690177.pdfspill PORTED ON KROLL MAP NO.:
BUILDING DEPARTMENT Applicant F111
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7111nalde Heavy Lines FO —BA-m—l-) -R E a 8 -
PERMIT APPLICATION C 7
NAME (OR NAME OF BUSINESS) -91—DE YARD SETBACK STREI
F IS ::�)J— —
-RAILING ADDRESS USEEI-ZO E LOT J
E;PHO
CITY I TELEPHONE NUMIJ11;R
r—,K) �-7/3 HEIGHT BUILI
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'0�P,-TT—LC—:
VATE LICENSE NUMBER
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esal Description of Property (Show Bel
-- 6'71 -3
RESIDENTIAL
AS
GLINE
NEW
NON-RESIDENT
SIGN
_=j
RETAINING
WALL
DEMOLISH
ALTER
EXCAVATE
OR FILL
PENCE
( .......... x .......... Ft.)
REPAIR
PRE�MOVE
INSP.
SWIM
POOL
iUMBER OF STORIES
NUMBER OF
11 DWELLING
UNITS
OLN Wit 0
PROROSED USE
I hereby acknowledge that I have read thin application; that the In-
formation given to correct; and that I am the Owner. or the duly author-
ited agent of the owner. I agree to comply with city and state laws ragu
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 BUILDXNGS shall be com-
plated In six months.)
jIGN TURE (OWNER Oft AGENT) DATE SIGNED
F7—NOTE: Applicant Subject to Plan Check 14ee
This Permit covers work to be done an Prlva40 Property ur4l�x-
Any carstructlen an the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
PERMIT
690177
NUMBER
R "W
IACK A YARD SETBACK
7
�SITZ
—I VLACA14T
Z
[3 YES C3 NO
LEA VARIANCE V um=�
EXISTING STREET R/W ............ FT- DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ........ .. IPT- ............ In.
TYPE
0 YES [] NO
Plan Check No .....
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATMNTION
TIUS PERMIT
AUTHORIZES
ONLY TILE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PH 0-1107
Valuation
C� 01
[3 YES 0 NO
Poo
Cd
I
Go
No.
I Vi 1 0 () J[J�Ijj 16
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-
Itnowledged in space provided.
a-