710316.pdffF
E'OS'I
BUILDING DEPARTMENT I Appucant Fin
` PERMIT APPLICATION Inaldo IIeavy linos joB ,,
Mrs. Ted J. Smith
MAILING ADDRESS
20035 84th WestNQ 1
CITY t
Edmonds, Writ 98020
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ADDRESS
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H CITY
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Lot #3, East Edmond Acre Div. #2
According
to plat thereof
recorded in
Vol. 12 of
Plat Page 66,
Records of
w
a•
Snohomish
County, Wash, less the Fast
a
1501 thereof as measured
parallel to the
East line
thereof.
NEW
GAS
RESIDENTIAL a LINE
^•"
J�' ADD
❑""""'CC
NON-RESIDENTIAL ❑ SIGN
RETAI' ENO
❑ DEMOLISH
WALL
ALTER
EXCAVATE
❑ ORFILL
FENCE
(Ft.)
........ ..z..........
❑
REPAIR
F-1INSP.
PRE -MOVE
'
(�"�
SWIM
` POOL
4
.s
DWELLING
UNITS
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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 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
shall be completed In ninety days; MOVED -IN BUILDINGS shall be eom.
pleted In six months.)
NOTE: Applicant Subject to Flan Check Fee
This Permit covers work to be done on private property ONLY.
Any construction on the public domain (curb@, sidewalks, driveways,
marquees, etc.) will require separate permission.
003;5--
YARD SETBACK I W
/)l
PERMIT
NUMBER 710316
SETBACK I REAR YARD SETBACK '
p/ CI
AREA VACANT SITE P4.
YES NO ! '
.nrxn AREA I VARIANCE NUMBER w
EXISTING STREET R/W P�J�v/r'.�FT. DEFICIENC /THIS_ PROPERTY
COMP. PLAN ST. R/W .f..!01'. �••'z-+•
REMARK briveway slopes not to exceed those
included on Standard Drawing #103
0 YES
C.4 C2 wtT
r6
Plan Check No .....................
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
ATTENTION
Tltlg PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDDIONDS
PR 0-1107
11
90-5
Valuation
I
0 YES -t&NO
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0
N
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VCY GROUP /
T-- r
CGS 6195K J
00-3 POE
S&:S s
WIAJ126tu
Fee Receipt No.
00
Itgon161L1
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.
DIRECTOR'S SIONATUIW I w
FILE
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