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PROPOSED USE
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DEPARTMENT
USE
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PLUMBING lz
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BUILDING
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GAS
PERMIT APPLICATION
Inside Heavy Lines
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PLAN CHECKED BY
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THIS SITE IS LOCATED IN THE CITY
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TELEPHONE
ACTUAL L�T^ RE TOTAL
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NAME
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FIE CODED 31.04.4.
REMARKS
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TELEPHONE NUMBER
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TOTAL AMOUNT DUE
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
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EXISTING STREET R/ `T DEFICIENC./Y THIS PROPERTY
(O.O.FT.
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NATURE OFWO^IS TO BE I
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COMP. PLAN ST. R
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REMARKS
Driveway slopes not to exceed those
ATTENTION
APPLICATION APPROVAL
M ADDItEStl
t 37L( ��C1� m o n !1
indicated on Standard Dwa. No. 103
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x•111 be employed In of the Labor Code of the State of Washington
TIDH PERMIT
p X
relating to Workmen's Compensation Insurance.
CHEIIY
Signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITION'K which
CITY
11TELEPHONENUMBER
shall be completed In ninety days; MOVED -IN BUILDINGS shell be oom•
knowledged in space provided.
LI�
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METER 81'LE SERVICE SIZE CLEARANCE CHECKS BY
OR AGENT) DATE SIGNED
INSPECTION
D EC '8 K NA HE
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STATE LICENSE NUMBER
CITY LICENSE NUMBER
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EDIIIONDS
aa3-01 -- 7A19
NOTE: Applicant Subject to Plan Check Fee
REM—A-;G —
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775-2525
This 11ermlt curers work to be done on private property ONLY.
Any construction on Ilio public domain leurbe, eldex•niks, drlrewye'
FILE
-Legal Description Of Properly (Sho / xee.,Below or Attach Four Coples) . Aer. f%/tb
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ria / r-rr� s..
CONNECTION ERIFIEp BY
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PERC. TEST
PERMIT NUMBER
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PROPOSED USE
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add
FIRE 7�Qpi♦•, I TYPE OF STREET IMPROVED
��)/ N NO
PLUMBING lz
26.60
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HEAT & GAS LINE
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GAS
Cl YES ❑
SPECIAL INSPECTOR REQUIRED I OCCUPA Y O OUP
Q YES NO i /
$/t
FENCE
RESI➢ENTIAL
LINE
PLAN CHECKED BY
NEW
SIGN
THIS SITE IS LOCATED IN THE CITY
❑
NON-RESIDENTIAL
SIGN
OF EDMUNDS. LOCAL SALES TAX
RETAINING WALL
---
ADD
31_
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RETAINING
WALL
FIE CODED 31.04.4.
REMARKS
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DEEfOLITiON
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ALTER ❑
EXCAVATE
ORFILL
❑
PRE -MOVE INSPECTION
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EXCAVATION OR FILL
REPAIR ❑
IRE -MOVE
a
SWIM.)
POOL
QL�7/ //�
/ 1t��tU/i P 01 0 Ir7�¢
TOTAL AMOUNT DUE
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
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aa
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NATURE OFWO^IS TO BE I
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Valuation
_
Receipt
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Plan Check N
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BUILDING
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PROPOSED USE
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add
PLUMBING lz
26.60
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HEAT & GAS LINE
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PLOT PLAN (Ind C Building setback., abutting streets)
$/t
FENCE
SIGN
RETAINING WALL
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SWIMMING POOL
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DEEfOLITiON
PRE -MOVE INSPECTION
�(tOM FU�Ud6
EXCAVATION OR FILL
TOTAL AMOUNT DUE
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aa
I hereby acknowledge that I have read this aPPllcntlan; that the in.
formation Elven le correct; and that I One. the owner, or the duly author.
Iced agent of the owner. I agree to comply with city and elate law. regu-
law
ATTENTION
APPLICATION APPROVAL
and
Ialing Conat"Ctloa; and in doing the work authorized thereby, person
x•111 be employed In of the Labor Code of the State of Washington
TIDH 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 DEMOLITION'K which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac -
shall be completed In ninety days; MOVED -IN BUILDINGS shell be oom•
knowledged in space provided.
pitted In alx ...the.)
OR AGENT) DATE SIGNED
INSPECTION
D EC '8 K NA HE
(') /
LL(OWNEII
Y
DEPARTMENT
G�1/ Y
CITY OF
1
EDIIIONDS
Dw E
NOTE: Applicant Subject to Plan Check Fee
—�
775-2525
This 11ermlt curers work to be done on private property ONLY.
Any construction on Ilio public domain leurbe, eldex•niks, drlrewye'
FILE
marquees, etc.) will require eeI-11 permlasl...
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•'�„
flea Ch,elt Nn.
BUILDING
RESIDENTIAL
PLUMBING
PERMITUSE
ZONE NU ERBU!LDING DEPARTMENT nppucant Fm p' 1yT ' '11 �
❑ YES _0 NO
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HEAT A GAB LINE
PERMIT APPLICATI®Id Inside heavy Lines JOS
EBB
FENCE
SIGN
LINE
PLAN CHECKED
NAME (Olt NAME OF BUSINESS)
THIS SITE IS LOCATED
IN THE CITY
SWIMMING POOL
PERMISSI t ACT L
LOT COVERAGE I.OT COVEIAGE I
NON-RESIDENTIAL
PRE-MOVF. INSPECTION
slGx
EXCAVATION Olt FILL
MAI UNG `) ( .'
/ PEITMIdBIBLE IT PIROPOs£D HEIGHT )
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0 ADD
formation given to correct; and that I am the owner, or the duly author.
CITY
TELEPHONE NUMRLR AC'I UAL LOT AREA TOTAL, BLDG. ART
RETAINING
7� %! i. ,rif.�
t.' �- J / (( +�� 1 E, UIR • YARDS PRO.i.POSED YARDS
SHOULD BE CODED
,
relating to Workmen's Compeneatlon Insurance,
AUTHORIZES
i
NAME FRONT BIDE REAR FRONT SIDE REAR
ah¢I) be completed In Nnely days; MOVED -IN IIUII.DINOS shall be cern-
�.,IO, UBE
ANCF:
plated In six month..)
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INSPECTION
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LEGAL LOT qR OR CgtyDITNAL
ADDRESSp,YEB O.NO PIDRMIT NUMBER} (
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Pf)AttPI1N6 DEPT.jAPY7{OVAL i.'li� �' ., AT)Z}' -
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FENCE
CITY TELEPHONE NUMBER •' / iii-% �, 1
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775.2525
cc
STREET /W J
I STREET R/� `DEFICIENCY THIS PROPERTY
OR FILL
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.........-x..........Ft.,
EXISTING r.1�.�,�...F1'.
NAME I /
j COMP. PLAN ST. R/W .�y7�.F'T.
REPAIR
PRE -MOVE
�. 'I /..1 .'1 tj l �,i .I r,'..�.�•l i' REUARKS
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ADDRESS sini)e5 noi. to exceed
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0 1i il� 1h it !'li'.�'! MI •,n,i-1 /..1 rl.•1 in-
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CHECKED BY
El
POOL
CITY TELEPHONE NUMBER
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(I/BE ✓ !� �- METE R SIZE BERVIC£ SIZE CLEARANCE CHECKS BY
NUMBER F
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STAENNUM ER
TE LI
CITY LICENSE NUMREIt /
•
+
DWELLING
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)
Legal Description of Property (Sho !Below or Attach Four Copies)r' )
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(S
s
' TYPE CONNECTION VERIFIED BY
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NATURE OF WORK TO BE DONE t
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PER . !!' U.8
R)E n
1p��3sij
Fee
ilecslpl I
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FIRE ZONE TYPE OF CONSTI)UCTION STREET IMPROVED
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I P RES
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•'�„
flea Ch,elt Nn.
BUILDING
RESIDENTIAL
PLUMBING
GA8
❑ YES _0 NO
.+. ,?-, )
HEAT A GAB LINE
FI NEW
FENCE
SIGN
LINE
PLAN CHECKED
BY
THIS SITE IS LOCATED
IN THE CITY
SWIMMING POOL
DEMOLITION
NON-RESIDENTIAL
PRE-MOVF. INSPECTION
slGx
EXCAVATION Olt FILL
OF EDMONDS. LOCAL SALES TAX
I hereby acknowledge that I have read this oppllCalion; that the In.
0 ADD
formation given to correct; and that I am the owner, or the duly author.
Ized agent of the owner. I agree to comply with city and elate laws re gtl•
RETAINING
REMARKS
ATTENTION
SHOULD BE CODED
3104.
relating to Workmen's Compeneatlon Insurance,
AUTHORIZES
NOTE: Permit Limit One Year (Except IIEMOL.ITIONN which
DEMOLISH
ah¢I) be completed In Nnely days; MOVED -IN IIUII.DINOS shall be cern-
WALL
plated In six month..)
SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
ElALTER
EXCAVATE
r
FENCE
NOTE: Applicant Subjeci to Plan Check Per
775.2525
This Permit covers work to be done on private properly ONLY.
❑
OR FILL
.........-x..........Ft.,
REPAIR
PRE -MOVE
SWIM
.'_/.:•;�:
n./�''.
(,-.
.. f.+.r
INSP.
El
POOL
NUMBER OF STORIES
NUMBER F
DWELLING
I
)
I
UNITS
/
NATURE OF WORK TO BE DONE t
I
Valunl inn
Fee
ilecslpl I
.,.' • •+.•.'•.. _:
•'�„
flea Ch,elt Nn.
BUILDING
PROPOSED USE
t�.
PLUMBING
U
aPLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT A GAB LINE
21
/ l
( `. \ ` ) `
FENCE
SIGN
RETAINING WALL
I'. -
"t
SWIMMING POOL
DEMOLITION
PRE-MOVF. INSPECTION
EXCAVATION Olt FILL
TOTAL. AMOUNT DUE
I hereby acknowledge that I have read this oppllCalion; that the In.
formation given to correct; and that I am the owner, or the duly author.
Ized agent of the owner. I agree to comply with city and elate laws re gtl•
,at,., construction: and In doing the work authorized thereby, no person
ATTENTION
Will be employed In violation of the Labor Code of the State of Washington
TITIN PERMIT
relating to Workmen's Compeneatlon Insurance,
AUTHORIZES
NOTE: Permit Limit One Year (Except IIEMOL.ITIONN which
(I1t'DRI1K STTitE
12 NOTED
ah¢I) be completed In Nnely days; MOVED -IN IIUII.DINOS shall be cern-
plated In six month..)
SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DEPARTMENT
CITY Or
EDNIONDS
NOTE: Applicant Subjeci to Plan Check Per
775.2525
This Permit covers work to be done on private properly ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
nuOquees, etc.) will require separnle pclude —
ttl, rJ !.J
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.
D REC OR's SIGNATURE
DATE
INSPECTOR
i