY OF
FENCE
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N�L.�K--Y-_.. 1" C �L. UPC �- 1 70
ElALTER
❑ EXCAVATE
OR FILL
❑
775-2525
This !'smut nm'rro work le be dans an Private property ONLY.
REPAIR
PRE -MOVE
INSP,
❑
SWIM
POOL
NUMBER OF STORIES NUMBER O
-
c-:.,:� r�l.T►?_L� L 1'��l � 3`� y'b�lV
( DWELLNGF
}J
f�
,
UNITS
NATURE OF WORK TO BE DONE.
Valuation
Fee
Recclnt h
':' i�•.., C.�:'r
I l._�.. _,. ;;.( �'_�
Plan Check N. .....................
BUILDING
6. po�
O
�3(yr
4 PROPOSED USE
PLUMBING / \
-7 V
r?
-
r
D
a PLOT PLAN (Indicate Bulidlll( eetbncke,,aU{lttla6
elrocla)
HEAT & GAS LINE
O
FENCE
SIGN
RETAINING WALL
--
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
J J
APPLICATION APPROVAL j
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac- i
knowledged in space provided.
DIRECTOR' S,SIONATVRE
DAT
INSPECTOR
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
formation given Is correct: and that I am the owner, or the duly author-
Ired agent of the owner. I agree to comply with city and state law. regu.
ATTENTION
lating construction: and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
THUS PERMIT
relating to Workmen'. Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except IIEMOLITIONS which
ONLY THE
WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
IIGNATURE (OWNER OR AGENT) DATE 117ONEU
INSPECTION
DEPARTMENT
I
CITY OF
ED51ONDS
NOTE: AhPlicaut Subject to Plat Check Fee
775-2525
This !'smut nm'rro work le be dans an Private property ONLY.
Any construction an the public domain (curbs, sidewalks, driveway.,marquees,
etc.) will require separate permission.
J J
APPLICATION APPROVAL j
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac- i
knowledged in space provided.
DIRECTOR' S,SIONATVRE
DAT
INSPECTOR
N
.... ..... .
N