710102.pdf,
POSTED ON KROLL HAP NO.:
BUILDING
.DEPARTMENT
ApplicantFtll
PERAAITAPPLICATION
Inside Heavy Lines
JOB ADDRESS
NAME(
346 01ympic
Ave*
Erwin Liebett
SIDE YARD SETBACK
STREE
_
HAILING ADDRESS
I
21220-68th w*
USE ZONE
LOT A
C
y
I
CITY
TELEPHONE NUMBER
t
.
M I Co
7848-159th P1e N. E.
45455
Wash, 1 885-1527
or
❑ NEW
u RESIDENTIAL
O
OAS
LINE
ADD
❑
NON-RESIDENTIAL
❑
SIGN
DEMOLISH
RETAINING
ALTER
El
OOR FIIAL
❑
I(.'... I CE
PRE -MOVE
... .s_........Ft.)
swim
REPAIR
INSP.
POOL
DWELLING
UNITS
REAR YARD SETBACK �u -
VACANT SITE ,.
13
YES NO
VARIANCE NURSER -
)
I
EXISTING STREET R/W .......... FT. DEFICIENCY THIS PROPERTY ) -
COUP. PLAN ST. R/W ............FT. ............FT,
REMARKS
CHECKED BY
METER SIZE I SERVICE SIZE I CLEARANCE I CHECKED' BY
❑ YES ❑ NO
Plan Check No .... -.._...........
BUILDING
PLUMBING
HEAT A OAS LINE
FENCE
SIGN
tRETAINING
N
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 $m 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.)
1 3/19/71
NOTEV Applicant Subject to Plan Check Fee
This Permit coven work to be done on Private PraPerty ONLY.
Any construction on the publle domain (curbs, sidewalks, driveways,
mnrquen, etc.) will require separate Permission.
i
TOTAL AMOUNT DUE
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
Pn g-Iio7
❑ YES ❑ NO
• %l00
Valuation
7,00
APPLICATION APPROVAL ,
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided
iATU
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