680501.pdfFBUILDING DEPARTMENT -_ Applicant Fill POSTED ON KROLL MAP NO..
U I I I
PERMIT APPLICATION Inside Heavy Lines JOB ADDRESS
I !
Am (OR NAME OF BUSINESS)
I �? /
aam
ADDRESS
CITY
STATE LICENE
Z Al-)
Legal Destriptic
FA
WOMEN,
M,A
NEW
ALTER
REPAIR
F 0
10
6 e 40 r
it
a ;4* e t; h 7'Ae 6
Ly l� /, Y
RESIDENTIAL
Z&BE
NON-RESIDENTIAL
SIGN
DEMOLISH
RETAINING
WALL
EXCAVATE
OR FILL
PENCE
I ........ . X .......... Ft.)
PRE -MOVE
INSP.
SWIM
POOL
IES
NUMBER OF
DWELLING
UNITS
TO BE DONE
4 _J 1-�� Z
EXISTING STREET R/W ............ FT.
COMP. PLAN ST. R/W ............ XT.
[] YES
[J NO
Plan check No .......
BUILDING
t
N
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
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 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 DE5101JTIONS which
shall be completed in ninety days; MOVED -IN BUILDINGS shall be com-
pleted in six months.)
�___ I //—/ el - W
NOTE: Appli"nt Subject to Plan Cbeck Fee
This Permit coven work to be done on private property ONLY.
Any construction an the public domain (curb@, sidewalks, driveways,
marquees# erge,) will require separate permission.
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY TIM
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR B-1107
PERMIT
NUM13ER
680501
YES
NO
[501
DEFICIENCY THIS PROPERTY
YES 0 NO
Valuation I Fee
I . (9 C2 1,1 7.,� . �
APPLICATION APPROVAL
This application is not a pernlit until
Signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
Imowledged in space provided.
�. / .21 W
Oil.
IT
1 1. It It, I I
I IT ltt; At,., .4-0 1 T I, . t -l" It
itllt,t Ill ?1.1 l I.—, It, I. I I I
I
ae I I I I I e tlI
lt't I t, t I I I lrg
-ItI .I pT I I I I., -..1 .1 -1 -11 lill"'I -1, It
It, ..It I Olt 7
1, it I I I
T I I I I " I I I I I I I I I
"t'iO7.1l .�nttt I I I I I I I IT I I I IT I T I
I I -IT 11 1 1 1
9'J' e Ill 4 [1 - l - - I . 1 4 1 1 1" 1 1 A )l Z' I.; I 1 0 . I I., I � 'I,, I I
TlI4 4GT(V U'U'le It -1 4 1 if I T 6, 1,, 1 '% I 'i
I'LI"At I I I IP
" I - t 11 -111 1 'OITI III I IT .1 1' 1 -.4 LN I
I it ij I I I I It It
, , I I I -of:
IT I It I I I` If: T, I I I t
I P. 1. 1 1
Till jlml c I (I'lft
I I' I Im, It 'p g 0.,
I It
try I I it T, .
OlIat", If 4 j IT' 1 11 PIT 4 141, It l U
IT I It 1, 1 It, l lo
XIll V,,A 'll 1 .1 1 1
IT I I IT I k I I - 1. 1 1% V I 'I
I It 'j" I 1 1, 1
I,
It I If t
Ill r It. It
I It it L I to I
lt FJ.I;J,, 'A
A I, e 4 It. ITT 1 0
rr 1 0
I I I It 'T"', r4 1. . I , . 1, "
I It .1; 1 1 1 1 1 1 1 ; I It
tl I I I 1 1, , i " I I I r I
All a Iml I'... w", Im,et, 11 L .1 . I ttt'l I I .. I I I I I a I t I I I
I
I lit, It, pt I
5 , I I A k 1. It 1 1. 1 It I I t I
I It I I ... I I at. It I I. 1 .1'. If 11 1 z It I " I I -I L
I 1—ft d' I. I I I . I . . I I — � I I I
1. 4 41 j.
I I It j I If I I I 1 0 1 It 1 1-14 1 1
It K.
till
t 0 IT
lit
It
I I.
If I
WO
I
1 4
4 1 1 1 1. 1.
t
4
I ep
I I
1
ro I I
I L I
I L
It
I I
tr I ,
i
L
I T.:
RFrnRD:0F'k§PECT10NS
'L "� , I J'% I It Il:tt
Iti
I
I
)'tl
L It
. .. ... .
APPLICATION & (JILDING PERMIT
Appl. N05
. .....
CITY OF EDMONDS Building Department
Permit limit, one year
APPUCATION is hereby made for a permit to construct the following work, in
accordance with the, accom,
panying p lans and specifications. Two sets are submitted herewith for approval.
n= alter ell.
Off -St.
work;�'Mn'�) r epair ...................................................................
Parking .......................
T T
Qc pancy .............. % Se =e .. ....................... e ...........................
'Y'
Address..7 Lot ............ ........... Blk ............. Addne .. ... ...
.... . ............. . ................... .. x
k..Lot frontage ........................................ Area ........................................... Septic tan .... ........... .............. ....
front ..... ................. r. side ...... . ................... 1. side .. Z ....................... rear.. ...................
Bldg. setbacks
Owner&IL.AJ ..... ....... ':?� ............... Addres& .... UZ . .... ... .... ...... No .............................
.............
Builde;;ftz-�a . ..... ..... Address ... Tel. Noxz..�� .........
Plansby ......................................... ................... )Address ................... ................. Tel. No .............................
V
Remarks................................................................................................................................ .................................. ...... ly,
This pormit covers work to be done
onPrivate D:r.QPArt,'V ... 01ILY . ...................... ............................... ........................................................... I
........................ . .................
Any construction on the public domain
s i dewa 11, t3.2.
...................... M ...... ............ 0 ........... . .................................. ............................................
etc.) will require sep2rate permissio
The above is a correct statement, and I agree to comply with 5f applicable Codes and State laws regulating this
work.
Ik 01
Signed Owner/Agent.r/ ................................ Addr7ss. ................... Date.!/n�-/"``�C.
to with. the
PERMIT for the above work is hereby approved, subject to the above conditi=4 and compliance
proved plans and specifications, and Building Department notations there=
Valuation........... ........ Permit fee. ...... ;.071-/ ................. Recd. by ............. ... . ..... .......
404
.0 -0)
Building Department, By ............................................. % ..... . ............... Date—./.4. ........ ...............
A
This Permit does not cover Plumbing, Sewer or Electrical installations. 4,
. . . . . . . . . . . . . . . . . . .