939 PINE ST.pdfi
5, a`
L ,
t� I
APPLICATION BUILDING PERMIT ( Appl. No. .....!...` {
CITY OF, EDMONDS Building Department Permit limit, one year
gj%"' ,
APPLICATION is hereby made for a permit to construct the following work, in accordance with the accom
panying plans and specifications. Two sets are submitted herewith for approval.
Off-St
new alter
Workaddn repair ...................... ..... ......... .. Parking 1.
Occupancy....._. ................. Const. type. .......... .................... Use zone.....!. : Fire zone ..........................
r
Address.... �r�3% .�uecJ�l :.....:........... Lot.....__............... B/ % Addn. �yy�•��....`�� ,5
"f Lot frontage.........1J.Y ................... Area...:.......:.......... Septic tank....'``
Bldg. setbacks — front.._.._._. r. side .....� .......... 1. side....... ''..� ...... rear .. D..%
/
Ownei��........................................... Address....... .lra.3 .... Tel. No. ........
Builder.... ... Address ......... .................. ..... Tel. No ......:
Plans by......... _.... Address..........................• ............. Tel. No... ....._ }
Remarks... ...:.. .......... ............... .......... ..._..
The above is a correct statement, and I agree to comply with all applicable Codes and State laws regulating the 1
work.