690049.pdf6
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BUILDING DEPARTMENT
t FT
Applicant Fin
POSTED ON KROLL MAP
NO.: PERMIT
NUMBER
690049
PERMIT
APPLICATION
Inside Heavy Lines
—jo—H—AD—D-RF-138
A
NtSM? (OR NAME 0 B
SIDE YARD SETBACK
STREET SETBACK REAR XAMP DET—BACK
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_]PLILING ADDRESS
j,u,x AREA VACANT SITJ9
E] NO
[ZE1,EPHONE) NUMBER
;j
/571 0
CK -) � EL./ / � I E,-' /
2
I
Dencription of Iroperty (Show j3elow or Attach Four Copies)
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6t-a -2t
D-SNEW
RESIDENTIAL
AG S
P LINE:
DADD
NON-RESIDENTIAL
SIGN
rAINING
DEMOLISH
HW—ALL
ALTER
EXCAVATE
F1 OR FILL
FENCE
( x Ft.)
.......... ..........
REPAIR
PRE -MOVE
F-1 INSP.
swim
POOL
FUMBER OF STORIES
I NUMBER OF
DV,rELLING
UNITS
EXISTING STREET R/W J�R-XT- DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W CI. -FT . —
indicated on Standard Drawing #103.
it
[] YES
13 YES [3 NO
No occupancy until residence is connected
to the sewer.
Plan Check No ......... ... .......
BUILDING
PLUMBING
recta)
t
BEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
t Ib a In"
I hereby acknowledge that I have read this ft;pIlratlon; that the in.
r-
ou th�
formation given Is correct; and that I am the owner, or the duly author-
y
ws ro
Ized. agent of the owner. I agree to comply with city and state laws regu-
ATTENTION
0 n
lating construction; and In doing the work authorized thereby, no Person
on
will be employed In violation of the Labor Code of the State of Washington
THIS PERMIT
relating to Workmen's Compensation Insurance-
AUTHORIZES
S c
NOTE: Permit Limit Ono Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be cem-
plated in mix months.)
I D
TURE (OWN Olt AGENT) ATE SIGNED
INSPECTION
it 6
1-yu C11110
DEPARTMENT
vlel,
CITY OF
EDMONDS
V
NOTE: Applicant Subject to Plan Check Fee
PR 6-1107
a �pemjt �Cven work �to be done on private Property ONLY.
Any construction on the public domain (curbs# sidewalks, drlvvwiLys,
marquees, etc.) will require 50PA=te PcrallflBlOn-
Valuation I Fee
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.
,1q,4f
i
I
T OF SURV
PARCEL.A: The North 85.00 feet of the West 100-00 feet of Lot 19
. . . . . . . . . . .
ecorded in
Volume 13 of Plats, on Page 66, records of Snohomish County
Pine Ridge, accordin( to the plat thereof r
Washinqton.