700571.pdfBUILDING DEPARTMENT I AppUcant FiU
PERMIT 'APPLICATION Inside Heavy lAnes
616.�
A a
PERMIT
NUMBER
Aw. i5 4
13 YES E3 NO
PLOT PLAN APPROVED
7
ADDRESS
STREET R/W
EN38TING STREET R/W ........... FT. DEFICIENCY THIS PROPERTY
CITY
TELEPHONE NUMBER
COMP. PLAN ST. R/W ........... XT- ............
0
REMARKS
1
CHECKED BY
CITY
NUMBER
/110 go�e)
METER SIZE SERVICE SIZE
CLEARANCE
CHECKED BY
igm NUMBER
CITY LICENSE NUMBER
_3
REMARKS
19
k
I Legal Description of Property (9how, Below
or Attach Four Copies)
13 YES [3 NO
GAS 0 YES 0 NO
NEW o RESIDENTIAL LINE PLAN CHECKED BY
1:1 NON-RESIDENTIAJ .,GN
ADD RETAINING REMARKS
1:1 DEMOLISH El WALL
ALTER EXCAVATE PENCE
E] OR FILL ( ........ . x .......... Ft.
REPAIR PRE -MOVE swim
1:1 INSP. POOL
NUMBER OF STORIES NUMBER Or
DWELLING
UNITS
NATURE OF WORK TO BE DONE Valuation Fee Receipt No.
ZW 1P1#VC00E V— rool Plan Check No .....................
PROPOSED UBEW BUILDING
PLUMBING
T PLAN (Indicate Building setbacks, abutting streets) HEAT & GAS LINE
VWFV�
PENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE 9.90
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 lawn regu-
lating construction; and In doing the work authorized thereby, no person ATTENTION APPLICATION APPROVAL
will be employed In violation of the Labor Code of the State of Washington TIUS PERMIT This application is not a permit until
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elating to Workmen's Compensation Insurance. AUTHORIZES signed by the Building Official or his Dep-
la
ONLY THE
LNOTE: Permit Limit One Your (Except DEMOLITIONS which WORK NOTED uty; and fees are paid, and receipt is ac-
shall b!comPlat I ed In ninety days; MOVED -IN BUILDINGS shall be com- knowledged in space provided.
pleted In six months.)
U V
SIONATURE,','(OWNIER OS,�kGE T) A E SIGNED INSPECTION
_I DIREC7TaSIGN URE
�6, DEPARTMENT
XA7 CITY OF
EDMONDS DATEF
NOTE: APPlicant Subject to Plan Check Fee PR 6-1107
This Permlt covers work to be done on private Property ONLY.
Any construction on the public domain (cnrbas oldewalksp drIvewayst
marquees, ego.) will require separate parntlislon. FILE
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X-
77:
J;�"; V,
Appl. No . ............... . ...... . ...
APPILIOATION 11111.0111111 PERMIT
'',CITY OF EDMONDS Bulkling Departnmt Permit limit, one year
APPLICATION is hereby made for a permit to construct the following work, in accordance with the accom,
plans and specifications. Two sets are submitted herewith for approval.
panying:
new X alter Offst.
addnrepair .......... Residew.0 .................................................................................. Parking . . ...... . ..........
................ .............. Const. type .............................
1n2nc-y-- ..Use zone...., =(o ......... Fire zone ...........................
....... ....... .. %? ......... Blk ....................... Addn'..6��IIVA��
Addi3ess, ........... ..
................. ........ ..... ............
Irdn ............. 'A. 4r ........ Area ............. 7f ��..%)*eptic tank ............. ........................ . .... . ...........
... .......
front ....... . ........ r.. side .......... e� . . ........... L. aide ............ rear ........... 1"a . ......
Owner ......... ........... Addr .............. Tel. . . .. . . ....... 4'
ess'
........................................
Builder .. ................. .... Addresa. :7� .... .......... Tel.
................................................................. Address ................................................... Tel. No .......................... . .
Rzmark& .................................................................................................................................................................................
The above is a correct statement, and I agree to comply with all applicable Codes and State laws regulating this
work.
Signed OwnerlAge(t --- - --- Address .............................................. Date.. 57-17-S-f
PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance with the ap,
proved plans and specifications, and Building Department notations thereon.
..........
Valuation .................................................... Permit fe�� ........ Recd. by .. e-�l ................... .............. ......
BuildingDepartment, By ..................................................... .. ................ Date ........................ .....................................
INSPECTION RECORD
Fdn, OK ............................................ Frame, OK .................................................... Final, OIC ........................... I ............
This Permit does not cover Plumbing, Sewer or Electrical installations.
I
J
AMOAT
ION BUUING I'MMIT, Appl. No. . ... . ..
;.,,,OF: EDMONDS BuMAng Departmmt
Permit limit, one year
ce ith the coom
is hereby made for a permit to construct the following work, in accordan w a
plans and specifications. Two am are submitted herewith for approval.
Off -St.
alter
J000
adan .................... ........ . ................. Parking . . .. . .. . ...........
..............
repair .... ........................................
t7..
...... ...... ........... use zone ... . ............ Fire zone.. ........... .......
...... Const. type..
...... Addn ......................... ...........
................ ....... ... Lot ...... .... B11L .................
�9.6'X /.2c) tank .......... A4v-e� I ....................
...................... ..... Area ........................................... Septic . ......................
r. side .............. .......... 1. side.. ...............
front ............
.......... rear ..........
'61. No
................................... dd ......
Address ................................................... Tel. NOJQM6-=!��...
- -------------- ......... . .......................
Address ............
......... Tel. No .............................
is a correct statement, and I agree to comply with all applicable Codes and State, laws regulating this
work.
t.Z .... ............. � 4--i-A ..... ddress ............................................ Date..z .................
rned Owner/Agen
SiL
I'M Ell
FERMff -for the above work is hereby approved, subject to the above conditions, and to compliance with ap-
proved plans and specifications, and Building Department notations thereon.
x
d. by .. . . .. . ...........
Valuation ......... / . ..... 6= ............... Permit fee ......... 3J ................. Rec .......... . 7--
his 1MI I lit IL to
0 .. . . .. . ...... ...
..... ................... Date .....
pn private propartY ONLY.
�curbs, sidewalks, drivoways, marquMSPECTION RECORD
kc.)..wiii require separate permission.
Fdn; OK ... .......................................... Frame, OK .................................................... Final, OY L .......................................
This Permit does not cover Plumbing, Sewer or Electrical installations.
V
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