640095.pdfJ.
40095
PLAN FILE NUMBER
BUILDING
1hu
Permit AppliCUtiOn
Applicant F1
Inside Heavy j,'I'nes
PERMIT
NUMBER
W4�1SIDE YAhD
7 /.1-- 4—
A-- Q15,
TELEPHONE NUFN
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NEW I " DEMOLISH
ADD 2--
ALTER 2P 71eRESIDENTIAL Nu
%BER OF
ELLING
REPAIR NON-RESIDENTIAL UNITS L
Aw
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 outhor-
Ized agent of the owner. I agree to comply with city and Mato laws MgU-
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
relating to Workmen's Compensation Insurance.
NOTE: PERMIT LIMIT ONE YEAR
I TURE (OWNE)R AGENT) DATE IGNE
=�— — , J — I ; 7 746 � e
CHECK &
FILE
USE ZONE
Required
n YES
METER 812
�31&u
0 YES
4� r
0 NO
!T BACK REAR YARD
FaDMUMBER VA AINWT blTz
A ;�d I W I ON
,/,S- I :�`ES 0
LOT AREA I —VARIANCE NUMBER
ALL BUILDING SETBACKS
NOTE: TO EAVE LINES
;72 6
BUILDING
I
VALUATION
BUILDING PERMIT
FEE
PLUMBING
3
PERMIT FEE
HEAT & GAS LINE
4
PERMIT FEE
DEMOLITION
5
PERMIT FEE
6
AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 0-1107
A
rs
Z
N
NO
RED OCCUPANCY GROUP
OF BLOGS.
TOTAL FKK
ev
2. 00
O-D
APPLICATION APPROVAL
This application is not a permit until
signed by the Director of Building Inspec-
tion, or his deputy; and fees are paid, and
receipt Is aclmowledged In space provided.
DIREC SIGNATUR:;��
"01
DATE
N
I