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750273.pdf' BUILDING DEPARTMENT AppllcantFtu ZONE NUMBER 1502 � PERMIT APPLICATION inside heavy Lines ,IDH ADDRESS 43 0 NAME (Olt NAME OF BUSINESS) ACrUAL , COVESYAOE I�r- / 1-•• )!'Q A / LOT COVERAOF. LOTC VERA LOT ; - / /x- td —.iiJ Pb, --:i,/ E/8S- I.t�. - C -I .1/LLSSi-- Al A D / o�3v ��r= I'EltAf lddlHLE HEIOIIT PItOPOBEU HEfORT O —y� C TY TELEPHONE NUMBbIt ACTI1nL LOT AREA TOTAL LLUO. AREA REQUIRED YARDH PROPOS YARDtl BIUE RF.An L V FRONT HIDE REAR FRONT NAME - F U VA LEGAL LOTN PERMIT ANCE OR CONDITIONAL UBE HER W ADDRESS ❑ yES � NO ' PLANNING DEPT. API'ItOVA + DATE: MCITY TELEP ONE NUMBER STREET !� EXISTINGST STREET R/W ............FT. DEFICIENCY THIS PROPERTY e i yW NAME COMP. PLAN ST. R/W ............FT. ............FT. �• �t / •/ ��/ /I ' %J REMARKS 1 J 04 ADDRESS ' CHECKED IIY / U ae TELEPHONE NUMBER C CITY �� I W _ I T O I METER SIZE SERVICE 81ZE CLEARANCE CBIACKED HY D STATE LICENSE NUASDEIi CITY LICENSE NUMBER I �•r I I REMARKS Legal Description of Property (Show Below or Attach Four Coplee) /� /�)F1 A LL C R 5 YPE CONNECTION VERIFIED 8Y PERC. TEST PERMIT NUMHE + I I ,j _ /� / / / "'t- REMARKS r q C� tjoal >i- kl-A)iASJr_ CO k/ W L 't D FIS TYPE OF COLNBTR%CT1QN I BTREBT IMPROVED JOCCUPANCY NA1lON ;� 100-S �'�i l / Mid/ 2C(I I ` ;p AID, ASF Sly h r 9PECI PI CTOR SQUIRED GROUP GAS RESIDENTIAL ❑ LINE ❑ YEB CHECXED HY SITE 15 LOCATED IN THE CITY ❑NEW PLAN THIS OF EDMONDS. LOCAL SALES TAX ❑ NON-RESIDENTIAL ❑ BION y /�'`•{.//��.t'{+.t�-(,-% SHOULD BE CODED 31.04. ADD RETAINING 1:1DEMOLIell ❑ WALL MARK FENCE �'�/(/D%/�ltiG/G/%Ory ] II--� G/•rO C�/ f / ) ':I AER EXCAVATE ❑ LT ❑ OR FILL I .......... "......... Ft.) ❑ REPAIR PRE -MOVE ElSWIM ❑ INSP. POOL I •-� �y �) ,J L' v �- + NUMBER OF STORIES NUMIIER DWELLING UNITS I NnTURE OF WORK TO HE DONE Valuation Far AecclDl Na. ^t / % /I Ci ��%� 1-9fC 4 C/ �/J��]/ Pion Check No ..................... /�l/l, /�� / �-Sdc S j PROPOSED UBE PLUMBING D aPLOT PLAN (Indlenle Hulidln6 setbacks, abutting A'Cete) HEAT dr GAB LINE A FENCE SIGN RETAINING WALL N SWIMMING POOL DEMOLITION I PRE -MOVE INSPECTION EXCAVATION OR FILL TOTAL AMOUNT DUE of Ihereby acknowledge that I have read this nDPllcotlon; that We In. formation given le correct; and that I am the owner, or the duly author. Ized agent of the owner. I agree to comply with city and stale laws regu. ATTENTION APPLICATION APPROVAL Int ing construction; and In doing the work authorized thereby, no Person will be employed In Violation of the Labor Code of the State of Washington THIS PERMIT This application is not a permit until misting to Workmen's Compensait.. Insurance. AUTHORIZES signed by the Building Official or his Dep - ONLY THE NOTE: Permit Limit One Year (Ezaept DEMOLITIONS which WORN NOTED uty; and fees are paid, and receipt is Be shall be completed In ninety days; MOVED -1N BUILDINGS shall be nom- Itnowledged In space provided. plated In elg manths.) SIGN URE (OWNER Oli ENT1 DATE S10NE INSPECTION DEPARTMENT D E TORI8 NATURE , - \/B CITY OF EDIVIONDB D T . NOTE: Applieaut Subject to Plan Cbeck Fre �� 775-2525 This Permit culrre work to be done on Dr1VAle property ONLY. Any eonalructloo on the public domain (curbs, sidewalks, driveways. FILE i marquees, etc.) 0711 r"ulre separate permission. REQUIRED YARDS PROPOSED YARDS NAME t FRONT SIDE REAR FRONT HIDE REAR ADDIU:BBLEGALYES LOT VARIANCE O!i CONDITIONAL USE M 0 YES 0 NO PERMIT NUMIBER 1 U PLANNING DEPT. APPROVAL DATE: CITY I TELEPHONE NUMBER STREETR/W EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY 0 COMP. PLAN 8T. R/W FT. ............FT, ' ............ -. REMARKS "i p7 , J .1 I T 100-1, FIRE ZONE TYPE OF CONSTRUCTION eTR - MPROVED r) NO ` ri,/F SPECIAL INSPECTOR REQUIRED BUILDING DEPARTMENT ZONE IT NUMBER 7,) T RESIDENTIAL GAS E] YES aNO Appllcaint Fill D NEW l LINE PERMIT APPLICATION Inside Heavy Lines IOB NON-RESIDENTIAL ��');- e3oN f,,f^-'-{ r"� NAME (OR NAME OF BUSINESS) ADDR as -__ - ALTER EXCAVATE FENCE a` F _ <i"r 6 �) PP:RMISSIBLE % LAT COVE LANCE •• ' . ACTUAL LOT COVESRAOE I t (. .......... .......... REPAIR ❑ PRE -MOVE SWIMi- YIiOPOBED Il EIGHT � INSP. POOL O PEliMiltl BIBLE HEIGHT O NUMBER OF STORIES NUMBER OF DWELLING C YWZINPHONE NUMBER ACTUAL LOT AREA TOTAL BLDG. AREA REQUIRED YARDS PROPOSED YARDS NAME t FRONT SIDE REAR FRONT HIDE REAR ADDIU:BBLEGALYES LOT VARIANCE O!i CONDITIONAL USE M 0 YES 0 NO PERMIT NUMIBER 1 U PLANNING DEPT. APPROVAL DATE: CITY I TELEPHONE NUMBER STREETR/W EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY 0 COMP. PLAN 8T. R/W FT. ............FT, ' ............ -. REMARKS "i p7 , J .1 I T 100-1, FIRE ZONE TYPE OF CONSTRUCTION eTR - MPROVED r) NO ` ri,/F SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP T RESIDENTIAL GAS E] YES aNO D NEW LINE PLAN CHECKED. Y I THIS SITE IS LOCATED IN THE CITY NON-RESIDENTIAL ��');- e3oN f,,f^-'-{ r"� OF EDMONDS. LOCAL SALES TAX SHOULD BE CODED 31.04. ADD RETAINING ❑ DEMOLISH WALL RHMARHB. - ALTER EXCAVATE FENCE a` i% j; '% ' ' OR FILL (z I•Y.) ❑ ❑ / .......... .......... REPAIR ❑ PRE -MOVE SWIMi- INSP. POOL O NUMBER OF STORIES NUMBER OF DWELLING UNITS NATURE OF WORK TO BE DONE -! ik_/:�.+. J.•"/�/L://IJ/�l /.(�/.:.,i (- Li L-'/f,ei:/✓/ / �/: -;i'i. Valuation Fee Receipt No. ' Plan Check Si o ..................... % BUILDING PROPOSED UdE - - PLUMBING PLOT PLAN (IndlC¢t"O11L1IagraM n i,. ceiling street.) HEAT & GAS LINE q \ FENCE SIGN RETAINING WALL N SWIMMING POOL DEMOLITION PRE -MOVE INSPECTION EXCAVATION OR FILL TOTAL A51OUNT DUE 7 _. I hereby acknowledge that I have rend this application; that tha In. formation given le correct; and that I not the owner, or the duly author- ized ati agent tr the owner. I agree to comply with city and state Inwe Inting caaetruetlon; and In doing the work authorized ATTENTION APPLICATION APPROVAL the[eby, no parson person will be employed In violation of the Labor Cade of the Slate of Weablaglon to Workmen's TIIN PERMIT This application is not a permit until relatlag Compensation Insurance, AUTHORIZES signed by the Building Official or his Dep - NOTE: Permit Limit One Year (EXCODI, DEMOLITIONS which ONLY WORK NOTED uty; and fees are paid, and receipt is ac - shall be completed In ninety days; MOVED -IN BUILDINGS shall be corn- knowledged in apace pieled In six months.) provided. SIGNATURE l0\VNER OR AGENT) DATE SIGNED INSPECTION DIRE TOR'S SIGNATURE DEPARTMENT r CITY OF EDMONDS DATE. % 1 NOTE: Applicant Subject to Plan Check Pee�.— This Permit co— work to bo doneon private properly ONLY. 775-2525 t ' Any ronelrurllgn on thepublic dontnin (eutbs, eldew'Wks, drh'ewayy marquees, etc.) will require separate permisslon. INSPECTOR y J