680205.pdfPOSTED ON KROLL MAP NO.:
BUILDING DEPARTMENT
Applicant Fill
PERMIT APPLICATION
Inside Heavy Lines
JOB ADDRESS
NAME (OR riAaaw oFBUSINESS)
2 OLI
SIDE YARD SETBACK STREET I
IJAILINU A-LJIJ�Mll
13ec);;i o —9) srco %EdAiw(i
929-22121
USE ZONE LOT ARE,
CITY
Wlo"rlivriju JNUMBwt
?79
720-
HEIGHT BUILDINC
NAME
544445_1� s
_9L_0TPLAN APPROVED
14
—jWDRESS
STREET R/W
U
-U,—TY
TELEPHONE NUMBER
EXISTING STREET R/W ............ FT-
COMP. PLAN ST. R/W ............ FT -
REMARKS
NAM
705DREBS
CITY
ELEPHONE NUMBER
METER SIZE SERVICE SIZE C
STATE LICENSE NUMBER
CITY LICENSE NUAMWISibult
PERMIT
NUMBER
1�j 4
13 YES [3 NO
DEFICIENCY THIS PROPERTY
... ........ FT.
Legal Description Of Property (3how Below or AttaCM irour L;opiea)
VN.
All that portion of Lot 25, East Edmonds Acres -Division No'. 2. according to
��p�4t-�thereof recorded in volume 12 of plats,, page 66j, records of Snohomish
.-PountygWashington, described as -follows:
1� �IB6ginning at the Northeast corner of said Lot 25; thence South 0025,2111 West
��along ihe.Easterly'line thereofi'.tiS feet; thence North 8900gt2311 West, parallel
with the Northerly line of said Lot, 130 feet; thence North 002512111 East,
..parallel with the Easterly line of said Lot, 65 feet to Northerly'line'
.thereof;,thence South,8900912311,East along said.Northdrly.line 130 feet*to'
point.of beginning.
SPECIAL INSPECTOR REQUIRED occ
RESIDENTIAL GAS [] YES (3 NO
NEW LINE PLAN CHECKED BY
1:1 E NON-RESIDENTIAL SIGN
19_1ADD RETAINING REMARKS
RDEMOLISH WALL
ALTER EXCAVATE FENCE
r_1 OR FILL ( .......... x .......... Ft.)
REPAIR PRE -MOVE swim
M INSP. POOL I
DWELLING
UNITS
Plan check NO .....................
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
t
SIGN
N
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read thin application; 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 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
relating to Workman's compensation Insurance.
NOTE: Permit Umit One Year (Except DEMOLITIONS which
shall be completed In ninety days; AZOVED-IN BUILDINGS shall be 00m.
plated In six months.)
3IGNATURE (OWNER Ojt,,A�ENT) DATE SIGNED
e
NOTE: ApPliWilt Subject to Plan Check Fee
,is Permit covers work to be done on private property ONLY.
Am construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will reQuire separate permission.
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY TILE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
[] YES 13 NO
Valuation Fee
o
APPLICATION APPROVAL
Z
N
No.
This application is not a perniit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
�7
FILE
I
I
I
N & WORK PERMIT
Application No. 6:2
CITY OF. EDMONDS Building Department Permit Limit, One Year
APPLICATION is hereby made for
"ermit to construct the following work, In accordance with the accompanying plans
and specifications:
New/Addn . ........................
....................................................... Ground Area ..................................E. No. stories ... z
tted.........................................................................................................E. Const. Type ...... ................ Height ...... ��: ............
Adxdrs Use Zone..e:-, 71re Zone ....................
;��) ........... zz*EE****** &Z,
et e_l 4— Z r.;;rL_
Pz
t...
.................................................. . .... .....
......... C ..... lock .. ....... Sewerage ....................................
...... Width ...... 6/(;a ... ........... Min. Bldg. Setbacks, Front and Rear ... ...... :?�� ....... Sides ..... ....... 14 . . ....
C�
Phone................................
107 -5 J e�z./
// L_/ 20
........ . ................... .....................................................................
........ Address...
.41
2 / 4( el�
by........................................................................................... Address ........................................................................ Phone ...............................E.
'Heating by ....................................................................................... Address ........................................................................ Phone ................................
Elect. by ........................................................................................... Address .......................................................................E. Phone ...............................E.
Remarks
.........................................................
The above is a correct st,a;m_'en'tand
Signed: Owner/.
to comply with all applicable Codes and State Laws regulating the work.
Date.2E...-3.=.6;.._:i�
PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance with the approved plans
and specifications and Building Department notations thereon.
VALUATION PERBUT FEES
Bldg . .... $
V ......... ;0 .......................... ......................
APPROVED:
Date......... ...........
Plbg $
.................................
...............
Heat .... $ .......... .
Elect.
BUILDING DEPARTMENT Others ... $ ........................................
0 01
By ... k1A ..... ................... TOTAL FEE $ ......................
NOTES: No work requiring Building Department or City Engineer's inspection shall be covered before inspection and approval.
Twenty-four (24) hour notice requested. Contact the City Engineer prior to construction of all site utilities, su
curbs, paving, driveways, sewer, water and street connections.
I
14, L
RECORD OF INSPECTIONS
Date Passed
Foundation
Plumbing (Partial)
(Rough)
I
Fra me
Aff..