680149.pdfI
—FoEiTED oil KROLL MAP NO.: PERMIT
BUILDIN6 DEPARTMENT ApplicaIlit -M NUMBER 680149
wide Heavy Lines -
JOB ADORE
PERMIT APPLICATInN TL
NAME (OR NAME OY BUSINESS)
FAi r,8 A,4//< (5 131DE YARD SETBACK HTREET SETBACK REAJ?, YARD SETBACK
1 MAILINO A"ImEbts
VACANT SITE
� -7306 ST S. VVI USE ZONE ARE
o 0 YES I] NO
—CITY TE—LEPRONE NUMBER I
D t!� HEIGHT BUILDING AREA VAIUAVUJd NUM�� Ilk
NAME
PLOT PLAN APPROVED
ADDRESS
18"VREET R/W—
CITY TE�LEPJJONE NUMBER EXISTING STREET R/W ............ rr, DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ Irr- .......... FT.
REMARKS
14AM
DWIV69,
CHECKED 13Y
CITY TE—LEPRONE NUMBER
STATE LICENSE NUMBER CITY LICENSE NUMBER METER SIZE SERVICE SIZE CLEARANCE CHECKED BY V
REMARKS
Legal Desert tion of Property (Show Below or Attmlx Four Copies)
o -F F IV W 6-C TYPE CONNECTION VERIFIED BY
z
0-F IVL- 6-f SEC /3 PERC. TEST PERMIT NUMBER
70 WAI �i H_LP �Z7N 109 /V 6,6 4- REMARKS
VVIA 15S S C 6 UNrV 6A
1 FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
YES [3 NO
SPECIAI. INSPECTOR REQUIRED OCCUPANCY GROUP
YES [3 NO
I EJ RESIDENTIAL In
NEW (L PLAN CHECKED BY
NON-RESIDENTIAL SIGN
ADD ItETAINING REMARKS
DEMOLISH El WALL
ALTER EXCAVATE IPENCE
n OR FILL ( .......... x .......... Ft.)
REPAIR PRE -MOVE SWIM
El INSP. POOL
_WUMBER OF STORIES NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE
Valuation Fee Receipt No.
Plan Check No ......... ... .......
PROPOSED USE
BUILDING
PLOT PLAN (Indicate Building setbacks, iiRulting streets) PLUMBING
HEAT & GAS LINE
FENCE
t SIGN
N
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I hereby ackncm,ledge that I have read this application; that the In. TOTAL AMOUNT DUE C:1, 0 0
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 reim- ATTENTION APPLICATION APPROVAL
lating COastrucU011; and in doing the work authorized thereby, no person
will be employed In violation of the Labor Coda of the State of Washington THIS PERMIT This application Is not a permit until
Misting to Workmen's Compensation Insurance. AUTHOIUZES
ONLY THE signed by the Building Official or his Dep-
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED uty; and fees are paid, and receipt is ac-
shall be completed in ninety days; MOVED -IN BUILDINGS shall be com. knowledged in space provided.
plated In six months.)
BE (OWNER OR AGENT) DATE SIGNED INSPECTION 1:7 B BIG
.1
0 1 Z
DEPARTMENT
CITY OF DATE'
EDMONDS
NOTE: Applicant Subject to Plan Check Fee PR 0-1107
This Permit coven work to be done an private Property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
m=quees, etc.) will require separate permlsslon.
,(, T
FILE CZ, �
I