660288.pdf7 7
7'
�T
OX
POSTED ON KROLL MAP NO.: BUILDING 660288
BUILDING DEPARTMENT Applicant M
PERMIT
NUMBER
Inside Heavy Lines
APPL11
JOB ADDRESS
1�72,3
� -
SIDE YARD SETBACK
_7.4�.-
STREET SETBACK HEAR YARD BETBACK
-A AL
70'% Ave �L)
UBE ZONE
LO REA VACANT SITE
TRIPRONS NUMB
13 YES [3 NO a
'A
Wt4w S #7A/3 -0437
HEIGHT
BUILDING AREA VARIANCE NUMBW
PLOT FLA
REMARKS
TRILMPHONE NUMBER
REMARKS
IQ
mot.) _PQ rA
METML SIZE SERVICE SIZE I CLEARANCE ICHECKED BY
0 MBFA
S 11q
REMARKS
CITY LICENSE NUMBER
.............
TYPE CONNECTION
VERIVIND BY
LesW Description of Property (Bbow Below or Attach Four copies)
PERC. TEST
PERIM NUMBER
1013 Mex4owdake E
FIRE ZONE TIYPE OF CONSTRUCTION STREET n[PROV111D
113 YES 0 M
SPECIAL INSPE OCCUPANCY GROUP
OTOR REQUIRED
13 YES 1*
PLAN CHECEODD BY
VALUATION TOTAL PRE
WORK TO B DONE
BUILDING
I VALUATION
Z
:Fwako�.p QARpgyT!s!i'dc!S Ani�
BUILDING PERMIT
z FEE
of
PLUMBING
3 PERMIT FEE
HEAT & GAS LINE
PERMIT FEE
NUMBER OF STORIES
El NEW I 0SIGN
SIGN PERMIT
EI
5 FEE
A Lgn- ADD DEMOLISH I El PENCE
�REMENTIAL
DEMOLITION
6
ALTER NUMBER OF
PERMIT FEE
DWELLING
UNITS
L
PLAN CHECK
REPAIR NON-RESIDENTIAL
7 FE E
PROPOSED USE
a Rocs M
8 AMOUNT D
3/3 z-?-
/V
I hereby acknowledge that I have read this application; that the In-
ATTENTION
APPLICATION APPROVAL
formation given Is correct� and that I am the owner, or the duly auth or-
fled agent of the owner. I agree to comply with city and state laws regu-
THIS PERMIT
This application is not a permit until
lating construction; and In doing the work authorized thereby, no person
the Labor the
AUTHORIZES
S Inspec-
igned by the Director of Building
will be employed In violation of Code of state of Washington
ONLY THE
relating to Workman's Compensation Insurance.
WORK NOTED
tion, or his deputy; and fees are paid, and
(Except Demolitions which shall
NOTE: Permit Umit One Your
receipt is aclmowledged in space provided.
be completed In ninety days.)
SIGNATURE (OWNER OR AGENT) DATE
INSPECTION
DIRECTOR*B SIGNAT RE
DEPARTMENT
CITY OF
NOTE: Appfi4xt Subject to Plan Check Fee
EDMONDS
DA�V
t
PH 0.1107
.Me permit covers work to be done on Private Property ONLY.
Any construction an the public domain (curbsp eldewalkno drIvewayst
FILE
marquees, eft.) will require separate permission.
4