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POSTED ON KROLL MAP NO.: PERMIT 0-41179
BUILDING DEPARTMENT Applicant Fm NUMBER 600
lip"Cant
PERMIT APPUCATION Insl7deHeavy Lines JOB ADDRES13
NAM (OR NAME OF BUSINESS)
SIDE YARD SETBACK STREET SETBACK REAR YARD SETBACK
MAILING ADDRESS
lo,
feel USE —ZONE LOT AREA VACANT 8IT15
]M YES NO
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CITY HONE NU B
BUILDING AREA VARIANCE 1 13
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NUMBO�_
0
BE NUMBER CITY LIONNUN INUMBEII
to / �z m6 I
on of Property (Show Below or Attach Four Copies)
9 NEW
[&RESIDENTIAL
1
FI
GAS
LINE
LENON-RESIDENTIAL
I
0
SIGN
ADD
0
—
DEMOLISH
RETAINING
WALL
EXCAVATE
FENCE
ALTER
F]
OR rim
( x Ft.)
0 REPAIR
M
PRE -MOVE
INSP.
F-1
........ . .........
SWIM
POOL
DWELLING
UNITS
NATURE OF WORK TO BE D70 E
]FROPOSED USE
PLOT PLAN (Indicate Building setbacks, abutting streets)
N
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1113
I hereby acknowledge that I have read this appileation; 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 law regu-
lating construction; and In doing the work authorized thereby, noaZson
will be employed in violation of the Labor Code of the Slats of Washington
relating to Workmen's Compensation Insurance.
NOTE: Permit Limit One Year (Except DE31OUTIONS which
shall be completed in ninety days; MOVEDAN BUILDINGS shall be core-
pleted In six months.)
NOTE: Applicant Subject to Plan Check Fee
This Permit coven work to be done on private property ONLY.
Any construction on the public domain (curbsp sidewalks, driveways,
marqums, ate.) will require separate perralsslon.
EXISTING STREET R/W E.15L.FT. DEFICIENCY THIS PROPERTY
COUP. PLAN ST. R/W .... 0 .. 1"T.
DrivewaV slopes not to exceed those
indicated on Standard Drawing #103.
L( 1 3411
[I YES E] NO
Plan Check No ............
1-10—swo
luct,
PLUMBING
HEAT & ftW LINE Ol L
PENCE
SIGN
RETAINING WALL
A-1.11OWWWAR-0-1011
PRE -MOVE INSPECTION
EXCAVATION OR FILL
Valuation
.7
0 YES 0 NO
Fee Receipt No.
TOTAL AMOUNT DUE 0 �_, 0 a I ks
N�
ATTENTION APPLICATION APPROVAL
THIS FERBUT This application Is not a permit until
AUTHORIZES
ONLY THE signed by the Building Official or his Dep-
WORK NOTED uty; and fees are paid, and receipt Is ac-
knowledged in space provided.
INSPECTION D= Is BIG RE
0 BIG
DEPARTMENT
CITY OF - 7,1�
EDMONDS DATE
PR 6-1107 W
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