690307.pdfBUILDING
DEPARTMENT Applicant MR
PERMIT
APPLICATION
Inside Heavy Lines
NAME (on NAmm OF BUSINESS)
6&"741
A/
'MAILING ADDRESS
70� ks,",6
ONE NUMBER
6
NAME
A( ff WAI
,Yd,
ADDRESS
CITY
TELEPHONE N UMBER
NAME
AD ERESS
Z-1
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—C
IUMBER
of 'Pr—owpertAcehow Below or Attach Four Copies)
Legal Description
TH PTN TR 49 TGW VAC RD AW DAF BAAP
20 a FT N & 9 42,64 FT E OF NW COR TH
49 TH N 88018123" E AIA CA VAC RD
266,39
NEW
El RESIDENTIA
0
GAS
LINE
NON -RESIDE TIAL
SIGN
RETAINING
0
F1
WALL
DEMOLISH
E] ALTER
0
EXCAVATE
OR FILL
FENCE
( x Ft.)
........ . . ........
REPAIR
F-1
PRE -MOVE
INSP.
F1
SWIM
POOL
DWELLING
UNITS
t
N
I
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-
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 Your (Except DEMOLITIONS which
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted In At months.)
NOTE: APPlicant Subject to Plan Check Fee
Iiiis- -Parnot coven work to be done an private Property ONLY -
Any construction an the pubtle domain (curbs, sidewslics, drlvow&Ys,
marquess, eu.) will require separate permission.
ON KROLL MAP NO.:
PERMIT
NUMBER
DRESS
'ARD SE7rBACK
TREET
SETBACK
B
REAR YARD SETBACK
7 't,
�2_
,C� ,
'2_'g— 1
-
ONE
LOT AREA
VACANT SITZ��
r__
1
1 13 YES
LREA
I VARULNOM NUMH;JE�H_
EXISTING STREET R/W ... ........ FT.
COMP. PLAN ST. R/W ............ FT.
YES
Plan Check No ..........
BUILDING
PLUM33ING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
AT=NTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
CITY OF
EDMONDS
PR 6_1107
DEFICIENCY THIS PROPERTY
Valuation
MW
[J YES
Fee
APPLICATION APPROVAL
Z
14
No.
This application is not a pernilt until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
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