750043.pdf-_ 750043
ONE NUS
BUILDING DEPARTMENT
Applicant FLU
t
PERMIT APPLICATION I
Inaklo Heavy Linea
IOD
ADDRESS l 9f
N E (OR NAME OF BUSINESS)
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PERM1S8 . ACTUAL
LOT COVERAGE' ^j I LOT COVERAGE O
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PEftMIBBIBLE HEIGIIT x,33/ PROPO IiICIGHT
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ACIUAL I/n A)REA _CA�7?vT- TOTAL 1 DDGI . AREA _
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7PHONE
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REO IRE& YARDS ...POSED YARDS
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FRONT BIDE REAR FRONT BIDE REAR
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ADDRESS
LEGAL LOT VARIANCE OR CONDITIONAL USE
Qi YES 13 NO PERMIT NUMBER
F.
CITY TELEPHONE NUMBER
PLANNING DEP . P VAL
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STREET /lV
EXISTING STREET R/VP5./�r.5'r, DEFICIENCY THIS PROPERTY
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NAME
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COMP. PLAN ST. R/ ... ...... ... .1 /�....FT.
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REbfARRB Driveway slopes not to exceed those
rDREBB
indicated on Standard Dwg. No. 103
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CITY
TELEPHONE NUMBER
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METER 81LE
SERVICE 812E
CLEARANCE
8 ATE LICENSE NUMBERCITY
LICENSE NUMBER
CEC E Y
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REMARKS
Legal Description of Property (Show Below or Attach Foer Caples)
TYPE CONNECTION
VEFI
PERMIT NjMBF11
(V
REMARKS
W
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
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—A/ ❑ NO
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SPECIAL INSPECTOR RE�iUIRED OCCUPANCY GROUP
®' RESIDENTIAL
SAS
❑
C1 YES O
,
NEW
LINE
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL
❑ NON-RESIDENTIAL
❑ BIaN
/ OF EDMONDS. LOCAL SALES TAX
` l/,y
❑
,���/%�-� SHOULD BE CODED 31.04.
t�6fARx9.{,
❑ DEMOLISH❑ WALL
❑ ALTER EXCAVATE ❑ FENCE�/
L(�,i:/jl/�/4�G%/(JI✓ �L_ ,(/ /� i% /�%�
❑ OR FILL (,....................Ft.)
❑ PRE -11 OVE SWI
REPAIR M
F-1 INSP. ❑ POOL
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�y i�� t%�L= Ci% /!/ O'✓ .�// ��s�C1G %Z(J�`j
NUMBER OF STORIES NUMBER OF
i
DWELLING
UC/ UNITS
O WORK TO flE DONE
Valuation
Fee Receipt No.
j
/NJATURE// /
Plan Check No .....................
BUILDING
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PROPOSED USE����
PLUMBING
O
PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT A GAO LINE
P �.
FENCE
SIGN
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RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
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I hereby acknowledge that I have read this application; that the In.
TOTAL AMOUNT DUE
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formation given Ie 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
APPLICATION APPROVAL
lating '-"Mellon; and In doing the work authorized thereby, no Dereon
will be employed in violation of the Labor Code of the Stale of WMIlInglon
THIS PERMIT
This application is not a permit until
relating to Workmen's Compenealloa 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 -
shall be completed In ninety days; MOVED -IN BUILDINGS Shall be corn•
knowledged in Space provided.
pietid In six months.)
SIGN \TURF, (OWNER OR AGENT)
DATE SIGNED
INSPECTION
1R '8 a GNATURE
y1
DEPARTMENT
CITY OF
i
EDhfONDB
ATE
'
NOTE: Applicant Snhje to Plan Check Fee
_--
This Permit arc rrurk to ho done on private property ONLY.
775-2525
F
Any conelrucilan an the public domain (curbs, sldewal Its, drh'ex'ays,
FILE
1
marpucee, ale.) Will require separate permleslon.
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E TYPE OF COJRUCT2BaL/ / ( Pyty l/IP1tDVED
FIRE ZONE
V /�� (
i
i
I
�
SPECIAL INSPECTOR REQUIREDJ GROUP
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BUILDING
DEPARTMENT
Ap,U.t Fill
USE
PERMIT r
(OCCUPANCY
�
PERMIT APPLICATION
Inside Heavy Lines
� r (
JOB �N,
)
ADDRESS � "1'116-
1 / 6
CHECKEI❑6Y
THIS SITE IS LOCATED IN THE CITY',
NAME (OR NAME OF BUSINESS)
• I jjt I _•
•! -;
-' /) .G:YL
/ C `'
PERM "TELE ^/ ACTUAL
LOT COVERAGE? `"�)� LOT CUVEtYAGE (�
❑ SIGN
;
'
OF EDMONDS. LOCAL SALES TAX
I
f i ( I !. !. / i i) r .%' •) , J
❑ ADDEl❑
j
`HTO
RETAINING
AILING ADDRESS I
PERMISSIBLE HEIGHT PROPOSED EIGHT
SHOULD BE CODED 31.04.
0
DEMOLISH WALL
TOTAL 6. AREA
1 ,
1
C+TY TELEPHONE
ACTUAL LOT AREA
NUMBER �S
/
I.
";-1 1 .0 or,, //r
/ / •J "ii (.'1) �I
REQUIR D YARDS �kOPOSED -D8
REAR
❑REPAIR ElPRE-MOVESWIM
INSP. POOL
`-Vit%[_: !./
,:�I 7�_ `I: Z�`i✓S/%='c.;,;:,..J'
NAME
FRON 8'1 IDti REAR FRONT SIDE
LEGAL L07''VARIANCEOR CONDITIONAL USE
I
ADDRESS �
IT NNUMBER
NO PERMIT
�. YES [3PE
N
�.,,. UNITS
-PLANNING IEIT./IZIIAL DATE,:
i
CITY, TELEPHONE NUMBER
R'
C
(
i'--, b,I U iV Jz
STREET V
EXISTING STREET R/ l:h/P�'C. DEFICIENCY THIS PROPERTY
r -
NAME
BUILDING
COMP. PLAN ST. R/�C!.`.�.:FT.
/�t;.s .'Li G
I
(�
4
-rA'I r. K / 1 1 G KM1I
REMARKS
Dri Jeway SloDes !tot t0 (:Y.CP.ed thDiE'
�1+
�
nDPREBs
r f 7,indicated
PLUMBING
on Standard Dwi*. 110. 103
8
w
1 (!. Ci X
` CHECK 1II
1
TELEPHONE NUM DEh
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c-ILt-(�
Jl3F��
H
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.
II�_
METR58LEv 1111
CR
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BT TE LICENBE NUMBER
CITY LICE BE NUMBER I /
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SIGN
C� t71 G _ / U I.""; 'I
REMARKS
I
i I
Legal Description oI Property (Show Below or Attach Four copies)
%
N
TYPE CONNECTION VERIFIE
l
-
O
�+
P R B PER f7 N MBER
N I
a
Ij
RE t s — _
14
m I
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E TYPE OF COJRUCT2BaL/ / ( Pyty l/IP1tDVED
FIRE ZONE
V /�� (
i
i
I
�
SPECIAL INSPECTOR REQUIREDJ GROUP
% RESIDENTIAL
GAS
❑ LINE
i
YES NO
❑PLAN
(OCCUPANCY
�
El NEW
CHECKEI❑6Y
THIS SITE IS LOCATED IN THE CITY',
❑NON-RESIDENTIAL
❑ SIGN
/
�! :�
OF EDMONDS. LOCAL SALES TAX
I
❑ ADDEl❑
RETAINING
;.�.q�,..,-% C�.;
REMARKS i
SHOULD BE CODED 31.04.
DEMOLISH WALL
- U
1 ,
❑ FENCE
EXCAVATE
i.. i•'.^. _./ /J :JG,/
/tJ/-� %��::-'.C/ (%.CJ V �Y/.-J
I.
ALTER ❑
OR FILL ❑ (.....................Ft.)
l
❑REPAIR ElPRE-MOVESWIM
INSP. POOL
`-Vit%[_: !./
,:�I 7�_ `I: Z�`i✓S/%='c.;,;:,..J'
NUMBER OF
NUMBER OF STORIES NUMBER
I
1
�.,,. UNITS
NATURE OF WORK TO SE DONE
Valuation
Fee
Receipt Na.
Plan Check No .....................
BUILDING
err -/G/ •' I /
/�t;.s .'Li G
I
(�
4
PROPOSED USE
'
PLUMBING
a
PLOT PLAN (Indlento Building setbacks, abutting streets)
HEAT @ GAS LINE
FENCE
SIGN
I
i I
RETAINING WALL
%
N
SWIMMING POOL
DEMOLITION
i
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAMOUNT DUE
AL
I hereby acknowledge that I have read lits application; that the fn-
/
formation d, given is correct; and that I athe owner, or the duty author-
Ired agent of the owner. I agree to comply with city and state, laws regu-
ATTENTION
APPLICATION APPROVAL
lating construction; and Ip doing the work authorized thereby, no person
Will be employed In violation of the Labor Code of lbs Stale of Washington
TIH8 PER511T
This application is not a permit until
,
totaling to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY "IE
WORK NOTED
uty; and fees are paid, and receipt is ac -
shall be completed In alaoty days; MOVED -IN BUILDINGS shall be cam.
knowledged in apace provided.
pteled In etx months.)
SIGNATURE (OWNER Olt AGENT) DATE SIGNED
INSPECTION
DIRECTOTS SIGNATURE :1
I
DEPARTMENT
s.
'ITY OF
EDNIOND9
DATE /
I
NOTE: Applicant Subject to Platt Check Fee
•-> / _-
1
775-2525
This Permit cuvcrs Work to be done on private property ONLY.
Any cunstructtnn .11 the public domain (curbs, old -1k., driveways,
INSPECTOR
mNVueee. Me.) will reVulre separateperntlse ton.
_