680028.pdf.3�
MENT Applicant 11111
RInN I Inside Heavy Lines
471-T
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17
RESIDENTU
OLINr
GA13 U
[KNEW
NON-RESIDI TIAL
SIGN
DADD
RETAINING
WALL
0
ALTER
DEMOLISH
EXCAVATE
OR FILL
FENCE
( x Ft.)
........ . ..........
REPAIR
PRE -MOVE
INSP.
El
SWIM
POOL
rUMBER _0F STORIES
J—
NUMBER OF
DWELLING
2—
UNITS
LOS -,
CON I
0 ON XROLL MAP NO.,. PERMIT
- 028
680
NUMBER
DURESS
I REAR YARD SETBACK
YARD OET13ACK FT—REET SETBACIC
r _f
*OWE LOT A
VACANT BrXJU
Ion—
N
13 YES 13 No
IT BUILDING AREA
N UWUE—R
0.
VED
WKA�El H/W
EXISTING STREET DEFICIENCY THIS PROPERTY
I t
'ONNECTION
0 YES
Man Check No ........ . ...........
'I
BUILDING
PLUMBING
t
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
b%
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read thbi 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.
lating conatruction; and In doing the work authorized thereby. no person
will be employed In violation of the Labor Coda of the State of Washington
relating to Workmen'fi Compensation Insurance.
NOTE: Permit Limit Chick Year (Except DE51OLITIONS which
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
NOTE: Applicant Subject to Plan Check- Fee
-This rerredt covers work to be done on private PrOPOrtY ONLY-
A,ay construction on the public domain (curbs, sidewalks, driveways,
marquees. etc.) will require sepamic Pez=15010n-
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PH 6-1107
149
'.FT,
Z
tA
qLm Y
r. ICLEARANCE C::��B
VEID By
PER39,UUMBER
[] YES 13 ITO
Fee
APPLICATION APPROVAL
This application is not a pern-dt until
Signed by the Building Off Icial or his Dep-
uty; and fees are paid, and receipt Is so-
Imowledged in space provided.
rum
I
xV
41,
L�D
_VS60-th 100.00.feet
of the North 200.00 feet of the
tract of land
described as
-h
u It
Inclusive; TOGETHER WITH THE South
half of vacated
Elwood Avenue
%acen said
Lot 1; all In Block 18, First Addition
-to the City of Edmonds,
0� the
plat thereof recorded In Volume-2 of
Plats, on Page
31, records of
'JI
'4s -unty,
Washington.
V_ 11