680189.pdfff I
--- ---------- --------- ------ ----- - . .......
E7
TY. HIU6W
Applicant Fill
inside Heavy Lines
S- a r-4 s
- 2-X
S-0 0.,+h
TELEPHONE
ICNSE NUMBER CITY CENS.
� -0 / - A1qj I I —
Intinn of Pronerti (Show Below or Attach Four
C." 1111,10y PA /� H_
RESIDENTIAL
GAS
LINE
NEW
NON-RESIDENTIAL
SIGN
F-1
RETAINING
WALL
0
ALTE
F
DEMOLISH
EXCAVATE
on FILL
F-1
FENCE
( .. ....... x . ........ Irt.)
REPAIR
PRE -MOVE
INSP.
El
SWIM
POOL
NUMBER OF
DWELLING
UNITS
KROLL MAP NO.; PERMIT
1A5_ a/ NUMBER
680189
Is AC
15� - '00�
SETBACK STREET SETBACK
REAR YARD SETBACK
LOT AREA
VACANT SITE
113 YES [3 NO
AREA.
I VARJANcE NUMBER
MwAmzx n/W 50
EXISTING STREET R/W ... ........ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ........... XT. ... 0
REMARKS
Driveway slopes not to.exceed those
indicated on Standard Drawing #103. Property 10
included in Sewer L.I.D. 161 propq
,gPA for 4.
construction summers 1968, ";n'c'771 _, I
rYPE CON CTION VErVD BY
MBER
PERC. TEEF PET3 NU
REMARKS
FIRE ZO TYPE 0 R ON STRE T IMPROVED
1 1 [3 YES [3 I -TO
PECTOR,
XEQULIW OCCUPANCY GROUP
[3 YES 13 NO �?< 1 -1
Plan Check No ..................
PROPOSED USE
I BUILDING
to Building setbacks, abutting streets)
PLOT PLAN (InalCa PLUMBING
HEAT & GAS LINE
PENCE
IJ SIGN
N
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application-, that the In-
formation given to 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- AT=DMON
lating construction; and In doing the work allthorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington THIS PERMIT
relating to Workman's Compensation Insurance. AUTHORIZES
ONLY THE
NOTE: Permit Clinit One Your (Except DE5101JTIONS which WORK NOTED
shoal be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.) INSPECTION
ITI-ONATURE (OWNER Oft AGENT) JJJLXju SIGNED DEPARTMENT
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee PR 0-1107
Thin Permit coven work to be done on private property ONLY.
Any construction on the pubIlo domsJu (curbs, sidewalks, driveways,
marquees, ejo.) jvItI require separate pernilssl0n.
Valuation I Fee I Receipt No.
Eli
I 110.001W400
APPLICATION APPROVAL
This application is not a pernlit until
Signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
Imowledged In space provided.
FILE
I