750329.pdf;0
BUILDING DEPARTMENT Applicant YII cantP
ZUOSNE -Imo. NUMBETR 750329 '..�
PERMIT APPLICATION
Inside Heavy Linea ADjois
ADDREBH
N (OR A E OF BUSINESS)
PElialltlBIHLE � � J
LOT CORAGE 1 LO UCL RAGE I
'MAILINO DDREBH d VE�� 4� l�T l •�
PERMISSIBLE HEIGHT / PROPOSED ILIGHT ,ry .•s / Y 1
O C TY TE PHONE NUMBER ALTDe bAR A TOTAL' I.DO.,AREA i
LL,')) REQUIRED YAItDB P.ROG.... YA RDB
E FRONT BIDE REAR FRONT BIDE REAR
�
ADDRESS L L LOT VARIANCE OR CONDITIONAL UeE
NYAES NO PERMIT NULIHER
NO JrPT. A VAL /- �yrATE;
C C1TY TELEPHONE NUMBER
STREET1V / C
�_. EXISTIN TREET R/Rl".. .tax.- DEFICIENCY THIS PROPERTY rj
NAME �
COMP. PLAN ST. R/.&-*.-. 6/v ).....FT. W W
REMARKS
c ADDRESS Driveway slppes not to exceed those o ,
indicated on Standard Dwg. No. 103 w
t - CHEC E Y I
F 111'1 TEL7EP%HONE NUMBER j
V I� METER SlL 111111E 812E CLE RAN 1 CHE BY
STATE LIICDENSE NUMBER C1 Y LICE��18E NUMBEli
REMARKS C
Legal Descrlpton of Property (Show Below or Attach Four Copies)
TYPE CONNECTION VERyr
Y / L PERC. TEST Iu W M ER I
REMARKS
TL"'y Zk,&0.%ea, Ct). l/42,L" _
/ r./�/�^
./LI I Ee ❑ No
(5;—
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
a 5,-70
❑ YES ��Iti
C GAB
RESIDENTIAL ❑ LINE
NEW
PLAN CHECKED
THIS 517E IS LOCATED IN THE CITY
/ OF LOCAL SALES TAX
NON-RESIDENTIAL BIG
. �, �4_-
ULDEDMONDS.
B CODED 31.04.
❑ ADD RETAINING
DEMOLISH ❑ WALL
FENCE
El
I / �i C)/" S/ U/!/C•
Re, I �' /� L1B, C I7 73
ALTER ❑
OR FILL(.....................Ft.)
REPAIR E] PRE -MOVE El SWIAI
NSPPOOL
0 i /{ d 1FC 7—/—U &.1 5 /L� 11V /
NUMBER OF STORIES NUMBER OF
DWELL NO
Off/ UNITS
NATURE OF WORK TO BE DONE
Vnluallon
Fee
It -MIA Na,
Plan Check N. .....................
z_r
D
BUILDING
_ -
PROPOBpD USE
PLUMBING
aPLOTIPL (Indicate Building setback., abutting streets)
HEAT & GAS LINE
CI C _
FENCE
tRETAINING
WALL
---
N
— -
SWIMMING POOL
DEMOLITION
PRE -MOVE. INSPECTION
EXCAVATION Olt FILL
--
TOTAL AMOUNT DUr.
/Q/ fV
Ihereby 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.
tzed agent of the owner. I agree to comply with city and elate laws regu-
ATTENTION
APPLICATION APPROVAL
tat,., cooetruellon; and In doing the work authorized thereby, no person
will be employed In violation or the Labor Code of the State of Washington
TITIN PERMIT
This application is not a permit until
relating to workmen'. Compensation Insurance.
AUTHORIZE"
signed by the Building Official or his Dep-
—pt
TEVxcept DEMOLITIONS wh1th
oxl.v Tu r.
%,ORH NOTED
uty; and fees are paid, and receipt Is ac-
.b.mpleted In alt y ; MOVED -1N BUILDINGS atoll be win•
knowledged In space provided.
Piet Q 1 elz month..
tll UItE (OlV OR E DAT'' TONED
INSPECTION
lid/
I1 Tlt'
DEPARTMENT
,84ONAT
..l
"
CITY Or
F.D11I NDS
DA•rr:
NOTE: Applicant Subject to Pla Cheek Kr
7-�
775-2525
This Pe bill c n'ero work to be duan an Private properly ONLY.
i
Any construction on flat public domain (curbs, sidewalk., driveways,
FILE
ntnsquees, ele.) .111 require separate perml.Mon.
M CT—I
NAME
m ADD tLSH
F
0
LJ
\.I. AA
.VTilRT7� J I!J 1 (7
S'STREETW
EXISTINT�TREET R/W41 0 �E'T. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/w�rl (1C_. ...1•+....pT. -'"
REMARKS 1)rivewav slpnnS not to exered Plos-
indi catf'd oil St-Indavd Dtap. No. 100 No. 100 t-
CREC
1 � 1 •t
29
v or Attach Four Copies) d
TYP CONNECTION VERIFT, BY
PLRC. TEST
FIRE ZONE
�I
RMIT
UILDING DEPARTMENT APPllPaIltFiu z�NE1\ NU
RESIDENTIAL ❑. LINE
NEW
NoSIGN
/ ADD ❑ RETAINING TS
DEOLLl HALL
ALTER ❑ EXCAVATE ❑ FENCE
OR FILL (.......... X..........Ft.)
Ej YES WNO
PLAN CHECTD q
/ /5 Ir'
R ARKS
J
�/ 1,/�/-1 )i !�'(�
PERMIT APPLICATION Inside heavy Linea JIGS rI /
ADDRESS Q
�0 _�• /`
REPAIR ❑ PRE -MOVE SWIM
INSP. ❑ POOL
J N J L• 1 ! %(! ��,;/ Y / vi.: i/V 1 �Y- G i �.I /�
—
/ ,//
PERMISSIBLE / /fi'(.C•C. lll//�CNJJ��.
NAeCE _1 -R!1 -,ME OF BUSINESS) /1
%� LOT COVERAGE !7 L.
OTUC L IAGE'MAILIN
1
i j
t t!.:> ire/}7(�i((`1� d • ;u ;% �C&
DWELLING
O AUURESB pERM18sIBLE HEIGHT t PROP0330E1GHT
UNITS
y1j. TOTAL SLl]O. AREA
CITY TE PHONE(N�/UMB(I�.Rl 1 7Ux 0 5A 1 '
]l
NATURE OF WORK TO BE DONE
Valuation
/ PROPTO"S'Fr.D YARDS
PR
�^ ~ % REQUIR YARDS
/NAME FRONT SIDE FRONT BIDE RE.ALR,
Recelpt No,
j
^REAR
/
Plan Check No......................
G LF GAL LOT VARIA CE OR CONDITIONAL VSE
A UltEtlB• Q YE9 ❑ NO PERMIT NUMBER
/ IjEPT. '
0
M CT—I
NAME
m ADD tLSH
F
0
LJ
\.I. AA
.VTilRT7� J I!J 1 (7
S'STREETW
EXISTINT�TREET R/W41 0 �E'T. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/w�rl (1C_. ...1•+....pT. -'"
REMARKS 1)rivewav slpnnS not to exered Plos-
indi catf'd oil St-Indavd Dtap. No. 100 No. 100 t-
CREC
1 � 1 •t
29
v or Attach Four Copies) d
TYP CONNECTION VERIFT, BY
PLRC. TEST
FIRE ZONE
7 j _ �- 5-- .7 Q `)
1GAS
1 �"_. — /,/O44EB t3 NO
SPECIAL INSPECTOR EQUIRD EOCCUPANCY GROUP, \^
R
j
RESIDENTIAL ❑. LINE
NEW
NoSIGN
/ ADD ❑ RETAINING TS
DEOLLl HALL
ALTER ❑ EXCAVATE ❑ FENCE
OR FILL (.......... X..........Ft.)
Ej YES WNO
PLAN CHECTD q
/ /5 Ir'
R ARKS
J
�/ 1,/�/-1 )i !�'(�
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
1I 'L BE CODED 31.04.
// t//- Y G /t-� l�l.= V Iq /.�
REPAIR ❑ PRE -MOVE SWIM
INSP. ❑ POOL
J N J L• 1 ! %(! ��,;/ Y / vi.: i/V 1 �Y- G i �.I /�
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE
Valuation
Fee
Recelpt No,
Plan Check No......................
0
BUILDING
% \ �/
PROPOSED USE l
Z,". '/
dll� Lam/ a�
PLUMBING
�
.�
PLOT'PLG/ AN (Indicate Hulldln6 tbncke, abutting streets)
HEAT & GAS LINE
PENCE
_
SIGN
RETAINING WALL
N
HWIMMINO POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION Olt FILL
TOTAL A51OUNT DUE
I hereby acknowledge that I have read this application; that tho In-
formation given Is correct: and that I athe owner, or the duly author.
Ized age^[ o[ the owner. I agree to comply with city and stale laws regu-
lath. construction; and In doing the work authorised thereby, no person
will be employed In vlolallon of the Labor Code of the Slate of Washington
ATTENTION
Tills PERMIT
APPLICATION APPROVAL
This application is not a permit until
-
relating to Workmen's Compensation Insurance.
NOTE: Permit Limit One Year (Earept DEMOLITIONS whleh
ehall be completed In ninety. days; 51OVED-IN RUILDINOS shall be com-
AUTHORIZES
ONLY THE
WORK NOTED
Signed by the Building Official or his Dep -
uty; and fees are paid, and receipt is ac-
knowledged in Space provided.
pleted In six months.)
1
SIGNATURE (O\VN£. OR AGEN VAT Fj-SIGNED /
NOTE: Applicant Subject to Plan Check Fce
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
775-2525
DIRECTOR'S 81,6NAT E/ J
I /.
DATE
%� Jf `1 /•
INSPECTOR
work to be doe en VII -Ce 11-Perty ONLY.
This 'ermlt c n
Any cIan elructlon on the public domain (curb., sidewalks, drI_ays,
marquee., etc.) will require separale permission.