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BUILDING DEPARTMENT gppiieant Fill
USE
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PERMIT (1AC71"1
NUMBER 750480
PERMIT APPLICATION Inside Heavy Lines
ADDRESS
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NAME
(OR NAME OF BU SIN E551
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LEGAL OT LOT AREAIBOIV
ISION NO.
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MAILING
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330 9 6�r1 LV-
VARIANCE OR
GOND, USE NO.
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TELEPHONE NUMBER
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PROPOSED YARDS
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SIDE
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NAME
ALLOWABLE
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UCITY
TELEPHONE NUMBER'
PLANNINr= near. APPROVAL O`A-WE
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- to _
NAME
Sr J.
STREET R/W
EXISTING STREET R/W
FT. DEFICIENCY THIS PROPERTY
0 ADDRESS
his T
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COMP. PLAN ST. R/W
FT. FT.
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REMARKS
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Ic CITY
TELEPHONE NUMBER
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CH ED BY
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STATE LICENSE MBE-
CITY LICENSE NUMBER
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Legal Description of Property (Show Below
or Attach Four Copies)
STREET AND/OR UTILITY
❑ Y
WORK REQ'D
❑ NO�
UNDERGROUND
❑ YES
WIRING REQ'D
0<,N0
o
SF[ A?TA GH)zt
VERIFIED Y
6
TYPE CONNECTION
EE
E3 YES
P MIT NUMBER
W
at
SEPTIC SYSTEM
APPVD BY CITY ENG.
❑ NO
W
J
REMARKS
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I
W
J
METER 512E
SERVICE SIZE
CLEARANCE
CHE BY
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W
REMARKS
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❑NEW L_I RESIDENTIAL LINE
E�
FIRE ZONE TYPE OF CONSTR UCTI
CODE/))////��//��
❑ NON-RESIDENTIAL ❑ SIGN
A.
CIAL INSPECTOR A
J
1
EA
OCCUPANCY OCCUPANT
RETAINING
❑ DEMOLISH ❑WALL
SP
REQUIRED
GROUPr / LOAD
❑ EXCAVATE FENCE
ALTER []EXCAVATE
OR FILL ❑ (� X FTI
❑ YES O
_VE
F•
PLAN CHEC E BY
THIS SITE
IS LOCATED IN THE CITY
W
OFOUDMONDS. LOCAL SALES TX
REPAIR PRE-M
❑ ❑OVE
INSP. ❑PO`
K
13
+I
NUMBER OF STORIES
NUMBER OF
ARK
-• �O�tI
jy� �`72
0
DWELLING
UNITS
m
-
NATURE OF WORK TO BE DONE
C RPo2T
I i
VALUATION FEE
PROPOSED USE
PLAN CHECK
NO.
pF,
PLOT PLAN INDICATE BUILDING SETBACKS.
aG QU
ABUTTING STREETS)
BUILDING
N
to
PLUMBING
f
D
0
HEAT & GAS LINE
0
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
TOTAL AMOUNT DUE
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I hereby acknowledge that I have read this application; that the in-
. e...eet; and that I am the owner, or the duly author-
formation given i.
Ired agent of the owner. I agree to Comply with city and state laws reg..
thereby, no
ATTENTION
APPLICATION APPROVAL
lating construetlon; and In doing the work authorized person
will be employed In violation of the Labor Code of lhs stale or Wa.hington
THIS PERMIT
This application Is not a permit until
relating to Workmen's ComP.thut mt Insurance.
AUTHORIZES
Signed 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-
.hall be completed In ninety day., MOVED-IN BUILDINGS .hall be nom-
WORK NOTED
ltnowledged Space provided.
pleted In .Ix month..)
INSPECTION
SIGp` gTc�R IOWNER R AGE
DATE GNE
DEPARTMENT
IRE OR 51G UR
J �/�
CITYOF
1 `
EDM ONDS
DATE
NOTL, pplicant Subject to Plan Check ]-Tc
775.2525
This Permit Covers work to be done on private property ONLY,
on the domain Icurbs, sidewalks, driveways,
ORIGINAL - Fk YELLOW - Impec lar
Any construction public
marquees, etc.) will require separate permission,
PINK -Owner COLD - Av.e,ur
I
USE. PERMIT
BUILDING DEPARTMENT l gpplicant Fill ZD"E NUMBED
PERMIT APPLICATION inside Heavy Lines ,DB f 1
NAME (OR NAME OF BUSINESS; ,,^h ,� �� (/ / "' � ([•-+ LNC—', l •;. �1 ` ,
!-: LEGAL LOT LOT AREA _ SUBDIVISION NO,
to - ) fL ES ❑ NO
W MAILIN DRE55 '1
/ VARIANCE OR ADB NO.
.ZT,: CORD, USE NO.
O CITY ELEPHONE NUMBER D
PROPOSED YARDS �" HEIG YT Z
00'FRONT % t!� its, DE f `� REAR t'j z
NAME
ALLOWABLE PROPOSED ! I
SIGN AREA 5IGN AREA
U
W ADDRESS
OTHER
= REOUIREMENTB
U
0:CITY TELEPHONE NUMBER - V.'J'C.'�-d- G/`� �.✓,l.C/ orf is "1 1 I
C PLANNING DEPT. APPROVAL - DATE
1OhL11L/Iy c� -
' I
NAME - /
/ r STREET R/W
E .�7jY ri �1, LL - (,'I I rl t EXISTING STREET R/W FT. DEFICIENCY THIS PROPERTY l
O ADDRESS i
COMP. PLAN ST. R/W FT. FT. �
F CITY TELEPHON E NUMBER REMARKS Z
• 1`/ CHECKED BY W
G :� A771_ ._ i
U STATE LICENSE NUMBER CITY LICENSE NUMBER Z '
Legal Description of Property (Show Below or Attach Four Caples) STREET AND/OR UTILITY ❑ YES Id I
WORK REO'D ❑ NO
UNDERGROUND ❑ YES '
Z WIRING REQ'D "El \NO
H TYPE CONNECTION VERIFIED BY
West 139.66 ft. of the S 1/2 of tract /
U 6 an measuced along the s line Qf.tractin
❑ yE5 PERMIT NUMBER W
0 6 all in block 4 Lake Ballinger Land Co. APPY BYeE NG N W
N I
Q RE
O
W A AA 11
J
METER SIZE SE V C 1 C EA NC H
E
F
REMARKS 6
3
❑ NEW �,R EStOENT IAL L NE FIRE ZONE TYPE OF CONSTRUCTION CODE
!-
❑
ADD NON-RESIDENTIAL ❑ SIGN
/
RETAINING SPECIAL INSPECTOR AREA V OCCUPANCY OCCUPANT
❑ DEMOLISH ❑WALL REq UIRED GROUP r LOAD i
❑ ALTER ❑ ORFILL
❑ I ENCS X_FT C3 YES
CH ECK❑HD BY THIS SITE IS LOCATED IN THE CITY W
❑OF EDMONDS. LOCAL SALES TAX D
REPAIR PR-MOVE ❑POOL I'�'/" '/ SHO BE E i !
INSP. _
REMARKS
NUMBER-OF STORIESN UMBER OF f _ B
DWELLING
UNITS m
NATURE OF WORK TO BE DONE i
VALUATION FEE
PROPOSED USE PLAN CHECK
Z NO.
O
a PLOT PLAN INDICATE BUILDING SETBACKS,
C ABUTTING STREETS) BUILDING i• /---
U i
N PLUMBING
O
I
HEAT S, GAS LINE
0
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
I hereby acknowledge that I have read this application; that the In- TOTAL AMOUNT DUE
formation given Is correct; and that I am the owner• or the duly author-
Iced agent of the owner. I nares to comply with city and state taws regu- ATTENTION
lacing construction; and In doing the work alltharized thereby, no person APPLICATION APPROVAL
will be employed In violation at the Labor Code of the elate Of R'aabington THIS PERMIT
relating to Workman's CompensatlOo. Insurance. AUTHORIZES This application 1s not S permit until
ONLY THE signed by the Building Official or his Dep-
NOTE: Permit limit One Year (E—Pl. DEMOLITIONS which WORK NOTED nty; and fees are paid, and receipt is ac
shall be completed in ninety days: MOVED-IN BUILDINGS shall be nom-
Pieted In six months,) knowledged in space provided.
INSPECTION
JSIGNATURE IOW NER OR AGENT) DATE SIGNED DEPARTMENT DIREC.TORIS SIGNATURE
1 CITY OF
EDMONDS ATE:;
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 -Pile YELLOW -Inspector
marquees, otd.) will require separate permission. PINK - 0.ncr GOLD - nssesscr {f
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23309 76th W. West 139.66 feet of the South I- of tract 6 as mea-,,.
cured along the South line of tract 6 all in block 4 Lake Ball- *a
inger Land Company, subdivision #1 as per plat recorded in
volum 9 of plats on pages 57 and 58, Records of Snohomish
te of Washington.
jty}
Count , situate in the county of Snohomish, staj .
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LIEGAL DESCRIPTION
23309 76th W. West 139.66 feet of the South I- of tract 6 as mea-,,.
cured along the South line of tract 6 all in block 4 Lake Ball- *a
inger Land Company, subdivision #1 as per plat recorded in
volum 9 of plats on pages 57 and 58, Records of Snohomish
te of Washington.
jty}
Count , situate in the county of Snohomish, staj .