750486.pdf,
❑ NEW
El
RESIDENTIAL
EIL NE
formation given Is correct; and that I am the owner, or the duly author-
❑
NON-RESIDENTIAL
❑ SIGN
❑ ADD
❑DEMOLISH
lets ng cenetructhm; and In doing the work authorlsed person
will be employed In violatt-A Of the Iabor Code Of the State Of W"Ifington
❑WALL NING
❑ ALTER
❑
ORCFILL TE
FENCE X_FT)
NOTE: Permit Limit One Year (Except DEMOLITIONS which
❑
Uty; and fees are paid, and receipt is ac-
^❑
wlm
POOL
REPAIR
knowledged in space provided,
INSP.
I 1
L_F
NUMBER OF STORIES
DATE SI N
NUMBER OF
R'(GNAT/t{,�/a1E•�
CITY OF
7J�EDMONDS
DWELLING
,
Subject to Plan ChCck ee
775.2525
UNITS
This Permit covers work to he done on private PProperty ONLY.
Any the domain (curbs, sidewalks, driveways,
—�
NATURE OF WORK TO skvoriE
ORIGINAL •File YELLOW - Inspeclor
Construction on public
marquees, ote.) will require separate permission.
PINK - Owner GOLD - Assessor
BUILDING DEPARTMENT
AppncantFII1
USE
ZONE
PERMIT -
NUMBER750486
..)
PERMIT APPLICATION
(oxide Heayy L.nes
JOe
ADDRESS
3
NA(OR NAME OF BUSINESS)
6E
^` ��
LEGAL LOT
LOT A
AfAD
VISION NO.
en
El YES ❑ NO
Z MAILING ADDRESS
•
Z
T�L)
VARIANCE OR
GOND, USE NO.
.
_
/3
0 CITY
ELEPHONE NUMBER
0
Z
_HEIGHT
PROPOSED YARDS
=
Y/ '-Lf
/�^ L:
FRONT SIDE
REAR
Z
Q
NAME
ALLOWABLE
PROPOSED
-I
e•
).
SIGN AREA
SIGN AREA
U
W ADDRESS
F
_ -
OTHER
REQUIREMENTS
-
C CITY
Q
TELEPHONE NUMBER
PLANNING DEPT. APPROVAL
DATE
NAME
STREET R/W
EXISTING STREET R/W
FT. DEFICIENCY THIS PROPERTY
E
O ADDRESS
COMP. PLAN ST. R/W
FT. FT.
F
U
E CITY
TELEPHONE NUMBER
REMARKS
u
Z
)-
p
¢
W
CHECKED BY
V STATE LICENSE NUMBER
CITY LICENSE NUMBER
Z
u
Leval Descriotion of Property (Show Below or Attach Four Copies)
STREET AND/OR UTILITY
❑ YES
W
ZI
Z
O
F
a
U
U
N
W
0
0
WORK REQ'D ❑ NO
UNDERGROUND ❑ YES
WIRING REQ'D ❑ NO
TYPE CONNECTION VERIFIED BY
❑ YES PERMIT NUMB
SEPTIC SYSTEM
q PPVD BY CITY ENG. ❑ NO
REMARKS
METER SIZE SERVICE SIZE JCLFARANCE CHECKED
PLAN CHECK
NO,
E
W i
W
N
NO �
BY THIS SITE IS LOCATED IN THE CITY W
OF EOMONDS. LOCAL SALES TAX
SHOU D O
O
J
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
VALUATION I FEE
❑ NEW
El
RESIDENTIAL
EIL NE
formation given Is correct; and that I am the owner, or the duly author-
❑
NON-RESIDENTIAL
❑ SIGN
❑ ADD
❑DEMOLISH
lets ng cenetructhm; and In doing the work authorlsed person
will be employed In violatt-A Of the Iabor Code Of the State Of W"Ifington
❑WALL NING
❑ ALTER
❑
ORCFILL TE
FENCE X_FT)
NOTE: Permit Limit One Year (Except DEMOLITIONS which
❑
Uty; and fees are paid, and receipt is ac-
^❑
wlm
POOL
REPAIR
knowledged in space provided,
INSP.
I 1
L_F
NUMBER OF STORIES
DATE SI N
NUMBER OF
R'(GNAT/t{,�/a1E•�
CITY OF
7J�EDMONDS
DWELLING
,
Subject to Plan ChCck ee
775.2525
UNITS
This Permit covers work to he done on private PProperty ONLY.
Any the domain (curbs, sidewalks, driveways,
—�
NATURE OF WORK TO skvoriE
ORIGINAL •File YELLOW - Inspeclor
Construction on public
marquees, ote.) will require separate permission.
WORK REQ'D ❑ NO
UNDERGROUND ❑ YES
WIRING REQ'D ❑ NO
TYPE CONNECTION VERIFIED BY
❑ YES PERMIT NUMB
SEPTIC SYSTEM
q PPVD BY CITY ENG. ❑ NO
REMARKS
METER SIZE SERVICE SIZE JCLFARANCE CHECKED
PLAN CHECK
NO,
E
W i
W
N
NO �
BY THIS SITE IS LOCATED IN THE CITY W
OF EOMONDS. LOCAL SALES TAX
SHOU D O
O
J
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
VALUATION I FEE
TOTAL A GLINT DU
a
I hereby acknowledge that I have reed this application; that the In-
formation given Is correct; and that I am the owner, or the duly author-
Ired agent of the owner. I agree to comply with city and state lawn regu-
thereby, no
ATTENTION
APPLICATION APPROVAL
lets ng cenetructhm; and In doing the work authorlsed person
will be employed In violatt-A Of the Iabor Code Of the State Of W"Ifington
THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation 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-
eholl be comple in Nnety days; MOVED -IN BUILDINGS atoll be wm-
yyORK NOTED
knowledged in space provided,
p ed In elx Onlh..)
INSPECTION
DATE SI N
DEPARTMENT
R'(GNAT/t{,�/a1E•�
CITY OF
7J�EDMONDS
�'�WllrRAGENT
,
Subject to Plan ChCck ee
775.2525
DATENOTE:Applicaalt
This Permit covers work to he done on private PProperty ONLY.
Any the domain (curbs, sidewalks, driveways,
ORIGINAL •File YELLOW - Inspeclor
Construction on public
marquees, ote.) will require separate permission.
PINK - Owner GOLD - Assessor
ti
„
.... .. t N
r
f I�
t
I
RECORD OF IMSPECT10id5
Date Passed
Foundation-_ -_
P;umN: o !Pitt;.!► — -- `.
(Rough)—.f_....
I
Furrace
FII„I /.6-.- G .....
;I
,