750106.pdf750106 '
USE
PERMIT
BUILDING DEPARTMENT I Applicant FIR ZONE (n NUMBER
PERMIT APPLICATION
Inside Heavy Lines aGs
ADDRESS
NAME (OR NAME OF SUBiNEee) - i i
Pk:IihildSIBLE me ACTUAL
Balt HomAs IAT COVERAGF. -� LOT COVaAGE O` O
MA1/.dpIQADpr�ESdh S.W. O PROPOSED HEIGHT 'l• rl
`iJCOVVIi33 LL 77TT FERb1IBeiHLE HEIOIIT /n i
t ✓ 7 H
C CITY I TELEPHONE NUMBER ACTUAL OT AiIL TOTAL I UG.OARF� t }
Frlmnnrig,e WAC �{'An REQUIRED YAADB IR"...
EU YARDS
FRONT BIDE REAR FRONT BIDE REAR
NAME
fit; G 1S 215 9h/
LEGAL LOT VA. IANCE OR CONDITIONAL UBE I
N ADDRESS Q YES ❑ NO PERhtII NUMBER j
= PLANNING DE T. OVAL
O
CITY TELEPHONE NUMBER a, -
STREET R/LV nt- O
EXISTING STREET R/Wr,t .x.'.'�F'r. DEFICIENCY {T�HIS PROPERTY}
NAME COMP. PLAN ST. R/*..F'r. .••!._.l••F1'• .'
Thomas E Belt REMARKS Driveway slopes not to exceed those
ca U ADDRESS t7
indicated on Standard Dwa No 10�K D IIx IM
i£ 9AD8 215th SW
CITY TELEPHONE NUMDER 11 1''•BY
Edmonds Washington I 776-2829 METER BILE SERVICE SIZE CLEARANCE Cl�CIL BY 1
STATE LICENSE NUMDER I CITY L10EN81•. NUMBER / // I I ` /
(�l
nl—QQ�% REMARKS Q
Legal Description of Property (show Below or Attach Four Coplee)
/�// 1273
TYPE CONNECTION
I VERIFIED BY
Lot 16 Elm View Addition TKUT IPERMI UMHEA
w Division Q REMARKS to
to
� I
f.
.OWI FIRE ZONE I TYPE OF CONSTRU ON STREET IMPROVED
ES ❑ NO
SPECIAL INSPE,C�R
TO/REQUIRED OCCUPANCY GROUP
GA8 ❑ YES }�r`+t1 I
�i RESIDENTIAL ❑ LINE PLAN CHEC ED DY THIS SITE IS LOCATED IN THE CITY
NEW
❑ NON-RESIDENTIAL SIGN SH ULDEDMBE S. LOCAL SALES TAX i
❑ ��� SHOULD BE CODED 31.04. i
❑ ADD RETAINING ARK
❑ DEMOLISH ❑ WALL j _
❑ ALTER ❑ EXCAVATE FENCE �/ d/t%I� Q/dG i'/!h/ f�L l/l3G /y 73
OR FILL ❑ (.......... X .......... Ft.)
❑ REPAIR E]
SWIM
INSP.❑ POOL 51 ,) i7fc m /'✓ ! •� "'..r�
NUMBER OF STORIES NUMBER OF
DWELLING
I 8 Basement I UNITS ,
NATURE OF WORK TO BE DONE Valuation Fee Receipt No.
S i nq IA_Fam i I y Men Check NO... ...................
[Zy BUILDING �/ ��`� 433GL
4 PROPOSED USE UQ
a PLUMBING
W
PLOT PLAN (Indicate Building ectb¢Cke, abutting eLCe.ts) HEAT &. GAS LINE
tl
� FENCE
SIGN
TOTAL AMOUNT DUE
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 auUtor-
RETAINING WALL
(zed agent of the owner. I agree to comply with city and state law. regu.
ATTENTION
.all.. construction; and In doing the work authorized thereby, no person
SWIMMING POOL
THIS PERMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
I
DEMOLITION
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In .1. months.)
PRE -MOVE INSPECTION
INSPECTION
DEPARTMENT
EXCAVATION OR FILL
CITY of
_
EDMONDS
Title Permit euvere mark to be done on private property ONLY.
Any Vona,
...it.. on the public domain (curbs, sidewalks, drlveways,
marquee., tc.) .111 require separate perntleJon.
7F,
1/6zs=1
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.
FILE
TOTAL AMOUNT DUE
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 auUtor-
(zed agent of the owner. I agree to comply with city and state law. regu.
ATTENTION
.all.. construction; and In doing the work authorized thereby, no person
Will be employed In vlels tle. of the Labor Code of the State of Washington
THIS PERMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEh10LITIONH which
ONLY THE
WORH NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In .1. months.)
IIGNA•TU1tE ( VNE OA AGENT) DATE SIGNED
INSPECTION
DEPARTMENT
CITY of
EDMONDS
NOTE: Applicant Subject to Plan Check Pee
775-2525
Title Permit euvere mark to be done on private property ONLY.
Any Vona,
...it.. on the public domain (curbs, sidewalks, drlveways,
marquee., tc.) .111 require separate perntleJon.
7F,
1/6zs=1
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.
FILE
y '
QYES 0 NO PERMIT NUMBER
1
PLANNING DEPT. ^;') OVAL DATE:
�4- 7-
CITY
TELEPHONE NUMBER
hV '�
I
GAS
❑ LINE
STREET
STREET R/{V
-(� / •�
EXISTING STREET R/W( _LIFT. DEFICIENCY THIS PROPERTY
NAME{.�
�-- NG DEPARTMENT Applicant Fla
USE /n�
zoNE /n
PERMIT 1/
NUMBER
REMARKS
Orivel•tav not to exceed those
C ADDRESS
r*,,� �). I'
IT APPLICATION I Ineldo Heavy Lines
Ioa—
ct`tccx•D EY
CITY
D
TELEPHONE NUMER
DEMOLISH ❑
I
ADDRESS
/O
/
/•{// / (f .!J fJ� !Z/•/G
I
I
V F(i m:lD,I r' Wchinntnr77fi-ilii'-1
METER SIZEBERVICE SIZE CLEARANCE
NAME OF BUSINESS)-
r,
PERMISeIBLE ' n j ACTUAL %%
COVERAGE LOT COVERAGE
I CITY LICENSE NUMBER
_!/ r'
I ! //
I
I r,/-'
l.�rLOT
Ste/
L
/0
I i i', )meni UNITS
DRES
S.
FEC.,
PERM1881BLE HEIG IT
PROPOSED HACTUAL
Fee
Receipt No
Cir. •, I ,� F :m 1 1 „
flan Cheek N. .....................
['•yI
BUILDING
4 PROPOSED USE
NUMHER
LOT AR A�
l„CQ
TOTAL SLUG.TELEPHONE
PLUMBING
HEAT & GAS LINE
IRED YARDSP POKED YAIIDa
(� 5
PLOT PLAN (Indlcato Hulmt l�ng�t4ao aC.al�7 in6 streets)
FRONT SIDE:
REAR FRONT SIDE HEAR:.lt
D
FENCE
SIGN
RETAINING WALL
LEGA_1L OT
VAIIlANCE OR Coil") ITIONAL USE
N
M ADDRESS
QYES 0 NO PERMIT NUMBER
PLANNING DEPT. ^;') OVAL DATE:
�4- 7-
CITY
TELEPHONE NUMBER
hV '�
I
GAS
❑ LINE
STREET
STREET R/{V
-(� / •�
EXISTING STREET R/W( _LIFT. DEFICIENCY THIS PROPERTY
NAME{.�
COMP. PLAN ST. R/ - .ZS..FT. ....i,,,..!•FT.
Thnm: F f;n 11'
REMARKS
Orivel•tav not to exceed those
C ADDRESS
r*,,� �). I'
slopes
inriicatr-I on Standard il':r1I, 'In. 1(1?
uR'1f;_'lI S}h R'J
ct`tccx•D EY
CITY
D
TELEPHONE NUMER
DEMOLISH ❑
I
N
El ALTER EXCAVATE FENCE
�
/
/•{// / (f .!J fJ� !Z/•/G
I
I
V F(i m:lD,I r' Wchinntnr77fi-ilii'-1
METER SIZEBERVICE SIZE CLEARANCE
CHECK • BY
STATE LICENSE'NUMBER -
I CITY LICENSE NUMBER
_!/ r'
I ! //
I
I r,/-'
Legal Description of Property (Show Below or AttaCla tour copies)
y // AL!�/SSG ,s(,)
TYPE CONNECTION VERIFIED BY
Or
(ri
lot 16, E I f:1 View 11dCl i -t i OflPRR ST PERMI�
` AIHER
\ I
W1,70Clan r RE A I
< ,Jj (t
v
FIRE ZONE I TYPE OF RU O e P
SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
RESIDENTIAL
GAS
❑ LINE
E] YES p,.NS
-(� / •�
xcw
PLAN CHECKED33YTHIS
SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL
0 S,GN
r*,,� �). I'
OF EDMONDS. LOCAL SALES TAX
ADD
RETAININGL
/.+ / ..�- _t
R/EMARK'$51
SHOULD BE CODED 31.04.
DEMOLISH ❑
El ALTER EXCAVATE FENCE
�
/
/•{// / (f .!J fJ� !Z/•/G
,?
❑ OR FILL (......cY.......... Ft')
PRE -MOVE
REPAIR SM tt
REPAIR ❑
_ .
%
INSP. POOL
.� , IZ" _� 1 16
F,
O i S/i4' �'1✓J! /!JN -r
NUMBER OF STORIESNUlSBER OF
DWELLING
I i i', )meni UNITS
NATUREt OF WORK TO BE DONE
Valuation
Fee
Receipt No
Cir. •, I ,� F :m 1 1 „
flan Cheek N. .....................
['•yI
BUILDING
4 PROPOSED USE
PLUMBING
HEAT & GAS LINE
(� 5
PLOT PLAN (Indlcato Hulmt l�ng�t4ao aC.al�7 in6 streets)
D
FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read thin application; that the In-
�7
formation given Is correct; and that I Sun the owner, or the duly author-
tzed agent of the owner. I agree to comply with city and State law. Mind.
ATTENTION
APPLICATION APPROVAL
toting construction; and In doing the work authorised thereby, no person
wM be employed In violation of the Labor Cade of the State of Washington
THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except nEMO1.IT1oNwhich hich
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac -
.hall be completed !n ninety days; MOVED -IN BUILDINGS Shall be coin•
Imowledged In space provided.
pitted In six months.)
SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DIRECTOR'S SIGNATURE
DEPARTMENTII
/
CITY OF
[1 i . i t---i—
ED3IIONDS
DATE' ^ �.�•
NOTE: Applicant Subject to Plan Check Fee
/
775-2525
This II—ift covers work to be dune on private properly ONLY.
Any construction an the public domain (curb$, sidewalk., drlvew'ar$,
marquees, ete.) will require separate per,nl.$ian.
INSPECTOR
m