710517.pdff 'BUILDING DEPARTMEN
PERMIT APPLICATION
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I
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NAME (OR NAME OF BUSINESS)
G ADDRESS
rAD' c. /JDRESSY
Applicant Fill
Inside Heavy Linea
POSTED ON KROLL MAP NO.:
PERMIT
NUMBER
JOH ADDRESS
'7
BIDffi YARD BETHACKI
^! n
Q�
STREET 8ETHACK
lam•
(REAR YARD SETH/
'
LEPHONE 8;R
USE ZONE
LOT AREA
I VACANT SITE
❑ YffiB NO
2 _ 1 7
o`
HEIGHT I
BUILDING AI AA7j
ADD
I VARIANCE MBE]
PLOT PLAN APPROVED
STREET E/w t7
EXIBTIN6 STREET R/W ...� .....FT. DEFICIENCY
COMP. PLAN ST. R/W ......d..FT.
THIS PROPERTY
.... ..FT.
TELEPHONE NUMBER
1p ADDRESS
.3aia-�l
F CITY TELEPHONE 1
z �&_,V T4_
$ STATE LICENSE NUMBER I CITY LICENSI
'Qa3-d i-;§-30 �--
Legal Description of Property (Show Selow or Attach Four
1 i0-%/ _r
O
G
a
REEIDENTIAL
LINE GAS
NEW
I
NON-RESIDENTIAL
❑
SIGN
® ADD
❑
RETAINING
WALL
❑
DEMOLISH
ALTER
❑
ORCFFILL ffi
FENCE
...x.......... Ft.)
REPAIR
❑
PRE -SWIM
NP1iOVffi
❑
POOL
7UMBER OF STORIES
NUMBER OF
DWELLING
UNITS
OF
❑ YE8 ❑ NO
IS 7
❑ YES ❑ NO
THIS SITE IS LOCATED IN THE
REMARKS
TAX SHOULD BE CODED 31.04.
Plan Check NO....
BUILDING
PLUMBING
HEAT 6 GAB LINE
FENCE
SIGN
tRETAINING
WALL
N
I
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
I hereby acknowledge that I have read this application; that the In-
f
ormation given is correct; and that I am the owner, or the duly authae-
agent or the owner. I agree to comply with city and state laws regu-
g construction; and In doing the work authorlsed thereby, no person
be employed In violation or the Labor Code of the State Of Washington
ing to Workmen's Compensation Insurenoe.
TE: Permit Limit One Year (Except DEMOLITIONS which
be completed In ninety days; MOVED -IN BUILDINGS shall be oom-
d la six months.)
ATURE (OWNER OR AGEN DATE SIGNED
'].O '-'j
/NOTE: 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.
TOTAL AMOUNT DUE
Valuation
650.1
Fee
qa
W
.
oe
No.
ATTENTION
APPLICATION APPROVAL
THIS PERMIT
This application is not a permit until
AUTHOEIZES
signed by the Building Official or his Dep-
THE
WORK NOTED
uty; and tees are paid, and receipt is ac-
knowledged in space provided.
INSPECTION
DIRECT 'S Sf RE
DEPARTMENT
CITY OF
DATE
/O
EDMONDS
Pa 6-1107
FILE