690036.pdfI
I
BUILDING D
PERMIT AP
F/2
DNEW
F1 .
ALTER
REPAIR
ARTMENT
KATION
Applicant FM
Inside Heavy Lines
� - _4V �
GAS
El RESIDENTIAL F1 LINE
ElNON-RESIDENTIAL F� SIGN
RETAINING
DEMOLISH WALL
EXCAVATE FENCE
OR FILL ( ........ . x . ........ Ft.)
PRE -MOVE SWIM
INSP. POOL
DWELLING
UNITS
/I
I hereby acknowledge that I have read this application; that the in-
formation given Is 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 Workmealx Compensation Inemrance.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be completed in pinety days; MOVED -IN BUILDINGS shall be com-
NOTE: Applicant Subject to Plan Check Fee
This Permit coven work to be done an private Property ONLY.
Any construction an the Public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
PERMIT
NUMBER
REAR YARD SETBACK
USAZONIG LOT AREA VACANT GITE
k(0 0 YES (3 NO
HEIGHT I III DING AREA I VARJANOE NUMBER
EXISTING STREET R/W .......... FT.
COUP. PLAN ST. R/W ............ FT.
[] YES 13 NO
DEFICIENCY THIS PROPERTY
[3 YES [3 NO
I
Plan Check No ............ .... ...
Valuation
Fee
Receipt No.
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
OLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
J
71�
TOTAL AMOUNT DUE
-all o-0
ATTENTION
APPLICATION APPROVAL
TM8 PERMIT
This application is not a permit until
AUTHORIZES
ONLY THE
signed by the Building Official or his Dep-
WORK NOTED
uty; and fees are paid, and receipt is ac-
Imowledged in space provided.
INSPECTION
DEPARTMENT
3 SI9'P
CIT
DATE
EDMONDS
PR 6-1107
17
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m��,ilrl
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1E6
s,!.�
APPLICATION BUILDING PERMIT
CITY OF EDMONDS Building Department
A 1. No. ..X4
..................
pp ..................
Permit limit��o'ne year'.
APPLICATION is hereby made for a permit to construct the following work, in accordance wiffi 'the accam,
panying plans and specifications. Two sets are submitted herewith for approval.,
Off-Sts
new alter� IIJ
Work addn repair ................................ ......... ................. Parkini,
.................... .... ....... ..............
Occupancy ............................... Const. type ................ .............. zone ...... e7.4�
. ....... Fire zone� ...........................
Address ...... . ........................................... .. .
. .......... . t . ........ .
. ......... Blk ........................ Addn ....................... ..............
Izt.frontage ....................................... A= ....................
..... . ................. Septic tank ...........................................................
Bldg. set -backs froxit .......................... r. aide ............................. 1. side .............................. . rear ...............................
-- I-P-j
Owner-. . ..... 7 . . . . . . . . . . . . . . . 9� . . . /! �.-��Ad d ress. .... ze..Z�A ..... W-Zxe4el. No ....... .....
A.
Builder ... . ...... . ........................................... ... Address .................................................... Tel. No....
............... .
Plans................................................................... Address .............
......................... .......... Tel. No ....................
...........
by
Remarks........................................................................................................................................................ .............
Q,
_v"
I "n q F,-
CAT ON & BUILDING PERMIT Appl. No. ..........
Permit limlt� one year
Building Deparhnent
:EDMONDS
Y,
following work, in accordance with the accom-
ON is hereby made for a permit to construct the
,,4"UCATI
and specifications. Two sets are submitted herewith for appmval.
nying plans
new alter off'st
... . . ..................................................................... Parking ......................
addn repair .............................................
or
e ...........................
se zone../' > il I
re zo
Occupancy; ............................... Const. type ................................ U ...
Addn..................................
'Ad ress
... ........ Lo'.S
. ........ ................ -.!!VBe ................. . .
Lot frontage ....................................... Area ......................................
...... Septic tank .......................................................
W 2
f74
Bl4g. setb front ... ... ... ...... r. side .. ............. 1. side ............ .......
_�3
g
Address ... /272-.� ... Ail. N4.x.p
.. ....... .......
--/ .........................................
Tel. No .............................
Buil &..v .. 'Address. ...........
Build& ..... .. .... .................. .. .......... .....