700073.pdf7%
BUILDING DEPARTMENT
PERMIT APPLICATION
NAME (OR NAME OF BUSINESS)
11nag V_ R R I'd
LING —as
Applicant Fill
Inside Heavy Lines
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Al�
ADDRESS
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CITY TELEPHONE NUMBER
X,�E-3 -o/- 5--O.L
-gai Description of Property (Show
a — If
P119 7-
M
ON KROLL MAP NO.: PERMIT
NUMBER
1
BUILDING DEPARTMENT
PERMIT APPLICATION
NAME (OR NAME OF BUSINESS)
11nag V_ R R I'd
LING —as
Applicant Fill
Inside Heavy Lines
0 /7V 5 7-1f e c-7-
Al�
ADDRESS
'ef —0 'gox eq
CITY TELEPHONE NUMBER
X,�E-3 -o/- 5--O.L
-gai Description of Property (Show
a — If
P119 7-
M
ON KROLL MAP NO.: PERMIT
NUMBER
1
-7
1000 -73
RESS
00�?
,RD SETBACK
8TRNhTr UNWLSILCK
REAR YARD SETBACK
NE
gp
LOT AREA
VACANT SITE
[] YES 1?<0,_
FTTT.nT?M kRRA,
I VARIANCE RU—MBER
EXISTING -STREET R/W DEFICIENCY THIS PROPERTY
COUP. PLAN ST. R/W ........ .. A". ....... .... 3".
FIRE ZOaA6� I TYPE OF k1117nM1V.V LMXROVED
P/,q T- )ee(_0 R z V,9/. 5-' Bwge, IL I �� — �j I [] YES a No
ke co Az 5; /V&q SPECI" INSPECTOR REQUIRED OCCUPANCY GRO
GAS 0 YES
NEW' RESIDENTIAL LINE PLAN CHEIC
NON-RESIDENTLILL SIGN I
RETAINING REMARIW
DEMOLISH El WALL
DALTER EXCAVATE FENCE
OR FILL I ........ x . ........ Ft.)
REPAIR PRE -MOVE SWIM
1:1 INSP. NUMBER OF POOL
NUMBER OF STORIES
DWELLING
UNITS /v C7 /(,., C::�
NATURE OF WORK TO BE DONE
Valuation Fee Receipt No.
Plan Check
PROPOSED USE
0,,#R 57-04/1 BUILDING
Q PLOT PLAN (Indicate Building setblICKS, abutting streets) PLUMBING
ft HEAT & GAS LINE
PENCE
t SIGN
N
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I hereby acknowledge that I have read this application; that the In- TOTAL AMOUNT DUE
formation ifiven Is correct; and that I am the owner, or the duly author-
ized agent of the owner. I agrea to comply with city and state laws regu- ATTENTION APPLICATION APPROVAL
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 THIS PERBUT This application is not a permit until
relating to Workmen's Compensation Insurance. AUTHORIZES
ONLY THE Signed by the Building official or Itis Dep-
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED uty; and fees are pald, and receipt is ac-
shall be completed in ninety days; MOVED-W BUILDINGS shall be com- knowledged in space provided.
pleted in six months.) . j/
—diGNATURE (0 4ER PH #GENT) DATE SIGNED INSPECTION DIRECTOR'S SIONATURM
2t7 —,,7 DEPARTMENT
CITY OF
JDATa
EDMONDS
NOTE: ApplilantlSubject to Plan Check Fee PR 0-1107
This Permit covers work to be done on private property ONLY.
Any oonstruction on the public domain (cerbs, sidewulks, drivemaye, rum
marquees, etc.) will require separate permission.
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