690291.pdfK -
BUILDING DEPARTMENT Applicant FLU
PERMIT APPLICATION inside Heavy Lines
NAME (OR NAME OF BUSINESS)
MAILING ADDRESS
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0 CITY TELEPHONE NUMBER
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690291
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REAR YARD SETBACK
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VACANT
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3 YEII 13 No
VARIANCE NUMBER
____ — —_ __1 -_
EXISTING STREET R/W ............ FT- DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT- ........... FT.
REMARKS
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OF
- �J 1 13 YES [3 NO
GAS no IL
NEW RESIDENTIAL LINE 90-11CHECKED BY
NON-RESIDE� �JLL SIGN I Y—bi
ADD RETAINING —IMb—LARKS
GAS
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I'AEl "'IN
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0 T �TAINING
DEMOLISH WALL
[�rALTER EXCAVATE PENCE
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OR FILL .......... x .......... Fit.)
REPAIR PRE -MOVE SWIM
INSP. POOL
4UMBER OF STORIES NUMBER OF
,; I'
DWELLING T C_ I V_�SMLSC_r I
UNITS
'TATURE OF WORK TO BE DONE Valuation Fee Recelpt r
Rd=
Plan Check No ................ . ...
BUILDING
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;d PROPOSED USE
PLUMBING
PLOT PLAN (IV
c to Building setbacks,
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
L AMOUNT
I hereby acknowledge that I have road 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-
ATTE NTION
A NTIO"
lating construction; and In doing the work authorized thereby, no person
7
will be employed In violation at the Labor Code of the State of Washington
Pr
.RJ IIT
THIS PER511T
T US
relating to Workmen's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
17T"A
ONLY THE
10
WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be rom.
pleted In six months.)
IIGNATURE (OWNER It AGENT)
DATE SIGNED
INSPECTION
I
DEPARTMENT
ITY OF
C Cl� y � F
EDMONDS
NOTE: Applicant Subject to Plan Chech Fee
PR 6.1107
This remit covers work to be done on privnte property ONLY.
Any construction on the public donutin (curbs, sidewalks, driv&WILY5,
nmLrquees, etc.) will require separate permission.
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APPLICATION APPROVAL
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This application is not a permit until
isigned by the Building Official or his Dep-
uty; and fees are paid, and receipt Is ac-
knowledged in space provided.
7 —,;1 y , I
V
NEED
CITY of EDMONDS
Civic Center - Edmonds, Washington 98020 Telephone (206) 776-1107
Extension 28
BuIldIng Department 4
September 291, 1.1372
Terrace Realty
56th Avenue Wast
Mountlake Terrace2 Washington
..... . . . . . . .
RE: Re�iderice at 21511 88th
Avenue West
Gentlemen2
was issued for alteration to the.
A,building permit., number, 690291
above residence and has expired without the work being completed.
An inspection made yesterday has revealed that the home has been
posted by the U.S. government as being under repair.
hat a sanitary problem may
Complaints received by the City indicate t
exist. A check of Public Works records indicates that the building
is not connected to the City sewer system.
Prior to any occupancy of this structure., in addition to any other
it will he required to be connected to the
corrections to be '11i'de,
public sewer System.
Sincerely,
CITY OF EDMONDS
tl-r-ry M. -alitcutt
Building official
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Direc-Lur of- Public Work.,;
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