690246.pdfU
POBTED ON KROLL MAP NO.:
BUILDING DEPARTMENT Applicant Fin
PERMIT APPLICATION Indde Heavy unes JOB ADDRESS
LM OF BUSINESS) _6 a i
SIDE TARD BETBACK I STR
MAII-ING ADD 6iaatz + if .74
L6830 176th St SW
TELEPHONE NUMB]
o1w
E E
dmonds, Washe 743 0488
NAME
ADDRESS
CITY TELEPHONE NUM
NAME
Wesley Bibbee
ADDRESS
17522 71st W
CITr PHONE NUM
Edmonds, Wash* 743 3023
STAMM LICENSE NUMBER CITY LICENO _NUA
Legal Description of Property (Show Below or Attach Four Cople
ID-9 Meadowdale beach
PERMIT
miusim 690241
VIMM.AWFROW11111111111
I Vj
0 YES
STREET R/W DEFICIENCY THIS PROPERTY
PW
9
ELY 1209861 of S 120 of Th Iltn
PERC.TEST
PERMIT NUMBER
rPE 1 4A T.V IV & N OP 00 RDS
REMARK
EXC RDS
FIRE ZONE TYPE OF 00 CTION
STRE39T IMPROVED
E3 YES naw".
INSPECTOR REQUIRED
CY GROUP
YES 000----
.
-,I,— /
GAB
EIRESIDENTIAL LINE
P7 13
0 NEW
E] NON-RESMENTLILL E] WON
FXI RETAINING
REMARKS
WALL
4��
DEMOT-TaN
El EXCAVATE FENCE
e're__r 70N mr'�.e
ALTER
OR FILL El
. ........
El REPAIR PRE -MOVE SWIM
INSP. El POOL
I Es
NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE
ADD CARPORT
Valuation
Fee
Receipt No.
X
0
Plan Check No .............. ..
PROPOSED UBE
BUILDING
_51 I!r.* 21
Q
PLOT PLA.N (WICRtO Building setbacks, abutting streets)
PLUMBING
BEAT & GAS LINE
PENCE
t
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLI77ON
P ... M 0
PRE -MOVE INSPECTION
MICA V
EXCAVATION OR FILL
the
I hereby acknowledge Ulat I have read this applicetilon; that the in-
TOTAL
TOTAL AMOUNT DUE
formation given IS correct; and that I am the owner, or the duly author-
Ised agent of the owner. I agree to comply with city and state laws regu-
A T
ATTENTION
APPLICATION APPROVAL
person
latlng construction; and In doing the work authorized thereby, no person
hingion
will be employed in violation of the Labor Code of the State of Washington
W
TMS PERM"
This application to not a permit until
relating to WorkmeWs Compensation Insurance.
Al
AUTHORIZES
signed by the Building Official or his Dep.
NOTE: Permit Umit One Your (Except DEMOLITIONS which
ONLY TRE
WORK NOTED
uty; and fees are paid, and receipt is ac-
shall be completed in ninety "YA; MOVED -IN BUILDINGS shall be com-
knowledged In space provided.
pleted in six months.)
SIGNATURE (OWNER OR AGENT) DATE SIGNED'
INSPECTION
DIRACTOWS BIG
D D EPARTMENT
!
Av
CITY OF
NOTE: Appfi"nt Subject to Plan Check. Fee
EDMONM
DATE
4�1,�
PR 6-1107
This Permit covers work to be done on Private Property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marqueesl etcj will require separate permission,
I