660529.pdf- -----------
nac m
POSTED ON KROLL MAP NO.: BUILDING
PERMIT
BUILDING DEPARTMENT Applicaiat Fill NUMBER 0529
// �/
Inside Heavy Lines JOB ADDnNas
PERMIT APPLICATION
NAME (on NAME OF BUSINESS) 3,
MM S. OLC— 6kkt4PA0 SIDE YARD REET 13ETBACIC HEAR YARD SETBACK
I Z-4 Z
AILING ADDHEUB
Sd aw. USE ZONE LOT AREA VACANT SITE
CITY TELEPHONE NUMBER P(YES [3 NO J
661 Me K J's I a HEIGHT BUILDING AREAk VARIANCE NUMBER
NA LE
L) PLOT PLAN APPRO D Ik
VV4 (1- ei�.t av�
ADDRESS
HE .4k.�
*7,3 45 0
of !ELEPHONE NUMBER
RIM -
NAME
REMARKS
ADDRESS W
METIPR SIZE BE AR&NCE C
C4 2
CITY V TELEPHONE NUMB
REBEARKS
STATE LICENSE; NUMB
ER CITY LICENSE NUMBER
TYPE CONNECTION VERIFIE
Legal Description of Property (Show Below or Attach Four Coples)
/.e7 IrE—RC.TEST PERMIT r7ER
t9 Al D -s— FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
NEW
Els,
SIGN
NUMONH OF
ADD I
DEMOLT
FENCE
F-1
ALTER
Fa`
RESIDENTIAL
NUMBER OF
REPAIR
IFI
NON-RESIDENTIAL
DWELLING
UNITS
F]
I hereby acknowledge that I have read this application; that the In.
formation given in 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.
(Except Demolitions which shall
NOTE: Permit Limit One Your be completed In ninety days.)
_4GENT) DATE SIGNED
I ATURE (OW EROR
U
1;1441 11A�t2l
NOPE: Applican�t Sitbject to Plan Check- Fee
Thin remit covers ivork to be done on private property ONLY.
Any construction on the public domain (curbs. sidewalks, driveways,
inarquees. etc.) will require seporate permission.
C] YES
BUILDING
I
VALUATION
BUILDING PERMIT
2
FEE
PLUMBING
3
PERMIT FEE
HEAT & GAS LINE
4
PERMIT FEE
SIGN PERMIT
5
FEE
DEMOLITION
6
PERMIT FEE
PLAN CHECK
7
FEE
81 AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PH 6-1107
WE
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.
FILE