660522.pdf'OSTED ON KROLL BUILDINI
P NO.: PERMIT
BUILDING DEPART I
MENT Applicant FIR NUMBER
Inside Heavy Lines JOB ADDRESS
-PERMIT APPL CATION
4-1 '' � ., � I
iL 11 IN41VMA InTit NAME nIr RTTRTN�MRAI J C�
,/. 1/0 1
/o/ r
USE ZONE LOT AREA VACANT SITE
1�2 4r TjjjL.Erk1U14N X4UMdBFR g�s [3 NO 0
-8 ER
HEIGHT BUILDING AREA. VARIANCE NUMB
PLOT PLA APPOVED Ik
67 REMJOKS
TELEPHONE NUMBER
7-
c. REMARKS
uv'
ADDRESS z
METER SIZE SER CLEARANCE CHE
YJCE, SIZE
R �f�7 C f.
TELEPHONE NUX&BER
TOITY
REMARKS
STATE LICENSE NUMBER CITY LICENSE NUMBER
TYPE CONNECTION -44P E BY
Le 11 Description oF Property (Show Below or Attach ur pp 3)
PERC. TEST Pl3ftX'R NUMBER
z 6
FIRE ZONE TYPE OF CONSTRUCTION STH T IMPROVED
_4T [:] YES [3 NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
rQ
[3 YES 91_1�
PLAN CHECKED BY
.4
VALUATION ___j0TAL FKK
BUILDING
WORK TO B D E VALUATION 10/ z
BUILDING PERMIT
2 FEE
PLUMBING
3 PERMIT FEE
HEAT & GAS LINE
4 PERMIT FEE
NUMBER OF STORIES
NEW SIGN SIGN PERMIT
ADD DEMOLISH FENCE 5 FEE
DEMOLITION
ALTER RESIDENTIAL NUMBER OF PERMIT FEE
DWELLING PLAN CHECK
REPAIR NON-RESIDENTIAL UNITS 7 FEE
81 AMOUNT DUO
I hereby acknowledge that .1 have read this application; that the In- U
formation given Is correct; and that I am the owner, or the duly author- ATTENTION APPLICATION APPROVAL
or the duly nut
0
her'
lzed agent of the owner. I agree to comply with city and state laws ngu. THIS PER311T This application Is not a permit until
on
I r :j
lating construction; and in doing the work authorized thereby, no person AUTHORIZES
W
will be employed In violation of the Labor Code of the State of Washington ONLY THE signed by the Director of Building Inspec-
relating to Workmen'B Compensation Insurance. WORK NOTED tion, or his deputy; and fees are paid, and
(Except Demolitions which sball receipt is acknowledged in space provided.
NOTE: Permit Limit One Year be completed In ninety day'.
SIGNATURE (OWNER OR AG T DATE SIGNED INSPECTION DIRECTOR'S SIGN4TU_4E
DEPARTMENT
CITY OF DAT& 1 (57
NOTE: Applicant Subject to Plait Check Fce EDMONDS
PH 6-1107
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways, FILE
marqueesv etc,) will require separate permission.
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