22004 98TH PL W (2).pdfAPPLICATION',-, BUILDING PERMIT Appl. No . ..... ......
CITY OF EDMONDS Building Department Permit lmuft� one year
APPLICATION is hereby made for a permit to construct the following work, in accordance with the accom-
panying plans and specifications. Two sets are submitted herewith for approval.
new alter Off -St.
Workaddn repair ............... 7.� ......................................................................... Parking ......................
Occupancy ................................ Const. type ................................ Use zone ..... *T ....... Fire zone .........................
Address..... .............................. ..... ..................... .. Lot ........................ Bk ....................... Addn ................................
Lotfrontage ........................................ Area ........................................... Septic tank ..........................................................
Bldg, setbacks front ........................... r. side ............................. 1. side .............................. rear ............................ I
'52
Owner5e. el. No.Z�
Builder ..............
..................................................... Address .................................................... Tel. No .............................
�)7
Plans by ............
Remarks .............
................. Address .................................................... Tel. No .............................
....................... ....... ..... ............................... I .................... ................................................................................................
.. ......................
.... ......
. . .. ........ . .................. ........ ..................................
The above is a correct statement, and I agree to comply with all applicable Codes and State laws regulating this
work. A
Signed Owner/
Address/rA ?X. 9 .....
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.
/t9;_0 CrC5 C�_� 7 / .......... ..... 4
Valuation ................... ............ Permit fee ........... !�� .. . .... Reed. by ....... . >
Building Department, By.....:.� ................................................................... Date .........
................. .. : .. 4o .......................
This Permit does not cover Plumbing, Sewer or Electrical installations.
NOW
BUILDING DEPARTMENT
PERMIT APPLY
14AME (OR NAME OF BUSINESS)
7A
01
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0
Applicant F111
inside Heavy Lines
f )to bl
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TEL
n,�_ea -S �7
DNEW
DRETAINING
0 ALTER
REPAIR
RESIDENTIAL
11:1
NON-RESIDENTIAL
F1
'AS
CLINE
SIGN
WALL
FENCE
( ........ . x .......... Ft.)
swim
POOL
D DEMOLISH
EXCAVATE
OR FILL
PRE -MOVE
INSP.
TUMBER OF STORIES
NUMBER OF
DWELLING
UNITS
STED ON KROLL MAP NO.:
PERMIT
NUMB
-720188
3 ADDRESS
o
)E YARD SETBACK STREET SETBACK
REAR YARD SETBACK
BE ZONE
LOT AREA
VACANT SITE
1
1 13 YES [3 NO
�1
I
'IQHT
I
I BUILDING AREA
I VARIANCE NUMBER
STREET R/W
EXISTING STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT. ............ FT. 101
TYPE OF
[j YES [3 NO
[j YES [:] NO
ILN WINUKWU 13Y THIS SITE IS LOCATED 1N THE"
rITy OF EDMONIDS. Ll."CAL SALES
MARKS TAX SHOULD BE CODED 31-04-
;-enr_e_ MW51- (20M
C,(—? ah
CC Q I AA �CI52 loo'Yl e V1 —t -S I
q 0 C4- 1rzqe_ Z-OK �1 kqg�soytJ
I Valuation I Fee I R=
Plan Check No .....................
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
I
tRETAINING
WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
formation given is correct; and that I am the owner, or the duly author-
Ized agent of the owner. I agree to comply with city and state laws ragu-
lating construction; and In doing the work authorized thereby, no person ATTENTION
will be employed In violation of the Labor Code of the State of Washington THIS PERMIT
relating to Workmen's Compensation Insurance. AUTHORIZES
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED
shall be completed In ninety dl�M-,AkOVED-ILN BUILDINGS shall be com-
i-LONAwim 11OWUR OR DAT/_ 1,11;1� INSPECTION
E "'o
DEPARTMENT
'2-
CITY OF
NOTE: Applicant Subject to Plan Chelk Fee EDMONDS
PH 6-1107
This Permit coven work to be done on private property ONLY.
Any construction on the public dormsin (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
W
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
Imowledged in space provided.
FILE
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