750197.pdfd
BUILDING DEPARTMENT
ZONE
PERMIT
TR 750197
Applicant Flu
PERMIT APPLICATION
Inside heavy Lines
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NAME (OR NAME OF BUSINESS)
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PERMISSIBLE n
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LOT COVERAGE
LOT COVERAGE
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MAILING ADDRESS /
PERMISSIBLE HEIGHT
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TELEPHONE NUMBER
ACTUAL LOT AREA
TOTAL BLDG. AREA
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REQUIRED YARDS PROPOSED YARDS
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NAME
FRONT HIDE
REAR FRONT SIDE REAR
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ADDRESS
LEGAL LOT VARIANCE
NO PERMIT
OR CONDITIONAL USE
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YES NUMBER
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PLANNING DEPT. APPROVAL DATE:
CITY
TELEPHONE NUMBER
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STREET R/W
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EXISTING STREET R/W ............FT.
DEFICIENCY THIS PROPERTY
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NAME
COMP. PLAN ST. R/W ............FT.
............1".
D Eli N C J— 2
REMARKS
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ADDRESS
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CHECXED BY
FC3TY
TELEPHONE NUMBER
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METER tllLE
SERVICE SIZE
CLEARANCE
CHECKED BY
STATE LICENSE NUA/BEiiI
CITY LICENSE NUMBER
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Legal Description of Property (Shaw Below or Attach Four Coplee)
REMARKS
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TYPE CONNECTION
yERlFIED BY
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FERC. TEST
PERMIT NUMBER
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n
REMARKS
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FIRE ZONE TYPE OF
CONSTRUCTION STREET IMPROVED
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ICYES ONO
SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
. RESIDENTIAL CA9
❑ LINE
❑ NEW
C] YES [3 NO
11
.
PLAN CHECKED BY
THIS SITE IS LOCATED IN THE CITY
❑ NON-RESIDENTIAL ❑ sIGN
Of EDMONDS. LOCAL SALES TAX
❑ nDD RETAINING
SHOULD E CODED 3104
❑ DEMOLISH ❑ WALL
REMARKS
❑ ALTER EXCAVATE FENCE
Fence requirements - section 12.14.040
❑ on FILL ❑ Js�...lrx....f/...Ft.)
❑ REPAIRPRE-1,OVE SWIM
❑ INSP. F1POOL
attached.
NUMBER OF STORIF-S NUIIIBEI1 OF
DWELLING
UNITS
NATURE OF WORK HE DON_E
Vniurtllon
Fee
Receipt No.
Y
Pion Check Nn.....................
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BUILDING
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ll
UPLUMBING
PROPOSED USE
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aPLOT
PLAN (Indicate Building setbacks, abutting streets)
HEAT k GAS LINE
PENCE/1
6✓C f
Q Q
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE-MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
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1 hereby acknowledgo 'hot I have rend t61e that N
application; e in.
formnfire given le correct; and that I ant the owner, or the duly author.
,
Ized ..gent of the owner. I ..grin to comply with ally and elate Inwe ergo-
APPLICATION
toting conru
etctloo; and In doing the work out➢prized Hereby, no person
ATTENTION
APPROVAL
will be employed In violation of the Labor Code of the State of Waahlagton
THIS PERMIT
This application is not a permit until
relating to Workmen's Camps ... Unit team"".
AUTHORIZES
NOTE: Permit limit One Year (Except DEMOLITIONS which
ONLY THE
signed by the Building Official or his Dep-
Ut and fees are paid, and receipt is ac-
p
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----
shall be completed In ninety days; MOVED-IN BUILDINGS shall be cont.
WORK NOTED
knowledged in space provided.
plated In six months.)
81GNATUItE (OWNER OR AGENT)
DATE SIGNED
INSPECTION
DEPARTMENT
DIR 's IONJ E
ORff
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CITY OF
F.DMONDS
DATE-
NOTE: Applicant Subject to Plan Check Fee
Thle I'ernllt c sere work la bo done on private properly ONLY.
775-2525
Any cans.....11. on the public d..mnla (curbs, sldrw'nllrs, driveways,
r:lu.... rl r.l .,III ,ulr, nrnrtrulr I �,Issimi.
FILE
ZON
BUILDING DEPARTMENT I AppLcantFlu E
PERMIT APPLICATION Inside Iieavy Linea
F' MAILING ADDR
JOB
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CITY
�MO�✓
NAME
ADDREe6
F
U
C CITY
! NAME
ce ADDRESS
�CEf6yi CITY
L
S STATE LICEN8
Legal Deacrlplts
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n
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O
• TELEPHONE NUMSE
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% 4 - '7 P.2
NUM BETR. 7501 `�7
ADDRESS
Plan Check No... ..................
PERMISSIBLE
LOT COVERAGE
ACTUAL qq
LOT COVERAGE
PERMISSIBLE HEIGHT
PROPOSED HEIGHT t
s
ACTUAL LOT AREA
TOTAL BLDG. AREA �
REQUIRED YARDS PROPOSED YARDS 1
FRONT BIDE REAR FRONT SIDE REAR
LEGAL LOT VARIANCE Oit CONDITIONAL USE
YES E3 NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
STREET R/W
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
REMARKS
YES Q NO
CHECKED HY
SERVICE 872E
I CLEARANCE
I CHECKED BY
rREUARH8
(OCCUPANCY GROUP
❑
NEW
(VERIFIED HY
El
GAS0
LINE
SIGN
PERMIT NUMBER
THIS SITE IS LOCATED IN THE CITY
SO EDDMONDBE COS. LOCAL SALES TAX
SHOULDED 31.04.
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m
wry
Plan Check No... ..................
.VIVa In
e'llta: GUNri '1'YYY: U[ ............
UI.-11VIY 114r.G1 latYl4V vssV
YES Q NO
(O
4
SPECIAL INSPECTOR REQUIRED
(OCCUPANCY GROUP
❑
NEW
RESIDENTIAL
NON-RESIDENTIAL
El
GAS0
LINE
SIGN
YES 0 NO
PLAN CHECKED BY
THIS SITE IS LOCATED IN THE CITY
SO EDDMONDBE COS. LOCAL SALES TAX
SHOULDED 31.04.
0
ADD
ALTER
DEMOLISH
EXCAVATE
El
RETAINING
WAIT'
FENCE...(? /
REMARKS
Fence requirements — section 12.14.040
PLOT PLAN (Indicate Building Setbacks, abutting streets)
HEAT & GAS LINE
❑
OR FILL
,
VV�i Y1 ...Ft.)
FENCE
1:1
REPAIR
❑
INSP.PRE-
❑
SWIM
POOL
attached.
(UMBER OF STORIES
NUMDER OF
T
RETAINING WALL
�
N
DWELLING
1
SWIMMING POOL
UN1T8
DEMOLITION
i
W
m
wry
Plan Check No... ..................
BUILDING
(O
4
PROPOSED USE
PLUMBING
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PLOT PLAN (Indicate Building Setbacks, abutting streets)
HEAT & GAS LINE
,
FENCE
l
bmf/
r Q O
SIGN
T
RETAINING WALL
�
N
1
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have [Sad this application; that the In-
r 00
formation given given Is correct; and that I sm the owner, or the duly author -
(zed agent of the owner. I agree to comply with city and stale law. reg.-
ATTENTION
APPLICATION APPROVAL
I
gating constructlon; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Wasbinston
TRIS 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 (Except DEMOLITIONS which
ONLY TRE WORK NOTED
uty; and fees are paid, and receipt is ac-
'
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
knowledged in space provided.
plcicd In els months.)
SIGNATURE (OWNER OR AGENT)
DATE SIGNED
INSPECTION
DlR OR's 1GNATU
�, �1 �/ i
!� i)
�7.
%S'i:'%tL�'.:,tJ�%
DEPARTMENT
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—
CITY OF
EDMONDS
DA '
NOTE: Applicant Subject to Plan Check Fee
—7S
775-2525
01
This 1'ernu[ corers work to be done on Private properly ONLY.
Any construct,(,, an the publle d.m.1. (curbs. Sidewalks, drW.—Y..
FILE
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USE
PERMIT -�C,•"a
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BUILDING DEPARTMENT
AppllrmtFin
'°
N°"8flR
PERMIT APPLICATION
I Inside Heavy Lines
JOB
ADDRESS,
7
NAME (OR.NAME.OF BUS1NE861
12,z5
't
PEItMISSIBLE '7
ACTUAL
LOT COVERAOF.
LOT COVERAGE
MAILING ADDREBB
PERMISSIBLE HEIGHT
PROPOSED HEIGHT
p
x
•,
O
751TY
/
TELEPHONE NUMBER
ACTUAL LOT AREA
TOTAL BLDG. AREA
z
1
1
r -, ./ I.
/ti - /
REQUIRED YARDS PROPOSED YARDS
NAME
FRONSIDE
T
REAR FRONT BIDE REAR
LEGAL LOT VARIANCE OR CONDITIONAL UBE
NUCONDITIONAL
aUl
ADDRESS _
[3 YES ❑ NO PERMIT
yM
PLANNING DEPT. APPROVAL DATE:
U
aj
CITY
TELEPHONE NUMBER
cc
STREET R/W
EXISTING STREET R/W ............FT.
DEFICIENCY THIS PROPERTY
p
NAME
COMP. PLAN ST. R/W
FT. ............FT.
,(
REMARKS
ADDIIE88
1
,Gy
67
CHECKED BY
N
CITY
TELEPHONE NUMBER
'
$
METER BILE
SERVICE BIZE
CLEARANCE
CHECKED BY
'
STATE LICENSE NUMBER
CITY LICENSE NUMBER
I
I
I
a
,
REMARKS
le
1
Legal Dcacrlptlon of Property (gnaw Below or Attach Four Coplee)
1
1
TYPE CONNECTION
VERIFIED BY
1'
I
p
11
(�
PERC. TEST
I PERMIT NUMBER
L.
E
W
REMARKS
m
+�
O
G
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
1
(] YES p NO
�.
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
i •,
1�1 ❑ GAS
LIN
�]• RESIDENTIAL LINE
NEW
❑ YES NO
I
PLAN CHECKED BY
THIS SITE IS LOCATED IN THE CITY
EDMUNDS. LOCAL SALES TAX
SIGN
NON-RESIDENTIAL ElSHOULD
SHBE CODED 31.04.
E] ADD RETAINING
REMARKS
DEMOLISH WALL
ALTER EXCAVATE ❑ FENCE /1-ence
regU i rimien'tS - SeCT1 On 12-14-040
OR FILL:..Ft.)
swim
E] REPAIR [:1INSP�[OVE POOL
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS
1
NATURE OF WORK O HE DONE
Valuation
Fee Receipt No.
r �/1-_.0#--�
Plan Check N. .....................
O
BUILDING
PROPOSED USE
PLUMBING
Q
PLOT PLAN (Indicate Bdl1 .gTft�bpeSe- Ntrmg street.)
t
HEAT A GAS LINE
1 U
PENCE
I)
(I
SIGN
tRETAINING
WALL
1
N
--
SWIMMING POOL
DEMOLITION
1
PRE -MOVE INSPECTION
EXCAVATION OR FILL
,1
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
-1.00 O
formation given Is correct; and that I am the owner, or the duly author -
tied agent of the owner. I. agree to comply with city and elate laws rcgu.
ATTENTION
APPLICATION APPROVAL
Iallnrconstruction; and In doing the work aulhorlmd thereby, no person
will be employed In violation of the Labor Code of the Stale of Washington
THIS PERMIT
This application is not a permit Until
relating to Workmen*. Compensation Ioeurance.
AUTHORIZES
signed by the Building Official Or his Dep-
"----�
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY Tit
WORK NOTED
Uty; and fees are paid, and receipt is ac.
i_�.---'
shall be completed In nicely days; MOVED -IN BUILDINGS shall be win.
ilnowledged in Space provided.
pleted In mix months.)
SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DEPARTMENT
DI OR'8 'a{GNATU /}
"'.�..: �'
1
(/,(
/..f .J._ /. '
. r.
CITY OF
r iT)''C(j��;j
I
EDMONDS
DATE
NOTE: Applicant Subject to Plan Check Fee
5- _ •I
775-2525
`�
This Permit eaves work to be done an private property ONLY.
Any construct on on the public domain (carbo, sidewalk., driveways,
m.vrmerr, Mr.) will rrenlrr ee lmratr pennl.M.n.
INSPECTOR
c
s
:
I
RECORD OF INSPECTIONS
Date Passed
Foundation .
Plumbing (Partial)
I
(Rough)
Fra me
Furnace & Fuel Lines
Final
y