750360.pdfBUILDING DEPARTMENT
ZONE
USE PERMIT J
Applicant FILL zO �s — NUMBER
PERMIT APPLICATION I Ingldo Heavy Linen ,DD RESS
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ADD
NAME fOR NAME OF BUSINESS)
/--,[ PEf4 a
RMISSIBLE ACTUAL
/ S LOT COVERAOEt - l._ LOT COVERAGE - f S°
C
.A4 ADDRESS x'17 p
PERMISBI . HE OII� ,
PROPOSED HE OH t Z
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Cl Y /-� ,t / TELEPHONE NUMBER fO L� REA6 4r Aon �OOV HtjD6 AR^E^ x
[/ 1� D /� {% S 7 7? �Sz �1 REQUIRED YARDS �lr/ �`P••11--O----CCE((- YARDS r5y
NAME ry�s_3s%� FRONT BIDE REAR FRONT BIDE REAR
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W ADDRESS
L ELOT VARIANCE OR CONDITIONAL 9E
ES � NO PERMIT NUMBER
N N E T. P OVAL ^ TE:
C CITY TELEPHONE NUMBER �
V'STREET R71V
,5 -=-A ? 7 L EXISTING STREET R/W ...... ..FT. DEFICIENCY THIS PROPERTY J�
NAd1E �y t
CODTP. PLAN ST. R/W ..Cl.'/ .FT. ......._...FT. W J
�I/�/(lrr� rd tet/. N� . REMAIL Driveway slopes not to exceed those o f
fA AD11 JS
indicated on Standard Dwq. No. 103 x �;
FCY / a TELEPHONE NUMBER •7� 1 O
17r� f
V METER BILE I BERVlCE re1ZE I CLEAT ANCE I EC
STATE LICENSE NU/DfHERq CITY LICENSE NUMBER
REMARKS ! 8
Legal Description of Property (Show Below or Attach Four Copies) // L � (I//n
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-A -I erC% 33-7/ %a /, C// TYPE �COfNNECTION i D VERIFIED
� FERC. TEST PERMIT NUMBER
/ W REMARKS m
f CN(C OK.OA
"l FIRE ZONE I TYPE OF CONS RUCTION STRE T IMPROVED
,SIL- E9 NO
SPECIAL INSPECTOR REQUIREDOCCUPANCY GROUP
AL GAS ❑ YES •10 I T� -T—/
RESIDENT E] TY
EW NON-RESIDENTIAL ❑ SIGN PLAN CHEC CE DY OF I EDMONDS.S S TE IS O LOCAL CATED I SALES TN THE AX
ADD ❑ RETAINING Vin ARx SHOULD BE CODED 31.04.
DEMOLISH V / �I ' ! L q./ -�
ALTER ❑ EXCAVATE0.
g�� CO/f%SVJL/i/�L'J /U� �L �/ (�1.�(;/ 1/ f✓
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REPAIR ❑ INSPFSOVE ❑ O i..`J.....Ft.7 S!/ ,`Qy�C.C! V� OX/ 517-47"' V.f/ci'Gi/eJs I.
NUntBEll. Ob` STORIES I NUMBERDWELLING OF U
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NATURE OF W BE DO D Valuation Fee Rcccipt No.
Plan Check No... ..................
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BUILDING
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aPROPOSED USE
PLUMBING
tS�5�77 fir' i
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PLOT PLAN (Indicate Building eethneke, abutting etrecls)
HEAT A GAS LINE
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/
9
FENCE
a,ao
SIGN
I
RETAINING WALL
eWIMM[NO POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
'
1 hereby acknowledge that I have read this application; that the In.
TOTAL AMOUNT DILE
i r Q o
[ermntlon given U correct; and that I am the owner, or the duly author -
teed agent of the owner. 1 agree to comply with city and state laws neigh.
ATTENTION
APPLICATION APPROVAL
laling eonstrucilon; and to doing the work aulborlred thereby, no person
will be employed In violation of the Labor Code of the Slate of Washington
THIS PERMIT
Thin application is not a permituntil
relating to Workmen's Compensation Insurance.
AUTHORIZES
elgned by the Building Official or his Dep-
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TH
WORK NOTED
uty; and fees are paid, and receipt Is ac-
shall be completed in ninety days; MOVED -IN BUILDINGS shall be coin-
knowledged in space provided.
pleted In nix months.)
S1GN RE (OWN OR A DATE BiGNED
INSPECTION
1 OR' NATO
DEPARTMENT
_
4 J
CITY OF
J
EDMONDS
DATE
NOTE: Applicant Subject to Plan Check Fee
— 3
775-2525
This P-11111 torero work to be done on private property ONLY,
Any conslrucllnn on lite nubile domain (curbs, sidewalks, drlrewaye,
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I L D I N G DEPARTMENT Applicant FIR
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ZONE NUMBER
Inside
PERMIT APPLICATION I Ineldo Hcuvy Linos
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ADDRESS �J
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4.,? o •1 rJ)(
(ACTUAL
NAME (OR NAME OF BUSINESS)
4/ ,� /` / i �_,
PERMISSIBLE �! I)) JJ
LOT COVERAGE 4- �� LOT COVERAOE 1, -per., -
Ems-
e1
MA a NG ADDRESS
G�-� •L\hf`M- l L
PEltal [89IIILE FIEIGI[F P1tOPO8ED HEIGHT t
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CITY
NUM
TELEPHONE Bl,R
ACTUAL T AREA TOTAL BLDG. EA
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->
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REQUIRED YARDS , , PROPOSED YAR
NAME
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FRONT HIDE HEAR FRONT REAR
4_1 (}SID)E
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ADDRESS ., 1
LEGAL T VARIANCE•` ITIONAL HL
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E NUMBER
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STREET R/W
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ST
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NAME/
COMP. PLAN ST. R/W ..(pQFT. ......FT.
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REMARKS nrive4'(rly siopc5 not t0 t'.Y.CC& th(IS„
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ADDDR 1 B -
i')dic�ted 1)n Standard Dwn. 70. 1`E
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CHECKED BY
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SIZE
SERVICE SIZE CLEARANCE
CHECKED BY
STATE LICENSE NUMBER CITY LICENSE•' NUMBER
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REMARKS
<
Legal Description of Property (Show Below or Attach Four Cop les)
j ,.7r % �3 / /-J �. /�D/
'TYPE CONNECTION 41 p
VERIFIED B
-
PERC. TE 8 i I /
N 1 ER
a
/•
(a
REMARKS
m
0
11
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.�,
FIRE ZONE TYPE OF CONSTRUCTION STREET Ial
/
SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
E]- RESIDENTIAL
GAS
1:1
❑ YES a'NO
�-- / -'
NEW
LINE
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
)
NON-RESIDENTIAL
SIGN
r f �, /-'�,_��• OF EDMONDS. LOCAL SALES TAX
,) /,d -- � L : SHOULD BE CODED 31.04.
ADD ❑RETAINING
}YALi,A.1--
REMARK �\
DEMOLISH
EXCAVATE F+,EN�CE ��
!a //
/ •..
ALTER El OR FILL (:SA.....x..L.
El
SP{O`lO�L
REPAIR [:]INBPM1IOVE O
NUMBER ON' BTORI EH NUMBER OF
DWELLING
---•" UNITS
NATURE OF WORK(J TO DE DONE, ;) /%
Valuallen
Fee
Receipt No.
(2, .. l)J`'
Plan Check No .....................
!.
6UILDING
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`f'r.'.'3t'.-•
[O
4
PROPOSED USE
a
PLUMBING
/
aPLOT
PLAN (Intents Building setbacks, abutting streets)
HEAT & GAS LINE
}' UT
^c
FENCE '
�) •
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION Oil FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
formation given In correct; and that I am the owner, or the duly author.
-
Ind agent of the owner. I agree to comply with city and state laws regu.
ATTENTION
APPLICATION APPROVAL
lating coaatmetlon; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Stale of Washington
THIS PERMIT
This application is not a permit until
rotating to Workmen's Compensation Insurenu,
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
µ'ORI[ NOTED
uty, and fees are paid, and receipt is ac -
shall be completed In ninety day.; MOVED -IN BUILDINGS shall be nam-
Imowledged in space provided.
pleled In six month,.)
H1ONA URE (OWNER OR AGENT) DATE SIGNED
INSPECTION
D R CTOR'S, HIONATURE
J
DEPARTMENT
I _
.... ..:...:.,. ..-
CITY OF
...-,-�
EDbiONDS
DATE 01(�
NOTE: Applicant Subject to Plan Check Fee
775-2525
This Permit a re work to be done on P4 -t. properly ONLY.
Any row—U..on the public domaln (carbo, sldswdke, driveways.
marquees, eta.) will require separate perndulon.
INSPECTOR
Plumbing (Partial) 9 -3,o — 4,1
(Rough) z s _ T S
Frame
Furnace
{
& Fuel LinesL—a_, j�
Final
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