740584.pdfAPPLICATION 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 apace p ^ vld� d.
uA•r
TOTAL AMOUNT DUE
I barely acknowledge that I have read this application; that the In-
i
Ized agent of the owner. I agree to comply With city and state law. regu.
ATTENTION
I.U.g conetructlon; 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
relating to Workmen's Compensation I¢sur¢nce.
AUTHORIZER
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USE PERMIT
ZOO NUMBER 740584
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BUILDING DEPARTMENT
PERMIT APPLICATION
Applicant Fill
Inside Iieavy Lines
�AljATUItE (ON i O Aft T) DATE SIGNED
INSPECTION
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EPARTMENT
DEPART
ADDRESS
21400 - 72nd Avenue West
PERMISSIBLEACTUAL
LOT COVERAGE a LOT COVIAAGE
PERMISSIBLEHEIGHTPROPOSED HEIGHT
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NAME (OR NAME OF BUSINESS)
DANMORE COMPANY
MAILING ADDRESSa
NOTE: Applicant Subject to Plan Check Fre
Suite 500-400-108th N.E
ACTUAL LOT AREA TOTAL BLDG. AREA
This Persalt a ver. work to be dune on private property ONLY.
O CITY TELEPHONE NUMBER
Any eonstructlou on the public domain (curbs, sidewalks, d,11—Y.,
"aware., etc.) Wit reeulre separate permission.
REQUIRED YARDS PROPOSED YARUH
NAME
FRONT BIDE REAR FRONT SIDE REAR
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LEGAL LOT VARIANCE OR CONDITIONAL USE
CI YES Q NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
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ADDRESS
STREET R/W
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
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CITY
TELEPHONE NUMBER
COMP. PLAN ST. R/W ............FT. ............FT.
REMARKS
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NAME
MacDonald-Miller CO.
(CHECKED BY
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METER BILE SERVICE SIZE (—CLEARANCE CHECKED BY
REMARKS
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ADDRESS
e 11063 Pacific Highway So.
(5 CITY
8 Seattle, Wn. 98168 1
TELEPHONE NUMBER
763-9400
STATE LICENSE NUMBER
223-02-4035 1
CITY LICENBE NUMBER
Legal Description of Property (Show Below or Attach Four Copies)
TYPE CONNECTION VERIFIED BY
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PERC. TEST PERMIT NUMBER
REMARKS
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FI YE TYPE 0"i.BelYSTRUCTION STREET IMPROVED
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SPECIAL INSPECTOR REQUIRED OCCUPANCY GROOUUP
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❑ YES NOl / (/
PLAN CHECKED BY THIS SITE IS LOCATEDD IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
GAS
❑ RESIDENTIAL ❑ LINE
NEN ❑ NON-RESIDENTIAL SIGN
ADD RETAINING
DEMOLISH WALL
ALTER ❑ EXCAVATE FENCE
OR FILL (..........x.......... Ft.)El
REMARKS
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REPAIR ❑ INSPPRE-MOVE SWIM
❑ POOL
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NUMBER OF STORIES
NUMBER OF��
DWELLING
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Valuation Fee R... 1pt No, �
Plan Check N
NATURE O�F,tWORK
� T,OO BE DONEE.
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BUILDING
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PROPOSED USE
Convalescent Center
PLUMBING / , O�
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HEAT & GAS LINE of 3 , p b
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PLOT PLAN (Indicate Building eatbncks, abutting etteate)
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FENCE
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SIGN
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TRETAINING
WALL
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ISWIMMING
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DELIOLITION
PRE-MOVE INSPECTION
EXCAVATION OR FILL
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 apace p ^ vld� d.
uA•r
TOTAL AMOUNT DUE
I barely acknowledge that I have read this application; that the In-
lorm.11en given Is correct; and that I an, the owner, or the duly author.
Ized agent of the owner. I agree to comply With city and state law. regu.
ATTENTION
I.U.g conetructlon; 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
relating to Workmen's Compensation I¢sur¢nce.
AUTHORIZER
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TOE
R'ORK NOTED
shall be completed In Nasty day.; 110VED-IN BUILDINGS shall be earn -
pitted In six months.)
�AljATUItE (ON i O Aft T) DATE SIGNED
INSPECTION
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EPARTMENT
DEPART
OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fre
77S'YS2S
This Persalt a ver. work to be dune on private property ONLY.
Any eonstructlou on the public domain (curbs, sidewalks, d,11—Y.,
"aware., etc.) Wit reeulre separate permission.
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 apace p ^ vld� d.
uA•r
USE PERMIT
DEPARTMENT NUMBER / :X534
BUILDING' Appll(notFWZONE
PERMIT APPLICATION Insido Heavy Lines
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NAME (OR NAME OF BUSINESS)
ADDRESS
71400 - 72nd Avon Ue West
ACTUAL
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PERhf ISSIBLE 7o
LOT COVERAGE _ LOT COVERAGE
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MAILING ADDRESS
PERMISSIBLE HE GII , v -„ PROPOSED HEIGHT
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1 !-(; 550-"t:'1(i-1 JL1 h t1. 1'
CITYTELEPHONE NUMBER
ACTUAL LOT AREA TOTAL BLDG. AREA
(;/ij .i•/;< GN'1!,4 Alt-�S',ii
REQUIRED YARDS PROPOHF.D YARDS
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NAME
FRONT BIDE REAR FRONT HIDE REAR
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LEGAL LOT VARIANCE OR CONDITIONAL USE
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ADDRESS
YES NO PERMIT NUMBER
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PLANNING DEPT. APPROVAL
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CITY TELEPHONE NUMBER`/
STREET R/W o
EXISTING STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
NAME
MaCCion3I d-141 I I er Co.
COMP. PLAN ST. R/W ............FT. ............FT.
ROMARKS
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ADDREBB
1106- PacIilC Highway SO.
CHECKED BY
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CITY TELEPHONE NUMBER
Sc61--He, 14n. 48168IIIVVV
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METER SIZE SERVICE SIZE CLEARANCE CHECKED BY
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NUMBER�I STATE LICEN80 NUMCITY LICENSE NUMBER
LICENSE
223-02-4035
Legal Description of Property (Show Below or Attach Fou[ Copies)
REMARKS
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T P CO N N '(�\ VERIFIED BY
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PERC. T P U
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REMARKS
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I TYPE OrF GONBTAUCTION eTREET IMPROVED
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SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
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RESIDENTIAL ❑ GAS
C]YES 'RNO U
NEW LINE
PLAN CHECXED IIP THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL sION
OF EDMONDS. LOCAL SALES TAX
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ADD RETAINING
DEMOLISH WALL
REMARKS SHOULD BE CODED 31.04.
ElALTER EXCAVATE FENCE
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OR FILL (.......... x..........Fl.)
REPAIR PRE -MOVE El SWI X
INSP. POOL
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NUMBCR ON` STORIES F
NUMBER Oil
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UNITS
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NATURE OF WORK TO BE DONE
Valuation Fee Recelpt No,
Plan Check No ..................... ..--•--'—"
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BUILDING
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PROPOSED USE
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C.onva I escent Cent(+r
PLUMBING 0�)
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PLOT PLAN (Indicate Building setback., abutting streets)
HEAT & GAS LINE
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1"
FENCE
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SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
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I hereby acknowledge that I haus read this application; that the In.
TOTAL AMOUNT DUE
formation given Is correct; and that I am the owner, Or the duty nulhor-
Ized agent of the owner. I agree to comply with city and elate law. regu-
ATTENTION
laling construction; and In doing the work authorized thereby, no Person
APPLICATION APPROVAL
will be employed In vlol¢llon of the Labor Code of the State of Washington
THDI 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 w•hlCh
ONLY THE
WORK NOTED uty; and fees are paid, and receipt is ac.
shall be completed In ninety days: MOVED -IN BUILDINGS .hall be com-
knowledged in apace provided.
pleted In six months.)
SIGNATURE (OWNER OA AGE T) DATE tl16NED
. rI.
INSPECTION - "
DIRECTO 'S ,SIGNATURE j.
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DEPARTMENT V/
_ 7'1• .�.�.l
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CITY OF ' 1 i !7 P..! <?,_. ,��•.--
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1•'
EDMOND$ -ATE ; /•,
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NOTE: Applicant Subject to Plan Check Fee
This Permit covenwork to be dente an private properly ONLY.
775-2525
Any construction on the public domain (Curbs, OdewOlk., drh'ex•ays,
marquees, etc.) will require separate permission.
INSPECTOR
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