670392.pdfPOSTED ON KROLL MAP NO.:
Applican PERMIT 670392
NUMBER
BUILDING DEPARTMEN t F III �d
Inside Ileavy Lines -JOH ADDRESS
OF BUSINESS) /3
PERMIT APPLICATION
NAME \0RAME 9
ET SETBACK REAR YARD SETBACK
ETBACK STRE
SIDE "RD 8
to —0
MAILING A.IJURNkiti I M 1 /-.05 )4,
USE ZONE VACANT SITE
VAILLC S 7' No
rRTIE YES
0 L
CIT HONE NUMBER
/ /--I VAiffA—Ncr, NUMBER 9k
�UjIFING AREA
HEIGHT
Fe 6
NAME
_FLOT —PLAN APPROVED
_jWDRESS
STREET R/W
EXISTING STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
CITY TELEPHONE NUMBER
1h. COMP. PLAN ST. R/W ............ FT- ............ FT.
REMARKS
NAM
BY
CHECK
fall
ADDRZ5b
METER SIZE SERVICE SIZE CLEARANCE CTIV
DR BY
CITY
A
L CITY LICENSE NUMBER
13TATE LIUNNt3N NUMBEIL
TYPE CONNECTION VERIFIED
or Attach Four Copies)
f Prop I
on o/ erAD�eloW
2
PERO. TEST
Z
0 to
Ji� 0 A REMARKS
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
[J YES [:3 NO
0 SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
YES XNO
PLAN CHECKED BY
GAS
RESIDENTIAL El LINE
NEW
NON-RESIDENTIAL
SIGN
RETAINING
ElDEMOLISH El WALL
ALTER EXCAVATE FENCE
OR FILL .......... X .......... Ft.)
REPAIR PRE -MOVE swim
Q INSP. POOL
NUMBER OF STORIES I NUMBER OF
DWELLING
UNITS Z�
NATUR WORK r
I;//- _"/ZE D r
Plain Check No .....................
E
PROP
BUILDING
P PLOT PLAN (inuicate Building SUDUCK3, uoutuar
PLUMBING
HEAT & GAS LINE
FENCE
az
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE-ITOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT 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 PERMIT
relating to Workmen's Compensation Insurance.
AUTHOIUZES
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITION'S which
JVORK NOTED
c "eted in ninety days: MOVED -IN BUILDINGS shall be com.
mdl�e 0J'x
np
pilte. 1, , month,.
—SIGNED/
INSPECTION
1 tjA URE (OWNER OR A T) UA_TrE
DEPARTMENT
t11
�
iv=ILL
2122=
CITY OF
EDMONDS
NOTE: Applicant Subject to Plait Check Fee
6-1101
This permit covers work in be done on private property ONLY.
Any construction on the public domain (curbs, sldcwalks� drivewayst
marquees, etc.) will require separate permission.
Valuation I Fee
170,
'V %_J
15 .'> — 1
��16 0
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.
DIREC 0 8 SIGNAT R
Z74�7
FILE
NO. 1,
Co's Pl&t Subdivision
Block 7 Lale Ballinqer Land , - I
0 .' Vj . a
0 T?l
th".. Nest I— C d I uti I - - itie's over and across the North
ement for ingress, egress an of the
�! t� of the West 120 feet of said Lot 19 and South 8 feet
at, TOGETHrm WITH
e 'i VA30 feet or Lot 18 Block 7 of said pl
I TMETHER_ WITH nonexclusive
adjacent to said Lot 199 that
for ingress egress and utilities over and across
18 and 19 and oVer"
dley Ro - - i ml
"cated Bra ad adjacent to said lots
tion of V, orded in
r lat rec
Lot 14, BlocR i) of said plat; as per p n
and across f Pl"Its On pap.es S7 antl S8. records of S ollom"sh County
Volume 9 o State of Washin1ton.
tite County of Snolloinish,
situate in
t&14
RECORD OF INSPECTIONS
Date. -Passed
L S Foundation
Plumbing (Partial)
...... — ------ ---------- — (Rough)
Frame
L
1 1, _ - ____ -11 1