650353.pdfED ON KROLL MAP NO.:
DING DEPARTMENT
CATION I Applicant FM
FAIT APPLI Inside Heavy Lin 17OB ADDRESS
`RNAP D 6 r--
A F,
, W �6 1)
LICENSE NUMBER
- 0 1 — /3 el 13
6 6
ascription of Property (Show BeloN
L� 6T A P
� 0 r- -rJ4 E N
,7HkNCC! I
Ji, I t4 E 3Y 4:)' TH 15 N
nk
USE Z
TELEPHONE NUMBER �u j
PP, ;3— ;96, ? d HEIGHT
4(,j
I
or Attach Four Copies)
i)#VRF fl)
f
X�
�--
PERC. T7E&T
MIA �11CH /�;v
�F-S'CAW PD PiZoPirl2ty,
FIRE ZO11tE
—2E
TYPE OF
P7-Hj-; gra.yq n '
Lf- SEc /84-r�27
SPECIAL INSPECTOR
RE
-9--
0
'THA-1vC6 Al 33til
2: V AAbNG
�dEtICE-
s -3:361 -7 o Pr o)-
? #7 �L xv o le J 14 &
PLAN CHECKED BY
IAIL� jpj,4!,-`or-rHF. '30��b5' r: 10 IV,
I
-4
BUILDING
VALUATION
WORIC TO 13E DONE
AIA-Wl 84-�JIMJVT, C0A11FiFTF:10
BUILDING PERMIT
2
FEE
X
WIT,q I Al 6— V/ 1) N'T
3
PLUMBING
PERMIT FEE
HEAT & GAS LINE
Q
4
PERMIT FEE
NEW
F ADD I
DEQOLISH -
SIGN
FENCE
NUMBER OF STORIES
—
5
SIGN PERMIT
FEE
6
—
DEMOLITION
PERMIT FEE
S
ALTER
RESIDENTIAL
NUMBER OF
REPAIR
IF!
NON-RESIDENTIAL
DWELLING
UNITS
7
PLAN CHECK
FEE
-/::A M / /, �/ 11 Wr::- /, � I A/ e
8
AMOUNT DUE
I hereby acknowledge that I have read this application: that the In-
formation given In correct; and that I am the owner, or the duly author-
ATTENTION
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
will be employed in violation of the Labor Code of the State of Washington
relating to Workmen's Compensation Insurance.
THIS PERMIT
AUTHORIZES
ONLY THE
WORli NOTED
NOTE: Permit Limit One Year (Except Demolitions which shall
be completed in ninety days.)
SIGNATURE (OWNER OR AGENT) DATE SIGNED
INSPECTION
C
DEPARTMENT
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
Pit 6-1107
This Perndt covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways.
marquees. etc.) will require separate permission.
PERMIT- 650353
NUM13EIR
F2
-'T SETBACK
REAR YARD SETBAFT
11EA
VACANT SITE
�s
06 [j NO
IING
AREA
VARIANCE NUMBER
2
1
CHECKED BY
it BP
FNV"ER
ij YES [I NO
I V V. 69 e) I
APPLICATION APPROVAL
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.
FILE
d: did-
lo I o
do," I. I Ldd
I
d I If
did I fd� 9
1 4 1 -N. ff mad TO 1 4 1
J4
If.
19 1 r f j I +d.
15 f
Id19
TIT
6 � �
If If I I f.d 1. 1 Idd
19 1
4
f 1 do
01 ld 1 99
rd� fdd
I I r
I do,
Id.
.IT J. vd . r 0
d
do Ii I
I I I . I I . I I I I I 14 1 1 1
4
d
of ... . . I I I I. . I I I
, d . � , , TI
L T I dd
p
o
do, 4
IT I
I
01 1 4
I I L d I
Ir
IL I
.1 ft
I 'dooT 4 d
JfY 1 0
oll
- vil od
t 1 4 If I I I
4
IT 0
d"7
d I, I I I I I I
offdor "d 9
19
19
of I . .. . . .. . If,
I If I I I , I
odd,
do I
IT If 4, f of
I d
; ,
T, ld
If r d 91 1
47
of
fo,
If
4
ord, If
19 1
p
Tod 4 1 1
I If d,,, do,j Tood d. I
L I," of
19 1
I
p I
I
I IL
3 dr, I I I I , t � I T" 1 4, -
d
If; I
L)i I-
I I I I d L d I f
%, IT
I fi,
1, 4 1 Id. I If II I, 1 1
LI
I d f;f f I I
t9 I
If I I I 1 1 1 1 1
1 4 1
Id
p '4
k
If" RECORD OF INSPECTIONS
I did -I,d, 9 19
d
p
p
k I I'd I d._ I I Date Passed
Foundation
If
!do M 9 4 1
'p 1, 1
Id T 9,
Olumbina. (Pa I pd I
L