750435.pdfJ
�` �C\mss. in
REMARKS
1
N
Q
J
PROPOSED USE
VALUATION FEE
Z
METER SIZE
SERVICE SIZE
CLEARANCE
U
BUILDING DEPARTMENT Applicant Fill
USE PERMIT
ZONE NUMBER
4J!^5
I
PERMIT APPLICATI®N Inside Heavy Linos
,OB
C ABUTTING 5TREETS)
BUILDING
U
ADDRESS
1
❑
NEW
NAME (OR NAME OF BUSINESS)
FI RE��Z�D.NE TYPE OF CONSTRUU, ION
❑
❑
ADO
ALTEREXCAVATE
LEGAID
LOT AREA
SUBDIVISION O.
JC(
SPECIAL INSPECTOR
REQUIRED
❑ YES C1
AREA
WAIL NG ADDRESS a
❑ YEES ❑ NO
REPAIR
❑PRE-MOVEr
INSP.
O POOL
Z C
;0 133 �
VARIANCE OR
COND. USE NO.
ADB NO.
NUMBER OF STORIES
NUMBER OF
RETAINING WALL
CITY -
TELEPHON NVMBER
OWELLING
SWIMMING POOL
D
77/ —
PROPOSED YARDS
HE/IG�—HT
=
formation given is correct; and that I am the owner, or the duly author-
-I
NAME
FRONT SIDE
REAR
I('
C
-
APPLICATION APPROVAL
ALLOWABLE PRO
ED
-I
-
U
SIGN AREA
SIGN A
a
ONLY THE
signed by the Building Official or his Dep-
F ADDRESS
'VJ
WORK NOTED
uty; and fees are paid, and receipt is ae-
`----�
plelea in elx monlhe.)
UEOUIREMENT
OTHER /
SIGNATURE IOWNER OR AGENT) GATE SIGNED
INSPECTION
DEPARTMENT
DIRECTO ' SITU E
E CITY
TELEPHONE NVMBER
t n
i
a-01
-
a
NOTE: AIpplicallt Subject to Plan Check Pee
DEPT. PRO L
DATE
This Permit covers Work I.. done on private property ONLY.
�t/A�N�NING
.L�
- - �l
zT
ORIGINAL • Filc YELLOW - Inspcuw
marquoes, ate.) will require separate permission.
NAME
i I.
J r
,{ /J
E TO U1 A•I C `
STREET R/W
EXISTING STREET R/V�r0/ L) FT. DEFICIENCY THIS PROPERTY
1-
Q ADDRESS
(o y/O a
i!!
COMP. PLAN ST. R/vyli❑/ FT.
e
(� FT.
a
F CITY
TELEPHONE NUMBER
REMARKS
z
`,'./,f
_ /
U ST LICENS NUMBER
CITY L CENSE NUMB R
CHY
ECK
so
3 0 dL 3 8
B
c,2
Legal Description of Property (Show Below
or Attach Four Copies)
STREET AND/OR UTILITY
❑ YES
w
WORK REO'D ❑ NO
UNDERGROUND ❑ YES
O
WIRING REO'D ❑ NO
F
a
TYPE CONNECTION VERIFIED BY
j
E
N
W
j
❑ YES
PERMIT NUMBER
W
SEPTIC SYSTEM
Q
APPVD BY CITY ENG. ❑ O
W
,
J
�` �C\mss. in
REMARKS
1
N
Q
J
PROPOSED USE
VALUATION FEE
Z
METER SIZE
SERVICE SIZE
CLEARANCE
U
NO.
6 PLOT PLANINDICATE BUILDING SETBACKS,
C ABUTTING 5TREETS)
BUILDING
U
REMARKS
1
❑
NEW
D RESIDENTIAL GAS
LNE
[E]
FI RE��Z�D.NE TYPE OF CONSTRUU, ION
❑
❑
ADO
ALTEREXCAVATE
❑ NON-RESIDENTIAL
❑ DEMOLISH
❑ OR FILL
.:.N
RETAINING
❑ WALL
.1�./wI
1^ I ((F CE X�FT)
•,SWIM
///1�
JC(
SPECIAL INSPECTOR
REQUIRED
❑ YES C1
AREA
OCGUP�
GROVP
_NO
PLAN CHECKED BY THIS SITE IS LO
REPAIR
❑PRE-MOVEr
INSP.
O POOL
OF EDMONDS.
SHOULD Er
REMARKS
NUMBER OF STORIES
NUMBER OF
RETAINING WALL
OWELLING
SWIMMING POOL
UNITS
TOTAL AMOUNT DUE
1 hereby acknowledge that I have read tills application; that the In-
F
IN THE CITY n.
SALES TAX D
14 -
NATURE OF WORK TO BE DONE
NATURE
�` �C\mss. in
PROPOSED USE
VALUATION FEE
Z
PLAN CHECK
U
NO.
6 PLOT PLANINDICATE BUILDING SETBACKS,
C ABUTTING 5TREETS)
BUILDING
U
N
W
PLUMBING
C,
_
M
HEAT ae GAS LINE
O
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
/ 1
IF r
FFF / I
TOTAL AMOUNT DUE
1 hereby acknowledge that I have read tills application; that the In-
formation given is correct; and that I am the owner, or the duly author-
Iced agent of the owner. I agree to comply with city and state laws mgu-
ATTENTION
lating const Mellon; and in doing the worst authorlcad thereby, no person
APPLICATION APPROVAL
.
will be employed In violation of the Labor Code of this State of WYhington
THIS PERMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
This application is not a permit until
NOTE: Permit limit One Year (Exeept DEMOLITIONS which
ONLY THE
signed by the Building Official or his Dep-
—
ehnll be completed In ninety days: MOVED BUILDINGS shall be com•
WORK NOTED
uty; and fees are paid, and receipt is ae-
`----�
plelea in elx monlhe.)
71nowledged in space provided.
SIGNATURE IOWNER OR AGENT) GATE SIGNED
INSPECTION
DEPARTMENT
DIRECTO ' SITU E
CITY OF
t n
i
a-01
NOTE: AIpplicallt Subject to Plan Check Pee
775-2525
DATE rr
This Permit covers Work I.. done on private property ONLY.
om
Any construction on the public dain (curbs, sidewalks, driveways,
ORIGINAL • Filc YELLOW - Inspcuw
marquoes, ate.) will require separate permission.
PINK - O. - r GOLD . ',
e
r �
r�
•
ty
:
I;
i
!
_
`75Dy35,
bate Passed
-
Frvn,r
Fornace e I r t r:
Final
d
N �
C REMARKS 1 i
W
J
METER SIZE SERVICE SIZE CLEARANCE CHECKED BY i
�
\
I
F
BUILDING DEPARTMENT Applicant Fill
USE PERMIT
ZONE NUMBER ^7r -r)435
OF CONSTRU ON CODE
PERMIT APPLICATION Inside Heavy Lines
,OB DRESS
AD `(O
/�
NAME (OR NAME OF BUSINESS)
a L/—
RETAINING
❑ ADD ❑ DEMOLISH ORE LL
REOUIREID SPECTOR AREA OC GROUPA (L LOAD
LEGA LOT
LOT AREA SUBOIV ISION O,
J--
THIS SITE IS LOCATED IN THE CITY
W
AIL NG ADDRESS
❑YES ❑ NO
OF EDMONDS. LOCAL SALES TAX
BE
O
i
�
VARIANCE OR
COND. USE NO.
ADB NO.
G
CITY
TELEPHON NUMBER
NUMBER OF STORIES NUMBER OF
U
Z
J
DWELLING
PROPOSED YARDS
HEIGHT
4.,
=
Z
NAME
m
�
FRONT SIDE REAR
i
ALLOWABLE
PRO E^� D
-1
a
-
).
VALUATION FEE
SIGN AREA
SIGN A
PLAN CHECK
U
W
ADDRESS
OTHER
NO.
=
LL PLOT PLANINDICATE BUILDING SETBACKS,
EQUIREMENT
C
CITY
TELEPHONE NUMBER
e;
PLUMBING
ANNING DEPT. PRO L DATE
I ,2
O
NAME
M
HEAT & GAS LINE
TO (UZI U I"
STREET R' -
EXISTING STREET R/vyl'o/ p FT. DEFICIENCY THIS PROPERTY
�eoo
D ADDRESS
COMP. PLAN ST. R/4-0/" FT. D FT.
FENCE
1
B
Q
E CITY
TELEPHONE NUMBER
REMARKS
Z
z
It
to
-
_ /
O ��
U ST LICENS NUMBER
12
CITY LICENSE NUMBER
1 hereby acknowledge that 1 hove read this application:
formation glyen U correct: and that I am the owner, or the duly author-
CHECK Y
W
Z
-
3 vOL 38
ATTENTIONAPPLICATION
APPROVAL
i
latint construction; and In deing the work authonud person
will be employed in violation of the Labor Code of the Slate or Washington
THIS PERMIT
,2
Legal Description of Property (Show Below
or Attach Four Copies)
STREET AND/OR UTILITY ❑ YES
W
signed by the Building Official or his Dep-
WORK REQ'D ❑ NO
ONLY THE
and fees are and receipt is rue-
UNDERGROUND ❑ YES
WORK NOTED
ceppaid
knouty
knowledged in space provided.
Z
WIRING REQ'D ❑ NO
INSPEC
O
F
TYPE CONNECTION VERIFIED BY
RTION
DEPARTMENT
DIRECTO S1 TV
6
U
yy
-� �' %
We
❑ YES PERMIT NUMBER
W
W
O
SEPTIC SYSTEM
APPVD BY CITY ENG. ❑ O
(.i"'V/
W
N �
C REMARKS 1 i
W
J
METER SIZE SERVICE SIZE CLEARANCE CHECKED BY i
K
W
REMARKS
F
❑ NEW RESIDENTIAL LINE
FIRE ZONE TYPE
OF CONSTRU ON CODE
❑ NO N•R ESIDENTIAL ElSIGN
/�
RETAINING
❑ ADD ❑ DEMOLISH ORE LL
REOUIREID SPECTOR AREA OC GROUPA (L LOAD
❑ ALTER ❑
ORFILL®( XAF.T)
O qNE CH EC K❑ED BY
J--
THIS SITE IS LOCATED IN THE CITY
W
❑ PR E -MOVE
❑
OF EDMONDS. LOCAL SALES TAX
BE
O
REPAIR
[],SW"
INSP. POOL
SHOULD
Z
REMARKS
D
NUMBER OF STORIES NUMBER OF
u'
J
DWELLING
D
UNITS
NATURE OF WORK TO BE DONE
m
�
i
VALUATION FEE
PROPOSED USE
PLAN CHECK
ZO
NO.
LL PLOT PLANINDICATE BUILDING SETBACKS,
ABUTTING STREETS)
BUILDING
W
PLUMBING
O
M
HEAT & GAS LINE
j
U
�eoo
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
that the In-
TOTAL AMOUNT DUE 2 t 0
1 hereby acknowledge that 1 hove read this application:
formation glyen U correct: and that I am the owner, or the duly author-
-
Ired agent of No owner. t ngrce to comply with city and stab lass Rim
Marshy, no
ATTENTIONAPPLICATION
APPROVAL
i
latint construction; and In deing the work authonud person
will be employed in violation of the Labor Code of the Slate or Washington
THIS PERMIT
This application is not a permit until
relating to Wotkmen'a Compensntton loauNmea.
AUTHORIZES
signed by the Building Official or his Dep-
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
and fees are and receipt is rue-
shall be completed In ninety days; MOVED -IN BUILDINGS Shall be com-
WORK NOTED
ceppaid
knouty
knowledged in space provided.
pitted in six months.)
INSPEC
SIGNATURE (OWNER OR AGENTI GATE SIGNED
T
RTION
DEPARTMENT
DIRECTO S1 TV
yy
-� �' %
OF
/�ECITY /CQ7,�t
2l.•
" /A /D
ED MONDS
(.i"'V/
NOTE: pplicant SNb%eCt to Plan Oleck Fee
775.2525
DATE
This Permit duvers work to be done on private property ONLY.
tha domain (curbs, sidewalks, driveways,
RIGINAL - 1`0o YELLOW - Inspector
ORIGINAL-
i
Any construetlon on public
marquees, etc.) will require separate permission.
marquees,
PINK - 0.ner COLD - A,wsscr
r
.•
NAME
STREET R/W
EXISTING STREET R(W;,,i,')/./t-.
FT. DEFICIENCY THIS PROPERTY
Be PERMIT!i
0 ADDRESS j
COMP. PLAN ST. F? W/I iii�`�C,.
, FT. /"� FT.
BUILDING DEPARTMENT
Applicant Fill
NE NUMBER
'150435
REMARKS
O
Z
PERMIT APPLICATION
inside Heavy Lines
,OB •'
-
�,
W
'\
ADDRESS / (,'
i.:l.!•�. �/
CHECKED BY
U STATE LICENSE NUMBER
CITY LICENSE NUMBER
NAME (OR NAME OF BUSINESS)
i� tt�"l_J'I'/t :
'
..
I
LEGAL LOT•
LOT AREA
SUBDIVISION,
O.
('
STREET AND/OR UTILITY ❑ YES (
❑ YES ❑ NO
i..
('
or Attach Four Capias)
WORK RrEQ'D
ygj
MAIL NG'ADDR ESS
UNDE
❑YES
t
Z
VARIANCE OR
ADB NO.
i
0
•TELEPHONE'NUMBER
GOND. USE NO.
E IF V
O
'?
F
a
O CITv
Z
M T N M
E
W
PROPOSED YARDS
HEIGHT
Z
I
?�
FRONT SIDE REAR
W
O
APPVO BY CITY ENG.
2
Q
W
N
NAME
ALLOWABLE
PROPOSED
-1
a
W
H
SIGN AREA
SIGN AREA
SERVICE SIZE
CLEARANCE
CHEC KEO BY
I
u
W ADDRESS
E
f
OTHER • I- l
'
C CITYTELEPHONE
NUMBER
J
Q
3
-
❑ NEW RESIDENTIAL L NE
SIGN
❑
1'•J I
i
:.
Q
TYPE OF CONSTRUCTION
PLAA NNINGNG DEPT. •APPROV/TL` `I""` �
DATE
I
.•
NAME
STREET R/W
EXISTING STREET R(W;,,i,')/./t-.
FT. DEFICIENCY THIS PROPERTY
0 ADDRESS j
COMP. PLAN ST. F? W/I iii�`�C,.
, FT. /"� FT.
_
Q " -
tI CITY TELEPHONE NUMBER
REMARKS
O
Z
p /
-
W
'\
CHECKED BY
U STATE LICENSE NUMBER
CITY LICENSE NUMBER
STREET AND/OR UTILITY ❑ YES (
Z
W
i..
Legal Description of Property (Show Below
or Attach Four Capias)
WORK RrEQ'D
171 No
UNDE
❑YES
Z
WIRI
0
TYPE C O
E IF V
F
a
R
NS
M T N M
E
W
SEPTIC SYSTEM
?�
W
O
APPVO BY CITY ENG.
W
N
J
Q
REMARKS
W
'1
METER 512E
SERVICE SIZE
CLEARANCE
CHEC KEO BY
E
W
REMARKS
!F 1
Q
3
-
❑ NEW RESIDENTIAL L NE
SIGN
❑
1'•J I
i
:.
FIRE ZONE
TYPE OF CONSTRUCTION
CODE
NON-RESIDENTIAL 1:1
❑ AOD
RETAINING
❑ DEMOLISH ❑
SPECIAL IN
REQUIRED
AREA
OCCUPANCY-. OCCUPANT
GROUP LOAD
WALL
❑EXCAVATE FENCE!
ALTER ❑ OR FILL i� (- X /�' FTI
❑ YES ❑ NO
O
PLAN CHECKED By
THIS SITE
IS LOCATED IN THE CITY
EDMONDS. LOCAL SALES TAX
E]OF
REPAIR ❑PRE -MOVE ❑SWIM
INSP. POOL
HOO DBE D
SHOULD
O
Z
NUMBER OF
.`
REMARKS:
I
NUMBER OF STORIES
DWELLING
L1 %
UNITS
m
NATURE OF WORK TO BE DONE
t' - /,' �!-
%•
, I
I.
it
VALUATION FEE
PROPOSED USE �'
PLAN CHECK
Z
0 _
NO.
y PLOT PLANINDICATE' BUILD N 19E BACKS,
�-
C ABVTTING�9TREES)-
BUILDING
UWi
W
PLUMBING
0
m
HEAT & GAS LINE
O
FENCE
��. trt (••
SIGN
RETAINING WALL
,
SWIMMING POOL
,
I hereby saknuwladge that I h-, .ad this Spat iCation; that the In-
TOTAL AMOUNT DUE
rormation given Is correct; and that I are the Owner, or the duly author-
ized agent of the owner. I agree to complY with city and state laws MSU-
thereby, no
ATTENTION
APPLICATION APPROVAL
lating construction; and In doing the work authorized person
Willbe employed In ylolallort or the labor Code of the State of Washington
THIS PERMIT
This application is not permit untll
pp
relating to Workmen's Compemsllon Insuranee.
AUTHORIZES
signed by the Building Official or his Dep
-
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
utyi and fees are paid, and receipt is ac -
.hall be completed In Nnety days; MOVEDdBUILDINGS shall be m•
WORK NOTED
knowledged in space provided.
plated In mix months.)
INSPECTION
SIGNATURE (OWNER OR AGENT)
DATE SIGNED
DEPARTMENT DIRECTOR'S SIGNATURE /
_
- CITY OF
r; : r'' I / C.Gf L-�L• �l
"
EDMONDS
GATE ~
NOTE:.Appllcant Subject to Plan Clieck Fee
i / "`
775-2525
i / -�
This Permit covers work to be done on private property ONLY.
the domain (curbs, sidewalks, driveways,
-
ORIGINAL - File YELLOW - InspcUor
I
Any construction an public
marquees, etc.) will require separate permission.
PINK -0—e, COLD - Ascesscr
I