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USE PERMIT
BUILDING DEPARTMENYONE 7_10357 �% r NUMBER 0 L 7
Applicant Fla I �lJ3J
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PERMIT APPLICATION Inside Heavy Linos os�
.ADDRESS
NAME (Of{ NAME OF BUSINESS)
PEith[[SdIBLE ACTUAL qq
IAT COVERAGEa LOT COVERAGE
C MA1LiN0 AD dB !'
.... C_PEIth118dIHLE HE[Ot1T PROPOSED HEIGHT y j
O pa;//W)
TELEPHONE NUMBER ACTUAL LOT AREA TOTAL BLDG. AREA kp'Ft
REQUIRED YARDS PROPOSED YARDS Y
NAME FRONT SIDE REAR FRONT SIDE REAR
1., 20 S IS 7-0t1 AL LOT VARIANCE OR CONDITIONAL USE
LE
N ADDRESS EB 0 NO PERNIIIJIUMBER
PLA 6 DEPT. RO L D TF.: 'i '
al CITY I TELEPHONE NUUSER
cc 8T ET/
EXISTIN TREET R/W ............FT. DE IENCY THIS PROPERTY L
i
COM -
P.
COM. PLAN ST. n/W .,..........FT. ............FT. [a
REMARKS y
[C4Cy ADDIt6de x
W (.CHECKED BY
[+ CITY TELEPHONE NUMBER
x
� METER BILE SERVICE 812E CLEARANCE CHECKED BY
V STATE LICENSE NUMBER CITY LICENSE NUMBER t57 I et j
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REhtAl2Ktl ;
Legal Deacrlplion of Property (Show H.IOW Or Attach Fouc Coplea) �
Lo / TYPE CONNECTION I VERIFIED BY
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PERC. TEST I PERMIT NUMBER C
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REMARKS m
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"I FIRE ZO TYPE OF ONSTRUQ7'lON STREET IMPROVED '
YES 0 NO
SPECIAL INSPECTOR REQUIRED OCCUPANC OUP
RESIDENTIAL ❑ LIN 0 YES ] NO
NEW
LINE PLAN CHECKED DY THIS SITE IS LOCATED IN THE CITY
I� NON-RESIDENTIAL ❑ SIGN 01' EDMONDS. LOCAL SALES TAX
IXI ADD RETAINING RE/MARK'ti\` �/ /� , S\HOEj ULD� B)E 1CODETD 31.0�4J. '7'
�rr"'SSS ❑
DEMO LISH WALL Ci�N7 ( It.-.Ul.i I loo mus -r HAI c
ALTER EXCAVATE FENCE t��/� fir./ , 1 �%
❑ OR FILL (..........z..........Ft.) Cii� (7 I N ��% ' 5v B J ec,'T
ElPRE -MOVE BWIht
REPAIR ❑ INSP. Q POOL
NUMBER OF BTOItIEB NUMBER OF
DWELL/NO ')t/
UNITS
NATURE 'O'jF,nWORK TO BE DONry1E 1 Valuation Fee ReceiptNo.
Plan Check N...... ...........
[y BUILDING
C,
PROPOSED USE ��1100
PLUMBING
PLOT PLAN (Indlente Building isellack., abutting trecta) BEAT d: GAS LINE I
6V FENCE
SIGN
]L i�RETAINING WALL —
N
e�.j • I SWIMMING POOL
N a—
DEMOLITION
t
PRE -MOVE INSPECTION
�� ,L• `. EXCAVATION OR FILL
s OO /e7C1j_,
Z hereby acknowledge that TOTAL AMOUNT DUE I have rend thio application; that the In.
(ormatlon given le correct; and that I am the owner, or the duly author -
,red agent of the owner, i agree to comply with city and State laws regu- ATTENTION APPLICATION APPROVAL
telling construction; and In doing the work authorized thereby, no person
will be employed In Violation of the Labor Code of the State of Wmbington THIS PERMIT This application is not a permit until
relating to Workmen'. Compenantlnn Imuranze. AUTHORIZES signed by the Building Official or his Dap -
NOTE: Permit Limit One Year (Except DEMOLITIONS which ONLY OTETHE ut and fees are aid, and receipt is ac-
R'ORK NOTED Y� P P
.hall ba completed In ninety dnya; MOVED -IN BUILDINGS .hall 6e rola• knowledged in apace provided.
plcled In slz month.,)
SIGNATURE (OWNER Ott AGENT)DATE OIONEU INSPECTION
/1 ^7 DEPARTMENT DIRECTOR'S fONA
CITY OF
ED51ONDS DATE I
NOTE: Applicant SaG]ect to Plari Cbeck Fee (p 2J
775-2525 T
Thl. Penult eu.'ers work to be done on private property ONLY. .
Any construction on the public domain (curb., eldew'alk., driveway.,
....quer., etc.) x111 require repm.te perml..I.n. FILM
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RESIDENTIAL
PLAN 6DEPT. 'RO L
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7C CITY
TELEPHONE NUMBER
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STREET R/)P
❑ NON-RESIDENTIAL
❑ SIGN
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EXISTING TREET R/W ............FT.
DEF!,(OENCY THIS PROPERTY
NAME
I•nNG
RETAINING
COTSP. PLAN ST. R/W ............FT.
............
/
/�^'
REIfARKS
TYPE OF CONSTRU ION STREET IMPROV,
_ i' [9 YES L] NO
Cd ADDRESS
(1:�� �_i U5
❑ ALTER EXCAVATE
❑ OR FILL ❑ (.....................Ft.)L,,
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FCITY
I TELEPHONE NUMBER
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�',: NUMBEPERMR 4035,
BUILDING DEPARTMENT Applicant Fill ZOO ! j
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PERMIT APPLICATION I Inside IleaYy Lines—you-
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STATE LICENSE NUMBER
1
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NAM➢ (OR NAMEOF HU81NE88)�' 1 •
^ PERM IS82B),E m ACTUAL
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LOT COVERAOEs
LOT COVESiAOE
G 111,
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Legal Description of Properly (Show
Below or Attach Four Caples)
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MAILING A13 / a9 j' _ PERMISSIBLE HEIGHT PROPOSED HF1011T
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PLUMBING
V
l 1, �' �/ -
CIrY. 1 TELEPHONH NUMBLR
ACTUAL LOT AREA
TOTAL L.G.BAREA
z
5si
,
FENCE
j•''�•"�".{] 4"'.�_ •� / 1• 7t'. f.
/-.•4 •/' !l /.rte•. 1 / `'
REQUIRED YARDS PROPOSED YARDS
FRONT AIDE REAR
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NAME FRONT 915E REAR
Zama ?C S 1 2.0
LF.OAI. I.OT VARIANCE OR CONDITIONAL USE
kUl
ADDRESS
l��IfEB ❑ NO
PERTIIT NUMBER
-
1S
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RESIDENTIAL
PLAN 6DEPT. 'RO L
/ A�' ��/
•L iG
V
7C CITY
TELEPHONE NUMBER
✓E AI. - t 7,
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J't'i
��'j"'•Lo
STREET R/)P
❑ NON-RESIDENTIAL
❑ SIGN
'
EXISTING TREET R/W ............FT.
DEF!,(OENCY THIS PROPERTY
NAME
I•nNG
RETAINING
COTSP. PLAN ST. R/W ............FT.
............
/
/�^'
REIfARKS
TYPE OF CONSTRU ION STREET IMPROV,
_ i' [9 YES L] NO
Cd ADDRESS
(1:�� �_i U5
❑ ALTER EXCAVATE
❑ OR FILL ❑ (.....................Ft.)L,,
` �j
�I Pv (CS, rEc�
O
�e'
l"�v (� (�
-(-j
✓ v v
I CHECKED SY
FCITY
I TELEPHONE NUMBER
J
i/�
%�(-� i%rj �-t
z
UNITS
CLEARANCE
METER BILE CHECKED BY SERVICE SIZE
STATE LICENSE NUMBER
NATURE OF WORK TO BE DONE I I
I CITY LICENSE NUMBER
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\MAlilid
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RE
13UILDIN6
Legal Description of Properly (Show
Below or Attach Four Caples)
�
W PROPOSED USE
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RESIDENTIAL
❑ GAS
LINE
YES NO
❑ NEW
PERC.
Ll V I SE
J't'i
��'j"'•Lo
❑ NON-RESIDENTIAL
❑ SIGN
'
REMARKS
p
r
I•nNG
RETAINING
REM//ARKS
A
;d
/�^'
FIRE ZONE
// /. I
TYPE OF CONSTRU ION STREET IMPROV,
_ i' [9 YES L] NO
7/]
RESIDENTIAL
❑ GAS
LINE
YES NO
❑ NEW
PLAN c1IEcxED BY
THIS SITE IS LOCATED IN THE CITY
❑ NON-RESIDENTIAL
❑ SIGN
SH ULD BE S. LOCAL SALES TAX
SHOULD BE CODED 31.04.
ADD
I•nNG
RETAINING
REM//ARKS
J' -y
❑ DEMOLISH ❑ LL
/�^'
FENCE
(ILJ iJ.0 I_
(1:�� �_i U5
❑ ALTER EXCAVATE
❑ OR FILL ❑ (.....................Ft.)L,,
` �j
�I Pv (CS, rEc�
PRE -MOVE SWIM
REPAIR
l"�v (� (�
-(-j
✓ v v
INSP. POOL
1
NUMBER OF STORIES I NUMBER OF
DWELLING
%�(-� i%rj �-t
I'; / 3
UNITS
-
NATURE OF WORK TO BE DONE I I
Valuation Fee Receipt Nov
E
/'..i: !• f. ,•..- � i'. .:1 i ...
I'Ian Check No .....................
13UILDIN6
l�,�y h
W PROPOSED USE
PLUMBING
V
HEAT & GAS LINE
aPLOT PLAN (Indicate Building TaGc�, c�`¢qrrpp\\ tllrl�aLrecte) ,
FENCE
4
-
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
-+•
PRE -MOVE INSPECTION
I�) I i `'•^
EXCAVATION OR FILL
TOTAL AMOUNT DUE
1 hereby acknowledge that I have read this application; that the In-
1
formation given Is correct; and that I am the owner• or the duly author.
,
[Zed agent agent of the owner. I agree to comply with city and state laws reg,-
ATTENTION
APPLICATION APPROVAL
lating cnastructice; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washing -,.n
THIS PERMIT
This application is not a permit until
relating to Workmen's Compensation Imuranee.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (EzcePL DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is Be
shall he completed In ninety day.; MOVED -IN BUILDINGS shall be com.
knowledged in space provided.
Pleted In .1. months.)
SIGNATURE (OWNER OR AGENT) DATE 81ONED
INSPECTION
DIRECTOR'S SIGNATURE
DEPARTMENT
u.)/`t.-
CITY OFD
ED51ONDS
ATE
NOTE: Applicant Subject to Plai) Check Fee
775-2525
This Permit cen— work to bo done on private property ONLY.
!
Any construction on the public damage (..,be, sidewalks, driveways.
INSPECTOR
marquees, etc.i will require sepsrate Permisslon.
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