740403.pdfr
Plan Check No .....................
BUILDING
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6, PROPOSED USE
PLUMBING
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BUILDING
DEPARTMENT
Applict FillZONE
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NUMBERF-puluz 740403
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PERMIT APPLICATION
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JOB
ADDRESS .-.SI�IA
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NAME (OR NAME OF BUSINESS) tT LLL111 '
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SIGN
PERa118B18LE ACC TUAL
LOTCOVERAGE
tRETAINING
WALL
LOT COVERAGE
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PERMISSIBLE HEIGHT PROPOSED HEIGHT
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TOTAL DLDO. AREA
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CITY
TELEPHONE NUMBER ACTUAL LOT AREA
EXCAVATION OR FILL
REQUIRED YARUtl PROPOSED YARDS
BIDE REAR
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TOTAL AMOUNT DUE
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NAME
1 hereby acknowledge that I have rend 161s apDllcntlon; that We In-
FRONT HIDE REAR FRONT
p
t,t
;
LEGAL LOT VARIANCE OR CONDITIONAL USE
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ADDRESS
teed agent of the owner. I agree to comply with city and elate lawn regu-
ATTENTION
(3 YES O NO PERMIT NUMBER
,at,..Con.lruclion; and in doing the work authorized thereby, no person
-
PLANNING DEPT. APPROVAL DATE:
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CITY TELEPHONE NUMBER
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signed by tale Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
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ehall be completed In ninety days, MOVED -IN BUILDINGS Shall be com-
knowledged In space provided.
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
pleted In six month..)
NAME
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COMP. PLAN ST. R/W ............FT. .....FT.
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REMARKS
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ADDRESS
23 a
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1747
NOTE: Applicant Subject to Plat Check Fee
CHECKED 8Y
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CITY
TELEPOHONE NUMBER
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Any cunei ruction on the public domain (curb., sidewalks, driveways,
FILE
CHECKED BY
marquees, ete.l will require separate pernilssicn.
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71 —96,61? METER SIZE SERVICE SIZE CLEARANCE
STATE LICENSE NUMBER
CITY LICENSE NUMBER I I
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REMARKS
Legal Description of Property (Show Below or Attach FourCopies)
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TYPE CONNECTION VERIFIED BY
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REMARKS
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FIRE ZONE TYPE/OfF�CONBTR CTION STREET IMPROVED
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SPECIAL INSPECTOR QUIRED OCCUPANCY GROUP
❑ YES I
RESIDENTIAL
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❑ LINE
PLAN CHECKED BY
NEW
THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL �
i^� OF EDMODS. LOCAL SALES TAX
SIGN
A 7G (nL.� BE CODED 31.04.
,® ADD
ElDEMOLISHWALT
RETAINING
MARKS
FENCE
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ALTER
EXCAVATE
OR FILL
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O SWIM
POOL
B f' D/-
NUMBER OF STORIES NUMBER OF
DWELLING
(
UNITS
NATURE OF la
TO BE DONE
Valu.tien Fes Receipt
No.
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Plan Check No .....................
BUILDING
3��00
aYa"
6, PROPOSED USE
PLUMBING
-
Q PLOT PLAN (Indicate Building setbacks, abultln6 attecta)
BEAT & GAS LINE
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FENCE
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tRETAINING
WALL
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BWIMMiNO POOL
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DEMOLITION
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PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
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1 hereby acknowledge that I have rend 161s apDllcntlon; that We In-
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turmoilon riven Is correct: and that I am the owner, or the duly author -
teed agent of the owner. I agree to comply with city and elate lawn regu-
ATTENTION
APPLICATION APPROVAL
,at,..Con.lruclion; and in doing the work authorized thereby, no person
hill he employed In violation of the Labor Code of the Stale of Washington
THIS PERMIT
This application Is not a permit until
mlatleg to Workmen's Compen U.n. Imuran..
AUTHORIZES
signed by tale Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is Bc-
ehall be completed In ninety days, MOVED -IN BUILDINGS Shall be com-
knowledged In space provided.
pleted In six month..)
SIGNATUREER OI AGENT)DATE SIGNED
INSPECTION
DEPARTMENT
DI BIG ATU
CITY OF
iJ
EDMONDS
DATE
NOTE: Applicant Subject to Plat Check Fee
� � a _
F
775-2525
Till. Permit a vork lu be sone on private property ONLY.
Any cunei ruction on the public domain (curb., sidewalks, driveways,
FILE
marquees, ete.l will require separate pernilssicn.
I
NATURE OF ORK TO BE DONE
-
V.1-11..
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BUILD 1 N G DEPARTMENT Applicant]LInes
USE �1
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PERMIT
NUMBER i
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LINE
CHECKED BY
❑PLAN O
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NEW
Inside HeavATD
PERMIT APPLICATION
ADDRESS
SIGN
(OR NAME ON BUSINESS)°'ACTUAL
BUILDING
%NAME
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L
LOT COVERAGES
REMARKSElDEMOLISH
LOT COVESiAOE94
U
HEIOFIT
PROPOSED HEIGHTPElibtISS18LE
PLOT PLAN (Indicate Building setback., abutting ntrects)
ACTUAL LOT AREA
❑
TOTAL BLDG. AREA ?.
U
E
CITY
REQUIRED YARDS PROPOSED YARDS
NAME FRONT SIDE REAR FRONT SIDE REAR
LEGAL LOT VARIANCE OR CONDITIONAL USE f
ADDRESS YES ❑ NO PERMIT NUMBER i
PLANNING DEPT, APPROVAL i DATE:
- - - --'------- Tit -.1 ? ,
IC4 LADDRESS3 r,( 1. R - 71 —<Y /
STREET It/W
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............Fr. . ............FT,
REMARKS
CHECKED BY
NATURE OF ORK TO BE DONE
-
V.1-11..
Fee Receipt No.
SPECIAL INSPECTOR
0
RESIDENTIAL
El
11
LINE
CHECKED BY
❑PLAN O
El
NEW
❑
NON-RESIDENTIAL
SIGN
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BUILDING
ADD
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SNC
WALL
REMARKSElDEMOLISH
U
LINE
11- Lnre�
PLOT PLAN (Indicate Building setback., abutting ntrects)
ALTER
❑
OR AVAILL E
z..........Fl.)
PENCE
❑
REPAIR
S
PRE -MOVE
'� l iGr(jl
tYl�tl.
1
.7
❑
INSP.
POOL
;UMBER OF STORIES
STREET It/W
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............Fr. . ............FT,
REMARKS
CHECKED BY
/ I aT, E9 ❑ NO
OCCUPANCY GROUP
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TA)
NATURE OF ORK TO BE DONE
-
V.1-11..
Fee Receipt No.
SPECIAL INSPECTOR
��
RESIDENTIAL
El
11
LINE
CHECKED BY
❑PLAN O
El
NEW
❑
NON-RESIDENTIAL
SIGN
/
V I
BUILDING
ADD
i
L
SNC
WALL
REMARKSElDEMOLISH
U
LINE
FENC
PLOT PLAN (Indicate Building setback., abutting ntrects)
ALTER
❑
OR AVAILL E
z..........Fl.)
PENCE
❑
REPAIR
PRE -MOVE
SWIM
1
❑
INSP.
POOL
;UMBER OF STORIES
NUMBER OF
N
DWELLING
I
SWIMMING POOL
UNITE
i
/ I aT, E9 ❑ NO
OCCUPANCY GROUP
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TA)
NATURE OF ORK TO BE DONE
V.1-11..
Fee Receipt No.
��
I
)1.—
Plan Check N. .....................
/
V I
BUILDING
i
PROPOSED USE
PLUMBING
U
LINE
PLOT PLAN (Indicate Building setback., abutting ntrects)
HEAT A, GAS
s:'.J
PENCE
1
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
i
PRE -MOVE IN13PECTION
EXCAVATION OR FILL
/
TOTAL AMOUNT DUE
I hereby acknowledge that I havo read this application; that the In
formation given le correct; and that I am the owner, or the duly author -
told agent of tho owner. I agree to comply with city and elate laws regu-
ATTENTION
APPLICATION APPROVAL
tall.. construction; and In doing th. work authorised 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
..at,.. to Workmen'. Compensation Insurance.
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 receipt Is ne-
ehall be completed In ninety days: MOVED -IN BUILDINGS .hall be cum-
knowledged In space provided.
{
Ileal In .1. ...the.) -
SIGNATURE (OWNER OR AGENT)
DATE SIGNED
INSPECTION
DIRECTOR'S 8113NAYUIT ///
_
DEPARTMENT
I - t_ r /,)„'`•1%;�i1- C/!
CITY OF
”
Subject to Plan Check Fee
EDMONDS
DATE 4r
NOTE: Applicant
775.2525
\This Permit corer.work to b. done on private property ONLY.
the domain (curbs, emewniks, drWewgs'
P
�I'
Any construction on public
nmryueee, etc.) will require eeparal. permission.
INBPECTOA
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