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710082.pdfBUILDING DEPARTMENT Applicant Fill PERMIT APPLICATION IRBIdo Heavy Lines NAME ( ` REI) MAILING ADD S CITY TEL NUMBER �Vhh wo0� buJhlev 6 co h -ems Z3-a/-///V6 or NEW RESIDENTIAL GAS ,LINE NON-RESIDENTIAL ADD ❑ SIGN RETAINING - Wes' DEMOLISH E EXCAVATE CE EN...x ALTER ❑ OR ❑ (. Ft.) REPAIR ❑ PRE -SWIM IN P. ......... ❑ POOL NUMBER OF STOORRIIES��//� L y_ry ,d%'y I NUMBER OF DWELLING / ^� .'5'r UNITS NATURE OF WORK TO BE DONE 013. /3 -.-� �r 5 .. PROP08 BE ;G2q q PLOT PLAN (Indicate Building setbacks, abutting streets) O I hereby acknowledge that I have read this application; that the In- formation given In 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 Workmen's Compensation Insurance. NOTE: Permit Limit One Year (Except DEMOLITIONS which &hall be completed In ninety days; MOVEDAN BUILDINGS shall be com- pleted In six months.) IIONATURE (OWNER OR AGENT) DATE SIGNED -71 1116l_ E: APMcant Subject to Plan Check Pee 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 permleslon. PERMIT NUMBER i] YES a; 082 •BETDACK j YARD O T BITE ❑ NO t HOE NUMBER{) l ; EXISTING STREET R/W ...........FT. DEFICIENCY THIS PROPERTY COMP. PLAN ST. R/W ............FT. ............FT. REMARKS TYPE ❑ YES i7 NO YES NO Plan Check No ..................... BUILDING PLUMBING / 3 HEAT do OAS LINE FENCE SIGN RETAINING WALL SWIMMING POOL DEMOLITION PRE -MOVE INSPECTION EXCAVATION OR FILL No. TOTAL AMOUNT DUE I IA/' C© 115,9 )�4 ATTENTION I APPLICATION APPROVAL TIUS PERMIT This application is not a permit until AUTHORIZES signed by the Building Official or his Dep- ONLY TILE WORK NOTED uty; and fees are paid, and receipt is ac knowledged in space provided. INSPECTION DI TOR'BQIGNAT RE aw DEPARTMENT CITY OF 1i z Irl-' •i,C �� u EDMONDS DATE PR 6-1167 (1 — FILE ! i ! l .. _..� 1. ,.. ,i f !y1�L lrr)It ��Idd, 1 e i t L Hy VILL(ltie 1`.L l 7) >. + .W. l !ix W1y)4 1. ::[ f i{'S .;14IAlr I. v Y1f t ,I. 4 ILL`r :ILI ,d r , + r :•.7 t .. .> I : ,r •? i�?b_LJ. f.... ._... I__ f -_ If ,. _ 7 11 .. . f[rj Ylj� t\(.T9T.'.•')•A-�kF'S},}3tJ.l'WgS Y('hf••n,J 11'/MM 7{Jw4'!l•CtYi LL•.h MWR4\WtA0.Y,Y.3. 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