690104.pdft /
POSTED ON KROL
BUILDING DEPARTMENT Appllcao�7tFffl
L
Inside Heavy Lines JOB ADDRESS
PERMIT APPLICATION 4N
- , E (OR NAME or BUBINE§81
BIDE YARD SETI
G
MAILItJA ADDRESS /0
c4
USE ZONE
8 e4—
C 0 TY
ITY TELEPHONE NUMBER
1_ HEIGHT
6'y 0_5
4
Fsr W, 1774
dAP NO.
K STREET
'. zv� I
NUMBER
L-1
6901,04
EAR YARD BETB
C;Z 61
TC-ANTSITE
(YES No
ARIANCE NUMBER
N
STREET RIW
EXISTING STREET R/W , -?n�EXT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. ItLV� gr..rr. ... la ... FT.
Z
CITY TELEPHONE NUMBER
vll& evig o
REMARKS
Driveway slopes not
N�PE
ag e R * b2a ymr k/I
indicated on Standard Drawing #103.
R ADDRESS
CHECKED BY
CITY
0 f
Cd A::)-S ta
ER
METER SIZE I SERVICE SIZE CLEARANCE
CRECAKED By
STATE LICENSE 14UJUBER
CITY -LICENSE NUMBER
Legal Description of Property (Show Below or AttachFour Copies)
4- ielIKA&C 041/11�61
TYPE CONNECTION�
VERIFIRD By
PERO. TEST
PERMIUUMBER
W X__
REMARKS
FIRE ZO TYPE OF CpMgTRUCTION STREET IMPROVED
1 0 YES NO
CTOR REQUIRED
11 YES )<NO
OCCUPANCY GROUP
GA13
2"'RESIDENTIAL LINE
WON-IIESIDENTIAL SIGN
A.
DEMOLISH Lj WALL
ALTER EXCAVATE FENCE
OR FILL ( .......... x .......... Ft.)
El REPAIR PnE-MOVE swim
INSP. POOL
PLAN CHECIMD BY
REMARKS
NUMBER OF STORIES
NUMBER OF
DWELLING
UNITS
NATTOF WORK TO 13E DONE
EW 4 AfS �Xf UC
Valuation
Fe7=Reccipt.
No.
Z
Plan Check No ........ . ...........
PROPOSED USE
i
BUILDING
PLUMBING
PLOT PLAN (indicate Buildl Mucks, abutting streets)
%
T
HEAT & GAS LINE
FENCE
It
SIGN
RETAINING WALL
SWIM NG POOL
DEMOLITION
PRE -MOVE INSPECTION
Y)
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the in-
formation given to correct; and that I am the owner, or the du1Y 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
ATMNTION
THIS PER311T
relating to Workmen's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
shall be completed in ninety days; MOVED -IN BUILDINGS shall be com.
pleted In six months.)
INSPECTION
DEPARTMENT
ATURE (OWNER OR A
DATE SIOND
kAAJ
CITY OF
EDMONDS
U
NOTE: Applicant Subject to Plan Check Fee
PR 6.1107
This Permit Covers work to be done on private Property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
nuLrquees, etc.) will require separate permission.
. I "
33'.'00
I W8 -6 1(00 1
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-
Imowledged in space provided.
FILE
I
I
--- -------- � I
I
Type Const. I Basement
Floor Load signs in place (per Sec. 2.3o8 U.B.C.) — Capacity signs posted (per Sec. 3301 (i) U.B.C.)
Floor load and rooyn capacity signs, when required, viust remain posted at all thnes.
THE TRI—PI= HAS BEEN INSPECTED AND APPROVED AS COMPLYING WITH
PROVISIONS OF THE EDMONDS BUILDING CODE AND WITH UNIFORM BUILDING CODES.
Issued this ?.4th --day of March 19 71
CHIEF BUILDING OFFICIAL By.
This certificate shall be posted In a conspicuous public area and shall not be removed, mutilated or obscured and shall be main-
tained in legible condition at all times. Any change of occupancy requires a new certificate.
I