690003.pdfW
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KROLL M" NO.: PERMIT
NUMBER 690003
BUILDING DEPARTMENT Applicant FM
/ / -6�
PERMIT APPLICATION Imide.11cavy Lines JOB ADDRESS
NJ70R NAME OF BUSINESS)
SIDE YARD 111171713AUK. STREET SETR�CK REAR ilRD SETBACK
7�
.2 0
MAILING ADDREUb e Z134 I
USE ZONE LOT AREA f VACANT SITE
CITY TELEPHONE (9 13 NO
AI -NA WNCE Nu�� W
EIGHT BUIRDING
L3 4? W 1-7 A,- I - I
14
t—, Cl /V PLOT PLAN uvmu
14
sTn7R/
/V ums NO STREET R/W Z.aFT. DEFICIENCY THIS PROPERTY
C TNL1Nrj1U�Ai UMBER COMP. PLAN ST. R/W ..90..XT.
NAME )14,( 1/1 / REMARKS
d'-V (110to 4,-3 7�_ DrivewAy—slopes not.to exceed those
indicated on Standard Drawing #103.
-ADD—=, 8 A
/y- /Z<- 7
CITY' TE—LEPUONE NUMBER
774, ci, UETRI�SIZE SERVICE SIZE CLEARANCE By
STATE LICENSE NUMBER CITY LICENtim rlu-�Nn
A 2- 3 - REMARKS
Legal Description of Properfy—(Show Below or Attach Four Copies)
TYPE Cd-NNECTION VERIM" BY
_7 d PERO. EST PW\7 UMBER
19 d REMARKS
I= ZONE TYPE OF CONSTRU�=ON STREET IMPROVED
YES ff<O
14 �-* _q
PECULL INSPECTOR REQUIRED 0CUUrANCY GROUP
2rN
GAS C]YES 0
RESIDENTIAL E] LINE PLAN CRECKE Y
E9__NEW
NON-RESIDENT L F� SIGN
=Li RETAINING
ElDEMOLISH WA_LL
ALTER EXCAVATE PENCE
I F-1 OR FILL ( ......... �x .......... Ft.)
El REPAIR PRE -MOVE SWIM
1:1 INSP. POOL
_WUMBER OF STORIES NUMBER OF
DWELLING
UNITS 7
0
Plan check
PROPOSED US
I
BUILDING
&
-40)
-FLOT —PLAN (IndicatelBUilding notnacm, abutting streets)
PLUMBING
Ca
0
HEAT & GAS LINE
E
FENCE
t
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.
ATTENTION
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
TUIS PERMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
ONLY THE
E. P lit Limit/One Year (Except DEMOLITIONS which
WORK NOTED
11 comel[reMted in nin �ry aye; MOVED-XN BUILDINGS shall be coin -
2
Piet ins, months.) /
INSPECTION
SIGN RE
0 AGE T)
DATE SIGNED
7
1_7
DEPARTMENT
4 1 2-1
CITY OF
EDMONDS
(POTE: Applicant Subject to Plan Cbech Fee
rn 6-1107
-- ---- nw.v
Any 00marUCHOU on �0 11ul-- 1-1 -
roarqueeg, etc.) will require separate PCM119510n.
valuation I Fee
M
APPLICATION APPROVAL
No.
This application Is not a permit until
signed by the Building official or his Dep-
uty; and fees are paid, and receipt is ac-
linowledged in space provided. -W,
FILE