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BUILDING DEPARTMENT
PERMIT APPLICATION
Applicant
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POSTED ON KROLL MAP NO.:
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PERMIT
NMBER -710421
JODDRB
1x"90 �
NA! (OR NAME OF SUSINESB) �
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SIDE YARD SETBACK
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STREET SETBACK BEAR YARD SETS/
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O ADDRESS /{ / '7�
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LOT AREA r VAOANT SITE
IDYES NO
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TELEPHONE NUMBER
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C�
HEEXOR
I BUILDING AREA IVARIANCE NUMBSI
NAME
/&V A /^ S % F �/1 C G / II^ S %�111S
PLOT PLAN APPROVED
// �/ /��/�
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STREET B/W
EXISTING STREET R/W ...Ill0 FT. DEFICIENCY�S PROPERTY
MP PLAN 13 R/W ....0... FT. •,�, ....FT.
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TELEPHONE NUMBER
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RE
Driveway slopes not to exceed those
NAME
0/ // 90 /471
indicated in Standard Drawing 103.
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ADDRESS
/1.31a- q_o Ave &2�
CHECKED BY
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CITY
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EPH E 14UMBER
M3,03V
MET SIZE SERVICE IZE I CLEARANCE
31� N I •1/r j�
J �I
CHECK BY
STATE LICENSE NUMBER
�z3 D 8
CITY LICENSE NUMBER
RE lit ? �Ux • SSA IfI /`(yam
./(' "`••Y `V•EE•RIFIED
Legal Description of Property'(annow Below or Attach Four copies)
L p-t• 13 - / 7cr fv / 3 7. _
TYPE CONNECTION
BY
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t
RESIDENTIAL
GAS
LINE
®
NEW
I.ADD
t
NON-RESIDENTIAL
❑
SIGN
❑
❑
RETAINING
DEMOLISH
ALTER ❑
OROFILL AVATE
CE
FEN..z11.)
REPAIR ❑
INSP.
..........
swim
POOL
;UMBER OF STORIES
I NUMBER OF
DWELLING
UNITS
1
An approvdd septic tank installation design
jke e I -/ r/ V- I (] YES 6�WO
SPECIAL INSPECTOR REQUIRED OCCUPANCY GROU
YES (P
❑ EC
PLAN CHECKED BY THIS SITE IS LOCATED IN •
CITY OF EDMONDS. LnrAl
REMARKS TAX SHOULD BE CODED 31
—i6- -1
Plan Check No .....................
BUILDING
ON
PLUMBING 13
HEAT A GAB LINE O
FENCE
SIGN
tRETAINING WALL
N
ISWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
hereby acknowledge that I have read this application; that the In.
on given is correct; and that I am the owner, or the duly author.
ent of the owner. I agree to comply with city and state laws rngu-
ATTENTION
construction; and In doing the work authorised thereby, no person
employed In violation of the Labor Code of the State of Washington
THIS PERMIT
to Workmen's Compensation Insurance.
AUTHORIZES
: Permit Limit One Year (Except DEMOLITIONS which
LNOTE:
WORK NONLY OTED
e completed In ninety dare; MOVED -IN BUILDINGS shall be com-
n six months.)
RE (OWNER OR AGENT) DATE SIGNED
INSPECTION
DEPARTMENT
_ 7 /
OITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
PR 6-1107
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.
Valuation Fee Receipt No.
/I if 70 f14
Id{p t7a
21. St
good
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�---13 L , b 61 �216
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.
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All t}m t portion or 'rracTo ; r , ..LzL u u �� •.., ., ...__.- - � r�
County, Washington described as fo i 10-.13:
'+Ol, i� ':j• ^J.OnCr the Be lino of said Tract 37,
BCginni�lg At a pO L1 %, ��� ; thonce
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32 .01 i"t. and S. 89 G 0 :•T. , 37.3� ft • {rG:tl �:a1i1 i� Cll:_l _ O'a S<i1d =='SC V 3tii st line of } 1
1 f j J •11 i th , o S . 3°181 N . , ;jai allot to tclo �a
continuing S. 89°2 r., 2u t., g°181 y., ,.
said Tract 379 60.00 i"t•; t}�°nco i(. 88°7.� 10"" :., for ?..0.0 ft.; thO::CH S.
for 10.0 ft.; 'thenco }'. S8°15105�� �•, ll<.95 ft. to a }ao�.nt of curve, the tangent of
Which boars Id. 89°241 L.i thence . o�thcssta 3.7 i^7.o�z C}�U�1�Y,of a curve to thollef�.',:
r: �� �'. , a distance of. F5.1� to
havina, a radius of 45.22, and 1 cen i£�1 .. c:� 'i e 1
•, ° a''" ', , 55 to PG:i.nIt of Fsoginningo
to a point of tan,ont; tho Co :+. �2 17� •?� f'