22022 98TH AVE W (2).pdf0.
BUILDING DEPARTMENT T—Appli—cant FIR
PERMIT APPLICATION Inside Heavy Lines
NAME (OR NAM OF BUSINESS)
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MAILING ADDRESS
OITY ______NE NUMBER
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Description of Property (Show below or AttaA
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NEW
RESIDENTLA
NON-REBIDI TIAL
0
GAS
LINE
SIGN
REPAIR
0
El
M
DEMOLISH
EXCAVATE
OR FILL
PRE -MOVE
INSP.
El
RETAINING
WALL
PENCE
( .......... x .......... Ft.)
swim
POOL
ElALTER
FUMBElt OF STORIES
NUMBER OF
DWELLING
UNITS
I -
MAP NO.: PERMIT
NUMBER 670323
USE ZONE LOT AREA VAU"E DKL�
CIYES 1K NO
RTfflDlNn A-TMX I VARIANC
EXISTING STREET n/W ........... FT. DEFICIENCY THIS PROPERTY 0
COMP. PLAN ST. R/W ............ FT. ... ....... 33T.
REMARKS
BY
Z
METER SIZE I SERVICE SIZE I CLEARANCE CHECKED By
REMARKS
3
SPECIA.
El YES
Z
0
rian Check No ................. .
IPROPOSED
Q
USE
BUILDING
PLUMBING
PLOT PLAN (Indicate Building setbacks, abutting streets)
ft
HEAT & GAS LINE
PENCE
t
SIGN
RETAINING WALL
SWIMMING POOL
PEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
the I
I hereby acknowledge that I have read thin application; that the In-
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formation given is correct; and that I am the owner, or the duly author-
eg
ized agent of the owner. I agree to comply with city and state laws regu-
Person
lating construction; and in doing the work authorized thereby. no Person
u
]
ATT]ENTION
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will be employed In violation of the Labor Code of the State of Washington
THIS PERMIT
relating to Workmen's Compensation Insurance.
AUTHORIZES
NOTE: Permit Limit One Your (Except DEMOLITIONS which
shall be completed in ninety days; MOVED-XN BUILDINGS shall be emn-
ONLY TEE
WORK NOTED
pleted In mix months.)
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INSPECTION
DEPARTMENT
CITY OF
EDMONDS
PH 0-1107
BIG TURE (OWNER OR AGENT)
.9ATE 131UNED
NOTE: Applicant Subject to Pla� Check Fee
This Permit covers work to be done on private Property OX41,y.
Any construction on the public domain (curbs, sidewalks, driveways,
marqueesp etcJ will reQuIre separate permission,
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Valuation
0
El NO
0
1 17, S-0 1 5 FIT 0
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 aC-
ImowIedged in space provided. -
FILE
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