680327.pdfi
—FX�WrED ON KROLL MAP NO.: PERMIT
68003327
BUILDING DEPARTMENT
U I L DING D P ART
Applicant Fill
NUMBER
PERMIT APPLICATION
M'! P
9
Inside Heavy Lines
ROB ADDRESS
ME OF BUSINESS)
(OR VA 1
FNAME
Edmonds School District
On� 8 S 001
#15
SIDE YARD SETBACK STREET SETBACi
REAR YARD SETBACK
AILING ADDRESS
M M I I ADD=
96th Be W.
3800 196th S.We
ZONE J�ux
u2a"'� 1
VACANT SITE
YES NO
CITY TELEPHONE
CITY
NUMBER
[3 [3
-1
1
1
I BUILDING AREA
I VARIANCE NUALLSEU
04
U Waldron & Pomeroy
W ADDRESS
21.5 — 8th Ave. N.
CITY
Seattles Wn.
223-02-7265
El NEW
ADD
ALTER
REPAIR
Contractors
or
1:1 RESIDENTIAL
I
, E
15a
NON-RESIDENTYALI
rl�
!GN
DEMOLISH
OR FILL
RETAINING
WALL
PENCE
( .......... x .......... Ft.)
EEXCAVATE
l
PRE -MOVE
INSP.
SWIM
POOL
EXISTING STREET n/W .......... FT -
COMP. PLAN ST. R/W ............ FT -
0 YES 0 NO
DEFICIENCY THIS PROPERTY
[] YES 13 NO
L
NUMBEIC ul., Wrvlu�b a uw.D�� U"
DWELLING
UNITS
NATURE OF WORK TO BE DONE
Plumbing
Valuation Fee Receipt No.
4
Plan Check No ............ .... ...
PROPOSED USE
BUILDING
PLOT PLAN (Indicate Building aetbacka, abutting streets)
PLXOEBING
19
0
HEAT & GAS LINE
PENCE
SIGN
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 In correct; and that I am the owner, or the duty author-
Ized al:ent of the owner. I agree to comply with city and state laws regu-
ArTENTION
APPLICATION APPROVAL
lating constrUC1,10n; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the State of Washington
THIS PERMIT
This application Is not a permit until
relating to Workman's Compensation Insurance.
AUTHORIZES
signed by the Building Official or his Dep-
NOTE: Permit Limit One Year (Except DE31OLITIONS Which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
shall be completed In ninety days; blOVED-IN BUILDINGS shall be com-
lailowledged in space provided.
plated In nix months.)
0 AGENT) DATE 810
81 N (0 It NED
Zo
INSPECTION
DEPARTMENT
DIRECTOR'J, ATURE
_5UE�io
C11TY OF
EDMONDS
DATE
NOTE: Applicant Subject to Plan Check Fee
b
PR 8-1107
This permit covers work to be done oa private property ONLY.
Any construction an the public domain (carbs. sidewalks, driveways,
FILE
marquees, atej win require separate permission.
19
CAW)
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