710396.pdfr
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I
PORTED ON KROLL MAP NO.: I PERMIT
BUILDING DEPARTMENT ApplleantFill NUMB710396
PERMIT APPLICATION Inside Heavy Lines JOB ADDRESS
_ S.
NAM ' OR NAME OF II Ss) -7 9 0 9 to� 3 ' S
t RO�� BIDE YAIi�T ;CK STREET '9'ETK!5-1 I REAR YARD >!.THAC!<
MA3LING — IESB
UBE ZONE LOT AREA VAOANT SITE .
CITY / C/ OTIELEPHONE NUMBER 2 S ❑ YEB it NO
-7 7 �42 HEIGHT I BUILDING AREA I VARIANCE UMB
E EFC
NAMV� J\lJ .
i
PLOT PLAN APPROVED
U
CFI
U
F
z
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0
yy4
M
U
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W
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a
0
0
(snow aclow or
NEW
RESIDENTIAL
AS
LINE
❑
NON-RESIDENTIAL
❑
SIGN
ADD
RETAI❑ KING
FJ
WALL
DEMOLISH
EXCAVATE
FENCE
ALTER
❑
ORFILL
xFt.)
❑ REPAIR
❑
PRE -swim
❑
..........
POOL
IN P.
IUMBER OF STORIES
NUMBER OF
DWELLING
I
UNITS
ral
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
TYPE OF
❑ YES ❑ NO
❑ YES ❑ NO
rL IiIIL'lilalwL nx THIS SITE IS LOCATED IN THE
CITY OF EDMONnS- LOG L SALE
REMARKS TAX SHOULD 8E CODED 31.04.
_
Plan Check No .....................
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
tRETAINING
WALL
N
ISWIMMING
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 slate laws regu-
ATTENTION
lating construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
THIS PEItbfIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
(VOTE: Permit Limit One Year (Except DE51OLITIONS which
ONLY THE
WORT{ NOTED
shall be completes in ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
3IGNATUIt (OWNE AGENT) DATE 81GNED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
NOTE: Applicant Subject to Platt Check Fee
PR 0-I107
This Permit covers work to be dune on private property ONLY.
Any construction an the public domain (curbs, sidewalks, drhrow&7s,
marquees, etc.) will require separate permission.
Valuation I Fee
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-
Imowlpdged in spacq proV4de(il ..r
firLI vv• —V ----Y
FILE
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