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RESIDENTIAL OAS ❑
IT—
YES ;
❑ LINE PLAN CI{ECKE Br, _ _ THIS SITE IS LOCATED IN THE CITY
NEW I NON-RESIDENTIAL ataN OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
ADD ❑ DEMOLISH LiRETAINING REMARKS t
i
WALL
lJ0'T !`�`-^•
ALTER ❑ EXCAVATE FENCE D
til
OR FILL � (.......... s ..........
Ft.)` , 7t ,
7 REPAIR ❑ IRE-IdOVE O POOL 57RUC7 v�� Sur�e� "T I v `,
NUDIBER OF STORIES NUMBER OF s f ^�-F p�cT� o cave,
I I
DWELLING
UNITS
NATURE OF yWORK TO BE
DONE Valuation Fec Receipt No.
RV 1 t//� ytfA (� IrM d�c,,� �( �����% �( Plan Check No. 1
lO S'rb `Cf�4. r �YM..� '^� l�� BUILDING ) S� "_0_)
OL
0. PROPOSED UBE 00«
'4y DnC 5 PLUMBING
3FJ
PLOT PLAN (Indicate Building setbacks. abutting Streets) HEAT & GAS LINE '
_Th FENCE
T_ S�) -
SIGN
ILJ�—tri RETAINING WALL
I (�JiMDL N
S41F1.� I
SWIMMING POOL i
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
70 j4C TOTAL AMOUNT DUE �•�
I hereby acknowledge that I have read this application; that the In-
formation given Is correct: and that I am the owner, or the duty author-
Ized agent of the owner. I agree to comply with ally and elate law. raga- ATTENTION APPLICATION APPROVAL
toting construction; and in doing the work authorized thereby, no person
will be employed In violation of the Labor Cade of the Slate 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-
ONI.Y THE and fees are paid, and recei t is ac -
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED uty, P
ac-
,NOTE:
be coo Bled In ninety days; MOVED -IN BUILDINGS shall be cam- knowledged in space provided.
leted In 81X
onth..) I
i L// B1pNATU)tE AOWNT OR AGENT) - ZHIZED INSPECTION DIRECTO '9 H1aNA RE
DEPARTMENT
7aCITY OF DAT fI,_•-_---...._..__,
EDAIONDS
N TE: Applicant Subject to Plan Cbrck Far 775-2525 {t'
Till. Perntlt eaten,work to be dune on private property ONLY.
Any eanstruellon an the publle domain (turbe' sldestAlks, drOW"., FILE
marquee., ale.) will revulre separate perIV
mission.
11
USE ^/ n PERMIT /
NUMBER75U �.3U
BUILDING DEPARTMENT
Appueant Fnl
...
Z° K\ivy
PERMIT APPLICATION
Insldo heavy Lines
J ADDRESS 3 � _ —7 0 — • ADDRESS . 1
'
NAME (OR NAME ON BUSINESS)
Iy
Py:itMlltlaIIILE me ACTUAL /
/r��'I
IJ
IAT COVERAGE D )A LOT COVERAGE B �'
/V
MA1L7 O AD�DREe-- t• -Ll ///
�{
PERM 1SeIBLE HEI IT PROPOSED 1{LOHT
G
�7,a 6 >c, �,V0 t�r�.��
G�'
ACTUAL LOT AREA TOTAL IIL1M. AREA
!
C Y
TELEPBONE NUMBER
�•
REQUIRED YARDS PROPOSED YARDH e'
'j-0
NAME
`
FRONT SIDE REAR FRONT SIDE REAR
-i !
T I\�
O
CONDITI NAL U.F.
1
ADDRESS
LEGAL LOT VARIANCE OR
RYES ❑ NO PERMIT NUMBER
yF
y
PLANNINy PROV ATI"
W
! -
U
K�
TELEYI{ONE NUMBER
CITYSTREET
R/ \Y C
J,.�
EXIBTIN6 STREET R/W ............FT. DEFICIENCY THIS PROPERTY 'r
a
�
NAME
COMP. PLAN ST. R/W ............FP. ............FT. FI
REMARKS O
4C'
ADDRESS
'•4
v,N
BY
CITY
E
TELEPRONE NUMBR
ICRECKED
A ,
METER SIZE SERVICE SIZE CLEARANCE CHECKED BY
.
STATE LICENSE NUMBEat
CITY LICENSE NUMBER
I I
REMARKS
Legal Description at Property (Show Below
Or Attach Four Caples)
QT
TYPE CONNECTION VERIFIED BY
'
C
t�bT `CZll
NUMIBEA
1+
PERC. TEST PERMIT y.
W
W
REMARKS
�
\
FIRE E TYPE OONeTRUCTION STREET IMPROVED
I
,r�nllll
I
YES Ej NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP,'
NO �—
RESIDENTIAL OAS ❑
IT—
YES ;
❑ LINE PLAN CI{ECKE Br, _ _ THIS SITE IS LOCATED IN THE CITY
NEW I NON-RESIDENTIAL ataN OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
ADD ❑ DEMOLISH LiRETAINING REMARKS t
i
WALL
lJ0'T !`�`-^•
ALTER ❑ EXCAVATE FENCE D
til
OR FILL � (.......... s ..........
Ft.)` , 7t ,
7 REPAIR ❑ IRE-IdOVE O POOL 57RUC7 v�� Sur�e� "T I v `,
NUDIBER OF STORIES NUMBER OF s f ^�-F p�cT� o cave,
I I
DWELLING
UNITS
NATURE OF yWORK TO BE
DONE Valuation Fec Receipt No.
RV 1 t//� ytfA (� IrM d�c,,� �( �����% �( Plan Check No. 1
lO S'rb `Cf�4. r �YM..� '^� l�� BUILDING ) S� "_0_)
OL
0. PROPOSED UBE 00«
'4y DnC 5 PLUMBING
3FJ
PLOT PLAN (Indicate Building setbacks. abutting Streets) HEAT & GAS LINE '
_Th FENCE
T_ S�) -
SIGN
ILJ�—tri RETAINING WALL
I (�JiMDL N
S41F1.� I
SWIMMING POOL i
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
70 j4C TOTAL AMOUNT DUE �•�
I hereby acknowledge that I have read this application; that the In-
formation given Is correct: and that I am the owner, or the duty author-
Ized agent of the owner. I agree to comply with ally and elate law. raga- ATTENTION APPLICATION APPROVAL
toting construction; and in doing the work authorized thereby, no person
will be employed In violation of the Labor Cade of the Slate 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-
ONI.Y THE and fees are paid, and recei t is ac -
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED uty, P
ac-
,NOTE:
be coo Bled In ninety days; MOVED -IN BUILDINGS shall be cam- knowledged in space provided.
leted In 81X
onth..) I
i L// B1pNATU)tE AOWNT OR AGENT) - ZHIZED INSPECTION DIRECTO '9 H1aNA RE
DEPARTMENT
7aCITY OF DAT fI,_•-_---...._..__,
EDAIONDS
N TE: Applicant Subject to Plan Cbrck Far 775-2525 {t'
Till. Perntlt eaten,work to be dune on private property ONLY.
Any eanstruellon an the publle domain (turbe' sldestAlks, drOW"., FILE
marquee., ale.) will revulre separate perIV
mission.