700257.pdfDEPARTMENT
APPLICATION
_SM=G ADORE
A.2 91
71,71
Is
NEW
ADD
ALTER
REPAIR
KROLL BE" NO.: PERMIT
Applicant Fill NUMBER 700257
11111111110 HeaVY �00 JOB ADDRES13
ttl /Z of-/ 0 OWN XAUV oM`A"^V- I ____ ---
tlr- '. USE ZONE LOT AMA VAV� X ITE
wELaarmuriE NUMBER Rs — E3 YES 13 NO
7q - 7ST-fl HEIGHT BUILDING _XREA VARIANCE NUMBE
or
LJ RESIDENTIAL
F� NON-nESIDENTIAL
DEMOLISH
EXCAVATE
OR FILL
PRE -MOVE
INSP.
DWELLING
UNITS
—,9,4,3,109
LICENSE NUMBEI
,I - 0,; — hi 6
bflGAS
LINE
ti
SIGN
FRETAIMNG
WALL
PENCE
( ........ . x .......... Ft.)
SWIM
POOL
____ I
E)aSTING STREET R/W ............ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............ FT. ............ in.
[3 YES
REMARKS
TYPE
[3 NO
Plan Check No .....................
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
tRETAINING
SIGN
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 �thor-
lied agent of the owner. I ag ree to comply with city and state lawn regu-
lating construction; and In doing the work authorized thereby, no person
will be employed In violation of the Labor Code of the btato of Washington
relattog to Workmen's Compensation Insurance.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be completed In ninety days; MOVEDAN BUILDINGS $hall be oorn-
pleted In six months.)
f
—20
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, driveways.
nuirQuees, etc.) will require separate permission.
[:] YES E] NO
Valuation I Fee
TOTAL AMOUNT DUE
AT=NT11ON APPLICATION APPROVAL
THIS PERMIT This application is not a permit until
AUTHORIZES eigned by Uie Building Official or his Dep-
ONLY THE
WORK NOTED uty; and fees are paid, and receipt is ac-
knowledged in space provided.
INSPECTION —1 ------ 1.
CITY OF 1 36 ! 164L I Of
EDMONDS DATE a
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WON C-AILDING PREff Appl. No . ..................................
Permit lunit, one Year
EDMONDS Building Department
with the accom-
'hemby made for a permit to construct the following work, in accordance
sets are submitted herewith for approval.
Off-st
................... Parldng ......................
................ .............................
Use zone ... ................
Fire
................ Const. type ............................... %
Lot..A ........... Bl� ........................ Ad4r
I.111.e ...........
............
............... .......... . ............................... Septic tank .........................................................
1. side ......... 2�--Z ....... rear.../A�Z! . ...........
r. side ............. 5 .........
1-0"J CAddress ..... ......... A��J�9?7tel. NoAIA�! ....
...................... Address .................................................... Tel. No .............................
..... ............ ........
... Address .................................................... Tel. No .............................
.........................................................
/A S ...............................
Remarlm................. 7 ........................................................................................................................... . ..
This permit COVers viork to be done
".0par.ty .. ONLY . ............................................................................................................................
ublic domain
Cns-r—tion on t-io P
ry 0
A.
iia1wdrJ-UeU"LaYz....Ma=UeJQ5 ............................................................................................
. .........
-,arate permission.
iire se
The Lto.) Vail reql all applicable Codes and State laws regulating thia
ve is a correct statement, and I agree to comply with
work..
b
. . . . . . . . . . . . . .
Date..
Signed ewner/Agent-ev.
and to compliance with the aP-
PERMIT for the above work is hereby approved, subject to the above conditions,
plans and specifications, and Building Department notations thereon.
proved I
...... 0 ............ Recd. by.
Permit fm ...... .... / ............................ ........... .
Valuation ...................................
Department, By .............................................. 1� . .......... Date ... ��.t ....... az . ................ .
Building
sewer or Electrical installatio"S.
This Permit does 'not colver Plumbi"g,