660385.pdfRTMENT Applicant Fill
7tn c Is
ATION Llside Heavy Lines
"A P L I C
57-5
�1111`n -
- 5ra
or
17 1 —A!M�*o :5:F.&2
(/ 1,9S17W' /Z/
�'Jl � �A(!� � M C] YES
l�',
LJ
NEW
I El
" SIGN
0
0
ADD
I DEMOLISH
17ENCE
94
0
ALTER
RESIDENTIAL
NU
�LER OF
F-1
NON-RESIDENTIAL
DW
UNITS
RREPAIR
I hereby acknowledge that I have read this application; that the In-
formation given Is 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-
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.
I Demolitions which shall
NOTE: Permit Limit One Yeareb"execoPmpleted In ninety days.)
SIGNATURE (OWN191C utt Au�111J DATE SIGNED
NOTE: Applicant Subject to Plan Chuck Fcc
This Permit coven wark to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, drlve�vays,
marquees, etc.) will require Repwate permlanion.
[] NO
BUILDING
I
VALUATION
BUILDING PERMIT
2
FEE
PLUMBING
3
PERMIT FEE
—
-7jjEJLT & GAS LINE
4
PERMIT FEE
—
_;IGN PERMIT
5
FEE
DEMOLITION
6
PERMIT FEE
PLAN CHECK
7
FEE
8
J
AMOUNT DUE
ATTENTION
THIS PERMIlT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
BUILD11"k
PERMIT b60385
NUMBER
Z;LV_=ZZ V&/#— �
MrM AV.TRAnX I REAR YARD SETB7
VACANT SITE
S'7
0 YES [3 NO 0
VARIANCE = I
NUMBER
a,
STREET IMPAUV.
0 YES 0 NO
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 aelmowledged in space provided.
FILM
IA
It
I I
.4 N I;,.
FFFFF It
t-P,
It
r T
I
tI
r J �L. NJ I
I L I
NI,
4.—S
Lp
L
rF Lj I I
4t
'I I d
I t
" L
It
I d
L 'r,
L
I
p 'r Td
p 4
p I
tI,
L:-': 1 14
.1
I t
6 d I
RECORD* OF INSPECTION
I d
—S�TC
I d a d'
r Date
I
p .,.!r FOWdfiion
p Pi u n1 V, ng PC, foll 6A
;r (Roughl —40
L I d Frarno
Euel 13
Furnacm
Final zcm)s Ew�f 11 (4 ell
77