710337.pdfC
Y&UILDING DEPARTMENT Applicant Fill
ERMIT APPLICATION Inside Heavy Lines
NAME (OR NAME OF U61NE88)
�f S . V. /' 06
'e/
A"2.
O DRESS /�
TELEPHONE NUMBER
i
Cl
CIT
or
NEW
RESIDENTIAL
El
GAS
LINE
❑ NON-RESIDENTIAL
SIGN
ADD
KING
❑ DEMOLISH
rl
WALL
EXAVATCE
E
ALTER
D ORCFILL
E]
(.EN...z„Ft.)
REPAIR
PRE -MOVE
R INSP.
M
........
swim
POOL
DWELLING
UNITS
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 -
tied agent of the owner. I agree to comply with city and state laws regu-
lating construction; and In doing the work authorised thereby, no person
will be employed In violation of the Labor Code of the Stale of Washington
relating to Workmen's Compensation Insurance.
NOTE: Permit Limit One sear (Except DEMOLITIONS which
shall be completed In ninety dny LOVED -IN BUILDINGS shall be com-
pleted In six monthe,yJ
OTE: Applicant Subject to Plan Check Fee
This Permit coven work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
3a3-
PERMIT
NUMBER
W1"s-e &
u � �
710337
t�
.CANT BITE
1
YES ❑ NO
I
PLOT PLAN APPROVED I ,
,
STREET R/W I
EXISTING STREET R/W ............FT. DEFICIENCY THIS PROPERTY ;
COMP. PLAN ST. R/W ............FT. ............FT.
REMARKS
YES ❑ NO
❑ YES 0 NO
L
.r
THIS SITE IS LOCATED IN THE
f`IT)( OF EDMO DS Leeft
S E
TAX SHOULD BE CODED, 31. . `
Valuation
Plan Check No .....................
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
Fee
Q O
1 TOTAL AMOUNT DUE I I /1 O O I /i)I/I 1
ATTENTION
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR 6.1107
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.
FILE
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�/APPLICATION � �,CUILDICG PERMIT Appl. No .. %/ -
!• f
C11'1f'�`OF EDMONDSBuilding Department Permit limit,' one, year
PPLICATION is hereby made for a permit to construct the following work, in accordance with the 'accom•
g plans and specifications. Two sets are submitted herewith for approval. j
t
s
alter ,.,...new Off St.
ork addn repair
/%�i................................................................. Parking ...................... {
°Occupancy......... .... Const. type-- ..�............. Use zone ...........-_.�. �. Fire zone..:...
�r J.41. // i
�P -.Lot ............. Blk ....................... Addn....�. j.:.�
Address.. �...........^.....4..... .....
�.• �%
1f l St ♦ - X
i w-,iry y�� �i�� 1 .re i� '
Ng�'�N� ., �, i t }a L Lot frontage .... ........... ...............-....................._._...__.._. tan .. .... ......... tt
�.j�f�[ Area. Septic k. .. .. ...... ....... ' 1
} i , r„ .. Bldg aet�backs 1 y i
tq�� —front ........................... r. side ................ ... side.........-. rear_.... ...:..
..... +
ei7
.... N ..'.
ffimio
Owner_ •• ••••••-.• Address. 4� o__-..y istil�sfii ' i
Builder ............ .......................... ............... Address T i
I , M;,AI
Tel. No
Plans bAddress._. ................... Tel. No...
Remarks........... ................... .......... .....
..... ... ...... ........ .. ........ ............. .......
s
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APPLICATION soulLn't R�RIJIT Appl. No /�. .
urx
14
71
CITY OF EDMONDS Buildi ej Department Permit. limit, one year .
r , APPLICATION is hereby made for a permit to construct the following work, in accordance with the accom•
m�«fa panying. plans and specifications. Two sets are submitted herewi�h,for approval
z
I � ter
Work ddn repair
/,t•••..............
s V Parking
p
1 1F--.. Fire zone ..... -. '
Occupancy ......... ........ ..... Const. type ../Z ...........--..... Use zone.....'
a _ ......� ....... .............. Blk ..... ii
Address.. � /._...__..... ... 1 ,
Area x. l•7' Septic tank..
-•
> Lot frontage }}
.. .. ...................
Bldg. front .. r. side ... e..._ i
1. side rear
y
��.,... �.... Tel. NoI
......... ..... Address. ...
Owner...._.... .ct . 1�
................................... Address .................................................... Tel. No .. ;
Valuation ..�9a1
... Permit fees Recd.{�/o/jF
�l
>/- S �'G• . Date ...._.,le�
..:
Building Department, Byt�`�`" '
I