740471.pdfBUILDING DEPARTMENT D� PERMIT 7404-71Apptle:mt FHl ZONE NUMHEA
PERMIT APPLICATION Inside Heavy Lines IOn
ADDRESS '9320 20
NAME loft NAME OF BUSINESS) (y'��(J Ehed e.e I[ Pl eicQ-
</ PERMISEeil—N it AC UAL /
�., ✓1 U J LOT COVERAGLOT COVERAGE
p' MAI N6 ADDR 8 '
PRE -MOVE INSPECTION
EXCAVATION OR FILL –
I hereby acknowledge that I have read this application; that the in-
TOTAL AMOUNT DUE
formatlon given iscorrect; and that I — the aware, or the duly author.
REQUIRED YARDS PROPOSED YARDS
toting construction; and In doing the work authorized thereby, no person
NAME
will beemployed In violation or Ne Labor Code of the State of Washington
THIS PERMIT
PHONY" HIDE REAR FRONT SIDE REAR
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS whichONLY
TItE
ehpll be completed In .1-ty days: MOVED -IN BUILDINGS shall be Som-
WORK NOTED
plated In six months.)
IIONATU/iE _(OWNEROR ACENT)DATE B16NED
WADDRESS
Q ` t
DEPARTMENT
LEGAL LOT VARIANCE OR CONDITIONAL USE
CITY OF
Ii
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
0 YES NO PERMIT NUMBER
775-2525
This 1'e lilt coven work to be done on private property ONLY.
yh
Any co.zl urtl.n en the public dem.ln (ra,bs, nIdr.., drlvewnys,
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Up, CITY
TELEPHONE NUMBER
PLANNING DEPT. APPROVAL DATE:
c
I
STREET R/tV
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
C
I I
NAME
i
PLAN ST. R/W ............FT. ............FT.
al
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,I AlOMP.
yV94 4 121";121";;,1rC_ /C A f%
REMARKH
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O
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/ ^
Y. O/' A�C�X �O /
CHECKED BY.
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CI1-'K11
NUMBER
V r-1 11 �L ��� `�
^T�E/L�EPHONE
/"73
METER SIZE
SERVICE SIZECLEARANCE
CHECKED BY
STATE LICENSE NUMBER
CITY LICENSE
NUMBER
A pR ~ 3 O
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REMARKS
E
Legal Description of Property (Show Below or Attach Four
Copies)
TYPE CONNECTION VERIFIED BY
O
I
PERC. TEST PERMIT NUMBER
se
REMARKS
m
.1
V
v
.1
FIRE ZONE TYPE OF CON8TRUCTION STREET IMPROVED
I
I YES E] NO
SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
-
RESIDENTIAL
GAS
❑ YES [] NO
I
NEW
LINE
PLAN CHECKED ax THIS
SITE 15 LOCATED IN THE CITY
NON-RESIDENTIAL
❑
SIGN
OF EDMONDS. LOCAL SALES TAX
ADD ❑ DEMOLISH
❑
WAINING
SHOULD BE CODED 3104.
REMARKS
ALTER ❑ EXCAVATE
OR FILL
FENCE'
(..........x..........Ft.)
❑ RP•.PAIR ❑ INSP* PRE -MOVE
❑
SWIM
POOL
NUb[HER OF eTOItI ES
NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE
/
/
Valuation
Fee Receipt No.
c.-- Fi y7 __.
1 e•aJ- >v_
Plan Check No .....................
X.
BUILDING
4 PROPOSED USE
aPLUMBING
'S /) a
a
O( y'U
Z PLOT PLAN (Indicate Building Setbacks, abutting streets)
HEAT & GAB LINE
9
FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
'
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL –
I hereby acknowledge that I have read this application; that the in-
TOTAL AMOUNT DUE
formatlon given iscorrect; and that I — the aware, or the duly author.
lied agent of the owner. I agree to comply with city and state law. ngu-
toting construction; and In doing the work authorized thereby, no person
ATTENTION
will beemployed In violation or Ne Labor Code of the State of Washington
THIS PERMIT
relatla6 to Workmen's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS whichONLY
TItE
ehpll be completed In .1-ty days: MOVED -IN BUILDINGS shall be Som-
WORK NOTED
plated In six months.)
IIONATU/iE _(OWNEROR ACENT)DATE B16NED
INSPECTION
Q ` t
DEPARTMENT
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
775-2525
This 1'e lilt coven work to be done on private property ONLY.
Any co.zl urtl.n en the public dem.ln (ra,bs, nIdr.., drlvewnys,
���., r,lu.•.... rtr.l x111 rrinlrr rrp.rul,• I'r ioi..lun.
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt Is ac.
knowledged in space provided.
FILE