750244.pdf'�J I
BUILDING DEPARTMENT Applicant FLU O �ZS-� NUADER 750244 !
PERMIT APPLICATION I Inside HeaYyLlnea JOB l �7�� _ 8o)I'��
ADDRESS
NAME (OR NAME OF U------1
PERMISSIBLE ACTUAL °' y
LOT COVERAGE LOT COVESiAGE
35 to I I,
MAILING ADD E88 PERM Itl�IDDLE HEIGIIT PROPOSED HEIGHT' f f
yi»-air P/• !�/ 77 II
O ACTUAL L T AREA TOTAL BLDG. AA= A
TELEPHONE NUMBER P nn� rn1
1 Y _ I I 1 f 1t `y ' fKC-1 it C.O KnI
EQVIRED YARDS P P08ED YARUB
NAME FRONT SIDF. REAR FRONT BIDE REAR '
_ 5 'L' 15 'f - 1 15 i
kl ADDRESS LEGAL LOT VARIANCE OR CONDITIONAL USE 1
FYI YES [] NO PERMIT NUMBER I j
FPT. VAMAA j
CITY I TELEPHONE NUMBER j
i STREET{V O '
EXISTING TREET R/W ............FT. DEFICIENCY IS PROPERTY ,
NAME
COMP. PLAN ST. R/W ............p'T. ............ P"T. W �
Jack Tenneson REMARKS
0
ADDRESS W '
(CHECKED BY
C11'YI TELEPHONfl NUMBER
F
7. METER 81ZE I SERVICE SIZE CLEARANCE CHECKED BY
STATE LICENSE NUMBER CITY LICENSE NUMBER V
223-01-3217 I REMARKS
Legal Desoriptlon of Property (Show Sole, or Allaeh Flour Copice) /L
Lot #5 - Maplewood Grove #2 TYPE CONNECTION VERIFIED BY
{+ 000—D-00 PLRC. TEST PERMIT NUMBER y. I
I � J
4i REMARKS
J
a FIRE ZONE I TYPE OF CONSTRUCTION I STREET IAIPROVED I j
V 1 I�YES "NO
B ECTAL INSPECT R REQUIRED OCCUPANCY GROUP
GAS ❑ YES ''�NO
NEW RESIDENTIAL El LINE PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
IE]NON-RESIDENTIAL ❑ SIGN OF EDMONDS. LOCAL SALES TAX
ADD RETAINING REMARKS S(H''O�ULD BE CODED 31.04.
ElDEMOLISH WAIT' A l I t l0 e7 9 M USC r g'73
ALTER EXCAVATE FENCE f,�lA. I�AtW �lC�.\ ClV ;
OR FILL 0 (.......... x..........Fl.) � ACV Y'�C4eD DF 41 LJ
❑
REPAIR ❑ INSPPRE-A[OVE ❑ swim POOL 1
NUelBLR OF STORIES NUMBER OF J
DWELLING '
UNITS
NATURE OF WORK TO BE DONE Valuation Fee Receipt No.
Pat 1 o Cover Plan Check No .....................
[O BUILDING
0, PROPOSED USE
�q PLUMBING
w
PLOT PLAN (Intllcnlo Milling setbacks, abutting street,) HEAT A GAB LINE
1 FENCE � 1g
W,
1 SIGN
v I
RETAINING WALL
SWIMMING POOL I
t:r DEMOLITION
ry>�PRE -MOVE INSPECTION
QESi�Cuc l
EXCAVATION OR FILL
I
TOTAL AMOUNT DUET J
I hereby acknowledge that I have rend this application; that the In- llllll���777
formal,,, given le correct; and that I am the owner, or the duly author -
(zed agent of the owner. I agree to comply with city and state laws regu- ATTENTION APPLICATION APPROVAL i
Inting conaiructloa; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington TIUS PERMIT This application is not a permit until
relating to Workmen's Compeneatlon Insolence. AUTHORIZES Signed by the Building Official or his Dep.
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which WOOL NOTED uty; and fees are paid, and receipt is ac -
shell be completed in ninety day.; MOVED -IN BUILDINOS shall be Co.- Itnowledged in Space provided.
pleted In .Ix month,.)
SIGNATURE (OWNER OR AGENT) DATE SIGNED INSPECTION DIRECTO BIONATUR
DEPARTMENT
CITY OF
r DATE
ED11fOND3
NOTE: Applicant Subject to Plan Check Fee 77 OND �^ 7+ c
Thl. Pe'"114 ravrre Werk In he deal on private property ONLY. i J
Any e,n,iruetlun on O,.Vnblle domain (curb., std—Un., drlrewWs, FILE
marquee,, flr.l w1U require ,epnrale perad..lon.
aE PERM
1ONE S () NUMBER l r.. . . 1 Fe 4 \ V
BUILDING DEPARTMENT Applicant Fill
--- PERMIT APPLICATION Inside Heavy Lines ,on
ADDRESS
NAME (OR NAME OF BUSINESS)
PE..MItl818LE _ ACTUAL
/1"/r" !•4,/�_i I/T /`%. �il/fJ� LOT COVERAGIP /-��/ LOT COVERAGE
MAil.l 6 AD E �e J t (� I
OSED PERMIUMBLE HEIGHT PROPHEIGHT
./ i C
T11TY'— TELEPHONE NUMBER AUf A'L/L/p�T AREA TOTAL BLDG. AREA
i• • �' � � / i OUIRED YARDS P OPOtlED YARDS
NAASE FI;ONT BIDE REAR FRONT BIDE REAR
�S� 1 L I),
w
V
jade lonneson
U` ADDRESS
F CITY I TELEPHONE
T.
U
STATE LICENSE NUMBER CITY LICENF
223-01-3217
Legal Description or Property (Show Below or Attach Fbu
Lot r;5 - Maplewood Grove N2
O
000-0'-00
n
W
O
v
YES 0 NO
8--; W
EXISTING STREET R/W ............FT. DEFICIENCY If. PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT. W
REMARKS
-VA- ARA
VE
E:
:ONSTRUCTIOL,
_.V
0 YES [] NO
❑
NEW
ADD
ALTER
REDENTIAL
SI
NON-RESIDENTIALa;ax
❑
GAS
LINE
RETAINING
WALL
FENCOR
❑ YES 'ELNO
I 1
PLAN CHECKED RY
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
DEAfOLIBH
EXCAVATE
REMARKS
I'' {7
WO fL IC
'(� /� --rf
� '-> ` I �i I j
❑
REPAIR
❑
❑
FILLC.x_........Fl.)
PRE -MOVE
SP'NUaSBER
❑
❑
PSWI I OOL
%Tia'CI'���...._
CTA1l.-I
(UMBER OF 8TOR11.8
OF
SIGN
RETAINING WALL
71WELLINa
SWIMMING POOL
�U �•l2
DEMOLITION
UNITS
. ... ..' ""...,
Plan Check No .....................
O
(.�
BUILDING
4 PROPOSED USE
aPLUMBING
PLOT PLAN (Indicate Building setback., abutting Streets)
HEAT A GAS LINE
FENCE
I
SIGN
RETAINING WALL
SWIMMING POOL
�U �•l2
DEMOLITION
PRE -MOVE INSPECTION
i
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this appilc¢tlon; that We In.
formation given Is correct; and that I nm the owner, or the duly author-
ized agent of the owner. I agree to comply with city and state law, reg"-
lating "intructlon; and In doing the work authorized thereby, an person
ATTENTION
will be employed In vfololloa of Ne Labor Code of the Stale of Washington
THUS PERMIT
mblUrlg to Workmen's Compensation Insurance,
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TIIE
shall be completed In ninety days; MOVED -IN BUILDINGS shall be care.
WORK NOTED
pletcd In els month..)
SIGNATURE (OWNER OR ACENT) DATE "IONED
INSPECTION
, '
�'i, "j
DEPARTMENT
""/'J ..r //�, /f/"• �.% 'r %- ' ,
CITY OF
NOTE: Applicant SriGjcet to Plan Cbrck Fee
EDNIONDS
775-2525
This Permit corer, work to 1. don n prlvate properly ONLY.
Any construction oa the public domain (curb&, sidewalks, driveways,
mareuses, elc,) -111 reemre eep¢rme pond&alon.
ValuationFee
��
�(J0.06 th , D
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,
INSPECTOR