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PER�IMITA J
BUILDING DEPARTMENT AppucantP►u
USE
�— PERMIT APPLICATION Inside, Heavy Llnos
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ADDRESS
80' 8
NAME 11111 NAME OF BU81NE88)
PERMISSIBLE ^( ACT�U�A
%
LOT COV LOT COVAAOE tU
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ERAO
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P,L
RAILING ADDRESS
PEItAlitltl[DLE fiEI IIT � PROPOSED I! }OST/
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TOTAL bA�
ELEPHONE NUMBER
ACTUAL. L(>a' A LAL
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REQUIRED YARDS PAOPOHF.0 YARUH
NAME
FRONT HIDE REAR FRONT BIDE REAR
mss' 7 tVAR.s`
S c�
LOT .11 NDITIONAL USE
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ADiSAEtlH
®•YF:e NO PERMIT NUMBER
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PLANNING D)]!'p. ,mATE:
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01TY
TELEPHONE NUMBER
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tlTIIEETR/W I G-{�
EXISTING STREET R/{V''�?/`t`I'T DEFICIENCY THIS PROPERTY
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COMP. PLAN ST. R/tV"*��t."L.::1T. ....4.7...Fr.
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REMARKS Driveway slopes not to exceed those
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nnuAEHtl
indicated on Standard Dwg. No. 103
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CHECISE(p� HY
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CITY
TELEPHONE NUMBER
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7
AIFTER SIZE SERVICE BILE CLEARANCE
CHE ED Y
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STATE LICENSE NUMBER
CITY LICENSE NUMBER
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REMA1tHH
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Legal Description of Properly (show Below or Attach Four Copies)
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TYPE CONNfECTION VERIFIE BY
PERC. TEST
PERM NUMBER
IC
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REMARKS
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F1RE/20NE TYPE OF CONSTRUCTION 8T12EET IMP IOVED
NO
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SPECIAL INSPECTOR
REQUIREDOCCUPANCY GROUP
JIO
C]YES 23,W6r ��
y� RESIDENTIAL
GAS
LINE
pV NEW
PLAN CHE ED Y THIS SITE IS LOCATED IN THE CITY
OF EDMONDSSALES TAX
7r NON-RESIDENTIAL
❑
BION
❑1
BE CODED 31L
ADD ❑
❑ RETAINING
.ply KING
AR
DEMOLISH
FENCE
�
ALTER EXCAVATE
OR FILL (.......... x.......... Ft.)
,,.r.I� ,aryliU�C'
am I
REPAIR
❑
s� T�/�/�
❑ INSPAIOVE
POOL
_ty��U/ fr/ �� �•`� /�S
NUMBER OF STORIES NUMBER OF
DWELLING
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UN1T9
/
NATURE OF WORK TO B/E DONE
Vnluallen
Fee
WcelPt
No.
ZL- L/6, "zt,L�'/
rinn Check Nn.....................
BUILDING
I4y
AUPOSED U8E
yCl
c�
PLUMBING
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/ [
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( PLOT�PLAN (n Ie. Bul ding setbacks, nbuttln6 streets)
HEAT Ec CAB LINE
h
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-
FENCE
-
SIGN
yl
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RETAINING WALL
—
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n N
—
SWIMMING POOL
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DEMOLITION
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PRE-MOVE INSPECTION
EXCAVATION OR F1LL
TOTAL AMOUNT DUE
1 hereby nekenwiedg. that I have rend this application: that the In.
/✓ `'
formation given Is correct; and that I ata the owner, or the duly author-
Ized agent of the owner. I agree to comply with city and state laws regu.
ATTENTION
APPLICATION APPROVAL
Inting construction; and In doing the work authorized thereby, no person
x'111 be employed In violation of the Labor code of the sate of Washington
THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation Ineurance.
AUTHORIZES
signed by the Building Official or his Dep-
NOTE: Permit limit One Year (Execpt DEMOLITIONS whleh
ONLY THE
WOmi NOTED
uty; and fees are paid, and receipt is
BC-
ehell be completed In ninety days; AIOVED-IN BUILDINGS shall be core-
lenotvledged in space provided.
ptcled In six months.)
'NElt O.�9llawr) DATE SIONEU
SIGNATURE (ORli
INSPECTION
DEPARTMF•NT
Dl EC OR' BIG ATUI
CIT Y OP
-'
EDMONDS
DATE
NOTE: Applicant Subject to P1, L: beck Fre
775-2525
This Permit r.ark to be done an Private property ONLY.
Any e-struellolton the public dnmaln (curbs, slden'aiks, drivew".,
FILE
nuupuecs, etc.) x'111 r,Vutre separate pennlsslaf.
Ou 4k 70 I_el
130 'F
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04 Ile- E"'�l &Z
10 P A�JaiSee, iF777elleCf P//. T
iSal2 ?- A.
e s
7 -7L ea
2a
-,2 7 361
1qj 05
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120. f 7(i 00' 126.99'
135470
81240 I 4b 96720
5UTUR DEVE LIOPME 1\1 T
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A
75.00' 106.99, _0
ACCsiS. va) uril.11-t FAFEMENIT '0
82.0c),
c I . .D.
60740 o 805841
102.00-----L- 87.78'
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FIRE TYPE OFC N8 CT O ED
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177-P.
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--v 0 NO
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SPECIAL INSPECTOR REQUIRED OCCUPANCY OROUP
to / 7"�
BUILDING DEPARTMENT
Applicant Fm
USE
/ "U�I�t. /
/
RESIDENTIAL
❑ GAS
a NEW
PERMIT APPLICATION
Inside Heavy Lines
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ADD HESS
/
NON-RESIDENTIAL
SIGN
!
CUS /�l�� /
/
OF EDMONDS.
SHOULD BE CODED 31.04.
ADD RETAINING
❑DEMOLISH WALL
FENCE
NAME (OR NAME OF BUS)NEBd)
AOT O
r'� LOT COVESYAGE
/ r �,
t'}7I%4.72' C ! IV
'
NUMBER OF STORIES NUMBER OF
�� �J
DIVELLING
IAT COVERAOE� � /..,
LOT-TECOVERAIBLEGE
, r rl
UNiTB %
M^ IANO ADDRESS
PEltbl ldtllBLE HEIGHT r PROPOSED
O
1
Pian Check No .....................
'ter: + TELEPHONE N MD R
CITY
ACTUAL LO•r AREA TOTAL IILIXI, AREA t
�7•,_
I S Fr
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BUILDING
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P)toposED YA RDB
s'
PLUMBING
NAME
HEAT A GAS LINE
FRONT dIUE REAR FRONT NIDE REAR
,
_
9iZ / S'
1'� I
1
FENCE
LEGAL LOT VAIt ANNE Oft CONDITIONAL USE
SCI
N
ADDRESS
(�'Y}:S � NO PERMIT NUMBER
RETAINING WALL
CITY - TELEPHONE
NUMBER
PLANNING EPT. AP •It(IYAL .. A�
!'V' r•/-1/�/� 'Y-
) N
..
LT R/W
EXISTING STREET DEFICIENCY THIS PROPERTY
NAME
pp ^^
COMP. PLAN ST. R
�W7
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i
REMARKS nrl-vauav ziUPe> not. to exceed those
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FIRE TYPE OFC N8 CT O ED
�ZOE
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177-P.
r_zJN''-
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--v 0 NO
J eY{i
SPECIAL INSPECTOR REQUIRED OCCUPANCY OROUP
to / 7"�
❑ YES la] ISO
I _T �!
RESIDENTIAL
❑ GAS
a NEW
LINE
PLAN CHECrED Y
1
THIS SITE IS LOCATED IN THE CITY
LOCAL SALES TAX
/
NON-RESIDENTIAL
SIGN
!
CUS /�l�� /
/
OF EDMONDS.
SHOULD BE CODED 31.04.
ADD RETAINING
❑DEMOLISH WALL
/.
RE MAR(
%J
FENCE
ALTER ❑ On FILL E IF ......... ........... F�.)
PRE -MOVE swim
❑ REPAIR ❑ INSP. POOL
/ r �,
t'}7I%4.72' C ! IV
./�
Cl _-�1ITs
NUMBER OF STORIES NUMBER OF
DIVELLING
UNiTB %
NATURE OF WORK TO BE DONE !
Valuation
Fee Receipt No.
.(•, : i.// ::�� :) i ./ : !tea
Pian Check No .....................
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BUILDING
111,�`"'.•il
PROPOSED USE
PLUMBING
aPLOT PLAN (Intl nto. Bu Iding .Ctbacks, abutting streets)
HEAT A GAS LINE
,
1'� I
1
FENCE
SCI
SIGN
RETAINING WALL
e
) N
BWIhtMIN6 POOL
Al
DEMOLITION
ti•�i�
'•' •`
/!h '__.+`I
PRE -MOVE INSPECTION
_
EXCAVATION OR FILL
j,
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
✓
on given Is correct; and that 1 am the owner, or the duly author-
nt of the owner. I agree to Comply with City and state Iowa Mgu-
ATTENTION
APPLICATION APPROVAL
onstruction; and m doing the work authorized thereby, no person
"Played In violation of the Labor Code of the Biala of Washington
THIS PERMIT
This application Is not a permit until
to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
uty: and fees are paid, and receipt is He
LNOTE:
completed In ninety day.; MOVED -IN BUILDINGS shall be cont-
knowledged in space provided.
n elx monlM1n.)
-
U1tE (O\VNEft OR AGENT) DATE SIGNED
INSPECTION-IDHjECTOR'S
81GNATU P
I
• '.- I
DEPARTMENT
V i., Ij�,(. •.!lf t%hr—/
• '
•: � : -
NOTE: Applicant Subiert to Plan Cberk Fee
CITY ON
ED51ONDS
DATE J1
775-2525
This Permit a nrrs work to M, dans nn private prolwrty ONLY.
Any eon.truetlon on the Public domaln (curb.. Mdrw lk., 10—sr.,
INSPECTOR
marquee., elc.l will rNulre .el—ate per -halon.
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