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PL
'r E� POSTED ON KROLL MAP NO.:
7
BUILDING DEPARTMENT NUE b[ShCR RApplloant Inn 690059
PERMIT APPLICATION Inside Heavy Lilies IOB ADQDREBB/�
(O NAME OF BU Mao) lJ /! / ✓��4 . _ r>t�Y/� �:W W7�
�i Q Dittf r S....SIDE YARD 8�"11 `BACK B E7' BETHAOK REAR YARD SETBACK
MAILINGAD a �Q '[.r% oZ�'/ ./it/n) to
C /U /�tj�. B O 1 LOT AREA VACANT SAWSf
iTY PRONE NUMBER .A I YES ❑ NO i
S . 0.,r 7 0 HEIGHT 777"' I BUILDING AREA VARIANOE NUMBER P.
NAME
PLAT P A ROVED )Z
.O_��'O.7'l �� • BT R/W
t ITY TELEPHONE NUMBER E TINn STREET R/W .// �.FT. DEFIODE!IOY THIS PROPERTY j
COMP. PLAN ST. R/W ''7 [�....PT. » ...PT.
/ w REMARKS O
'� NAME
Driveway slopes not to exnPad thnRP
indicated on Standard Drawing #10323?3a'
/ K47ze �� CHECJ= BY t
r CITY TELEPHONE NUMBER
p METER SIZE SERVICE SIZE CLEARANCE CKED BY
STATE LICENSE NUMBER CITY LICENSE N MBER I I I i
�I
REMARKS .
Legal Description of P perty (Show Below or Attach Four Copies) - ADO E'Dr.Lji., NI.L i"(ftL 5o'w tS '� D t Jo
Ail S TYPE CONNECTION VE B i
Z•_ PERO, TEST PERMIT N ER +
A REMARKS
j.
I
FIRE PROVED
YEaREE S
ZONE TYPE OF CONSTRUCTION TT IMPROVED
I I o ,
SPECIAL INSPECTOR REQUDiED IOCOUPANOY GROUP -
RESIDENTIAL GAB O YES o :I:
LINE (:.
NEW PLAN CHECKED BY
NON-RESIDENTIAL ❑ SIGN •+
❑ ADD WALL REMARKS
❑ OUTER EXCAVATE FENCE
j
OR FILL � (...x»........ LnJ
� -MOVE (', SWIM
REPAIR O
NUMBER OF STORIES NUMBER OF
DWELLING
UNITS 1
NATURE OF WORK TO BE DONE
/� - n /� n I-•� A, _ Valuation Fee Receipt No. j
it
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 authoa�
Wed 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 DEMOLITIONS which
shall be completed in ninety days; MOVED -IN BUILDINGS shall be com.
pleted in six mcathe.)
NOTE: Applicant Srybiect to Plan_ Check Fee
This Permit coven work to"be done on private property ONLY.
Any construction on the public domain (curbs, aldewatks, driveways,
marquees, do,) will require separate permlesion.
Plan Check No.»...._.»»..... -
BUILDING i
PLUMBING
HEAT & OAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION i
PRE -MOVE INSPECTION i..
i
EXCAVATION OR FILL I
TOTAL AMOUNT DUE
ATTENTION APPLICATION APPROVAL i
THIS PERMIT This application is not it permit until ! I
AUTHORIZES ONLY THE Signed by the Building orDept, Official his : 1
i
WORK NOTED uty; and fees are paid, and receipt is act,
llnowledged in space provided. j
INSPECTION 1 l
DEPARTMENT CTO 'B BIONAT
CITY OF
EDMONDS D
r'J t
PR 6-1107 ~ ~It'
FILE
S 1 C Nt S� T}
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