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Valuation
Fee Receipt No.
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Plan Check No .....................
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BUILDING
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USEI 70574
PROPOSED USE
BUILDING
DEPARTMENT I AppIleantFln
NUMBER
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PLOT PLAN (Indicate Building setback., abutting streets)
HEAT & GAS LINE
Inside Iienvy Lines
PERMIT APPLICATION
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FENCE
ADDRESS
A
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NAME (Oft NAME OF BUSINESS)
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PEItMItldIBLEACTUAL
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IAT COVERAGE ? /�` c•� LOT COVESFAOE
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MAILING//ADDR/E/B i
PERMISSIBLE HEIGHT PROPOSED HEIGHT a
tRETAINING
O TOTAL 111
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CITY
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TE/L�E/PHONE/NUMB�jl.ft
ACTUAL SOT
/= A�bAREA
REQUIRED YARPROPOSED YARDS
F.q011Tf SIDE REAR
NAME
FRONT SIDE REAR
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7{�
LOT VARIANCE OR CON TIONAL UeE
SWIMMING POOL
HALEGAL
ADDRESS
OYES 0 NO PERMIT NUMBER
y
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DEMOLITION
y
16
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PLANNIN EP APPROVA
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CITY TELEPHOfIE NUMBER
STREET R/W O
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY Ai
NAMEFT.
COMP.PWN ST. R/W ............FT. ............
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REMARKS '4
ADDRESSW
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U
BY
CITY TELEPIIONE NUMBER
(CHECKED
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METER SIZE SERVICE SIZE CLEARANCE CHECKED BY
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STATE LICEN86 NUMBER
LICENSE NUMBER
Intln6 sane( ruction; and In doing the work authorized thereby, no Dexon
will be employed In violation of the Labor Code of the State of Washington
THIS PERMIT
This application 1s not a permit until
relating to Workmen'. Compensation Insurance.
(CI
Signed by the Building Official or his Dep.
NOTE: Permit Limit One Year (Except DEMOLITIONS whlch
ONLY TIL
WORK NOTED
uty; and fees are paid, and receipt is so
.hall be completed In ninety days: MOVED -IN BUILDINGS shall be wm-
knowledged 1n space provided,
plated In six months.)
REMARKS
HGNATUIID OWNER 1 -AGENT) DATE SIGNED
INSPECTION
RE
IN.CTOR'S -QIGNAT E i J
Legal Description of Property (dhow Below or Attach Four Copies)
✓
CITY OF
TYPE CONNECTION VERIFIED BY
EDhIONDB
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NOTE: AO(iUcant Subject to Plan Check Fee
— • — y
775-2525
PERC. TEST
PERMIT NUMBER �
t•I.
FILE
marquees, atr.) will raq.,,. e,P-rata permission.
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REMARKS
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(Cil
FIRE ZONE OF CONSTRUCTION STREET IMPROVED
(TYPE
NO
YES 0
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
GAS
RESIDENTIAL
❑ YES [] NO I
LINE
NEW
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
TAX
�t NON-RESIDENTIAL SIGN
SHOULD IlE CODEDD 31 pgSALES
❑ADD ❑ WTA.ININC
DEMOLISH AL
REMARKS
El ALTER EXCAVATE ❑
❑ ORFILL( x .......... Fl.)
SWIM
REPAIR ❑ INSPhfOVE El POOL
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
NAOF W,DIt1t '1'O HE DONE
Valuation
Fee Receipt No.
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Jai- [yr/�L1lr//
Plan Check No .....................
/a V
BUILDING
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Q
PROPOSED USE
PLUMBING
PLOT PLAN (Indicate Building setback., abutting streets)
HEAT & GAS LINE
FENCE
SIGN
tRETAINING
WALL
7{�
I
SWIMMING POOL
`
DEMOLITION
16
V�
PRE -MOVE INSPECTION
EXCAVATION OR FILL
J�
r
TOTAL AMOUNT DUE
I hereby ,knowledge that I have read this application; that lila 1n•
lormatlon given iscorrect: and that I Rin the owner, or the duly author.
(red agent of the owner. I Agree to comply with city and state law. rag.-
ATTENTION
APPLICATION APPROVAL
Intln6 sane( ruction; and In doing the work authorized thereby, no Dexon
will be employed In violation of the Labor Code of the State of Washington
THIS PERMIT
This application 1s not a permit until
relating to Workmen'. Compensation Insurance.
AUTHORIZES
Signed by the Building Official or his Dep.
NOTE: Permit Limit One Year (Except DEMOLITIONS whlch
ONLY TIL
WORK NOTED
uty; and fees are paid, and receipt is so
.hall be completed In ninety days: MOVED -IN BUILDINGS shall be wm-
knowledged 1n space provided,
plated In six months.)
HGNATUIID OWNER 1 -AGENT) DATE SIGNED
INSPECTION
RE
IN.CTOR'S -QIGNAT E i J
DEPARTMENT
✓
CITY OF
EDhIONDB
DATE
NOTE: AO(iUcant Subject to Plan Check Fee
— • — y
775-2525
Till. I'erndt acv work la be done a Private Property ONLY.
Any construction on the public duntnin (curbs, sidewalks, drl-..Ye,
FILE
marquees, atr.) will raq.,,. e,P-rata permission.
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LIGE Ntib 8 1405'74—
BUILDING
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BUILDING DEPARTMENT Applicant Fill ZONE {� '
PERMIT APPLICATION I Inside Heavy Line-
77717
inea JOB }� '
ADDRESS �- I — /I•
NAME loft NAME OF It
PERM IdtlIBLE ACTUAL 'f
LOT COVERAGE. LOT COVESiAOE
MAl NO ADDRESS _ PROPOSED HEIGHT
I PERJIItldiBLE HEIGHT / [ � '
` n
/11-1 TOTAL BLDG. AREA 7
CITY T LEPHONH UMBER ACTUAL LOT AR A' ., 3
I j(,. j �// •_� R QUIREO YAR.. PROPOSED YARDS
REAR FRONT BIDE REAR
W
FRONT HIDE. -
t
LEGAL LOT VARIANCE OR CONDITIONAL USE f
YES [3NO PERMIT NUMBER
PLANNING DEPT: APPROVA[.
TELEPHONE NUMBER / 1��7
STREET R/W '
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. [� .'
REMARKS �
YES M NO
D
EDMONDS.
Valuation
YES rl NO
RESIDENTIAL
❑
GAS
LIN
NEW
'J•
BUILDING
--S) n
n
U V
❑
NON-RESIDENTIAL
BION
ADD
U
PLOT PLAN (Indicate Building ntback., abutting at rest.)
HEAT & GAS LINE
NINE
❑
DEMOLISH
❑
WALL
El ALTER
ORFILL
E]
PENCE
x .......... Ft.)
❑ REPAIR
❑
PREINBPA1OVE
El
swild
POOL
;UMBER OF STORIES
NUMBER OF
RETAINING WALL
DWELLING
UNITS
TATURE OF WORK TO BE DONE
L_!
SWIMMING POOL
YES M NO
D
EDMONDS.
Valuation
YES rl NO
Plan Check No.. ..................
'J•
BUILDING
--S) n
n
U V
PROPOSED USE
PLUMBING
U
PLOT PLAN (Indicate Building ntback., abutting at rest.)
HEAT & GAS LINE
FENCE
'
SIGN
RETAINING WALL
L_!
SWIMMING POOL
,
DEDIOLITION
PRE -MOVE INSPECTION
_
_
EXCAVATION OR FILL
\
TOTAL AMOUNT DUE
I
I hereby acknowledge that I have read this application; that the In-
formation given Is correct; and that I aal the owner, or the duly author-
ized agent of the owner. I agree to comply with city and elate lawn regu-
ATTENTION
APPLICATION APPROVAL
Rating conte" tion; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Slate of Wmhington
TIHB PERMIT
This application is not a permit until
relatlpg to workmen's Campeneallon Imuronee.
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 raid, and receipt Is ac-
ehall be completed In ninety day.; MOVED -IN BUILDINGS Shall be Com-
knowledged in space provided.
plcted in eI. Mo. he.
SIGNATURE (OIVNER OR AGENT) DATE SIGNED
INSPECTION
DlftEUR'B @1GNATUItE n (fj
/
-
I
DEPARTMENT
'
CITY OF
EDIILOND3
—
DATE
Cheek Fee
NOTE: Applicant Subject to Plan
775-2525
Tole l'leolit rocr. work to Im done on private property ONLY.
I
Any cun.tructi m on the public domain (curb., eldowalke. drRewsys,
INSPECTOR
marquee., Me.) will require .epvate perntl.elon.