650155.pdfE�
Applicant Fill
Mit Applicatio nside Ileavy Lines
nTI
PERMIT
NUMBER 650155
OF BUSINESS)
JOB ADDRES9
IX6
/Anderson
SIDE YARD
SET BACK
REAR YAR
81st West
A'Z"FELONE NUMBh;R
USE ZONE
MAP NUMBER
VACANT SITE
PR 6-3238
0 YES 0 NO
LOT AREA
VARIANCE NUMBER
BUILDING AREA
HEIGHT
ALL BUILDING
SETBACKS
N
NOTE: TO EAVE LINES
REMARKS
TELEPHONE NUMBER
Dwroachment Permit PERMIT NUMBER STREET GRADE CHECK
BotheiUl Way *E9
Required
n YES NO I I
Z
W
I
TELEPHONE NUMBER
METER SIZE SERVICE SIZE CLEARANCE JCHECKED By
e Wash. EK 2-6888
IF 'LICENSE NUMBER CITY LICENSE NUMBER
REMARKS
Jill
BLOCK TRABcaTlchts
2 Seaview
Fenr,-e on roperty line on 187 S.W.
TYPE CONNECTION VERIFIED BY
and 81st West
PERC. TEST PERMIT NUMBER
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVrD'
YES NO
E] YES [] NO
OTAL rKE Z
FENCE - 3 ft, high
I
BUILDING
VALUATION
Town country Gedsar f-,2��'g .74-
2
BUILDING PERMIT
FEE
FENCE
2.00
NEW
DEMOLISH
NUMBER or STORIES
PLUMBING
ADD
I
3
PERMIT FEE
—
4
HEAT & GAS LINE
PERMIT FEE
ALTER
REPAIR
Fil RESIDENTIAL
NON-RESIDENTIAL
�R OF
NUMBE
DWELLING
UNITS
5
DEMOLITION
PERMIT FEE
PROPOSED USE
AMOUNT DUE
2.00
I hereby acknowledge that I have read this application; that th 112-
formation given is correct; and that I am the owner, or the duly auth or-
ATTENTION
APPLICATION APPROVAL
lzed 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 LIMIT ONE YEAR
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
This application is not a permit until
signed by the Director of Building Inspec-
tion, or his deputy; and fees are paid, and
receipt Is acknowledged in space provided.
11
1
3IG5A.TUj �(O%VNER OR AGENT) DATESIGNED
IRWT=0R"G TURE
-24-6�
CITY OF
EDMONDS
PR 6-1107
//,DATE
— �117-41�1
LOT I. HECK & APPRO VED
FILE