690078.pdf.,I
POSTED ON KROLL MAP NO.: PERMIT 690078
BUILDING DEPARTMENT Applicant Fill 0 1 NUMBER
PERMIT APPLICATION Inside Heavy Lines JOB ADDRESS _fft
NAMT (OR NAME) O"USINESS) d A otro 2 —_ 76 — a.
SIDE YARD SETBACK STREET SETBACK REAn XARD SETBACK
ADDRESS
CA S- 4^j
USE ZONE LOT AREA rE
TAEP�IONE NUMBER TEB [3 NO
HEIGHT 13UILDING AREA VARIANCE NUMBER N
NAME r
PLOT PLAN APPROVED
ADDRESS
STREET R/W
of �TXIXPHONE NU EXISTING STREET R/W .... 6AM. DEFICIENCY THIS PROPERTY
I , COUP. PLAN ST. R/W.A'.4?..FT. .... FT.
2 et��_xo;; REBLARKS
NAMM Driveway slopes not to exceed those
indicated on STandard Drawing #103.
ADDRESS C
V
rg
C CK-ED BY
BE
v71A
:NSE NUMBER CITY LIC]
0/— / Qq � 1 —0 Z/
ption of Property (Show Below or Attach I
LL-rRESIDENTIAL GAS
Q"NEW LINE
NON-RESIDENTIAL SIGN
I
RETAINING
DEMOLISH WALL
ElALTER EXCAVATE FENCE
OR FILL ( ......... �x .......... Ft.)
REPAIR PRE -MOVE SWIM
INSP. POOL
OF
DWELLING
UNITS
[] YES
't
Plan Check No ............ . .......
PROP
6
�QR OSED USE
BUILDING
PLOT PLAN (Indicate Building setbacks, abutting streets) PLUMBING
HEAT & GAS LINE
S7-0 (t
FENCE
SIGN
6-
RETAINING WALL
N
YU SWIMMING POOL
DEMOLITION
2 PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL A.MOUNT DUE
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- 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 THIS PERMIT
relating to Workmen's Compensation Insurance. AUTHORtZES
ONLY THE
NOTE: Permit Umit One Year (Except DE31OLITIONS which WORK NOTED
shall be completed in ninety days: MOVED-XN BUILDINGS shall be com-
pleted In six months.)
IIGNATURE (OWNER 0 AGENT) DATE SIGNED INSPECTION
C.-> n —/ DEPARTMENT
la;2 69 1�0 CITY OF
NOTE: Appli"IltWbject to Plan Chcck Fce EDMONDS
PR 6.1101
This Permit covers work to be done on private property ONLY.
Any oongtruction an the public domain (curbs, sidewalks, drivewaYs,
marqueess etc,) will require separate permission,
0 YES [] NO
Valuation I Fee
12 S-Z Sol A 3 � "
j
17 / . ��OIILL Qq I
APPLICATION APPROVAL
This application is not a pernilt until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
Imowledged in space provided.
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