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750354.pdf
USE PERMIT DEPARTMENT Applicant Fm E NUMER 750354 -` PERMIT APPLICATION Inside Heavy Lines Io ADDRESS NAME (OR NAME OF BUSINESS) _ 6 ( O s'�^t-, r�/ V PEKMISMI-E 7 ACTUAL eJ 7 1' Il IAT COVERAGE �C�1� LOT COVA.GE J 0/n ; MAILING ADDRESS •✓ / J V �.h q PERMISSIBLE HERMIT � PROPOSED H ' O�T y I I,a l 3o I� �t : \ ! CiT TELEPHONE NUMBER1 /CTUQL-I.OvT AREA TOTAL 65.D0. ARA —3,3 / �1 —`Till �;REQU'f REQUIRED YARDS 5 ATPR10T_POSF.0 YAItDd NAME FRONT SIDE REAR FRONT SIDE REAR 25' IL 2S 5n' I 0 2(0 ADDRESS LE L LOT ARIANCI: OR CONDITIONAL U.E i F+ s NO PERMIT NUMBER 1 1 O bE T. APY'1 C CITY TELEPHONE NUMBEIt �• �- f STREETIt/ V EXISTING S EET R/W ............PT. DEFICIENCY THIS PROPERTY y NAME COMP. PLAN ST. R/W ............FT. ............FT. I,IRpdI REMARKS 7 G ADDIIE138 0pi (CHECKED BY LS CITYTELEPHONE NUMBER 'O I METER el'LE SERVICE SIZE CLEARANCE CHECKED BY O STATE LICENSE NUMBER CITY L10EN8E NUMBER REMAliKd 1I E Legal Description of Property (//Show 1B/el/ow or Attach/j Four Copies) TYPE CONNECTION VERI[FIIEEDD BY LF -1, `r " I ` On l t_\`) ly (I PERC. TEST PERMIT NUMBER W i (moi (,) i— r' O I—t4J t /a Tek/q REMARKS W1 O � �Y S OF�Air�t� hlc� �c cit-cr k) -1. ZONE TYPE OF CONSTRUCTION STREET IMPROVED j ' ItGI Lz. sS S 11 t=t O f= tJ �s� t � S VJ ^ ❑ YEe )'5:xo OF T,0, 11 SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP ®❑ GAS ❑ YES �NO RESIDENTIAL LINE PLAN CHECK El NEW L. BY THIS SITE IS LOCATED IN THE CITY NON-RESIDENTIAL J SIGN I V'J OF EDMONDS. LOCAL SALES TAX © ADD SHOULD BE CODED 31.04. I ❑ DEMOLISH ❑ yEAT�A,INfNG REMARKS FALTER EXCAVATE PENCE �� O 'S Com. 1'4• �,J �� 1 �. I OR FILL (.........,x..........Ft.) REPAIR ❑ NPMOVE O POOL NUMBER OF STORIES NUMBER Oil DWELLING UNITS NATURE OF WORK TO BE DONE n (� Ilnnn J Valuation Fee Recclpt No. Room I-1 I�Q/� flan Check No.. BUILDING .5 0 Q I L PROP BED USE - ' PLUMBING 1 ° Ti it0of'I - Lo_�trU�, APLOT PLAN (Indleato Building Setbacks, abutting Street.) HEAT A CAS LINE .CA FENCE SIGN _ RETAINING WALL — N SWIMMING POOL DEMOLITION PRE -MOVE INSPECTION EXCAVATION OR FILL �� II hereby acknowledge that I have rend this application; that WTOTAL AMOUNT DUE 7- 177 e In- ' Ron Elven to correct; and that I om the owner, or the duly author. (zea agent a[ the owner. t agree to compiY with city and elate laws regu• ATTENTION APPLICATION APPROVAL ktua. eonmMetlon; and In doing the work authorized thereby, no person will be employed In violation of the Labor Code of the State of WaShlagton THIS PERMIT This application is not a permit until relallug to Workmen's Compensation Insurance. AUTHORIZES Signed by the Building Official or his Dep - ONLY THE NOTE: Permit Limit One Year (Except DEMOLITIONS which µ•OAR NOTED Lty; and fees are paid, and receipt is ac - Shall be completed In ninety day.; a[OVED-IN BUILDINGS shall he cont• knowledged in space provided. pleled in six months.) SIGNATURE (OWNER O12 GENT) DATE SIGNIJI INSPECTION 1 EC 81 N HE DEPARTMENT i .C. �Yl CITY OF , EDMONDS DATE NOTE: Applicant Subject to Plan Check Fee 9—.2p— ! 7 %1 775.2525 This 1-0 mit covers work to be done an privateProperly ONLY. Any canelructlan on the public domain (curb., aidewmks, driveways. FILE marquees, etc.) will require Separate permission. ' X /01 P91VATE PRIV 'WAY =XTENOS WF C�5') 7"0 80fh AVE. W. . a EMS TING ROLIc =50.r i j. m < 81.01' PROPosF'p 10' .'ADDITION. _RELOCATED f 9' _ .PATIO DECK //rG„ ! lli 26'. OWNER : DENNIS D1=f�! � ND /8123 So ih AV F IV, DRT�' - JULY l�, �- SG'7 e' yon c /�p't. r , Plan Check No ..................... %J r BUILDING -•, `1 1!\, () (� () 2- (} r I q PROPOSED USE , i l I i ',: „ d til -• !�- hti I l t', rC /-, f T— V PLOT PLAN (Indicate Bulldl¢g ee( (O pbutting Street.) BEAT & GAS LINE �� r - 1 A BUILDING D E P A R T M E IN T Applicant Fill, ZONE t'C ,� NU�/BI T ' \. (v\ \ ' I q�+ SIGN Inside Heavy Lines PERMIT APPLICATON ADDRESS / a / 2 3 -� � ---fit• GIlj - RETAINING WALL.y NAME (OR NAME OF HUBINESB) '', `' . I 6WIMMTNO POOL I. \t 'n 1 1 d 1 nl (\ I J ACTUAL J COVESRAOE LOT COPERMItlVERAGE. 81IILE ^ LOT ,J pppttt n I / J _ p 11 PRE -MOVE INSPECTION MA1L[NO AD RE S '. PEILe11337BLE HFIOTIT � � t -a'. PROP OS ED 'IEIOtIT y I J l r1 CITY TELEPHO�NE NUMHER..yy,, ACPUAL LOT AREA TOTAL HLDO(_.�{A-HEA }.. `'. /�.,; /•% % Y ~3 ", 3EEii 9 '•.I I hereby eknowledge that I have rend this application; that the In- REQUIRED YAITUB R OSED YARUtl NAME FRONT HIDE BEAR FRONT BIDE REAR Ized agent of the owner. I agree to comply with city and elate law. rag.- ATTENTION k 42 1¢ting ce..11,tla¢; and In doing the work authorized thereby, no person ! x•111 be employed inviolation of the Labor Code of the Slate of Wington ¢ah THIS PERMIT ft ADDRESS LEGAL LOT VAI A; F. OR CONDITIONAL NUe1BER AUTHORIZES signed by the Building Official or his Dep - i NOTE: Permit Limit One Year (Except DEMOLITIONS which ONLY THE WORK NOTED pi F Ea•YF.S NO PERMIT , }; pleted In Hix m..the.) •t , PLNNINO DEPT. API•RO. / D '• : T "' INSPECTION .til 1 /:' ! . / /• -, /,) -� /_•, 'l I � DEPARTMENT C CITY TELEPHONE NUMBER � STREET R/t}'1 .� •l" NOTE: Applicant Subject to Plan Check Fee 775-2525 EXISTING STREET R/W ............Fr. DEFICIENCY THIS PROPERTY 'L4 This Pernik covers work to 1w done on private property ONLY. Any ca..tructioit on the public domain (curbs,sld-alk., drlvex'ays, NAME COMP: PLAN ST. R/W ............FT. ......... ...FT. marquee., etc.) x'111 require separate V-11.0... REMARKS ., I m ADDIT - . .. U!! CHECKED BY C CMT TELEPHONE NUMD ' O I [ i ? r METER SIZE I SERVICE SIZE CLEARANCE CHECKED HY ATE ENBE UMBER CITY LICENSE NUMHER .�� `� I I 711 k�,y.•F `I 1, N :Af -REMARKS + ':�` Leget Description of Property (Show Below or Attach Four Copies) G1l ��/t {�•~ TYPE NECTION VERIFIED BY PER ES P R I 1 � I J4 ItENARK9Li QE) se _ E -i' FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED j S C I!D' i 1= r(1 ��,...� �.. 1�— �f — tJ ❑ YEBNo SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP M1 RESIDENTIAL GAS ❑ LINE ❑ YES �`[]_NO �� , I NEW PLAN CHECKED BY THIS SITE IS LOCATED IN THE. CITY ; ❑ NON•RE92DENTIAL ❑ SIGN I��� OF EDMONDS. LOCAL SALES TAX 'I ED\• ADD RETAINING SHOULD BE CODED 31.04. REMARKS .. 1 i DEMOLISH WALL Lj FE E j y-1 -" 9,--.P- \(j... V,j 0 1't..- V 'Y F i•+ 1.. ALTER ❑ ORCFILL (..........x .......... Ft.) OR ,_ REPAIR PRE -MOVE El swim INSP. POOL NUMBER OF STORIES NUMBER OF DWELLING UNITS NATURE OF WORK TO BE DONE Valuation Fee Receipt No.� r , Plan Check No ..................... %J BUILDING -•, `1 1!\, () (� () 2- (} r I q PROPOSED USE , a � .. l� M", A PLUMBING I i ',: „ d til -• !�- hti I l t', rC /-, f T— PLOT PLAN (Indicate Bulldl¢g ee( (O pbutting Street.) BEAT & GAS LINE �� r - 1 A ' \. (v\ \ ' FENCE q�+ SIGN RETAINING WALL.y I 6WIMMTNO POOL I DEMOLITION 11 PRE -MOVE INSPECTION I II EXCAVAT3ON OR ly'ILL TOTAL AMOUNT DUE 7 QG! I hereby eknowledge that I have rend this application; that the In- ect; and that I ant the owner, or the duly auth formation given le c or- Ized agent of the owner. I agree to comply with city and elate law. rag.- ATTENTION APPLICATION APPROVAL 1¢ting ce..11,tla¢; and In doing the work authorized thereby, no person ! x•111 be employed inviolation of the Labor Code of the Slate of Wington ¢ah THIS 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 DEMOLITIONS which ONLY THE WORK NOTED uty; and fees are paid, and receipt is ac - .hall be completed In ninety days; MOVED -IN BUILDINGS shall be conn- knowledged In space provided. pleted In Hix m..the.) •t SIGNATURE (OWNER OR AGENT) DATE SIGNED INSPECTION -DIRECTOR'S SIGNATURE /:' ! . / /• -, /,) -� /_•, 'l I � DEPARTMENT �• (F! /(�l / !/ /til'-' �' °. / , �, i //'r:.:' .•� : ,� � / .. , l t i CITY OF EDDIONDS .� NOTE: Applicant Subject to Plan Check Fee 775-2525 This Pernik covers work to 1w done on private property ONLY. Any ca..tructioit on the public domain (curbs,sld-alk., drlvex'ays, INSPECTOR marquee., etc.) x'111 require separate V-11.0... '. .. .. .. .. :. ..., .. if i Li ly1., I f' r i _ I %5CJ35y RECORD OF INSPECTIONS Date Passed Foundation�7Si A �U Plumbing (Partial) (Rough) 2.E U Frame ��! Furnace & Fuel Lines / Final.? a b