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RETAINING
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PERMIT APPLICATION '=[do Heavy unee o
ADDREBe
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SWIMMING POOL
NAME (OR NAME orBUSINESS) / (
IPER
DEMOLITION
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REPAIR
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THIS PERMIT
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AUTHORIZES
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CITY
TELEPHONE NUMBERACrjJlJL
yoT REQ, / TOTAL BLDG. AREA
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uty; and fees are paid, and receipt is ac -
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.hell be completed In .1-ty day■: MOVED -IN DDII,DINOS ■hall be wm-
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plated In ■Ix month..)
QUIRa Y
REUtAE YARDS PROPOSE YARDB
FRONT RIDE REAR FRONT SID}) REAR
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INSPECTION
NAME
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DEPARTMENT
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LEG LOT VARIANCE OR CONDITIONALUBE
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PR 8-1107
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CITY
TELEPHONE NUMBER
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Any mn$lruclloa an the public dented -C. -ti., $IdewelW, drlvMLY.,
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marquee■, etc.) will require ■eparate lwrod.■lon,
NAME 1
i11o,_S/1 Ca�JT. �C.e 17r1aPPiNGJ
COMP. PLAN ST. R/ ....... ...0• -FT.
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REMARKS Driveway slopes not to exceed those
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REMARKS
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Legal De■cription of Property (Show Below or Attach Four Coplee)
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FIRE ZO�jNE TYPE OF CONSTRUCTION eTREETIMPROVED
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RESIDENTIAL
NON-RESIDENTIAL
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PROPOSED UBE
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THIIS SITE IS LOCAJT/ED IN THE CITY
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APPLICATION APPROVAL
DEMOLITION
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PRE -MOVE INSPECTION
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EXCAVATION OA FILL
PRE•MOVE
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AUTHORIZES
LUMBER OF STORIESDWEL
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac -
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.hell be completed In .1-ty day■: MOVED -IN DDII,DINOS ■hall be wm-
knowledged In space provided.
plated In ■Ix month..)
UNiTBENOF
$tQNATU (OWNER OR AGENT) DATE ZONED
INSPECTION
IRE 'S ION TURF
NA"r'unri Vr' �yynx 1v UN1 LULYYi
Plan Check No.. ......... .........
Valuation
Fcc Rccelpl No.
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01
PROPOSED UBE
BUILDING
PLUMBING
HEAT A GAB LINE
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a PLOT PLAN (Indicate Building .etbacke, abutting ■treat.)
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formation given 1■ correct; and that I = the owner, or the duly wthpr-
SIGN
RETAINING WALL
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d agent o1 the owner. I Care. to comDlY with city and $tate lawn Mild-
SWIMMING POOL
APPLICATION APPROVAL
DEMOLITION
tette; "net"Cl.n; and In doing the work authorized thereby, Do parson
PRE -MOVE INSPECTION
EXCAVATION OA FILL
will be toyed In violation of the Labor Code of the State of Washington
AMOUNT DUE
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I hereby acknowledge that
that 1 have read lhle application; that the 1n•
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formation given 1■ correct; and that I = the owner, or the duly wthpr-
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d agent o1 the owner. I Care. to comDlY with city and $tate lawn Mild-
ATTENTION
APPLICATION APPROVAL
tette; "net"Cl.n; and In doing the work authorized thereby, Do parson
will be toyed In violation of the Labor Code of the State of Washington
THIS PERMIT
This application is not a permit until
to
telae.; to Workman•■ compematlon Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac -
.hell be completed In .1-ty day■: MOVED -IN DDII,DINOS ■hall be wm-
knowledged In space provided.
plated In ■Ix month..)
$tQNATU (OWNER OR AGENT) DATE ZONED
INSPECTION
IRE 'S ION TURF
DEPARTMENT
\(`i`�
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CITY OF
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EDMONDS
DATE
NOTE: Applicant Subject to Plan C ck Fee
PR 8-1107
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Tide Fermlt corers work to be done on private property ONLY.
Any mn$lruclloa an the public dented -C. -ti., $IdewelW, drlvMLY.,
FILE
marquee■, etc.) will require ■eparate lwrod.■lon,
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I hereby acknowledge that I have reed this application; that the In-
m
formation given Is correct; and that I athe owner, or the duly author-
Ired agent of the owner. I agree to Comply With city and state laws regu-
lating conetrictloa; and In doing the work authorised thereby, no person
will be employed In violation of the Labor Code of the State of Washington
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UBE PERMIT
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relating to Workmen's Comtwel-Ilan Insurance.
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signed by the Building Official or his Dep -
BUILDING DEPARTMENT Applicant Flli
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pleled In elxmonths.)
31ONATUIiE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DEPARTMENT
PERMIT APPLICATION Imide HeaYy Lines
-A
ADDRESS
CITY OF
EDIIIOND$
PR a -lad?
DATE , . .. .
INSPECTOR
Tills Peanut covers work to be done an private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate Perllllsolan.
NAME
(OR NAME OF BUSINEES)
PERMIHSIBLF, ACTUAL
LOT COVERAGE C;' LOT COVESYAOE r?
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PERMItlBIHLE HElOkITs PROPOSED HEIGHT
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ACTUAL LOT AREA // -' TOTAL BLU°. AREA
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NAME1:7,
FRONT BIU�— REAR FRONT BIDE REAR
GA21 L LOT VnRIANCL OR CO D T10 -NAL USE
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ADDRESS
Y a 13 NO PERMIT NUMBER
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LANNirj0 DEPT. PROV I+ DATE;
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NUMBER
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CITY
TELEPHONE
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NAME % `�
COMP PLAN ST R/WV) b}. ..(.,i...FT•
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WE" PHONE NUMBER
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METER 832E SERVICE
SIZE CLEARANCE
$EItBY
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E_C—N. UMBER
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REMARKS
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Legal Description oI Property (allow Below or
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TYPE'CONNECTIONV11
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FIRE ZONE TYPE OF CONBTAU
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P YES No
SPECIAL REQUIRED OCCUPANCY GROUP
NEW
❑ RESIDENTIAL
❑
El -LINE
❑
[jYES P.NO � f
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PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
NON-RESIDENTIAL Blax
❑ ADD ❑ ❑ RETAINING
WAIT'
SHOULD BE CODED 31.04.
R MA, KB"�
DEMOLISH
❑ ALTER ❑ EXCAVATE FENCE
OR FILL ❑ x ..........
❑ REPAIR PRE -MOVE ❑ ""m
❑ INBP. POOL
NUMBER OF BTORIE9 NUMBER OF
�
DWELLING
I
UNITS
NATURE OF WORK TO BE DONE
V.Wotlon
Fee Receipt No.
I ! •r- : •
Plan Check No .....................
$Oi
L,/ —
BUILDING
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PROPOSED —USE)
PLUMBING i - `l
3
PLOT PLAN (Intllcnte Building setbacks, n➢offing streets)
HEAT A GAS LINE
a
FENCE
SIGN
.
RETAINING WALL
IN
—
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I hereby acknowledge that I have reed this application; that the In-
m
formation given Is correct; and that I athe owner, or the duly author-
Ired agent of the owner. I agree to Comply With city and state laws regu-
lating conetrictloa; and In doing the work authorised thereby, no person
will be employed In violation of the Labor Code of the State of Washington
TOTAL AMOUNT DUE
ATTENTION
Ting PERMIT
�:i .., %
�% I • .� )
APPLICATION APPROVAL
This application is not a permit until
relating to Workmen's Comtwel-Ilan Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
Permit Limit One Year (E ... pt DEMOLITIONS which
,hall he completed In ninety days; BIOVED-IN BUILDINGS shall be com-
ONLY TILE
WORD NOTED
uty; and fees are paid, and receipt is no
knowledged in space provided.
pleled In elxmonths.)
31ONATUIiE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DEPARTMENT
DIRECTOR'S SIGNATURE
,..
NOTE: Applicant Subject to Plan Check Pee
CITY OF
EDIIIOND$
PR a -lad?
DATE , . .. .
INSPECTOR
Tills Peanut covers work to be done an private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate Perllllsolan.
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RECORD OF INSPECTIONS
Date Passed
Foundation 44
Plumbing (Partial) t�4
(Rouoh)
rv:
Fra me
Furnace & Fuel Lines '
16-16- 9r%�
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