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BUILDING DEPARTMENT Applicant FillZ°E ,�/�{ LNU�BI>�t 740419
PERMIT APPLICATION I
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NAME (OR NAME OF BUMNE88)
STEVENS OCNTAL C�:NT�R.
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CITY TELEPHONE NUMSEa
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NAME
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PERMISSIBLE^�
LOT COVERAOEe
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ACTUAL LOT AREA
TOTAL BLDG. AR
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REMARKS
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STATE LICENSE NUMBER
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CITY LICENBE NUMBER
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REMARKS
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NATURE OF WORK TO BE DONE
Valuation
Fee Rccclnt No.
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Legal Description of Prepelty t.how Below
or Attach Four Copies)
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BUILDING
TYPE CONNECTION
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THIS SITE IS LOCATED THE CITY
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REMARKS
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❑ DEMOLISH ❑ WAIT'
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EXCAVATE
OR PILL (..........x..........Ft.)
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❑ REPAIR ❑ PRE-INSP. El SWI I
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NUMBER OF STORIES NUMBER OF
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UNITS A 6H f
NATURE OF WORK TO BE DONE
Valuation
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PLUMBING
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RETAINING WALL
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SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
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TOTAL AMOUNT DUE
acknowledge that I have read this application; that the In.
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formation given In correct: and that I and the owner, or the duly author-
ized agent of the owner. I agree to comply with city and state law. regu.
ATTENTION
APPLICATION APPROVAL
lating cons motto.; and In doing the work authorized thereby, no person
x•111 be employed In violation of the Labor Code of the Slate of Washington
THIS 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
WORE NOTED
Uty; and fees are paid, and receipt Is ac -
.hall be completed In ninety days; MOVED -IN BUILDINGS .hall be com-
knowledged in space provided.
pleted In I. month,.)
S(ONA'1'LIRE (OWNER OR A EN
DATE SIGNED
INSPECTION
DEPARTMENT
DI TOR'S AT -
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CITY OF
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EUbIONI)8
DATE
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NOTE: Applicant Subject to Plan Check Fee
775-2525
Tills 1'ermlt c erre work In be done on private property ONLY.
Any esnetrucu.n on the public domain (curb,, sidewalk,, driveways,
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marquees, etc.) will require separate permission.
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BUILDING DEPARTMENT
Applicant Fill
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PERMIT APPLICATION
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PERMISSIBLE HEIGHT PROPOSED O
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ACTUAL LOT AREA TOTAL 33LDG. AREA
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REQUIRED YARDS PROPOSED YARDd
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FRONT BIDE REAR FRONT BIDE REAR
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LEGAI; LOT VARIANCE Olt CONDITIONAL USE
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REMARKS F•
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CHECKED BY
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METER SIZE eEItVICE SIZE CLEARANCE
CHECKED BY
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STATE LICENSE NUMBER CITY
LICENSE NUMBER
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Legal Descrlptlon of Plepelty 1111111 Below or Attach Four Copleel
TYPAMK Etl
VERIFIED BY
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S�ti1'
PERC. TEST
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REMARKS
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FIRE ZOfJ`E TYPE OF CONSTRUCTION BTR tPROVED
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SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
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❑ RESIDENTIAL
GAS
LINE
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NEW
PLAN CHECKED DY THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL
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LOF EDMONDS, LOCAL SALES TAX
ADD
RETAINING
REMARK�cr SHOULD BE CODED 31.04.
DEMOLISH C WALL
ALTER ❑ EXCAVATE ❑ FENCEOR FILL x..........Ft.)
SWIM
REPAIR u INSP.RE-MOVE O POOL
. NUMBER OF STORIES NUMBER OF
DWELLING
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/ UNITS / I (J ii Q..
NATURE OF WORK TO BE DONE
Valuation
Fee
Receipt No.
INS ' vN VIV!))IV r`
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ANU rrJSiT4:-t. 3u „x 7 , 6'EnwDuo S IVn�
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BUILDING
PROPOSED USE
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PLUMBING
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PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT & GAS LINE
F? r1FyY�19
FENCE
SIGN j
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
-
EXCAVATION OR FILL
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TOTAL AMOUNT DUE
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I hereby acknowledge that I have read this application; that the In-
/
•
formation glVen Is correct; and that I am. the owner, or the duly author.
--
Ised agent of the owner. I agree to comply with city and slate Tawe regu-
ATTENTION
APPLICATION APPROVAL
t
lating constructiea; and In 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 Compensation Insurance,
AUTHORIZES
signed by the Building Official or his Dep-
1
NOTE: Permit Limit One Year (Except DEMOLITIONS whleh
ONLY THEI
{YORK NOTED
uty; and fees are paid, and receipt is ac -
shall be completed In ninety days; MOVED -IN BUILDINGS shall be nom-
knowledged in space provided.
pleted In Six months.)
SIGNATURE (OWNER OR AGENT).-) DATE 8I07ED
INSPECTION
DEPARTMENT
Dlft OR'S
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Ca:/ZCrG%�� GL
'�'� �•'' '- ' =
CITY OF
NOTE: Applicant Subject to Plan Check Fee
zurIOND3
DATE
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775.2525
T61e Permit corers work to 1w done an private properly ONLY.
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Any construction on tile public domain IcurbS. Sidewalks, drheways'
INSPECTOR
marquees, etc.) will require Separate permission.
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RECORD OF INSPECTIONS
Mate Passed
Foundation
Plumbing (Parti.11)
(RauL!h)