750474.pdfU ' r'✓'(o tf
W
O J
NEW I[_] -RESIDENTIAL ❑ LANE
❑MDN-RESIDENTIAL ❑SIGN
❑ ADO ❑
....LIS. ❑ R TAINING
❑ ALTER ❑ ORO F1 LL ❑ FENCE X—�
❑ REPAIR O NPMOVE POOL
NUMBER OF STORIES NUMBER OF �i
NATURE
%/' DWELLING
UNITS
NAT R,E ar- WORK TO BE DONE/
/Yr<'k C"ch C, ;,/ V/.tc /-/D /2
Z v
O n L, / ` /i
6 PLOT PLAN INDICATE BUILDING SETBACKS,
� ABUTTING STREETS)
o
O /
SEPTIC SYSTEM
APPVD BY CITY ENG.
❑ YES
❑ NO
P R T NUMB W
W
tormntlon given 1s correct: and that I — We owner, or the duly author-
N
i
BUILDING DEPARTMENT
ApplicentFill
inside Heavy Lines
Z°"E NUMBER
SERVICE SIZE
t
PERMIT APPLICATION
toting construction; and In doing the work authorised no person
will be employed /n vtolallaa of the I.abor Code of the Btale of Weahlogto.
,DB
ADDRESS
This application Is not a permit until
s B, pP
NAME (OR NAME OF BUSINESS)
signed by the Building Official or his Dep -
5
NOTE: Permit limit One Your f6.eept DEMOLITIONS whleh
� Al �'t /1 C ' / 6/ ",',/
LE i;, ,r T
❑ NO
LOT AREA
I+
BV ODIV ISION NO.
WORK NOTED
CONSTRU ON C E
E
W
MAILING ADDRESS
C�I/Y ES
(GNAT RE OWNER O AGENT)
D
Z^^
`/ C J --7y
-3'-3
VARIANCfi OR
COND. USE NO.
ADD NO.
7;ESIGN
j
A
O
10
CITY
ELEPHONE NUMBER
/ C
EDMONDS
DATE
B
=
/Ipplicalit
PROPOSED YARDS I
O\V
HEIGHT`
2�
.AMC
FRONT�g SIDE REAR
y
l
Y
I.
ALLOWABLE
SIGN AREA
PROPOSED
SIGN AREA
i
Su
F
ADDRESS
OTHER
REQUIREMENTS ' I+
U
a:CITY
C
TELEPHONE NUMBER
PLANNING EPT. APPROVAL DATE
NAME
STREET R/W
EXISTING STREET RM(01�0 FT. DEFICIENCY THIS PROPERTY
O
ADDRESS
COMP. PLAN ST. R/W(' �(,Q FT. D FT.
4
/
r -� 1"
D
F
CITY
TELEPHONE NUMBER
REMARKS
Driveway slopes not to exceed those
C
'/
'/
C ECK
BY
W
U
STATE LICENSE NVMBER
CITY LICENSE NUMBER
Z
— ���/�
D
Z
oZ2?—off
Legal Description of Property (Show Below
Or Attach Four Copies)
STREET AND/OR UTILITY ❑ YES
W
U� T 3
WORK REQ'D ❑ NO
Z
O
4 o %
/'AlWIRING
/1,-
UNDERGROUND ❑ YES
REQ'D AND
FTYPE
(1 t-- Cr I , -
CONNECTION VERIFIED Y
e,
f /
U ' r'✓'(o tf
W
O J
NEW I[_] -RESIDENTIAL ❑ LANE
❑MDN-RESIDENTIAL ❑SIGN
❑ ADO ❑
....LIS. ❑ R TAINING
❑ ALTER ❑ ORO F1 LL ❑ FENCE X—�
❑ REPAIR O NPMOVE POOL
NUMBER OF STORIES NUMBER OF �i
NATURE
%/' DWELLING
UNITS
NAT R,E ar- WORK TO BE DONE/
/Yr<'k C"ch C, ;,/ V/.tc /-/D /2
Z v
O n L, / ` /i
6 PLOT PLAN INDICATE BUILDING SETBACKS,
� ABUTTING STREETS)
o
O /
SEPTIC SYSTEM
APPVD BY CITY ENG.
❑ YES
❑ NO
P R T NUMB W
W
tormntlon given 1s correct: and that I — We owner, or the duly author-
N
REMARKS
METER SIZE
SERVICE SIZE
CLEARANCE
CH ED
toting construction; and In doing the work authorised no person
will be employed /n vtolallaa of the I.abor Code of the Btale of Weahlogto.
THIS PERMIT
This application Is not a permit until
s B, pP
W
AUT HORIZES
signed by the Building Official or his Dep -
,
NOTE: Permit limit One Your f6.eept DEMOLITIONS whleh
F
Q
R;7R S
3
FIRE ZONEYPE
WORK NOTED
CONSTRU ON C E
-
pletcd In s1. month..l
�P� ir,de, 9.7 JV
PLAN CHECK
NO.
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
EA
TH
OF
VALUATION
r' H
TED IN THE CITY o
CAL SALES TAX
04 Z
D
J
m
I hereby acknowledge that I have read this npplleatlon; that the In•
TOTAL AMOUNT DUE
.f=
tormntlon given 1s correct: and that I — We owner, or the duly author-
lned agent of the owner. I agree to comply with city and date law. reg.•
thereby,
ATTENTION
APPLICATION APPROVAL
'
toting construction; and In doing the work authorised no person
will be employed /n vtolallaa of the I.abor Code of the Btale of Weahlogto.
THIS PERMIT
This application Is not a permit until
s B, pP
relating to workmen's compensation lasuranLa
AUT HORIZES
signed by the Building Official or his Dep -
,
NOTE: Permit limit One Your f6.eept DEMOLITIONS whleh
ONLY THE
uty; and fees Bre paid, and receipt is Be-
.hall ba completed In nW.ty days; hfoVED-IN BUILDINGS shall be nom•
WORK NOTED
knowledged in space provided.
-
pletcd In s1. month..l
INSPECTION
(GNAT RE OWNER O AGENT)
D
DEPARTMENTDI
R' NAT
7;ESIGN
j
CITY OF
'
NOTE: Sub%ecr to Plat C7leck Fee
EDMONDS
DATE
---
/Ipplicalit
775-2525
This Permit covers work to ba done on private property ONLY.
on the domain I. sidewalks sidewalks, driveways,
ORIGINAL •file YELLOW - b�spec for
Any construction public
marquees, pts.) will require separate permission.
PINK - Owner COLD • Aa>es[a'r
J
VALUATION FEE
�- BUILDING DEPARTMENT
Applicant Fill
Z°NE f 5 iK�. NUMBER i
17
PERMIT APPLICATION
Inside Heavy Lines
JOB y<,
M ABUTTI G TIYE675j_
BUILDING
/�
U
N
W
PLUMBING
ADDRESS
D 1
to
HEAT & GAS LINE
NAME (OR NAME OF BUSINESS)/Iles•
-" (j (.I�`tl.(,. C•' ✓,
FENCE
� �!'/
LEGAL.LOT
LOT AREA
SUBDIVISION NO,
RETAINING WALL
E
SWIMMING POOL
DYES ❑ NO
'�����
/ ( •)_ [t -
W
ZJ
MAILING ADDRESS
-•- -
VARIANCE OR
formation given Is correct; and that I em the owner, or the duly author-
ADB NO.
;O
�' /�/ •. �/� __ �
COND. USE NO,
'
lating construction; and In doing the work authorised person
x111 be employed In violation of the Labor Code of the State of Washington
THIS PERMIT
This application is not a Perinit until
CITY
TELEPHONE NUMBER
AUTHORIZES
aligned by the Building Official or his Dep -
Z
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
I
l ,,/, PI r7 ;/j
% .. 1 J
PROPOSED YARDS11
SIDE dV REAAy7�/
HEIGHT
Z ':
!
pleled In eta months.)
��
NA
FRONT��
SIGNATURE OWNER OR AGENT) DATE SIGNED
< 1
OIRECTOR'S SIGNATURE I
ALLOWABLE
PROPOSED
y 1
ED MONDS
1-
SIGN AREA
SIGN AREA
I
U
W
F
ADDRESS
• i
OTHER
Q
marquees, atc.) will require separate permission.
U
REQUIREMENTS �r(
4,'JI �� . .,.41,/ • �"'� J�Vl
�J l
E CITY
TELEPHONE NUMBER
R
PLANNING APPROVAL DATE
.D13PlT.
`_.j ,l� i / y
'w.,
NAME
/.. /
1, L„il>�✓�L._
STREET R"/
EXISTING STREET R/WC(bFT, DEFICIENCY THIS PROPERTY
!!
COMP. PLAN ST. R/W (j,.1�(.; (1 FT, FT.
1
I
I-
G
O ADDRESS
U
Iti'
U
/ '
K CITY
TELEPHONE NUMBER
REMARKS
Ily^_" ,lopeq not: to (:):CI'.eil 'I hos,-
I. i (
..
R ..
U STATE LICENSE NUMBER
CITY LICENSE NUMBER
CHECKED BY
W
Legal Description of Property (Show Below
or Attach Four Copies)
5T 6tJ O 1 T O YES
W ( .
�.}�'
(I �'
WORK R
�. ,.%T- G�)ii �l `J' 'J
UNDERGROUND ❑
1 -
Z J
WIRING REQ'D
_
TYPE CONNECTION VE F
6
1,.
U r.. r. '/ Y•-'M"Q !%:1 /e Y/ T�(`/e' Cr
❑YES
PERMTNUMBER
N
W
SEPTIC SYSTEM
\ (
3
APPVD BY CITY ENG. ❑ NO
W I
W
I
J 'i� i 1./.'f%!9 �- !.%: '7 h
REMARKS
Q �
O
'
1
W
J
METER SIZE
SERVICESIZE
CLEARANCE
CHECKED BY
alal
REMARKS
3
\/ NEW
'❑ RESIDENTIAL
❑ GAS
LINE
FIRE ZONE TYPE OF CONSTRUCTION CODE'
❑ NON-RESIDENTIAL
❑SIGN
l
ADD
❑DEMOLISH ❑WALLINING
SPECIALINSPECTOR
REQUIRED
AREA •
•�
OCCUPANCY
GROUP _-. !
OCCUPANT
LOAD
,.
❑ ❑-fe0
L-•
F
❑EXCAVATE FENCE
ALTER ❑ OR FILL ❑ (� X FT)
YES-
PLAN CHECKED' BY
THIS SITE
IS LOCATED IN THE
CITY
W
E]
OF EDMONDS. LOCAL SALES TAX
D
REPAIR E]NSPPRE-MOVE ❑SWIM POOL
''�/T-'f,%''�!/ HOU DBE
Z
NUMBER OF STORIES
NUMBER OF
REMARKS
/i
,'I 1 fJ:l '/J�.1%
G
DWELLING
UNITS
„/ `.!
J-
7
m
NATURE OF WORK TO BE DONE
J
VALUATION FEE
PROPOSED USE
Z
PLAN CHECK
17
M1 PLOT PLAN iN DICAT I prI 5 BACKS,
,`
M ABUTTI G TIYE675j_
BUILDING
/�
U
N
W
PLUMBING
,
D 1
to
HEAT & GAS LINE
FENCE
SIGN
'
RETAINING WALL
SWIMMING POOL
/ ( •)_ [t -
TOTAL AMOUNT DUE
I hereby acknowledge thnt I have rend this application; that the In-
formation given Is correct; and that I em the owner, or the duly author-
ized agent of the owner. I ogres to comply with city and state Iaws ragu•
thereby, no
ATTENTION
APPLICATION APPROVAL
'
lating construction; and In doing the work authorised person
x111 be employed In violation of the Labor Code of the State of Washington
THIS PERMIT
This application is not a Perinit until
relating to Workmen's Compensation Insurance,
AUTHORIZES
aligned by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
Uty; and fees are paid, and receipt is ac -
uty; s all fesed
shall be completed In ninety days; MOVED -IN BDILDINGS shall be cum-
WORK NOTED
space provided.
pleled In eta months.)
INSPECTION
SIGNATURE OWNER OR AGENT) DATE SIGNED
DEPARTMENT
OIRECTOR'S SIGNATURE I
CITY OF
-
ED MONDS
DATE
NOTE: Applicant Subject to Plan Check Fee
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 liunectar
'.
f
marquees, atc.) will require separate permission.
PINK - Owner GOLD- Asse5,o, i
~--_-.-�--___`=-_-�-�-,----'-,'--- -�,--z--�"-------`------