1028 PUGET DR (2).pdfAPPLICATION ` BUILDING PERMIT C Appl. No. ...........
CITY OF EDMONDS Building Department Permit limit, one year y .
APPLICATION is hereby made for a permit to construct the following work, in accordance with the accom, Y'
panying plans and specifications. Two sets are submitted herewith for approval.
new alter n � ,_�._ Off -St w
Work addn repair ...............J� Parking ._... i
Occupancy............ ........ Const. type ............................... Use zone. r..1 ... Fire zone .......... ..... �
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Address.....(.......... .......................... Lot........................ Blk................... Addn.....::.. ..
Lot frontage........................................ Area ........................................... Septic tank................................................_. . Bldg. set -backs — front ............................ r. side ............................. 1. side.......... ...... rear.::..... ...
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Owne .. � ., .......... ........ Addresa..l O 2' ;!y" � : SCt. Tel.
Builder.. L��.: .. Address .. ��' y� .C�_ yjW, No 1
Plans by................................................................ Address ......... ......... ......... ......... Tel. No ....... ....... .
Remarks.....
The above -is a correct sta and I agree to comply with all applicable Codes and State laws regulating this
work.
Signed Owner/Agent.... - P^ " w. ................. Address.............. .................
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PERMIT for the above work is hereby approved, subject to the above conditions, and to compliance with the ap%
proved plans and specifications, and Building Department notations thereon.
Valuation ........t. ....:........� c............ Permit fee.... ........ Reed: by.. `
Building Department By
........... .............. Date.....
INSPECTION RECORD
Fdn, OK ............................................ Frame, OK .................................................... Final, OK........................................[ ;
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This Permit does not cover Plumbing, Sewer or Electrical installations.
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