670144.pdfC,
UILDING
B DIN
=PERMIT
M11
DEPARTMENT
APPLIC ATION
Applicant FIB
Imide Heavy Lines
POSTED ON KROLL MAP NO.: PERMIT
I NUMBER
670144
jOB ADDRESS
/Vo-a-f J
NAMM , R NAME OF BUSINESS
71 -ran
I
SIDE YARD SETBACK
STREET SETBACK
BEAR TARAJ SET B
MAILING ADDRM33
wU
Z-02
a ff --ZONE
LOT AREA
VA—CANT-81TE
I YES NO
13
OITY A A
TI=PRONIC NUMBER
I
�5 ed_�#Aw'_
— /"J / �
As
NEW RESIDENTIAL LINE
NON-RESIDENTIAL I F� SIGN
RETAINING
DEMOLISH WALL
MEXCAVATE FENCE
OR FILL ( ........ . x .......... Ft.)
7REPA'IR PRE -MOVE SWIM
INSP. POOL
tUMBER OF STORIES NUMBER or
DWELLING
UNITS
oA.7'
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-
latIng construction; and in doing the work authorized thereby. no person
will be employed In violation of the Labor Code of the Slats Of Washington
relating to WorkmeWs Compensation InsuranCe.
NOTE: Permit Limit One Year (Except DEMOLITIONS which
shall be completed in ninety days; MOVED -IN BUILDINGS shell be com-
pleted In six months.)
SIGNATURE (OWNER OR A T) DATE SIFNEP
NOTE: Applicant Subject to Plan Check Fee
This Permit coven work to be done on private property ONLY.
Any Construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate PemdlslO"-
EXISTING STREET R/W ........... XT.
COMP. PLAN ST. R/W ............ FT.
[3 YES [3 NO
Plan Check No ............
BUILDING
PLUMBING
HEAT & GAS LINE
FENCE
SIGN
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
THIS PERMIT
AUTHORIZES
ONLY THE
WORK NOTED
INSPECTION
DEPARTMENT
CrrY OF
EDMONDS
PR 6-1107
DEFICIIIIINCY THIS PROPERTr
13 TIM 0 NO
APPLICATION APPROVAL
1�
No.
This application is not a permit until
signed by the Building official or his Dep-
uty; and fees are paid, and receipt Is ac-
Imowledged in spewe provided.
I
I