670381.pdfPOSTED ON KROLL MAP NO.: PERMIT
670381
BUILDING DEPARTMENT Applicant 1:1111
/ 10
NUMBER
��tn e 9
PERMIT APPLICATION Inside HCaVY Lines
15Z
JOB ADDRESS
NAM (OR NAPA OF BUSINESS)
\IV J�E7S r C�&TE_ T&O I LDE-TLS
MAILING ADDRESS
SIDE YARD SETBACK
STREET SETBACK
REAR yARD SETBACK
. 0. Tinx c-r ,
1�4
96
PTL ir- a a i
EXISTING STREET R/W
COMP. PLAN ST. R/W
A23 01
26
I
00 #
FIRE ZO TYPE OF CONSI
3NE 1 __111�_r
SPECIAL INSPECTOR REQUIRM
F] YES Z-kq 0
RESIDENTIAL
I
M
GAS
LINE
NEW
NON-RESIDENTIJAL
ADD
SIGN
RETAINING
DEMOLISH
WALL
ALTER
EXCAVATE
OR FILL
PENCE
( x Ft.)
.......... ..........
REPAIR
Q
PRE -MOVE
INSP.
swim
POOL
TUMBER OF STORIES
NUMBER OF
DWELLING
UNITS
s.* er,
�ATURE OF WORK TO BE DONE
Plan Check No .....................
PROPOSED USE
BUILDING
I`Z C� L-� A
'abutting
PLOT PLAN (Ind-IMMIA11-39 Mffs, streets)
PLUMBING
2.43
HEAT & GAS LINE
PENCE
SIGN
lo� 'n-psz
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AIMOUNT 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 duly author-
lzed agent of the owner. I agree to comply with city and state laws regu-
ATTENTION
laung 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 PERMIT
relating to Workmen's Compennation Insurance.
AUTHORIZES
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which
WOrM NOTED
shall be completed in ninety days; 31OVED-IN BUILDINGS nhall be com.
pletod In six months.)
(OWNER OR A T
A SIGNED
INSPECTION
ZATURE
DEPARTMENT
997--/.16
CITY OF
EDMONDS
NOTE: Applicant 9�i�tbject to Pian Check Fee
Pit 6-1107
This Permit covers work to be done on private property ONLY.
Any construction on tbe public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
VA —CAM 131TE
13 YES 13 NO
VARIAN 3E —NUMBER 041
DEFICIENCY THIS PROPERTY
Valuation
1 0- � .
YES 13 NO
Fee
tz
z
No.
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-
knowledged in space provided.
1�
FILE
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