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750365.pdf
.,. __... .... .., ... .�. _.. .-... 7..__... .. _. ... _ ._., ... ... ..... _.- _._ _. _ .. .. ....-._..... _. .. _... .......... RESIDENTIAL NON•REBIDENTIAL ... i _ _-, LINE SIGN ❑PLANE CHE CE 3YO _, � / �LV/ I y THIS SITE IS LOCATED IN THE CITY SH ULD BEEDMONS. LOCAL SALES TAX SHOULD BE CODED 31.04. 0 DPERM BUILDING DEPARTMENT FW zo11E$S_8 NUMB& R 750365 DEMOLISH EXCAVATEOR ❑ ❑ WAI.AI.'NING PENCE Appucant , -///r Q7� �'�F�/ UP e / % !/ PLUMHIN6 PERMIT APPLICATION InBlde Heavy Lines ADD -! ADDRESS - `7 HEAT & GAS LINE t Q NAME (OR NAME OF x BUSINESS) NAME ❑ INSP J +/ LOTC VERA m LOT CO / j ^' �7 IAT COYERAOEe �J f LOT COVERADE NO dd..11 JI7 W / D j /� �^ •S /l/G �����C.��/r./ M ILING ADDRESS PEItMIeSIBLE HEIGHT / PROPOSED H 6HT y �/(,� DWELLING / C `•' C ACTUAL LOT .�rR�rnEA TOTA LBO. i CITY TELEPHONE NUMBER A � .{� 1� U / �( d' —� REQ IRED YAIiDe PROP isD YARDS DEMOLITION PRE -MOVE INSPECTION NAME FRONT BIDE REAR FRONT FIDE REAR L, ' �� 1 EXCAVATION OR FILL WADDRESS Q L AL LOT VARIANCE Ott CONDITIONAL USE YES NO PE It MIT NU HER TOTAL AMOUNT DUE l I hereby acknowledge that I have read this appllcatton; that the in• h �] formation given Is correct;and that I — the owner, or the duly aulhmr I G P [ G DEP APPI APPLICATION APPROVAL Iating Co.. Mellon; pad In doing the work authorized thereby, ao person CITY TELEPHONE NUMBER TIDE PERMIT BrREET n/ EXISTING 8 ET R/W ............1. DEFICIENCY THIS PROPERTY � A � signed by the Building Official or his Dep. NOTE: Permit Limit One Year (Except DEMOLITIONS which NAME COMP, PLAN BT. R/W ............FT. ............1'f. uty; and fees are paid, and receipt is ac - shall be completed In ninety day.; MOVED -IN BUILDINGS shall be corn. knowledged In space provided. O REMARKS '• � ' 09 ADD1tE88 O W DEPARTMENT I � HECKED HY i I F CITY TELEPHONE NUMBER I /g (CF 775-2525 I Thl. Pe a4l r -. work In be done an prlrate property ONLY. Any construction on the public domain (curbs, sidewalk., drlYewys. CHECKED BY p( C O METER 112.71E SERVICE SIZE CLEARANCE ' STATE LICENSE NUMBER CITY LICENSE NUMBER I REMARKS ` Legal Description of Property (Show Below or Attach Four Copies) TYPE CONNECTION VERIFIED BY r. o PEIiC. TESTPERMIT NUMBERd. �4 r REMARKS W aj IV'• FIRE EI TYPE CoNBT CTION STREET IMPROVED I O•D ❑2 xcw RESIDENTIAL NON•REBIDENTIAL Ej LINE SIGN ❑PLANE CHE CE 3YO _, � / �LV/ I y THIS SITE IS LOCATED IN THE CITY SH ULD BEEDMONS. LOCAL SALES TAX SHOULD BE CODED 31.04. 0 HDD ALTER DEMOLISH EXCAVATEOR ❑ ❑ WAI.AI.'NING PENCE MAR / V //(/-N/ , -///r Q7� �'�F�/ UP e / % !/ PLUMHIN6 V ❑ FILL .z..........Ft.) HEAT & GAS LINE Q REPAIR ❑ INSP FENCE SWITIT❑ POOL j tL �(J Hr�� %� D/' /� �^ •S /l/G �����C.��/r./ IUMBER OF STORIES NUMBER OF DWELLING / SWIMMING POOL UNITS DEMOLITION PRE -MOVE INSPECTION JATURE OF WORK TO HE DONE EXCAVATION OR FILL Vniunllon Fee R—I.L N. TOTAL AMOUNT DUE (Il`/ • U v v r� ss--� n zT -•'• O Plan Check No ..................... BUILDING 0 iY PROPOSED UBE `Iq PLUMHIN6 V PLOT PLAN (Indicate Building setbacks, abutting street.) HEAT & GAS LINE Q yJ� O FENCE SIGN RETAINING WALL SWIMMING POOL DEMOLITION PRE -MOVE INSPECTION EXCAVATION OR FILL TOTAL AMOUNT DUE I hereby acknowledge that I have read this appllcatton; that the in• �] formation given Is correct;and that I — the owner, or the duly aulhmr Ized agent of the owner. I Hare. to comply with ..I, and .tate law. regu• ATTENTION APPLICATION APPROVAL Iating Co.. Mellon; pad In doing the work authorized thereby, ao person will be employed In vlolptlan of the Labor Code of the State of Washington TIDE PERMIT This application Is not a permit until rclntmg to Workmen's Compensation Insurance. AUTHORIZES signed by the Building Official or his Dep. NOTE: Permit Limit One Year (Except DEMOLITIONS which ONLY Tiff {YORK NOTED uty; and fees are paid, and receipt is ac - shall be completed In ninety day.; MOVED -IN BUILDINGS shall be corn. knowledged In space provided. pleted In slz month..) 7—yl— 7 S30 A�taj d F:N'1'1 DATE SIGNED INSPECTION OR' NA'r RE DEPARTMENT r CITY OF i EDbIONDB wTE � NOTE: Applicant Subject to Plan Check Fre 775-2525 Thl. Pe a4l r -. work In be done an prlrate property ONLY. Any construction on the public domain (curbs, sidewalk., drlYewys. FILE nrnraue<., Me.) "III rrpulre eep¢r¢Ie p<tmlesl.n. /RESIDENTIAL NEW LINE NON-RESIDENTIAL El SIGN ADD ❑ DEMOLISH ❑ WALI. KING ALTER ❑ EXCAVATE FENCE on FILL I .......... x .......... Ft.) ❑ O REPAIR ❑ PSWIM N MVE SP.O POOL NUMBER OF STORIES NUMBER OF DWELLING UNITS NATURE OF WORK TO BE DONE �(f' i 1. e) ✓ L:, �-: ,..Q )ti o:.w; / Pian Cheek No ..................... 7. Oy BUILDING 4 PROPOSED USE PLUMBING >, o C \ PLOT PLAN (Indicate Building setbacks, abutting streets) HEAT & GAS LINE FENCE SIGN { t RETAINING WALL SWIMMING POOL DEMOLITION PRE -MOVE INSPECTION EXCAVATION OR FILL FIRE ZONE TYPEOF CONSTRUCTION STRE T IMPROVED %.�.•� )1! ©'YES E] NO SPECIAL INSPECTOR REQUIRED I OCCUPANCY GROUP YES B•NO _7 PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY )g / OF EDMONDS. LOCAL SALES TAX SHOULD EE CODED 31.04. REMARKS �( ✓ )� .) /i'i/V /tom / !�Iy /✓d` �' /p/�� 1 S�.),', TOTAL AMOUNT DUE I hereby acknowledge that I have rend this application; that the in- formation given to correct; and that I nm the owner, or the duly author- n ATTENTION lating construction; and In doing the work authorized thereby, no person ' will hoemployed In vlolniton of We Labor Code of the Slate o/ Washington T1179 PERMIT relating to Workmen's Compensation Insurwtce, AUTHORIZES NOTE: Permit Limit One Year (Except DEMOLITIONwhich USE PERMIT BUILDING DEPARTMENT Applicant Fill zoxE 1; - �? NUM -7— !65 shall be completed In ninety days; MOVED -IN BUILDINGS ahall be conn PERMIT APPLICATIONinsideHeavy Line )O ADDRESS ItONATURE (OIVNER OR AGENT) ' ` DATE tl10NED NAME (OR NAME OF BUSINESS) PERMISSIBLE ^e ( uy 7 r( ACTU/A LOT COVERAGE, L LOT COVERAGE 1 $ t MAILING ADORE— / PEIth318SIBLE FIEFGHT - / PItOiOdED HERBY , 1 EDMONDS % -- - ; i -- TOTA UO. 775-2525 This Permit eaten ..,it In be darn on Private property ONI.T. ACTUAL LOT AVR�.EA 2lt7 (i ,i. Any construction on the public domain (curbs, sidewalk-, driveways, CITY` TELEPHONE UMBER i 1 �. irR E/D YAilt}Dtl YROPO LD YARDS BEAR NAME FRONT HIDE,: REAR FRONT SIDE �5 /NE G N'%a� L LOTrl PARI OR COND3OAL USE I t I W AD REtlB `f'YEd 0 NO PERMIT NUMBER , ' pEPT. APYR )` CITY TELEFRONE NUMBER jJ . `I I STREET It/tI EXISTING ST .ET R/W ............FT. DEFICIENCY THIS PROPERTY j NAME COMP. PLAN ST. R/W ............Fr. ............E,7'. nit) :� . �J REMARKS m x is ADDRESS Q C� H e CHECKED BY off" t flr l CITY TELEPHONE NUMBER VMETER N E E BY SIZE I I E f Ir A G' kF7 i I STATE LICENSE NUMBER ( CITY LICENSE NUMBER REMARKS "VeJ j I , Legal Description of Property (Show Below or Attach Four Copies) TYPE CONNECTION VERIFIED BY ! y, 1 I Z O [y+ PERC. TEST PERMIT NUMBER /RESIDENTIAL NEW LINE NON-RESIDENTIAL El SIGN ADD ❑ DEMOLISH ❑ WALI. KING ALTER ❑ EXCAVATE FENCE on FILL I .......... x .......... Ft.) ❑ O REPAIR ❑ PSWIM N MVE SP.O POOL NUMBER OF STORIES NUMBER OF DWELLING UNITS NATURE OF WORK TO BE DONE �(f' i 1. e) ✓ L:, �-: ,..Q )ti o:.w; / Pian Cheek No ..................... 7. Oy BUILDING 4 PROPOSED USE PLUMBING >, o C \ PLOT PLAN (Indicate Building setbacks, abutting streets) HEAT & GAS LINE FENCE SIGN { t RETAINING WALL SWIMMING POOL DEMOLITION PRE -MOVE INSPECTION EXCAVATION OR FILL FIRE ZONE TYPEOF CONSTRUCTION STRE T IMPROVED %.�.•� )1! ©'YES E] NO SPECIAL INSPECTOR REQUIRED I OCCUPANCY GROUP YES B•NO _7 PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY )g / OF EDMONDS. LOCAL SALES TAX SHOULD EE CODED 31.04. REMARKS �( ✓ )� .) /i'i/V /tom / !�Iy /✓d` �' /p/�� 1 S�.),', Fee r,-- �_' APPLICATION APPROVAL This application is not a permit until Signed by the Building Official or his Dep- uty; and fees are paid, and receipt is ac- knowledged in space provided. Df CTO R'e SIGNATURE /) DAT�� INSPECTOR TOTAL AMOUNT DUE I hereby acknowledge that I have rend this application; that the in- formation given to correct; and that I nm the owner, or the duly author- h,ra ¢gent of the owner. I agree to comply with city and elate laws rasa- ATTENTION lating construction; and In doing the work authorized thereby, no person will hoemployed In vlolniton of We Labor Code of the Slate o/ Washington T1179 PERMIT relating to Workmen's Compensation Insurwtce, AUTHORIZES NOTE: Permit Limit One Year (Except DEMOLITIONwhich ONLY TILE WORKS ORK NOTED shall be completed In ninety days; MOVED -IN BUILDINGS ahall be conn plctcd In six months.) 7- Z / / ' ItONATURE (OIVNER OR AGENT) ' ` DATE tl10NED INSPECTION ( .>y' DEPARTMENT CITY OF EDMONDS NOTE: Applicant Subject to Plan Check Fee 775-2525 This Permit eaten ..,it In be darn on Private property ONI.T. Any construction on the public domain (curbs, sidewalk-, driveways, marquees, etc.) will require-epurate perm) -elan. Fee r,-- �_' APPLICATION APPROVAL This application is not a permit until Signed by the Building Official or his Dep- uty; and fees are paid, and receipt is ac- knowledged in space provided. Df CTO R'e SIGNATURE /) DAT�� INSPECTOR