1026 PUGET DR (2).pdf-- -
/
.R
1
i
A I
APPLIOION & BUILDING PERMIT
Appl: No
t
CITY OF EDMONDS Building Department
Permit limit, one year
5
APPLICATION is hereby made for a permit to construct the following work,
in accordance with the accom•
parrying plans and specifications. Two sets are submitted herewith for approval.
new alter J
Off -St.
f
s
Work addn repair .............. ...... -�/� : �,% �......................................................... Parking . ....
Occupancy ....................... Const. type................................ Use zone 5 %� ... Fire zone
i
aq
/ � G
L
Address....11 a�..�� ll.frG.i� Iot. ...k/�.:........7.. Addn...5��. .
O
...
Lot frontage. ..... Area .... �� !.: ir..%. ....... Septic. tank ... ..:! ; ..
Bldg. setbacks — front............................ r. side .....; ....9r........ 1 side............................... rear ..................... .............
' Owner..Q� v--2 . �3��`
.. I
Builder.... ...... Address..::... ..:.... Tel. No...... ..... 1
Plans by . ........: ........ .. ...... ................. Address.................................................... Tel. No.........
.k
Remarks.. ..... . ........ .. ......... ... ...
.. ..... ........... ..... ..... ....
....... ......... ........ .......: ........: ...... ......... ................................................
The above is`a correct statement, and I agree to comply with all applicable Codes, and State': laws regulating this 1
work. ,
I
Signed Owner/Agent I 1(I/,A J. .. ........ Address ........ ,h ...... Date.6.1. fa 4
PERMIT for. the above work is hereby approved, subject to the above conditions, and to compliance v' �A' the alp, ;
proved plans and .Specifications, and Building Department notations thereon.Ij
DD
Valuation 1 ..... ......................... Permit fee ......... .�......
Recd. by..
Building Department, By........... ................ Date..... .... --0' : r