690006.pdfff -
L
DEPARTMENT I APP11011111t M
APPLICATION Inside "e&vy "nes
2 ov ]SUSIXIIIIIII)
f—LEPH02VID—NUMBER
.4 5f
. 1; .. PF:.&
LALM:=
6&lonlof Property (81101
ADD
10 r-M
FIREPAIR
)�'L
tt/'06' .3 P &/ A 2--
El RESIDENTIAL
GAS
FILINE
14ON RESIDENTIAL
SIGN
DEMOLISH
RETAn-TiNo
WALL
EXCAVATE
FENCE
El
OR FILL
( ........ .
PRE -MOVE
INSP.
swim
1:1 POOL
J-0,r .4r4c#X4 yhlg_�7—
C
P NO.. PERMIT
I NUMBER
n 530 - 5th Avenue South
EXISTING STREET R/W .......... rr-
COMP. PLAN ST. R/W ........... I"-
I hereby acknowledge Met I have read this application; that the In-
formation given to correct; and Mat I am the owner, or We duly author -
,sod agent of Me owner. I Ograe to comply with city and State laws regu-
I&MIg construction; and In doing the work authorl"d thereby, no Person
will be employed in violation of the Labor Code of Me State of Washington
relating to Workmend Compensation 103u=cO-
NOTE: Permit Limit One Your (Except DEMOLITIONS which
&hall be completed in ninety days; MOVED -IN BUILDINGS Shall be 0010-
plated In Nil Months-)
NOTE: APPlicant Subject to Plan Check Fee
TWO permit covers work to be done on PrIVA" Property ONLY -
Any construction On the public domain (curbs. sidewalks, drivsWAYS,
amaque". e4e.) will require separate permission-
OF
[3 YES E3 No
JdART —"=
'loll
YES 13 NO
JUANOM NUMBER
/ � ,;4 7-1;?
DEFICIENCY THIS PROPERTY
I
go
13 YES 0 NO
RMAP"
Board of Adjustment findings-11-26-68
Reqaest !kg greatedwAtij - 4-00 011 Owing;
That ordinance is allow amount Of 'signing
reqnested by app-ileast 4:6 F& --- A %dt""
months from approval of this variance.
kpp±icant wk-11 remove Big& ;Lp GZ!d4"gvkcA i
not passed,
Plan Check No....
F*10--
-LIA-bli�re
PLUN33ING
HEAT & GAS LINE
FENCE
SIGN
RETAXNING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
Fee
C, �0 1 .5, C) a
I :D - 'ZI 0 1111 1600
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.
.0
. IS
W
RECORD OF INSPECTIONS
Date Passed
Drainage
Sewer
Parking
Landscaping
Fire Dept*