20429 79TH PL W.pdfk
Building Permit Applicatio
PERMIT
NUMBER
NAME (OR LqAssis ov BUSINESS)
JOB ADDRESS
�2c)
C9
MAILING A1JJJnLb5
Y
SIDE YARD
1
SET BACK jt�AR YARD
-- I
(?z
7 60
�
-.5—
IP
""3 —
CITY TELEP 01-IE NUMBEat
UVE
MAP NUMBER VAC T SITE
Vj C
1 0 YES NO
C A�
BUILDING AREA
LOT AREA VARIANCE NUMBER
NAME
14
ADDRESS
HEIGHT
PW
ALL BUILDING SETBACKS
NOTE:
—NUMBER
t 5 fe" R k_
TO EAVE LINES
CITY
I TELEPHONE
REMARKS
NAME
/7 oe;
94
ADDRESS
Encroachment Permit
r�"LU'r Nu�m� GRADE CHECK Is
/L) tAj
Required
rP1 YES ri NC
4
IN
CITY TELEPRONN 14 U MBER
_ERVICE SIZE CLEARANCE cnECKED BY
METER SIZE S
H
z
-77 (9 7c//
f3 M
I
STATE LICENHN NUTI�zn CITWT
REMARKS
LOT BLOCK
TYPE CONNECTION
VERIPIED BY
1:9
PERC. TEST
PERMIT NUMBER
FIRE ZONE. TYPE OF.ICONSTRUCTION ROVED
�
a.) NO
.
SPECIAL INSPECTOR
REWuinPjij
0 CCUPANCY GROUP
YES NO
PLAN
CHECKED By
NO. OF OLD05.
PERIBLOO.
TOTAL PRE
4
WORK TO 13
t�DONN
12
0
BUILDX q�G
VALUATION
I
BUILDING PERMIT
2
FEE
NEW
DEMOLISH
NUMBER OF STORIE
PLUI%IBING
ADD
3
PERMIT FEE
H AT & GAS LINE
ALTER
RESIDENTIAL
NUMBER OF
4
pE IT FEE
DEMOLITION
NON-RESIDENTIAL
DWELLING
UNITS 5
REPAIR
PERMIT FEE
P;ffOPOSED USE
r /9-
RFe
6
AMOUNT DUE
I hereby acknowledge that I have read this application*, that the in-
ATTENTION
APPLICATION APPROVAL
formation given Is correct; End that I am the owner, or the duly author-
ized agent of the owner. I agree to comply with city and state laws regu-
THIS PERM[IT
This application is not a permit until
luting construction; and in doing the work authorized thereby, no person
AUTHORIZES
signed by the Director of Building Inspec-
will be employed In violation of the Labor Code of the State of Washington
ONLY THE
tion, or his deputy; and fees are paid, and
relating to Workmen's Compensation Insurance.
WORK NOTED
receipt Is aelmowledged in space provided.
NOTE: PERMIT LIMIT ONE YEAR
DIRECTOR'
U �,71'd 9.'
DU vaq ly
5i
GNED INSPECTION
-6-1, 1 jVTffjRjEEff '(OWIKJER OR A'GE DEPART?dENT
27//r
CITY OF
—NA—TE
CHE9�y APPROVE0
EDMONDS
MAR 9 - 19b4
N
7AYT-P ,
PR 6-1107
Ile
I
I
Furnace & Fuel Lines —
Final