650183.pdf-!-T
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BLOCK
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Applicant Fit
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tion I Inside Ileav-v T lines
Far
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PERMIT
NUMBER 650183
�DDRESS t�o a-1 IV .2 6:a ep Y-01 7- -
-77
YARD
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ZONB MAP NUMBER VACANT SITE
0 YES E] -NO
DING AREA LOT AREA VARIANCE NUMBER
,HT L BUILDING BET13ACKS ow
NOTE: ATLO EAVE LINES
Required
[I YES M-rro
[] YES [3 NO
6
Z
N
03
PQ
I
NO. OF ELD08.
PERJBLOG.
TOTAL FEE
Z
FA
ow
BUILDING
VALUATION
—6
33UILDING PERMIT
FEE
NUMBER OF STOIRUIE 2
o 'E S 2
NEW
DEMOLISH
PLUMBING
ADD
3
3
PERMIT FEE
E] ALTER
RESIDENTIAL
4
NUMBER OF 4
REAT & GAS LINE
PERMIT FEE
REPAIR
NON-RESIDENTIAL
DWELLING
UNITS
0
—
5
5
DEMOLITION
PERMIT FEE
PROPOSEPD1.111
,4 6
6
AMOUNT DUE
I hereby acknowledge that I have read this application; that the In.
t.. In-
formation given to correct; and that I am the owner, or the duly author-
Ll
ATTIUNTION
APPLICATION APPROVAL
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
P
will be employed In violation of the Labor Code of the State of Washington
relating to Workmen's Compensation Insurance.
THIS PER511T
AUTHORIZES
ONLY THE
WORK NOTED
This application Is not a permit until
signed by the Director of Building Inspec-
tion, or his deputy; and fees are paid, and
NOTE: PERMIT LIMIT ONE YEAR
receipt is acknowledged in space provided.
;IGNATURE (OWNER 0 AGENT) DATE SIGN
/�D
INSPECTION
DEPARTMENT
CITY OF
ONDS
DIRECTOR'S SIGNATURE
DA%E�
P & APPROVED
I- - �'_7 -1107
PR 0
FILE
- — �r - c!n,i,), gg* -ii t 'ri.nst L5 feet:
"I AL IrES(
PPOTrEIRTy—
Barney D, Arstad
611 Oak Stroet
Edmonds, Wash. 98020
Vashingtond,
BegimiiMp, at tho Southi
of the SW4 of the SWI, of S&
VvRe 3 thence South
thonce North I' East 20 fee,
begluning-, thence North 37*
Thenoe North 44" 371 39" 1.',ai
South I * West 20304 foot; '
west 162 feet to the true pi
situated in t4o County of a