660343.pdfm
BUILDING DEPARTMENT
Applicant F111
inside Heavy Lines
PERMIT APPLICATION
NA�
............
FNA"'
0
N N
( 1�/ " 7Z /0 1 1
USE ZONE LO
MBE
NU
R )NEI
TELEP ft
ZU4 (J d ;M] HEIGHT BU
Wmr
"IM�MARKS
10le- /:S.
METER BE
� TE ONE NUMBER -34M
1!�', _11af ZF�l W=RKS
Mr 7A7�
Oak rok ve-arfc_
13 YES
I
BUILDING
VALUATION
rO BE DONE
2
2
BUILDING PERMIT
FEE
3
PLUMBING
PERMIT FEE
HEAT & GAS LINE
4
PERMIT FES
SIGN PERMIT
NEW
E
El SIGN
ITORIES
rORIES
5
FEE
ADD
DEMOLISH
FEN(
6
DEMOLITION
PERMIT I=
ALTER
E, RESIDENTIAL
N OF
PLAN CHECK
D=BER
ELLING
REPAIR
EJ NON-RESIDENTIAL
UNITS
7
FEE
RED BE
1/21.7,
Z r
8
1 AMOUNT DUE
I hereby acknowledge' that I have read this application; that the In-
ATMNTION
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 rOgU-
THIS PERMT
I&Ung 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 Workman's Compensation Insurance.
WORK NOTED
(Except Demolitions which shall
NOTE: Permit Limit One Your be completed In ninety darn.)
I
SIONAT (uW14101% UK AUNAW) -DATE 1GNE
y
INSPECTION
F"7 �
DEPARTMENT
CITY OF
7—
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
PH 6-1107
TWO Permit coven work to be done on private property ONLY -
Any construction on the public domain (curb%, sidewalks, drlv&wayx,
marquess, etc.) will require 5011ftrOte permission -
BUILDING
PERMIT
660343
NUMBER
�ACK
REAR YARD SETBACK
VAUAWK 15KKM
�_00 13 No
a3mu AREA VA-IUANCE NUMBER
0 CLEARANCE
VERM
MMUCTION STREET IMPROVED
13 YES
FED OCCUPANCY GROUP
VALUAVON TOTAL F99
ON
C7
t
APPLICATION APPROVAL I
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.
77777,77 7- �7
ow, . ........
�4-
A
ea diidalq�:!B6ib
h, tapord4i: bf-�:'Sn6 Cbi"-"� Mviall-k"W",
B egj Hnd--��'6,f "`S�AA 3,;:-Ti,�:
4 W,,
o
th f
WOO r "f- j!
erfto
-thof�j,dft�;-', h
t
a7 Z& I
f56.
bt- 6k - t
�oqv ra i, 6oh imL, an :6f 2
ve i,,;zhe;'��tangorit: -61' Vh i oh
I,e
L!j n E; C , r Ly,
+
V.4 ra -ang e'i'o
I'll I 6c
2
v;thencie P :3, 6AO:i 261-D
'0
-90'.
if 2,1,
iS
37o
hn4
m tho
't t
I
o ter
ray
2
fti�bft.7biz N OE&ION9
-,Dbte'Tjs�ed,
Final