690320.pdf. . . . . . . ...... .. . . . . ...... .. ..... I �17 0�
POSTED ON KROLL MAP NO.: PERMIT
BUILDING DEPARTMENT Applicant Fill NUMBER
L 690320
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PERMIT APPLICATION Inside Heavy Lines JUB ADDRESS
I NAME (OR NAME OF BUSINEHH)
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E] NEW
RESIDENTIAL
NON-RESIDENTIAL
GJASE SOJ'�
L N.,
SIGN
El DEMOLISH
El ALTER EXCAVATE
0 OR 17ILL
REPAIR -1 PRE -MOVE
1:1 INSP.
RETAINING
WALL
PENCE
( .......... x .......... Ft.)
SWIM
POOL
NUMBER OF
STORIES
NUMBER OF
DWELLING
UNITS
NA OF
U% �
WORK TO BE DONE
k /_1% - — —
%� — I-IZI Lj _j
R SETBACK
D
STI kET SFFB
REAR YAR SETBACK
NE
LOT AREA
VACANT SITE
YES NO
BUILDING AREA
I VARIANCE NUMBER 0.
EXISTING STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT. ............ . FT.
ZONE I TYPE OF
YES
BY
Ki I (j YES E] NO
OCCUPANCY GROUP
I � I
REMARKS
6\)eyZ_ CAg�,Fb�2_-T
k'tA
Plan Check No .....................
BUILDING
PROPOSED USE
PLUMBING
PLOT PLX—N( ndicato Building setbacks, abutting stre is) HE- AT & GAS LINE
:2 01)
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
t
DEMOLITION
1 4— 7,
PRE -MOVE INSPECTION
EXCAVATION OR FILL
to Cl -ILE;
TOTAL AMOUNT DUE
I hereby acknowledg6 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.
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.
AUTHORIZES
NOTE: Permit Limit Ono Year (Except DE31OLITIONS which
ONLY THE
WORK NOTED
I be completed in ninety days; BIOVED-IN BUILDINGS shall be coin-
p etcd�kn �1,4,)
3IGNATLVtE (OW It AGENT)
D T SIGNED
INSPECTION
ZnMMM
C� .
DEPARTMENT
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
PR 6-1107
This Permit covers work to be done an private property ONLY.
Any construction on the public domain (curbs, sidewalks, drivewa7s,
marquees, ate.) will require separate pertalsolon.
Valuation I Fee I Receirlt No.
MEW091
1 51 "
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-
Imowledged in space provided.
FILE
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