650138.pdf.......... . ...... ..... ...
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PLAN FILE NUMBER
PERMIT 650138
Applicant
ng Permit. ApplicationITIns'lile Heavy Lines
NUMBER
(OR N E OF BUSINESSL
OB ADDRESS
a 'k, 1�11_
eb Lk V%
BIDE YARD
SET BACK REAR YARD
Lk)
rELEPHoNE NUMB—
USE ZONE
MAP NUMBER VAC T SITE
13 NO
E
BUILDING AREA.
LoT AREA
VARIANCE NUMBER
88
HEIGHT
L BUILDING SETBACKS
'TO
NOTE: EAVE LINES
TE�LEPHONENUMBZR
j7.
.NAM
HESS
Encroachment Pe
PERMIT NUMBER ADE CHECK
Required
n- YES n
TELEPHONE NUMB
METER SIZE SERVICE SIZE CLEARANCE CHECKED By
I
STATE !�CENSE NUMBER
NUMBER
REMARKS
LOT BLOCK TRACT
TYPE CONNECTION
VERIFIED BY
ERC. TEST
PERMT NUMBER
FIRE Zol�E OF CONSTRUCTION STFMET IMPROVED
[] YES [3 PTO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
0 YES El NO
PLAN CHECKED BY
WORK TO SM DONE �Zo
NO. OF OLDGS.. PZRIBLOO. TOTAL FEE
09
BUILDING
VALUATION
<,A, A
BUILDING PERMIT
2 FEE
STORIES
_��LU
J2 - �49_v
NEW L"UMOLISH
G
3 PER�MIT
F
4t
ADD
—
HEAT & GAS LINE
ALTER RESIDENTIAL NUMBER OF
4 PERMIT FEE
.0 DWELLING
UNITS
DEMOLITION
REPAIR NON-RESI
5 PERMIT FEE
6 [AMOUNT DUE
I hereby acknowledge that I have read this application: that the in-
ATTENTION
APPLICATION APPROVAL
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-
THIS PER311T
This application is not a permit until
lating construction; and In doing the work authorized thereby, no person
AUTHORIZES
signed by the Director of Building Inspec-
will be employed In violation Of the Labor Code of the State of Washington
ONLY THE
tion, or his deputy; and fees are paid, and
relating to Workmen's Compensation Insurance,
WORK Z40TED
receipt is acknowledged in space provided.
NOTE: PERMIT LIMIT ONE YEAR
URE
..... INSPECTION
SIG TE 8 GNED
NANURE (OWNER OR AGENT) DA
DEPARTMENT
CITY OF
PE
EDMONDS
r
LOT PLAN C PROVED
i
=
PR 6-1107
/7/ FILE
0
I A