690373.pdfE4
Z
INSURNW.A POSTED C
BUILDING DEPARTMENT Applicant Fill
PERMIT APPLICATION Inside Heavy Lines J013 ADDII
K4ME ( NAME OF Q11SINESS)
PL.OkAla. lyvuttj SIDE YAI
MAP NO.: PERMIT
NUMBER 6903-73
4 0
,CK STREET SETIJACK RE ARD BET13ACK
MAILING ADDRESS
Z VACANT SITEI
`idw I LOW AREA
C TELEPHONE NUMBER [3 YES W90
g;MA_#�Oea HEIGHT BUILDING AREA VARIANCE NUMBER P4
t��Y� 95Z_
L-4w3aw
-2'-Z;3 D 10 266
S_ruij
or
STREETTF/`W
LO EXISTING STREET R/W .... ....... FT. DEFICIENCY 7IS �PROPERTY
NUMBER COUP. PLAN ST. R/1V ............ rr. ... ........ ITT.
-0 01 1 RnMARKA
FIRE
[] YES
RESIDENTIAL
GAS 0 YES
LINE
ElNEW
PLAN
NON-RESIDENTLAALL
El
SIGN
ADD
�..j
RETAINING REMAI
WALL
DEMOLISH
ALTER
EXCAVATE
PENCE Ft.)
Ft.)
OR FILL
( ........ . x ..........
REPAIR PRE -MOVE
INSP.
SWIM
POOL
IUMBER OF STORI
NUMBER OF
DWELLING
UNITS
rian Check No ..................
BUILDING
Valuation
Ff
PLUMBING
streets) HEAT & GAS LINE
PENCE
SIGN
tRETAINING WALL
N
SWrMIUNG POOL
DEMOLITION
PRE.MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
T'
the I b-
I hereby acknowledge that I have read this application; that the In-
au tho r
formation given In correct; and that I am the owner, or the duly author-
n u-
Ized agent of the owner. I agree to comply with city and state laws regu.
Spar
ATTENTION
0 a
lating construction; and In doing the work authorized thereby, no Vernon
blogt
will be employed In violation of the Labor Code of the State of Washington
THIS PEnMT
relating to Workmen's Compensation Insurance.
AUTHORIZES
8 which
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
.om_
shall be completed In ninety d MOVED -IN BUILDINGS shall be com.
PlatA In six months.) 7;
_
31 TURE R
DATE BIG NEI)
INSPECTION
"'L ,
V_45�0 6
�
DEPARTMENT
q
CITY OF
EDMONDS
NOTE: Applicant Subject to Plays Chech Fee
PR 6-1107
This Permit coven work to be done on private Property ONLY.
Any construction on the public domain (curbs, sidewalk$, drivewaYs,
marqueest etcJ will require separate pertnisslon,
Receipt No.
r 10 , ero I zv 73
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
9
N- . � - ____ - . _ _.�
9
I q
1 L
- -- - - - - - - - - - - -
'41
6441�O 713r4e;'� o4 t�c,�2 70�ye::�
AQ A�IW
o 4—e�94
X7
rT
RECORD OF INSPECTIONS
Date Passed
r: Foundation A�.� �6 r
Plumbing (Partial)
(Rough)
Frame
0,
Furnace & Fuel Lines.
1
Final
A
DI
RECO RD OF INSPECTIONS
Date Passed
Drainage
Sewer
Parking
Landscaping
Fire Dept.