690253.pdfF4
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C.,
BUILDING DEPARTMENT
PERMIT APPLICATION
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E NO WN
Applicant Fill
Inside Heavy Lines
NEW
RESIDENTIAL
I
-1
F
GAS
LINE
El
NON-RFJ31DENTIAL
SIGN
RETAINING
D
DEMOLISH
0
WALL
EXCAVATE
PENCE
ALTER
0
OR FILL
Ft.)
PRE -MOVE
. ........
SMM
REPAIR
M
INSP.
POOL
DWELLING
UNITS
ORK TO BF1 ONE
I-t4,041
I hereby acknowledge that I have read this application; that the In.
formation given Is 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.
I&Ung construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the Slats of Washington
relating to Workmen's Compensation Insurance.
NOTE: Permit Limit One Your (Except DEMOLITIONS which
shall be completed In ninety days; MOVED -IN BUILDINGS shall be oom.
pleted in six months.)
L/V
NOTE: �ppficant Subject to Plan Check Fee
This Permit oovers work to be done oa private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) wis require separate permission.
/ &9 /
YARD SETBAC
EXISTING
0 YES
Plan Check No....
F-Mm
Lis
It/w ............ PT.
BUILDING
PLUMR[NG
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
PERMIT
NUMBER
69025,
A
Rig
ICTBILCK AR YARD SETBACK
VA CANT SITE
�o
AREA
VARIANCE NUMBER
Of
DEFICIENCY THIS PROPERTY
............
CHECKED BY
LEARANCE
CHECKED BY
VERIFIED BY
PERMIT NUMBER
JOTION STREET IMPROV
YES ;7N__0Pr
OCCUPANCY GROUP
-4—
--�A -') �n;
Fee
No.
ArMNTION APPLICATION APPROVAL
THISPERMT Tills application is not a pernilt until
AUTHORIZES signed by the Building Official or his Dep-
ONLY THE
WORK NOTED uty; and fees are paid, and receipt is ac-
knowledged in space provided.
INSPECTION DIRECTOR'S SIGRIA-7
DEPARTMENT
My OF
EDMO"S DATE -
PR 6-1107 P? 3
7 1
Mll I
115
APPUGATION WILDING PERMIT Appl. No.14 .......
CITY OF EDMONDS Building Department Permit limit, one year
k, in accordance with the accom'.
APPUCATION is hereby made for a permit to construct the following wor
panying plans and specifications. Two sets are submitted herewith for approval.
Off'st.
new........................ Parking .................
repair ...................... .....................................
Work addn
Use zone ..... e::� ............. Fire zone .................. . �.a"
Const. ty e ...............................
Occupancy ............................... p 'Y
.............
......................
................ Lot ..... / . . .. ....... Blk ....................... Addn.
Address .... AO.Z. . .......................
......... Septic tan]
Lot frontage ........................................ Areaef?�� ............................ . . .........
-rear ...............................
Bldg. set -backs front ........... ....... r. side ...... ............ 1. side ................ I .............
4e
No......................
Owne.......................... ....
Builder................ .... . ................... Address ................................................... Tel. No .............................
Plansby ................................................................. Address ............................................... Tel. No... ........................ . .
................ I ................
Remarks.................................................................................................................... . .................
ent, and I agreetD Comply with all applicable Codes and State laws regulating, this.
The above is a correct statem
work.
* . ..... Date .. 46�n��
Signed Owner/Agent 07, ;F11'
PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance wA'h, the ap,
tions, and Building Department notations thereon.
proved plans and specifica
no .9 ........... Recd. by...
.. ..........
Valuation ............... . ......... Permit fee ...... . 44
. . . ..... Date .....
6.0 ............................
Building Department, By .................. .....
INSPECTION RECORD
naK ................................
Fdn, OK ............................................ Frame, OK ................................................. -%Fi LO .......
This Pe7mit does not cover Plumbing, Sewer or Electrical itistallatiow.:
R.
-k�
-g
BUILDING PERMIT 'Appl. No. . .... 7 .......
APPUGATION
Pe ear
imit,: one y,
':';��'-CITY OF EDMONDS Building Department rmit I*
the ac6om,
following work, in accordance with
ade for a permit to construct the
OW is hereby m
for approval.
o sets are submitted herewith
panying plans and specifications. Tw
Off -St.
new so"O' alter ......... . ..... Parking ......... . ...........
........................... . .............
rkL addn repair .............. ... .................. ................
se zone ... ......... Fire zone ...........................
........................ U
ccupancy ................. .......... Const. type .......
.... ArAPW
.... .............. Lot ....... . .. 4 .......... Blk ....................... Addn ........................
dress ......
0 X / 0'0 Septic tank.. .... ....
. .......... .... .. ..........
Area ...... o�� .................................
..............................
ot frontage .........
rear................ .........
e.......... 1. side .............................
Ildg. set -backs front ........ 4.ZO ........... r. sid
......................... . .....
......... Address. ... A2 ..... �e No� ........................ . .
...........
. ...................
Tel. No ............................
Address ...................................................
. . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .
Builder ...........
......... Tel. No ...........................
Plawby ................................................................. Address ...........................................
...................................
.......................................................................................................
Remarks ..................................
ating this
comply with all applicable Codes and State laws regul
ent, and I agree to
Ile above is a correct statem
work.
ate/.
.............. D
ed Owner/AgentA dress .............................
Sign
th the ap
the above conditions, and to compliance wi
PERMIT for the above work is hereby approved, subject to
proved plans and specifications, and Building Department notations thereon.
....... .... ................
it fee ...... ................. Recd. by....
J ............ ....... 0
Valuation ................ Perm
=..q .... ....................... . .
epartment, By ..... . ......... .................... Date ........
Building D .....................
INSPECTION RECORD
Final, OK .......................................
Fdn, OK ............................................ Frame� OK ... ................................. ............
This partnit aoes not cover Plumbing, Sewer or Electrical installations.