660150.pdf:TM.ENT AppUcant M
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Legal DMHVtIOU
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"0.:
WORK To um DONE
NUMBER OF
NEW
SIGN
:ADWDJE
FENCE
94
DEMOLISH
.01
"TERI E3
RESIDENTIAL
NUMBER OF
I
DWELLING
REPAIR
NON-RESIDENTIA.L
UNITS
I IbLershy acknowledge that I have read this application; that the 113-
formation given In correct; and that I am the owner, or the duly author-
Ized agent of the owner. I agree to comply with city and state laws regu-
I&tlng 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.
(Except Demolitions which shall
NOTE: Permit I:Imit one Your be completed In ninety days.)
NOTE: ApPlicant Subject to Plan Chet* Fee
This Permit covers work to be done on private Property ONLY.
Any construction an the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate Permission -
I
13 YES
L MAP No.: BUILDING
PERMIT
660150
AR YAR BACK
3ACK STREET SETBACK RE
LOT AREA VACANT 0 a
J,
113 YES C3 NO I*
VARIANCE NUMBER
BUILDING AREA
---------------------
IOVED
Z
ERVICE SIZE CLEARANCE CHECKED BY
[ON D, BY
PERMIT NUMBER
TMEI-OF CONSTRUCTION STREET IMPROVED
[3 TES 13 NO
OTOR REQUIRED OCCUPANCY GROUP
13 NO
BUILDING
I VALUATION
BUILDING PERMIT
2 FEE
PLUMB NG
I
2
HU'IM'N
T
0
VA rAN
LU 10
NG EP
UIM P *WT
EE
PLU ING
3 PERMIT FEE
3
HEAT & GAS LINE
4 PERMIT FEE
a
— -TIGN PERMIT
5 FEE
rn
DEMOLITION
6 PERMIT I=
P T., (MECK
LAN SECK
7 FEE
81 AMOUNT DUE
ATTENTION
THIS PERMT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
APPLICATION APPROVAL
This application is not a pern-At until
signed by the Director of Building InsPec-
tion, or his deputy; and fees are paid, and
receipt is aclmowledged in space provided.
, - IV-6
FILE 4
I
RJOATION SUILDING PERMIT Appl. No.
`EDMONDS Building Deparhnent Permit limit, one year
15 hereby made for a permit to construct the following work, in accordance with the accon-*,
Two sets are submitted herewith for approval.
Off -St
repair .. ..... ...................................................... ............... Parking ....
..............
.... . ....
...................
Co t ty e ...........................
........................
p
..... Use zone ... Fire zone...
......... ... ......... ........
.......... Lot.2- 4.3 ........ Blk ....... .............. Addn..A/-.^ ...... �1�
-!� ................
Septic tan1L .
Am ILY ........ . ...... ......
..... ............ .... ...
..................
ront
f ........ r. side ....... 4 .......... 1. side ..... J.S ..... ............. 'rear .......... S ..................
7
Te
..... . ............... . Address..Je..!5.�� ............ . ...... No.6& ......
UBWder . .......... Address ... ......... tei. �0,ze.: .........
...............
5
Xv
................ ............................. Tel. No.'
....................................... ....... Address. .. .................. ....................... .
ksRe'm'ar ....................................................................................... . ................................................................... ..................
.................................................................................................. ............................................................... .... .. . ..
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .... . . . . . .
Ile above is a correct statement, and I agree to comply with all applicable Codes and State laws' rijda' this
work.
Signed Address ............................................ .....7 ... ..... 7-
PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance With the 401
proved:pians and specifications, and Building Department notations thereon.
Valuatio, n ........... .......... ................ Permit fee ........... & ............... Recd. byAX.16. .. At--�-r .. �11
4,
Building Department, By ............................... ............. Date ..... .. ....
.................................
This Permit does not covcr Plumbing, Sewer or Electrical installations.
I
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