660533.pdfPOSTED ON KROLL MAP NO.: BUILDING
BUILDING DEPARTMENT PERMIT 660533
CATIot I
I Applicant Fin NUMBER
15�TJON Inside Heavy Lines JOB ADDRE13B
FPERMIT APPLI
1147-
NAME (OR NAME OF BUSINESS)
SIDE YARD SETBACK STREET SETBACK REAlt IiAnU t31171
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CITY TELEPHONE NUMBER
YES 13 NO
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- J� 7
1
HEIGHT
NG AREA VARIANCE NUMBER
C-1
NAME
PLOT PLAN APPROVED
N
ADDRESS
REMARKS
CITY TELEPHONE NUMBER
NAM
REMARKS
ADDRESS f,,-
14 �;'.;? 44
METER SIZE SERVICE
SIZE CLEARANCE CHECKED BY
CITY TELEPHONE NUMBER
Z
Z,1,3 - 00 A __/
REMARKS
STATE LICENSE NUMBER CITY LICENSE NUM�WBER
TYPE CONNECTION
VERIFIED BY
-mir Copies)
Legal Description of Property (Show Below or Attach r
I
99
PERO. TEST
PERMIT NUMBER
ell
I
Z
FIRE ZONE TYPE OF CONSTRUCTION STR T IMPROVED
YES El NO
_9P_ECIAL INSPECTOR REQUIRED OMIUPANCY GROUP
A
YES [3 NO
A
PLAN CHECKED BY
BUILDING
VALUATION
WORK TO BE DONE I
a et-Tt'i'd.
BUILDING PERMIT
FEE
Z
3
PLUMBING
PERMIT FEE
HEAT & GAS LINE
4
PERMIT FEE
NEW
F1 AMD
DrJAROLISII
SIGN
El FENCE
%,r=; OF STORIES
—
5
—
12
0
SIGN PERMIT
FEE
DEMOLITION
PER?,IIT FEE
-
ff ALTER
E] REPAIR
RESIDENTIAL
NON-RERIDENTXALI
NUMBER OF
DWELLING
UNITS
6
—
7
PLAN CHECK
FEE
8
AMOUNT DUE
I hereby acknowledge that I have read this application; that the In
formation given In correct; and that I am the owner, or the duty nuthor.
ATTENTION
APPLICATION APPROVAL
ized agent of the owner. I agree to comply with city and state lawn mgu-
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.
(Incept Demolitions whIch nhall
NOTE: Permit Limit One Year w complete(I in ninety dayc.)
THIM PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
This application is not a perTnit until
signed by the Director of Building Inspec-
tion, or his deputy; and fees are paid, and
receipt is acknowledged In space provided.
SIGNATURE (OWNER Olt AGENT) DATE SIGNED
IN13PECTION
DEPARTMENT
DIR T RW SIGN A#
CITY OF
EDMONDS
DATE
NOTE: Applicant Stibject to Plat; Cbeck Fee
PR 6-1107
Z /S
FILM
Thia Peranit vovi�rn work to be done on private prope.rty ONLY.
Any conm1ruction oil thl- 1111blir '10"Win (curbs, fthirwalks, drivewnym,
nutrqureg. r1r.) %%III require mepatrate perminnion.