640226.pdfCd
P1
Applicant FIB
Idina Permit Application 11n.1d. H, Lt.
LA
Au Iz- E_ L
N -, Lo k)
y
NEW DEMOLISH
ADD I
ALTER RESIDENTIAL NU OR OF
REPAIR NON-RE131DENTIAL I UNITS
'R v— e_� i ip a ki—r ) is, L_ d (1.%TL0VPz.g
I hereby acknowledge that I have read this applicatic1n; thm; 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 _UMLT ONE YEAR
FILE
6�
BUILDING
N FILE NUMBER
PERMIT
640226
NUMBER
t
ADDRESS
7��Iv
YA��
SET BACK REAR YARD
';7
7L—
ZONE
MAP NUMBER VACANT SITE
/I/ el 0 YEB (3 NO 0
LDING AREA
LOT AREA VARIANCE VU�Ain
GHT
8 T
ALL 13UILDING SETBACKS
NOTE: TO EAVE LINES
&ARKS
Required
�S 0 NO
;TIR SIZE 1 13191
0 YES . [] NO
BUILDING
1
VALUATION
BUILDING PERMIT
2
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
DEPARTMF24T
CITY OF
EDMONDS
PR 0-1107
[] YES 13 NO
0. Or BLOG9. PERIBLOG.. TOTAL FEE
6 o-v
0
APPLICATION APPROVAL
This applIcation Is not a permit unt]
signed by the Director of Building Inspec
tion, or his deputy; and fees are paid, an
receipt Is acknowledged in space provide
ATURE
L
d
d.
0.
P
orhis map repvoesen -s Xwo teerae. s io7 1he -saaaAhereel
-iormae.1 44� Of, 46"411"1004 Sea b/;fw rra46 P
po fhon d I
PC /3
ten Xe f J7
L)ESC Rl P T1 Off 5:
7""if a. c i COYO
s
0 0 e A mef
Mor rr
1he *f C fl� S3 4vf 93A x/ o
k I
90003OA70,w ?p Sao/110
bole 44 .rai
e9, f-Ir am k* lmesmmo./� -1D op b
b6forolrof iffy, ad �01 7"fe aC at 6 (o 01 rdmonq's -.52:
3 Am We Me
in See 13. rwis 4:
r re otc;
I I k I I I I I
L
op )8er;pto�nt
dc
a, �flo
se o �4 e
421A� -1#ooce� .50 77
sswaf arraef
0;4e!�4 Ale,
A v1h *rarf �M
I JeXv 7jL
/00 /St* j or a/6
e (I
3' A77W
I. ILI, 1. iott'
lo7(
0 13 43 7 U#*Io 2 2 to 0 P, fhe oyce
I q of Oro
ero aA 4f 2 po ?
are 10
0 kro a 3" we
lemeracy (op 4 1hedc
for
mer .Sre
OL/I in rratf meg 4oll, Vo 4 cofr
I
7
Was
I I
i m:rh iter so r sle ye wo s bdye n 4a
Liol e JAeis
r ev 0 lrf ac"
So Ace cormo
e *So C) 06 Ate 40/ �//j e
40te; pop rVad 4f4oJ`mff*ls
a.# d1h e Acosof 4
/Ov A.giP C Lmdole 900 lie ;e 4 lot -X /
i