690139.pdfV
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t ILDING DEPARTMENT
Applicant Fill
RMIT APPLICATION Inside Heavy Lines
(OR NAME OF BUSINESS)
P 4�tl /5-
Atc
DRESS
TELEPHONE NUM
49 f 5_V/_ �P�_
ke w.
TELEPHONE NUMBER
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XIA
,agal Description of Property (snow mciow or i
14 4y C.: /:/ 6:5p
M RESIDENTIAL
GAS
LINE
NEW
NON-RESIDENTLAL
SIGN
RETAINING
WALL
DEMOLISH
ALTER
EXCAVATE
OR FILL
PENCE
( ........ . x . ........ Ft.)
REPAIR
PRE -MOVE
INSP.
El
SWIM
POOL
NUMBER OF
DWELLING
UNITS
qAT OF WORK TO BE DONE
I hereby acknowledge that I have read this application; that the In-
formation given in 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 WorkmeWs Compensation Insurance.
NOTE: Permit Umit One Your (Except DEMOLITIONS which
&hall be completed in ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six month".)
3IQNATURE_LqWNElt 7U A I ATE SIGNED
Z'4/4 wc-4:4!�: 01 C
NOTE: Applicant Subject to Plan Check Fee
-ibis Perm -it coven work to be done on private Property ONLY -
Any construction on the public domain (curbs. sidewalks, drIVOWAYB,
marquees, etc.) Win require separate Pcrmlffg'on'
P NO.: PERMIT
I NUMBER
/_S�&
REET 81
')�s I
mx�� n/W
EXISTING STREET R/W AO. -FT. DEFICIENCY
COMP. PLAN ST. R/W-57.P..x-r. A
Driveway slopes not to exceed
indicated on Standard Drawing
E] YES
Plan Check 110 .......
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIM NG POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR PILL
TOTAL AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
NO
PROPERTY
30
0 YES 13 NO
Z
W
Valuation Fee Receipt No.
-340
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
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q11
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Dullt) at
Aa
socordbe to PlGt a
tIte., with the "Meddale, Treats. OF
Snohomish Qmnty.. Vgghington. described
Xt of Treat *260 records Of de got a" I
Al
IftifAme 6 of Pl&tGv PASG
or of geid Tract 55, th10 Best ala"S the amth low
3"420jiggy at the South"st COM to the Meet line of
thQWQ North, Per"'fil
174.75 foot to the true point Of t allel to the South ling thereof, LG9.74 feet; 0114=0
t-, theme W"t Per
the gout
Ifteat 55j, 125 fee h line thereof, 120.74 f0fto 0A40" Swath
Morth 175 feet; thOn" gest pgwallel to line of "id Treat 55; theme Wellt 'time
pWalel to the wast line 300 feet to the South feet
gt to the point of beginning; RX(MPT the South -5
South line of Tract 55s, 20 fe ed under Auditor's File 1b.
the ad to the CitY Of R&wnds by deed rGCO`Ld
thereof AS COUN&Y
2027832.,.