740376.pdfI
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❑ GAS
LINE
❑ YES
BUILDING DEPARTMENT
PERMIT APPLICATION
Applicant Fin
inside IieaYy Linos
UBE PERMIT '7 '7
ZOO NUMBER (4O3 / 6
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ADDRESS /s—/
PLAN CHECKED BYI
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NAME 11111 NAME OF1iUelNEBB)
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LOT COVERAGE LOT COVESiAGE
LETMIeeiBLE 7- LOT Co
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MAILI O ADDRESS
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PENA18838LE HEIOkT PROPOSED HEIGHT
CITYTE NUMHl.A
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AME
ACTUAL LOT AREA TOTAL BLDG. AREA
REQUIRED YARDSPROPOSED YARDS
FRONT BIDE REAR FRONT BIDE HEAR
RETAINING
W
Fy
yq'PLANNING
SHOULD BE CODED
,
ADDRESS
LEGAL LOT VARIANCE OR CONDITIONAL UBE
YES 0 NO PERMIT NUMBER
(]PERMI
DEPT. APPROVAL DATE:
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CITY
TELEPHONE NUMBER
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STREET R/W
EXISTING STREET R/W ....... .... Ir. DEFICIENCY THIS PROPERTY
Co— PLAN ST. R/W ............FT. ............FT.
ALTER
❑ OR FILL (.....................Ft.)
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REMARKS
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CH CKED BY
CITY
T/ELF.PHO E NUMBER
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METER BILE SERVICE SIZE CLEARANCE ECKED HY
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REMARKS
STATE LICENSE NUMBER
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CITY LICENSE NUMBEA
NATUR/�E r WORK TO BE DO
Valuation
Fee Receipt No.
Legal DeecrlDllon o[ Ptoparty (Show Below or Allach Four Copies)
/ 1 CY%'L •
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TYPE CONNECTION
VERIFIED HY
BUILDING
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PLAN (Indicate Building setbacks, abutting streets)
REMARKS
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FIRE ZZOONNE� TYPE OF CONST CTION STREE IMPROVED
FENCE
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SIGN
SPECIAL INHPECTORED
OCCUPATNCY GROUP
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❑ GAS
LINE
❑ YES
NEW
rESIDENTIAL
PLAN CHECKED BYI
THIS SITE IS LOCATED IN THE CITY
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NON-RESIDENTIAL
s1aN
OF EDMONDS. LOCAL SALES TAX
31.04.
® ADD
RETAINING
/
MARKS
SHOULD BE CODED
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DEMOLISH WALL
EXCAVATE FENCE
ALTER
❑ OR FILL (.....................Ft.)
PRE -MOVE swim
REPAIR E] INSP. POOL
NUMBER OF
NUMBER OF STORIESILL
DNEIN6
UNITS
NATUR/�E r WORK TO BE DO
Valuation
Fee Receipt No.
/ 1 CY%'L •
Plan Check No .....................
BUILDING
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PROPOSED USE
PLUMBING
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aPLOT
PLAN (Indicate Building setbacks, abutting streets)
HEAT A GAS LINE
7
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FENCE
SIGN
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RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the in.
i
formation given Is correct; and that I am the owner, or the duly author-
Ized agent of the owner. I agree 1„ comply with city and elate laws Mgu-
ATTENTION
APPLICATION APPROVAL
lnting constructlon; and In doing the work authorized thereby, no Darman
will be employed In Violation of the Labor Code of the Slate of Washington
THIS PERMIT
This application is not a permit until
totaling to workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONH which
ONLY THE
WORK NOTED
utyi and fees are paid, and receipt Is ac -
Shall be completed 1. nasty days; MOVED -IN BUILDINGS shall be com-
knowledged In space provided,
pleted in six months:)
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SIONATRE.tOWNER OR AGE DATE SIGNED
INSPECTION
DEPARTMENT
I CToa e -N., RE
CITY OF
NOTE: Applicant Subject to Plan Cbeek Fee
FD151ONDS
775-2525This
DATE
PC Perntlt raven work to be done on private property ONLY.
Any construction on the Public domain (curbs, sidewalks, dfl—.7e,
FILE
marquees. etc.) will require separate Derntlselon.
FIRE ZONEI
S� /r1UAuty
/� �.rl O �_�' 02
A '
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7
PLOT PLAN (Indleata Hulrld\ingCs.tbaeke buSln6 streets)
YES
m'j7O 1 I _-7—
7
-,
USE PERMITNUMBER ^. r e
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OF EDMONDS. LOCAL SALES TAX
BUILDING DEPARTMENT AppllrmtFlll
.A
ZONE
SHOULD BE CODED 31.04.
�
PERMIT APPLICATION Inside Heavy L1nes
I
JOB
ADDRESS
/�/
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NAME (OR NAME OF BUSINESS)
Y "
ACOVERAGE
LOT COVAAGE
❑ NON-RESIDENTIAL
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ON
LOT
pADD
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SAILING ADDRESS-PERMISSIBLEYItOP08ED
HEIGHT
HEIGHT
4
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1 hereby acknowledge that I have rend this application; that the In-
BLD°. AREA
1
E](
.
CITY TELEPHONE NUMBIUR
ACTUAL LOT AREA
TOTAL
PRE-INSP.
❑
-.. ( /
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REQUIRED YAii US
PROPOSED YARDS
-SIDE REAR
❑
AUTHORIZES
NAME1
FRONT tlID1I REAR
FRONT
'
knowledged in space provided.
plated In six months.)
LEGAL LOT VARIANCE Oft CONDITIONAL USE
DWELLING
SIGNATURE (OWNER OR AGENT) DATE SIGNED
W ADDII 11
YES [3 NO PERMIT NUMBER
;
UNIT.
PLANNING DEPT. APPROVAL
DATE:
NATURE OF WORK TO BE DONE,
Fee
O
CITY TELEPHONE NUMBER
DATE
NOTE: Applicant Subject to Plan Check
775-2525i—
This Permit coven Work to be done un private property ONLY.
STREET
EXISTING.ST STREET R/W ............FT.
DEFICIENCY THIS PROPERTY
d
^ /
NAME()F,\) ^^ (-0,
) -)
COMP. PLAN ST. R/W ............FT.
REMARKS
............FT.
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ADDRESS
/I'
/.S /7 ( /
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CHECKED BY
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m CITY TELEPHO E NUMBER
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F
METER SIZE SERVICE SIZE CLEARANCE BY
STATE LICENSE NUMBER CITY LICENSE NUMBER
I I
ICHECKED
✓
_
77
.�. �! Q ✓ -'ci ��"
REMARK.
Legal Description of Property (.haw -77 7r Attach Four Copley)
TYPE CONNECTION
VERIFIED BY
i
PE611nT NUMBER
99
REMARK.
1
FIRE ZONEI
V
/� �.rl O �_�' 02
i PROPOSED USE
PLUMBING
NO
I
a
PLOT PLAN (Indleata Hulrld\ingCs.tbaeke buSln6 streets)
YES
m'j7O 1 I _-7—
7
`v `-�"�����
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
�
GAS
RETAINING WALL
NEW
J
SWIMMING POOL
❑ NON-RESIDENTIAL
_ 1 r.
ON
pADD
PRE -MOVE INSPECTION
RETAINING
EXCAVATION OR FILL
Valuation
DEMOLISH
O
WALK,
1 hereby acknowledge that I have rend this application; that the In-
ALTER
❑ OR FILL EXCAVATE
E](
x .......... Fl.)
Ized agent of th. owner. I or.. to comply with city and slate laws rcgu-
REPAIR
PRE-INSP.
❑
will beemployed Ia vlolathm of the Label Code of the State of Washington THIS PERMIT
This application is not a permit until
❑
AUTHORIZES
POOL
ONLY
MOTE: Permit Limit One Year (Except DEMOLITIONS Which WORK NOTED
NUMBER OF BTO.i..I NUMBER OF
shall be completed In ninety days; MOVED -IN BUILDINGS shall be COM-
knowledged in space provided.
plated In six months.)
DWELLING
SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
Di ECTOR'8 a130NATURE
UNIT.
'
CITY OF
NATURE OF WORK TO BE DONE,
Fee
EDMONDS
DATE
NOTE: Applicant Subject to Plan Check
775-2525i—
This Permit coven Work to be done un private property ONLY.
Any const2rtl.. on itis public dnmeln (curb., sidewalks, driveways,
INSPECTOR
FIRE ZONEI
TYP�F CO/STR CTION B T, 3DfP❑R
/� �.rl O �_�' 02
i PROPOSED USE
PLUMBING
NO
I
9 CIAL INSPECTOR REQUIRED OCCUPANCY GROUP
/
PLOT PLAN (Indleata Hulrld\ingCs.tbaeke buSln6 streets)
YES
m'j7O 1 I _-7—
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
`v `-�"�����
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
�
TREMA KS
I
RETAINING WALL
N
SWIMMING POOL
_ 1 r.
--n �" ZI i7.e� T,• iZ' /�b�t✓!- r'.'i/iiJ('.
PRE -MOVE INSPECTION
EXCAVATION OR FILL
Valuation
Fee
Receipt No.
\
•"j [/ f rrI' `
1 hereby acknowledge that I have rend this application; that the In-
Plan Check No .....................
formation given Is correct; 'and that I am the owner, or the duly aulhor-
[j
BUILDING
/� �.rl O �_�' 02
i PROPOSED USE
PLUMBING
V
-
PLOT PLAN (Indleata Hulrld\ingCs.tbaeke buSln6 streets)
HEAT & GAS LINE
`v `-�"�����
FENCE
9IGN
�
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL A3IOUNT DUE
\
•"j [/ f rrI' `
1 hereby acknowledge that I have rend this application; that the In-
formation given Is correct; 'and that I am the owner, or the duly aulhor-
Ized agent of th. owner. I or.. to comply with city and slate laws rcgu-
ATTENTION
APPLICATION APPROVAL
latmg canetntctlon; and In doing the work authorized thereby, no person
will beemployed Ia vlolathm of the Label Code of the State of Washington THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation Imurnna.
AUTHORIZES
signed by the Building Official or his lisp-
ONLY
MOTE: Permit Limit One Year (Except DEMOLITIONS Which WORK NOTED
uty; and fees are paidand receipt Is ac -
, P
shall be completed In ninety days; MOVED -IN BUILDINGS shall be COM-
knowledged in space provided.
plated In six months.)
-- -
SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
Di ECTOR'8 a130NATURE
DEPARTMENT
'
CITY OF
Fee
EDMONDS
DATE
NOTE: Applicant Subject to Plan Check
775-2525i—
This Permit coven Work to be done un private property ONLY.
Any const2rtl.. on itis public dnmeln (curb., sidewalks, driveways,
INSPECTOR
marquee., ele.l will require .eparote permission,
Frame
Furnace & Fuel Lines
Final