750436.pdfK
Ay/r /
C_-
STREET R/W
EXISTING STREET R/W./
-D FT. DEFICIENCY THIS PROPERTY
BUILDING DEPARTMENT Applicant Fill
USE
ZON $ NUM11BIR -750436
O
I-
U
COMP. PLAN ST. R/W J Y'�
PERMIT APPLICATION Inside Heavy Linos
❑ ADO
❑ ALTER
,De
ADDRESS-7/fiO
NAME (OR NAME OF BUSINESS)
CITY
W
/
A I-.7if L (_ Poll
L
LEG:i;LQT
* ES ❑ NO
LOT AREA
1 100 ��II
SUBDIVISION NO.
MAILING ADDRESS
OP.
Z
p
..J !1 D (i -' /_J
CITY ELEPHONE NUMBER
VARIANCE OR
GOND. USE NO,
ADB NO.
CITY LICENSE NUMBER
EA
,,r,J)1)7 C I,/ fl 5 �/ 7 ` / /� 3 `
/r // / O -J U
PROPOSED YARDS /J / /
FRONT SIDE / wZ REARJs�"
HEIGHT
_
NAME
or 't
I•
U
F
_
V VvN.R
ALLOWABLE
SIGN AREA
PROPOSED
SIGN AREA
ADDRESS
OTHER y
n ., V, -1w
Rr.U1REMENTS 6T' Q. 1/
{
=
U
R
PINK - COLD - A'
CITY
TELEPHONE NUMBER
WIRING REO'D ❑ NO
Q
PLANNING DEPT. APPROVAL DATE
NAME
K
Ay/r /
C_-
STREET R/W
EXISTING STREET R/W./
-D FT. DEFICIENCY THIS PROPERTY
NEW
ADDRESS
O
I-
U
COMP. PLAN ST. R/W J Y'�
A OFT. O FT.
Y
❑ ADO
❑ ALTER
¢
I,.
I,.
O
CITY
TELEPHONE NUMBER
REMARKS
REPAIR
F]INE-MOVE
pOOL
Driveway slope not to exceed those
OP.
U
inclicated on Standard UW9. HECBY
W ..
STATE LICENSE NUMBER
CITY LICENSE NUMBER
EA
DWELLING
�
No. 103
_
UNITS
or 't
Legal Description Of Property (Show Below or Attach Four Copies)
I!
STREET AND/OR UTILITY ❑ Y
WORK REO'D ❑ NO
_ /
�/�
`- ri D
rt ,.,t7s—
�w77t�'S'"a`
fi
{
UNDERGROUND ❑ YES
PINK - COLD - A'
7]
o
WIRING REO'D ❑ NO
E
U
Id0
Q
O
J
SEPTIC SYSTEM
APPVD BY CITY ENG.
O1
PLAN CHECK
NO,
3
3
NEW
-' RESIDENTIAL GAS
L NE
REM 5
FIRE.
T�
❑ ADO
❑ ALTER
❑ DEMOLISH ENTIAL ❑SIGNI�
RETAINING
❑ OOXRCF FILL ❑ i ENCS X—FT)
•\
SPECIAL REQUIRED INSPECTOR
13 YESNo
CHECKED BY
REPAIR
F]INE-MOVE
pOOL
xul.pTot2 b
OP.
REMARKS
NUMBER OF STORIES
NUMBER OF
UBC Ufa UM
!
EA
DWELLING
�
NATURE OF WORK
/
UNITS
- SHOULD El CIDE. 31
O1
PLAN CHECK
NO,
VERIFI
I '
E
Id
W
� I '
❑ YES P MIT NUMBER
❑ NO
HEAT & GAS LINE
i1ZE
E
CLEARANCal
CHEC ED
SWIMMING POOL
This application is not a permit Until
E
signed by the Building Official or his Dep -shall
ba completed In No<ly days; MOVED•IN BO1LDlN08 shell be coin•D
s
xul.pTot2 b
3
:ONSfRUfI
CON
CODE
`\\)
UBC Ufa UM
!
EA
OCCUPANCY OC UPANT
GROUP.F' LOAD
EDMONDS
In
0
THIS SITE IS LOCJ\A,TE IN THE CITY
OF EDMONDS. LOCAL SALES TAX
- SHOULD El CIDE. 31
O
0
\
_ /
? I
ORIGINAL - File YELLOW -Inspector
TO BE DONE
n I 5 i . dv 'L- s i . C /v C L- `JZ'tsa �c'd��
PROPOSED USE VALUATION'6
DUE
formation Is
I hereby acknowledge that I have reed tole application; that the In-rATTENTION
PLAN CHECK
NO,
E BUILDING SETBACKS,
ABUTTING
ABUTTING STREETS)
BUILDING Id'
D /
I
PLUMBING /7O AO
Ol. loo
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DUE
formation Is
I hereby acknowledge that I have reed tole application; that the In-rATTENTION
�/ (,/t/ / f / V
/
-
given correct; and that I am the owner, or the duly author-
Iced agent of the owner. I agree to comply with city and state lawn resin.
toting construction; and In doing the work aulhorlsed Marshy. no personAPPLICATION
APPROVAL
will be employed In violation of the Labor Code of the State of WashingtonTr0lating to Workmen's Compen.atlen Insurance.
This application is not a permit Until
S
NOTE: Permit Limit One Your (Eicept DEMOLITIONS which
signed by the Building Official or his Dep -shall
ba completed In No<ly days; MOVED•IN BO1LDlN08 shell be coin•D
Dty; and fees are paid, and receipt is eC-
plcted In .Ia month..)
knowledged in space provided.
IGNATURE (OWNER OR AGENT)DATE SIGNED INSPECTION
DEPARTMENT
-
DIRECT SIG A
]]
J7 /�!/r' lG'-LLI=.�'Vi% /•"�/�c� CITY OF
EDMONDS
DATE
`�
NOTE: Applicant Subject to Plan C71eck Fee
775-2525
This Permit covers work to he done on private pproperty ONLY.
_ /
- ,
ORIGINAL - File YELLOW -Inspector
Any construction on the public domain (curbs, ddewalks, drlveways,
{
marquees, etc,) will require separate permission. _
PINK - COLD - A'
7]