740618.pdfIlan Check Nu .....................
BUILDING
[k//J! / A
% 7
[0
4 PROPOSED USE
L7V
' _
` L.. -elO
'7y
PLUMBING
('T
BUILDING
DEPARTMENT
Applicant Flu
ZONES — NUMBPERMER 74U618
HEAT & GAB LINE
I
n
PERMIT
APPLICATION
Inside Heavy Elites
/
SIGN
tRETAINING
WALL
ADDRESS X01 O of l low///zi,
N
-
NAE (OH NAME ON BUSINESS)
SWIMMING POOL
PERMISSIBLE '*ACTUAL
LOT COVERAGE "J' `jo LOT COVERAGE
j
i
DEMOLITION
p�
MAILING D
—
EBB
PRE -MOVE INSPECTION
v
PERMISSIBLE IIEI.OfI�T^ . I'ItOPOBEjI�IFfIGIST
�
`
EXCAVATION OR FILL
tJ 7H
" (/Ir
{I
C
Ty
-1 urGt/
TELEPHONE NUMHE.R
ACTUAL 'A TOTAL G 3 3A p
S
I hereby acknowledge that I have rend this application; that the in-
7 / V (�
f �j
��
REQUtT'AO
IRED YARDS PROPS
h
Ized agent of the owner. I agree to comply with city and state laws reg.-
NAME
APPLICATION APPROVAL
laling construction; and In doing the work authorized thereby, no Derson
FRONT HIDE REAR FRONT E REAR
7,5 /S'QQZ5 Z40
will be employed In violation of the Labor Cade of the Stale of Woshinglon
THIS PERMIT
O
relating to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
LEGAL LOT VARIANCE OR CO DITIO L UB
ONLY THE
WORK NOTED
I
shalt be completed in ninety days; MOVED -IN BUILDINGS shall be Som-
N
ADDRESS
b n six months.)
(3 YES C] NO PERMIT NUMBER
S16NATU1tL WNER OR AGENT)
l
INSPECTION
C
-
DEPARTMENT
PLAN IN 'P APPR VAL 1 AT •
_
I
t
CITY
—
DATE
TELEPHONE NUMBER
<
I
STREET R/t
EXIOTINO STREET R/W1~.�. DEFICIENCY THIS PROPERTY
a
-
Any construction on the public domain (curbs, .1,1=lke, driveways.
morq.res, air.) x111 require separate permission.
NAME
/./.F�.I..FT.
R/l'�:/..��.I•'r. Sr/..FT.
COMP. PLAN BT. .....
XLw1�'
REMARKS Driveway slopes not to exceed those
C
ADDRE
indicated on Standard Rwq. No. 103
I A'r C E
EAe>e ffjtM f
CITY
I
TELEPHONE NUMBER
IZDUW(QlNb �C^lri
UWDtRC NL7
U
SERVICE SIZE CLEARANCE
METEIIL�ZE
I�(��
STATE CENSE NUDiBER
LI
CITY LICENSE NUMBER
I
REMARKS
<
Legal Description Of Properly ,(Show Below or Attach Four Copies)
//
8 6A1 C
a_L A k E_
TYPE CONNECTION
VERIFI .D
-GfCa�
��►n I
PERC. TEST
PER 1 NUM ER
y.
/
X 5
/' µ)
O
REMARKS
w
�
<
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
-�/V ES ❑ NO
22Zi
SPECIAL INSPECTORREWIREDOCCUPANCY
OR UP
❑ YES aNO
Z J d `I
I
GA8
RESIDENTIAL
❑ LINE
THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL
S. LOCAL SALES TAX
:L�rA
SIGN
SH ULDEDMBE CODED�31.0,4,./
ADD
El
RETAINING
RK
El
DEMOLISH
F E
�/HyOULDBE
[J -7
��� L'/�c7 ✓ /iii.//LrN �L-/C/ V.L: C� /
ALTER
EXCAVATE
❑ OR FILL
D (.....................Ft.)
E] REPAIR PRE-bfOVE
INSP.
swim
POOL
NUMBER OF STORIES NUMBER OF
DWELLING 1
UNITS
NATURF. OF WORK TO RF. OONF.
Ilan Check Nu .....................
BUILDING
[k//J! / A
% 7
[0
4 PROPOSED USE
L7V
' _
` L.. -elO
'7y
PLUMBING
('T
/ VV
If,
PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT & GAB LINE
n
FENCE
SIGN
tRETAINING
WALL
N
1
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DILE
(j (J'r r)
I hereby acknowledge that I have rend this application; that the in-
7 / V (�
f �j
formation given Is correct; and that I am the owner, or the duly author-
Ized agent of the owner. I agree to comply with city and state laws reg.-
ATTENTION
APPLICATION APPROVAL
laling construction; and In doing the work authorized thereby, no Derson
will be employed In violation of the Labor Cade of the Stale of Woshinglon
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 DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac -
shalt be completed in ninety days; MOVED -IN BUILDINGS shall be Som-
knowledged in apace provided.
b n six months.)
S16NATU1tL WNER OR AGENT)
DATE SIGNED
INSPECTION
R C R' BIO ATURE
-
DEPARTMENT
�1
CITY OF
EDMONDS
—
DATE
NOTE: irant Subject to Plan Cbeck Fre
%%5.2525
This Permit re— work I. be done on private properly ONLY.
Any construction on the public domain (curbs, .1,1=lke, driveways.
morq.res, air.) x111 require separate permission.
FILD
i
This Permit covers work to be done oa privets properly ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will ream,. separate permission.
INSPECTOR
20NE -��{• NVMDER
BUILDING DEPARTMENT Applicant FIR
_ (:.r
Inside Lines
PERMIT APPLICATION
-
ao
ADDRMS8 1 /
i
i%
-� ; ) '�` I
NAME (Ori NAME OF BUSINESS)
,?
PERMISSIBLE ^ ACT — 1
LILT COVERAGE .-, -. �i'a IAT COVAAOE Ill
E
MAILING AuRaas
HEIGHT HEIOT PROPOSED HEIGHT C
ACTUAL LOT AREA TOTAL BLDG. AREA,
o
C TY
TELEPHONE NUMBER
_ •
I)1)/REQUCE
. YARDS PRAO+ POSE7'D
-YARDH .I
REAR
NAME
FRONT SIDE REAR FRONT /,SIDE
fF.�
LEGAL LOT VARIANCE OR CON 1TIONNI, BE,..
la
ADDRESS
Q YEe ❑ NO PERMIT NUMBER ------�
PLANNING DEPT. APPROVAL DATE:
CITY
MEIt
TELEPHONE NUD
f,
STREET R/{V /.
THIS PROPERTY
G7
EXISTING STREET R/ /W-�'l�/. �rPT. DEFICIENCY
4;7I,f)
W f t
NAME
COMP. PLAN BT. R/ J.....:.:.FT. .....r..pT.
_ -
�)•'�`
lll•i •dl.Lra„ sion��s noi: to
;
Cd
.4REMARKS
-
ADDRESS"
iru:�c:,'i.•-d or, Stanriawl i.Vo, 10:
)
w �
Ill�jjj+
���1'o�.
t i; (i'l? IT Iii- J W7,1�L;. �. �. cA:{�y✓�J
CrM
5
CITY
TELEPHONE NUMBER
NY
ASETEi.Sl'LE SERVICE BiZE
CLEARANCE
CHECKED BY
STATE LICENSE NUMBER
I CITY LICENSE NUMBER
.: :'
I
REMARKS
t.
Legal Description of Property (Show Below or Attach Four Copies)
•.-/ }? (� I +1 A' F
TYPE CONNECTION VERIFIED BY'
.-�
1.
ERC. TEST PERAHTrUAfBER
t{
f
I
p7
w
;.\
1
i
r
Y
FIRE ZONE F e STREET IMPROVED
[STREET
/ YES ❑ NO
!
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
RESIDENTIAL
GI
LINE
❑ YES 0 NO _(_ '•'
I
CHECKED BY, IN THE CITY
``�
NEN
PLAN THIS SITE IS LOCATED
LOCAL SALES TAX
❑ NON-RESIDENTIAL
EJSIGN).J'/�.,
/, /-. •_, �,__. OF EDMONDS.
SHOULD BE CODED 31.04.
0 ADDEj F-1RETAINING
WAIS'
REMARKS,)
DEMOLISH
% _' _ / /
,;�;
❑ FENCE
EXAVATE
ALTER ❑ C
OR FILL L.........z.......... Fl.)
•
REPAIR PRE -MOVE Ej SWIM
INSP. POOL
-
NUAfBER OF STORIES I NUMBER OF
DNLLINO i
E
r UNITS
(1
NATURE OF WORK TO BE DONE
V
Vnluation
Fee Kht...ipl
No.
i
Plan Check N. .....................
Y
BUILDING
a
PROPOSED USE
PLUMBING
U
aPLOT
PLAN (Indicate Sul (tin Ctb oke �ahaltln6 BUceta)
HEAT & GAS LINE
J
I `
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
i
( •; -'�
I hereby aoknawiedgo that I have read this application; that the In-
./ ��/••)
1- /'-
1
Milan" given le correct; and that I am the owner, or the duly author.
I%ed agent of the owner. I agree to comply with city and elate laws regu-
ATTENTION
APPLICATION APPROVAL
1
leting construction; and In doing the work authorized thereby, no pernon
will be In violation of the Labor Cade of the State of Washington
THIS PERMIT
This application is not a permit until
;
relating to Workmen's Compensation Insurance.
to
AUTHORIZER
signed by the Building OPtIC161 Or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY Tit
WORK NOTED
utyi and Pees are paid, and receipt is Be
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
knowledged in space provided.
pitted In .1. month..)
,�
S
SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DIRECTOR'S SIGNATURE,,
,I
I
DEPARTMENT
is
CITY OF
t 4,-
NOTE: Applicant Subject to Plan Check Fce
EDMOND9
DATE -. .l'1 -• 'i
775-2525
This Permit covers work to be done oa privets properly ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will ream,. separate permission.
INSPECTOR