750344.pdfBUILDING DEPARTMENT UTNE NUMBS
Applicant Fill 750344
PERMIT APPLICATION Inside Heavy Lines
NAME (OR NAME OF BUSINESS)
O C1 TELEPHONE NUMBER
ME
ADDRESS
JOB
ADDRESS
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(ACCTUALAA
PERMISSIBLE<�
LOT COVERAGE
q
LOT COVERAGE
PEILNISBIBLE HEIGHT
PROPOSED HEIGHT
ACTUAL LOT AREA
TOTAL BLDG. AREA
REQUIRED YARDS PROPOSED YARDS
FRONT BIDE REAR FRONT BIDE REAR
LEGAL LOT VARIANCE OR CONDITIONAL USE
YES [3 NO PERMIT NUMBER
W
PRE -MOVE INSPECTION
EXCAVATION OR FILL
�J
I hereby acknowledge that I have rend this application; that the In-
formation given le cc...et; and tTOTAL AMOUNT DUE hat I nm the owner, or the duly author-
Q�
Ized agent of the owner. I agree to comply with city and .tate laws regu. ATTENTION APPLICATION APPROVAL
lating conetruetta.; and Ia doing 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'. Compensation Insurance. AUTHORIZES Signed by the Building Official or his Dep -
ONLY THE
N P-0 nit Limit One Year (Except DEMOLITIONS which WORK NOTED uty; and fees are paid, and receipt Is ac -
.hall a namplet d Ia ninety days; MOVED -IN BUILDIN08 .hall be nom_ knowledged In space provided.
pleI In six m nth..)
IIGN TU1tE WNER On AGENT) DATE ONED INSPECTIONDI$ TOR'. `e1ONAI
DEPARTMENT I
CITY OF
EDIIIONDS A
NOTE,: Applicant Subject to Plan Cljcck Fer
This Pr it l'mro work to be dune a. prate property ONLY. %%775-2525iv
Any construction on the public domain {curbs, sidewalks, driveways, FILE
marquees, etc.) will require separate permission.
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CITY
TELEPHONY. NUMBER
PLANNING DEPT. APPROVAL
DATE:
1
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STREET R/W
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EXISTING STREET R W ............FT.
DEFICIENCY THIS PROPERTY
NAME /
COMP. PLAN BT. R/W ............FT.
............FT.
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REMARKS
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TELEPHONE NUMBER
CHECKED BY
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TAT LICENSE NUMBER
CITY LICENBE NUMB
METER SIZE
SERVICE SIZE
CLEARANCE
CHECKED BY
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REMAItKd
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Legal Description
of Property (Show Below or Attach Four Copies)
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TYPE CONNECTION
VERIFIED BY
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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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❑ YES [3 NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
❑ YES NO
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RESIDENTIAL
LINE
LIN
PLAN CHECKED DY
THIS SITE IS LOCATED IN THE CITY
NON-RESIDENTIAL
F-1 SIGN
OF EDMONDS.TAX
ADD
RETAINING
31.04.LOCALSALES
SHOULD BE CODED
❑ DEMOLISH
❑
REMARKS
ElALTER
EXCAVATE
❑ FENCE
❑ OR FILL
(.......... x ..........
Ft.)
REPAIR
❑ PRE -MOVE
❑ SWIM
POOL
NUMBER OFSTORIES NUMBER OF
DWELLING
I
UNITS
NATUR OF WO/R)K TO HE DONE
Valuation
Fee
Receipt No.
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Plan Check Ne.
BUILDING
[D
4
PROPOSED USE
h
PLUMBING
U
aPLOT
PLAN (Indicate
Building Setbacks, abutting street.)
HEAT A GAS LINE
PENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
j
PRE -MOVE INSPECTION
EXCAVATION OR FILL
�J
I hereby acknowledge that I have rend this application; that the In-
formation given le cc...et; and tTOTAL AMOUNT DUE hat I nm the owner, or the duly author-
Q�
Ized agent of the owner. I agree to comply with city and .tate laws regu. ATTENTION APPLICATION APPROVAL
lating conetruetta.; and Ia doing 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'. Compensation Insurance. AUTHORIZES Signed by the Building Official or his Dep -
ONLY THE
N P-0 nit Limit One Year (Except DEMOLITIONS which WORK NOTED uty; and fees are paid, and receipt Is ac -
.hall a namplet d Ia ninety days; MOVED -IN BUILDIN08 .hall be nom_ knowledged In space provided.
pleI In six m nth..)
IIGN TU1tE WNER On AGENT) DATE ONED INSPECTIONDI$ TOR'. `e1ONAI
DEPARTMENT I
CITY OF
EDIIIONDS A
NOTE,: Applicant Subject to Plan Cljcck Fer
This Pr it l'mro work to be dune a. prate property ONLY. %%775-2525iv
Any construction on the public domain {curbs, sidewalks, driveways, FILE
marquees, etc.) will require separate permission.
BUILDING DEPARTMENT Applicant Fill °� "°RMIT
750344
PERMIT APPLICATION Inside Heavy Lines ADDRESS R Q
NAME (OR NAME OF BUSINESS) �- I'y.
e e �C� e Inn - V` LOT COVERAGE. LOT COVESYAGE i
ld M� 1.iNG DRESS " n PERMISSIBLE HEIGHT PROPOSED HEIGHT O �
O CI TEI LEPHONID NUMBER ACTUAL LOT AREA TOTAL DLDO. AREA
REpU1RED YAIIUtl PROPOSED YARDtl
AME FRONT tlIDE REAR FRONT HIDE REAR
i
1yi 1
U LEGAL LOT ARIANCE OR CONDITIONAL S
ADORE E
;
N 0 YEB 0 NO PERMIT NUMBER
PLANNING DEPT. APPROVAL DATE:
CITY I TELEPHONE NUMBER
STREET R/W O j
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
/ / / /LL S % r , COMP. PLAN ST. R/W ............FT. ........... FT. k7
7
REMARKS
—ci
R i
13 0 X F(W CHECKED 6Y
CIT TELEPHONE NUMBER
H �rJ00 �7 �31Z
_----__ _---^^- ^^ - ^ . METER SIZE I SERVICE SIZE I CLEARANCE I CHECKED BY I J
I[]YES EjNO
SPECIAL INSPECTOR REQUIRED I OCCUPANCY GROUP
[] YES Q NO
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
L - Lo ([
Plan Check No. ....................
RESIDENTIAL
F-1
IN.
BUILDING
NEW
❑
NON-RESIDENTIAL
El
SIGN
U
aPLOT PLAN (Indicate Building setback., ¢butting street.) HEAT A GAS LINE
ADD
❑
5�
FENCE
O
WALL RETAINING
ALTER
SIGN
DEMOLISH
El(PENCE
N
❑
OROFILLTE
x..........Ft.)
DEMOLITION
REPAIR
❑
MWINE
OVE
INSP.
El
;UMBER OF STORIEH
NUMBER OF
TOTAL AMOUNT DUE
DWELLING
/hereby acknowledge that I have read this application; that the In-
/ Q V
UNITS
,zed agent of the owner. I agree to comply with city and .tate law. regu- ATTENTION
lating construction; and In doing the work authorized thereby, no person
I[]YES EjNO
SPECIAL INSPECTOR REQUIRED I OCCUPANCY GROUP
[] YES Q NO
PLAN CHECKED BY THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
L - Lo ([
Plan Check No. ....................
7
BUILDING
(�
4 PROPOSED USE
PLUMBING
U
aPLOT PLAN (Indicate Building setback., ¢butting street.) HEAT A GAS LINE
'y 0-�(/,
5�
FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
/hereby acknowledge that I have read this application; that the In-
/ Q V
formation given Is correct; and that I am the owner, or the duly author.
,zed agent of the owner. I agree to comply with city and .tate law. regu- ATTENTION
lating construction; and In doing the work authorized thereby, no person
APPLICATION APPROVAL
will bo 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 Insuraece. AUTHORIZES
ONLY TI[E
' -6 lit limit One Year (Except DEMOLITIONS which WORK NOTED
Signed by the Building Official or his Dep -
Uty; and fees are paid, and receipt Is ac-
ehail o complat d In ninety days; MOVED -IN BUILDINGS shall be com-
knowledged in space provided.
Pict In six m nth.,)
SIGN TUBE WNER OR AGENT) DATE ZONED INSPECTION
DEPARTMENT
EI $ OR'S vSICNAT RE ') /,/
/J
CITY OF
A
EDhIONDB
NOTE: Applicalft Subjecl to Plan Cheek Fee
775-2525
/ —J.7S
This Permit rover. work to bo dune on private property ONLY.
Any construction on the public domain (curbs, sidewalk., driveways'
marquers, etc.) will require separate permission.
FILE
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S'FA L ENSE NUMBER
'Y LICENSE NUMBER
BUILDING DEPARTMENT Applicant Fill
RMIT
ZON'rE NUMBER
[y
4
PROPOSED USE
ICI
-�
PERMIT APPLICATION! I Inside Heavy Lines
10
PLUMBING
NAME (Oft NAME OF BUSINESS)
j, j /-�'•, /.,
PLOT PLAN (Indicate Hulldingbacks ut[ ng Teets)
A
21
15�_to
P
PI RM ISSIULE 'o ACTUAL
LOT COVERAGE LOT COVESFAGE
{
PRC. TEST P UMBER
F 1
d.
+
6
PERMISSIBLE HEIGHT PROPOSED HEIGHT
a
RETAINING WALL
y
N
CI TELEPHONE NUMBER
ACTUAL LOT AREA TOTAL BLDG. AREA
SWIMMING POOL
AME ,
REQUIRED YAItUd PROPOSED YA1tOd
FRONT SIDE REAR FRONT SIDE REAR
O
j
PRE -MOVE INSPECTION
U
ADDRESS
FIRE ZONE TYPE OF CONSTRUCTION EVT IMPROVED
TOTAL AMOUNT DUE
I�YES IjNO
LE GAI, LOT VAIt ANCENUOR CONDITIONAL USE
I hereby acknowledge that I hove read this application; that the In-
I
YES ❑ NO PERMIT MBER
fnrmntlon given le correct; and that I am the owner, or the duly author.
lxed agent of tan owner. I agree to comply with city and stats laws regu-
SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
PLANNING DEPT. APPROVAL DATE:
❑PLANBCHECKEL❑BYO
I
will be employed In violation of the Labor Code of the State of Washington
THIS PERMIT
CITY
TELEPHONE NUMBER,
REMARKS
AUTHORIZES
signed by the Building Official or his Dep -
❑ OR FILL
FILL ( *...........Ft.)
NOTE: Permit Limit One Year (Excret DEMOLITIONS whlclt
ONLY THE
WORE NOTED
uty', and fees are paid, and receipt is ac-
.hallbe completed In ninety days; MOVED -IN BUILDINGS shall be nom-
STREET n/W
O
pleted In elx months.)
SIGNATURE (OWNER Olt AGENT) DATE SIGNEDINSPECTION
/
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DI OR-II,a opIATURE J
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
4
NUMBER OF STORIES NUMBER OF
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t�
i' :�. %-�'� ,�'��� �. f-,,•, i � � .�/�. i
CITY OF
DWELLING
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NAME _
'
COMP. PLAN ST. R/W ............FT. ............ F T.
IC
IQ
DATE L _
UNITS
/ �L'Jjj Fj /
REMARKS
t
NATURE,tOF WORK TO HE DONE
' % /
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(Lei'
�i d (�
/ /
ni
BY
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14
INSPECTOR
07
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CITY
TELEPHONEP�/HONE N%UMDER/
CHECKED
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,/��_3
METER MIZE SERVICE SIZE CLEARANCE
CHECKED BY
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S'FA L ENSE NUMBER
'Y LICENSE NUMBER
BUILDING
[y
4
PROPOSED USE
ICI
U
PLUMBING
Legal Description of Property (Show Below or Attach Four Copies)
j, j /-�'•, /.,
PLOT PLAN (Indicate Hulldingbacks ut[ ng Teets)
A
21
15�_to
09 NC VERIFIED BY
/ {r� `
-
U
PRC. TEST P UMBER
F 1
d.
+
SIGN
RETAINING WALL
y
N
REMARKS
SWIMMING POOL
DEMOLITION
O
j
PRE -MOVE INSPECTION
j
EXCAVATION OR FILL
FIRE ZONE TYPE OF CONSTRUCTION EVT IMPROVED
TOTAL AMOUNT DUE
I�YES IjNO
I hereby acknowledge that I hove read this application; that the In-
I
fnrmntlon given le correct; and that I am the owner, or the duly author.
lxed agent of tan owner. I agree to comply with city and stats laws regu-
SPECIAL INSPECTOR REQUIRED
OCCUPANCY GROUP
❑PLANBCHECKEL❑BYO
I
will be employed In violation of the Labor Code of the State of Washington
THIS PERMIT
AS RESIDENTIAL ❑ INE
El NEW
NON-RESIDENTIAL HIGN
1-1
ADD ❑ DEMOLISH ❑ RETAINING
ALL NING
ALTER TE
❑
THIS SITE IS LOCATED IN THE CITY
OF EDMONDS. LOCAL SALES TAX
SHOULD BE CODED 31.04
REMARKS
AUTHORIZES
signed by the Building Official or his Dep -
❑ OR FILL
FILL ( *...........Ft.)
NOTE: Permit Limit One Year (Excret DEMOLITIONS whlclt
ONLY THE
WORE NOTED
uty', and fees are paid, and receipt is ac-
.hallbe completed In ninety days; MOVED -IN BUILDINGS shall be nom-
REPAIR PILE -MOVE SWIh[
INSP. POOL
pleted In elx months.)
SIGNATURE (OWNER Olt AGENT) DATE SIGNEDINSPECTION
/
',
DI OR-II,a opIATURE J
_
�
NUMBER OF STORIES NUMBER OF
..r
t�
i' :�. %-�'� ,�'��� �. f-,,•, i � � .�/�. i
CITY OF
DWELLING
I
'
NOTE: Applicant Subject to Plan Cbeck Fee
EDMONDS
DATE L _
UNITS
This I'cnnll a orck to be dune on ptivnte properly ONLY.
t
NATURE,tOF WORK TO HE DONE
' % /
Valuation I
FCC
Accelpt No.
INSPECTOR
i -- �• , -' -�
Plan Check No.... .................
BUILDING
[y
4
PROPOSED USE
U
PLUMBING
PLOT PLAN (Indicate Hulldingbacks ut[ ng Teets)
HEAT & GAS LINE
21
15�_to
-
FENCE
SIGN
RETAINING WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I hove read this application; that the In-
fnrmntlon given le correct; and that I am the owner, or the duly author.
lxed agent of tan owner. I agree to comply with city and stats laws regu-
ATTENTION
APPLICATION APPROVAL
intln6 co bet Motion; and In doing the work authorized thereby, no parson
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 his Dep -
NOTE: Permit Limit One Year (Excret DEMOLITIONS whlclt
ONLY THE
WORE NOTED
uty', and fees are paid, and receipt is ac-
.hallbe completed In ninety days; MOVED -IN BUILDINGS shall be nom-
knowledged in space provided.
pleted In elx months.)
SIGNATURE (OWNER Olt AGENT) DATE SIGNEDINSPECTION
/
',
DI OR-II,a opIATURE J
_
�
DEPARTMENT
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i' :�. %-�'� ,�'��� �. f-,,•, i � � .�/�. i
CITY OF
� EF."""'��i(' `i�+ `.t^'t'J
'
NOTE: Applicant Subject to Plan Cbeck Fee
EDMONDS
DATE L _
775-2525
This I'cnnll a orck to be dune on ptivnte properly ONLY.
t
Any construct ton an lite public domain (curbs, sldew•niks, driveway.,
marquees, etc.) will req.1re eep¢r¢le perntleelon.
INSPECTOR
i
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47
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RECORD OF INSPECTIONS
I
Date Passed
i I
Foundation
Plumbing (Partial)
(Rough)
Frame
i
Furnace & Fuel Lines
Final
4
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