700041.pdf;7M
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BUILDING DEPARTMENT I Applicant Fill
PERMIT APPLICATION Inside Heavy Lines
NAME (OR NAME OF BUSINESS) X:5)
MAILING AIJL*,fN - Ski
TELEPHONE NUMBER
14AME
ADDRESS
I CITY TELEPHONE NUMBER
NAME
1�10
CITY TELEPHONE NUMBER
Z
a I
TATE LICENSE NUMBER CITY LICENSE NUMISNIt
Legal Description of Property (Show Below or Attach Four Copies)
RESIDENTIAL
GAS
LINE
NEW
NON-RESIDENTIAL
D
SIGN
ADD
El
RETAINING
WALL
0 ALTER
DEMOLISH
EXCAVATE
D OR FILL
FENCE
( .......... x .......... Ft.)
ED REPAIR
PRE-MOVF
F� INSP.
SWIU
POOL
DWELLING
UNITS
rED ON KROLL, MAP NU-: PERMIT -7
NUMBER 100041
ADDRESS
WJ/
ETBACK STREET SETBACK RE R YARD SETBACK
ivO YARD
-7
USEL ZONE AREA VACANT 131TE
F44
k
I [J YES [3 NO
1EIGHT BUILDING AREA� NUMBER
?LOT P A ROVED
'T 1W
EXISTING STREET R/W ............
FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W
............ Fr. ............ Fr.
REMARKS
Z
CIMMLED BY
METER SIZE SLRVICE
SIZE CLEARANCE JCHLCKED By
cd
ITL�MARICS
TYPE CONNECTION
VERIFIED BY
PERC. TEST
PERMIT NUMBER
04
REMARKS
FIRE ZONE TYPE OF CONSTRUCTION STREET IMPROVED
YES NO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROUP
[J YES 0 NO
PLAN CHECKED BY
REMARKS
Plan Check No .....................
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
tRETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read thin 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-
lating construction; and in doing the work authorized thereby, no person
will be employed I-, violation of the Labor Code of the State of Washington
relating to Workmon-,1 Compensation Insurance.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be Completed In ninety days; MOVED -IN BUILDINGS shall be com.
pleted In six months.)
NOTE: Applicant Subject to Plan Check Fee
This permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driv&ways,
marqueet, etc.) will require separate permission.
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
JVORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6.1107
Fee
MF
M
1�0
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-
Itnowledged in space provided.
— =0)'- 7 0
a
t"IN
s Lake McAleer Five Acre Tracts
A portion of Tract 17 of Skelton' - ds of
8, page 212 recor
as per plat recorded in volume 6 of plat
described as follows:
Snohomish CountYi Washington.,
st line of said tract lying North
int on the Ea
Beginning at a po orner of said
Weqf, thereon 131.49 feet from the Southeast c South
2026138 11 A no feet to the
tinuing North 2,261.56 West f
tract; thence con South 87058132't
of the North 443-37 feet of said tract; thence
line
said South line 155-00 feet; thence South 20261381, East
West along
North 880011031, East., parallel with the South
69.88 feet% thence nt of beginning.
aid tract, 155-00 feet to the poi
I ine of 5
1,41
WII t �)Iy I %%N
RECORD OF INSPECTIONS
Date Passed
Foundation
Plumbing (Partial)
(Rough)
Frame
Furnace & Fuel Lines
Final
RECORD OF INSPECTIONS,
Date Passed
Drainage
Sewer
Parking
Landscaping
Fire Dept.
I - I -I----"- �, i