690171.pdfy
Z
01
BUILDING DEPARTMENT
PERMIT APPLICATION
. qfh Avenue N
r Q
Av
Edmonds
above
Applicant Fill
Inside Heavy Lines
POSTED ON XROLL MAP NO.:
PERMIT
NUMBER
690171
JOB ADDRESS
/(D/
P/ /V
SIDE YARD SETBACK
STREET SETBACK
REAR YARD 13ETBACK
USE ZONE
Pubj:LC Uses
LOT AREA
V�C;k= SITE
YES 13 NO
,EPHONE NUMBOF—
776-11o7
HEIGHT
")�- A- .1
BUILDING AREA
Ilk
VARIANCE NUMBER
Pr 6-4881
ripuou or rroperty (snow jjeiow or Art&= 10-OUr UOP168)
South 1/2 of the S.W. 1/4 of the
1/4 of the N.E. VY of 26-27-3
nX NEW
RESIDENTULL
F-1
GAS
LINE
113
NON-RESIDENTIAL
SIGN
RETAINING
M
DEMOLISH
WALL
MCCAVATE
PENCE
ALTER
OR FILL
( x Ft.)
REPAIR
El
PRE -MOVE
.......... . .......
SIVIM
INSP.
POOL
UMBER OF STORIES
NUMBER OF
DWELLING
UNITS
rATURE OF WORK TO BE DONE
Carpenter
Shop and Park Department Shop
J7�
LSTREVEM =8/'W
EXISTING STREET R/W 30
COMP. PLAN ST. R/W 61�
001
YES C'No
Plan Check No .......
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
t
SIGN
RETAINING WALL
SWIM31ING POOL
DEMOLITION
PRE -MOVE INSPECTION
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 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 Workmen -a Compensation Insurance.
NOTE: Permit Umit One Year (Except DEMOLITIONS which
shall be completed In ninety days; MOVED -IN BUILDINGS shall be oom-
pleted in six months.)
NOTE: Applicant Subject to Plan Check Fee
This Permit covers work to be do" on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will requin separate pernihislon.
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
FMMONDS
PR 6-1107
DEFICIENCY THIS PROPERTY
STREET IMPROVI
(:] YES gr1ro
V /I
Valuation I Fee
990
ILIWII� I
APPLICATION APPROVAL
This application is not a perinit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
Tax 44e e
t
1�
CITY OF EDMONDS
DEPARTMENT OF BUILDINGS .
CERTIFICATE OF OCCUPANCY
ir^nkA umi mkim rnnc c e an/.
will
101 Pine Street
At
-?ccupancy estab.lished by this certificate:
F-29 E-3
Building Permit Number
1�ire Zone III
690171
No. Stories 1
Type Const. V one hour I Basement
lU .
K ti
Frame L 4 1
-1 1 j9
Furnace &.Fuel U
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