740379.pdfr
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BUILDING DEPARTMENT Applicant Flu
��— PERMIT R 70037
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Insldo Heavy Lines
PERMIT APPLICATION
JOB
ADDRESS /
NAME (OR NAME OF HUB1NE08)�
Pt:ItM ItldIBLEJ ACTUAL
L011i
1/ G t L
LOT COVERAOE 3S V LOT CO
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id
_M LING ADDREHB
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PERM ItltlIDLE IIEtGI1T �Q / ItOP08ED I{EIGHT O
�yh Q
UA
AREA !
O
CITY'
T�ELEPHON�JE NUM�B/L•a
ACTUAL LOT AREA TOTAL BLUO.
•�
I
C V/ y„�
/ 7y % LI /
REQUIRED YARDS PROPOSER YARDS
1 1I
i
FRONT 8IDE R,IEALI FRONT REAR
NAME
R �O �O/1
L6 r
S
. ��.ryp/� 1i, • t } J•)Y
ADDREJ80
LF. LOT VARIANCE Olt CONDITIONAL UBE
E8 ON.PERMIT MUER
`I 1
yM
-r�f-i•
PLANN NG DEPT. APPROVAL OAT -� -
4S
CITY TELEP ONE NUMBER
A111
STREET R/W
EXISTING STREET R// .�.QFT. DEFICIENCY TH18 PROPERTY
,
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NAME
COMP. PLAN ST. R/FT. 41
j
REMARKS Driveway slopes not to exceed those
"°DREdd
indicated on Standard Dw4. No. BOE "
KE HY
S^7
CITY
TELEPHONE NUMBER
I
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METER 8lZE) B'RVIC 8{ZII CLEARANCE
CH BY
Q
STATE LICENSE NUMBER
CITY LICENSE NUMHElt
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REMA! i
Legal Description of Property (Show Below orAttach Foour Copies)
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TYPE CONNECTION
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G S S teRCi ru
PERC, TEST
R I UA ER a
d�
W
_G
REMARKS
a
e
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D
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FIRE Z�
I TYPE OF CQNBTR71,1 STREET IMPROVED
i
.
1V1i7' /C// YEB [3 NO
SPECIAL INSPE�C
OCCUPANCY GROUP
REQREQUIRED
❑ YES gli0 I /
GAB
�NEw
RESIDENTIAL
❑ LINE
PLAN CHECKED D THIS SITE IS LOCATED IN THE CITY
,
NON-RESIDENTIAL
OF EDMONDS. LOCAL SALES TAX
BION
RETAIADD MNG
SHOULD BE CODED 31.04.
RD 9
�
WALL
❑
DEMOLISH
EXCAVATE FENCE
/
ALTER ❑
OR FILL C., ...... .rt ..... .....Fl. )
slvnl
REPAIR ❑ PREP MOVE ❑ POOL
��I C C ✓ /� O'� .��Y C /VE��t/✓�%/tl
NUM ER OF STORIES NUMBER OF
DWELLING
' UN UN1T0
NATURE OF—U-0 BE DONE
Valuation
Fee RecelPt Na.
l
Plan Check N
7
Irk
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BUILDING
�
I
y
'1y
PROPOSED UBE
PLUMBING
fO
Q
HEAT @ GAS LINE
C
PLOT PLAN (Indicate Building setbacks, abutting streets)
�
FENCE
SIGN
1'
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE-MOVII INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I novo read this application; that the In.
uthor-
formation given Is c asci; and that I — the owner, or the duly author-.
-
l.ed agent of the owner. I agree to comply with City and elate, law. regu-
ATTENTION
APPLICATION APPROVAL
I.ting construction; and to doing the work authorized thereby, no person
Will be employed in violation of the Labor Code of the State of Washington
TIHB PERMIT
This application is not a permit until
relating to Workmen's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep-
NOTE: Permit Limit One Year (EICCPt DEMOLITIONS which
ONLY THE
{YORK NOTED
uty and fees are paid, and receipt is so
_
shall be completed In ninety day.; h10VED-IN BUILDINGS shall be Som-
knowledged in space provided.
pleted In is months.)
SIGMA ItE IOWNE1t Oli GENT) DATE dIGNEll��
INSPECTION
I O '8 S ON AT RD
l• I I _
DEPARTMENT
) 1
CITY OF
EDHIONDS
DATE
_
NOTE: Applicant Subject to Plat: Cbeck Fee
f
775-2525
1
This t'r Tnit -vers work in be done on prlYate Property ONLY.
Any roneirurllun an the public domala (curbs, sidewalks, driveways,
llmrmmee, Cie.) x'111 Mg -Ire separate permlesLn.
FILE
f
Cjr
UUUVLJLJ Ln= U LCL_:
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n...(:t� �iZC1 ,
DING DEPARTMENT Applicant FLU
BUILDING%
° NUMBERPERM
�— �� ti I '.' •'
7
1
I
;
PLUMBING
Inside Heavy Lines
MIT APPLICATION
JOB
A
ADDREBB / `I •'/ i1 G� .-• `/-1- CC/i,LG
/j L/
G" .
`'77
YES NO
(OR NAME OF BUSINESS) -
/—
ACTUAL
PI:Ith113 ^ J
0 []
/
LOT COVERAGf:'s _!� LOT COVEItAOE
LTA
w
I}
NG ADDRESS
PERDt1HelULE HEIGHT / PItOP09ED HEIGHT
✓'
/"
NUMHIOR
TOTAI. BLDG. AREA
ACTVAi.LOT AitEA�L''r)"O`L,�REQUIRED
GROUPI.
/PHON9E
YARDH PAOPOtlFm YARDS
❑ YES 'Nb
(PLANCHECKED BY, THIS SITE IS LOCATED IN THE CITY
// J OF EDMONDS. LOCAL SALES TAX
` _!./ ��. /t+. SHOULD BE CODED 31.04.
REMARKS
r _
'
REPAIR
FRONT SIUI•: RF.A FRONT SIDE
REAR
J
c �{ 7 .// l �•
cs� !/ (ZX �-� / /ti FJ •% / l �J'uy%� (, /•�JiJ
i.
'
DUMBER OF STORIES"
r-�
"1,EOA
LOT VAIiIANCL OIt CONDITIONALESS
�
SWIMMING POOL
M.'YES [] NO PERMIT.NUTIHER
fY %n•'S i
PLANNING DEPT. APPROVAL \.,.iLEP
DEMOLITIONj'
ONE NUMBER �
STREET V
STREET R/♦�.r/[:ir2•'I'• DEFICIENCY THIS PROPERTY
PRE -MOVE INSPECTION
GSTIl/W
EXISTING
1
N
Z
U
e
a
c
COMP. PLAN ST. R/(wicA'N'. 4—)•• -FT•
�.• ..n REMA' Dr•ivewav Slopes not to exceed those
icatizd or. Standard [Mo. `to. 103
V tiirrit y%r/P
S
- >/cL I � �/ I I yV ILC_.-•"� r�1
REMARKS , // �i
1/73
Plan Check No .....................
UUUVLJLJ Ln= U LCL_:
I
i
n...(:t� �iZC1 ,
BUILDING
(
p
FIRE ZO/NETYPE OF CCtNSTRUCTiGN STREET IMPROVED
;
PLUMBING
`'77
YES NO
HEAT & GAS LINE
0 []
PLOT PLAN (Indicate Building setbacks, abutting streets)
PENCE
SPECIAL INSPECTOR REQUIRED OCCUPANCY
SIGN
GROUPI.
f
I
6A9
�JNEW RESIDENTIAL E]LINE
NON-RESIDENTIAL F SIGN
ADD El❑ RETAINING
DEMOLISH WAIT"
ALTER ❑ EXCAVATE FENCE
OR FILL f.......... x..........Pi.)
❑ YES 'Nb
(PLANCHECKED BY, THIS SITE IS LOCATED IN THE CITY
// J OF EDMONDS. LOCAL SALES TAX
` _!./ ��. /t+. SHOULD BE CODED 31.04.
REMARKS
r _
'
REPAIR
❑
PRE -MOVE
INSP.
swim
POOL
c �{ 7 .// l �•
cs� !/ (ZX �-� / /ti FJ •% / l �J'uy%� (, /•�JiJ
i.
'
DUMBER OF STORIES"
r-�
UMBER OF
DWELLING '
UNITS
Plan Check No .....................
i
n...(:t� �iZC1 ,
BUILDING
(
p
I
PROPOSED USE
PLUMBING
HEAT & GAS LINE
y. 22—
aPENCE.
PLOT PLAN (Indicate Building setbacks, abutting streets)
PENCE
SIGN
I S
TRETAINING
WALL
�
SWIMMING POOL
I
DEMOLITIONj'
PRE -MOVE INSPECTION
1
EXCAVATION OR FILL
I'
DUE
I hereby acknowledge that I hove read this appllcntton; that the In-
TOTAL AMOUNT
III
formation given is correct: and that I nm ihs o r the duly author -
lied agent of the owner. I agree to comply with city and state law. regu-
ATTENTION
APPLICATION APPROVAL
lating conetruetloa; and In doing the work authorized thereby, no person
will be employed In vlolatlon of the Labor Cede of the Stale of Washington
THIS PERMIT
This application is not a permit until
totaling to Workmen's Compensatlnn Insurance.
AUTHORIZES
signed by the Building Official or his Dep -
NOTE: Permit Limit One Year (Except DEMOLITIONS whirl,
ONLY THE
WORK NOTED
utyi and fees are paid, and receipt is ac
.hall be completed 1n ninety dayf.: MOVED -IN BUILDINGS shall be com-
knowledged in space provided.
pleled In six months.)
��
IlGNATVi1E (O{VNEIt OH AGENT) llATE SIGNED
INSPECTION
DIRECTOR'S SIGNATSIRE r;
DEPARTMENT
/
r� •, .._ /'
CITY OF
•'''1 r
DATE
);"
NOTE: Applicant Subject to Plan Check Fee
s/ -- •
' `
775-2525
,!
This Permit corers work lu be duan un prlrnle nraperl)• ONLY.
Any construction on the public domain (curbs, nide—lits, drl—egrs,
INSPECTOR
marquees, etc.) will require separsle nermddsn.