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BUILDING DEPARTMENT Applicant Fill
PERMIT APPLICATION Inside Heavy Lines JOB ADDRESS
NAME (OR NAME OF BUSINESS) X,,6— 7
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ALTER
RESIDENTIAL
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REPAIR
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I hereby acknowledge that I have read this application; that the In-
formation given is correct; and that I not the owner, or the duly author-
ized agent of the owner. I agree to comply with city and state laws regu-
lating construction; and In doing the work authorized thereby, no person
will be employed in violation of thi Labor Code of the State of Washington
relating to Workmen's Compensation Insurance.
�Excepl Demolitions which shall
NOTE: Permit Limit One Year be completed in ninety days.)
SIGNATURE (OWNER OR AGENT) DATE SIGNED
NOTE: Applicant Sitbiect to Plan Check Fee
This Permit covers work to be done m private property ONLY.
Any construction on the public domain (curbs, sidewalks, drivewayfl,
marquees, etc.) will mquire. neparate permission.
[3 YES [3 NO
BUILDING
I
VALUATION
—
YFu_iLr31NG PERMIT
2
FEE
PLUMBING
3
PERMIT FEE
HEAT & GAS LINE
4
PERMIT FEE
SIGN PERMIT
5
FEE
DEMOLITION
6
PERMIT FEE
PLAN CHECK
FEE
8
AMOUNT DUE
AT=NTION
THIS PERAIrr
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
PERMIT
NUMBER
[] YES C3 NO
[] YES 0 NO
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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.
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FILE
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All that portion of the Northeast Quarter of the Northwest Quarter of section 19,
Township 27 North, Range 4 East, W.M.-, In Snohomish County, Washington, described as
follows: Commencing at the Southeast Corner of Said subdivision; Thence S
along the South line of said Subdivision, a distance of 433.60 feet to the Tnue Point
' .. .-g.-....= of ._ Tract of l_- herein_described; Thence_continuing S -8900412011W,
a distance of 76.00 feet; thence N 1*34141"E, a distance of 188.47 feet; Thence North
'to the True Point of Beginning. EXCEPT the South 30.00 feet thereof for road.
Together with an easement for Ingress and egress over, across, through and upon
;the Westerly 10.00 feet and the Northerly 10.00 feet of that portion of the Northeast
quarter of the Northwest quarter of Sec. 19, Township 27 North, Range 4 East, W.M., In
Snohomish County, Washington, described as follows: Commencing at the Southeast corner
of said subdivision; Thence S 89004120"W, al6ng the South line of said subdivision, a
distance of 509.60 feet to the True Point of Beginning of the Tract of land herein des-
cribed; Thence continuing S 8900412011W, a distance of 86.00 feet; thence N 1034141"E, a
..a distance of 188.47 feet to the True Point of Beginning. EXCEPT the South 30.00 feet
thereof for road.
Date Passed
Foundition
Franie
Lines -
Final �
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