680375.pdfa
IM1111111111
F BUILDING DEPARTMENT Applicant Fill
P M 7P cant 'Zin
P 5 'ON7 71mn�ldlc Heavy Lines
ERMIT! APPLICATION
j!s
ES
NAME (OR NAME OF BUSIN B)
Kenneth Byers
R=1LANG "DRESS
r
10
;18503 - 202nd S.W,
H, W, Pedrson
ADDRESS
554-4th Ave, So,
CITY
Edmondev Wn.
Pr.
or
Pr, 8-2515
E. 81 ft. E)�, SWA9 nel4t, nw)4 Sec. 19
T27N R 4E W,M9
RESIDENTIAL
EI, I
R
GAS
LINE
NEW
1:1
rLit
NON-RESIDENTIA.L
SIGN
[_�
RETA3[NING
WALL
DALTER
0
DEMOLISH
EXCAVATE
OR FILL
FENCE
( x Ft.)
........ . ..........
REPAIR
M
PRE -MOVE
INSP.
swim
POOL
NUMBER OF STORIES
NUMBER OF
DWELLING
UNITS
Enclosed Patio
See attached
AP NO.: PERMIT '80375
1 NUMBER
202nd S,W.
STREET 114TIlAlIK REAR YARD BETE
251 Min 15' Kin
LOT ARMA VACANT B17M
1 [3 YES ]MD;O
EXISTING STREET n/W ... ........ FT- DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT.
SPECIAL INSPECTOR REQUI
0 YES 3L NO
PLAN CHECKED B
7'�Z7.
Plan Check No ............
BUILDING
PLUMBING
BEAT & GAS LINE
FENCE
t
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 is correct; and that I am the owner, or the duty author-
ized agent of the owner. I agree to comply with city and state laws regu-
ATTENTION
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
THIS PERMIT
relating to Workman's ComPenfi&tlOa Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
shall be Completed in ninety days; MOVED -IN BUILDINGS shall be com-
pleted in six montho.)
-----------751FAGENT)
JIGNATURE (ONV—RR
DAT) SIGNED
I SPECTION
N
,N
7
DEPARTMENT
011TY OF
NN�111111111_ EDMONDS
NOTE: Applicant Subject to Plan Check Fee PR 0-1107
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
nmnueev, etc.) will require separate permission.
Valuation
I
!s%
[] YES 13 NO
Fee
WALWA 111111111
0
A4
96
APPLICATION APPROVAL )
This application Is not a pern-dt until
tAgned by the Building Official or his Dep-
uty; and fees are paid, and receipt Is ac-
knowledged in space provided.
FILE
f
I