680432.pdfPOSTED ON KROLL MAP NO.:
BUILDING DEPARTMENT Applicant OR
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es
MAIT APPIWATI N Inside Heavy Lin I J013 ADDRESS
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NAME (OR NAME OF BUSINESS)
C2 le6 ee
MAILING ADDRESS
CITY TERLEPHONE NUMBER
7 -2 e74 -Ie6 -7
ADDRESS
21 CITY TELEPHONE NUMBM�__
0. 1
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or
NEW
RESIDENTIAL
1
GAS
LINE
E]
NON-RESIDENTIAL
0
SIGN
ADD
RETAINING
0
WALL
ElALTER
DEMOLISH
EXCAVATE
FENCE
1-1
OR FILL
F1
( X Ft.)
.......... ..........
REPAIR
E3
PRE -MOVE
INSP.
El
swim
POOL
NUMBER OF BTGIUE13
I NUMBER OF
DWELLING
UNITS
PLOT PLAN (Indicate Building setbacks, abutting streei
I hereby acknowledge that I have read thin 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-
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 Workmen's Compensation Insurance.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be c ompleted in ninety days; IMOVED-IN BUILDINGS shall be earn.
Meted In u�i months.)
TH0901 . 993HUMMEW
NOTE: Applicant Subject to Plats Cbeck, Fcc
This por"t covers work to be done on private property ONLY.
Any construction on the public domain (cache. sidewalks, driveways,
nuerquees, etc.) will require separate permission.
CARD BAC STREET E
E LOT AREi
PERMIT
NUMBER 680432
TBACI ItEAn YARD SETBACK
VAVANT SITE
8 0 NO
AREA VARIANCE NUMIJaK
EX113TIN� STREET n/w ..(qP..rT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W /,a ... FT. ..... P .. FT. —0
REMARKS Driveway slopes not to exceed those
shown on Standard Drawing #103.
ct
TYPE CONNECTION
OF
[] YES
Plan Check No ................
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTENTXON
THIS PERMIT
AUTHORIZES
ONLY THE
WORIC NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
Pit 0-1107
Valuation
0 YES 0 NO
WIN
Z
No.
APPLICATION APPROVAL
This application is not a permit until
signed by the Building, Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
FILE
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