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750384.pdfII CU ,fjj T IZ ECO (Z d S AS/1S r,4 7-t T AIS SIL ��LAI V/ 3 � GASElNEW {U REBIDEN TIAL L NE �J ❑NON-RESIDENTIAL ❑ SIGN ADD ❑ DEMOLISH ❑ RETAINING WALL ❑ ALTER ❑ ORCFILLTE ❑ FENCE IM REPAIR MOVE ❑PO INSPOL NUMBER OF,((STORIESNUMBER OF UNITS ING NATURE OF WORK TO BE DONE r p,J FIRE ZONE PLAN CHECK TYY=CVn�rt.,a..,v�. _ �6c. / �7_3 USE PERMIT J1j BUILDING DEPARTMENT Applicant Fill ZONE NUMBER 150384 SPECIAL INSPECTO REA OCCUPANCY OCCUPANT GROUP LOAD PERMIT APPLICATION inside Heavy Lines JOB REQUIRED ❑ YES NO ADDRESS NAME (OR NAME PLAN CHECK D Y THIS SITE IS LOCATED IN THE CITY o W ,1 ///I 1 m {� � `/ '-A REq SV BDIV S10N N0,OFBUSINES Q',�/o O / 1 yEW Z 3 OIWOD LING ADDRESS `� / }y I �I VARIANCE OR PDB NO. 1I th / L � j GOND. USE NO. { - d�/ V CITY ELEPHONE NUMBER iih----��� HEIGNT 2 I (^ O JE D M O N IJ S / - 3/ PROPOSED YAR/DJp a-4,3SIDE � / REARM - SIGN FRONT lY i NAME N, RETAINING WALL PROPOSED SIG NO AREA SIGN AREA I- U e0 Id F ADDRESS OTHER I Hereby acknowledge that I have rend this aDDllcallon; that Wa fn- formation given le correct; and that I am the owner, or the duty author- Z REQUIREMENTS I Ixed agent of the owner. I agree to eomD1Y with Illy sad stab lava rogu- doing the work authorized thereby, no person � CITY TELEPHONE NUMBER DATE P ANNING PT- APPRO AL D laling construction; and In x111 be employed In violation of the Labor Coda of the Stab or Waahfugton THIS PERMIT NAME �S L4�` .//''I� (/STREET 1� AS •I 'O 1/ i EXISTING STREET R/W FT. DEFICIENCY THIS PROPERTY I, ating la Workmen's Compensation Insurance. C I. F u ADDRESS EBS COMP. PLAN ST. R/W FT. FT. ( r•/ D NOTE: Prmit Limit One Year (Except DEMOLITIONS which 11ehnil 1 E I- GEL, CITY T ELEPHONE NUMBER REMARKS Z a W be completed In ninety days; h10VED-IN BB[LDINOS Shan be nom- Z D V C. D BV W STATE LICENSE NUMBER CITY LICENSE NUMBER �(/ ( Z L---'rl 'J 6 Z plcled Im elX monlha.) INSPECTION OR UTILITY ❑ YES W Legal Description of Property (Show Below or Attach Four Copies) STREET AND/OR -SIGNATURE (Ow A NT) D�A^�TE SIG DEPARTMENT WORK REO'D Cl No W ES_ - X07- 2-� UNDERGROUND ❑ YES ,ED (y (11 CITY OF �( r/r /�(� �^ ` WIRING REO'D ❑ NO �r1J 1 C l ! 1 + I lJf J, FQ F )Lo r 09, / TYPE CONNECTION VERIFIED BY NOTE Applicmu Subject to Plat: Check Fee 775-2525 Ul o T') r V �Q C IG l� LI YES PER UMBER VE This Permit covers work to be done on private property ONLY. the dome (curbs, sidewalks, driveways, N SEPTIC SYSTEM W APPVD BY CITY ENG. ❑ NO N D (= DMAXI h --],?/ 1.3 i SN 1a ISt-r-------- Any construction on public marquees, etc.) will require separate permission. II CU ,fjj T IZ ECO (Z d S AS/1S r,4 7-t T AIS SIL ��LAI V/ 3 � GASElNEW {U REBIDEN TIAL L NE �J ❑NON-RESIDENTIAL ❑ SIGN ADD ❑ DEMOLISH ❑ RETAINING WALL ❑ ALTER ❑ ORCFILLTE ❑ FENCE IM REPAIR MOVE ❑PO INSPOL NUMBER OF,((STORIESNUMBER OF UNITS ING NATURE OF WORK TO BE DONE r p,J FIRE ZONE PLAN CHECK TYY=CVn�rt.,a..,v�. _ �6c. / �7_3 SPECIAL INSPECTO REA OCCUPANCY OCCUPANT GROUP LOAD ,�(( 4 UD /L,,(JQ �U '� REQUIRED ❑ YES NO N PLAN CHECK D Y THIS SITE IS LOCATED IN THE CITY o W ,1 ///I 1 m {� � `/ OF EDMONDS. LOCAL SALES TAX O / 1 OU D BE D 1 d Z R ARKS r d�/ 0 SIGN RETAINING WALL SWIMMING POOL VALUATION FEE PROPOSED USE PLAN CHECK (� L- O LL PLOT PLAN INDILATE BUILDIN SETBACKS, BUILDING ,�(( 4 UD /L,,(JQ �U '� ABUTTING STREETS) E N PLUMBING W ,1 ///I 1 m {� � `/ HEAT & GAS LINE O / 1 , FENCE SIGN RETAINING WALL SWIMMING POOL e0 TOTAL AMOUNT DUE I Hereby acknowledge that I have rend this aDDllcallon; that Wa fn- formation given le correct; and that I am the owner, or the duty author- I Ixed agent of the owner. I agree to eomD1Y with Illy sad stab lava rogu- doing the work authorized thereby, no person ATTENTION APPLICATION APPROVAL laling construction; and In x111 be employed In violation of the Labor Coda of the Stab or Waahfugton THIS PERMIT This application 1s not a permit until I, ating la Workmen's Compensation Insurance. AUTHORIZES signed by the Building Official or his Dep - NOTE: Prmit Limit One Year (Except DEMOLITIONS which 11ehnil ONLY THE NOTED nLy; and fees are paid, and receipt is ac- be completed In ninety days; h10VED-IN BB[LDINOS Shan be nom- WORK knowledged in apace provided. plcled Im elX monlha.) INSPECTION -SIGNATURE (Ow A NT) D�A^�TE SIG DEPARTMENT D REC S IGNA USE ,ED (y (11 CITY OF ! 1 + I lJf J, EDM NDS 1 NOTE Applicmu Subject to Plat: Check Fee 775-2525 This Permit covers work to be done on private property ONLY. the dome (curbs, sidewalks, driveways, ORIGINAL - File YELLOW - hupeclor Any construction on public marquees, etc.) will require separate permission. PINK - Owner GOLD - A,v5ser