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670035.pdfD ON KROLL MAP NO.: IT BUILDING DEPARTMENT Applicant Fill POSTE =ER 610035 c -eLia PERMIT APPLICATION Insid Heavy Lines LOB ADDRESS 61 fv.f� A 9 � U-6of 94A" 6 USE ZONE LOT A-REA VACANT SITE �HONE Lit t_r�Ea 13 NO UM �] HEIGHT 13UILDING AREA VARIANCE NUMBER ) e-- e '6 I STREET R/W I i-TELEPHONE NUMITor— EXIS77NG STREET R/W -ZS..YT. DEFICIENCY THIS PROPERTY 1 COMP. PLAN ST. R/W ............ FT. tV11 A/ C ........ 33T. REMARKS .5 r, ".7 S e-leeb ewleo.-1 / /7, cpZ'a 0/ CIT I TN"PHONE NUMBER I!Re -g1P1 IQ 3 - 0 1 - a 6) 5- or NEW RESIDENTIAL F-1 GAS LEI NON-RESIDENTIAL LINB SIGN ElADD DEMOLISH RETAINING WALL EXCAVATE PENCE ALTER OR FILL ( x Fnl.) PRE -MOVE .......... .......... SWIM REPAIR 1:1 INSP. El POOL ;UMBER OF STORIES UMBER OF NI)WELLING UNITS '441 - If 10 YES Ij ITO 0 YES [] NO PLAN CHECKED BY REMARKS All construction tocomply with the Uniforin Building Code. Meter size may be changed to 1 1/2 in. per Public Work-s-.7—C�geE­ and corrections made by plan check must carry through. A.E. rinn Check NS5�1._.16q PROPOSED USE BUILDING PLOYT _3�,AN (Indi, 1, abutting streets) PLUh=NG HEAT & GAS LINE 10 t PENCE SIGN RETAINING W AT I SWIMMING POOL DEMOLITION 7 3 71 PRE -MOVE INSPECTION EXCAVATION OR FILL TOTAL AMOUNT DUE I hereby acknowledge that I have read this application; that the In- 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 atato laws regu- lating construction; and In doing the work authorized thereby, no person ATTENTION wIII be employed In violation of the Labor Code of the State of Washington THIS PERMIT relating to Workmen's Compensation Insurance. AUTI[OIUZES NOTE: Permit Limit One Year (Except DFMOLITIONS which shell be completed in ninety days; MOVED -IN BUILDINGS shall be com- ONLY THE WORK NOTED pleted In six months.) INSPECTION 31ONATURE (OWNER Oft AGENT) DATE 81GNED DEPARTMENT CITY OF EDNIONDS NOTE: Applicant Subject to Plait Check Fee 1111. 6.1107 This Permit coven work to be done on privnte property ONLY. Any construction on the public domain (curbs, sidewalks, driveways, marquen, etc.) will require separate permission, Z Valuation I Poo I Receipt No I _Z1,0V E- F 3. 1­'16. 00 I 1/0 �7'.5-0 1 APPLICATION APPROVAL This application is not a permit until signed by the Building Official or his Dep- uty; and bees are paid, and receipt Is ac- knowledged in space provided. FILE I I APPLICATION is hereby made for a permit to construct the following work, in accordance with the accom, panying plans and specifications. Two sets are submitted herewith for approval. '00�� __ Off -St. ew alter epair .... ...... Parking ...................... Work r ........................................................ c % ...... nst type ............................... Use zone..471Z ............. Fire zone. ........................... oh , te, d .. ... ............ ... . .......... I .... . .. .... Lot ......................... j3lk ...... I ............... Addn ...................................... Lotfrontage ....................................... Area ........................................... Septic tank .......................................................... 7/ Bldg. set -backs — front ..... A. r. side ............ . .............. ............................. ...... 1. side. ............ a4_7xe�"I� .45� Tel. No.6�.Sg�:ZXS�Z ...................... Owner ................................ Address ...... ........................... L r Builder....... ............................................................ Address ..................................................... Tel. No ............................. Plansby ................................................................. Address .................................................... Tel. No ............................. Remarks........................................................................................................................................................................... ..... . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . : . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . The above is a correct statement, and I agree to comply with all applicable Codes and State laws regulating this work. I Signed Owner/ Address ............................................ Date..9�::::4.=��7_ PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance with the ap- proved plans and specifications, and Building Department notations thereon. .......... Valuation .... ............... Permit fee ............ 4 . . ........... Reed. by .... L. 2" ....... ............. ............. Building Department, By .................................. Date..:!V( . ...... 46--Z� .................... This Permit does not covcr Plumbing, Sewer or Electrical installations.