640355.pdfvilding Permit Application
E or BUSINESS)
NAMV (OR NAM
Mal A, Weinhardt
XAWNG ADDRESS
19214 94th Ave. WestjEdmonds
CITY IXJUL&
PRO
NAME
H. D. Price
ZEE,
WDRESS
4g3ff'S-' Lucille Street
TELEPHONE NUI
.ITY
Seattle., 18, Wn. IPA. 3.2086
9 Bit# of Edmonds.9 according.to the
at thereof -rAnnrdAd in 161-9 of Plat
ge 39., records of the Auditor of the
Aoi lnni,qA AnA nara Pa. and add one
NEW DEMOLISH
ADD
ALTER RESIDENTIAL NUMBER OF
DWELLING
REPAIR NON-RESIDENTIAL UNITS
��4k�ingle mit dwelling.
I hereby acknowledge that I have read this app--- tJ th
formation given Is correct; anti 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 -a Compensation Insurance,
NOTE: PERMIT LIMIT ONE YEAR
;IG ATURE (OWNER OR AGErJT) DATE SIGNED
19/25/64
�461%
,/ 4/ U)
C='� / Z
E YARP
5
0 NE
/ A
Required
I -I YES r-I NO
13 YES
BUILDING
VALUATION
BUILDING PERMIT
2
FEE
PLUMBING
3
PERMIT FEE
HEAT & GAS LINE
4
PERMIT FEE
DEMOLITION
5
PERMIT FEE
6
AMOUNT DUE
ATTENTION
THIS PERMT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
ED51ONDS
PH 6-1.101
PERMIT
NUMBER 640355
REAR YAnU
_TANT SITE
MBER VAC
1 0 YES 0 NO
ALL BUILDING SETBACKS
NOTE: TO EAVE LINES
"a [3 NO
TOTAL PRE
2-*2 J�w
APPLICATION APPROVAL
This application is not a perlinit, until
signed by the Director of Building Inspec-
tion, or his deputy; and fees are paid, and
receipt is acknowledged in space provided.
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