740071.pdfBUILDING DEPARTMENT Appllcmt
ZONE I1i� PERUSE 740071
PERMIT APPLICATION Iltgtde Hoavy
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NAME (OR NAME 08 BUB3NE88)
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LOT --BIBLE e ACTUAL
LOT COVERAGE LOT COVELGE /
MAI O REBS
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PERMISSIBLE HEIOIIT11pIt01`08EU II OHT
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CITY10111
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ACTUAL LOT AREA "13077��A--Lr'BLuc AAEA�
NAME
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PROPOS.: YAltD9
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FROtiT NIDE REAR FRONT N(nE REAR
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LEGAL LOT VARIANCE Olt CONDITIONAL UBE
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❑ YES NO PERMIT NUMBER
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CITYTELEPHONE NUMBS
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PLA O A P
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EXIST 6 STREET R/4 DEFICIENCY THIS PROPERTY
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NAME
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ADDRESS
R�A1t1BDmveway eZopes not to exceed those
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indicated on Standard Dwq. No. Z03
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CITY
] PHONE NUMB
CHECKED
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STATE LICENSE NUMBER
CIT CENSE NUM
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Legal DeseN lion o1 PrPoor
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REMARKS
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TYPE ( 0�8TR CTION STREET IMPROVED
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8 NO
SPECIAL INBPECTO R REQUIRE
OCCUPAN�C{y 6R0�I
RESIDENTIAL
❑ LINE
❑ YES � NO
I ]y
NEW
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NON-RESIDENTIAL
PLAN CHECKS BY JJJ
THIS SITE IS LOCATED IN THE CITY
BIaN
❑ ADD RETAINING
DEMOL18H WALL
OF EDMONDS. LOCAL SALES TAX
aHOULD BF ODED 31,04,
REMARKS
ALTER EXCAVATE FENCE
OR FILL L.........z......_.Ft.)
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REPAIR sm
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❑ INePMOVE El P0031
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NUM1IBER OI'BTORIEe NUMBER OF
DWELLING
UNITS
/
NATURE OF WORK TO HE ➢ONE
Vnlnnti.n
Fae 11-1pl No.
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P19. Check No .....................
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All (z �� C. /
PROPOS U8E 1 1
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BUILDING
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PLUMBING
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PLOT PLAN (Indicate Hulidlag aetbacke, abutting etr.ete)
HEAT & GAB LINE
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7` f.Lfl
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
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I hereby acknowledge that I have read tEle applleatlon; that the
formation
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glue. 1. correct; and that I am the owner, or the duly nuth
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f
Ized agent of the ewoer. I agree to comply with city and alate lawn ro
,.it......tmetloo; and m doing the work authorlud th.roby, oo
ATTENTION
APPLICATION APPROVAL
per
will be employed In vlolatlon a1 the Labor Code of the plate o1 WMh1ng
on
on
THIN PERMIT
relating to workmen•. Compen.atlon IMuranae.
AUTHORIZES
This application Is not a permit until
NOTE: Permit Limit One Year (Egeept DEMOLIT IONS whch
ONLY Tit
signed by the Building Official or his Dep.
.hall bcompleted In nJnety days; MOVE0.IN HOQ.DINOS shall be m
-
WORK NOTED
uty; and fees are paid, and receipt is ac -
I
pleted n elg month..)
knowledged 1n apace provided.
'
SIGNjJJ�TURE (OWNER OR AGENT)
DATE BIOMED
INSPECTION
Li1/lt-/9
7CI
DEPARTMENT
DIRECTO
ei0
_
CITY OF
NOTE: Applicant Subject to Plan Check Fee
EDMONDS
DATE
'
TN. Permit myon work to be don. on prlyal. property ONLY.
PR 6-1101
O� I
Any mMtmCHOa an the pabil. do.. (sorb., sidewalk., drIVow y.,
marCo... etc.) wk. regNre wpa1.1. wadilsloa.
FILE
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BUILDING DEPARTMENT AppllcantFLU ONE rPru ER
PERMIT APPLICATION
Inside iieaVy LiIIeg JOB�� '
ADDRESS
NAME (OR NAME OF BUBINEBB) //� 1
PER MIBBIH ACTUA" O ) ,
LOT COV ERA � LOT COVESiAOLr�
MAI
%'F�ADDRESB PLItaiI8B18LE HEIGHT .... PROPOSED ISLIOHTC'•tr� ° "'
TELEPHONE NUMHER ACTUAL LOT AREA
NA _, e r - ' ' -' FRONTI `dlDe. REAR FRONT SIDE _ REAR 1
F/ate w i. / / �'
N LE LOT VAHi) EC�tT OR COIlb T3 IONAff�8Z�� I
y ADDRESS [3 YES ❑ NO PERMIT NUMBER
ypp PLAN 6 D P P AL DAT
s7 CITY TELEPHONE NUMBER
O
' IBTUSTREET R/V( DEFICIENCY 'rH19 PROPERTY
NAME COMP. PLAN ST.....�y...FT. .d I
REMARKS C�
14 6 ADBY&Sf = prrT.t)e1JQ)y sZopes not to exceed those °
... • _ .� n n ' O CKED BY 'I
CITY I Lair HONE NUMHER IA j
p I 4•. ! _' BI ICE, Sms IqIrA ^ E ICH H Y i
V §TATE LICENSE NUMBER CITY'LiCENxe, IN _ Tll
Ck7)
REMA
Legal'Descrlptlon of Proplrty .(show Below or Attach Four Copies) i )^ i/ • /
TYP -CO NEC 1 VERIF ED BY
1A 1
R
J FRE/ZONy¢• TYP 11TII!frI MIT T M ROPED !
NO
SPECIAL INSPECTOR HEgUIR D OCCUPANCY GROUP
r • rj ❑ OAS ❑ YES `� NO '"r Sii 1
�J RESIDENTIAL LINE PLAN CHECKEDIIP
NEW THIS SITE IS LOCATED IN THE CITY '
NON-RESIDENTIAL SIGN OF EDMONDS. LOCAL SALES TAX I
ADD _ RETAINING REMARKS
SHOULD BE CODED 31.04
DEMOLISH WALL
ALTER EXCAVATE
OR FILL ❑ PENCE.x..........Ft.)
El REPAIR PRE -MOVE El SWIM -
INSP. POOL
NUMBER OF STORIES I NUMBER OF
DWELLING \ j
UNITS
NATURE OF WORK TO HE DONE
Valuation
Fcc Receipt No.
-
Plan Check No .....................
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[[[O
BUILDING
1
q....� -
a PROPOSED USE
PLUMBING
A GAS LINE
O PLOT PLAN (Indicate Hufltlingeetbacke, �a cbl�ttlrp`g (ptr'�ta)-.. HEAT
�V ,
y \
�
FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I
I hereby acknowledge that I have read this application; that the In-
TOTAL AMOUNT DUE
i
,
I h ! �� I !
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formation given 1s correct; and that I am the owner, or the duly author,
lied agent of the owner' I agree to comply with city and •late Iowa raga-
laling construction; sad In doing the work au11.rl..d thereby, on person
ATTENTION
APPLICATION APPROVAL
will be empicyed In violation of the Labor Code of lha Stale of Washington
TIDB PERMIT
This application is not a permit until
relating to Workmea's Compensation Insurance.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
AUTHORIZES
ONLY THE
WORK NOTED
signed by the Building Official or his Dep.
uty; and fees are paid, and receipt is ac
shalt be completed In ninety day&; MOVED -IN BUILDINGS shall be cam-
knowledged in space provided,
Plated In six =..the.)
SIGNATURE (OWNER OR AGENT) I DATE SIGNED
INSPECTION
DIRECTOR'. eIONATURE
`•t l:
DEPARTMENT
CITY OF
-
I'11�'Y�__uji�.
DATE
NOTE: Applicant Subject to Plan Check Fee
EDMONDS
PR 0-1107
,
_
INSPECTOR
_
This P.—It toren work to be done an private P-1,6114'ONLY.
Any construction on the Dublin donWo (earbs, sidewalks, driveways.
nlarauea&, etc.) will reymra separate permiselan.
-