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POSTED ON KROLL MAP Nor@ I PERMIT 680128
BUILDING DEPARTMENT Appli117#
/ p ,� NUMBER
1.
PERMIT APPLICATION Inside HJoB ADDREss ,
NAME,(OR NAME OF BUSINESS) �/�
/�/pi M/�S §O BBOf r y #1 SIDE YARD SETBACK S ET ETBACK REAR YARD SETBACK
NO ADDRESS / �„J I e �,4 j I a2 5 a i 724;y t7
770 � i N� UBB�j./�01 LOT AREA VACANT SITE
C CITY •7 TELEPHONE (M x a/ I DYES ❑ NO
2 w 9HEIGHT BUILDING AREA VARIANCE NUMBER p
ADDRESS
STREET B/W
CITY TELEPHONE NUMBER EXISTING STREET R/W ..._.......ST. DEFICIENCY THIS PROPERTY
COMP, PLAN ST, R/W p
REMARKS
NAME
FrAw r C9ONs T' l Ne ►
,e,%0fe* ia�
t�//16N�91.3 CHE Y
i $`CCIIT{/Y.�Q TT TELEPHONE NUM/�BERR /I i
•� ^'` • I L'4 18103 ��/'•/ . 7,r 7 V MET SIZE SERVICE E CLEARANCE CHE
STATE LICENSE NUMBER CITY LICENSE NUMBER •d( I ti
2 261 6 3 7 MARKS I 1 Legal Description of Property (Show Below or Attach Four Copies)
��
AL R
6ASRESIDENTI❑YE8NEW PINEPLAN
NON-RESIDENTIAL SIGN
•� ADD ❑ WALL
RETAINING REMA]
ElDEMOLISH
ALTER ❑ EXCAVATE
E � ((....
CE
OR .......s......_..Ft.)
swim
REPAIR ❑ PREIINSP.
POOL
NUMBER �O ♦F [STORIIESS (' NUMBER OF RA
Plan Check No, ........
PROPOSED USE^''/� �
?R 1 1), ih- � e BUILDING
PLOT PLAN (Indicate Building setbacks, abutting streets) PLUMBING
n HEAT h GAS LINE
p {�Q f )
"' 4 /�1 FENCE
O' t SIGN
K v N
RETAINING WALL
Aj
f®� SWIMMING POOL
' n\ DEMOLITION
PRE -MOVE INSPECTION
(�1 EXCAVATION OR FILL
.L
I
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 -
Iced agent of the owner. I agree to comply with city and state laws regu- ATTENTION
laling construction; and in doing the work authorised thereby, no person
will be employed In violation of the Labor Code of the State of Washington THUS PERMIT
relating to Workmanls Compensation Insurance, AUTHORIZES
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED
shall be completed In ninety days; IIOVF.D-IN BUILDINGS shall be oom.
plated In sl: months.)
Sl RE (OWNER OR GENT) _n DATE S GNE INSPECTION
K�/� / DEPARTMENT
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee PR 6-1107
This Permit coven work to be delta on private property ONLY.
Any construction on the publio domain (curbs, sidewalks, drlvavays,
marquees, eta.) Will require separate permission.
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1
IPIORIIIT�BER
p(
FaUCTION.
0
STREET
I ❑ YES
IMPROVED
"b(LT0
CD
IOCCUPANYROUP
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.
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