690364.pdfPOSTED ON KROLL MAP NO.: PERMIT
DEPARTMENT
NUMBER 690364
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Applicant FW
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Same MIA Awalftsm
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I rrLlq6AN 1Vn Jun ""axasts
GAM OF BUSINESS) /--?
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USE ZONE LOT AREA VACANT brrJa
ue.North T111JIFUUNE —NUMBER 13 YES [3 NO
on 774-6000 HEIGHT BUILMINO AREA VARIANCE NUMBER
FLOT PI.
EXISTING STREET R/W ........... FT, DEFICIENCY TMS PROPERTY
TELEPHONE NUMBER
COMP. PLAN ST. R/W ............ FT.
—laALARKS
CRECKED BY
TELEPHONE NUMBER
IP LICENSE NUMBER ALETER SIZE SERVICE SIZE CLEARANCE CILECKED BY
REMARKS
viparty.(Show Below or Attach Four Copies)
...... ....
00 feet, Tract 2. Puget TYPE CONNECTION VERIFIED By
Depot Five Acre Tractst
PERL. TEST PERMIT NUMBER
the Fast 165.00 feet thereof.
REMARKS
K; n.
rum ZONE TYPE OF CONSTRUCTION STREET IMPROVED
[3 YES 13 NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
GAS 13YES [3 NO
RESIDENTIA LINZ PLAN CHEOKED BY
NEW
NON -RESIDE
IAL SIGN
1MTALxING REMARKS
DEMOLISH 0 WALL
ALTER EXCAVATE PENCE
11 OR FILL ( ......... x ......... Ft.)
REPAIR PRE -MOVE swim
INSP. POOL
NUMBER or
DWELLING
UNITS
NATURE OF WORK To BE DONE Valuation Fee Receipt N�0.
Uemo-LIZ5"
rhm Check
BU`JLDING
PROPOSED USE
PLUMBING
HEAT & GAS LINE
PLOT PLAN (Indicate Building setbacks, abutting streets)
tRETAINING
PENCE
SIGN
WALL
SWIM311ING, POOL
DEKOLITIoN
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
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- ATTENTION
iaung construction; and In doing the work authorized thereby, no person
will be employed in violation of the Labor Code of the State of Washington TMS PERMIT
that
duly so
'a 'aw'
he In'
th"r-
P ragult
'y no erso
Washington
rIONS which
al a oom_
relating to Workman's Compensation Luntranos. fj AUTIIORIZES
ONLY TIM
NOTE: Permit Limit One Your (Except DEMOLITIONS which WORK NOTED
shall be. completed in ninety days; MOVED -IN BUILDINGS sball be com-
Plated In mix months.)
G 1)
IIGNATURE (OWNE OR AGMN DATE SIGNED INSPECTION
DEPARTMENT
CITY OF
EDMONDS
NOTE: Applicant Subject to Van Check Fee PE 6-1107
This permit coven work to be done an Private property ONLY.
Any construction on the public domain (curb*, sidewalks, driveways,
marquees, c4c.) Will require separate Permission.
1 :2-, C2 0 k -/40
APPLICATION APPROVAL
Title 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.
DIRZaTORIS SIGNATURE
DATE
FILE
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I I I - I - -
07
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