660163.pdfj
POSTED ON KROLL MAP NO.: BUILDING
PERMIT
660163
BUILDIN6
DEPARTMENT
C an t
Ap'pnmnt M
A p p
NUMBER
PERMIT
APPLICATION
e a ineg
InBide Heavy Lines
In si d e H vy
I
JOB ADDRESS
e� 3 /
NAME (on NAME OF BUSINESS)
'7JEK"'
SIDE.YARD SITrBACK
STREET SETBACK
TBACK
71) —BE
REAR TARD SETBACK
SIAILI14U 4DVAESS
0
�11 0 0
USE,*ONE
LOT AREA
VAC 8
CITY
-R
T NUMB F
0 YES [3 NO
4ELEPHONEE
HEIGHT
BUILDING �MA
VARIANCE NUMBM�—
NAME
APPROVED
ADDRESS
REMARKS
-U1—TY
ELEPHONE NUMBER
T LEPIIONM U�'t ER
— /4 0 �'; '1/
-ADDRESS /
S>2 V _3 061) 0 0
CITY TIgLarnONED AINUMBER
_7r
67WAn ey IV
0
[] YES 0 NO
BUILDING
VALUATION
wo ED NE
I
13UILDING PERMIT
FEE
2
3
PLUMBING
PERMIT PEE
0
HEAT & GAS LINE
4
PERMIT FEE
SIGN PERMIT
SIGN
NUMBER OF STORIES
NEW
5
—
FEE
DEMOLITION
PERMIT ISE
ADD
DEMEO]LISH
FENCE
F-1 ALTER
11 RESIDENTIAL
NUMBER OF
a
PLAN CHECK
DWELLING
I 71FEE
REPAIR
NON-RESIDENTIAL
UNITS
8
AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
ATTENTION
formation given to 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-
THIS PERMIT
I&ting construction; and in doing the work authorized thereby, no person
AUTHORIZES
will be employed In violation of the Labor Code of the State of Washington
ONLY THE
relating to Workmen's Compensation Insurance.
WORK NOTED
(Except Demolitions which shall
NOTE: Permit Limit One, Year be completed in ninety days.)
8 1 A T7W, (OWNER OR . GEN i DA E SIGNED
4
INSPECTION
DEPARTMENT
LGN
�C
- L;� /_46_
7
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
PR 0-1107
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 permimsion.
[3 YES [:I NO
'A 0. 4�'
Z
49
to
4
I
'C�*-RLV 1 2-001
IV 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.
DIRECTO S SIGNATUREa
DATE
FILE
t
I