700138.pdf11
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POSTED ON KROLL MAP NO.: PERMIT -
.11EPARTMENT Applicant Fill NUMBER 100 138
Inside Heavy Lines jOB ADDRESS
pl'eant Fin
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111CATI N Hea Lines ,
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9TBACK REAR YARD SETBACK
SIDE YARD ShTISAUkL STREET 61 -it
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kDDRESS
VACANT SITE
USE ZONE LOT AREA
UMB
7W—N ER 13 YES No
AOS — -2 0 1 - —
VARIA
NUMBER
7 -7/ — j .7 HEIGHT BUILDING NCE ME
W ADDRESS
STREET R1W
EXISTING STREET R/W ... ........ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. n/w ............ rr. ....... . .... FT.
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CITY
TELEPHONE NUMBER
REMARKS
NAME
ADDRESS
CHECKED BY
CITY Tjgj.�NPHONE NUMBER
4
27-
am 14ummulf. CITY LICENSE Nuhlbmn
IZE SERVICE SIZE CLEARANCE
CHECKED BY
REMARKS
Legal Desc Ption 0 Property (Show Below or Attach Four copies)
A� aT- /146
TYPE CONNECTION
VERJI=D
PERC. TEST
PERMIT NUMBER
REMARKS
0
FIRE CONSTRUCTION STREET IMPROVED
I
[] YES [3 NO
SPEUINAT INSPECTOR REQUIRED
ut;uuPANCY GROUP
[] YES 13 NO
GAS
NEW RESID�NTIAL El LINE
NON-RESMENTIAL F� SIGN
ADD RETAINING
DEMOLISH El WALL
DALTER EXCAVATE PENCE
M OR FILL U ......... Ft.
PLAN CHECKED BY
REMARKS
El REPAIR PRE -MOVE SWIM
INSP. 0 POOL
NUMBER OF ST0_R_1ES NUMBER OF
DWELLING
UNITS
NATURE OF WORK TO BE DONE
Valuation
Fee
vazo4.) F
Plan, Check No .................
BUILDING
PROPOSED USE
P ING
PLOT LAN (Indicate Building setbacks, abutting streets)
HEAT & GAS LINE
S100—
0
PENCE
SIGN
tRETAINING
WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In-
APPLICATION APPROVAL
formation given Is correct; and that I am the owner, or the duly author-
lzed agent of the owner. I agree to comply With city and state laws regU- ATTENTION
latinX 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'fi Compensation Insurance.
(Except DEMOLITIONS which
,�imit onele vxn�xN nuum
T21 IT: G"Plletcd. ninety days; U ING$ shall be eom-
TIIIS PERMT
AUTHORIZES
ONLY THE
WORK NOTZD
This application is not a pernilt until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
Itnowledged in space provided.
pleted k six Ina—D 8.)A 7
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47'
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
DIRECTOR's GNATUAE�p
or.
Applicant Subject to Plan Check Fee
PR 6-1107
FILE
Two Permit coven work to be done On PrITAte property ONLY.
Any construction on the public domain (curbs, sidewalks, drivowXY5,
marquees, de.) will require separate pernAsslon.
M, '14�74,-JRI
J-
I
I
BUILDING DEPARTMENT Applicant Fin
inside Heavy Lines
PERMT APPLICATION
14AME (OR NAME OF BUSINESS).
AILING ADDRESS
CITY TELEPHONE NUMBEA--
ADDRESS
CITY TZLEPHONF-NUALBER
- b� "WOUESYLIVU UL �roparty tkinow Below or Attach Four Copies)
Q
NEW
ADD
ALTER
ElR . EPAm
RESIDENTIAL
M
GAS
LINE
NON-RESIDENTIAL
SIGN
RETAINING
DEMOLISH
WALL
EXCAVATE
PENCE
1:1
OR FILL
E3
. ........ Ft.')
PRE -MOVE
INSP.
M
swim
POOL
DWELLING
UNITS
PERMIT
NUMBER 770
)B ADDRESS
WE YARD SETBACK
SA
STREET SETBACK
REAR YARD SETBACK
JSE ZONE
VACANT HrEJS
E3 YES NO
91GHT
BUILDING AREA
VARIANCE NUMBER
LOT PLAiT`APPRoVED-
3 STREET R/W .... ....... FT. DEFICIENCY THIS PROPERTY
PLAN ST. R/W .... ....... FT. ............ 11T.
CHECKED BY
imm—ARKS
TYPE CONNECTION VERIFIED BY
PERC. '�EST —gERMT �NUUBER
RE�S
FIRE ZONE. TYPE OF CONSTRUCTION T IMPROVE
13 YES [3 NO
0��UIAJ- LNSPECTOR YEEQUIRED JOCCUPANCY GROUP
(3 YES [3 NO
PlAn Check No -- -------
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PREIMOVE 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 nutbor.
Ized agent of the owner. I agree to comply with city and state laws ragu.
lating construction; and in doing the work authorized thereby, no person
will be employed In violation of the Labor Coda of the State of Washington
relating to Workmen's Compensation Insurance.
NOTE: Permit Limit One Year (Except DEMOLITIONS Which
Shall be complated'in ninety days; MOVED4N BUILDINGS Shall be com.
plated In six months.)
1IGNATURE, (0 , WN R OR AGENT) UATM �BIGNED
NOTE.. Applicant Subject to Plan Check Fee
This Permit covers work to be done on private property ONLy.
Any construction an the public domain (curbs# sidawalkat driveways,
m&rQu6es, Cie.) wall require Separate permission.
TOTAL AMOUNT DUE
ATTENTION
TIUS PERMIT
AUTIIORIZES
ONLY Iniz
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1107
(-.) L�� — I -) 11
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or lils Dep.
uty; and fees are paid, and receipt is ac-
Imowledged in space provided.
DIRMOTOR'S. SIONATU
INSPECTOR
9