750418.pdfi
BUILDING DEPARTMENT Applicant Fill
USE PERMIT NUMBER 750418
ZONE
`�--
PERMIT APPLICATION Inside Heavy Lines
jog
ADDRESS� - r� /
D OR ESS ��
I r7
NAME (OR AME O BVSI E55)
� / /
LEGAL OT
❑
LOT AREA
SUBDIVISION NO.
-/
pj
MAILING AD Ess
YES NO
"a¢D
ADB
NO,
/yam
Z
OGOND.
-
VARIANCE OR
USE NO,
)
CITE
EPHONE NUMBER
G
2 &
PROPOSED YARDS ,
f (�
HEIGHT'
Z
NAME
FRONT SIDE REAR
15
ALLOWABLE PROPOSED
J
a'
1-
U
SIGN AREA
SIGN AREA
-
F
ADDRESS
OTHER n
0
=
yyy... ..
REOUIREMENTs``/r rt M -II Le
���WNN
U
It
CITY
TELEPHONE NUMBER
W 11-�L-�^'
Q
PLANNING PT. APPROVAL DATE
NAME
STREET R
EXISTING STREET R/W FT. DEFICIENCY THIS PROPERTY
e:
O
ADDRESS
----
COMP. PLAN ST. R/W FT. FT.
j
-
C
CITY
TELEPHONE NUMBER
REMARKS
B
Z
Z
UCHECKED
BY
W j
STATE LICENSE NUMBER
CITY LICENSE NUMBER
'��
Z
23 - o - 1 (0
Legal Description of Property (Show Below
or Attach Four Copies)
STREET AND/OR UTILITY ❑ YES
w :
WORK REQ'D ❑ NO
UNDERGROUND ❑ YES
Z
WIRING REQ'D C1 NO
o
F•
yI
O - 02
TYPE CONNECTION VERIFIED BY
'
6
V
_
d
❑YES PERMIT
NUMBER
W
SEPTIC SYSTEM
D
APPVD BY CITY ENG. ❑ NO
alb
N
,
J
Q
REMARKS
�
W
J
METER SIZE
SERVICE 512E
CLEARANCE
CHECKED BY
R
REMARKS
W
G
I
i
❑ NEW RESIDENTIAL❑ LIN NE
3 �
�
FIRE ZONE TYPE OF CONST VCTION CODE
� 2
1—,( ❑ NON-RESIDENTIAL ❑SIGN
/�
��
I VI ADO ❑
DEMOLISH El RAL NTNG
REOUTSPECIARED S,P�E C�TOR gRE%An
ANT
GROUPANCY LOA
ALTER EXCAVATE FENCE
❑ OR FILL ❑ (_ X_FT)
❑ YES DIN. (7 J
pLgN cHE K av THIS SITE
IS LOCATED IN THE CITY
F'
rd
.-MOVE
EJEJR
OF EDMONDS. LOCAL SALES TAX
D
'
REPAIR ❑ OPOI L
$HOU D E
MAR
Z
i
NUMBER OF STORIES
NUMBER OF
DWELLING
/
d /C.'�G/ �GN •-K/ (/ V
J
UNITS
e1
NATU E F (YORK T BE DONE
-`/,(A-
;
VALUATION FEE
Z
PROPOSED USE
PLAN CHECK
O
NO.
y
PLOT PLAN INDICATE BUILDING SETBACKS,
iTR EETS)
/ 0.006
BUILDING
17—
fPLUMBING
R
ABUTTrI-NG
L7
PLUMBING
D
-
m
O
HEAT & GAS LINE
FENCE
SIGN
1
RETAINING WALL
SWIMMING POOL
TOTAL AMOUNT DUE / 7
I hereby acknowledse that I have read this application; that the In-
forma""glue' Ie correct; and that I ace, the owner, or the duly author-
Ized at of the owner. I agree to comply with city and state Iaws "so-
gen
lating construction; and In, doing the work authorized thereby, rep "so -
ATTENTION
APPLICATION APPROVAL
will be employed In Noletlon or Ne Labor Code of the State of Washtagton
THIS PERMIT
This application is not a permit until
relating to Workmen's Compene.tton Insurebes.
AUTHORIZES
signed by the Building Official or his Dep
-
NOTE: Permit Limit One Year (Except DEMOLITIONS wbich
ONLY THE
WORK NOTED utyi and fees are paid, and receipt is Be
shall be completed In ninety days; MOVED -IN BUILDINGS shell he cnm-
knowledged in space provided.
pletcd In six months.)
INSPECTION
'
SIGNATURE I NCR OR AG N ) DATE SIGNED
DEPARTMENT IRE
OF
WIGNTURECITY
EDMONDSDATE5n
C71cck a
775-25257
This Permit covers work to be done an private �raperty ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
ORIGINAL • F0,YELLOW • Inspector
marquees, etc.) will require separate permission.
PINK . Uv.ner COLD - A'wssar
y
.. _. _... ,.. _. .. . -. ---. .._. r ..... .. _ _ ... ..
... .. ...._.
.. .. .._
_._—_
e
�-
USE
ZONE :/
PERMIT
NUMBER 15D41 -0
I
BUILDING DEPARTMENT applicant Fill
L,r\
t J `!`•).
~-�
PERMIT APPLICATION inside Heavy Lines
jos^
__.,I,i-
��
I
-
ADDRESS -�' 1
— n•l ^9 __. / 14
1
NAME (OR NAME 0',F1 BUST E551+y� ,
,�` l
c',J ;+.�
v / '�V 1. •;J-�
r'
\_
LEGAL LOT
YES ❑ NO
LOT AREA
SUBDIVISION NO.
E
W
MAILING AO ESS
T
t
Z
3
— /
VARIANCE OR
GOND. USE NO.
ADB NO.
O
S
CITY
EPHONE NUMBER
t%
--{ IJ
'L (L(u.l
��� — 17 /
P
PROPOSED YARDS /
:^
r/ rl HEIGHT /
REAR •Y:I*
Z
NAME
FRONT
SIDE`
I/a%
<
,
I
ALLOWABLE
PROPOSED
-I
e'
F
U
SIGN AREA
SIGN AREA
1
W
ADDRESS
Z
OTHER
REQUIREMENTS
E
CITY TELEPHONE NUMBER
PLANNING DEPT. APPROVAL _ DATE
`�.. rZ '. -I
NAME ..`)
M. Q
STREET R[W
EXISTING STREET R/W
FT. DEFICIENCY THIS PROPERTY
E
I-
ADDRESS
COMP. PLAN ST. R/W
FT. FT.
U
REMAR
O
ECITY
TELEPHONE NUMBER
I.
Z
_
E
V
D
CHECKED BY
al
W
2
STATE LICENSE NUMBER
CITY LICENSE NUMBER
Legal Description of Property (Show Below or Attach Four Copies)
STREET AND/OR UTIL E D
11WORK REQ'D NO
w
UNDERGROUND
❑ YES
Z
WIRING REQ•D
13NO
F..
TYPE CONNECTION
VERIFIED BY
6
VU1^�^•^
`
W
❑ YES PERMIT
NUMBER
Id
-
SEPTIC SYSTEM
I
3.
D
APPVD BY CITY ENG.
❑ NO
W
J
Q
REMARKS
N
�
W
J
METER SIZE
SERVICE SIZE CLEARANCE
CHECK EO BY
I
E
W
I
F
REMARKS
3
❑ NEW RESIDENTIALElLGAS'
INE
FIRE ZONE TYPE OF CONSTRVCTION CODE
,
❑ NON-RESIDENTIAL ❑ SIGN
/,�, -.�
i - �•
•LOADPANT
1
'
LO'' ADO ❑DEMOLISH
NTNG
REOSPECUIREO SPECTOR
AREA,
UPANCY
GROCCOUP
WALL
❑ YES [],No
J-
l-
❑ EXCAVATE FENCE
ALTER
E]OR FILL ❑ (_ X_FT)
PLAN CHECKED BY
THIS
SITE IS LOCATED IN THE CITY
W
❑ REPAIR PRE-MOVE wim
Els
%�%�,
OF EDMONDS. LOCAL SALES TAX
HOU DE
SH..,. E
D
D
INSP. POOL
REMARKS'•
Z
NUMBER OF STORIES
NUMBER OF
'�
J
'•
0
1
DWELLING
UNITS
j;% ii
, f';:: p .l
70
NATURE OF WORK TO BE DONE
(
'
VALUATION FEE
Z
PROPOSED USE
PLAN CHECK
O
NO.
6
PLOT PLANINDICAB lJ F SETBACKS,
E
ABUY•TI 5 - ETS)
BUILDING
U
_
..
W
lu
.
PLUMBING
t
D
m
0
HEAT & GAS LINE
I
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
I
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In.
m
formation given Is correct; and that I athe owner, or the duly author-
Ired agent of the owner. I agree to comply with city and state laws regu-
la[Ing Coand In doing the work authorized lhareby, no person
ATTENTION
APPLICATION APPROVAL
'
will be employed In Violation of the Labor Code Of the elate Of WYhlagt0n
Compensation Insurance.
THIS PERMIT
This application Is not a permit until
relating to Workmen's
NOTE: Permit limit One Year (E—pt DEMOLITIONs which
AUTHORIZES
ONLY THE
signed by the Building Official or his Dep-
shall he completed to ninety day.; MOVED-IN BUILDINGS shall be coni-
WORK NOTED
utyc and fees are paid, and receipt Is ac-
Pleled In eta month.,)
ltnowledged in apace provided.
SIGNATURE (OWNER OR AG DATE SIGNED
1 F)
{
INSPECTION
DEPARTMENT
DIRECTOR'S SIGNATUREr
CITY OF
'f
EDMON)S
NQrl7i: Applicant S(irb}eci to Plan Check Jee
DATEt
-%
775-2525
�,:...
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
ORIGINAL • file YELLOW • Illspeclor
marquees, etc.) will require separate permission.
PINK. Owner GOLD-Assessor
i
Q
y
,
_
,
Q