028-81ST PL.pdfAPPLICATION t, BUILDING PERMIT
'EDMONDS Building Department
G
Appl. No...��'.......................
Permit limit, one year
iN is hereby made for a permit to construct the following work, in accordance with the accom-
nd specifications. Two sets are submitted herewith for approval.
alters Off -St.
QQ-` ................... Parking
.,repair..................................................................................•...........
....................... Ccnst. 1 xpe ............................... Use zone.. l(�.. ........... Fire zone ...........................
..:......:...... Lot .......�i4�......... Blk........................ Add .:?l:E�.�s�
e................................ Area ........................................... Septic tank .........................................................
front ...........`! �..... r. side ............. ........... 1. side.......... ............. rear...... f ..............
Address '�, �
1........... Tel. No fe...................
•
i' Builder .............................. Address......,............................................. Tel. No .............................
• Plans by.................................................................. Address.................................................... Tel. No .............................
Remarks.................................................................................................................:................................................................
The above is a correct statement, and I agree to comply with all applicable Codes and State laws regulating this
work.
Signed Owner/
DatesP..-//o._- 4'a
PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance with the ap•
proved plans and specifications, and Building Department notations
notations thereon.
ValuationJ6,.QsQ..O.......................... Permit fee..... nU................. Recd. by.........-i•-'"!` = _ •••••••••.....................
BuildingDepartment, By ................................. ..................... ................... Date ..................................................................
- - i
i
INSPECTION RECORD
Fdn, OK ............................................ Frame, OK ............. _..................................... Final, OK .......................................
This Permit does not cover Plumbing, Sewer or Electrical installations.