750088.pdfW PROPOSED USE�-
_.
_ .
`` i
Q
aPLOT PLAN (Indicate Bltliding setbacks, abutting Strode)
HEAT A GAS LINE
-
n
�
FENCE
USE
PERMIT
750 088
tRETAINING
BUILDING
DEPARTMENT
Applicant FW
ONE
NUMB=
PE IT
APPLICATION Inside Heavy Lines
IGS
ADDRESS
DEMOLITION
r
NAM lOR NAME OF U NESS)
PRE -MOVE INSPECTION
EXCAVATION OR FILL
PERM1SS18LEACTUAL
I
TOTAL AMOUNT DUE
I hereby acknowledge that I have reed this appllcnuon; that the In.
LOT COVERAOF.
LOT COVESEAOE
Wrmatlln given Is correct; and that I = the owner, If the duly author-
M
MAILiN ADDRESSO
ATTENTION
PERM ItlSIBLE HEIGHT
PROPOSED HEIGHT
baling 'Instruction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Clde of the State of Washington
THIS PERMIT
3 7
relating to Workmen's Compensation In-urmw,
AUTHORIZES
signed by the Building Official or his Dep-
'
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLYTILE
WORK NOTED
O
�
CIT
shall be completed In ninety days; MOVED -IN BUILDINas shall be com-
TELEPHONE NUMBER
ACTUAL LOT AREA
TOTAL BLDO. AREA
7.
j
i-
Oli AGENT)
TE S16NED DA
INSPECTION
DI CTOft'B NAT
REQUIRED YARDS PROPOSED YARDS
DEPARTMENT
:IaNVNER
NAME
CITY OF
FRONT SIDE
BEAR FRONT SIDE BEAR
ED➢fONDB
DATE JI
NOTE: Applicant Subject to Plan Check Fee
775-2525
This 1'rrmlt avers wnrk to be done on private property ONLY.
Any eon-IntcUnn mi the public domlln (curb-, ddewalke, driveway-,
FILE
LEGAL LOT VARIANCE OR CONDITIONAL USE
n,.aaree, ele.) will nature separate nvmladon.
N
ADDRESS
, YES 0.,40 PERMIT
NUMBER
PLANNING DEPT. APPROVAL DATE:
CITY
TELEPHONE NVMBEB
'
STREET R/W
EX78TIN0 STREET R/W
............FP. DEFICIENCY THIS PROPERTY
O
NAMEG
COMP. PLAN ST. R/W
............FT. ............FT.
W
REMARKS
ADDRESS
BY
CITY
TELEPHONE NUMBER
(CHECKED
M
7.
O
I
_
METER SIZE SERVICE 81ZE
CLEARANCE
CHECKED BY
Q
STATE LICENSE NUMBERI
CITY LICENSE NUMBER
REMABKa
a
Legal Description of Property (Show Below or Attach
Four Copies)
I
TYPE CONNECTION
VERIFIED BY
O
PERC. TEST
PERMIT NUMBER
y.
i
D
�
I
n
W
�
p;
REMARKS
ca
Cor
_ t -.+rhZAD
I'
V
FIRE VONE OF CONSTRUCTION STREET IMPROVED
-(
ITYPE
❑ YES ❑ NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
i
NEW
RESIDENTIAL
❑ OLINE
YES 0
❑PLAN
CHECKED BYO
THIS SITE IS LOCATED IN THE CITY
EDMONDS. LOCAL SALES TAX
0 ADD
NON-RESIDENTIAL
SIGN
RETAINING
REMARKS
So'
SHOULD BE CODED 31.04.
DEMOLISH
WALL
v
ALTEREXCAVATE
❑ OR FILL
FENCE
1..........Y..........Ft.)
O REPAIR
❑ NSPPRE-hIOVE
a W1
F-1POOL
NUMBER OF STORIES NUMBER OF
DWELLING
^
UNITS
NATURE OF
WORK TO BE DONE
Valuation
Fee Raccipt No.
Plan Check No .....................
I
O
L11�YV��
BUILDING
i
W PROPOSED USE�-
PLUMBING
Q
aPLOT PLAN (Indicate Bltliding setbacks, abutting Strode)
HEAT A GAS LINE
-
n
�
FENCE
BION
tRETAINING
WALL
_
N
SWIMMING POOL
DEMOLITION
r
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have reed this appllcnuon; that the In.
Wrmatlln given Is correct; and that I = the owner, If the duly author-
Ired agent of the owner, I agree to comply with city and state laws regu-
ATTENTION
APPLICATION APPROVAL
baling 'Instruction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Clde of the State of Washington
THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation In-urmw,
AUTHORIZES
signed by the Building Official or his Dep-
'
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLYTILE
WORK NOTED
utyi and fees are paid, and receipt Is Be
shall be completed In ninety days; MOVED -IN BUILDINas shall be com-
knowledged In space provided.
plated In six montha.)
Oli AGENT)
TE S16NED DA
INSPECTION
DI CTOft'B NAT
DEPARTMENT
:IaNVNER
/
7 `
CITY OF
ED➢fONDB
DATE JI
NOTE: Applicant Subject to Plan Check Fee
775-2525
This 1'rrmlt avers wnrk to be done on private property ONLY.
Any eon-IntcUnn mi the public domlln (curb-, ddewalke, driveway-,
FILE
n,.aaree, ele.) will nature separate nvmladon.
`r
•
USE PERMIT
�y
BUILDING DEPARTMENTINUMBF11
ZONE NUMBER
i
PERMIT APPLICATION
inside HeavyADDRESS
1 / I / `- � /
I
NAMEr (OR NAME OF BU. -ESS)
'� (' 1 -
PEItallddlOLE n ACTUAL
I
I
LOT COVE'RAOLOTCOVESiAGE
MA1L1N ADDRESS
PElihllddIHLE HEIGHT PROPOSED liElOHTCITYt-
.7/��
TEACTUAL
LOT AREA TOTAL BLDG. AREA("�/
%q
YARDS PROPOSED YARDSNAME
�,),��,.o..1.(��,REQUIRED
FRONT tlIDEREAR
tp�
LEOAI. LOT 1'AIUANCE Oit CONDITIONAL USE❑YEe,NOPEIthIIT
y7
ADDRESS
NUMBERPLANNING
DEPT. APPROVAL DATE:
CITYTE
STREET R/W
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
O
NAMEy
COASF. PLAN ST. R/W ............FT. .. .. .F"T.
F7
RETIARKS
Fj
t4
L
ADDRESS \
z
W�
CHECKED BY
-CITY TELEPHONE
NUMDER
F
l
CLEARANCE
MET'1
CHECKED BY
l
STATE LICENSE NUMBER
CITY LICENSE NU -1%!
l
J
I
C
til;S �V/C /SIZE
il
RE 1 K 1
Legal Description of Property (Show Below or Attach Four Copies)
1 (
/
J//
TYPE CONNECTION IV H
T
LED
I
O
I
PERC. TEST PERMIT NU tB
C
I
W
n
;d
REMARKS It
m
I
,a
'�( i h 1S7 ( �✓
',
i
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVEDI�
.mi
O YES0 NO
i
li
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
RESIDENTIAL
CA9
❑
❑ YES NO
I
❑ NEW
LINE
PLAN CHECKED DY THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL
OF EDMONDS. LOCAL SALES TAX
SIGN
SHOULD BE CODED 31.04.
ADD RETAINING
DEMOLISH WAIT'
REMARKS
E] ALTER EXCAVATE FENCE
/, ).
❑ OR FILL (-.........X..........Ft.)
El REPAIR PRE -MOVE SWIM
INSP. POOL
;• I 1(
i
NUMBER OF STORIES NUMBER OF
/
DWELLING
I UNITS
V ✓ %!!
4�i•
NATURE OF WORK TO BE DONE
Valuation
Fee
Receipt Na.
I
Plan Check No .....................
Z.
_tr `
!
11..1 (may 5�
BUILDING
L
PROPOSED UBE 111 7710 V`�•,
PLUMBING
i
I
PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT & GAS LINE
�
FENCE
SIGN
I
t
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
.ry
I
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I
I
I
I
TOTAL AMOUNT DUE
"5
l
t
1 hereby acknowledge that I have read this application: that the In-
formation given Is correct; and that I sum the owner, or the duly author -
(zed agent of the owner. I agree to comply with city and elate laws regu.
ATTENTION
APPLICATION APPROVAL
lating coastructlon; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Stale of Washington
THIS PERMIT
This application Is not a permit until
relating to Workmen's, Compensation Insurance.
AUTHOIUZF,B
eigned by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONN which
ONLY THE
uty; and fees are paid, and receipt is ac -
shall be completed In ninety days; MOVED -IN BUILDINGS shall be eom-
WORK NOTED
lmowledged in space provided.
pletcd In six months.)
SIGNATURE (OWNER Olt AGENT) DATE 81GNED
INSPECTION
DIR R'8 11 NA /f
DEPARTMENT
CITY OF
EDIIIONDB
DATL
'
'.
-
NOTE: Applicant Subject to Plan Check Fee
775 -2525
This Penult coven work to ba dant, an private property ONLY.
This,
I
Any on the public 1,nm, (curbs, sldewNks, driveways,
INSPECTOR
I
marquees, ete.) will regWre eePerot, permission.