740538.pdfBUILDING DEPARTMENT U�
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�--- PERMIT APPLICATION Ingtdo iioaYy Llnoe a�
ADDA
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,97
16
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PERMIT
NUMBER
FRONT BIDE REAR FRONT SIDE REAR I�
ti
LEGAL, LOT VARIANCE OR CONDITIONAL USE
0 YES ❑ NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
STREET R/W O 1.
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............F'r. ............FT. ki
REMARKS RW
b
W 11
ICHECKED BY
METER SIZE I SERVICE SIZE I CLEARANCE I CHECKED BY
a
II
REMARKS <
TYPE CONNECTION I VERIFIED BY
I
IT TEST PERMIT NUMBER y.
i
ri F.Tf n RKA m I
YES I7 NO
SPECIAL INSPECTOR REQUIRED IOCCUPANCY GROUP
Q YES ❑ NO
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
V eluntlon
Check N
RESIDENTIAL
❑
LINCASE
NEW
E]
NON.RESIDENTIAL
❑
PROPOSED USE
1911--
5=
❑
SIGN
RETAINING
❑
DEMOLISH
ElALTER
EXCAVATE
❑
FEN Cz
HEAT & GAS LINE
❑
ORFILL
�
.......... Ft.)
REPAIR
❑
INSPhfOVE
❑
Smid
POOL
IUMBEII OF STORIES
NUMBER OF
SIGN
21
DWELLING
J
RETAINING WALL
UNITS
N
PERMIT
NUMBER
FRONT BIDE REAR FRONT SIDE REAR I�
ti
LEGAL, LOT VARIANCE OR CONDITIONAL USE
0 YES ❑ NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
STREET R/W O 1.
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............F'r. ............FT. ki
REMARKS RW
b
W 11
ICHECKED BY
METER SIZE I SERVICE SIZE I CLEARANCE I CHECKED BY
a
II
REMARKS <
TYPE CONNECTION I VERIFIED BY
I
IT TEST PERMIT NUMBER y.
i
ri F.Tf n RKA m I
YES I7 NO
SPECIAL INSPECTOR REQUIRED IOCCUPANCY GROUP
Q YES ❑ NO
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
V eluntlon
Check N
[Plan
BUILDING
(,o�
PROPOSED USE
5=
PLUMBING
�
I
PLOT PLAN (Indic.(. Building setbacks, nb.ttlRg .tract.)
HEAT & GAS LINE
�
I
FENCE
I
SIGN
21
J
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
I
PRE -MOVE INSPECTION
EXCAVATION On FILL
�n
TOTAL AMOUNT DILE
1 hereby acknowledge that I have read this application; that the In.
V�V
formation given le correct; and that I are the owner, or the duly author.
Teed agent of the owner. I agree to comply with city and state laws regu.
ATTENTION
APPLICATION APPROVAL
(.ting construction; and In doing the work authorized thereby, no person
will 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 DE31OLITIONS which
ONLY TILE
WORK NOTED
uty; and fees are paid, and receipt Is Be
shall he completed In ninety days; MOVED -IN BUILDINGS shall be com-
knowle ged in space provided.
pleted In six months.)
I f I' .n
N TURE OWNER Olt AGENT)
DATE 830NED
INSPECTION
DEPARTMENT
DI R• 820 �,j� �
8`
U Z�fi" ;—q
M
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/ /
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CITY OF
ED51OND9
DATE
NOTE: Applicant Subject to Plan Check Fee
--—
775.2525
Tills We It co— work to be done an Prlvate Property ONLY.
'
Any construed.m on lir. public d.maln (curbs, eld..alk., dcl-."s.
FILE
marquees, etc.) will require separate permission.
1--- BUILDING DEPARTMENT
IApp]PERMIT
APPLICATIONdNAME(OR NAME O i BUSINEae)
MANGCSTY,. TELEP ONE
NAME
NADDRESS
CtTY
TELEPHONE NUMBER
NAME
moF ADDRESS
UU
C CITY TELEPHONE NUMBER
�9erlptlan Of Property (dhow Selow or
RESIDENTIAL
F�
LINE
❑ NEW
COMP. PLAN ST. R/W ............FT. ............FT. I
REMARKS
❑ NON-RESIDENTIAL
❑
BICN
USE PERMIT -)0
ZONE NUMBER 1
I CHECKED BY
REMARKS
RETAINING
ALL NTNG
]? C TI
❑ DEMOLISH
ADDRESS T'.C. J
+
ALTER
❑ ORCFILLE
❑
FEN X..........ILl,
Pk:ltelltldlDLE p ACTUAL %p{/y�
IAT COVERAGE LOT COVEeeAGE
.I
I
O
Pwim
OOL
DUMBER OF STORIES
NUMBER OF
PLOT PLAN (Indicate setbacks. abutting streets)
lBBuilding
PERMISSIBLE HEIGHT PROPOSED HEIGHT
DWELLING
lJ
FENCE
TOTAL BLDG. AREA 7
UNITS
I
NATURE OF WORK TO EE DON
ACTUAL LOT AREA
RETAINING WALL
E5, i
REQUIRED YARDS PROPOSED YARDS .
N
FRONT SIDE REAR FRONT SIDE REAR
SWIMMING POOL
I
DEMOLITION
LEGAL. LOT VARIANCE OR CONDIT)ONAL U8E 1
PRE -MOVE INSPECTION
PERMIT NUMBER I
YES NO j
EXCAVATION OR FILL
i+.
1--- BUILDING DEPARTMENT
IApp]PERMIT
APPLICATIONdNAME(OR NAME O i BUSINEae)
MANGCSTY,. TELEP ONE
NAME
NADDRESS
CtTY
TELEPHONE NUMBER
NAME
moF ADDRESS
UU
C CITY TELEPHONE NUMBER
�9erlptlan Of Property (dhow Selow or
PLANNING DEPT. APPROVAL
RESIDENTIAL
F�
LINE
❑ NEW
COMP. PLAN ST. R/W ............FT. ............FT. I
REMARKS
❑ NON-RESIDENTIAL
❑
BICN
\� ADD
I CHECKED BY
REMARKS
RETAINING
ALL NTNG
]? C TI
❑ DEMOLISH
❑
ALTER
❑ ORCFILLE
❑
FEN X..........ILl,
REPAIR
❑ INSP.
O
Pwim
OOL
DUMBER OF STORIES
NUMBER OF
PLOT PLAN (Indicate setbacks. abutting streets)
lBBuilding
DWELLING
lJ
FENCE
UNITS
I
NATURE OF WORK TO EE DON
RETAINING WALL
PLANNING DEPT. APPROVAL
DATE:
STREET R/W-
i
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
I
COMP. PLAN ST. R/W ............FT. ............FT. I
REMARKS
CHECKED BY
METER SIZE I SERVICE SIZE
I CLEARANCE
I CHECKED BY
REMARKS
]? C TI
VERIFIED BY
F7 V/1 I I
P
VLJUWI
MT AS
REMARKS
r.r<r. - I "" -
SPECIAL INSPECTOR Rk
0 YES Ej NO
O 1
E I .
�I
1
I
td �
STREET IMPROVED
0 YES 0 NO
GROUP
-ATED IN THE CITY ;I
LOCAL SALES TAX
ED 31.04.
1
Fee
I
Plan Check No-;--......
BUILDING
L c
PROPOSED USE
PLUMBING
HEAT & GAS LINE
PLOT PLAN (Indicate setbacks. abutting streets)
lBBuilding
lJ
FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby ncknowledgo that I 4nva rend this appllcatian; that the In-
t'
formation given Is correct; and that I am the owner, or the duly author-
Ired agent or the owner. I agree to comply with city and state laws "go-
ATTENTION
APPLICATION APPROVAL
Idling construction; and In doing the worst authorised thereby, no person
will be employed In violation of the Labor Code of the State of Washington
THIS FERh11T
This application is not a permit until
relating to Workmen's Compensation Insurance,
AUTHORIZE"
signed by the Building Official or his Dep-
NOTE: Permit Limit One Year (Exeept DRMOLITIONN which
ONI.Y TILE
WORK NOTED
uty; and fees are paid, and receipt is ac
shall be completed In ninety days; MOVED -IN BUILDINGS shot] be cam-
1(nOWledged in apace prOVided.
pleled In six months.)
816NATUItE IONNEit, Oli AGENT) DATE 81GNED
/
INSPECTION
DEPARTMENT
DIRECTOR'S SIGNATURE ..
/
.AI
, ' 1 -
OF
CIT Y OF
,'
EDAVON
Dw
NOTE: Applicant Subject to Plan Cbeek Fee
?�
7 5
This Permit covers work to be done on private properly ONLY.
Any conslrurtlnn an tha public domaln (,tube, sidewalks, driveways,
INSPECTOR
marquees, etc.) will require epared. Permission.
I