710361.pdft BUILDING DEPARTMENT I Applicant Fill
PERMIT APPLICATION Inside Heavy Lines
NAME ( S)
A) A it i7 o rN Ste- 2 Li c�r 1 o .;6 • �a i
MAILING ADDRESS
146, eQ , CU3 , LLD
CITY TOES LLCEPHONE NUMBER
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regal Description of rroperty (Snow Below or Attach
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PERMIT
NUMBER
LACK I STREET SETBACK
Out ._
EXISTING STREET RAW
/S1
10361
I
NO
DEFICIENCY )tHIS PROPERTY
Driveway slopes not to exceed those indic
on Standard Drawing #103.
smble- (LID 1
NFW
RESIDENTIAL
EJ
LINE
FANS
ADD
NON-RESIDENTIAL
❑
SIGN
❑❑
DEMOLISH
WAL SQING
REMA]
ALTER
EXCAVATE
❑
El(ENCs
PRE -MOVE
.......... Ft. )
swim
REPAIR
❑ INSP.
POOL
NUMBER OF STORIES
NUMBER OF
DWELLING
UNITE
OFCONSTRUCTION I STREET IMPROV:
�+ I{��,. YES Ej NO
REQUIRED I OCCUPA:rRo�!
Plan Check No .....................
BUILDING
PLUMBING
BEAT d: GAS LINE
FENCE
tRETAINING
N
SIGN
WALL
I
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 am the owner, or the duly author.
Ixed 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 com.
pleted In six months.)
NOTE: Applicant Subject to Play; Check Fee
This Permit covers work to be done on private properly ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permission.
TOTAL AMOUNT DUE
ATTENTION
TIUS PERMIT
AUTHORIZES
ONLY TILE
WORK NOTED
INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PR d-1107
Ez
CITY OF EDMONDS. LOCAL SALES I'
Valuation I Fee
00
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No.
- 1 019 — I4vo 4
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
c . P.
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