740412.pdf1
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BUILDING DEPARTMENT AppHaant 11
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PERMIT APPLICATION Ineldo Heavy Lines
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NAME (Oft NAME OF BUe3NE88)Q!y
ADDRESS
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1A
PERM ISSIDLE s
LOT COVERAGE
ACTUA
LOT COVERAGE
M
16,S
MAILING O ADDR111
PERMISSIBLE HEIGHT
PROPOSED HEIGHT
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C3T1—
TEL•'E7P/HONE NUMBLY—
ACTUAL LOT AREA
TOTAL BLDG. AREA
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REQUIRED YARDS PROPOSED YARDS
NAME
FRONT BIDE
REAR FRONT BIDE REAR
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NW
ADDRE88
LEGAL LOT VARIANCE OR CONDITIONAUSE
L 0 YES 0 NO PERMIT NUMBER
1
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PLANNING DEPT. APPROVAL DATE:
CITY
TELEPHONE NUMBER
STREET A/tV
O
I
EXISTING STREET R/W ............FT.
DEFICIENCY THIS PROPERTY
NAME
t
—7---- /��a.' f��Di1tA.S
COhfP. PLAN 0T. R/W ............F
-r. ............FT.
W
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REdARHB
F
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=_/A .4,
ADDRESS
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8 l6 (�%
CHECKED BY
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a-2-2110
M
CITY
NUMBER
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/ e
2 //— a [C�/A
72V- /9
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METER SIZE
SERVICE BILE CLEARANCE
CHECKED BY
O
STATE LICENSB N)UM7BER
CITY LICENSE NUMBER
2� - J 4-5r3
, (
Legal Description of Properly (show Below or Attach Four Copies)
AEMARHS
<
TYPE CONNECTION
VERIFIED BY
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A
I 1
Fy
PERC. TEST
PERMIT NUMBER
I 1
m
W
p
REMARKS
V
I
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
YES 0 NO
SPECIAL INSPECTOR REQUIRED GROUP
RESIDENTIAL
GAB
❑ LINE
❑ YES [3 NO
IOCCUPANCY
i
xsw
PLAN CHECKED BY
THIS SITE IS LOCATED IN THE CITY
NON•RE8IDENTIAL
gIGN
OF EDMONDS. CAL SALES TAX
EJ ADD
RETAI❑ HINC
REMARKS
SHOULD BE CODEDLO31.04.
DEMOLISH ❑ WALL
i ..
E ❑ FENCE
ALTER ❑ EXCAVATE
ORFILL JC Ft.)
1'
PRt-SWIf
REPAIR
❑ INSP' O POOL
NUMBER OF STORIES
NUMBER OF
j
DWELLING
UNITS
NATURE OF WORK TO BE DONE
Valuation
Fee RecciPt
No.
i
•
Plon Check Nn .....................
� 1
ROOSE ~ /"Z-1
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PUSE
I
PLUMBING
0
PLOT PLAN (Indlcnta Building eelbneks, abutting Streets)
HEAT k GAS LINE
r7s ^ n
t'
I
n
FENCE
1
SIGN
RETAINING WALL
-
N
SWIMMING POOL
I
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
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! Q O /
I hereby acknowledge that I have rend this aDpllcatlon: that the In-
formation given le Correct; and that I am the owner, or the duly author-
Ized agent of the owner. I agree to Comply with City and Stale Iowa regu-
ATTENTION
APPLICATION APPROVAL
Toting eomtruclloe; and In doing the work suthorl:ad thereby, no person
will beemployed in violallon of the Labor Code or the Ell.. of Washington
TIDE PERMIT
This application is not a permit until
relating to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit limit One Year (Except DEMOLITIONS which
ONLY TILE
WORK NOTED
uty; and fees are paid, and receipt is ac -
Shall be Completed In ninety days; MOVED -1N BUILDINGS shall be wm-
Imowledged in space provided.
pleled In six months.)
SIGNA tE (OWNER OR AGE T)
DAT' S10NE➢
INSPECTION
DI OR's 81DNAT /
DEPARTMENT
` {i 1 • �����
�7," �;(,
CITY OF
EDMONDS
NOTE: Appli"nt Subject to Plan Check Fee1-14
775-2828
This P—alt ro— work to be done on prlvote property ONLY.
Any eunstructlon an /he public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permisslon.
SSSS. - - r--
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ZONE
PERMIT G
NUMBER / t ;,,
+
BUILDING DEPARTMENT Applicant Fill
PERMIT APPLICATION Insldo Heavy Lines
aoltZ
ADDRESS
NAME (OR NAME OF BUSINESS)
/ /
I ( •1A{�StlT
PERM Igg
LOT COVERAGE
ACTUAL
LOTCOVEIIY AOE
•LOM�
WNO ADORES.
PEItAiISBIBLF. HEIGHT
PROPOSED HEIGHT
C
iR1
O
O1ITY
TELEP
U//MHLR
ACTUAL LOT AREA
TOTAL BLDG. AREA
J"G ��;
)I eNr/
/HONE- J^^
%. CO (-'
REQUIRED YARDS PROPOSED YARDS
?
NAME
FRONT SIDE
REAR FRONT BIDE REAR
i
p
r,
LEGAL LOT
VARIANCE OR CONDITIONAL USE
WM
ADDRESS
C) YES 0 NO PERMIT NUMBER
DATE:
t
PLANNING DEPT. APPROVAL
I
CITY
TELEPHONE NUMBER
i
STREET RJ{V
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
p
_
NAME
1 � ,
y:I 72= J7 / 9 KI- 04,'
COMP. PLAN BT. R/W ............FI'. ............FT.
REMARKS
E
I
ADDXEBB /
W
�{Bpi
•
2 (t 0 9 t1j
CHECKED BY
.pd
N
CITY
TELEPHONE NUMBER
I
O
METER BILE
SIZE CLEARANCE
CHECKED BY
Ci
8TA'lE LICENB NllLIBE2
CITY LICENSE NUMBER
1SERVICE
I
I
I
kF.
�z n -1 3 4 3
REMARKS
.I
Legal Description of Property tShOW Below or Attach Four Copies)
+
TYPE CONNECTION
VERIFIED BY
j
O
PERC. TEST
PERMIT NUMBER
d,
1
REMARKS
�
t7
I
1
.W7
FIRE ZONE TYPE
OF CONSTRUCTION STREET IMPROVED
YES [] NO
SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
I
❑ GAS
RESIDENTIAL LINE
NEW
C] YES El NO
THIS SITE
OF EDMONIS LOCATED IN THE CITY
DS.DELODCAL SALES TAX
�
PLAN CHECKED BY
NON-RESIDENTIAL ❑ SIGN
❑ ADD RETAINING
REMARKS
SHOULD 8E CO37.04.
'
❑ DEMOLISH WALL
ALTER ❑ EXORCFILL AVATE ❑ FENCz.......... Ft.)
REPAIR E]IN rMOVE El SIVIM POOL
rn1
NUMBER OF STORIES NUaII7ER OF
DWELLING
UNITO
_ __ __.
NATURE OF WORK TO BE DON E /
Valuation
Fee R—lPt No.
!'(1 it O o o !,/) l - /�
'.
Plan Check No.....................
BUILDING
-
g
PROPOSED USE
ate,
PLUMBING
U
BEAT A GAB LINE
n in
i
a
PLOT PLAN (Indicate Bull n6 a tb ,In �Ittfis streets)
1
FENCE
5
SIGN
tRETAINING
WALL
N
SWIMMING POOL
'
DEMOLITION
PRE-MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DILE
t� nn ^^ ��•� �\
I hereby acknowledge that I have rend t61e application;that the in-
formation given le correct; and that I am the owner, or the duly author-
�.
Ized agent of the owner. I agree to comply with city and elatelows regu-
ATTENTION
APPLICATION APPROVAL
j
Inling construction; and In doing the work authorized thereby, no person
Will be employed In violation of the Labor Code of the Stale of Waehmgton
THIS PERMIT
This application is not a permit until
relating to WorkmInsurance.en's Compensation Insurance.
AUTHORIZER
signed by the Building Official or his Dep-
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TiIE
WORK NOTED
uty; and fees are paid, and receipt is ac-
she][ be completed In ninety days; MOVED-IN BUILDINGS Shall be mm-
knowledged in space provided.
pleted In nix months.)
SIGNATURE (OWNER Oft AGENT ^I
. ) )
�.'_ ,. l fl 1
DATE SIGNED
/ /
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INSPECTION
DEPARTMENT
DI TOft'8 lGNA7,
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LC I"2 'G(
j' /.<� .1` ;; /.. G,( ,� . ('�
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CITY OF
U
EDMONDS
DATE-'-
NOTE: Applicant Subjcct to Plan Check Fce
775-2525
This Permit c Yen Werk to I. done an privet. property ONLY.
Any construction onthe public domain (curb., Sidewalks, dri—sya,
INSPECTOR
'lll require parate permiselon.
marquee., etc.) WSe
k.
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T
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,
RECORECf ONS
Date
Foundation
(partial)
Plumbing
(Rough)
Frame
Furnace &Fuel Lines
Final