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750456.pdf( i BUILDING DEPARTMENT Applicant Fill ZONE C(+ PERMIT j5�}C}�jV l/�t ( BUILDING DEPARTMENT Applicant Fill ZONE C(+ PERMIT j5�}C}�jV l/�t PERMIT APPLICATION Inside Heavy Lines JOB ADDRESS /V NAME IDR NAME OF BUSINESS) { e: V IC HO LEGAL LOT w OT.AjR EA SUBOIV ISION NO, yEj ❑YES NO NIA MAILING ADD ESS VARIANCE AD' CORD, USE N NO. /t (�� .���� OZ Q CITY ELEPHONE NUMBER HLI U_ PROPOSED YARDS HEIGHJ FRONT SIDE REAR 25 1 r / Ma r4)- N N Q NAME U J 6 1 NO AREAE' a0 �] SED ♦�Q SI Np AREAit, �� eM -t L,�.1 W H V a ADDRESS OTHER REQUIREMENTS `1r_ X Ir ,,.e� y. ',. SL S V` -lO ro K/` o tler - CITY TELEPHONE NUMBER N ING DEPT, APPR AL DATE a �� (1V_ ' I NAME r S, �hs STREET R/W tt VVV EXISTING STREET R/W FT. DEFICIENCY THIS PROPERTY ADDRESS L3 Q.../ �✓'L O I. U COMP. PLAN IT. R/W FT. FT. QO E Z CITY / TE P ONE R REMA S lA� P RL SZ-At-r-qW a LOC9 yIO,�I D Sa �-f f l W r� aY` W STATE LICENSE NUMBER CITY LICENSE NUMBER CHE ED BY U W 2 ei3 W Leggi Description of Property(Show Below or Attach Four Copies) STREET AND/OR UTILITY ❑YES That portion of the N. 135 Ft of Tracts WORK RECI'D XiNO lying UNDERGROUND �ES Z D r r easterly of P.S.H. No. I; except the E. WIRING REWD ❑ NO TYPE CONNECTION VERIFIED BY L 130 ft of Said tract 2; excepi file 11. & 10 ft as conve ed for road under ❑ YES PERMIT NUMBER pGl Id W SEPTIC SYSTEM D AF #693550 APPVD BY CITY ENG. ❑ NO U3W1 J Q W REMARKS J METER 512E SERVICE SIZE CLEARANCE CHECKED BY W W r Q 3 Meda S1 tcW El REMARKS A ❑ NERESIDENTIAL -LA.'. ID FIRE E -PE OF CONST VCT N CODE NO N -RES ENTIAL 17 � ��� ❑ ADD a BETAALL SPECIAL INSPECTOR AREA REOUI RED , OCCUPANCY OCCUPANT ROU LOAD DEMOLISH RETAINING ❑ ❑ ALTER EXCAVATE FENCE ❑ OR FILL (- X_Frl ❑ YES NO M1 W PLAN CH EC D B THIS SITE IS LOCATED IN THE CITY EDMON DS. LOCAL SALES TAX HOULD ECODEDU REPAIR ❑PRE -MOVE WIM E] REPAIR D Os INSP. POOL Z REMARKS /1 D(� �I h-'( RIOT I F-0,3 IrU O J NUMBER OF STORIES NVMBER OF DWELLING UNITS NATURE OF WORK TO BE DONE DEr �V /-+`�.rT O� �\ IG�} 1pqY_C t �Ujjj�L�� 1 L `2 ,i 31'z8d VALUATION FEE PLAN CHECK - Z PROPOSED USE O N0. 11.1 y PLOT PLAN IN LATE BUILDING SETBACKS, BUTTING STREETS) BUILDING t 5iv PLUMBING C J. �I_� C`cs M IJv �--/ l�iJ HEAT S, GAS LINE _ U 1 t{CJS.0 — FENCE �r ogOSLej SIGN �� ©e D S, -re o425 SL�^J RETAINING WALL SWIMMING POOL I hereby acknowledge that I hove reed thls application; that the In- TOTAL AMOUNT DUE O t Iormntion given Is correct; and that I are the owner, or the duly author- Iced agent of the owner. 1 -gree to comply with city and elate I--$ rogu- ATTENTION and lett.. con"Me"on; and In doing the work authorised thereby, no person APPLICATION APPROVAL will be employed In of the Labor Code of the Slate of Washington THIS PERMIT to Workmen'a Compensation Insurance. This application is not a permit until relating AUTHORIZES NOTE: Permit Limit One Year (Except DEMOLITIONS whichONLY THE signed by the Building Official or his Dep - .halt be completed In nicety days; MOVED -IN BUILDINGS Abell be com- WORK NOTED utyi and fees are paid, and receipt Is Re- pleted In etc months.) knowledged In space provided. INSPECTION SIGNATUREWNER�AGENT) DATE SIGNED DEPARTMENT DIRECTO 51 N U CITY OF EDMONDS DATE J NOTE: Ap&Afrr Subject to Plan Check Fee 775-2525 — S This Permit covers work to be done on private property ONLY. Any Construction on the public domain (curbs, sidewalks, driveways, ORI NAL - I'de YELLOW - Inspector marquees, ate.l will require separate permission. PINK - 0.:r^i^r COLD - •\ .. ; r r _ _ d t _ - �', � � .. .- .., .. .. .. ., _ _ _ ...�� ....a..�.� . _ _ ... _ . �.a�, .. r