740361.pdfValuation
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Receipt No.�r/`��7
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BUILDING DEPARTMENT PE tMIT
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PERMIT APPLICATION
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ATTENTION
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lating construction; and In doing the work authorized thereby, no person
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DWELLING
NAMEFRONT
TIUB PERMIT
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relating to Workmen'a Compeneatfoa Insurance.
AUTHORIZES
UNITS
NOTE: Permit Limit One Year (Except DEMOLITIONS which
OIII.Y TILE
WORK NOTED
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shall be completed In ninety days; 310VED-IN BUILDINGS shall be com.
LEGA LOT VARIANCE OR CONDITIONAL U /
knowledged in space provided.
pleled In IXmonth..)
BIGNATUR' (OWN OII ENT DATE SIGNED
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IRE O S IGNATU tE
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DEPARTMENT
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NOT •: Applicant Subject to Plan Check Fee
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775-2525
CITY TELEPHONE NUMBER
This 1'ennit caren work to be done on private property ONLY.
EXIST O STREET R/V� ��. DEFICIENCY THIS PROPERTY
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marquees, etc.) will require separate permission.
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COMP. PLAN ST. 11/40D•PFT• FT.
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indicated on Standard Dwg. No. 103
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Valuation
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Receipt No.�r/`��7
X77
CJI
I�SPECIAL
RESIDENTIAL
❑
OAS
LINE
❑ Y ES
I`IxI--'
NEW
PROPOSED USE
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PLUMBING
PLANCHl
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NON-RESIDENTIAL
SIGN
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ADD
❑WALL
DEMOLISH
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NING
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RETAINING WALL
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EXAVATE
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DEMOLITION
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El
REPAIR
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PREINSP�fOVE
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SWIM
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POOL
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NUMBER OF STORIES
NUMBER OF
ized agent of the owner. I agree to comply with city and elate laws regu-
ATTENTION
APPLICATION APPROVAL '
lating construction; and In doing the work authorized thereby, no person
and
DWELLING
will be employed In of the Labor Code of the Slate of Washington
TIUB PERMIT
This application Is not a permit until
relating to Workmen'a Compeneatfoa Insurance.
AUTHORIZES
UNITS
NOTE: Permit Limit One Year (Except DEMOLITIONS which
OIII.Y TILE
WORK NOTED
uty; and fees are paid, and receipt Is ac -
B=;70N BTREE IASP D
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ED OCCUPANCY GROUP
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THIS SITE IS LOCATED IN THE CITY I
OF EDMONDS. LOCAL SALES TAX
SHOULD EE CODED 31.04.
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NATURE OFF WORK TO DONE
Valuation
Fee
Receipt No.�r/`��7
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BUILDING,
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PROPOSED USE
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PLOT PLAN (Indicate Building a backs, abutting streets - BEAT & GAS LINE
FENCE
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SIGN
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RETAINING WALL
N
SWIMMING POOL
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DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
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I hereby acknowledge that I have read thin application; that the In-
TOTAL AMOUNT DUE
formation given is correct; and that I Am the owner, or the duly author-
ized agent of the owner. I agree to comply with city and elate laws regu-
ATTENTION
APPLICATION APPROVAL '
lating construction; and In doing the work authorized thereby, no person
and
will be employed In of the Labor Code of the Slate of Washington
TIUB PERMIT
This application Is not a permit until
relating to Workmen'a Compeneatfoa Insurance.
AUTHORIZES
signed by the Building Official or his Dep-
NOTE: Permit Limit One Year (Except DEMOLITIONS which
OIII.Y TILE
WORK NOTED
uty; and fees are paid, and receipt Is ac -
shall be completed In ninety days; 310VED-IN BUILDINGS shall be com.
knowledged in space provided.
pleled In IXmonth..)
BIGNATUR' (OWN OII ENT DATE SIGNED
INSPECTION
IRE O S IGNATU tE
//'� /
- 7
DEPARTMENT
r 1 2
CITY OF
DATE
NOT •: Applicant Subject to Plan Check Fee
�V-7 �
775-2525
This 1'ennit caren work to be done on private property ONLY.
Any construction on the public domain (curb., sidewalks, driveways.
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marquees, etc.) will require separate permission.
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REMARKSPT'].VQlJajr sl.one= T10Y, to exceed t}LOSE
indicated on Standa,d Fl,,,. Ido- 103
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TELEPHONE NUMDER
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METER el•LE SERVICE SIZE CLEARAN E
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BUILDING DEPARTMENT Applicant Fill
USE PERMIT
ZONE NUMBER
PERMIT APPLlCATBAPI
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OF BUSINESS)
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NAME (OR NAME
PERMISSIBLE
LOT COVERAGE (�
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LOT COVESiAGE
MAILING ADDRESS
PERMISSIBLE HEIOttT
PROPOSED HEIGI}T
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BLDG. ARE
CITY
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ACTUAL LOT AREA
TOTAL
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R QUIRED ARDS
P POKED YARDS
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NAME
FRONT SIDE, REAR
FRONT BIDE
REAR
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LEGAL LOT VAR IA NCL OR CONDITIONAL US
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ADDRESS
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PLA�7-- N6 DEP, ABP AL /.
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CITY
I TELEPHONE NUMBER'
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S;rEEET ft/tY
NATURE OF WORK TO /HED ONE Valuation Fee Receipt No.
Plan Check No...._ ...............
IO `t.-CC,r BUILDING ?t1 _ �.3 2—
L PROPOSED USE
py, PLUMBING ..1i
PLOT PLAN (Indicate Sul__ltll\\n�_c ,t 5k bulting streets j \ HEAT A GAS LINE
� m FENCE
V
C%- \ SIGN
RETAINING WALL
I�SWIMMING POOL
•� (;' \ DEMOLITION
11444 PRE -MOVE INSPECTION
A EXCAVATION OR FILL
r\
hi I
TOTAL AMOUNT DUE
1 hereby acknowledge that I have rend this application; that the in•
formation given le correct; and that I am the owner, or the duly aulhor-
Ired agent of, the owner. I agree to comply with city and elate laws regu- ATTENTION APPLICATION APPROVAL
lating construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Stale of Washington THIS PERMIT This application is not a permit until .
,.lating to workman's Compensation Insurance. AUTHORIZES Signed by the Building Official or his Dep -
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORII NOTED uty; and fees are paid, and receipt is ac- ;
shall be completed In ninety days: MOVED -1N BUILDINGS shall he eam- knowledged In space provided.
Pleted In slz months.)
SIGNATURE. (OWNER OR ;koliN'r�- DATE SIGNED INSPECTION DIREgTOR'S SIGNATURE f) 1
f / DEPARTMENT
CITY OFI
EDAIONDS DATE
NOTE: Applicant Subject to Plan Check Fee 775-2525
ThisPermit n n work lu be done on Private property ONLY.
Any construction on the public domain (curb., ehiewallts, drlreway.,
marquees, etc.) will require separate permission. INSPECTOR
EXISTING STREET R/V.kS..Fr. DEFICIENCY THIS PROPERTY
COMP, PLAN ST. R1h'?hP..FT. ... b...FT.
NAME
REMARKSPT'].VQlJajr sl.one= T10Y, to exceed t}LOSE
indicated on Standa,d Fl,,,. Ido- 103
ADDRESS
{7�i� S��/ A�
jj�l N) i.1 nyd) 91 N & 21�Q D
PHE �,q�HY
F CITY
V
TELEPHONE NUMDER
I
METER el•LE SERVICE SIZE CLEARAN E
�/ I / ii I
C1iEC D BY
I r:
STAT7E LICENSE�N%UM7BEER
i ---] `O/- / ,7l
CITY LICENSE NUMHEIt
REMARKS .r
Legal Deee Iptlon of Property "dhow Below or Llnch Four Copies)
.(�(.pflY /
TYPE CONNECTION
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VERiF3EDBY
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4—GIi1.•(l` l-/+^ �' :,e' /)'�.�y�i..(_.
PL•'RC. TEST
I FER11CAT NUMBER
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7,?
REMARKS
NATURE OF WORK TO /HED ONE Valuation Fee Receipt No.
Plan Check No...._ ...............
IO `t.-CC,r BUILDING ?t1 _ �.3 2—
L PROPOSED USE
py, PLUMBING ..1i
PLOT PLAN (Indicate Sul__ltll\\n�_c ,t 5k bulting streets j \ HEAT A GAS LINE
� m FENCE
V
C%- \ SIGN
RETAINING WALL
I�SWIMMING POOL
•� (;' \ DEMOLITION
11444 PRE -MOVE INSPECTION
A EXCAVATION OR FILL
r\
hi I
TOTAL AMOUNT DUE
1 hereby acknowledge that I have rend this application; that the in•
formation given le correct; and that I am the owner, or the duly aulhor-
Ired agent of, the owner. I agree to comply with city and elate laws regu- ATTENTION APPLICATION APPROVAL
lating construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Stale of Washington THIS PERMIT This application is not a permit until .
,.lating to workman's Compensation Insurance. AUTHORIZES Signed by the Building Official or his Dep -
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORII NOTED uty; and fees are paid, and receipt is ac- ;
shall be completed In ninety days: MOVED -1N BUILDINGS shall he eam- knowledged In space provided.
Pleted In slz months.)
SIGNATURE. (OWNER OR ;koliN'r�- DATE SIGNED INSPECTION DIREgTOR'S SIGNATURE f) 1
f / DEPARTMENT
CITY OFI
EDAIONDS DATE
NOTE: Applicant Subject to Plan Check Fee 775-2525
ThisPermit n n work lu be done on Private property ONLY.
Any construction on the public domain (curb., ehiewallts, drlreway.,
marquees, etc.) will require separate permission. INSPECTOR
I7:H
`i
SPECIAL INSPECTOOR REQUIRED OCCUPANCY GROUP
❑ YES 2'NLL
O I _^ / I
NEW
❑ ADD
❑ ALTER
❑ REPAIR
RESIDENTIAL
❑ NON-RESIDENTIAL
E]RETAINING
DEbSOLISH
❑ ORFILLEXCAVATE
PRE -MOVE
❑ INSP.
❑
❑
❑
❑
GAe
LINE
slcx
WALL
FENCE
1 ......... ........... Ft.)
SWIM
POOL
CHECKED BY PLAN
-_ THIS SITE IS LOCATED IN THE CITY
`! / OF EDMONDS. LOCAL SALES TAX `'/'.l�'-.' -. %'� -�� SHOULD BE CODED 31,04.
RDMARKS1
G_//
/
_
”!/%"•r- i j iI7 (7i�i .S /J /�v`,j/L C/F✓r
NUMBER OF STORIES I NUMBER OF
`I D{VELLING
UNITS
AlI, �'r✓w
NATURE OF WORK TO /HED ONE Valuation Fee Receipt No.
Plan Check No...._ ...............
IO `t.-CC,r BUILDING ?t1 _ �.3 2—
L PROPOSED USE
py, PLUMBING ..1i
PLOT PLAN (Indicate Sul__ltll\\n�_c ,t 5k bulting streets j \ HEAT A GAS LINE
� m FENCE
V
C%- \ SIGN
RETAINING WALL
I�SWIMMING POOL
•� (;' \ DEMOLITION
11444 PRE -MOVE INSPECTION
A EXCAVATION OR FILL
r\
hi I
TOTAL AMOUNT DUE
1 hereby acknowledge that I have rend this application; that the in•
formation given le correct; and that I am the owner, or the duly aulhor-
Ired agent of, the owner. I agree to comply with city and elate laws regu- ATTENTION APPLICATION APPROVAL
lating construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Stale of Washington THIS PERMIT This application is not a permit until .
,.lating to workman's Compensation Insurance. AUTHORIZES Signed by the Building Official or his Dep -
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORII NOTED uty; and fees are paid, and receipt is ac- ;
shall be completed In ninety days: MOVED -1N BUILDINGS shall he eam- knowledged In space provided.
Pleted In slz months.)
SIGNATURE. (OWNER OR ;koliN'r�- DATE SIGNED INSPECTION DIREgTOR'S SIGNATURE f) 1
f / DEPARTMENT
CITY OFI
EDAIONDS DATE
NOTE: Applicant Subject to Plan Check Fee 775-2525
ThisPermit n n work lu be done on Private property ONLY.
Any construction on the public domain (curb., ehiewallts, drlreway.,
marquees, etc.) will require separate permission. INSPECTOR
Foundation
Plumbing (Partial) S- 7
(Rough) Y
Frame
Furnace & Fuel Line
Finalz��