690352.pdf.- - - 1- 1. .1 � -1 .1. . 11 . 11 ... _. �. � . , - . 1. 1— . - �_ - . _ , �4_; W
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POSTED ON KRULL MAP NO-: PERMIT
NUMBER _f0352
BUILDING DEPARTMENT Applicant FlU
Inside Heavy LInOS JOB ADDRESS
PERMIT APPLICATION I
NAME (OR NAME OF BUSINESS) C;
SIDE YARD SETBACK STANEr SETBACK RE;ar�YARD SETBACK
fro A- J �, 4Z.4 IN/
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—HAILING
ADL __
)RES8
VAU"W br��
44 -1 -1 �11
USE ZONE L AREA
—
I
CITY
[] YES E3 NO
F, vV1L /,!)"VLrEPHONI,! 1NUSMWB)`!!0,,
HEIGHT BUILDING
I
AREA VARIANCE NUAIZ�n
I
;W
14AME
—
PLOT PLAN APPROVED
W
ADDREBB
STREET n/W
EXISTING STREET R/W ............ FT.
DEFICIENCY THIS PROPERTY
CITY -FE�LEPHONENUMBIM
IT.
COMP. PLAN ST. R/%V.:: ..... Fr.
............
a
REMARKS
cd
NAME
ADDRESS
Ala
uu4t;KED By
CITY I ELEPHONE INUAWWt
41tf 4V-
METER 131ZE SERVICE SIZE CLEARANCE CHECKED BY
U
STATE LICENSE NUMBER ULTX NUMBER
1
1
?4 '7
REMARKS
E] RESIDENTI�L
GAS
LINE
NEW
11
I
NON-RESIDENTIAL
SIGN
ADD
RETAINING
WALL
DEMOLISH
ALTER
EXCAVATE
OR FILL
FENCE
( ......... a .......... Ft.)
REPAIR
PRE -MOVE
INSP.
swim
POOL
NUMBER OF
DWELLING
UNITS
A
4
0 1
FROPOSED USE
_PLOT PLAN (Indicate Builaing ectoacics, abutting stre
OF
[3 YES 0 NO
STREET IMPROV.
[3 YES [3 NO
REMARKS
--k-ILA or% r—:< 71 C D.0,0
P—M rian Check No.
B U IL
BUILDING
PLUMBING
P L U W
T & G�AS
LINE
BE ALT & GAS LINE
I M A
PENCE
r N
ON
SIGN
S
tERETAINING
WALL
N
WIMMING POOL
S SWIT
EMOLITION
D DEM
PRE -MOVE INSPECTION
PRE
EXCAVATION OR FILL
EXC
I
TOTAL A51OUNT 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-
ized agent of the owner. I agree to comply with city and atato laws regu.
ATTENTION
lating construction; and in doing the work authorized thereby, no person
will be employed In violation Of the Labor Code uf the State of Washington
THIS PERMIT
relating to Workman's Compensation Insurance.
AUTHORIZES
ONLY THE
I
NOTE: Permit Limit One Year (Except DEMOLITIONS which
WORK NOTED
shall be completed In ninety days; BIOVED-IN BUILDINGS shall be com-
pleted In six months.)
r1`GNATURE (OWNER Oft AGENT)
DATE SIGNED
INSPECTION
1
DEPARTMENT
P
q
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
PR 6-1107
This remit coven work to be done an privage propedy ONLY.
Any construction on the public donsaht (curb@, sidewalks, driveways,
marquees, etc.) will require 86P&ratO permission'
6 � Q I sc-�
Valuation I Fee
�WN
I ) I C?) 1 S7-4-/
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.
I q_c� - (09
MLE