740627.pdfBUILDING�,,AEPRTMENT I Applicant Fill
ZONE PERMIT 70627
S — 6 NvatBER
PERMIT CATION Inside Heavy Lines
formation given In correct; end that I nm the owner, or the duly nuthor16
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Izrd agent of the owner. I agree to comply with city and slate laws reg.-
NAME (OR NAMINESS) _
�•
ADDREgB
APPLICATION APPROVAL
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PLltalldelBLE/
t/
H IES
AU
AUTHOO
This application Is not n til
p ermit un
N Mn LINO ADDRESS
LOT COVERAGE LOT COVERAGE
J l�
signed b Y the Building Official or his Dep_
tl
WORE NOTED
utY; and fees are paid, and receipt is
shat[ be cum-
Pleted In nix months.)
PEICH188IBLE HE361f PROPOSE IOHT
O j,
TUNE (OWNER Olt AGENT) BIGNED
INSPECTION
CITY TELEPHONE NUMHEA
ACTUAL I�)TREA T TA / LD6 AREA
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£ �!
Ntau s
=14$8
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NOTE: AppliSIIcant i )'o Plan Check Pre
NAME
FRONIf--ZEQUI eEDU YARll9 PROPOSED YARDS
RF.AItO.Nf
tM I -
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Any construction un the Public domain (curb., eldewall, dtlrelray.,
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nlatquees, ell.) will require sef,—te permleel on.
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ly
LE AL LOT VARIANCE pR CO ITiGNAI+ U
FILE
,AYES 0 NO PERafIT NUa1BER
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CITY
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TELEPHONE —NUMBER
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REMARKS
Driveway slopes not to exceed those
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indicated on Standard Dw No. 103
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TELEPHONE NUMBER
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0 BTATI•. LICENSE NUa1HER'MET
CITY LICENSE NUMBER
ER el'LE
SERVICE SIZE CLEARANCE
C E ED
BY
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--�t�'3 / iGi�yD
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I D Ipll n of I roperty [dhow Below or
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TYPE CONNECTION
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❑ NEW
❑ LINE
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❑ BIGN
PLAN
HECK DNON.RESIDENTIAL THIS SITE IS LOCATED IN THE CITY
OF
❑ ADD
RETAINING
❑ DEMOLISH ❑ WAL
EDMONDS. LOCAL SALES TAX
MAnxs ULD BE CODED 31.04.
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REPAIR ❑ ❑ S{Vial
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NUafIIEA O@` BTORIF.B NUafBER ON
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DWELLING
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UNITS
NATURE OFt7NORIC TO DONE
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.BE
Valuation
Fee
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Plan Check N. .....................
Receipt No.
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Y PROPOSED UeE
BUILDING
/61
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PLUMBING
—
PLOT PLAN (Indk"to Bulltlln6 setbacks, abutting streets)
HEAT & GAS LINE
FENCE
9ICN
RETAINING WALL
N
SWIMMING POOL
DEafOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I hereby acknowledge that I have reed this application; that the In-
TOTAL AMOUNT DUE
QQ
formation given In correct; end that I nm the owner, or the duly nuthor16
-
Izrd agent of the owner. I agree to comply with city and slate laws reg.-
Isting coastructlon; and In doing the work authorized thereby, ao Deraon
will be employed In 'totalhm
ATTENTION
APPLICATION APPROVAL
Of the Labor Code of the State of Washington
relating to Workmen's Compensation Insurance•
H IES
AU
AUTHOO
This application Is not n til
p ermit un
NOTE: Permit Limit One Year (Except
RIZZES
ONLY TIRE
signed b Y the Building Official or his Dep_
I/EaIOLITIONH which
$hall be completed In ninety day.; MOVED -IN BUILDINGS
WORE NOTED
utY; and fees are paid, and receipt is
shat[ be cum-
Pleted In nix months.)
ac-
knowledged In space provided.
TUNE (OWNER Olt AGENT) BIGNED
INSPECTION
17DATE
t a
DEPARTMENT
DI CT •B B30 RE
CITY OF
NOTE: AppliSIIcant i )'o Plan Check Pre
EDMOND9
DATE
Thin I'erntlt eo rrr. work in be done n prlvnte prePerty ON LV.
%%S-Z§ZJ
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Any construction un the Public domain (curb., eldewall, dtlrelray.,
nlatquees, ell.) will require sef,—te permleel on.
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RECORD OF INSPECTIONS.
Date Passed J
Foundation « T 1!
Plumbing (Partial)
(Rough)
Frame
Furnace & Fuel Lines
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Final "'"%�
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BUILDING DEPARTMENT I Applicant Fill ZONE _ 6 NSI 740627
PERMIT APPLICATION InB►de Heavy Lines
NAME (OR NAME OF BUS1NE88) l.. r, ` t�
�' MAILING ADDREBB L (`
O CITYTELEPHONE NUIiHhR
1— m" o: 's
NAME
ADDRESS
JOB
ADDRESS
RESIDENTIALE]
/� I
PERMISSIBLE
LOT COVERAGE
`p'),
ACTUAL
LOT COVERAGE
PERMISSIBLE 1161—
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//
PROPO?Ep-OHTPROPO?E��OH�jT
ACI'UAI1; IpT�+�
r
TELEPHONE NUMBER
�9TA
(�
REQUIRED YARDS
BIDE REAR
PROPOSED YARDtl
FRONT BID
ggqFRONT
qn
STREET W e .....:.F -
EXISTING STREET R/1_l. DEFICIENCY THIS PROPERTY
/REA/R
N/H IS+
LE�AL�LO.T�
YES NO
VARIANCE M R ITIONAL USN
PERMIT NUMBER
y
RESIDENTIALE]
/� I
ATE:
J
❑
NEW
PLANjiIlj,QAPPaiOVAL
� IL
CITY
TELEPHONE NUMBER
(EE n/ litYl
❑
I
RETAINING WALL
STREET W e .....:.F -
EXISTING STREET R/1_l. DEFICIENCY THIS PROPERTY
ADD El DEMOLISH❑
NAME
RETAAINING
�''- y1 O.
COMP. PLAN BT. R/h'r :.'..?.JFT. ....!J...FT.
SWIMMING POOL
Ua K �o,t s
❑
REMARKS Driveway slopes not to exceed those
ADDRE88
96 1 Z) �S_ ny P�
5r.i�
indicated on Standard Dw . No. 103
....Ft.)
CITY
TELEPHONE NUMBER
REPAIR ❑ MOVE
TOTAL AMOUNT DUE
Od
fymyN05
I
METER SIZE SERVICE SIZE CLEARANCE
C E CED BY
POOL
LICENSE NUMB�EEII.
CITY LICENSE NUMBER
I I I
APPLICATION APPROVAL
"SSTTATE
pro 3 C)( /G 7% D
REMARNtl
will be employed In violatlon of the Labor Code of the State of Washington
Legal Description of Property (Shaw Below or Attach Four Copies)
A/ir
relating to Workmen's Compensation Insurance.
UNITE
signed by the Building Official Or his Dep -
TYPE CONNECTION VERIFIED BY
ONLY THE
WOnH NOTED
Q,/ter/J''
�•V G l '
.hall be completed In ninety days; MOVED -IN BUILDINGS shall be nom-
knowledged In space provided.
I PERM NUMBER
/
PERC. TEST
TYPE OF C
T _
'-zJ .-
SITE IS L
EDMONDS.
Valuatian
❑ NO
a PROPOSED USE
RESIDENTIALE]
/� I
GAS
LINE
YES
❑PLAN
❑
NEW
�
FENCE
,
NON-RESIDENTIAL
❑
SIGN
RETAINING WALL
❑
ADD El DEMOLISH❑
RETAAINING
MAI
SWIMMING POOL
ALTER AVAT
❑
PENCEx..
❑ ORCI. LLE
it
....Ft.)
EXCAVATION OR FILL
REPAIR ❑ MOVE
TOTAL AMOUNT DUE
Od
I hereby acknowledge that I have read this application; that the In.
INSPswif
formation given le correct; and that I am the owner, or the duly author -
POOL
(UMBER OF STORIES NUMBER OF
ATTENTION
APPLICATION APPROVAL
lattng once Motion; and In doing the work authorlted thereby, no Yemen
DWELLING
will be employed In violatlon of the Labor Code of the State of Washington
THIS PERMIT
This application is not a permit until -
relating to Workmen's Compensation Insurance.
UNITE
signed by the Building Official Or his Dep -
NOTE: Permit limit One Year (Except DEMOLITIONS which
ONLY THE
WOnH NOTED
iATURE OF WORK TO BE DONE
.hall be completed In ninety days; MOVED -IN BUILDINGS shall be nom-
knowledged In space provided.
pleted In elx months.)
rrGTUriE (ONNER OR ACENT) DATE SIGNEll
INSPECTION
'-zJ .-
SITE IS L
EDMONDS.
Valuatian
❑ NO
a PROPOSED USE
Pian Check Nn .....................
BUILDING
PLUMBING
LINE
/� I
� PLOT PLAN (Indlento Building eetbneke, abutting streets) HEAT k GAS
9
�
FENCE
,
SIGN
• t
RETAINING WALL
N
SWIMMING POOL
IEEE
DEMOLITION
PRE -MOVE INSPECTION
it
EXCAVATION OR FILL
TOTAL AMOUNT DUE
Od
I hereby acknowledge that I have read this application; that the In.
'
formation given le correct; and that I am the owner, or the duly author -
(zed agent of the owner. I agree to comply with city and state laws regu.
ATTENTION
APPLICATION APPROVAL
lattng once Motion; and In doing the work authorlted thereby, no Yemen
will be employed In violatlon of the Labor Code of the State 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 DEMOLITIONS which
ONLY THE
WOnH NOTED
uty; and fees are paid, and receipt is ac--- —'
.hall be completed In ninety days; MOVED -IN BUILDINGS shall be nom-
knowledged In space provided.
pleted In elx months.)
rrGTUriE (ONNER OR ACENT) DATE SIGNEll
INSPECTION
D! CT 'B 8I0 RE
DEPARTMENT
CITY OF
GC..
EDhfOND$
DATE
NOTE: Applrtmtt SBGjeI' to Pldn CGrrk Fre
— —
775-2525
Title Permit r 'era work to be done on Private properly UNI.Y.
'
b.,
Any ran.,on the public do sin (curbs, sidewalk., drlrewaye,
FILE
mnrnnerorentrlsi .rpm prrml. nim,.
PERMIT APPLICATION I Inside Heavy Lines
NAME (OR NAME OF BUSINESS) f'_ L
_ (-I �lJic.K r�z
MAILING ADDRESS
.Uj ADDRESS
F
•yY
O
CITY I TELEPFlONE NUMBER
NAME
I.�ales K c r,,vs
C ADDRESS
K CITY I TELEPHONE NUMBER
14
mo v
Legal Description of Properly (Show Below or Aileen s"our Oopie.)
A
0
5
O
n
al
IO f
ADDRESS ;,•i y/(•�
)
?-, /
t'
'. !i •1 A its !.(.-1 F(:.•..
PERMISSIBLE' !
IAT COVERAGE ^ •�)
AC IIZi L JJ
LOT COVE AGE
\
CLEARANCE
PERMISSIBLE HEIGHT
PROPOSED HEIGHT
flan Check No .....................
ACTUAL IAT AREA
O
R'QUTAED YARDS
PROPOSED YA D8
FRONT SIDE REAR
FRONT BIDE REAR
SPECIAL
LE AL LOT VARIANCE OR UON ITIONAL USE
m VMR n Nn PERMIT NUMBER
PL.jN jY¢D Gr APPROVAL ���.j MATE:
H{•�(W
STREET
EXISTING STREET R/Wy{) .1.... DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R(W !�.1..-.,F1'. ...(_L..FT.
RDMARKS
Dri v, {way slopes not to P_XCee_d tilos(?
indicated on Standard kia. No. 103
V
BY
Irmf 71
METER SIZE
I SERVICE SIZEI
CLEARANCE
C EOHED BY
1
REMARKS
NO
NV � r �
1X, THIS SITE 15 LOCATED IN THE CIT)
OF EDMONDS. LOCAL SALES TA)
i-~ -- "•-SHOULD BE CODED 31.04.
NATURE OF WORK TOBE DONE
Vnlunllon
Fee Receipt No.
-: � •; .tom,, y.-.
flan Check No .....................
O
BUILDING
W PROPOSED USE
SPECIAL
RESIDENTIAL
q
E]INE
-AS❑
YES
PLAN CH
v
NEW
PLOT PLAT' (Indicate Building setbacks, abutting streets)
HEAT k GAS LINE
O
❑
NON-RESIDENTIAL I
❑
�
FENCE
❑
ADD
SIGN
NING
REMARK
WALL,'
F-1
❑
yALL
ALTER
DEMOLISH
EXCAVATE'
On FILL
❑
(ENC x .......... Ft.)
❑
REPAIR
PRE -MOVE INSPECTION
PRE-INSPAfOVE
❑
SWIM
EXCAVATION OR FILL
❑
POOL
!UMBER OF STORIESI
NUMBER OF
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
/ 7 T
DWELLING
a
formation given le correct; and that I m the owner, or the duly author-
_
Ized agent of the owner. I agree to comply with city and state law. regu-
UNITE
APPLICATION APPROVAL
lating construction; and I. doing the work authorized thereby, no person
NO
NV � r �
1X, THIS SITE 15 LOCATED IN THE CIT)
OF EDMONDS. LOCAL SALES TA)
i-~ -- "•-SHOULD BE CODED 31.04.
NATURE OF WORK TOBE DONE
Vnlunllon
Fee Receipt No.
-: � •; .tom,, y.-.
flan Check No .....................
O
BUILDING
W PROPOSED USE
�.
PLUMBING
v
PLOT PLAT' (Indicate Building setbacks, abutting streets)
HEAT k GAS LINE
O
�
FENCE
SIGN
tRETAINING
WALL,'
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
/ 7 T
a
formation given le correct; and that I m the owner, or the duly author-
_
Ized agent of the owner. I agree to comply with city and state law. regu-
ATTENTION
APPLICATION APPROVAL
lating construction; and I. doing the work authorized thereby, no person
will be employed In violation of the Labor Cade of the State of Washington
THIS PERMIT
This application Is not a pernit until
relating to workmen'. Compensation Imurance.
AUTHORIZES
eigned by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS Which
ONLY TILE
WORK NOTED
uty; and fees are paid, and receipt is ac -
.hall be completed In Nasty days; MOVED -IN BUILDINGS shall La con-
knowledged In space provided.
pleled In .Ix months.)
SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DIRECTOR'SISIGNATURE
f"
DEPARTMENT
% -ti.- i'..�
CITY OF
.,,...,_(,
EDMONDS
DATE
NOTE: A lieast SubecfI to Plan Check Fee
h!' j
775-2525
This Permit cuvere work to be done on private property ONLY.
Any mind ashen an the nubile dnmaln (curbs, sidewalk., drll'enaye,
INSPECTOR
,nlurrs, rlr.) rll1 rr,lulrr. nrpnrnlr ❑..... ion.
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