21223 95TH AVE W (3).pdf0. ............
APPLICATION WIJILOING PERMIT Appl. N' JZ12.
CITY. OF., EDMONDS Building Departmene Permit limit, one year
LICATION is hereby made for a permit to construct the following work, in accordance with the accom,
I an Aa'ns and specifications. Two sets are submitted herewith for approval.
ymgT P
JA�
Off -St.
114M alter
-'addrL ... ...........
-_,repair ....... ................................... . .............................. Parking ......................
6cupancy ................................ Const type. ................... ........................
Use zone... .............. Fire zone...
"""Address ......................................
..... .................. ..... Lot ......... ............ Blk ........................ Addr& ......
e
el J
S�-Y- 637 Septic tank. ...... ............
.... Area .... A�.t ........ fx ........ ......
�ontage ...................................
cks f 1. side ............. /0
g. set-ba ron�r-, ......................... r. side ............................. ................. rear ................................
'<Y/4el No 4 -7
Owne .......... ............................
r .................. ...................... Address. >_14ve.�5
M
ez- -7
. . . . . . . B ilder .............. ............... .... Address ............ 0 ................ ...................... Tel. No .............................
u
Plans by ... ...... Address ................................................. Tel. No .............
.................................... .................... ......
Remarks ....................................................
............ ...........
.......... 0 ...................................................... .............................. ......... 0 ......................................................................................
7.1 ...................................... 0 ...................................................... ................................................................................................
The above is a correct statement, and I agree to comply with all applicable Coder, and State laws regulating this
work.
Signed Owner/Ag ....... . . .. .... .. .. ..... .... ... ....... Address ............................................
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 thereon.
Vatuati . ........... . .... 0 ...... . Permit fee ........ 5<� ............ Recd. by ....... o ............................... ...........
Building Department, By .................. 0 ............ . ........................ Date .... . 7,;u . ...... 6.1 ............... ................ . . . . .
This Permit does not cover Plumbing, Sewer or Electrical installations.
-Z
At
OF EDMONDS
CAUILDING PERMIT
Building Department
W
Appl. No. ......
Permit limit� one year
MON is hereby made for a permit to construct the following work, in accordance with the accom,
Lim and specifications. Two sets are submitted herewith for approval.
Off -St.
Jt repair .......................... X_:�5 ............................................................................ Parking ......................
............................... Const. type ................................. Use zone ....... X�_.S'... Fire zone ..............
R-C2%6 -.. eq�- 4 / ........... Blk ........................ Addii_-. ow 7 A
.... . .... Lot ........
frontage....................................... Area ............................................ Septic tank ..........................................................
Ildg. =4=ks front ................ r side ............................. 1. side .............................. rear ................................
)wner..5.. b ................. Addres& .... . .A/Tel. NoZgA-.:�.�?,?`/
-Builder .............. .. ............................................... Address ............................. ...................... Tel. No .............................
Plansby .............................................................. Address .................................................... Tel. No .............................
Remarks ........ ....
rf ................................................. .....................
............
Al...
...........................................................
. ......................................................................................... ...... .............. ....... .......
........................... ....................................................................................................................................................................
The above is a correct statement, and I agree to comply with all applicable Codes and State laws regulating this
work.
Signed Owner/Agen4cla .. ......... AddressP Z��.�� .. n tDate.Z<2_77�2 :-C/,/
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 thereon.
Valuation .............. 1=15,
.................................... Permit fee ......... _; . ................ Recd. by...
- ( ... ... ...
Building Department, By ....... Z;e6� .................................................. Date ...... / ........................
This Permit does not cover Plumbing, Sewer or Electrical installations.