690256.pdfX,
BUILDING DEPARTMENT
PERMIT APPLICATION
0
CITY
/_ Y;41lx
ADDRESS
93 /6
CITY
NAM
C4
CITY
/0" �L 0 #
Applicant FM
biside Heavy Lines
6?AV13 91/
WA
2-
NEW L& RESIDENTIAL I
11:1 NON-nESIDENT1ALj
ADD
F� DEMOLISH
ALTER MCCAVATE
1:1 OR FILL
REPAIR PRE -MOVE
El INSP.
Ln
Zi!�E
SIGN
RETAINING
WALL
FENCE
( ........ . x . ....... Ft.)
SWIM
POOL
I
NUMBER BF STORIES
NUMBER OF
11-4"7_
DWELLING
UNITS
,P NO.:
PERMIT
NUMBER
2
/ 0 1 n 4:.-" 1 :? 5- 1 P? .2,5_1 /77
III Irl/ LOT AREA VACANT SITE
M! 8 E3 NO
r I BUILDING AREA I VARIANCE NUMBER
I /w
ma/w
EN3877NG sTREIT n/w FT. DEFICIENCY THIS PROPERTY
COUP. PLAN ST. R/w..-6_—.0_rr.
indicated on Standard Drawing #103.
I- -(I
,RXS
L _K�' 113 YES 13 NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GRO
13 YES 1!<no I . J 7 L
Plan Check No ..................
PROPOSED USE
BUILDING
PLUMBING
PLOT PLAN (Indicate Building Setbacks, abutting streets)
BEAT & GAS LINE
PENCE
Z.
t
SIGN
RETAINING WALL
SWIMMING 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 In correct; and that I am the owner. or the duly author-
lzed agent of the owner. I agree to comply with City and state laws regu-
ATTENTION
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
THIS PERMIT
relating to Workmen's Compensation Insurance.
AUTH0RXZE8
NOTE: Permit Umit 0 e Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
shall be completed in ninety MOVED -IN BUILDINGS shall be com-
plated In six months.)
INSPECTION
DEPARTMENT
4 4
CITY OF
EDMONDS
PR 6-1107
This Permit covers work to be done on private property ONLY.
Any construction an the public domain (eurbse sklawalkal drivewayss
marquees, etc.) will require Bapamte Permission.
Valuation
0, 1��,
NO.
111"7_00b-65-t'
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-
knowledged in space provided.
-7-69
4
0