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750473.pdfUSE PERMIT /"-; BUILDING DEPART ENT pp ZONE /� 'I NUMBER 1`�Un Applicant Pill ,J X PERMIT APPLICATION Inside Heavy Lines IOe ADDRESS C.�J NAM (OR NAME OF BUSINESS) , -- '�410 .217 LEGLOT AREA SU nDIV ISION NO. W ��,AWL/�L�OT —S NO 3 MAILING ADDRESS �,/' ��—Le{-J / ) VARIANCE OR ADB NO, O /-7_ (�t;_/ COND. USE NO. CITY TELEPHONE NUMBER D PROPOSED YARDS/ HEIGHT / f AME J FRONT 3,2 SIDE" REAR /�"' Z ALLOWABLE PROPOSED J F U SIGN AREA SIGN AREA o' F ADDRESS = orneR /l L� D 1 R EQUIREME NT9 f/„/I g(] (/() V R CITY TELEPHONE NUMBER �(�J _1 PLANNINtG D T APPR AL ,/,(DATE NAME �-+ r`�— STREET R/W a EXISTING STREET R/W FT. DEFICIENCY THIS PROPERTY O I- U AD R 55 COMP, PLAN ST, R/W FT. FT. CI. CITY TELEPHONE NUMBER REMARKS Z Z Z R U STATE LICENSE NUMBER CITY LICENSE NUMBER CHECKED BY W Z Legal Description of Pny (Show Below or Attach Four oples) STREET AND/OR UTILITY ElYES O W WORK REQ'. ❑ NO 1,07 UNDERGROUND ❑ YES Z op WIRING REQ'D C3 NO a TYPE CONNECTION VERIFIED BY C ElYES PERMIT NUMBER la W SEPTIC SYSTEM n APPVD By CITY ENG. ❑ NO W J G REMARKS METER SIZE SERVICE SIZE CLEARANCE CHECKED I W W REMARKS x� )'vet f ❑ NEW RESIDENTIAL L NE TYPE OF STRUCTION CODE R/' t , •� ❑ NON-RESIDENTIAL ❑ SIGN _ 0 Ut•`1 �M�, �h I lyI AOD SPECIAL INSPECTOR AREA OCCUPANCYV—O1CCUPANT/ /Ll -Y RETAINING DEMOLISH ❑t,.,ALL REOU IRE ( GROUP LOA❑ IV• ❑ f ❑ ALTER EXCAVATE FENCE YES NO ❑ OR FILL ❑ I_ X_FT) PLAN CHECKED BY THIS SITE IS LOCATED INT CITY w ElPRE -MOVE swim OF EDMONDS. LOCAL SALES TAX REPAIR o INSP, POOL SHOULD BE E REMARKS z NUMBER OF STORIES NUMBER OF / DWELLING O J / UNITS O NATURE OF WORK TO BE DONE a PROPOSED USE VALUATION F E Z PLAN CHECK O NO. N n PLOT PLANINDICATE BUILDING SETBACKS, h It ABUTTING STREETS) BUILDING , VO U W PLUMBING O m G HEAT & GAS LINE FENCE SIGN RETAINING WALL SWIMMING POOL I hereby acknowledge that I have read this application; that the In'TOTAL AMOUNT DUE O� formation given le correct; end that I am the owner, or the duly author- Ized agent of the owner. I agree to comply with ally Md .tel. law. ragll- Jaung conatrueuml; and in doing the work autborlsed thereby on person ATTENTION APPLICATION APPROVAL Will be employed In violation of Me Labor Code of the Slate of Washington THIS PERMIT relacibg to Workmen's compensation Inea—ce. This application is not a permit until AUTHORIZES NOTE: Permit Limit One Year (Except DEMOLITIONS which ONLY THE signed by the Building Official or his Dep- ehall be completed In ninety days; MOVED -IN BUILDINGS .bell be corn- WORK NOTED uty; and fees are paid, and receipt is aC- Plele eIX Month,.) knowledged in space provided. INSPECTION 51 NAT RE (OWNER AGENT) SIGNED DEPARTMENT DIRECTO SIGN JOATS .Z( _ CITY OF EDMONDS DATE C�� `7 NOTE: flpphcaiir subject fO Plan check Fee / _ 775-2525 !i'1 / S This Permit covers work to be done on private property ONLY. Any construction an the public domain (curbs, sidewalks, driveways, ORIGINAL - fdc YELLOW - Inspector marquees, etc,) will require separate permission. PINK . C)"'- tall n _ n.,,...:.. REMARKS er FIRE ZONE TYPE OF,cpNSTRUCTION CODE "I. . "\/ 1 1 1\Y_" ! 11.1. ❑ El RESIDENTIAL L NE on given Is correct; and that I am the owner, or the duly author- ADD 17, ❑ ❑ NON-RESIDENTIALk.lci. DEMOLISH ! ATTENTION BUILDING DEPARTMENT Applicant Fill USE PERMIT ZONE �� NUMBER ❑ OR FILL ❑ FENCE X—�,) ❑ _ REPAIR signed by the Building Official or his Dep - NSPMOVE PERMIT APPLICATION Inside Heavy Lines ,OB R, UMBER OF STORIES n six menthe.) NAME (OR NAME OF BUSINESS) ADDRESS .1 -171 URE (O �NER OR AGENT) DATE SIGNED INSPECTION DEPARTMENT UNITS LOT AREA SUBDIVISION NO. ATURE OF WORK TO BE DONE - CITY OFEDMONDS �. •. �i.r i�l lit LEGAL LOT DATE _ C�ti .i.C_.l' W MAILING ADDRESS:. ©"YES C1NO 3 S 775-2525 �-- lr7 Z ; 'J / l-'. .C, /..I VARIANCE OR ADO GOND. USE NO. NO. I Any construe on the public domain (curbs, sidewalks, driveways, 0 CITYTELEPHONE NUMBER marquees, etc.) will require separate permission. ) PINK - Owner GOLD - Assessor -- _ PROPOSED YARDS FRONT SIDE 1 REAR/C HEIGHT Z I ' NAM ALLOWABLE PROPOSED a a H U SIGN AREA SIGN AREA W ADDRESS F Z OTHER REQUIREMENTS 1 C CITY TELEPHONE NUMBER PLANNING DPIT//))�APPROVAL E P Rll `' q c �I �J NAME/I STREET R/W EXISTING STREET R/W FT. DEFICIENCY THIS PROPERTY O ADDRESS U COMP. PLAN ST. R/W FT. FT, i - < REMARKS I is j E CITY TELEPHONE NUMBER Z Z z �� a 0 U STATE LICENSE NUMBER CITY LICENSE NUMBER CHECKED BY W Z Legal Description of Property (Show Below or Attach Four Copies) STREET AND/OR UTILITY ❑ YES Z el - _ / `� t •, L,.�/ /(�'/ WORK REQ'D ❑ NO t6fi UNDERGROUND ❑ YES = 7" WIRING REQ'D 13 NO TYPE CONNECTION VERIFIED BY N ❑ YES PERMIT NUMBER W W SEPTIC SYSTEM 3 U APPVD BY CITY ENG. ❑ No W J REMARKS m J METER SIZE SERVICE SIZE CLEARANCE CHECKED BY REMARKS er FIRE ZONE TYPE OF,cpNSTRUCTION CODE "I. . "\/ 1 1 1\Y_" ! 11.1. ❑ El RESIDENTIAL L NE on given Is correct; and that I am the owner, or the duly author- ADD 17, ❑ ❑ NON-RESIDENTIALk.lci. DEMOLISH EWA LLRETA ATTENTION SP RI ❑ ALTER E] ❑ OR FILL ❑ FENCE X—�,) ❑ : Permit Limi4 One Year (Except DEMOLITIONS which LPermit REPAIR signed by the Building Official or his Dep - NSPMOVE PIM o OOL WORK NOTED R, UMBER OF STORIES n six menthe.) NUMBER OF DWELLING / URE (O �NER OR AGENT) DATE SIGNED INSPECTION DEPARTMENT UNITS DIRECTOR'S SIGNATURE ATURE OF WORK TO BE DONE - CITY OFEDMONDS PLAN CHECK NO. BUILDING PLUMBING HEAT & GAS LINE FENCE SIGN RETAINING WALL SWIMMING POOL OF EDMONDS. LOCAL SALES TAX VALUATION FEE 10'crl� hereby acknowledge that I have read this application; that the In. TOTAL AMOUNT DUE on given Is correct; and that I am the owner, or the duly author- ent of the owner. I agree to CO ply with ally and state laws roto- construction; and In doing the work authorized thereby, no person ATTENTION APPLICATION APPROVAL employed Ia violation o[ Ne labor Coda o[ th& stale of WashWgton to Workmen's Compensation InsnrmG. THIS PERMIT This application is not 6 permit until : Permit Limi4 One Year (Except DEMOLITIONS which LPermit AUTHORIZES ONLY THE signed by the Building Official or his Dep - e completed In Nnety days; a1OVED-IN BUILDINGS shall be nom. WORK NOTED uty; End fees are paid, and receipt is ae- n six menthe.) knowledged In apace provided. URE (O �NER OR AGENT) DATE SIGNED INSPECTION DEPARTMENT DIRECTOR'S SIGNATURE ';. � L.;f,-, a,� tet_.,; - CITY OFEDMONDS DATE _ NOTE: Applicant Subject to Plait Check Fee `' 7 ^ t 775-2525 �-- lr7 This Permit covors work to be done on private property ONLY. Any construe on the public domain (curbs, sidewalks, driveways, ORIGINAL -file YELLOW - Inspeelor marquees, etc.) will require separate permission. PINK - Owner GOLD - Assessor