750278.pdfPERMIT 7502
BUILDING DEPARTMENT7Applimnt Fill °"E NUMBER
PERMITAPPLICATION y Llnog o nnDRrseNADSE (OR NAME OF BUs1NES8)rPEitMtigtl�LE % ACTUAL/� 1-F5 ✓RE IAT COVERAGE LOTCOV AOE
C MAILS ADDRESSpl Pa,�Sw/a7��Q/7%PECtMItltlIBLE liEIUIIT 1ItOEilE[OHT
C OITy /` TEBGftACTIiAL LOT AREA TOTAL. IILDG. AREA
U REQUIRED "All"P1lOP2ee:D YARDS
mrnvm HIDE REAR FRONT BIDE
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N
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aU
NO
EXISTING STREET R/W ............FT'. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............Fr. ............FT.
REMARKS
1
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FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
I
IE]YES (3 NO
fC
ADDRESS
OCCUPANCY GROUP
pS,
C] YES C] NO
CITY
TELEPHONE
NUMBER
F
I
OF EDMONDS. LOCAL SALES TAX
O
SHOULD IE CODED 31.04.
REMARKS
O
STATE LICENSE NUMBER
CITY LICENSE NUMBER
Legal Description of Properly (Show Below or Attach Four Copies)
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Valuation Fee Rceelpt No.
1'Inn Check 7Tn.....................
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-SIGN
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tRETAINING
WALL
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a
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DEMOLITION
to
a
PRE -MOVE INSPECTION
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RESIDENTIAL
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GAS
LINE
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NEW
rl NON-RESIDENTIAL
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SIGN
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yALL NINC
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❑ DEMOLISH
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ALTER ❑ ORFILL
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FENCi..........Ft.:
REPAIR PN EpMOV��,I /r
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SWIM
ATTENTION
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lating construction; and In doing the work authorized thereby, no person
NUMBER OF STORIES NUMBER6OGF
DWELLING
I
THIS PERMIT
This application is not a permit until
UNITS
relaliog to Workmen's Compensation Iasurmu.
AUTHORIZER
NO
EXISTING STREET R/W ............FT'. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............Fr. ............FT.
REMARKS
1
'11�
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
I
IE]YES (3 NO
'SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
C] YES C] NO
PROPOSED USE
PLAN CHECKED BY
THIS SITE IS LOCATED IN THE CITY
3
OF EDMONDS. LOCAL SALES TAX
SHOULD IE CODED 31.04.
REMARKS
PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT & GAS LINE
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Valuation Fee Rceelpt No.
1'Inn Check 7Tn.....................
BUILDING
PROPOSED USE
PLUMBINGFIA
3
tye�
PLOT PLAN (Indicate Building setbacks, abutting streets)
HEAT & GAS LINE
j
i
FENCE
1
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-SIGN
tRETAINING
WALL
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SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
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TOTAL AMOUNT DUE
1 hereby acknoa'ledga that I have read this application; that the In.
formation given Is 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 regu•
ATTENTION
APPLICATION APPROVAL
lating 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
relaliog to Workmen's Compensation Iasurmu.
AUTHORIZER
signed by the Building Official or his Dep -
Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORE NOTED
Ut and fees are paid, and receipt is He
y' p
shell be completed In ninety days; MOVED -IN BUILDINGS shall be com-
knOWledged in space provided.
pleled In six months.)
SIGNATURE (OWNER OR AGENT)
DATE tlIGNED
INSPECTION
3RE T 'e SIGN UR
�p
/ 7
DEPARTMENT
CITY OF
EDMONDS
D TE
NOTE; Applicant Subject to Plan Check Fee
775-2525
This Permit covers Work to be done on private property ONLY.
Any' construction on it,. Public domain (curb.. sidewalks, drlrewa7s'
FILE
marque'., etc.) wlll reguire'Separate lerml.eleln.
'
DBE PERMIT
BUILDING DEPARTMENT
�r I AppLcltnt Flll zoNE NUMBER7,=1-•�", �3
_ PERMIT APPLICATION Inside Ileavy Lines '
NAME (OR NAME OF BUSINESS)
4 IV, /__ e
Al N6 D HESS
CITY TELEPHONE NUMBER
I�Plil )AIDS 7~7 y. - v; yo
JOB
ADDRESS I ? z)
i , / 6/1 r -i l
PERM ISSIBL. ^
LOT COVERAGE?
ACTUAL'
LOT CO AGE
PERMISSIBLE HEIGHT
PROPOSED HEIGHT
ACTUAL LOT AREA
TOTAL BLDG. AREA
REQUIRED YARDS PROPOSED YARDS
FRONT SIDE REAR FRONT BIDE REAR
A DRESS
LEGAL LOT
� YES NO
VARIANCE OR CONDITIONAL USF.
PERMIT NUMBER
INSR �;CY561 � POOL
NUMBER OF STORIES NUMBER OF
1
H
A DRESS
UNITS
NATURE OF WORK TO BE DONE
0
PLANNkq/ T. APPROVAL DATE:
"
Valuation
Fee Receipt No.
Plan Check No ...................:.
CITY
Z
TELEPHONE NUMBER
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3
Iy
BUILDING
4 PROPOSED USE
STREET R/w
_
PLOT PLAN (Indicate DUilldding setbacks, abutting streets)
HEAT @ GAS LINE
EXISTING STREET R/W ............FT. ' DEFICIENCY THIS PROPERTY'
NAME
SIGN
RETAINING WALL
c
_
COMP. PLAN ST. R/W FT.
REMARKS ............ ............FT.
W
"t A
!
G
x
ADDRESS
DEMOLITION
PRE -MOVE INSPECTION
C
EXCAVATION OR FILL
CHECKED BY
pi
CITY
TOTAL AMOUNT DUE
TELEPHONE NUMBER
.` V
I hereby acknowledge that I have read this application; that the In.
of
t
formation given le correct; and that I am the owner, or the duly author.
G
rOj
ized agent the owner. f agree It comply with city and elate laws regu.
!l
METER SIZE SERVICE SIZE CLEARANCE
tr
Iating construction; and In doing the work authorized thereby, no person
CH�KED BY
APPLICATION APPROVAL
STATE LICENSE NUMBER
CITY LICENSE NUMBER
I
I
AUTHORIZES
ONLY
ONLY TH
m
which
be completed In ninety days; MOVED -IN BUILDINGS shall be cam•
µOTU[ NOTED
uty; and fees are paid, and receipt is ac-
knowledged In space
pleted In six months,)
I
REMARKS
DATE SIGNED
kw7
F
DIRE TOR'S SIGNATURE i; /
DEPARTMENT
,
Legal ➢aeCtlplfon
f�
of Property (Show Below
or ALIaCR Four Copies)
k rs��%i'G tiS7ziJ !?-� f'G 7 -3
EDMONDS
DATE )
NOTE: Applicant Subject to Plan Check Fee
ti
TYPE CONNECTION VERIFIED BY
G
o
f'
PE C (T PERMIT NUMBER
Cd
w
R
w
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FIRE ZONE TYPE OF CONST N 8 M ROVED,
B 0 NO
SPECIAL INSPECTOR REQUIRED GROUP
.�
.
❑ GAS
IOCCUPANCY
[I YES 0 NO
j
ElRESIDENTIAL
NEW
r
LINE
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
1 :1NON-RESIDENTIAL
I D SIGN
OF EDMONDS. LOCAL SALES TAX
ADD
DEMOLISH
EJ RETAINING
WAL
REMARKS SHOULD BE CODED 3104
El ALTER
❑ ORFILL❑
FENCx..........Ft.)
REPAIR ❑ PRE -MOV
swig
INSR �;CY561 � POOL
NUMBER OF STORIES NUMBER OF
DWELLING
t'
UNITS
NATURE OF WORK TO BE DONE
Valuation
Fee Receipt No.
Plan Check No ...................:.
Z
3
Iy
BUILDING
4 PROPOSED USE
PLUMBING
_
PLOT PLAN (Indicate DUilldding setbacks, abutting streets)
HEAT @ GAS LINE
21O
FENCE
SIGN
RETAINING WALL
_
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
.` V
I hereby acknowledge that I have read this application; that the In.
t
formation given le correct; and that I am the owner, or the duly author.
ized agent the owner. f agree It comply with city and elate laws regu.
ATTENTION
tr
Iating construction; and In doing the work authorized thereby, no person
APPLICATION APPROVAL
will be In violation of the Labor Code of the Stale of Washington
THUS PERMIT
This application fa not a permit until
to
relating to Workmen's Compensation Insurmce.
NOTE: Permit Limit One Year (Except DEMOLITIONS
AUTHORIZES
ONLY
ONLY TH
signed by the BuildingOfficial or his De -
Dep
which
be completed In ninety days; MOVED -IN BUILDINGS shall be cam•
µOTU[ NOTED
uty; and fees are paid, and receipt is ac-
knowledged In space
pleted In six months,)
provided.
81ONATUJCE (OWNER OR AGENT)
DATE SIGNED
INSPECTION
DIRE TOR'S SIGNATURE i; /
DEPARTMENT
,
CITY OF
EDMONDS
DATE )
NOTE: Applicant Subject to Plan Check Fee
Thle Permit covers work to be done on private properly ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
INSPECTOR
(Rough) '�'/—
Frame U
Furnace & Fuel Lines
Final