670207.pdfBUILDING DEPARTMENT
PERMIT APPLICATION_
14MLN (OR N,�XE OF BUSINESS
ZEAILING ADDREIIB
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NAME'
ADDRESS
CITY
NAMM
so
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or
POSTED ON KROLL MAP NO.: PERMIT
NUMBER 670207
AppUcant FM
Inalde Heavy Linesl JOB ADDRESS V
DNEW
ALTER
REPAIR
RESIDENTIAL
19—WON-REMDENTI-IL
GAS
LINE
SIGN
RETAINING
WALL
PENCE
( .......... x .......... Ft.)
SWIM
POOL
DEMOLISH
EXCAVATE
OR FILL
PRE -MOVE
INSP.
ES
NUMBER OF
DWELLING
UNITS
1 0
USE ZORZE LOT AREA VACANT SITE
I I [] YES 13 NO
HEIGHT I IJILDING AREA I VARIANCE NUMB
EXISTING -STREET R/W ............ FT- DEFICIENCY THIS PROPERTY 0
COMP. PLAN ST. R/W ............ FT. ........... 3".
REMARKS 11
[3 YES . [3 NO
Plan Check No .....................
BUILDING
RETAINING WALL
SWIMMING POOL
DEMOLITION
PRE -MOVE INSPECTION
EXCAVATION OR FILL
TOTAL AMOUNT DUE
PLUMBING
HEAT & GAS LINE
FENCE
t SIGN
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.
ATTENTION
lating construction; and In doing the work authorized thereby, no person
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
I
ONLY THE
WORK NOTED
shall be completed In ninety days; MOVED -IN BUILDINGS shall be com-
pleted in six months.)
SIODWURE (C ER OR AGENT) —D
INSPECTION
DEPARTMENT
I
Wig"
CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
Pit 6-1107
This Permit covers Work to be done on private property ONLY.
Any construction on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separAte permission.
CHECKED BY
9
[] YES [3 NO
Fee
1 #9 0 In r5?s�q
APPLICATION APPROVAL
This application is not a pern-dt until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
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