680464.pdfPOSTED ON KROLL MAP NO.: PERM[rr
BUILDING DEPARTMENT ApplIewt M NUMBM 6804
PERMITAPPLICATION Inside Heavy Lines JOB ADDRESS
NAME (OR NAME OF BUSINESS) Avel
SIDE YARD SETBACK STREET SETBACK REAR YARD
0 jel�X
7 --jjS7_ I-
�.'A L�6ti*00)1140 W,4CH I ��Vmwllm llv��
A 1,4.
ADDRESS
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_61—Ty TELEPHONE NUMBER
U.'e:3,41 3 3 0C.
4=
1 NAVIA A '9
A DREW
STATE LICENSE NUM
.2 a,� — 0 / —
I
TELEPHONE NUMBEI
47 0 / W ,4 13
NEW
ADD
ALTER
REPAIR
NUMBER OF sTc
2--SAn,�'eg/
NATURE OF WOj
PROPOSED USE
Li RESIDENTIAL
GAS
LINE
SIDENTLOLL
SIGN
DEMOLISH
RETAINING
WALL
EXCAVATE
FENCE
-OR FILL
( ........ . x . ........ Ft.)
PRE -MOVE
SWIM
INSP.
POOL
IES I
NUMBER OF
DWELLING
UNITS
C TO BE DCNE
� It/-" e— 7�e 4r-�
Q lcl-e
10
PLOT PLAN (Indicate Building sel
t
f
F
Bill ZONE LOT AREA 01 1 VACANT orria
9�f, "7 7— 0 C 04E�S [3 NO
CIORT BUILDING AREA VARIANCE NUMBE]
01
10 PLAN APPROVED
A08TING/1WREET R/W ... !rfL .... FT. DEFICIENCY THIS PROPERTY
COUP. PLAN ST. it/w.z) .... FT. .... r� .. M.
L(
XP=
It
I � * I R-YES 13 NO
Valuation I Fee I Receipt No.
Plan Check No.1 .... L--V .. V q 4, ;�o
BUILDING 0
?04 00
PLUMBING 2.4 ai)
HEAT & GAS LINE
FENCE
RETAINING WALL
SWIMMING POOL
Nt> DEMOLITION
PRE -MOVE INSPECTION
cldrl e-,) .
I
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I he"
I hereby Acknowledge that I have read this application; that the in-
formation g
formation given to correct; and that I am the owner, or the duty author-
lzed agent of the owner. I agree to comply with city and state laws regu-
IVagent c
ATTEDMON
it ng const
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
will be empl
THIS PERMIT
relating to Workman's Compensation Insurance.
LNOTE:
AUTHORIZES
T Permit Umit One Year (Except DE51OLITIONS which
ONLY THE
WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be oom-
pleted In six months.)
U
81 ATU (OwNEWR AGENT) DATE SIGNI�D
INSPECTION
7
DEPARTMENT
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
---
PR 6-1107
This Permit covers work to be done an private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, ate.) will require separate permission.
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.
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:RECORD OF 4NSFaT10`N.,"
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Sewer
I-J �'Parking AW,
Landscapirg
Fire Dept.
"'IC
RECORD OF MPECTIONS
Date Passed
ve,
Foundation C—Ap
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Plumbing (Partial)
(Rough)
Frame
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Furnace & Fuel
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Appl. No—'. .. . ....... .....
APPUCATION BUILDING PERMIT
CITY OF EDMONDS Building Department Permit limit, o'nP- year.
ance with:the accom--
APPLICATION is hereby made for a permit to construct the following work, M' accord
with for appro%-A.
plans and specifications. Two sets are submitted here
panymg
Off -St.
new alter
. . . . . . . . . . .
Work addn. repair .................... I -
. ......... Parking .......... .
....................... Pi
Occupancy ................................ Const. type ............................... Use zone ..... re zone ...........................
. ... . .... .... .. . . .... ........ ..
...................... Blk ........................ Addn .....
A Z .q:::/
ddress ....... .. ... .. . ...... ;? ..... ............. Lot
...................... Area ........................................... Septic tank ..................................................... . ... .
Lot frontage ..................
r. side ................. ........ 1. side ....................... rear ...............................
Bldg. setbacks front. ..........................
N .. .................
es& ....... lze:�.
Owne&d ... I Tel., o..
...... .................... Addr
........ Address. .................................................... Tel. No ......... ....................
Builde . ...... .......... . ... k .... tZ -
Plans
....... Address .................................................... Tel. No .............................
by .................................... ......... ...........
L
-40� ................. .........
Remarks ...... .......... ......... �74.
11 rj%4pa nnA Rtntp- 6WA rev�uhx/L
/V —lut. - , Yrthis
4
t
7,
7
APPIJOATION & 17RILDING PERMIT
Appl. ..... .
CITY. OF EDF�ONDS Building Deparhnent
Permit fimit� on
e YW,
APPUCATION is hereby
made for a. Permit to construct the following work, in accordance with the acom,
% PanYing plans and specifications. Two sets ale submitted herewith for approval.
new alter
Off -St.
A
Work addn repair ........
........... . ............ I .......
................. Parking .
Occupancy .............................. Const. type ................................ Use zon
e....... ............ Fire zone .............................
Address ... A.j..
.................. Lot. .......... Blk ......
-104 ...... / .................. Addn...
Lot frontage ............................
. . . . . . . . Alrea ........................................... Septic tank .... .
Bldg- 6et-backs front ........................... r. side ............ ...... 1. side .............................. ra /S
r...................
. ............
Address. ..... No.
..... Tel.
Builder..
Y ..........
........ Address
Teli No ..........
. ..............
Plans by . .........................
......................................
Address ..................................................... Tel. No ..... ..............
Remarks ...... �
........................................... r ................................ I .............................. ete
to,
zo..t
....................
................. ............ CAL
.0 ..... ..... ......
........................
.......... .