680184.pdfApplicant Mn
UILDING DEPARTMENT
Inside Iffeavy IAneS
PERMIT APPLICAI
(OR NAME OF BUSINESS)
NAME
4, e-6PA1Acd1_&_
-Mmmo ADDRESS
75-
0 drA &ZI C�tr A1.0 *IA13
own.
of�
9
SIDZNT U
21-Iff-
GA
'a
NE
LII
aIEW
NON -RESIDE NJT
R
SIGN
ADD
RETAINING
WALL
ALTER
DEMOLJSH
EXCAVATE
on FILL
FENCE
( x . Ift.)
.......... ........
E] REPAIR
PRE -MOVE
EIINSP.
swim
POOL
rES
I -NUMBER OF
DVYrELLING
UNITS
C
P NO.: PERMIT
NUMBEIt 680184
YES
13 NO
UMBER
E213STING STREET R/W ....... ... XT- DEFICIENCY THIS PROPERTY
COUP. PLAN ST. n/W ........... FT- ............ Fr.
TYPE
0 YES 13 NO
Plan Check
PROPOSED USE
PLUMBING
PLOT LAN (Indicate Building setbacks, abutting streets)
BEAT & GAS LINE
FENCE
t
SIGN
N
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge Mat I have read this application; that the In-
formation given in 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 construction; and in doing the work authorized thereby, no person
will be employed in violation of the Labor Code of the State of Washington
relsung to WorkmeWs Compensation Insurance.
NOTE: Permit Limit One Your (Except DEBIOUTIONS which
shall be completed In ninety days; MOVED -IN BUILDINGS shall be core.
ATTENTION
THIS PERMIT
AUTHORMES
ONLY TBE;
WORK NOTED
pleted In six months.)
INSPECTION
DEPARTMENT
SIGNATURE 0 ER OR AGENT) DATE SIGNED
c- rev� 5
"o.�Aac 0 �Q& 3
LM
CITY OF
WMUNDS
NOTE: APPlicant Subject to Plats Check Fee
rR 6-1107
This permit coven work to be done On private Property 014'ux-
Any construction On the public domain (curbs, sidewalks, drivewaYs.
marquees, etc.) Will require sepwate permission.
ed I
[3 YES E3 NO
Fee
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.
DIRECTOR'S SIGN
.--i _� �
FILE
I a
; I
& "qUILDING PERMIT
kp
ITY OF EDMONDS
Building
Depc"meui
Pern-Lit
limit, one year
0", is hereby made for a permit to construct the following work, in accordance with the accom.-
J�d specifications. Two sets are submitted herewith for approval.
ter Off'st.
. .......... ... ...... :1 . ......
...... .............. Parking ......................
.... ............... Const. type ................................ Use ...t: ....... O?�.4/2 ...... Fire zone ...........................
.. ........ Blk .... ........... AddnZY7Y...Ztr..Aoq
................
......................... ) ............... Septic tank ....
front....J.421 ............ r. side ... az2� . ............ 1. side ... c7.0 ................. rear .. cr.O.W .................
Addrew jrl.V..Z.%�PiAr ............... Tel. No .............................
. ..... )A[dress..UO/g . ...... Tel. No?-1e
4_4 . ......... Address ... � . ....... Tel, No .............................
aarks.................................................................................................... .......................... ............................. I ......................
PERMIT for the above work is hereby approved, subject to the above condit
proved plans and specifications, and Building Department notations thereon.
Valuation .......... 48..i� .. .............. Permit fee ...... 5.4 . ............. Reed. ,
I
........... Date ... J.
Building Department, By ..............................
This Permit does not cover Plumbing, Sewer or Electrical installations.
with the ap,