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UILDING DEPARTMENT I Applicant Fill
PERMIT APPLICATION Inside Heavy Linea
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REID, MIDDLETON & ASSOCIATES, INC.
dAIEII4G ADDRESS
324 MAW STREET
NTY TELEPHONE NUMBER
EDMONDS I PR 8-1171
L. H. BRADBURY
ADDRESS
)a21� - 5th sU,xtri
CITY TELEPHONE NUMBER
Edmonds I 776-1112
1I Description or Property (Snow Below or Attaen Nour Cuplee/
SEC. 23, TWP. 27, R 3
'-129K BEG. 170' N & 30' W OF SE CDR
SEA TM. W 90' TN N 65.9' TM. W.
)_711 TM_ N 251 TH. E 122.711 TH. S
...w.war
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P No.:
PNUMBER
710261
q, --
.5
S o�•rEd-'
STREET
SETBACK (REAR
YARD SET13
LOT AREA
VACANT SITE
O YES ❑ NO
USTINO STREET R/W ............FT. DEFICIENCY THIS PROPERTY
COMP. PLAN ST. R/W ............FT. ............FT.
/U/c
y I 'Iy� I AYES ❑ NO
SPECIAL INSPECTOR REQUIRED (OC
NEW CUPANCY GROUP
YES 0
ElRESIDENTIAL ❑ LINE GASOPLAN CHECKED BY 110 Z)ITt 1--i`FLOCATED IN THE
NON-RESIDENTIAL SIGN CITY OF EDMONDS. LOCAL SALE
❑ ADD REATAA,INING REMARKS K IAX - CODED 31.04.
DEMOLISH 5L(7 YPes �'�/ �P 0610.
ALTER ❑ EXCAVATE ❑ FENCE /� („j��I
OR FILL (.......... 7t.......... Ft.)PRE-d�/
REPAIR ❑ IN P. swimPOOL /0c7 u / �� J D� Agv
NUMBER OF STORIES NUMBER OF /A//_ l q� t 6AJ 6AJ -67 %
/ DWELLING ` /V{7 /(�(/ ,rI v
66T 3,%]
UNITS
NATURE OF WORK TO BE DONE Valuation Fee Receipt No.
c&os4!F 1AJ D00 2
Plan Check No .....................
o BUILDING .3 �00
r
PROPOSED USE
�g1 _ f / ,,� )/f //7 �� PLUMBING
Q PLOT PLAN (Indicate Building setbacks, abutting streets) HEAT & GAS LINE
ri
FENCE
SIGN
tRETAINING WALL
N
ISWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read this application; that the In. .J
formation given In correct; and that I am the owner, or the duly author.
,zed agent of the owner. I agree to comply with city and state laws regu- ATTENTION APPLICATION APPROVAL
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 This application is not a permit until
relating to workmen'. Compensation Insurance. AUTHORIZES signed by the Building Official or his Dep-
ONLY NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTED uty; and fees are paid, and receipt is ac-
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com- Imowledged in space provided.
pleted In six months.)
SIGNATURE (OWNER OR AGENT) DATE SIGNED INSPECTION DIRECTORSI N
DEPARTMENT
CITY OF DATE
EDMONDS
NOTE: Applicant Subject to Plan Check Fee — �—
PR a-IIo7
This Penult covers work to be done on private property ONLY.
Any construction on the Public domain (curbs, eldewalks, driveways, FILE
marquees, etc.) will require separate permission. _
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`� REdod0000000jCORD OF INSPECTIONS a
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DatelrPass'ed
ee. �I l&5T- t"
,11 Foundation
M1 I Plumbing (Partial)
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✓+ Frame III :rj
o"ti Furnace &Fuel Lines L ST
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Final
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t=•- RECORD -OF- INSPECTIONS--- -- ,
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