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PLAN FILE NUMBER BUILDING
Building Permit Application IBA Hey Unes PERMIT 650047
NAME (OR NAME OF BUSINESS) - JOB ADDRE88 i
JoAnn Warner
MAII.IN6 ADDRESS BIDE YARD) S BACK) REAR YARD
r ; 18911-01ympic View Drive I
7
CITY TELEPHONE NUMBER USE ZONE - MAP NUMBER VACANT BITEEdmonds PE 8 5078 / I I ❑ YE8 0 NO p `
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II / NAME BUILDING AREA LOT A VARIANCE NUMBER I.-. ..
Lp
ADDRESS HEIGHT ALL BUILDING SETBACKS ,t
NOTE: TO EAVE LINES
Cr!
OiTY. TELEPHONE NUMBER REMARK,
NAME
?t ADDRESS Cued men Permit I.PERMIT NUMBER I STREET GRADE OHECK 0 •{
201 le
1
cbocos ry
e bath rooi
Remove• • bathe 11
NUMBER .. STORXESj
NEW
:r
■ DEMOLISH
■ ..
RESIDENTIALALTER
.:
REPAIR
NON-RESIDENTIAL
DWELLING
UNITS
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 author.
ized agent of the owner. I agree to comply with city and state laws rsgu-
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 WorkmeWs Compensation Insurance.
NOTE: PERMIT LIMIT ONE YEAR
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Idem
BUILDING
I VALUATION.
BUILDING PERMIT
2 FEE
PLUMBING
3 PERMIT FEE
HEAT & GAS LINE
PERMIT FEE
DEMOLITION
51 PERMIT FEE
61 AMOUNT DUE
ATTENTION
TIUS PERMIT
AUTHORIZE,
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 5-1107
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