680481.pdfC"
POSTED ON KROLL MAP NO.: PERMIT
BUILDING DEPARTMENT Applicant Fill I NUMBER 680481
PERMIT APPLICATION Inside Heavy Unes JOB ADDRESS
NAME (OR NAME OF BUSINESS) q '-1� -;�
X 1/17/? E r 7-25,�� SIDE YARD SETBACK STREET SETBACK REAR YARD SET13
NAILING ADDRESS I
grr ;eF— �9 .7) ;C USE ZONE —UO—TAREA VACANT SITE
CITY TELEPHONE NUMBER I C] YES [:1 NO
I—e P10011Y a .'IV P 1 1 P%R ? F0 !;� �/ I HEIGHT BUILDING AREA, I VARIANCE NUMBIJ
0 �5 CV j0o.4 �S IAIC
ADDRESS
CITY
TELEPHONE NUMBER
Q
STATE LICENSE NUMBER
CITY LICENSE NUMBER
t7
Lagoa Description of Property (Show Below or Attoch Four Copies)
14
NEW RESIDENTLAM 2&SE
RNON-RESIDENTIALJ
SIGN
I
.� RETAINING
M DEMOLISH FiWALL
ALTER EXCAVATE PENCE
M OR FILL Irt.)
. ........
PRE -MOVE swim
E]
REPAIR
M INSP. POOL
A
DWELLING
UNITS
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 author-
ized agent of the owner. I agree to comply with city and state laws regu-
lating construction; and In doing tho work authorized thereby, no person
will be employed in violation of the Labor Code of the State of Washington
ralsaing to Workmen'm Compensation Insurance.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be completed In ninety days; MOVEDAN BUELMINGS shall be com-
pleted In mix months.)
W,
NOTE: Applicant Subject to Plan Check Fee
This Permu; coven work to be done on privaU property ONLY.
Any construction an the public domain (curbst sidewc1lims drlv&witysp
marquees, etc.) will require separate permission.
EXISTING STREET R/W ......... VT.
[I YES 13 NO
Plan Check No....
L-PIR �Iel
PLUMBING
BEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTEISMON
THIS PERbUT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
cripy OF
EDMONDS
PH 6-1107
DEFICIENCY THIS PROPERTY
........... 11T.
rT'RESTnLPROVED
13 YES 0 NO
APPLICATION APPRO
This application is not a permit until
signed by the Building official or his Dep-
uty; and fees are paid, and receipt is ac- A.
knowIedged in space provided.
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RECORD OFIINSPECTION9 I., I tj
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....... .......
APPLICATION C BUILDING PERMIT
CITY OF EDMONDS Building Deipartment
Appl. No . .................................. .
Permit limit, one year
APPUCATION is hereby made for.a permit to construct the following work, in 'accordance with -the acc6m,
p anying plans and specifications, Two sets are submitted herewith for approval,
new alter Off -St.
........................................................... Parking ................
Work n repair
Occupancy; ............................... Const. type .... .................... Use zone ... .... Ere zone ..........................
Address .... ..... Lot ....... *3 .............. Blk ........................ Addn.2k&g!2Q
Lot frontag . ...... ..................... Septic ....................
Bldg. set -backs front ....... . S e.
........ r. side .......... /.±/` ............ 1. sid ......... ........ rear ...............................
Ow
ner .... .......... Addres&.Z,��/.��.Q� ...... Tel. No...62:!� .... . .........
Builder .. A
.......... Tel. No.eflLt-�Kle�?/
Plansby .................................................................. Address .......................................... ......... Tel. No... ................. ......... .
.......................... .................................................................................................................. ........... ....................
Remarks....
................................................................................................ ..........................................................
....................................... ...
The above is a correct statement, and I agrce to comply with all applicable Codes and. State laws regulating this,
work.
gen
Signed -Cwaer/A
.. .... .... 0
Address ..................................... ..... Date ..................
-77
PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance with tAe ap,
proved plans and specifications, and Building Department notations thereon.
Valuation ... �ZS92.e�C9.!2 ......................... Permit fee ..... �onS� ............. kecd. by ..... :7 ... ......
Building Department, By .................
...................... . ........ Date ... ......... cep .............................
NOTE This permit does not cover plumbing, sewer, or electrical installations, nor does it permit any work to be
done in the Right of Way. areas. Driveways and walkways must be planned to meet the official grades of streets
and alleys, and plans for future sidewalk development.
A