660116.pdf...........
POSTED ON KROLL MAP NO.:
BUILDING
16
G EPARTMENT
PERMIT 6)(:)o
Applicant M
NUMBER
APPLICATIONInside Heavy Lines
JOB ADDRESS
Z OF BUSINESS)
SIDE YARD SETBACK
STREET BETIJAUP,
REAR YARD SETBACK
4.
7 _111-1 11
�. , �7 1
/., S.— I
.7-
USE ZONE
L5_T AREA
—
VACANT
ELMEPHONE NUMBERR—
11�
1
0 YES
1. 0
—
i2t?
BUILDING A.REA
VARIANCE NUMBER
HEIGHT
PLOT PLAN APPR ED
R�o
TELEPHONE NUMBER
RE161ARKS
METER SIZE SERVICE SIZE CLEARANCE CHECKED By
TELEPHONE NUMBER
REMARKS
CITY LICENSE NUMBER
TYPE CONNECTION vFRLkih;D BY
escription of Property (Show Below or Attach Four Copies)
PERC. TEST PERMIT NUMBER
7o /9x-17- 7Hcezv�- 4cVXA9,F.V /W
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
_Z�Y/ 0 YES E3 No
SPECIAL INSPE; 7RQUIRED
0
[3 YES 0
OCCUPANCY GROUP
-_7 y LJ
V&,L L) 1W 4 -C go ars, 194&,c bly" Z /3 r ot-
Ymo"nm�rxl
PLAN CHECKED BY
tldvArry k.),4 5 14, 7cA/,
Fef -7- OF kle s 7
Buf6ING
VALUATION
V^4VATION
Z
WORK TO BE DONE
/701) /:!-/111,1 'Y' /fri n A/ 9 -z
BUILDING PERMIT
FEE
1/7-/�
3
PLUMBING
PERMIT FEE
HEAT & GAS LINE
1
A
5
PERMIT FEE
SIGN PERMIT
FEE
F-1 NEW
j ADD
LA
DEMOLI
1
SIGN
1:1 FENCE
NU ER OF STORIES
a
DEMOLITION
PERMIT FEE
ALTER
Q REPAIRI
1Z RESIDENTIAL
1:1 NON-RESIDENTIAL
BER OF
NUMB
DWELLING
UNITS
7
PLAN CHECK
FEE
AMOUNT DUE
3
I hereby acknowledge that I have read this application; that th in-
formation given Is correct; and that I am the owner, or the duly alor-
ATTENTION
APPLICATION APPROVAL
Ized agent of the owner. I agree to comply with city and state laws regu-
I&tIng conntrucUon; 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.
(Except Demolitions which shall
NOTE: Permit Limit One Year be completed in ninety days.)
(C IYVNEJR� 04 AGENT) DATE SIGNED
BIG RE (C
LI 61�,e d 5- �
I
2 1�1111110
THIS PERI%nT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
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.
DIRECTOR'S SIGNATURE
__1 I
NOTE: Applicant Subject to Plan Check Fee
PR 0-1107
FILE
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
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