660579.pdfME
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POSTED TN KROLL MAP No':
BUILDING DEPARTMENT Apidleant Fin 660579
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PERMIT APPLICATION
I NAME (OR NA24B OF BUSINESS)
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M LICENSE NUMBIOS CITY LICENSE 14u-�VJA
[Agal Description of Property (show I%low or Avmca vow
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NEW
RESIDENTIAL
GAS
LINE
NON-RESIDENTIAL
SIGN
ADD
RETAINING
WALL
[9-'ALTER
DEMOLISH
EXCAVATE
OR FILL
PENCE
( X .......... Ft.)
..........
REPAIR
PRE -MOVE
INSP.
swim
POOL
DWELLING
UNITS
NATURE OF WORK TO BE DONE 4i4evv% cki-
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TIDE —YARD SETBACK STREET SNT13AUM, ...... ...
Z
USE ZONE LOT AREA
0 YES E3 NO
I L
HEIGHT BUILDING AREA VA RIANCZ NUMk ER PW
PLOT PLAN APPROVED
STREET R/W CY THIS PROPERTY
EXISTING STREET R/W ............ FT- DEFICIEN
0
COMP. PLAN ST. R/W ............ FT- ........... FT.
REMARKS
0
Z
ED BY
METER SIZE SERVICE SIZE CL16ARANCE
BY
ICRECKED
RE ALRXS
I hereby acknowledge that I have read this 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.
roon
iating construction; and In doing the work authorized thereby, no PC
will be employed in violation of the Labor Coda of the State of Washington
relaUng to Workmen's Compensation Insurance.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be completed in ninety days; MOVED -IN BUILDINGS shall be com-
pleted In six months.)
12-- 13 - &' b
NOTE: APPlica"t Subject to Plan Check Fee
rYPE CONNECTION VERIFIED BY
PERC. TEST PERMIT NUMBER
REMARKS
FIRE'j_0NE PE OF CONSTRUCTION [PROVED
0 No
0—EciAL INSPECTOR itEwulimu OUC—UPANCY GROUP
[] YES [j NO
FLAN —CHECKED BY
7REMARKS
Valuation I Fee
Plan Check No.
No.
BUILDING c
0
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PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE-MIOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE c, cl
ATTENTION APPLICATION APPROVAL
THIS PEILItIT This application is not a permit until
AUTHORIZES signed by the Building official or his Dep-
ONLY THE
WORK NOTED uty; and fees are paid, and receipt is ac-
knowledged in space provided.
INSPECTION DIRE9TOR'S IONA
DEPARTMENT
CITY OF DATE
EDMONDS
PR 6.1107
This I -emit covers work to be done on prIvnTA properzy
Any construction on the public domain (curbs, sidewalks, driveways.
marquees, etc.) will require BePftrate permission.
FILE
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