670103.pdf..... .. ....
POSTED ON KROLL MAP NO.: PERMIT
NUMBER
BUILDING DEPARTh
RENT Appll nt Fill 67010:
PERMIT APPLICATION Inside Heavy Lines J013 ADDRESS
NAME (OR NAME OF aUkilIMEBB)
SIDE YARD SE7 TR EIT SETBACK
�Gl At 3 (7 �7/v c
MAILING ADDRESS
USE ZONE AREA
I cj2 3 9;t /4"n I'/- A (
JXELEPHONE NUMBER
HEIGHT
V/
'11AII) /I Cle
pf,�T,,PLA
S ZI�FD
e--1 Iv, e- d
P olle -F
V.5, o
2
6 cr K / _?_ —
:1T 4 E () 0 A C � e-,
GAS
R RESIDENTIAL LINE
NEW E'
12.
.CQI
1:1 NON-RESIDENTIAL SIGN
rAINI
0 �"" BET NG
0 El WALL
DEMOLISH
I
DALTER EXCAVATE FENCE
ED OR FILL 0 ( .......... x .......... Ft.)
REPAIR E3 PRE -MOVE SWIM
INSP. POOL
NUMBER OF
DWELLaNG
UNITS
NATURE OF WpRK TO BE DONE
t, i, �,I`7 /'? , , o 7' Ar�e:;*
r
SETBACK
a
Zo 0
j NO
UMBdER
STREUT R/W
EXISTING STREET R/W ............ FT- DEFICIENCY THIS PROPERTY 0
COMP. PLAN ST. R/W ............ FT- ...... FT.
REMARKS
CHECKED BY 0
Z
N
METER SIZE I SERVICE SIZE CLE RANCE C BY
LL I L I A
[3 YES
0
OF
Plan Check No .....................
PROPOSED USE
BUILDING
PLOT PLAN (Indicate Building setback butting streets)
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
-7
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL A31OUNT DUE
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-
ATTENTION
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
THIS PEnMIT
relat.ing to Workman's Compensation Insurance.
AUTHORIZES
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which
WORK NOTED
shall be completed In ninety days; 31OVED-IN BUILDINGS shall be com-
Pleted in six months.)
I
31ONATURE (OWNER Un Z"I) 1) TE IGNED
re 4
INSPECTION
DEPARTMENT
't 04-d
CITY OF
EDIVIONDS
NOTE: Applicant Snbject to Plait Check Fee
121t 0-1107
This Permit coven Work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks. driveways,
marquees, etc.) will require separate permission.
Valuation
0 YES W<O
Fee
APPLICATION APPROVAL
No.
This application is not a permit until
signed by the Building Official or his Dep-
uty; and f ees are paid, and receipt is ac-
knowledged in space provided.
, ro
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All that portior
,,.tbe 1A of the Ifi, of thc
of Sec 1c) Twn 27
described as follOWs!
..eg,,qt the sTS corn ? r of lot
,,,Vpll_q-y. Lane according to
plat recorded in Vol
o f lats page 96 record&-.3
P
Siaobowdsh County, State
`,'bf W,
qsbington; thence
-20" W alonI3 the- S
09057&
a
line of said lot 9,
of 137.62 ft to
the. SW corner thereof;
-.,.'tbence 3 0021.101" W along
tbe,E line of 81st ?1. W-
ft to. the 14W corner
lot 10 Valley Lane; thence
00), 81, E f
or 137-57 ft.
-to the corner of said lot
tbonce N 0022"51" E
ft to POB, situated in
. tbe�00unt-.y of Snobc�nisb,
Stqtel�:of Wasb-inGton , less
the South 5 ft. thcreof-;—,
PL
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qv
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12_q�-e- E'L_ rT
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M 871 S T- P�_
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