660223.pdfz
WING DEPARTMENT Applicant Fill
RMIT APPLICATION Inside Heavy Lines
�_(OR NAME OF BUSINESS)
frad L;Pnnd
L3 No. 107th
TELEPHONE NUMBI�R
. Lttle Em. 2-424.0
TELEPH
ME
0. B.
V I Y TELEPHONE NUMBER
ATE LICENSE NUMBKR CITY LITENSE -NUMBER
gal Description of Frperty (-Show Below , or Attach Four Copies)
Lot 14 Block 1 Admiralty Acres,
on
ue of work done$10,000)
" SIGN
NkEDWD I DEMOLISH I M FENCE
OSTED ON KROLL MAP N07
I BUILDING
PERMIT
I
660223
NUMBER
)B ADDRESS
ImN Sgoth W_
IDE Y ETBACK ISTREET SETBACK
REAR YARD SETBACK
USE ZONE LOT AREA
VACANT SITE
I
I
(3 YES [3 NO
0 i
-
]EIGHT BUILDING
AISZJL
VARIANCE NUMBER
94 1
A
�LOT PLAN APPROVED
REMARKS
I] YES 0 NO
0 ALTER [&j RESIDENTIAL NUMBER OF
II
DWE NG
1:1 REPAIR E] NON-RESIDENTIAL UNITS I
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-
Ized agent of the owner. I agree to comply with city and state laws mgu-
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.
(Except Demolitions which shall
NOTE: Permit Limit One Year be completed In ninety days.)
W�
NOTE. APPlicant Subject to Plan Check Fee
This Permit covers work to he done on private property UIN�1.
Any construction an the public domain (curbs, sidewalk", drlvmvnym,
murqueen, etc.) will require orpRrate penuission.
BUILDING wor,
ON
vALuATIc
ht-
BUILDING PERMIT
2
FEE 1/2 rperl
PLUMBING
3
PERMIT FEE
HEAT & GAS LINE
4
PERMIT FEE
SIGN PERMIT
5
FEE
DEMOLITION
6
PERMIT FEE
PLAN CHECK
7
FEE
81 AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
E] YES [3 No
z
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.
-� Z_
FILE
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