680462.pdfBUILDING DEPARTMENTJ
PERMIT APPLICATION
VNAM (OR NAM OF BUSINESS)
lfoole le 7- RS. rc' Ile
id DDREBU
-IV lb e <
C Gj
ITY TE.
(y 141 0 V C/ -S I
7 POSTED ON KROLL MAP NO.: PERMIT
Applicant Fill NUMBER 680462
" M
lEnside H7eavvy ]LiWnes JOB ADDRESS ;477" S7—
K HEAR YARD SETS.
USE ZONE LOT AREA VACAISW IJL'jVN
4E Diu 1'.1t
'EPHOPIN wu—MBER YEE) >(NO
ADDRESS
-(riTy TELEPHONE NUMBER
STATE LICENSE NUMBER CITY LJCENSE NUMBEI
I ') a ;5 0 / 6 � / C/I I
I I Leital DescriDtiOn 01 Property tonow Below or Attach Four Copies)
M
I bi I c ii s e te s 7)e / �1 a e- AddN. 4:�
EXISTING STREET R/W ............ FT.
COUP. PLAN ST. R/W ........... XT.
FIRE
DEFICIENCY THIS PROPERTY
13 YES [3 No
I
GAS
RESIDENTIAL IJNE
[] YES E] NO
DNEW
PLAN CHECKED BY
NON-RESIDENTIAL SIGN
DRETAINING
DEMOLISH WALL
REMARKS
E] ALTER EXCAVATE FENCE
OR FILL ( x Ft.)
.......... ..........
PRE -MOVE swim
WSJ REPAIR INSP. POOL
NUMBER OF
DWELLING
e!%y C_ UNITS
NATURE OF WORK TO BE DONE
(Y4PMO�?e 7—o Xf
Valuation Fee
No.
41JV01"10.) 1)"J".
Plan check NO ............ .....
-Receipt
4��ZIIW-7-55
PROPOSED U13E
A�& S/ olp,,v c- e -
BUILDING
(2 0
PLOT PIAN (Indicate Building setbacli"liu—tting street$)
PLUE33ING
HEAT & GAS LINE
PENCE
t
SIGN
N
RL`TAINING WALL
SWIMI[ING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
O'D 6
I hereby acknowledge that I have read this application; that the In-
formation given in correct; and that I am the owner, or the duly auMur-
lzed agent of the owner. I agree to comply with city and state laws regu-
ATTENTION
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 permit until
relating to Workmen*8 Compensation Insurance.
AUTHORIZES
Signed by the Building Official or his Dep-
NOTE: Permit Limit One Year (Except DEMOLITIONS Which
ONLY THE
WORK NOTED
uty; and fees are paid, and receipt Is ac-
shall be completed In ninety days; MOVEL�171 BUILDINGS shall be oom.
lmowledged in space provided.
pleted In six months.)
(OWNER OR AGENT) DATE 51 E
ei�p,ATY 7_
INSPECTION
DEPARTMENT
DIRECTOR'S 81�GNAZTUU
1 /0 -,/ 0
"gQW.,L
CITY OF
—5ANE
__7__ L/
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
Q
PR 6-1107
This Permit coven work to be done on private property ONLY.
Any an the public domain (curbs, sidewalks, driveways,
FILE
construction
marquees, etc.) will require separate permission.
al
I
- -a
0