680442.pdf-4
POSTED ON KROLL MAP NO.'. PERMIT
680442
T
BUILDING DEPARTMEN Applicant Fill.
NUMBER
PERMIT APPLICATI ON Inside Heavy Lines jOB
ADDRESS
ye (1�j 0
NAME (OR NAMM OF BUSINESS)
FUNNELL, Warren B. Florence I.
_ZJ7_�
1
SIDE�YARD SETBACK SETBACK REAR YARD BETJ3A(jn
S_
YgUMN ADDRESS
18621 79th Place W.
Us o LOT AREA VACANT SITE
NE
[3 YES
CITY TELEPHONE NUMBER
R
Edmonds, Wn. PR 6.1903
98020
2.
HEIGHT BUILDING AREA V�4%4ANCE 14UMBER
NAME
_9LOT -PLAN APPROVED
1
14
0
ADDRESS
TELEPHOWET-N—UMBER
,ME
iDRESS
TY
TELEPRONE14 ER
'ATE LICENSE NUMBER
CITY LICENSE NUMBER
�gal Description of Property (Show Below or Attach Four Copies)
Tract 2% Montebello Parkq according to
plat thereof recorded In volume 19 of
plats,
page 569 records of
Snohomish Co-
unty,
Washington.
E] NEW RESIDENTIAL
NON-RESIDENTIAL
" �"w I
DEMOLISH
ALTER EXCAVATE
OR FILL
REPAIR PRE -MOVE
INSP.
GAS
13 LINE
SIGN
RETAINING
WALL
PENCE
( .......... x .......... Ft.)
swim
POOL
one
UMBER OF
DWELLING
I UNITS
one
qATURE OF WORK TO BE DONE
portion of double -garage to be
-alter
STREET R/W
EXISTING STREET R/W ............ FT- DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ IT- ............ ITT.
REMARKS
Z
CHECKED BY
METER SIZE SERVICE SIZE CLEARANCE CHECKED BY
REMARKS
TYPE CONNECTION VERIFIED BY
PERC. TEST PERMIT NUMBER Cd
REMARKS
FIRE ZO TYPE OF CONSTRUCTION STREET IMPROVED
YES NO
ECTOR UIRED OCCUPANCY GROUP
0
YES 7:
PLAN� �CE�
��CKEDY
REMARKS_-�
recreation/laundry room.
rian check No .....................
PROPOSED USE
recreation/laundry
BUILDING
—PLOT
PLAN (Indicate Building SetbacKa. abutting street$)
PLUMBING
0
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 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 mgu-
ATTENTION
lating construction; and In doing the work authorized thereby, no person
be employed In violation of the Labor Code of the State of Washington
THIS rER3UT
will
relating to Workmen's Compensation Insurance.
AUTHORIZES
ONLY THE
140TE: Permit Limit One Year (Except DE51OLITIONS which
WORK NOTED
shall be completed In ninety days: MOVED -IN BUILDINGS shall be com.
pleted in six months.)
OR AGENT)
DATE SIGNED
INSPECTION
DEPARTMENT
/A/64
9/11/68
"t
CITY OF
EDMONDS
NOTE: A 7ticant subject to Plan Check Fee
PR 6-1107
This Permit covers work to tie done on Private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
Valuation I Fee i Receipt
I q, go 114 (16,
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-
Imowledged in space provided.
I
q--4,�O
te
kJ(>
O\L -
Frame
Furnace & Fuel
'Final
Lines
RECORD OF INSPECTIONS
Date Passed
Drainage
sowor
Mtking
Undstoping
Fim Dept.