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780201.pdfBUILDING DEPARTMEN PERMIT APPLICATION NAME (OR NAME OF BUSINESS) 3 I I0G30 ► 3e: leLe-Ii� 0 , _.— I- U W ADDRESS F I U E CIT V Q 0EADDRESSFKFI-`.JobUICENSE NUMB' ZI 0 6 K u In W is W ZONE NUMBER Applicant Fill R5 ��-- Inside Heavy Lines TDB HONE N 7iz4 56-719 780 01 ADDRESS (a.�<p'1jo.-JG V,1 =.,v 5? VG LOT AREA SUBDIVISION NO, LEGAL LOT *YES ❑ NO S ` S � STREET R/W I_ O FT, DEFICIENCY THIS PROPERTY EXISTING STREET R/W CS7 O FT, O FT. COMP. PLAN ST. R/W REMARKS w rr IIaf111 A rbv�n R E REQ'D. BYES UNDERGROUND WIRING REQ'D. SANITARY SEWER APPV'D BY CITY ENG. ❑ NO I ie YES ❑ NO ❑YES ®NO e YES VERIFIED BY ❑NO OYES PERMI ®NO or Attach Four Copied 5 S RKs � J � h Q 5,, a R SIGN AREA ENV. REVIEW ALLOWED I POSEDFCOMPLETE I EXEC ARKS OR CU PLANNING REVIEW BY ADD NO, DATE a, LOT COVERAGE YARDS FRONT 10 SIDE 2.S REAR SS X ❑ GAS FIRE ZONE TYPE OF ONSTRU ION CODE HrH ® NEW RESIDENTIAL LINE ❑ NON-RESIDENTIAL ❑ SIGN OCCUPANT OCCUPANCY ❑ ADD RETAINING SPECIAL INSPECTOR AREA � ❑ GROUP LOAD DEMOLISH L� WALL REQUIRED 2,950 El FENCE ❑ YES NO 1 ❑ ALTER EXCAVATE OR FILL ( x_FT) PLAN CHECKED BOFY THIS SITE IS LOCATED IN THE CITY EDMONDS. LOCAL SALES TAX PRE -MOVE SWIM SHOULD BE CODED 3t.04. ❑ REPAIR INSP. [:] POOL REMARKS NUMBER OF STORIES NUMBER OF 1 N 00LA1 IO /v DWELLING ' ` � � � L "e UNITS t� NATURE OF OF WORK TO BE DONE L.0T >D�1 1C- 1` GR ©�2.p- I 14' 1DL7J - VALUATION FEE PLAN CHECK /I PROPOSED USE NO. "'[ Z D /1 i Fs Q BUILDING SETBACKS, BUILDING '4' 6 PLOT PLAN INDICATE 3 III,ABUTTING STREETS) U PLUMBING W SX G /��hGN® CON rLTY"_' a HEAT & GAS LINE 0 S)A -�- A-1 eta a-` i '+ FENCE SIGN RETAINING WALL SWIMMING POOL application; that the in- TOTAL AMOUNT DUE 2 'v O I hereby acknowledge that I have read this ner, or the duly author - formation given is correct; and that I am tlwlthvc ty and slate laws regu- ATTENTION APPLICATION APPROVAL ized agent of the owner. I agree to comply no person lating construction; and in doing fire work authorized thereby, P ermit will be employed in violation of the Libor Code of the State of Washington AUTHORIZES until THIS PERMIT ltsigned by the Building official is or relating to Workmen' Compensation Insurance, p NOM Permit Limit One Year(Except DENIOLITIONs and TILL ONLY THE his Deputy*and fees are aid an PERMITS without conditional use permit, which shall be completed in 90 WORK NOTED videreceipt is acknowledged in space pro - days; MOVED -IN BUILDINGS Sllall be completed In six months.) INSPECTION DIRECT 'S 1 E DATE SIGNED DEPARTMENT SI AT �{R E (OWNER OR A ENT) CITY OF l- ��llll'CI�1�A EDMONDS DATE NOTE: Applicant Subject to Plan Check 11ee 775-2525 /7 fXJ ORIGINAL - File YELLOW - Inspector This Permit covers work to be done on private property ONLY. alks, driveways, GOLD - Assessor PINK - Owner Any construction on the public domain (curbs, sidew marquees, etc.) will require separate permission. F Z W s C :. r• �.1 iz \ )tll l! p1 S .. ` 1 ;d. -. __. .._ __.._.... _- -.. _.. e.-•-� YLF�It If I 'If 4t rt]I. T:i At It t�j \ s yd _.r 't. {, s3 1;i La t 1evy 7f ,lY r'1 1 ' If , 1 �1 '4Ito H n tt,I � I It Pit3s h,1 • -,fix , 4� I I. + " t y r of If I n �•yy Off, �1 I r' At .�, Sr r A { m. je- { - - ?} , 11. 1 If It it If If If '( S p • 1fi ( l i ♦ f , I t rr t I. .'MI If. III pI r tillIttlIf 1 ` I 'i• �� _1 1k d,lk If Of It Iff, It 1 ..,.