670243.pdfEli - I
09
POSTED ON KROLL
MAP NO.: PERMIT
BUILDING DEPARTMENT
7�_
Applicant Fill
/0
NUMBER
670243
PERMIT APPLICATION
Inside Heavy Lines
I
joB ADDREBS 9d
NAM (OR_.UAM OF BUS14ESS)
�V�
SIDE YARD SETBACK STREET UNTIJAU11.
REAR YARD SETBACK
10
MAILING ADDRESS
—
I r
;7 7r-
-� , <� ,
eJ :7-exe
USE ZONE
LOT AREA
VACANT SITE
CITY
TELEPHONE NUMBER—
lf�
HEIGHT
BUILDING AREA
&I-E13 [3 NO
VARIANCE NUMN.En
a
Z
Q
or
NEW
RESIDENTIA
,,
GAS
LINE
NON-RESIDE�NTIAL
IGN
FRETAINING
El
DEMOLISH
WALL
EXCAVATE
FENCE
ALTER
F
OR FILL
( x Ft.)
E]
REPAIR
E3
PRE -MOVE
INSP.
.......... ..........
swim
POOL
NUM33ER OF
DWELLING
UNITS
MKA�4p% "/ IV
EXISTING STREET R/W .6.��FT. DEFIC=CY THIS PROPERTY
COUP. PLAN ST. R/W ............ FT. I-fpxv.
2 At It
3 LL tt
[] YES M_Iq�o
Plan Check No ...... ...............
PROPOSED USE
BUILDING
PLOT PLAN (Indicate Building
setbacks, abuttl g streets)
PLUMBING
HEAT & GAS LINE
06.
FENCE
t
SIGN
RETAINING WALL
13
%
SWIMMING POOL
DEMOLITION
LPRE -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-
lzed 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 ATTENTION
will be employed In violation of the Labor Coda of the State of Washington THIS PEWIIT
relating to Workmen's Compensation Insurance. AUTHORIZES
ONLY TITE
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED
shall be completed In ninety days; 31OVED-IN BUILDINGS shall be com-
plated in six months.)
1ATURE (OW ER OR AGE04-h DATE SIGNED- INSPECTION
DEPARTMENT
CITY OF
EDMONDS
NOTE: Applicant Sub)cct to Plan Check Fee PR B-1107
This Permit covers work to be done an private property ONLY.
Any construction on the public domain (curbs, sidewalks, drlvmays,
marquees, etc.) will require separate permission.
04
4?:17 .
[] NO
Fee
.46
Z
No.
1 -6-10 6_41137yP
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt Is ac-
Imowledged in space provided.
DATE C:.." —
7— elo -7
FILE
-------------
....... '7o
bo
I 0�
aq
0 al
ale
/40
VMS.
-'75
W DetV
. 44
I RE ISTERE4D.-
AU'RITECT'
IT
V4 A V-T Flo sETH"
STATE 0
4S
A 4S
-145 JC�'S 40
I