19106 OLYMPIC VIEW DR (2).pdfR
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Appl. No. ... J/ /
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Permit limit, one year
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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.y1'
newx alter Off•St
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Residence _.......... Parlung _.._..
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Work addn repair .:......: ... ... .
Occupancy, %. ...:......... Const. type :.......:.. Use zone......3"1Z ... _..: Fire zone 13. ...: 1
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Address....... 1 mpic..View..Div Ye......: Lot _.....:........ Blk Addn ...::
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Lot frontage: .... 340!.......................... Area.: ftQ00! :.... Septic tank ..Yes....
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Bldg. set -backs — front........15.1.. ....... r. side..........i�2 1, side ........A!.. ..... rear ....201.. IWO
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Owner..$.&.A...Segal e...... Address.��. !J+ / y�. .:Tel i6T�
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..........................K�... Address .:::.... [..:.: Mf;
Builder ...Tel No
,•itr.E,4S, F , tr
tE0823ealeN
....... .....4...14?:$Addrs.Plans by LL
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Remarks .....:: .... ....... ... . . :: ....:
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The.above is a'correct statement, and I agree to comply with all applicable Codes and State laws rep, ung thts
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IS'gned Owner/Agent:.. ..... Address : Dam �� s
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PERMITfor the above work is hereby approved,, subject to the above conditions, and to compliance with the ap% r„
proved plans and specifications, and Building Department notations thereon.
/ Permit fee....... 3)40.0 Recd, by.. j
Valuation _Lg�l�>1 ......
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Building Department B . �^�'...... Date.. Q��j� _.. k
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INSPECTION RECORD 1 J1
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Fdn OK ......::....... ............ Frame, OK ............. _..............._ ::... Final, OK .......
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This Permit does not cover Plumbing, Sewer or Electrical installations. t
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APPLICATION "BUILDING PERMIT
CITY OF EDMONDS Building Department