18922 OLYMPIC VIEW DR.pdfI tqc.
APPLICATI&4 & WORK PERMIT
Application No . — .,,f
CITY OF EDMONDS Building Department Permit Limit, One Year
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APPLICATION is herOy made for a permit to construct the following work, in accordance with the accompanyln9 plena -
and specifications:
,. �' WORK — Nevr/Addn.. "�]. �' .........:� ...... .... Ground Area....: ........................ No Storlea..........
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(f ............«. f .G Lax 1 _ ... .
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Plans Submitted :°t.....`....... .. •• �...�su.. ....« Conat. Type ...... ._ .... Hefght. ,
—Address `4y ac.(ff� Use Zone....�Ylre'Zone.LOCATION
Recorded Lok.s�........... Block,.... .............. Add'n....... ........ 'k�Ltt/.....:..................`.::._.G.`.:�`4». ... Sewerage...»..... ...
Lot Area ......... ................._... Width. .._.............._ Min, 81d...... g. Setbacks, Front and Rear............................... Sides.... _.....
Owne / ... ... 3y ..... Address./D&3Rn.Y!`
Plansby ..(.,...r/7 q i_..............................✓// ................ ....... Address y.7... ........ ...._...._........_..... .. Phone.....
;.i •. L.........1...'.f...... Addreee...,l....':Phone.��`
' .. g. Y..... ...... �t
Bldg., b
Plbg. by ......... ......... _......._.................._... _.......................... Address .......... ».................. »... .............. ........... Phone...... ..:».:. ..
Heatingby ......«. . .« ... .. ... ...... ....
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.. Address ..................._...... ... ... Phone.:...
Elect. b - ... ........... Address ....................... .............. .... ............................ Phone .. .......... .- ....» ....
Remarks................ ............. ................... _... .....................»...._ .'.
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.... .....
..... ..................... ........................................... ......« . ...................................... ..... ..
................. ........... .............«.........................................«.. ...« ................... .... .... ....« S
The above Is a correct statement and I agree to comply with all applicable Codes and state Laws regulating the work..
. ,Signed: Owner/Agent.... »....» ..... dress_. ._....... ................................
PERMIT Por.thenbove work is hereby approved, subject to the above conditions, and to compliance with the approved.plans
and specifications and Building Department notations thereon.
VALUATION PERMIT FEES:
....�............. Bldg. .... $. �.1_...... ................
Plbg. ... $ ........ .............. '
APPROVED: Cleat .... $................. .......... i
Date.........y�......1 L.. � `' G�:...............---................. Elect. .... $........................................
_ ,
BUILDING DEPARTMENT Others ... $........ i
By.._1f.L= :..........«............ .... . �� TOTAL FEE $j.. G _............._....
NOTES: No work requiring B tid ag Department. or City En er's inspection shall be covered before inspection and approval. i
Twenty -Pour (24f hou}notice requested. Contact the City Engineer prior to construction of all site utilities, such as. 1
curbs, paving, driveways, sower, water and street connections.
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