750007.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 space provided.
1-9-75
FILE
TOTAL AMOUNT DILE
I hereby acknowledge that I have read this application; that the In.
i
Y _ [] YES " NO
NAME
ATTENTION
.7'
PLAN BT. R/VF'.-.i:.!!: ...1•% .T.
will be employed In violation of the Labor Code of the Slate of Washington
OCCU�PANCY GROUP
SPECIAL INSPECTOR REQUIREDPL
°- HU>�2 750001
AUTHORIZES
-REMARKS
Driveway slopes not to emceed those
BUILDING DEPARTMENT
AppllcaDt Fill
ESC -PNO
—
indicated on Standard DwQ. No. 103
PERMIT APPLICATION
I Inside IieaPy Lines
A DRESS
LINE
C}}ECY HY
67
NA E (OR NAME OF "0"1"11111,I
Thi
0 1
NUMBER
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CHE
/
/
775.2525
PEI2MISBIDL q ACTUAL
COVERAGE LOT COVERAGE
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❑
3TE3LE(7P�AON/YES
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A 4,V y
SHOULD BE CEDED 31.04.
LOT �t•lJ�v
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CR � D
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PERh1188IBLE FIEIOI1T..t ^/ PItOP08ED HEIGHT
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CITY LICENB�NU
ACTUAL LOT AREA TOTAL BLDG. A E
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ITY
rfELEPBONE NUMBER
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RIDDE AILDB
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PRE-MOVE
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Legal Deee1lPllO1 of Property
FRONT g DF.YARDB REAR FRONT REAR
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NUMBER OF STORIES
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PLRC. TEST
LE LOT ARMING). OR CON ITIONAL UBE /
PERMIT NUhfIIER
NATURE OF WORK TO BE DONE
ADDRESS
ES
r}YEg 0 NO PERMIT NUMBER
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PLANNING UEPT. PPROVAL TE:
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CITY
TELEPHONE NUMBER
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STREET R/tV
ti
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 space provided.
1-9-75
FILE
TOTAL AMOUNT DILE
I hereby acknowledge that I have read this application; that the In.
EXISTING STREET R/ .F'r. DEFICIENCYpT�RIS PROPERTY
Y _ [] YES " NO
NAME
ATTENTION
.7'
PLAN BT. R/VF'.-.i:.!!: ...1•% .T.
will be employed In violation of the Labor Code of the Slate of Washington
OCCU�PANCY GROUP
SPECIAL INSPECTOR REQUIREDPL
((1
AUTHORIZES
-REMARKS
Driveway slopes not to emceed those
01
DItE 8
ESC -PNO
—
indicated on Standard DwQ. No. 103
SIGNATURE (OWNER OR AGENT)DATE S1aNEU
RESIDENTIAL
LINE
C}}ECY HY
67
NEN
Thi
NUMBER
NOTE: Applicant Subject to Plats Check Fcc
CHE
/
OF' THE E MONDS.O LOCATED CALI SALES TY Ti
AX
775.2525
/C11�'Y
�
❑
3TE3LE(7P�AON/YES
L/
SHOULD BE CEDED 31.04.
ADD
CR � D
BY
8
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METER SIZE SERVICE SIZE CLEARANCE
B ATE LICENSE NUMBER
CITY LICENB�NU
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I
I
❑OR
EAVATFILL E
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7l
AEMAAKtl
REPAIR
`
PRE-MOVE
IP.O
Legal Deee1lPllO1 of Property
(Show Below er Attach Four Coplae)
/_`� ' •�"'s Ol
NUMBER OF STORIES
/11llSJ
, a
i' Y-/- (/ int 1 J d f Act, P1
TYPE CONNECTION VEErRIFIED BY
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�s.r Y�(a.` I.3 6 )
PLRC. TEST
PERMIT NUhfIIER
NATURE OF WORK TO BE DONE
I
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Q
REMARKS
W
o
a
t
a.
Plan Check Nn .....................
FIRE TYPE OF CONSTRUCTION STREET Ih1PR0
BUILDING
F�
W PROPOSED USE
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 space provided.
1-9-75
FILE
TOTAL AMOUNT DILE
I hereby acknowledge that I have read this application; that the In.
formation given is correct; and that I am the owner, or the duly author-
Y _ [] YES " NO
ized agent of the owner. I agree to comply with city and state laws regu-
ATTENTION
lating construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Slate of Washington
OCCU�PANCY GROUP
SPECIAL INSPECTOR REQUIREDPL
relating to Workmen's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TILE
1{'ORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
ESC -PNO
—
SIGNATURE (OWNER OR AGENT)DATE S1aNEU
RESIDENTIAL
LINE
❑ /"15-P
NEN
Thi
EDMONDS
NOTE: Applicant Subject to Plats Check Fcc
CHE
/
OF' THE E MONDS.O LOCATED CALI SALES TY Ti
AX
775.2525
This Per It coven work to be done on privule property ONLY.
NO. -RESIDENTIAL
❑
SIGN
L/
SHOULD BE CEDED 31.04.
ADD
RETAINING
WALL
REMARKS
EJDEMOLISH
ALTER
❑OR
EAVATFILL E
E](
FENCE
z Ft.)
REPAIR
E]
PRE-MOVE
IP.O
..........
SWIM
POOL
1 lav V + �+
/_`� ' •�"'s Ol
NUMBER OF STORIES
DtVELLING
UNITS
NATURE OF WORK TO BE DONE
Valuation
Fee Receipt r
C9 9 r�9
Plan Check Nn .....................
BUILDING
F�
W PROPOSED USE
PLUMBING
PLOT PLAN (Intlleato Building setbacks, abutting streets)
HEAT &GAS LINE
C
FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
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 space provided.
1-9-75
FILE
TOTAL AMOUNT DILE
I hereby acknowledge that I have read this application; that the In.
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 regu-
ATTENTION
lating construction; 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 Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TILE
1{'ORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted 1. el% manlhn.)
SIGNATURE (OWNER OR AGENT)DATE S1aNEU
INSPECTION
DEPARTMENT
h
CITY OF
EDMONDS
NOTE: Applicant Subject to Plats Check Fcc
775.2525
This Per It coven work to be done on privule property ONLY.
Any con.1—tlan on the public domain (curbs, sldewdIts. driveways,
nutrqu—, ele.) will require separate permleelon.
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 space provided.
1-9-75
FILE
U
0 NO
Plan Check No... ..................
RESIDENTIAL
BUILDING
EXISTING STREET
7
NAME ,.�
ATTENTION
//
!
BUILDING DEPARTMENT pppllcantFill
PERMIT
ONE NUMBER /JUOC%
PERMIT APPLICATION
I Inaldo Heavy Lines
l08
ADDRESS
REMARKS
Dr+V
BUSINESS)Fe
A D1tL•' d
SWIMMING POOL
ADD
NAME (OR NAME OF
DEEIOLIBH
PRE -MOVE INSPECTION
VATI.I.ININC
.'/
ALTER
LOT COVERAGE
[.OT COVAAOE
�1 AILlNO AD EBB.
PENCE
PERMISSIBLE HEIGHT �)
PIIOPOSED HEIORT
CITY
ORFILL
ACTUAL LOT AREA 1
TOTAL ULDO. A Etj(j
J ,Y A�W.P1 ✓
ELEPHONE NUMBER
REPAIR
❑
REQUIRED YARDS
PROPOrF13 YARDS
U
0 NO
DEFICIENCY TRIS PROPERTY
slopes not to exceed those
tV /k
0/, ,
STRUCTICN
.-I.(1._ I — 10 YES 0 NO
SPECIAL INSPECTOR REQUIRED IOCCUPANCY GROUP
0 YES �.NO '5_1
5_ )
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
l OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
REMARKS I
'L'u-1:
,__ .,
Vnlua[lon Fee I Recelat h
Plan Check No... ..................
RESIDENTIAL
BUILDING
EXISTING STREET
PLUMBING Ir
NAME ,.�
ATTENTION
//
COMP. PLAN ST.
will be employed in violation of the Labor Code of the State of Washington
- J
-
..f �.7 > fit.'
REMARKS
Dr+V
WALL
A D1tL•' d
SWIMMING POOL
ADD
indicated o
DEEIOLIBH
PRE -MOVE INSPECTION
VATI.I.ININC
El
ALTER
CITY OF
C11'Y
❑
PENCE
Th.LEP110NE NUMfl ER
❑
ORFILL
z .......... Ft.)
❑
REPAIR
❑
1.
❑
POOL I
NUTIHER OF STORIES
METER SIZE, SEI
STATE LICENSE NUalUE[i
CITY LICENSE NUMBER
DWELLING
UNITS
I
�
/ /
REMAI3Kd
Legal Description of Property (dhow Below or Alleeh hour Caples)
'A I !r ij
TYPE CONNECTIO.
O
li
i /
F'
s / J• I
PERC. TEST
V
REMARKS
DEFICIENCY TRIS PROPERTY
slopes not to exceed those
tV /k
0/, ,
STRUCTICN
.-I.(1._ I — 10 YES 0 NO
SPECIAL INSPECTOR REQUIRED IOCCUPANCY GROUP
0 YES �.NO '5_1
5_ )
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
l OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
REMARKS I
'L'u-1:
,__ .,
Vnlua[lon Fee I Recelat h
Plan Check No... ..................
RESIDENTIAL
BUILDING
GAS
LINE
PLUMBING Ir
NEW
ATTENTION
Is. Ing construction; and In dol p6 tho work authorized thereby, no person
]TEAT A GAS LINE
will be employed in violation of the Labor Code of the State of Washington
`
L
ISI
/�❑
NON-RESIDENTIAL
WALL
SIGN
SWIMMING POOL
ADD
DEMOLITION
DEEIOLIBH
PRE -MOVE INSPECTION
VATI.I.ININC
El
ALTER
CITY OF
❑
PENCE
❑
ORFILL
z .......... Ft.)
❑
REPAIR
❑
INSP.
❑
POOL I
NUTIHER OF STORIES
NUMBER OF
J
DWELLING
UNITS
DEFICIENCY TRIS PROPERTY
slopes not to exceed those
tV /k
0/, ,
STRUCTICN
.-I.(1._ I — 10 YES 0 NO
SPECIAL INSPECTOR REQUIRED IOCCUPANCY GROUP
0 YES �.NO '5_1
5_ )
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
l OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
REMARKS I
'L'u-1:
,__ .,
Vnlua[lon Fee I Recelat h
�1�.00 2�•°°
r_
I1�g- �.I
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 provided.
75
INSPECTOR INSPECTOR
Plan Check No... ..................
I hereby ncknowledgo that I have read this application; that the In-
BUILDING
formation given Is correct; and that I am the owner, or the duly author-
PLUMBING Ir
ized agent of the owner. I agree to comply with city and stale laws regu-
ATTENTION
Is. Ing construction; and In dol p6 tho work authorized thereby, no person
]TEAT A GAS LINE
will be employed in violation of the Labor Code of the State of Washington
FENCE
L
SIGN
NRETAINING
WALL
V
}
SWIMMING POOL
pleted In six months.)
DEMOLITION
31ONATUICE (OWNER Olt AGENT) DATE SIGNED
PRE -MOVE INSPECTION
I
EXCAVATION OR FILL
�1�.00 2�•°°
r_
I1�g- �.I
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 provided.
75
INSPECTOR INSPECTOR
TOTAL AMOUNT DUE
I hereby ncknowledgo that I have read this application; that the In-
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 stale laws regu-
ATTENTION
Is. Ing construction; and In dol p6 tho work authorized thereby, no person
will be employed in violation of the Labor Code of the State of Washington
TIUS PERMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
NOTE: Permit limit One Year (Except DEMOLITIONS which
il
ONLY OTE
WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall ba com-
pleted In six months.)
31ONATUICE (OWNER Olt AGENT) DATE SIGNED
INSPECTION
I
DEPARTMENT
. ,-
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
775-2525
This Permit covers work to be dane an private property ONLY.
Any reamructlon on the public damaln (curbs, sidewalks, drlvsways,
ra"quece, els.) will require separpte permisslon.
�1�.00 2�•°°
r_
I1�g- �.I
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 provided.
75
INSPECTOR INSPECTOR
.. ... �
f�St.
.�..
k S.
t S •.'.. •_
/
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t A�
,
•
-75-0007. :
RECORD OF INSPECTIONS
Date Passed
Foundation
Plumbing (Partial) _
(Rough)
Frame
Furnace & Fuel Lines
/^ Final
1