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BUILDING DEPARTMENT
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AppllennL FW
Z NE '� NUMBER
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PERMIT APPLICATION
Inside Heavy Lines
ADDRESS f 1 3/Q
NAME (OR NAME OF BUSINESS)
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fYCAI�Y"
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PERMISSIBLE ACTUAL
LOT COVERAGE �LOT COVJWAGE
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MAI-�1J0<ALDDS-RESH
iOPOS4PERMISSIBLE H
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CITY
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TELEPHONE NUMHIUR
ACTUAL LOT AREA TO T)Q. AREA
6REJQUIRED
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2
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YARDS , PROPOSED YARDS
NAME
FRONT HIDE REAR FRONT HIDE REAR
ter' /o' .ems' as /n P
is_
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LEGAL LOT VARUNCE OR CONDITIONAL U8E
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ADDR118H
AYES 0 NO PERMIT NUMBER
77
YLANffI O��EP APYR VAL
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CITY
TELEPHONE NUMBER
7
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STREET N/iV /�tt
EXISTING STREET R/4n/P?_- DEFICIENCY THIS PROPERTY
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NAME
COMP. PLAN HT. R/ ... ..5....FT,
REMARKS
Driveway slopes not to exceed those
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ADDREHH
indicated an Standard ilwj Nfl_ inn
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CHLC HY
TELEPHONE NUMDER
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METF�R% SIZE SERVICE/ SIZE LEARA C
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STATE LICENSE NUMBER.
C1fiY LICE B11
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NEARKB
Legal Description of Property (Show Below Or Attach Four Copies)
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TYPE CONNECTION
VERIFIED Y
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PERT ES
PE U EA
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REMARKS
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FIRE ZONE TYPE OF CONSTRU ION STREET IMPROVED
LEB 0 NO
HPECIAL INSPECTOR REQUIRED
OCCUPAN CY7'6-AOUP
,I
�RESIDENTIAL
❑ LINE
O YES
NEW
PLAN CHECKED II THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL
OF EDMONDS. LOCAL SALES TAX
SIGN
SHOULD 6E CODED 31.D4.,,
ADD RETAINING
WALL
RE Ks
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El ALTER EXCAV DEMOLISH
CFILLTE FENCz
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❑ OR .......... Ft.)
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REPAIR ❑ PRE-N SWIh
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S(1B�L-i '��
PA[OVE LS
POO
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NUMBER OF STORIES NUMBER OF
DWELLING
-2 /
UNITS
NATURE OF WORK TO HE DONE
Valuation
Fee
Recelpt No.
Plan Check No .....................
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BUILDING
PROPOSED USE
PLUMBING
HEAT @ GAS LINE
�sa
PLOT PLAN (Indicate Building .elbaeke. abutting street.)
FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
-
DEafOLITION
'
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have rend this nppllcnllon; that the In.
formation given le am the and that I athe owner, Or the duly author-
Ded agent of the owner. I agree to comply with city and elate law. regu.
A'rTl'E.NTION
APPLICATION APPROVAL
IaUng construction; and in doing the work authorized thereby, no person
will be employed In violation Of the Labor Code of the State of Wa.hington
THIS PERMIT
This application is not a permit until
relating to workmen'. Compen.atloa Insurance.
AUTHORIZES
signed by the Building Official or his Dep-
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TILE
WORK NOTED
uty; and fees are paid, and receipt Is ac-
shall be completed In ninety days: .MOVED -IN BUILDINGS shall be cam-
knowledged In Space provided.
pleted In A. months.)
SIGN RE (OWIir�OR AGENT) DATE SIGNED
INSPECTION
O .S S N TUBE
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DEPARTMENT
CITY OF
EDIIIDNDS
ATE
NOTE: Applirant Subject to Plan Check Fee
775-2525
/
This I"mill r fork le Iro on de on prlvnte properly ONLY.
Any eo.W1. 1.11 on Il,e ptbllc dmm�hr leurbe, ehilw'all". drh'ewaye,
marquee.. MC.l will req areseparate Permle.lon.
FILE
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I
SE PERMIT O
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BUILDING DEPARTMENT
Applicant Fill
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BONNE (, _' NUMBffit
1
PERMIT APPLICATION
Ineido Heavy Linos
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ADDRE$B
NAME (OR NAME OF BUSINESS)
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ACTUAL
PERMISSIBLE ' LOT COVETIAOE /,
2QT COVERAGE_ •
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1
PERMISSIBLE HGIOYIT PROPOSED RETORT)
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tpp�lt.
'• f ( lAREA1r
PHONE NUMBER
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ACPUAL LOT TOTAL II 6, A
0 L.. Pit, I
PROPOSED YARDS
REQUIItF.D YARDSi
BIDE REAR
FRONT BIDE. REAR FRONT
NAME
/
L 6A1. LOT VAR CE OR coxDlTIOnAL u
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A.. ..
[� YE8 � NO PERMIT NUMBER
+
PLANNING UBPTO-11 ,VAL (' DATE;
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CITY
,.
TE PHONE NUMBER
STREET R/W t
p
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EXISTING STREET RX.7,[.'YY'r. DEFICIENCY THIS PROPERTY
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NAME
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COMP. PLAN 8T. A/W.+.�j`.. .I..FT. ...b...FT,
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REMARKS r;l'iveway slopes not 1:o exceed those
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A DR B
�CKED,1 BY
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TREMPRONE.NUMBER
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CITY
L41 �MI 1\ J
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EIL S3'LCLEARANCE:I
MET BEIVl S
cnEckr
BE
}bNhBER
SATLEk,
CITY LEN�E616
n --I •`• --• I- I �. - % �, �S (_,.
REMn1i1Sd
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t
Legal Description a Pro arty lehow Below or Attach Four Copies)
P e-
�
1 �, - (•- �{ t; -A (l 1 1� i • '� (�-11 1. �1 F- �
TYPE CONNECTION VERIFIF,D 1,
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y
PERC. PE II MBER U
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t�
REMA ya?/
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FIRE ZONE TYPE OF CONBTRUGTIO T E
RESIDENTIAL
❑
LINE
NEN
❑
NON-RESIDENTIAL
13
ElADD
RETAINING
❑
DEMOLISH
❑
WALL
ALTER
❑
OROFILL E
EltEN...If
CE .....Ft.)
REPAIR
❑
PRE-INSPh[OVE
❑
SWIM
POOL
YUMBER OF STORIES
NUMBER OF
DWELLING
UNITS
/
I
T
SPECIAL INSPECTOR REpUIRED OCCUPANCY OAOUP
[3 YES
Q3,NO
I _U
1 _-I
Plwx. CHECKED BY ;
THIS SITE IS LOCAT D IN THE CITY
OF EDMONDS. LOCAL SALES TAX
t HOUL BE CODED 31.04.
REMARKS
ck No .....................
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p
t PROPOSED USE
NG
U
aPLOT PLAN (Indicate Building setback., abutting streets)
GAS LINE
7
SIGN
rDEMOLITION
tING
WALL
NI
ING POOL
ITIONVE
INSPECTIONATION
OR FILL
TOTAI. AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
formation given Is correct; and that I oro the owner, or the duly author-
ized agent of the owner. I agree to comply with city and elate lawn regu-
ATTENTION
lating construction; and In doing the work authorized thereby, no person
will be employed In violation of the L¢hor Code of the State of Waahingtan
Tn19 PERMIT
relating to Workmen's Compensation Insurance.
AUTHO LAZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORKNOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In .1. month..)
SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DEPARTSSENT
CITY OF
IaIaIIIII�EDIIIONDS
NOTE: Applicant Subject to flan Check Fee
775-2525
Thin Pr,ll cn work to be don. on prl,'nle properly ONLY.
A onelru ,ton the public domain (curb,, nldetvaik,, drlvow"..
ice.. ele.l w111 r.auire .".orate permlselun. /
V,luntlon Fee R.e.ipt No.
APPLICATION APPROVAL
This application is not a permit until
Signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
DIRECTOR'S SIGNATURE '
DATE J,
I ,� r-
1 I
INSPECTOR