660105.pdfBUILDING DEPARTMENT
POSTED ON KROLL MAP NO.: 33UILDING
PERMIT
660 105
Applicant FM
NUMBER
Inside Heavy Lines
PERMIT APPLICATION
JOB ADDRESS
-5
NAME (OR NAME OF BUSINESS)
A. ".
SIDE YARD SETBACK STREET SETBACK
REAR TAKU blr]RACK
MAILING ADDRESS
-79044 191ST PL, z,vJ
UFjE ZONE LOW AREA
VACANT SITE
CITY TELEPHONE NUMBER
t:_ D M 0 0 _D� pLtl ul 83 6
I I
HEIGHT BUILDING AREA
0 YES NO
VARIANCE NUMBER
.]
NAME
I I
PLOT PLAN APPROVED
ADDRESS
A
REMARKS
CITY TELEPHONE NUMBER
NAM
D- e)_8 '1�61NISIE-Al
REMARKS
ADDRESS
METER SIZE SERVICE SIZE CLEARANCE
CHECKED BY
'CITY TB"t'l:iU14jU NUMBER
;Z -5
REMARKS
14T A TE I IMUN CITY LICENSE NUMBER
21
TYPE CONNECTION VERIFIED BY
Legal Description of Property (Show Below or Attach Four Copies)
LOT 4 ZZVZA V i LLA G G:
PERC. TEST PEP -MIT NUMBER
Q0. 2,
FIRE ZONE TYPE OF CONSTRUCTION
STREET IMPROVED
vo L-L) �A� V L-AiS,
I r] YES NO
SPECIAL INSPECTOR REQUIRED JOCCUPANCY GROUP
12AG_E� F
[]
PLAN
YES NO
CHECKED BY
UJA%41QGTOO
VALUATION
TOTAL FKK
BUILDING
VALUATION
Z
0
WORK TO BE DONE 1
,�>
IN r'-'4Meoj?T
BUILDING PERMIT
FEE
11 At I P1 0 0 M 3
PLUMBING
PERMIT FEE
HEAT & GAS LJNE
0
02
4
PERMIT FEE
SIGN PERMIT
FEE
NEW
ADD I
E
DEMOLISH
SIGN
11:1 FEWCE
NUMBER OF STORIES
5
—
DEMOLITZON
PERMIT FEE
�LTER
REPAIR
RESIDENTIAL
NON-RESIDENTIAL
=ER OF
LING
UNITS
6
—
7
PLAN CHECK
FEE
AttOUNT DU2�L
S
I hereby aelchowledge that I have read this applicallon; that the In-
formation given In correct; and that I am the owner, or the duly author-
ATTENTION
APPLICATION APPROVAL
I
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.
11,c,p1 Demolitions which shall
NOTE: Permit Limit One Year be completed in ninety days
TIUS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
This application is not a permit until
signed by the Director of Building Inspee-
tion, or his deputy; and fees are paid, and
receipt is aelmowledged in space provided.
�RE (OWNER OR AGENT) DATE SIGNED
- SPNAakii-F (0
<5
�/<I 'M M _1;ZV_ 6
L
NOTE: Applicant Snbject to Plan Check Fee
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
DIRECTOR'S SIGNATURE
-
DATkV
FILE
This Permit covers work to be done an private property ONLY.
Any constructlort on the public domain (curbs, sidewalks, driveways,
nutrquees, etc.) will require separate permixalon.
goo