670296.pdfPOSTED ON KROLL MAP NO-:
BUILDING DEPARTMENT Applicant M
PERMIT APPLICATION Inside Heavy Lines JOB ADDRESS
NAME (Sp NAME OF BUSINESS) 17
Is Ala
/Vo,v
EXISTING STREET R/W . ......... YT-
COMP. PLAN ST. R/W ............ FT.
or
a
[] YES
NEW
RESIDENTIAL
GAS
LINE
NON-RESIDENTIAL
SIGN
ADD
RETAIMNG
WALL
EIJDEMOLISH
ALTER
EXCAVATE
OR FILL
F-1
PENCE
( x Ft.)
.......... ..........
REPAIR
PRE -MOVE
INSP.
swim
POOL
iUMBER OF STOT �S
NUMBER or
DWELLING
UNITS
?A E OF WORK TO BE DONE
".0 A " I D0202
, aI, .01 5-/
NO
OF
7 +Aid( R04 S
&L
Plan Check No .............. ... .
USE
Ad)"
BUILDING
PLOT PLAN (Indl Building setbacks, abutting streets)
PLUMBING
03
0
HEAT & GAS LINE
PENCE
t
SIGN
N
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that ths In-
101=1110
formation riven 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-
ATTEBMON
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
TM8 PERBUT
rsl&ttng to Workmen's COmPez5&tIOn Insurance.
AUTHOIE=ZS
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which
WORK NOTED
ghall be completed in ainety, days; MOVED -IN BUILDINGS sball be com-
pleted in six mo 5.)
0_0 DATE SIGNED
SIGNATURE ( ER APGT)
INSPECTION
DEPARTMENT
VI
�*2g4x` —Ica
Ztq�
CITY OF
EDMONDS
NOTE: Applicant Sliect to Plats Check Fee
PR 6-1107
This perroj$ covers work to be done on private property ONLY.
Any construction an the public donasin (curbs, sidewalks, driveways,
nwquees, etc.) will require separate permission.
E3 YES
RU
DEFICIENCY TRIS PROPERTY
C] YES E3 NO
Valuation I Fee
4LQ_
No.
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or Ms Dep-
uty; and fees are paid, and receipt is ac-
Imowledged In space provided.
DATE
—.PLO, L r7
FILE
-;T
tj-': 'y
--------- --
South 90 feet of the east 150 feet of the following described
property, that portion of governm ent 16t #4, in section 13,
township 27 N.R.3 E.W.M., described as follows: Beginning at
0
a point north 0 09 feet west 341*6 feet of the southeast corner
of southeast 1/4 of southwest 1/4 of section 13. Township 27 N.Re
7-
3 EOWOM, thence north 840 17 feet 4411 west 264.33 feet thence
0 outh 710 50 feet 44"
north 0 0,9-feet west 187 feet; thence.s
east 277*45 feet; thence south 00 09-feet east 127 feet to the
point of beginning; situated in the county of Snohomish, state
of Washington.