750414.pdfr 1
BUILDING DEPARTMENT Applicant Fill Zoe C NUM ITS %50� 14
PERMIT APPLICATION I Inside Heavy Lines AD CJD_ C
ADDRESS
NAME (OR NAME OF BUBINE68) ej��
Ie (� �� ./}-- , PERMI881BLF. ^/ ACTUAL I '
yo tel/ p �IIA.A� ^ J AJ LOT COVERAOEe LOT COVERAGE
MAILING ADDRESS PERMISSIBLE HEIGHT2� PItOPO EY HE1GH
_ 30 r �' TELEPHONE NUMBER UAL L TCAREA ^_ - _ `1 (] ` TO'AREJA �UUU7 ze !
CIT r —� 'ie%Sy! N> v' 1 T �V z
11J_ ftEQUIR D YAADB OPOShD YA19 p'
NAME FRONT _ S[DE HEFRDN SIDE REAR
F • c/
U LEGAL LO'f VARIANCE OR CONDITIONAL USE � '
W ADD EiYES NO PERMIT NUMBER h �. s I
G. A.FIr!VAL /^•'DATE:
C CITY TELEPHONE NUMBER `�-i
STREET R/WLI
a/// ♦L.AI'wW'r�-�-�//' / / /
_)3/7
) 3 l J EXISTING STREET R/W ............F7'. DEFICIENCY IHSH PROPERTY
NAME
COMP. PLAN 8T. R/W ............FT. ............FI'.
REMAIiRB •A,
Id ADDRESS x
CHECKED BY
CITY TELEPHONE NUMBER iJ
z tCr
O METER SIZE I SERVICE SIZE I CLEARANCE I CHECKED BY
U STATE LICENSE NUMBER CITY LICENSE NUMBER
f[C�r
REMARKS < I
Legal Description of Properly (.how Below or Attach Four Copies)
I
/I a TYPE CONNECTION VERIFIED BY
U Wl /1 PERC. TEST PERMIT NUMBER
W a REMARKS en
al FIREEJZjO�1� TYPE OF CO/N+B�TRI/�CTSON RR
IMPROVED
�� I S%C_Pti+ Kl YES ❑ NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GR—OUP
Apr .—�
NEW RESIDENTIAL LINE ❑PLAN CHECK XI3Y0•i,'
THIS SITE IS LOCATED IN THE CITY
NON-RE.IDENTIAL .ICN OF EDMONDS. LOCAL SALES TAX i
ADD RETAINING EMARK. SHOULD BE CODED 31.04.
R
El DEMOLISH
WALL
EJ ALTER ❑ ORFILL
EXCAVATE ❑ FEN C........... Ft.)
REPAIR ❑ PRE-MOVEOINSP. POOL
NUA1HCl; OF 8T01t1E8 NUMBEI; OF
DWELLING /
UNITS
NATURE OF WORK �TOf BE DONE Valuation Fee Receipt No. '
ja/. Q4, �I/V"' Plan Cheek No..................... .20
1
X01 BUILDING '
a, PROPOSED USE
PLUMBING
� PLOT PLAN (indicate Building setbacks, abutting streets) HEAT & GAS LINE
i
� FENCE
stcN � 0 Q 11� 2
tRETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE-MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE '/ 6, � C)
I hereby achnowledgo that I have rend this oPPllcatlon; tont the In-
formulion given Is correct; and that I am the owner, or the duly author.
Ized agent of the owner. 1 agree to comply with City and elate law. r.gu. ATTENTION APPLICATION APPROVAL
Inling construction; and In dolog the Work authorized thereby, no Verson
will be employed It% violation of No Labor Code of the State of Washington THIS PERMIT This application Is not a permit until
relating to Workmen's Compeneauoa Insurance. AUTHORIZE. signed by the Building Official or his Dep.
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS Which WORK NOTED utyi and fees are paid, and receipt Is ae-
eltoll be Completed In nloety days; MOVED-IN BUILDINGS Wl be cont- knowledged in space provided. ..
pleted In is ...the.)
H ATUttE (OWN 67 Olt GENT) DATE SIGNED INSPECTION DI"CTOWS a
DEPARTMENT
CITY OF
EDMONDS DATE t 1..
NOTE: A/pl iraut Subject to Plan Check Fre /
775.2525
Tkle 1'erntlt r vers work to be done un private Droperty ONLY.
Any construction Cn the public domain (curbs, sidewalks, driveways, FILE
mnrpucee, etc.)
will 1"tlro separate Permission.
1
/J
Plan Check No ....L..
1
., 7D
C
USE �j PERMIT 750414
B U I L D I N G DEPARTMENT
Applicant Fill
ZONE K C NUMBER
/ /
SPECIAL INSPECTOR REgUfI2ED
PERMIT APPLICATION
Inside Heavy Lines
I
JAGS �
ADDRESS
�i`�✓
El LINE
NAME (OR NAME OF DUBINESS)PER
/ +ttI� t' j 1
.G._.'L _i
tA, �r//��
I.OTCO
LOT ACOVERAGE 1` VERAGE
/ pm1
MAILING ADDRE88 fn� ,
CHECKED THIS SITE IS LOCATED IN THE CITY
TAX
PERMI88IIILE HEIGHT r-, / PROPOSED/HEIGHT(-..]�
❑
NON-RESIDENTIAL
SIGN
TO AL 1 REA
ADD
CITY
TELEPHONE NUMBER
UAL LO AREA
REMARKS
❑
D YARDS1 P OPOBED VARDH
WA LL
NAME ,-
1
FRONT HIDE REAR FRONT `BIDE REAR
{r
((�+o
J/� �I ����t�
n/U /
--..E`
U
L✓I V
ADDRESS
/(,/
SWIM
❑
LEGAL LOT VARIANCE OR CONDITIONAL
Q -YES ❑ NO PERMIT NUMBER
S
/
() J !�(�)_NNING
INSPASOVE
P r. _l l�.7
V
C
CITY
TELEPHONE. NUMBER
'APPROVAL
r 11 i •Ir
RETAINING WALL
�Jr
STREET R/l
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
NAME
_
COP. PLAN ST. R/W ............FT. ............FT. _
UNITS
/M
(i%'-r1QJ(J
REMARKS
tgd
{"
ADDRESS
Valuation
r CIIECKED DY
C`
r(`/rJ
I
CITY
TELEPHONE NUASDER
p
I
METER SIZE
I SERVICE BIZE I CLEARANCE
I CHECKED BY
/J
Ir
Plan Check No ....L..
., 7D
t —• i /�.
PQ YES 0 NO
✓
SPECIAL INSPECTOR REgUfI2ED
I OCCUPANCY GROUP
RESIDENTIALNEw
El LINE
NO
❑PLAN BY(�
t0yl
a, PROPOSED USE
CHECKED THIS SITE IS LOCATED IN THE CITY
TAX
❑
NON-RESIDENTIAL
SIGN
/(',(� SHOULD 6E CODED 31045ALE5
ADD
WING
❑
REMARKS
❑
DEMOLISH
WA LL
HEAT & GAB LINE
❑ ALTER
❑
OR FILLTE
E] PEN z..........Ft.)
REPAIR
SWIM
❑
FENCE
❑
INSPASOVE
POOL
SIGN
QUMBER OF STORIES
NUMBEROF
RETAINING WALL
DWELLING
I
_
UNITS
NATURE OF WORK TO DE DONE
SWIMMING POOL
Valuation
Fee
Recel
Ir
Plan Check No ....L..
., 7D
✓
BUILDING
t0yl
a, PROPOSED USE
PLUMBING
r�
O PLOT PLAN (Indlcnt¢ Hulldln e t k.D [tl 6 , streets)
HEAT & GAB LINE
21
FENCE
SIGN
RETAINING WALL
j
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
formation given 1. correct: and that I am the owner, or the duly author.
Seed agent of the owner. I agree to comply with City and statelaw. regu-
ATTENTION
APPLICATION APPROVAL
..ting construction; and In doing the work authorized thereby, no person
will bo employed In vlolatkm of the Labor Coda of the Stale of Wmhington
THUS PER511T
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 DE310TATIONS which
ONLY TILE
WORK NOTED
uty; and fees are paid, and receipt is Be
.hall be completed In ninety day.; MOVED -1N BUILDINGS shall be win-
knowledged in space provided.
pletcd In six months.)
SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DIRECTOR'S 81GNATUR E
-
r"
I
DEPARTMENT
•--f.l.�:!-d �,. �'_.�/I'�.J�t✓ ^�
'
CITY OF
EDNIOND$
DA
NOTE: Applicant Subject to Plan Check Fce
775.2525
f
This Permit cot'ers work In be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, drlveways,
INSPECTOR
-
marquees, e1..) will require separate permission.
I
e