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640100.pdf7m Permit Apj FBuilding NAME (OR NAME OF BUSINEI A/ M—MIANG AD DRESS CITY NAME 92 V wu� Wu "Xi "U"M I ' W., 41e �PHONE 3-, FIR T P Lines N=BER 640100 JOB ADDRESS ?_Z r NEW Lj DEMOLISH _31 ADD I I ALTER RESIDENTIAL NUNUMITBBE R OF nREPAIR F] NON-RESIDENTIAL DWELLING I I a / reby a / cknowledge that I hal(e 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 regu- 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 FILE Required 1`1 YES 0 YES BUILDING VALUATION BUILDING PEIWT 2 FEE PLUMBING 3 PERMIT FEE HEAT & GAS LINE 4 PERMIT FEE DEMOLITION 5 PERMIT FEE 6 AMOUNT DUE ATTENTION TIUS PERMIT AUTHORIZES ONLY THE WORK NOTED INSPECTION DEPARTMENT OITY OF EDMONDS PR 6-1107 REAR YARD VACANT SITE El YES NO VARIANCE NUMBER $11T NUMBER STREET GRADE CHECK Z CLEARANCE BY L ICHECKE VERIFMD BY PERMIT NUMBER rSTRUCTION ST T IMPROVED xS NO tED OCCUPANCY GROUP or BLOCS. PERIBLOG. TOTA7FICIC 7� 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 acknowledged in space provided. A APPLICATION BUILDING PERMIT Appl. Nd__44-4.*r.. CITY OF EDMONDS Building Department Permit limit,'one,'Year, accom. is hereby made for a permit to construct the following work, in accordance with the ,panying p.ans and specifications. T o sets are submitted herewith for approval. Ic 41", new 00"""'alter Off -St. Parking . . ...... . ........... rk 'addn repair ( ..... ... 7 type ...... Y ................. Use zone ..... rz ................. Fire zone ..... ........... ccupancy.... Lot ....... . .... Blk ....................... Addn.... Address ...... ............. ............... . ........... Lotfrontage ........... 60 ................... Area ........................................... Septic tank ........ ............... ......... front ..... :::?�ff ........ T ............... rear ............................... �:�Bldg. set -backs ........... r. side ........... ............. 1. side ................ . . Owne gLn ................................................... Tel. No .......... r. . ......... ....... Addre, ................... Address ................................................... Tel. No .... ......................... . . Builder .............................. ----------- - -- - Plansby ................................................................. Address ........................................... I ......... Tel. No ..................... 6 ........ 7 Remarks....................................................................................................................................................... applicable Codes and State laws regUL B'd The above is a correct statement, and I agree to comply with all t work. Signed Owner/Agen ........... ddress.Z2.2 .6.1�4 ....... Date 3 ki M lm �;Z PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance with the, ap,,. proved plans and sOecifications, and Building Department notations thereon. 'by ............. ...................... Valuation ............ 6-:z ... t ... ......... Permit fee ..... 7/ ................... Recd. .......... Date ........ ........ ..................... ....................... ......... .. . ......... Building Department, By ....... INSPECTION RECORD Fdn, OK ............................................ Frame, OK .................................................... Final, OK ......... .............................. This Permit does not cover Plumbing, Sewer or Electrical installations.