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PERMIT APPLICATION Inside Heavy Lines
TAME (OR NAME OFBUSINESS)
23135 - 75th P1.West
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rATnnnAa_Wn_ I PR 6-
owner - builder
A
7.
IVACANT- "T1
❑ YES �170
ARMIw ( VARIANCE NUMBER
EXISTING STREET R/W ...........FT. DEFICIENCY THIS PROPERTY
COMP, PLAN ST, R/W ........ ...-..-••�'T•
wwV.RRN
y v l STATE LICENSE NUMBER CITY LICENSE NUMBER I
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Legal DescriDtloa of Property (Show Below or Attach Four CoD1esSec.4 ble2 levy cod o225,D-8A NNECTION VERIFIED BY
a e a nger an os•p _su1 I,of, _NW neIrnerlot 4th.south' albENT I PERMIT NUMBER et
ffi�n e • ;$ • 1
• • -al_ east
=' nX RESIDENTIAGAS 13YES S:
L ❑ LINE PLAN CHECKED BY HY
® NEW ❑ NON-RESIDENTIAL ❑ SIGN
ADD ❑ RETAII-IING
DEMOLISH
ALL
ALTER, ❑ EXCAVATE❑ FENCE
on Fuji ...g_........ Ft,)
REPAIR ❑ PRE-INSPMOVE Q PO L
NUMBER OF STORIES N ' OF
ELLING
one .I U ITS single rese
NATURE OF WORM TO 13M DONS'
add new carport 181 x 211
Plan Check No....».._......_...
fronto ex s Ou e,.gar.
O BUILDING
PROPOSED USE
PLUMBINGI carport
O LAN Indicate Building setbacks, abutting streets) HEAT t GAS LINE
O
�? QDP, Ll WE FENCE
rr— 1 yP,
_ SIGN
'j r.- RETAINING WALL
9L�D I��
T u N
_Ai
a� I SWIMMING POOL
µ - O
U( V'' DEhiOLITiON
w ><
f— W
r
� n 1 PRE -MOVE INSPECTION
m bO'L l ,Ip MUCCAVATION OR FILL
TOTAL AMOUNT DUE
I hereby acknowledge that I have read tbts application; that the In-
formation given Is correct; and that I am the owner, or the duly author-
ized agent of the owner. I agree to comply with city and state laws regu- ATTENTION
lating construction; and in doing the work authorized thereby, no parson
will be employed In violation of the Labor Code of the State of Washington THIS PERMIT
relating to Workmen's Compensation Insurance. AUTHORIZES
ONLY THE
NOTE: Permit Limit One Year (Except DEMOLITIONS which WORK NOTZD
shall be completed in ninety days; MOVED -IN BUILDINGS abalt be oom-
pleted In six months.)
BIG) � TURE ( OR AGENT DATE SIGNED nNSPECTION
10/1 /69 DEPARTMENT
L CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee Ps 4-1.167
This Permit coven work to be done an private Property ONLY.
Any censtractlon on the public domain (curbs, oldewalks, driveways,
marquees, eta.) will require separate permisslon.
Valuatlon Fee
No.
49r/702
APPLICATION APPROVAL
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is new
knowledged in space provided.