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PERMIT 1 I I
BUILDING DEPARTMENT Applicant Pill ZOO NUMIIER
VBE /50
J 120
PERMIT APPLICATION Imide Heavy Linda-T.9—
PERMIT
D `/ .i
ADDI(E9B %J Z
`W7
OR NAM OF BUSINESS)
)y / PEIiAiIdtlIBLE ry ACTUAL JJ 1
A. /�A iln / )IAMnM /,.I %"/%// LOT COVERAGE. LOT COVF.TYAOE
M O E 0
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Q Cy T HONffi L
W ADDRRES
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W D ESB •,���� 1 �i/�� �/ ��C
TE PHONE N
U ATE LICE BEO % MHE�/ I TY LICENSE
t.edg^al Deacrlption o[ P[oDerty %8;ow Helow or Attach Four 1
W4A
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P%IlDI1tltlIDLE fl%IDIIT YitOf'OdF.0 "N"'I'T
b
I
OAB
LINE
ACTUAL LOT AREA TOTAL BLDG, AREA
7
REQUIRED YARDS PROPOSED YARDS
NON-RESIDENTIAL
❑
FRONT H[D' REAR FRONT IUE R
���/
0HR
OF EDMONDs. LODEDCAL SALES TAX
.
!
❑ ADD
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LED— I.— VAItIA CI: It OND I I—— USE
LETA"".
WA.L
9
YE (] N PERMIT NUMBER —3,�-14
VUluatton
PbWD A OVAL ATF
DEMOLISH
itEE N/t O
:=
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EXI9 N6 STREET R/W ...I. ...... DEFICIENCY
//THIS PROPERTY
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❑ ALTER
COMP. PLAN ST. R/W ...`.':O..FT. .....V...FT.
❑
( z Ft 7
REMAAKE Driveway slopes not to exceed those
o
indicated on Standard Dwct No 103
PLUMEIN6
w
CNECX}K
HEAT & GAS LINE
S�'•�
METER BIZ% SERVICE SIZE CLEARANCE
CFIEC E BY
m
RE7IIARIId
SCC Enl(��1�t=l�itJ� ac4�UI k.CMEutf � IS y
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TYPE CONNECTION
VERIFIED Y'
I
PERC. TEST
PERMIT N S Ell
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S
� 1
N
REMARKS
FIREZO TYPE OFC/OJNS/T/RUCTION STREET IM`P/ROVED
l .si/iC/���Csf=� l O YES 70 NO
9P ECIA INSPECTOR REQUIRED
CUP
IOCCUPANOW
OR
RESIDENTIAL
❑
OAB
LINE
9 ❑ NO
PLAN CHE KE DY
THIS SITE IS LOCATED IN THE CITY
i
NEW
NON-RESIDENTIAL
❑
BtaN
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0HR
OF EDMONDs. LODEDCAL SALES TAX
.
!
❑ ADD
E]
❑
LETA"".
WA.L
9
NA TUR OF W�+ORK TO'-,BBE/DONE /
VUluatton
Peerrp
DEMOLISH
FENCE
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4 �GC,/'J.T/.C/D
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❑ ALTER
❑ EXCAVATE
FILL
❑
( z Ft 7
7SI
❑ .....................
PRE -MOVE SWIM
REPAIR O INSP. POOL
1
3 u�
NUMBER OF STORIES NUMBER OF
DWELLING
'
UNITS
NA TUR OF W�+ORK TO'-,BBE/DONE /
VUluatton
Peerrp
Receipt No.
n /
,y��n
Plan Check Na.:.T?::.i.l..:
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-,
SUILDIN66o
7SI
`%-7rt'
77 NV
4 P�N�u/i��7i�%!'�7j}•('/ /�,r /
//��C/�//N� ���-/Y✓�SI%�(,
PLUMEIN6
�L-•
PLOT PLAN (ndlc.te Building aetoacKa, ulting streets)
HEAT & GAS LINE
S�'•�
O
FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
'v5/3
Sb
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
'-
formnllon given la correct; Andm that I athe owner, or the duly author-
Ized agent of the owner. I agree to comply with city and state laws ngu-
ATTENTION
APPLICATION APPROVAL
laung canatructlon; sad In doing the work authorised thereby, no person
will be employed In violation of the Labor Code of the State of wmhlogton
THIS PERMIT
This application Is not a permit until
relating to workmen's Co peM.11 n Ingurance.
AUTHORIZER
signed by the Building Official or his Dep -
6ip.0
t P rmit Li it ne Year (E:eept DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is Be-
e leted In Nety ays; MOVED -IN BUILDINGS .hall be corn-
knowledged in_space provided.
pl e e a.
.
dl R R O AGENT)
D
INSPECTION
I C R'S
IDNATURE
V
27774/
DEPARTMENT
r l
,��.
/
v CITY OF - --
DATE
EDMONDS r
NOTE: Applicant Subject to Plan Check Fee
PR a-uoI
Thb Permit coven work to be done op private property ONLY.
A.Y a 01tictlon on the public damela (curb., sldewalks, driveways, FILE
marquee., etc.) will require separate P—abillon. - /
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TYPE CONNECTION
1\
\VERIFIED BY
USE PERMIT
BUILDING DEPARTMENT
ZONE ... DER
PERU. TEST
PER IT NUMBER
Applicant rffl
PERMIT APPLICATION Inside Heavy Lines
JOB
NAME (OR NAME OF BUSINESS)ADDRESS
REMARKS,
PERMISH1111,12PI!, I t Al
LOT COVERAGE LOT COVE AGE
0
PERMISSIBLE HEIGHT PROPOSED SLEIGHT
4
FIRE ZONE TYPE OF
CONSTRUCTION STREET IMPROVED
1
ACTUAL LOT AREA TOTAL BLDO.AREA
TELID o
� 1. 1 YES "E3 NO
0
SPECIAL INSPECTOR REQUIRED
'OCOUIANCY GROUP
REQUIRED YARDS PROPOSED YARDS
NAME
'E] NEW `10' GAS LINE
FRONT HID111 REAR FRONT S _1D F REAR
I
THIS SITE IS LOCATED IN THE CITY
PLANCHECKEDBY
—CONDITIONAL
(f --I
OF EDMONDS. LOCAL SALES TAX
ADURISO
VA USE
=�GEABJ LOT VARIANCE Oil
Rt7 14,
q ljnIJLD BE CID D ED 31.04.
0 P FR SIT NUMBER'
No
1
•PLANNING
DEPT. APPROVAL, 1J I., _DAT9 - j r
❑ ALTER EXCAVAT FENCE
14
CITY
list NUMBER
❑ 0. FILL
STREET R/W
EXISTING STREET R/W FT. DEFICIENCY Tills PROPERTY
REPAIR ❑ PRE -MOVE B
INSP. Q .'GOT
ILS V,
AME
N "
COMP. PLAN ST. R/W FIT.
NUMBER OF STORIES NUMBER 1111
DWELLING
REMARKS
UNITS
Z
Valuation
Fee
k--
-CI—TY. - ONE NUMBER
CHECKED BY
C
154
Receipt No.
:3
ri.. Chrok No ..........
77
BUILDING
—
METER SIZE CLEARANCE
CHECKED BY
PROPOSED USE I 1 1; , I -
PLUMBING
TYPE CONNECTION
1\
\VERIFIED BY
�x
PERU. TEST
PER IT NUMBER
REMARKS,
0
4
FIRE ZONE TYPE OF
CONSTRUCTION STREET IMPROVED
1
� 1. 1 YES "E3 NO
0
SPECIAL INSPECTOR REQUIRED
'OCOUIANCY GROUP
'E] NEW `10' GAS LINE
C] NO
I
THIS SITE IS LOCATED IN THE CITY
PLANCHECKEDBY
NON-RESIDENTIAL E] SIGN
(f --I
OF EDMONDS. LOCAL SALES TAX
ADD RETAINING
Rt7 14,
q ljnIJLD BE CID D ED 31.04.
DEMOLISH WALL
1
❑ ALTER EXCAVAT FENCE
❑ 0. FILL
REPAIR ❑ PRE -MOVE B
INSP. Q .'GOT
ILS V,
NUMBER OF STORIES NUMBER 1111
DWELLING
UNITS
NATUR' OF WORK TO BE DONE
Valuation
Fee
Receipt No.
:3
ri.. Chrok No ..........
BUILDING
—
PROPOSED USE I 1 1; , I -
PLUMBING
PLOT PLAN PLAN (Indicate LMAS)
A a
HEAT & GAS LINE
21
____-
r-_
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL
TOT
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application: that the In -
I,
given In correct; suall that I sud the owner, or the duly Author.
lzed a a
agent of th owner. I our.e to comply with city and late law, .9",
ATTENTION
APPLICATION APPROVAL
lasing construction; and In doing the work authorized thereby. .. on
will be, employed In violation of the Labor Code of the State of Washington
THIS PERMIT
This application is not a permit until
relating to Workmen'. Camps ... line Ituntrance.
AUTHORIZER
signed by the Building Official or his Dep -
'c.
NOTE: Permit Limit One Your (Except DEMOLITIONS which
ONLY THE
We RK NOTED
uty; and fees are paid, and receipt Is ac -
shall be completed In ninety days; MOVED -IN 111111MINGS shall be carn.
knowledged In space provided.
Plei.d,fri'atis, month..)
SIONAT�URZLOWNER OR AGENT) DATE SIGNED
INSPECTION
DIRECTOR'S SIGNATURE
'
DEPARTMENT
,
CITY OF
NOTE: Applicant Subject to Plan Check Fee
ElDlIVIONIDS
DATE
This Permit coven work to W done im privets property ONLY.
PR 6.1107
Any construction an the public domain (ectibs,sidewalk., e—jr
irl.,
INSPECTOR
marquees, etc.) will require sepasnat. permission.