700144.pdf. . ..... .... ------------------- ---- ----
POSTED ON KROLL MAP NO.: PERMIT
BUILDING DEPARTMENT Applicant Fill NUMBER ---1700144
Inside Ilcavry Lines
PERMIT APPLICATION 17]— joB ADDRE138
NAME (Olt NAMN Ur IS-TS—INESS) /ga - 's
1? 120 7 C2 Id/
j6 /14 &--,s Z1. /Vs SIDE YARD SETBACK STREET SETBACK REA.Lt. YARD SETBACK
MAIlalN11 AVIJIM��
q — �2 0,Y USE ZONE L A VACANT SITE
TELEPHUNIG r4UWIJk;R_ /Of�Y_43 1 0 YES 0 NO
HEIGHT BUILDING AREA VARIANCE NUMBER
n A jP —�:i 0 9 -/ I
C9
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Z
Z
or
NEW
RESIDENTIAL
I
n
GAS
LINE
NON-RESIDENTIAL
SIGN
RETAINING
DEMOLISH
WALL
EXCAVATE
FENCE
ALTER
F]
OR FILL
( a Ft.)
......... ..........
REPAIR
PRE�MOVE
INSP.
swim
POOL
NUMBER OF
DWELLING
UNITS
EXISTING -STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
COUP. PLAN ST. R/W ............ F'r. ...... I ..... IV.
C] YES [:] NO
Plan Check No .....................
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I hereby acknowledge that I have read this 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 In violation of the Labor Code of the State of Washington
relating to Workman's Compensation Insurance.
NOTE: Permit Limit One Year (Except DEINOLITIONS which
shall be completed In ninety days; MOVED -IN BUILDINGS shall be eam.
Meted in six months.)
NOTE: Applicant Subject to Plan Check Fee
This FermIt covers work to be done on private property ONLY.
Any construction an the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
TOTAL AMOUNT DUE
ATTENTION
THIS PEF9511T
AUTHORIZES
ONLY THE
WOra NOTED
INSFECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6-1101
[:] YES
RFR
Valuation I Fee
IMPROVED
[j NO
APPLICATION APPROVAL
This application Is not a permit until
eigned by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
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