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BUILDING DEPARTMENTPERMIT
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Legal Description of Properly (Show Below r Attach Four Copies)
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FIRE Z E TYPE OF ONBTRUCTION STREET IMPROVED
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SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
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LINE
[3 YES NO I :SJ_I
.® NEW
PLAN CHE E BY THIS SITE IS LOCATED IN THE CITY,
tttt����It 01 EDMONDS. LOCAL SALES TAX
NON-RESIDFiNTIAL
SIGN
I SHOULD 6E CODED 31.04.
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ElADD ❑ DEafOLIBH RETAINING
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REMARKS`
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NUMBER OF STORIES NUMBER OF
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Valuation
Fee
Receipt No.
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SWIMMING POOL
DEMOLITION
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PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
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I hereby acknowledge that I haus read this application; that t In.
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formation Rlv Iscorrect; and that I am the owner, or the duly author-
Ired agent of the owner. I agree to comply with city and atste Iowa rag.-
ATTENTION
APPLICATION APPROVAL
lating construction; and In doing the work authorized thereby, ne %,..an
will be employed In violation of Na Labor Code of the Stale of Washington
THIS PERMIT
This application Is not a permit until
relating to Workmen'. Compensation Insuraace.
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 paid, and receipt is ac -
shall be completed In Nnety days; MOVED -IN BUILDINGS shall be com-
knowledged in space provided.
plated In elz months.)
SIGNATURE (OWNER OR AGENT)
DATE SIGNF
INSPECTION
DIRECTOR'Q SIO A�UIR
DEPARTMENT
/ri/
CITY OF-
EDMONDS
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NOTE: Applicant Subject to Plan Check Fee
775-2525
I
This Penn It c ark to hn dnne an prlynte properly ONLY.
Any construction on the public domain (curbs, sidewalk., dri-way..
FILE
marquee., etc.) will require .ep¢rate permission.
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BUILDING DEPARTMENT AuenYy
USE PERMIT
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Inside Lincs
PERMIT APPLICATION
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ADDRESS _
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NAME (Oft NAME 08 BUtlINEee)
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PERMISSIBLE t ACTUAL e�,
LOT COVERAGE �`� )a LOT COVEFFAGE (•�'--•
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MAILING ADI REMM
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PEK\II89IBLE HEIGFIT _ / YItOP08ED HEIOI�T
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CITY
TELEPHONE NUMBER
ACT.,VAL L 7 AREA TOTAL BLDC),,,AREA
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REQUIRED YARDS PROPOSED YARDS
NAME
FRONT SIDE REAR FRONT SIDE REAR
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ADDRESS
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LEGAI, LOT VARIANCE OR CO ITIONAL OE,,
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EIYES 0 NO PERFII'If
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PLANNIDEEP APPROVAL DATE:
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CITY �r
TELEPHONE NUMBER
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STREET R/IV
EXISTING STREET A/W^.�C�:iiFT. DEFICIENCY THIS PROPERTY
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CREED BY
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TELEPHONE NUMBER
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METER SiLE SERVICE SIZE CLEARANCE CHECKED BY
ATE 7 ICENBE N M ]i
LICENSE NUMBER
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CITY
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Legal DeacNptlon of Property (Show Below or Attach Four Copies)
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TYPE CONNECTION
VERlFIED,BY -
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PERC. TEST
PER I ' USHER
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REMARKS
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FIRE ZONE TYPE OF -CONSTRUCTION STREET IMPROVED
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j..,� -V] YES [3 NO
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SPECIAL INSPECTOR REQUIRED OCCUPAN--C^jjY'' GROUP
GAS
a RESIDENTIAL ❑
NEW LINE
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CJ YES El NO
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PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL ❑ SIGN
if(L- OF EDMONDS. LOCAL SALES TAX
ADD RETAINING
REMARKS SHOULD 8E CODED 31.04;
DEMOLISH WALL
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1'
EXCAVATE FENCE
❑ ALTER7.n
NLS F-�GW�� '+`('-)1'-- '�, UC�.V •�(`�'�l'.'�y
OR FILL (..........a:_........Ft.)
!
REPAIR PRE -MOVE SWIM
INSP. POOL
NUMBER OF STORIESNUMBER OF
DWELLING
UNITS
NATURE OF, WORK TO BE DONE
Vnluotlon
Receipt No.
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No. Ch -11 N..:: �... ....1L
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BUILDING
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PROPOSED USE
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ter•-'” ' /
PLUMBING
A
PLOT PLAN1 ( Ira a IIullding a ba lul, abu t ng; elrcete)
FEAT & GAB+I±INE . ? 1
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22
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4: JAL:., '1
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FENCE
1,
' F
SIGN
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RETAINING WALL
1
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
1
AMOUNT DUE
F7-,
�'-
I hettby acknowledge that I have rend this application;
atlon; that the !n-
formation given Is correct; and that I am the ower, or the duly author•
agent o1 the owner. f agree to comply with Illy and Siete taws ttgu-
ATTENTION
APPLICATION APPROVAL
-
,ftedat,
Innng construction; and In doing the work authorized install, he
will be employed In violation of the Labor Code of the State of Washington
TIUS PERMIT
This application is not a permit until'
relanag to workmen'. Comp ... auon Insurance.
iu
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DE59OLITIONS which
ONLY TIIE
WORK NOTED
utyt and fees are paid, and receipt is ac -
shall be completed In ninety days; MOVED -IN BUILDINGS .hall be com-
knowledged In apace provided.
pleled In six months.)
-SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DIRECTOR'S SIGNATURE;
DEPARTMENT
CITY OF
" II t t.' , ..l..t';.F-, ;r.r_..�
i
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
�Y
This Perrot coven work to be dune on private property ONLY.
775-2525
Any construction on the public domnin (curbs, sidewalks, drlvewaye,
marquees, etc.) will require Separate permission.
INSPECTOR
I
Title Officer I
i Dc ^ription:
Thra portion of the SE 1/4 of the SE 1/4 of the SE 1/4 of Section Y
23, Township 27 N.R. 3 E.W.M.. described as follows:
( Beginning at the Southwest corner of said subdivision on the }
tenter line of 3rd Street; thence North on said center line
.174)'feet; thence East 30 feet to point of beginning; thence
cdiatinue East 65 feet; thence North 67.4 feet; thence West
65 feet; thence South 67.4 feet to point of beginning; (Being
portion of Lots 20 and 21, Block 2, Olympic View Addition to
Edmonds, according to the unrecorded plat thereof.)
situate in the County of Snohomish, State of Washington.
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rl y- 0 to 15
RECORD OF INSPECTIONS
Date Passed
Foundation
;Plumbing (Partial) _
) , _P.(RoLigh)-
pf Frame
Furnace & Fuel Line
Final
WV