670265.pdf1
BUILDING DEPARTMEN
PERMIT APPLICATION
9
on
G
C
or
RESIDENTIAL GAS
LINE
NEW
NON-RESIDENTIAL ❑ BION
❑ ADD O RETAINING
El DEMOLISH
ALTER IMC❑ OR rI ATE PENCE_x_........ I%,)
PRE-MOVE1 swim
REPAIR ❑ INSP, ED POOL
` wa
7 ON RROLL MAP NO.: I NUMBER 670265
DRESS
R` I I zvrfs� Cl NO
a 1 Wh_ It
RTI
ARA � ��n�� � Plan Cheek No....__....___...
OHED USE
BUILDING
PLOT PLAN (Indicate Building Wetbacks, abutting streets) PLUMBING
/ HEAT d: GAS LINE
1 PENCE
ij 7q/N1� SIGN
c _ N
RETAINING WALL
SWIMMING POOL
(((- - - • - �� N DEMOLITION
3y�'f1s1 �Z PRE -MOVE INSPECTION
E:{CAVATION OR FILL
C TOTAL AMOUNT DUE
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 -
lead agent of the owner. I agree to comply with city and state laws regu- ATTENTION
laUng construction; and to 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
HE
NOTE: Permit Limit One Year (Except DEMOLITIONS which ONLY shall be completed In ninety days; MOVED -IN BUILDINGS shall be com. WORR NOTED
plated In six month+,)
IIGNATURE (OWNER OR GENT) DATE SIGNED INSPECTION
A 3 J DEPARTMENT
G CITY OF
EDMONDS
NOTE: Applicant Subject to Plan Check Fee
PR g-1107
This Permit Coven work to be done on private property ONLY.
Any oonstractlon on the public domain (curbs, sidewalks, driveways,
marquees, etc.) will require separate permisslon.
Valuation
Alum
.540
W .O D
1�9.od�
APPLICATION APPROVAL
1
This application is not a permit until
signed by the Building Official or his Dep-
uty; and fees are paid, and receipt is ac-
knowledged in space provided.
DIRECTOWS SIONAT I
66
OL. U r
FILE
?a
}G
")/
N It )1
1 �
a
tl
01 a
G
)
4
r
r
t
F
i
m
1
If
v
t
1 ,
+'
I
1
.
i
•R
x -
1p
I
If
41
It
S7S ��I 1J 4�kgi�u� x 3 AtkILL
t I
71s%'ti, 5,1It
fr !` yt4r7
h+ ti it A
Nit III III
IN
S yn t•IN
Lef 'P7 t
J_��fh sW' g
�if
�Sf }II 15 Tu��4,M1$U1Ly1 r 'I sS,�' r.
S',x ,
8p�y"¢.
II
It I I If I I I I I 1
...
I
IN
j
1
M1
M1
1
1
f
i