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�X NUMBER,,,',e., BUILDI
AppH&hf:Flll PERMIT
hildingfirmit Appi lInside Heavy Lines NUMBER (,Ar-iz.1ri-V
NAME (OR NAME OF BUSINESS) JOB ADDRESS
.-S
MAfrLfNG ADDRESS SIDE YARD SET BACK REAR YAIW
CITY TELEPHONE NUMBER, USE ZONE MAP NUMBER VAU"T SITE
4eW M 0AW5 17�lf - Y6 7 1 A/ 10'YES
NAME BUILDING ARE& LOT AREA VARIANCE NUMBER
HEIGHT
ALL BUILDING SETBACKS
NOTE: TO EAVE LIKES
TE—LEPHONM
NUMBER REMARKS
NAME
AD STREET GRADE CHECK
Encroachment Perml
t, PERMIT NUMBER
0 '.
RNuired 4
vo /v/d/z/v� N
e4 0 0 -YES n NO
CITY TELEPHONE NUKBERR METER a CLr.%RA C CHRcI= BY
IZE SERVICE SIZE N, E
J�
AV/4-
STATE LICENSE NUMBER CITY LICENSE NUMBER REMARKS
LOT BLOCK TRACT
VERIFIED BY
T I
T PERMIT NUMBER
J. RE ZONE TYPE OF CO STRR T.IMPRov
-$13TRUCTION ED:
0 YES
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
[]YES 0 NO
PLAN CHECKED BY
-/7
WORK TO BE DONE
NO. OF BLOGS. TOTAL FKX 1
BUILDING
I VALUATION
7 00
BUILDING PERMIT
NUMBER OF STORIE 2 FEE
--�XEW DLIMOLISH
PLUMBING
3 PERMIT FEE
ADD
El
HEAT & GAS LINE
ALTER' RESIDENTLILL 4 PERMIT FEE
NUMBER OF
DWELLING DEMOLITION
�,REPAIR NON-RESIDENTIAL UNITS
5 PERMIT FEE
.!f eROPOSED USE
1114 L 6 AWO . UNT DUE
I hereby acknowledge that I have read this application: that the In.
ATTENTION- APPLICATION. APPROVAL
formation given. In, correct; and that I am the Owner, or the duly authior-
�jl - . I . I . !� . .1
lzed agent of the owner. 31 agree to comply with city and state laws regu- THIS PERMIT This application Is not a.permit until
lating coustruction;. and� in' doing the work authorized thereby, no person AUTHORIZES
signed by the Director of,B
will be employed in vlo1aUo6 oj�tho Labor "a of the State of Washington uIldingInspec-,
ONLY THE
relating to Workmen's Compensation I Insurance. WORK NOTED tion, or his deputy; and fees are paid anid:�'
d In Space provid'ed.:�
receipt is ablalowledge
NOTE: PERMIT LIMIT OWYEAR
INSPECTION
SIGNATURE (OWNER OR AGENT DATE SIGNED DIRECTOR'SSIGNAT
DEPARTMENT
ITY OF
DATE
&APPROVED EDBIONDS
PLOT PLAN CHECF
1-a 6-1107
INSPECTOR
4
C-1i
Y
Earl Dillman Morris
A R C H I T E C T
Professional Associate The Seattle Chapter - A.I.A.
106 4th N. PR 8-1808
Edmonds, Washington
EscRIPTIONs
LWAL D
t I"
operty l6los North Meadowdale Hoadv Edmonds*
Irene 13, Kef9en pr P
dule Beach tan acre tracts$,
That portion Of r7ract 48v Headow
Intersection Of
Itining at a point of
described as followas Beg. -
with corner road thence souther17 along
North line tract 48 nee want
ond 60 fact thence north to north boundry the
said r
)f beginninge Also that -portion of tract 49 17ing
to point
West of following described lines' 13091:..Iiing at -a point 20
north and 42964 feet east Of north west corni9r tract
feet
to 3outh line'ot tracte Also
south 14 degrees east
4rd thence rtion.
of Meadowdale Beach; all that PO
D-3 supplement Plat
ae, beginning at a Point 349M, feet w03t
'5 -w-1
eing lii I 1� ; �. Z , T
east of follor west 22014 feet thence 11, - . ,
of south east corner of tract 36 thence Y'.
40 feet thence north 84 degrees 43 minutes West 132045
minutes
north 61
vacated ro d
4, feet to ;oint of beginning thence south 12 degrees
ast 3354,25 feet to road plus portion of
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iv:
W
A I PE I
RECO
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F d
oun a on
Plumbing1j" 7
r'(Rou�h)",
Fra
me
Furnac�e'& FU61 Lines
7
F 661
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