670397.pdfA
POSTED ON KRO" MAP NO.: PERMIT
BUILDING DEPARTMENT Applicant Fill /M NUMBER 6 10,3V
Inside Heavy Lines JOB ADDRESS
p '
0 Han
'C
ca
t FM
Vy Line,,
PERMIT APPLICATION gr ep -04
NAME (OR NAM OF BUSINESS)
SIDI' YARD 111AIII STREET SETBACK REAR YARD, BETE
610— 4L L4�Lfl %
I J A/ AV M1
Q ADDRESS
-73 A .5 USE ZONE WX SITE
LOT AREA VAIJA
CITY TELEPHONE NUMBER &<B 13 NO
6 e, 34
0 _ 16
_36 BUILDING AREA
A/ 4 1'�
CITY
Legal Description of Property (Show Below or Attach Foui
d /4 S " o F zJ 11,r- 'jo F
z
0
- b --2-
z
0
19
NEW
I L9 RESIDENTIAL
F
GAS
LINE
DADD
LEINON-RESIDENTIAL
r
SIGN
DEMOLISH
RETAINING
WALL
0
EXCAVATE
PENCE
ALTER
OR FULL
El
( x Ft.)
PRE -MOVE
.......... ..........
swim
REPAIR
INSP.
POOL
ES
NU1133ER OF
DWELLING
UNITS
I
(?i", I? �I %�- �
I hereby acknowledge that I have read this application; that the I
formation given In correct; and that I am the owner, or the duly auth
ized agent of the owner. I agree to comply with city and state laws rog,
lating construction; and In doing the work authorized thereby, no pers
will be employed In violation of the Labor Code of the State of Washingt
relating to Workman's Compensation Insurance.
NOTE: Permit Limit One Year (Except DEMOLITIONS whi
shall be completed in ninety days; MOVED -IN BUILDI.NGS shall be co
plated In six months.)
(OWNERYM.GE DATE SIGNED
Mot.
NOTE:(IAPPlicant Subject to Plan Check Fee
Title Permit covers work to be done an private property ONLY,
Any construction on the public domain (curbs. aldenulks, driveways,
marquees, etc.) %vill require separate permission.
'R 'B/W
CISTNG STREET R/W DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W.4-.!5�.FT.
31Y V
[] YES
Plan Check No .....................
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
t
SIGN
N
RETAINING WAL1
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AIMOUNT DUE,
n.
r-
ATTENTION
on
on
TIUS PERMIT
AUTHORIZES
ONLY THE
ch
WORK NOTED
m-
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 0-1107
iW BY
0 YES
Fee
APPLICATION APPROVAL
z
This application Is not a permit until
signed by Me Building Official or Ills Dep-
uty; and fees are paid, and receipt Is ac-
knowledged in space provided.
FILE
I
1, __ . _.., _____-_1_ I I