17120 SEA LAWN DR (2).pdfa
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API ON & WORK PERNIIit.....,' Application No.��3 —�
CITY OF EDMONDS Building Department Permit Limit, One year
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APPLICATION is hereby made for a,permit to construct the following work, in accordance with the accompanying plana t,
and specifications:
»............ Ground Area........ No. Stories..........
WOB,H —New/Adds. 5
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Plana Submitted .......'................................� ............................ Cc t Type .......... Height-,,,,,,,.,
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LOCATION — Address 7� , 6; c c N 0�' •• . rr
.........._.................. ................................eE...._........./........ Use Zone.' -5... � 70/
Zone.............. � t .
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rf/ic.-cam.-C--�/Recorded Lot.......» _Block ................. Add'n � ...... ..deed../ ........ ..... Sews rare. 1
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Lot Areal.., a '3� .... Mina Bl Setbacks Front and Rear.2 ��f'dea........?�
. .. ..._...%i _..%........... Width. ,........ deed. dg. ........
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Owner..... _ �� �e Address.. �
Plans by..: _ »..:._deed».._...... ...... _edge .. ......................... Address,..... ». _..:..._... _......_... Phone.....:...
Bldg. by... fJ—cG�..:......».._............... Address.. ....deed... deed _. _... Phone...... .
Plbg. by......... ........................ _.............. ........ Address .... ..._........... .. .... _.._....... Phone ,
Heating by ......»..»........ ......_.._...... ..........._........... Address....... .1110. »...........
Phone.....,... I
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Fleet. by.. deed.. .»...........................:..................._........... Address....................... ... ..............._... ..._... Phone. f � ,y:
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Remarks..; _ f
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.. dodged_ .._...... _.. .. .................. _.....�._
_" to 11,VVI edge 6 ...� .....deed. _deed........ �.._ _.._......:_
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The above is a correct statement and I agree to comply with all applicable Codes and State Laws regulating the work.11 IP
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Date..." ?��' 43
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Signed: Owner/Agent ...� I
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PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance with the approved planaLd
and specifications and Building Department notations thereon. 'L I
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VALUATION PERMPr icTE)P19L.
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Plbg. .... .......
APPROVED: Heat deed a........ _...................... i l
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APPRO�
Date...........-!' iZ......... ..................... Elect. ....$deed......Y...................._.... i
BUILDING DEPARTMENT Others ... 3 ....................................:..
By,
i�cl.t...�!9ZUeri t I31d _ TOTAL FEE ;cede
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NOTES: No work requiring Building Department or City Engineer's inspection shall be covered before inspection and approval ��
Twenty -lour (24) hour notice requested. Contact the City Engineer prior rior to construction of all site utilities, such as
curbs, paving, driveways, sewer, water and street connections.
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