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BUILDING DEPARTMENT
Applicant Fill
t 12 /�58
PERMIT APPLICATION
Inside Heavy Lines
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ADDR
NAME (OR NAME OF BUSINESS)
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LOT COI
LOT COVERAOFs � p
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PEIthtltlBIDL6 '1 fEIOHT 'C/r',
NUMBER
ACTVAL LOT AREA
CITY TELEPHONO
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REQUIRED YARUB PROPOSp;U YAIiUH
FRONT BIDE REAR FRONT HIUE REAR 1
NAME
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EGAL LT VAKfAN E 011 CON DITf BE
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YES, O NO PElth1IT AIllER
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PLA EPT. APY OVAL TE
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CITY TELEPHONE
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E%IBTI INO STREET RJg/L��'L,r.��/. DF,FICIENCYTFIIB PROPERTY
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NAME
COMP. PLAN HT. R/V43`,! .i.... •
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REMARKS
Driveway slopes not to exceed those
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CITY TELEPHONE
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MEe1ZE SERVICE 812E CLEARANCE
CHECK D HY
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STATE CENBD NUh1BER CITY
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LICENSE NUMBER
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REMARKS
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Leg¢ Des.rlptbM or or Attach Four Copll-es)�
}'PProppeerrty(Show/6oloW
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aFIRE
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BTKE IMPROVED
13 NO
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SPECIAL PE OCCUPANCY OCCUPANCYI-GROUP
GAS
❑ YE"
RESIDENTIAL
� LINE
PLAN CHECKED DY THIS SITE IS LOCATED IN THE CITY
:'
NEW
OF EDMONDS. LOCAL SALES TAX
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NON-RESIDENTIAL
❑ SIGN
/
J�iyL/ SHOULD 1E CODED 3AL04.
ADD RETAININGdARK8
WALL
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El DEMOLISH
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PRE -MOVE SWIM
REPAIR ❑ ❑ POOL
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o1 4 (' V r� i / �/ (/ /L
NUMBER OF STORIESI NUMBER OF
D W ELLIN6
4—= UNITS
NATURE OF WORK TO BE DONE
Valuation
Fee Receipt No,
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G7 i N C ' l C : Pr7�'•-e ! lP'C2 2 r
Plnn Check No ........ _............
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BUILDING hl�f{2
PROPOSED USE
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PLUMBING
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PLOT PLAN (inydicate{(IIullding setbacks. abutting Street.)
HEAT @ GAS LINE
SL
Y�L�•�s
u1
FENCE
SIGN
RETAINING WALL
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N
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SWIMMING POOL
DEMOLITION
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PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
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I hereby acknowledge that I have read this application; that Ne In-
formation given le correct; and that I arlt the owner, or the duly author.
Ixed ¢gent of tIt owner. I .gree to comply with city and elate laws regu•
ATTENTION APPLICATION APPROVAL
lating construction; and In eoing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
THIS PERMIT This application is not a permit until
relating to workmen's Compensation Insurance.
AUTHORIZES signed by the Building Official or Me Dep-
'
NOTE: Permit Limit One Year (Except DEMOLITIONN which
ONLY THE
µ'Onx NOTED uty; and fees are paid, and receipt is ac-
ehall be completed In ninety tiny-; MOVED -IN BUILDINGS shall be corn-
knowledged in space provided.
plelcd In SIX months.)
4MWATFItE (OWNER OK AGEN ) DATE SIGNED
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DEPARTMENT IR T e 8}O ATURE
DEEPARTMENT
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jv.res
CITY OF
EDMONDS DATE
NOTE: Applicant Subject to Plan Check Fee
775-2525
Thin Permit corer work 1, be done ea private properly ONLY.
Any comd uatlml on the public domain (curb., sidewalks, drit—Ys,
FILE
morqucee, rte.) will require neporale permin Non.
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BUILDING DEPARTMENT
USE .1 I PERMIT
ZONE NUMBER
I'll,pplicantFill
ldo Iieavy Lines
APPLICATION
,De �/
-",PERMIT
ADDRESS
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NAME (OR NAME OF BUSINESS)
PERMISSIBLE ms ACTUAL % •�
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LOT COVERAGE.:.. / LOT COVERAGE
01 -UAILING.ADDR
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PERMISSIBLE HEIUIiT;- PItOP08E)� tEIGHT 1
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T LEPHON" UMBER
ACTUAL LOT AREA, { TOTAL BLD.. AR 'A
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REQUIRED YARDS POPOSED YARDS
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NAME•
FRONT 81UE REAR FRONT BIDE: IVEAR
�LE.AL LOT VARIAN E OR CONDITI AL USF.
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ADDRESS
YES; NO •4 PERMIT FYI777
`PLANNING'
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EPT. APP OPAL i Z: ATE••t
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CITY TELEPIIONE NUMBER
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STREETR/W I'
EXISTING STREET R/Wn. ALT. % DEFICIENCY PROPERTY
NAME
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rTtHIS
COMP. PLAN ST. R/ W� 7......
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REMARKS c. ling llC1'� Y() exC':cd tl!Osi�
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ADDRESS /
9T.dyx.,Ited on otandarel Dwa. On. 1.R3
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FCITY
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I TELEPHONE NUMBER
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C7x-ECIKED" Y
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VI CLEARANCE
METER SL:E SERVICE SIZE CLEARANCE
D BY
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STATE LICENSE NUMBER
I CITY LICENSE NUMBER
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REMARICB
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Legal Description of Ppopert (Bkow Below or Attach Four Copl..)
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TYPE CONNECTION VfRIF D &
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PERC. TEST PERMIT NUMBER
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REMARKS
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FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
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I V '[3 46 ❑ NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
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NEW PIANE
_
YES
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PLAN CHEO THIS SITE IS LOCATED IN THE CITY
JE]RESIDENTIAL
NON-RESIDENTIAL SIGN
ADD RETAINING
_ OF EDMONDS. LOCAL SALES TAX
? H• ,SHOULD BE CODED 31.04.
DEDIOLISH ALL
❑ ❑
FE NC
EXCAVATE E
l„,r �I /✓�.•�%ul� .:: r'�G�lz �� r�/ .:i
-
ATER
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' OR FILL (. ... ... )
❑
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REPAIR ❑ PRE -ME P
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NUMBER OF STORIES NUD[HER OF
j
DWELL 0 j
¢ ; �ra> 4- UNITS
NATURE OF WORK TO BE DONE
Val—tion
Fac
Receipt Na.
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Pian Check No..... ................
BUILDING
[[Oyy
ly
PROPOSED USE
PLUMBING
G
aPLOT
PLAN (Indicate Building setbacks, abutting streets)
HEAT & GAS LINE
i
FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
,
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL ADIOUNT DUE
."-0
%
I hereby acknowledgo that I have read this application; that the In-
v�
formation given Is correct; and that I am the owner, or the duly minor-
,
a
Ized gent of the owner. I agree to comply with city and stale laws regu-
ATTENTION
APPLICATION APPROVAL
laung conetriellon; abl In dole. the work authorised thereby, no person
will be employed In violation of the Labor Cade of the State of Wuhln.ton
Tine PERDtIT
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 (Except 11E3IOLITION8 which
ONLY TIRE
WOIM NOTED
uty; and fees are paid, and receipt Is ac -
shall be completed In ninety day.; DIOVED-IN BUILDINGS shall be corn-
knowledged In space provided.
plated In six month..)
SIGNATURE (OWNER OR_AGENT DATE SIGNED
INSPECTION
DIRECT R•S SIGNATURE
�.
I
DEPARTMENT
_
OF
Y
CITY
EDDIONDS
DATE / 1
NOTE: Applicant Subject to Plan Check Fre
775-2525
This Permit c work to bo done on private property ONLY.
Any construction on the public domain (..,be, sidewalks, driveways,
INSPECTOR
marquee., etc.) will rebates separate permission.
75aa i
58
RECORD OFINS
Date Passeo
Foundation -Z-
7J (�
Plumbing (Partial)
(Rough)
Frame
Furnace�—
& Fuel Lines u
;�BS Final ?—
1
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i�
75aa i
58
RECORD OFINS
Date Passeo
Foundation -Z-
7J (�
Plumbing (Partial)
(Rough)
Frame
Furnace�—
& Fuel Lines u
;�BS Final ?—