690443.pdf:4
?41
i::
0
UILDING DEPARTMENT Applicant Fill
PERMIT APPLICATION Inside Heavy Lines
0
L
v or
6
NEW
ADD
EDALTER
ED REPAIR
RESIDENTIAL
I
NON-RESIDENTIAL I
ElDEMOLISH
EXCAVATE
R OR FILL
PRE -MOVE
1:1 INSP.
F�
E]
GAS
LINE
SIGN
RETAINING
WALL
FENCE
( ........ . x .......... Ft.)
swim
POOL
FUMBER OF STORIES
NUMBER OF
DWELLING
UNITS
C-3
0,iF -
s4vz��.,, -
Cie �, CT
PERhilT
NUMBER
1) '17�, 'i &t,_) -
690443
131DE YARD SETBACK
STREET SETBACK
REAR YARD 13ET13ACK
2
USE ZONE
I LOT AREA
VACANT UEEN
/9S .- F
I
I [] YES [3 NO
EXISTING STREET R/W ............ FT.
COUP. PLAN ST. R/W ............ FT.
FIRE ZONE
T
- JTX
SPECIAL I]
[3 YES
I U11]
�,770/i —/ze-,qQ
TO
r1an Check No .....................
BUILDING
PLUMBING
ag streets)
HEAT & GAS LINE
FENCE
SIGN
I
tRETAINING
WALL
N
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I hereby acknowledge that I have read this application; that the In-
formation given to 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 Cimit One Year (Except DEMOLITIONS which
shall be completed in ninety days: MOVED -IN BUILDINGS shall be com-
pleted in six months.)
RGNATURE (OWNER OR AGENT) DATE 131UNED
NOTE: Applicant Subject to Plan Check Fee
This Permit covers work to be done on private property ONLY.
Amy construction on the public domain (curbs, sidewalks, drIvewaYs,
mai etc.) win require separate permission.
- /Q
DEFICIENCY THIS PROPERTY
Valuation
STREET IMPROVED
[] YES 13 NO
Fee
r4
Z,
04
Z
No.
TOTAL AMOUNT DUE
ATTENTION
APPLICATION APPROVAL
THIS PERMIT
This application is not a permit until
AUTHORIZES
I
signed by the Building Official or his Dep-
ONLY 'THE
WORK NOTED
uty; and fees are paid, and receipt Is ac-
knowledged in space provided.
INSPECTION
DIRECTOR'S
DEPARTMENT
CITY OF
DATE -i -
L EDMONDS
C:2 00-
PR 6-1107
FILE 40.
C4
I
LYMMIlood 'Wash ................... _Juns 24
RECEIVED FROM --- LWVD L. BUM and MMY A, UMTON his wifo .......... . .. . . .......... ...... ........ 11,69
. . . . .. . ..... .. ... .. .... ................. . ........... . ... ..... 9 ...... . ... ..... . .. . ............................
(Hereinafter c&IW Pu e.)
u
'111111111tism AM NWIM
... ................. ............ . .
In the form of check for S-44M.
Cash for . ... . . ................... Hot@ for paid or del! agent as earnast money In part payment of the I
a In i
prd'aset price of that certain real aslat ......................... County, Washington, commonly known as .. .. .. ....................................... ..........................................
vs.'skamb, wash.
.............. . .............. . . ... ............... .................. . ...
-4 legally descrilsed as fQIlQW16 to WIlt (purchaser and seller authorize agent to Insert legal description over their signatures)
.36 of b6plemod Ville AMiticia, accardLn to the plat: therecof recorded In Volum 20 of Plate
1219 ratecills of 9hobAmIA Comtya WashInStons, MOM tbe Mat 120 feet wild MCM the lbot
Iftt Mid UMT the ftath 10 feet Auld MWXM the ftl1eal" dm=lbed piwelon: ftS. at a
on N Ll" of said Te. 36s 120* E of NU cormw thaveaf; th 8 OV32513711 a along said Ys line
i.=,710111 th 3 6046W V Pemi. with 3 Ifte of ed. Tz. 6.67*; th M 42 85049'12" v 105*979 to p/a/�b
Atvl.
Foundation
Plumbing (Partial)
-- ---------- (Rough)
4 '70
Frame
Furnace & Fuel Linest
Final -A _-5'7-7 0