690300.pdfPOSTED ON KROLL MAP NO.: PERMIT
NUMBER
.-BUILDING DEPARTMENT
Applicant F111
b903OO
�,-PERMIT APPLICATIO14
7 7 7
litside Heavy Lines
jog ADDRESS
NAME (OR NAME OF
7--
SID13 YARD SETBACK tjTREUE SETBACK REAR YARD SETBACK
C
)MAXLING ADDRESS
3 Er
CITY TELEPHONE NUMBEUt
4�ow-77V�or
NAME
HESS
VS
�i 30a- It
CITY TJG"-PkiUNN NUMBER
I s— 0 dj, ab.A 614— 6,5:s /
-, TUA_1� _C1% 4
ADDRE1313
? - + 4\v-
KA413-97.1v
E2ZNE W
-1 RESIDENTLA
F L
AS
GLINE
ADD
1 1:1
NON-RESIDENTIAL
SIGN
RETAINING
DEMOLISH
WALL
EXCAVATE
FENCE
ALTER
OR FILL
( x Ft.)
REPAIR
1:1
PRE -MOVE
INSP.
E]
.......... ..........
swim
POOL
R OF
DWELLING
UNITS
ITATURE OF WORK TO BE DONE
rP.0 IVL�11 1;1 0 a%A &IJ10
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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 lawn regu-
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 DE51OLITIONS which
shall be completed In ninety dayn; MOVED -IN BUILDINGS shall be com-
pleted In SIX Months.)
2V �/b
NOTE: Applicant Subject to Plars Check Fee
This Permit covers work to be done on private property ONLY.
Any construction an the public domain (curbs, sidewalks. driveways,
marquees, etc.) win require separate pernAsslon.
J�- A-
17,tv/W
,REV
KIST�fft STREET R/W ............ FT.
COMP. PLAN ST. R/W ............ FT.
0 YES [:I NO
rise check No ............
BUILDING
PLUDMING
HEAT & GAS LINE
PENCE,
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
VACANT Tff��
YES NO
Ir
A
VARIANCE NU �ER
DEFICIENCY THIS PROPERTY
13 YES 0 No
Valuation I Fee
G
Z
w
ATTENTION APPLICATION APPROVAL
THIS PErt'.%IIT This application is not a permit until
AUTHORIZES t3igned by the Building Off icial or his Dep-
ONLY THE
WORK NOTED uty; and fees are paid, and receipt Is ac-
Imowledged in space provided.
INSPECTION DIRECTOR'S SIGNAMT%g
DEPARTMENT
CITY OF
EDDIONDS DA��V'
PR 0-1107
FILE
I
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