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740371.pdfe f . j PERMITUSE 40311 �., BUILDING DEPARTMENT AppllcantFill ZONE NUMBER r PERMIT APPLICATION Inside Heavy Linen I IO ADDRESS 0 j NAME OR NAMD OF UBINEBB) �� / O ACTUAL 1-- L,OT C VERA IAT COVERAGE LOT COVESRAOE PIfOPOdED HEIGHTX i 1 (a O ADURE �j PEIlhlltldlDLE HEIGHT FY �L�D ` •I O .� O y TELEPHONE NUMBER ACTUAL LOT AREA TOTAL BLDG. AREA A D6 REQUIRED YARDS PROPOSER YARDS NAME FRONT BIDE REAR FRONT SIDjr.REAR 1y LEGAL LOT VA IANCE OR CONDITIONAL USE ig AUD1tEtltl I] YES NO PERMIT NUMBER PLANNING 6 DEPrI'PROVAL CITY 11TELEPHONE NUMBER STREET EXISTINGGSTREET R/W ............FT, DEFICIENCY THIS PROPERTY NAME COMP. PLAN ST. R/W ............FT. ............F1'. W . L LU REMARKS+ m AU 1tEB19 O Z BY CITY TELEPHONE NUMBER (CHECKED E j I METER SIZE SERVICE 81ZE CLEARANCE 'I CHECKED BY O STATE LICENSE NUMSBERCITY LICENSE NUMBER I I 01 REMIARKd ` . Legal Description of Property (Show Below or Attach Fear Copies) I TYPE CONNECTION VERIFIED BY O I ' PERC. TEST PERMIT NUMBER a l I ' W W REMARKS m � ;7 J � W FIRE ZONE OF CONSTRUCTION STREET IMPROVED (TYPE YES [] NO SPECIAL INSPECTOR REQUIRED GROUP RESIDENTIAL LINE ❑PLANS IOCCUPANCY I NEW CHECKED BY THIS SITE IS LOCATED IN THE CITY NON-RESIDENTIAL BIG. OF EDMONDS. LOCAL SALES TAX BE CODED 31.64. ❑ ADD RETAINING WALL ❑ REMARKS SHOULD i DEMOLISH ❑❑ EXCAVATE �j FrCE ALTER �/j� (� ;t OR FILL (. REPAIR ❑ IN P. IOVE ❑ ePOOOL l NUMBER OF STORIES NUMHER OF DWELLING UNITS NATURE OF WORK TO DONE Valuation Fee Receipt No. i r --� Plan Check N. ..................... i 0 BUILDING , 4 PROPOSED USE PLUMBING U a PLOT PLAN (Indicate Building setbacks, abutting streets) HEAT do OAS LINE I FENCE SIGN tRETAINING WALL' 1 SWIMSMING POOL — I DEMOLITION PRE -MOVE INSPECTION EXCAVATION OR FILL O 9V? TOTAL AMOUNT DUE I hcreDy acknowledse that I have rend this application; that the In- CP1, / �l formation given iscorrect; and that I am the owner, or the duty author- Ised agent of the owner. I agree to comply with city and state laws reg.- ATTENTION APPLICATION APPROVAL I¢ling contraction; and 1. 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's Compe... it.. iesurance. AUTHORIZES signed by the Building Official Or WS Dep - NOTE: Permit Limit One Year (Except DEMOLITIONS which ONLY THE WORK 140TED uty; and fees are paid, and receipt is ac .hall be comple d II ninety days; MOVED -IN BUILDINGS shall be Co.- knowledged in space provided. pitted In d1ONAT 1 WNER O AG r DATE Bl NEll INSPECTION D OR's B1l4wTU /' DEPARTMENT ;',y Ali (,.�!()Ur ` ,•/:'(, CITY OF DATE EDMONDS :_----�"— - NOTE: Applicant Subject to Plan Cheek Fee ^a 775-2525 This Penult corers work In be done no private property ONLY. Any construction on the public domain (curbs, sidewalks, driv..".. FILE marquee., etc.) will regWre separ¢le perml.elon. 1 �a • RESIDENTIAL LINE BUDING IL DEPARTMENT ApplleantFill PERMIT, .. 740371 I BUILDING I PERMIT APPLICATION Inside heavy Lines JOB ADDRESS ADD ❑ NAME lOR NAME OF. BUSINESS) AL r PP:ItalltldlBLE ea ACTUCOVESYAGE ❑ WALL MNG J ALTER LOT COVERAGE LOT ci !I �. AILING AD DR ... PERMISSIBLE HEIGHT PROPOtlED HEIGHT i El REPAIR 1 ACTUAL LOT AREA TOTAL BLDG. AREA F :h O CITY TELEPHONE NUMHbR IN9PFIOVE FENCE POOL -2 REQUIRED YARDS PROPOSED YARDS FRONT BIDE REAR FRONT HIDE REAR NAME SIGN DWELLING I LEGAL LOT VARIANCE OR CONDITIONAL USE .'7 Wp ADDRESS YE9 NO PERMIT NUMBER yi -. PLANNING DEPAPPROVAL DATE: T. d CITY T19LEPHONE NUMBER STREET V' EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY SWIMMING POOL NAME I COMP. PLAN 8T. R/W FT. ............FT. REMARKS , .. �a YES ❑ NO YES E3 NO OCCUPANCY GROUP I � THIS SITE IS LOCATED IN THE CITY OF EDMONDS. LOCAL SALES TAX SHOULD IIE CODED 31.04. I Valuation Fen I Receipt No. i ii'J .I:�t-t _� RESIDENTIAL LINE NEW BUILDING NON-RESIDENTIAL ❑ SIGN ADD ❑ DEMOLU ❑ WALL MNG - ALTER ❑ EXCAVATE OR FILL '© FENCE��l' (�..LZ.z...... iSt.) El REPAIR HEAT & GAS LINE El SWIM PLOT PLAN (Indicate Building setbacks, abutting street.) ❑ IN9PFIOVE FENCE POOL IUAIBER OF STORIES NUMBER OF SIGN DWELLING I RETAINING WALL UNITS YES ❑ NO YES E3 NO OCCUPANCY GROUP I � THIS SITE IS LOCATED IN THE CITY OF EDMONDS. LOCAL SALES TAX SHOULD IIE CODED 31.04. I Valuation Fen I Receipt No. i ii'J .I:�t-t _� Plan Check N. ..................... BUILDING [OF ` M PROPOSED USE a - PLUMBING ' U HEAT & GAS LINE PLOT PLAN (Indicate Building setbacks, abutting street.) FENCE 7� _� SIGN RETAINING WALL -. N SWIMMING POOL I DEMOLITION i PRE -MOVE INSPECTION EXCAVATION OR FILL 4, l7 v I / rlf/'21 TOTAL AMOUNT DUE I hereby acknowledge that I have read this application; that the In ` tormallan given 1, correct; and that I am the owner, or the duly author. Ired agent of the owner. I agree to comply with city and stale laws reg.- ATTENTION APPLICATION APPROVAL { lath. coastruetloa: and In doing the work autherlxed thereby, no parson - willbo employed In vlolalloa of the Labor Code of the Stale of Washington THIS PERMIT This application is not a permit until relnlln6 to Workmca's Compensation Imuranu. AUTHORIZES signed by the Building Official or his Dep - NOTE: Permit Limit One Year (Except DEMOLITIONS w•hleh ONLY TIIF. WORK NOTED uty; and fees are paid, and receipt is ac - shall be completed In ninety day.; 1§10VED-IN BUILDINGS shall be cam. Itnowledged in space provided. pleled In ala month..) 1 ) SIGNATURE DATE 819NED / INSPECTION DEPARTMENT DIREOR'S SIGNATUj{E �(//� i/q•�p,' (//� �`."'..1'..`!�• /i'f..(��GtAv CITY OF EDDIOND$ D NOTE: Applicant Subject to Plan CGeck Fee ` )7 t/ r 775-2525 TitlePermit cm'ers cork to be done on private vrapertY ONLY. 1 Any construction on the public dnmoln (curbs, sidewalks, driveway., INSPECTOR marquee., ell.) x'111 r"mra separate pernll.Mon.