750470.pdfI "L G 3 - 01 - 3954
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NEW RESIDENTIAL LINE
4
PROPOSED USE
NON-RESIDENTIAL ❑ SIGN
PLUMBING
CITY OF
ADD
WAI.A7.INING
EDOND
EDDEMOLISH
750470
1
ALTER E ❑
E.CAVATon
ZONE^
BUILDING DEPARTMENT AppllcantFlu L_/ NUMBER
(ENC. .......... Ft.)
❑ FILL
ADDRESS
PERMIT APPLICATION Inside Heavy (Anes JOB ADDRESS - 7
MOVE El swim
REPAIR ❑
NAME (OR NAME OF BUSINESS) _
H ^/ T' ACTUAL •'�
PEILAfItlIBLE
'�
INS POOL
/ z� cOVERAaELOT COVFSinaE 51
NUMBER OF STORIES NUMBER OF
N Ai—'A O ADDRE P' 1B E HE'IO,�ya' PSI pY�O IED HEIaH�. j
Cb
IIDIVA&ZAANG %
����+
L Yyo• � f " c✓Ivr C n =�S
'
UNITS
,� A E TSL ULDr�,'FtFI�
O rTUAI'r.�O
CITY TELIDP ONE NUMBER (t
SIGN
NATURE OF WORK TO BE DONE
f'(J
/Ch" , /s %y �f 1(RE�OUj14RE YAIt UB PROPOSED YARDH a
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F 1
f
F I 'VL t / w'1,1
.•AME i FRONT HIDE REAR FRONT HIDE REAR
1
'
RETAINING WALL
EOAI. LOT t'AKIA NCE OIi CON DIT {
F.HS Y H ONS F IIT NU
N —
DEPT. PROVA / DATE:
1
-
TELEPHONE NUMBER - ' �
tlT .ET R/ T
EXISTING STREET R/W ....I.r.. ...F"r. DEFICIENCY THIS PROPERTY
I
COMP. PLAN ST. R/W .........r.'..FT. ......... ...FT.
DEMOLITION
r 1 ti ti CIC wl i N (/ REMARKS
all Qh/ 3T'(ZEGi P<}P-F:t A/(,,r I-II'71 rEn a Q�••
ADDRE(HT— Z
W
t N .U.Kt Q CHEC B
%I SG
t'
7
3 1 PC I C At L.I%•` Y ✓/
HONID N MDF.R
PRE -MOVE INSPECTION —
� CITY TE 1
J
C IIt
V .. l r f / r.......,...., ..,mo . incvuc vrrvnMET.a12E I SERVICE 812E I CLEARANCE I CHECKED 8 I M
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I "L G 3 - 01 - 3954
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P.(I �. $ •� S /�i C C L r h / S/ � c+r
NEW RESIDENTIAL LINE
4
PROPOSED USE
NON-RESIDENTIAL ❑ SIGN
PLUMBING
CITY OF
ADD
WAI.A7.INING
EDOND
EDDEMOLISH
PLAN (Ipdicafo
Building setback., u tuns .rescue)
ALTER E ❑
E.CAVATon
Thls Penult ..".workto be done on prlvnte property ONLY.
(ENC. .......... Ft.)
❑ FILL
Any C...lrucllmt on file public domain (curb., sidewalks, driveways,
MOVE El swim
REPAIR ❑
.) marquee., etc.) 11111 regWr...,.ate permission.
l
INS POOL
FENCE
NUMBER OF STORIES NUMBER OF
i
IIDIVA&ZAANG %
'
UNITS
.. ...
SIGN
NATURE OF WORK TO BE DONE
f
F I 'VL t / w'1,1
PE CONNECTION (VERIFIED BY
RC. TEST PERMIT NUMBER
MARKS
3Ewelt5 Mar Ada1LAt:^C
rnNE I TY�CTRUCTION STREET IMP OVIO�
LI YES NO
ECIAL INSPECTOR REQUIRED (OCCUPANCY GROUP
YES NO
AN C BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04.
M 1 S pp
_ Valuation Fee
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P.(I �. $ •� S /�i C C L r h / S/ � c+r
Plan Check No.,T..Y......{
DUILDINC
4
PROPOSED USE
DIR C OR'S SIONATU
C
PLUMBING
CITY OF
EDOND
QPLOT
PLAN (Ipdicafo
Building setback., u tuns .rescue)
HEAT & GAS LINE � r
Thls Penult ..".workto be done on prlvnte property ONLY.
Any C...lrucllmt on file public domain (curb., sidewalks, driveways,
FILE
.) marquee., etc.) 11111 regWr...,.ate permission.
l
FENCE
i
—
I -
.. ...
SIGN
RETAINING WALL
N —
1
-
I SWIMMING POOL
I
DEMOLITION
PRE -MOVE INSPECTION —
EXCAVATION OR FILL
A7,6,0
wj/- '60
it
TOTAL AMOUNT DUE
I heresy aclmowledgo that I have read lhle application; that the In-
tormntlon given 1. correct: and that I am the owner, or the duty author-
Ized agent of the owner. I agree to comply with City and .Lata law. r.gu- ATTENTION APPLICATION APPROVAL
letting at
and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington THUS PERMIT This application is not a permit until
relating to workmen'. Compensation Iasurnmen. AUTHORIZES signed by the Building Official or his Dep -
ONLY TILE
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED uty: and fees are paid, and receipt is ac -
shall be completed In ninety days•, MOVED -IN BUILDINGS .hall be cam- knowledged in space provided.
piled In nix months.)
tl1O[jATU1iF: (OlYNER Q�t AGENT) DATE S10NE!%
J /DEPARTMENT
/ fo /l S
INSPECTION
DIR C OR'S SIONATU
C
J
CITY OF
EDOND
OTE: Applicant Subject to Plan Check Fee
77 2525
77
Thls Penult ..".workto be done on prlvnte property ONLY.
Any C...lrucllmt on file public domain (curb., sidewalks, driveways,
FILE
.) marquee., etc.) 11111 regWr...,.ate permission.
l
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