750164.pdf__
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tormntlon given le correct; and that I nm the owner, or the duly author.
SPECIAL Iver—un REQUIREDT
I OCCUPANCY
PROPOSED USE
a
LEGAL LOT VARIANCE OR CONDITIONAL UBE
F-1
'
pUj ADDRESS
THIS SITE IS LOCATED IN THE CITY
I
I
NON-RESIDENTIAL
❑
SIGN
PLANNING DEPT. APPROVAL DATE:
I
CITY
NUMBER
PERMIT
SIGN
•
f�1 SHOULD BE
BUILDING DEPARTMENT
Applicant FILL
ZINE NUMBER
j
REMARKS
PERMIT APPLICATION
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ADORES,
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761 Spruce
ALTER
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NAME (OR NAME OF HUBINESe)
PEitM7S8IIILE me ACTUAL
.
OROFILL
N CITY
TELEPHONE NUMBER
Al Stubbs
LOT COVERAGE LOT COV ESYAGE
REPAIR
METER SIZE SERVICE SIZE CLEARANCE CHECKED BY
N
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MAILING ADDRESS
O CITY LICENSE NUMBER
STATE LICENSE NUbiHE3i
PERbtI881IILE HEIGHT PROPOSED HEIGHT
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F
IN PT[OVE
0
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761 Spruce
ACTUAL LOT AREA TOTAL IILDO. AREA
A
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CITY
TELEPHONE NUMBER
Plat of Edmonds Block 3
Edmonds Washin ton
778-4121
REQUIREDYARDS PROPOSED YARDS
REAR FRONT SIDE REAR.I
n
NAME
TOTAL AMOUNT DUE
FRONT BIDE
,
tormntlon given le correct; and that I nm the owner, or the duly author.
SPECIAL Iver—un REQUIREDT
I OCCUPANCY
PROPOSED USE
a
LEGAL LOT VARIANCE OR CONDITIONAL UBE
F-1
C'Ae
LINE
pUj ADDRESS
THIS SITE IS LOCATED IN THE CITY
0 YES 0 NO PERMIT NUMBER
I
NON-RESIDENTIAL
❑
SIGN
PLANNING DEPT. APPROVAL DATE:
I
CITY
NUMBER
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SIGN
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f�1 SHOULD BE
(TELEPHONE
STREET R/N
EXISTING STREET R/W ............Fl`. DEFICIENCY THIe PROPERTY
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NAME
REMARKS
COMP. PLAN ST. R/W ............FT. ............FT.
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� AD➢REBS
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CHECKED BY
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OROFILL
N CITY
TELEPHONE NUMBER
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Ir
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REPAIR
METER SIZE SERVICE SIZE CLEARANCE CHECKED BY
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O CITY LICENSE NUMBER
STATE LICENSE NUbiHE3i
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I� i
IN PT[OVE
POOL
REMARKS
;UMBER OF STOKES
Legal Deserlptlan of Properly (Show Helow or Attach Four Copies)
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Ke l l ogg
Plat of Edmonds Block 3
TYPE CONNECTION I VERIFIED BY
IIWFLLING
I
Lots 21
22 and 23.
PERC. TEST PERMIT NUMBER
W
vsTn
RF. OP WORK TO HE DONE
nW
WREMARKS
aFIR
TYPE NSTRUCTION STREET Ib1PROVED
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�! 0 YES 0 NO
GROUP
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TOTAL AMOUNT DUE
Check No .....................
BUILDING
tormntlon given le correct; and that I nm the owner, or the duly author.
SPECIAL Iver—un REQUIREDT
I OCCUPANCY
PROPOSED USE
a
RESIDENTIAL
F-1
C'Ae
LINE
❑ _ _
PLAN CHECK..IIY
THIS SITE IS LOCATED IN THE CITY
El
NEW
El
NON-RESIDENTIAL
❑
SIGN
� L�
Y{L� OF EDMONEIC LOCAL SALES TAX
CODED 31.04.
PENCE
INSPECTION
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SIGN
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f�1 SHOULD BE
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ADD raa�
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KING
REMARKS
SWIMMING POOL
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WALLAVAT
PRE -MOVE INSPECTION
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ALTER
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FENCE
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OROFILL
(............_.......Ft.)
REPAIR
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IN PT[OVE
POOL
;UMBER OF STOKES
NUMBER OF
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IIWFLLING
I
UNITS
vsTn
RF. OP WORK TO HE DONE
I Valuation FCe I Receipt I
riem0-1 t S.h carpnrt
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TOTAL AMOUNT DUE
Check No .....................
BUILDING
tormntlon given le correct; and that I nm the owner, or the duly author.
PROPOSED USE
a
ATTENTION
PLUMBING
_—Plan
O
PLOT PLAN (Indlanta HaIlding eetbaoks abutting streets)
x•111 be employed In violation of the Labor Code of the State of Waablugton
HEAT &CAS LINE
relating to Workmen's Compensation Insurance,
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
9
shell be completed In ninety days; MOVED -IN BUILDINGS shall be com-
O
PENCE
INSPECTION
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SIGN
•
CITY OF
RETAINING WALL
EDMONDS
N
775-2525
SWIMMING POOL
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DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL.
a,00
a,00
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
FILE
TOTAL AMOUNT DUE
I hereby ncknowkdge'hof I have read this eppllcntlon; that the in-
tormntlon given le correct; and that I nm the owner, or the duly author.
(red ng,nt of the owner. I agree to comply with city and elate laws regu.
ATTENTION
lating construction; and In doing the work authorized thereby, no person
x•111 be employed In violation of the Labor Code of the State of Waablugton
TITIN 1'EItMIT
relating to Workmen's Compensation Insurance,
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY TIIE
x'Oiili NOTED
shell be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In elx month,.)
1,
3IGNATUDE ( WNEa E AGENT) DATE elONED
INSPECTION
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DEPARTMENT
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
775-2525
This 1'ennit covers work to Im don on private property ONLY.
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1®IISIAIIIIII�II wip r aulrr r rale uu„Ise. ns�lstlttweos•.esrila.snswe�ll
a,00
a,00
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
FILE