740638.pdfi
PE
BUILDING DEPARTMENT Applieaat Fill °NE NUM ITE11740638
PERMIT APPLICATION Inside Heavy Linea GB � A
ADDRESS `�
NAME NAME OF HUB1N➢ �t f )
/`moi_ PE1tMItlBERA ACTUAL t I�
f LAT COVERAGES LOT COVE�FiAGE j
M MAl ADORE 8 �— PERMISSIBLE HEIGHT PROPOSED HEIGHT O ! {
Ia
CITY j T➢CEPH N➢ NUMBER ACTUAL LOT AREA TOTAL BLDG. AREA ''AAAcjjj I,
�fM�) REQUIRED YARDS PROPOSED YARDS k
NAME FRONT SIDE REAR FRONT SIDE REAR
LEGAL LOT VARIANCE OR CONDITIONAL USE
a�j ADDRESS C3 YES 0 NO PERMIT NUMBER 3 -
PLANNING DEPT. APPROVAL DATE:
CITY TELEPHONE NUMBER �
STREE`.'R/W O
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY A 1
E o ............FT. [� COMP. PLAN ST. R/W ............FI'. M
O REMARKS
IQd ADDRESS -I d
`2 I CHECKED BY W
CITY TELEPHONE NUMIIER
E.
L C y til N W C I / ` ��—Y3 METER SIZE SERVICE SIZE CLEARANCE CHECKED BY
V STA ➢ LICENBII NUMBER / CITY LICENSE NUMBER
ST
`'((x
D/ �T 1 �/ `e r REMARKS
Legal Description of Properly (Show Below or Aileen Four Copies)
j
TYPE CONNECTION I VERIFIED BY
C
PERC. TEST I PERMIT NUMBER l
i
a !;
4I REMARKS n1I
� I
.i
V
a
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
❑YES ❑NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
RESIDENTIAL GAB ❑ YES ❑ NO
NEW LINE PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY i
NON-RESIDENTIAL ❑ OF EDMONDS. LOCAL SALES TAX
SICN
SHOULD BE CO1.04.
DED 3
ADD E] DEMOLISH ❑ RETAWALINING REMARKS
EJALTER EXCAVATE FENCE ,
OR FILL (.....................Fl.)
REPAIR ❑ PRE-INSPbtOVE E3POOLL
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
NATU E OF WORK TO BE DONE Vntunllon Fee Receipt No. I
i• Plan Check No .....................
Z
Q BUILDING
PROPOSED 8E
o r PLUMBING
MPLOT PLAT lndlca a Building setbacks, pinfung se .Ste) HEAT A GAS LINE
i
� PENCE 1
SIGN
RETAINING WALL
N
SWIMMING POOL
i
DMIOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In- '
formation given le correct; and that 1 — the owner, or the duly author.
feed agent of the owner. I agree to comply with city and elate law. regu. ATTENTION APPLICATION APPROVAL
bating Construction; and In doing the work authorized thereby; no person
will be employed In violation of the Labor Code of the Stale of Washington THUS PERMIT This application is not a permit until
relating to workmen's Compensation Insurance. AUTHORIZES signed by the Building Official or his Dep-
TH
NOTE: Permit Limit One Year (Except DEMOLITIONS which ONLY OTE ut and fees are aid, and receipt is Be
WORK NOTED y, P P
.hall he completed In nLqCU days;OVED-IN BUILDINGS shall be com- knowledged in space provided.
pleted In six months
O TUItE It OR OE DATE StONED INSPECTION DIRECTOR'S SIGNATURE
DEPARTMENT /
CITY OF'C': _ 71
... .r . , ,.. , , . /`; .' : �•__---
NO 8: ppficdut SaEDMOND9 DAT
hject Io Plats Check Fee ' (qj
775.2525
This Permll c 'er1 Nark in be done on private property ONLY.
Any construction on the public domain (Curbs, sidewalks, dtiv—scys, FILE
marquees, etc.) will require separate permission.
y
) ( t 1
_. D
BUILDING DEPARTMENT Applicant Fill USE PERMITI I
ZONE NUMBER
PERMIT APPLICATION Inside Heavy Lines
NAM_E•(OR NAME OF BUSINESS)
et � i � f ii .�J't Yrs • Fl )., r � .-. C\ ,
MAI NO ADDREBB /I
O CITY•• TELEPRONE NUMBER
NAME
WADDRESS
F
JOB
ADDRESS l
PERMISSIBLE .
LOT COVERAOF.
ACTUAL
LOT COVERAGE
PERMISSIBLE HEIGHT
PROPOSED HEIGHT
ACTUAL LOT AREA
TOTAL BLDG. AREA
REQUIRED YARDS
FRONT SIDE REAR
PROPOSED YARDS
FRONT SIDE REAR
CITY
TELEPHONE NUMBER
LEGAL LOT VARIANCE OR CONDITIONAL USE
YES [3 NO PERMIT NUMBER
Vp.
CITY
TELEPHONE NUMBER
PLANNING DEPT. APPROVAL DATE:
1
i
STREET"/1V
EXI8TIN6 STREET R/W ............FT.
DEFICIENCY THIS PROPERTY ;0c
Ii
1
NAME
/ ,, `` /I.. LL s
C_. CJ (� �� tJv Y{.1..j, (f
COMP. PLAN ST. R/W ............
FT. ............F.T. ki�l
NQ �l iJ
REMARKS
Z
ADDRESS ��-(
x
S 2 d \
CHECKED BY
W '
e
C
CITY
TELEPHONE NUMBER
O
L_ M1 Ill ttJ I-'�J
71: (�
-I
S/ ATE LIC/ENS(E NUafBEII
CITY LICENSE NUMBER
METER 81ZE I SERVICE SIZE
I CLEARANCE
I CHECKED BY
/ 7 t!' /J C
1+
W
I /
Legal Description of Property (Show Below or Attach Four Copies)
REMARKS
C
r
TYPE CONNECTION
VERIFIED BY
O�
y
L•' E
PERMIT NUMBER
d.
1�
a
p
al
I
FIRE ZONE TYPE OF CONSTRUCTION a IMPROVED
I
i
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
❑ RESIDENTIAL
❑
❑ YES 0 NO
❑ NEW
L.
PINE
PLAN CHECKED BY
THIS SITE IS LOCATED IN THE CITYDS.
q NON-RESIDENTIAL
❑ gICN
F EDMON TAX
�HOULD
❑ ADD RETAINING
❑ DEMOLISH ❑ WALL
_
REMARKS
IIE CODEDOCAL 31.04.SALES
❑ ALTER AVA
❑ FENCx
ORC'ILLTE
❑ .......... Ft.)
EIREPAIR ❑ PRE -MOVE BWITf
INSP. EJ
NUMBER OF STORIES NUAfBEll OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE
n
Valuan tl
Fee
a
Receipt N e.
;I
_
Plea Check N o
i
x
BUILDING
11
PROPOSED UBE
rTJ
PLUMBING (
I 0 o
l
l..I
.r 1L I
_t!
)'
A
PLOT PLA (Indlca/o St(1....6 c ba c bU",as etreela)
V v
HEAT k GAS LINE
9
1/
PENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
-
DEMOLITION
PRE -MOVE INSPECTION
IjI
EXCAVATION OR FILL
1
TOTAL AMOUNT DUE
I hereby acknowledgo that I have read this appllcnllon; that the In-
il.(?
formation given iscorrect; and 'hot I mh the oWoor, or the duly author -
Iced ¢gent of the owner. I agree to comply with city and state law, reg.-
ATTENTION
APPLICATION APPROVAL
I
lag on
tinconstruction; and In doing the worst authorized thereby, no pers
Will be employed In vlotatloh of the Labor Code of the State of Washington
THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation Imuraau.
AUTHORIZES
algned by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
Uty; and fees are paid, and receipt is ac -
shell be completed In West day,; MOVED -IN BUILDINGS shall be corn.
WORK NOTED
]cnowledged in Space provided.
pleled In six months.) }
'-SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DIR� OR's aNATU
47
j
DEPARTMENT
).'
�i/l�ll
I
CITY OF
EDMONDS
D AT
Al
NOTE: pplicant Subject to Plan Check Fee
775-2525
This Permit Severe work to be done on pd.to property ONLY.
Any construction on Clio public domain (curb,. sidewalks, driveways,
marquees, etc.) will require separate permission.
INSPECTOR
1