700285.pdf. . I
rBUILDING DUARTMENT
MIT
PERMIT APPLICATION
t
Z
Z
Z
Applicant Fill 0
Inside 11cavy Lines I
�31�a leol-sl
uv,410,441
OF 0-c- N W
F,7 At k WC, 6: A4.' 72VeWc g�c N
M
DNEW " RESIDENTIAL " LINE
I E] NON-RESIDENTIAL F� SIGN
ADD RETAINING
DEMOLISH El WALL
DALTER XCAVATE PENCE
'OR FILL ( ........ _x .......... Ft.)
REPAIR PRE -MOVE SWIM
INSP. POOL
rUMBER OPSTORIES NUMBER OF
DWELLING / -3,ol c-ce-ma
40,e,j,,
,7,r _j,
UNITS
NO.: PERMIT
I NUMBER
'700285
JOB ADDRESS
2: -,/ :7, ( — ;2� 0 35%5-
SIDN YARD SETBACK
STREET SETBACK
RNA YARD
USE ZONE
LO AREA
VACANT SITE
1 0 YES . ;,��;o
BUILDING AREA
VARIANCE NUMBER
PLOT PLAN APPROVED
STREET R/W
EXISTING STREET n/w ............ FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. n/%v ............ F-r. ............ FT.
[:I YES 0 NO
Plan Check No .....................
BUILDING
PLUMBING
HEAT & GAS LINE
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that Zbe 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-
ATTENTION
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 PERMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Year (Except DEMOLITIONS which
ONLY THE
WORK NOTED
I
shall be completed In ninety days; MOVEDAN BUILDINGS shall be com-
pleted In six months.)
3IONATURE (OWNER
DATE SIGNE15
INSPECTION
VOREN
I
DEPARTMWT
�,J,4
tv
�W
CITY OF
WAt
EDMONDS
NOTE: =Itcan ubject to Plan Check Fec
PR 6-1107
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
Valuation
0 YES [] No
Fee
JH
M
r,9,06 I 15ao?a
APPLICATION APPROVAL
This application Is not a permit until
signed by the Building Official or Ills Dep-
uty; and fees are paid, and receipt is ac-
lmowledged in space provided.
4ce;"— �2-_4C —
FILE
I
a
7�
T14& AM�41
'HE 14ORTAEAST QUARTER OF THF-1
-THE 4MTtjtA3T CORNER OF
�_-4�E61M I � .1,9. 0:
r. E 4 EASTO'
ST T6WNsmP 27 NORTH, RANI
imkSf,,jWjjTER OF 2*2"'WESt
THENCENORTH 410W
-.WASHINGTONj
TH'
&CIE 'SOUTH
�,F WEST 333#6V:FF.ET; THENCE SM
tT
ORT14 8906402011 EAST 333.60,
_3
�2.FIEET;� THENCE N.
06
AND
-T�A' HE.SOUTIV M FEET
el"SAI 0 - LAST DESCRIBED., CT T
tdR ROADS
Of EDMONDS
CITY
E�-,SOUTM 5 FEET CONWYED TO
IP,
NO. 210 5191
Aft)
ANY SALE OF S
ESTATE F S
xC15E SALE TAX UPON
AEAL,
"'ll SIXI F,
4 *"' PAID�
UNDER ORDINANCE NO
FOR SEWER..
S Sg By CITY OF EDMONDS.
161 Al C1tNQ J* Ir NO. 16 B',- PAYABLE IN TEN ANNUAL JHE
13S -ASM NAL.AMOUNT OF $454.-B
4 PLUS INTERESTS * ti�� -.THE ORIGI
tfkiStAQ1!KT * NSTALMENT WILL BE
LMENTt ARE'PAID., THE, FIFTH
FI,R%T. FOW INSTA
UENT.'MARCH 20, 1971p IF UNPAID.
PELimq
Co
k �10 AEC
_ORD OF INSPECTIONS
to Date Passed
L Foundation
Mumbing (Part
e0t (Rough) ------
Frarne
Furnace & Fuel Lil"es�.
Final j
RECORD OF INSPECTIONS
7--
Date Passed
Drainage
Sewer
Parking
Landscaping
Fire Dept. ------