680381.pdf� M
—FO—STMDoN KRO" MAP NO.: PERMIT 68038
MUIIIWUILDIN6 DEPARTMENT AntilicalIt 11 1 NUMBER ��f I
PERM APPLICATION inside Heavy Lines joB ADDRESS
NAME (OR NAav OF BUSINESS) 8503 . 202nd S.We
Kenneth Byers SIDE YARD SETBAC 1 8
MAILING ADDRESS 7 1)4- Min LOT
8503 . 202nd S.W, Er
us z98
TELEPHONE NUM1311IR
Edmondsq Wne PR 8 1389 HEIGHT
t
IADDRESS
STREET R/W
CITY TELEPHONE NUMBER EXISTING STREET R/W ........... XT.
I I COMP. PLAN ST. R/W ........... XT-
He W. Pearson
ADDRE"
.5.511�_4th Ave. So,
—0—m—Y-47— - TELEPHONE NU24
Edmonds, Wn, PR 8 251.5
STATE LICENSE NUMBER O= LICENSE NI
223 4
.21.�25
Legal Description Of Property (tinow Below or Attach Four col
E, 81 ft, EY29. SW341 NEAq See. 19
Z
2 T27N R 4E W.M0
01 1,
Min 151 Min
VACAN V 111rig
13 YES :me
LREX VARIANCE NUA�� OW
DEFICIENCY THIS PROPERTY
x
FIRE ZONE TYPE OF CONSTRUCTION
AT T IMPROVED
REE
YES [3 NO
_6PECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
RESIDENTIAL
GAS
LINE
[] YES i& NO
NEW
PLAN CHECKED BY
NON-RESMENTIkL
SIGN
I
El
RETAINING
WALL
REMARKS
ALTER
DEMOLISH
EXCAVATE
F] OR FILL
PENCE
........ . x .......... Ft.)
ElREPAIR
PRE -MOVE
SWIM
INSP.
POOL
NUMBER or
DWELLING
UNITS
NATURE OF WORK TO BE DONE
Bedroom
addition, shower
and
vanity,
—
I Valuation
Fee Receipt
N",,'
Plan Check No ......... .. .
PROPOSED USE
BUILDING
ed A ZZ
PLOT PLAN (Indicate Building setbacks, abutting Streets)
PLUMBI G
HEAT & 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 duly author-
lzed agent of the owner. I agree to comply with City and state laws regu-
ArrENUON
APPLICATION APPROVAL
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
This application is not a pern-At until
relatIng to Workmen's Compensation Insurance.
AUTHOR[ZE8
signed by the Building Official or his Dep-
NOTE: Permit rimit One Yetir (Except DEMOLITIONS which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt is ac-
Shan be completed In ninety days; MOVED -IN BUILDINGS shall be com-
knowledged in space provided.
pleted in six months.)
SIG NATURE OR AGENT) DATE IONL
INSPECTION
DEPARTMENT
DIRECTOR'S SIGNATU
AVE 6
()ITY OF
Fee
EDMONDS
NOTE: Applicant Subject to Plan Check
PH 6-1107
This peratit covers work to be done an private property ONLY.
Any construction an the public domain (curbs. sidewalks, driveways,
FILE
numqueeg, etc.) will require Separate permission.